Bones fracture for a variety of reasons, such as the intensity of the impact, angle of impact and the properties of the bone itself. We hear a lot about bone density and fracture risk and while the density of bone is an important aspect of the overall strength of bones, whether or not a bone breaks may have little to do with bone density and more to do with the bone quality.
Healthy bone is both dense and flexible. Certainly, if the bone density is low enough, bones will fracture more easily. However, density alone is not the only bone feature to think about when considering an individuals fracture risk.
Consider the two women in the example below.
Let’s say that there are two women with the exact same bone density and same body size. One of the women has sustained two low impact fractures of major bones. The other woman has not sustained fractures.
What would cause one woman to fracture more easily than another?
In short, something is wrong with her bone quality, even though her bone density is identical to the other woman. In this example the woman that is fracturing more easily indicates that her bones are more fragile and her case should be looked at very carefully. Several tests should be done in an effort to answer this question. Also, a complete history and nutritional assessment should be evaluated.
Just a few of the possibilities as to why her bone quality is not as good include:
She could be taking a medication that is interfering with her bone health such as a proton pump inhibitor (used for gastric reflux). Another top medication that interferes with bone health is a corticosteroid (Prednisone).
Not enough protein in her diet – recent studies have shown that protein is essential for bones. 1/3rd of our bones are protein. We need about 30% of our calories should be protein.
Poor digestion, especially loose stools, which point to malabsorption of nutrients.
Poor dietary habits such as avoiding eating a nourishing breakfast and instead drinking coffee and having a pastry for breakfast then waiting until 2:00 PM to eat lunch.
She drinks three diet sodas each day and loves her sugar
Perhaps she is simply not getting enough protein, calcium, vitamin D, magnesium, potassium and other nutrients?
Maybe the woman who is not fracturing has better balance and the woman who fractures has poor balance and falls frequently. This still does not account for why she is experiencing low-trauma fractures.
Understanding your personal risk, beyond bone density, by assessing factors other than bone density alone, will help you determine a safe and effective course of action, including exercise.