Bone health: Considerations for different ages and how Physiotherapy can help

by | Feb 27, 2024 | Healthy posture & movement

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Bone health is essential for providing support, protecting organs, and enabling movement, while also reducing the risk of fractures and osteoporosis as you age. This blog will delve into the factors influencing bone health, strategies for optimizing it at different life stages, and the role of physiotherapy in enhancing bone density.

What influences bone health?

Your bones are being continually renewed, with your body breaking down old bone (resorption) and replacing it with new bone (formation). More activity puts more strain on your bones and your body responds by laying down extra bone, while less activity and strain means that bone is removed. The rate and ratio of bone formation and resorption effects bone mass and varies during the stages of life, as does the effect of diet and physical activity. Peak bone mass (the total amount of bone present when the skeleton is fully mature) is determined by genetics and other factors, such as activity and nutrition in childhood. 

Consideration for your children and teenagers 

As children transition into their teenage years, the puberty phase offers a unique window for significant bone building. During this critical period, approximately 25 to 30 percent of their adult bone mass is gained, forming the foundation for their skeletal strength in adulthood. The amount of bone gained during this time equals the amount that is lost during the rest of their adult life. Simply put, if bone mass isn’t optimised during this time, your child’s body will have less reserve to draw from when they begin to lose bone mass with normal aging. This makes puberty a particularly valuable time to build your child’s bone mass with physical activity and by ensuring that they eat a balanced diet.

Weight bearing and impact activities like running, jumping, dancing or sport aids in shaping and strengthening their developing skeleton, contributing significantly to the peak bone mass that individuals achieve during their growth years.

Hints to optimise bone health during this time:

  1. Jumping from about 50 centimeters is a simple activity that can easily be included in physical education at school or in games at home. Such weight bearing activities are most effective in early or mid-puberty.
  2. Body weight: Very low body weight in children and adolescents may limit peak bone mass
  3. Calcium: 1,300 mg per day in children 9–18years. NOTE: supplementing with too much calcium can be harmful
  4. Vitamin D: In South Africa skin exposure to sunlight (short periods without sunblock) usually allows the body to make enough vitamin D; where sun exposure is limited, recommended levels of vitamin D intake are 200 IU per day for children and adolescents.

Consideration for your 30s to post-menopause 

In the young to mid-adult years, maintaining bone health is about sustaining bone mass through consistent physical activity and a balanced diet. Research demonstrates a positive correlation between exercise and bone mass, emphasizing the importance of engaging in activities such as aerobic exercises (e.g., walking, jogging, dancing), strength training (using weights, elastic tubing, or body weight), and high-impact exercises (e.g., jumping, running, tennis). 

By focusing on these forms of exercise, individuals can effectively stimulate bone formation and counteract the effects of age-related bone loss, which typically commences after the age of 40-50, leading to a potential 25 percent reduction in peak bone mass. As individuals transition into the phase of accelerated bone loss, notably post-menopause for women and after the age of 70 for both men and women, the primary focus is on minimizing bone loss and mitigating the risk of fractures, particularly in the spine and hips.

Hints to optimise bone health during this time:

  1. A program including weight-bearing aerobic exercise (walking, jogging or aerobics) and weight lifting can maintain bone mass; walking for exercise can improve BMD of the hips and spine
  2. Balance exercises and functional strength decreases the risk of falling and associated fractures
  3. Body weight: Very low body weight is linked with low bone mass and increased risk of fractures
  4. Calcium: eat calcium rich food; recommended daily intake is 1,000 mg per day age 19–50, 1,200 mg per day over age 50. NOTE: excessive amounts of calcium can increase the risk of heart attack and stroke
  5. Vitamin D: In South Africa skin exposure to sunlight (short periods without sunblock) usually allows the body to make enough vitamin D; where sun exposure is limited, recommended levels of vitamin D intake are 400 IU per day age 50–70, 600 IU per day over age 70.
  6. High protein diets can limit the amount of calcium absorbed by the body

How physiotherapy can help you achieve your best bone density

  • No matter how minor an injury may feel to you, leaving it uncared for can result in compensatory patterns that cause real problems years later. Make the choice to take care of any physical pains and injuries within 3 months. Getting physio treatment and working together on your rehabilitation will make sure you return to your optimal level of activity. This will enable you to exercise to achieve and maintain your optimal bone density
  • You can be active regardless of your current age or physical abilities. If you are unable to return to your previous level of activity we can help you find new activities – we are used to being creative and solving problems, as well supporting and encouraging you. We’ll get behind you all the way to get you to the point where you are able and happy.
  • If the thought of building up a sweat and muscle burn is enough to make you or your family member turn and turn and hide from the hills, we can help you find fun and safe ways of increasing your physical activity.
  • We work with other health care professionals as needed to help get you comfortably active. Within Ubuntu we work with a Biokineticist, podiatrist, dietician, chiro and orthotist. Should further referral be needed, we work with sports physicians as well as orthopaedic surgeons.


Bone health is crucial for overall well-being, impacting mobility and protection. Balancing physical activity, nutrition, and proactive care at different life stages is key to achieving optimal bone density. Physiotherapy offers tailored treatment plans to promote bone health, ensuring a strong foundation for an active lifestyle.

Book an appointment at our practice to take proactive steps towards better bone health.

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