How Bones Work or Remodel
Bones are under continuous metabolic changes. They arenever static in there nature. Bone tissue is continually developing into thickerstronger tissues or thinning into weaker tissues. Except in growing bones, therates of bone deposition and absorption are equal to each other so that thetotal mass of bone remains constant through out our lives.

Osteoblasts- are cells with-in bone tissue which are responsible for creating new bone tissue and are found on the outer surfaces of the hones and in the bone cavities.

Osteoclasts- are responsible for bone resorption or absorption. These bone cells are also found on the outer surfaces and cavities of bone tissue.

Osteocytes- are the basic cells of bone tissue.

The necessity of bone remodeling
Bone must adjust its strength in proportion to thedegree of bone stress. Consequently, bones thicken when subjected to heavy loadsEven the shape of the bone can be rearranged for proper support of mechanicalforces by deposition and absorption of bone in accordance with stress patterns.The bones of athletes become considerably heavier than those on non-athletes. Ifa person has one leg in a cast but continues to walk, the bone of the leg in thecast becomes thin and as much as 30 per cent decalcified within a few weeks,while the opposite bone remains thick and normally calcified

Prevention of Osteoporosis
When one understands how bones work, understanding theprevention of Osteoporosis becomes easier. Just as pills are not the answer tobuilding strong healthy muscles, neither are they the answer for buildinghealthy strong bones. The same type of physiological processes are at work. Whenexamining the bone and muscle density of the average elderly individual, notedatrophy exists for both men and women This is mostly due to their sedentary lifestyle. As most Americans age, we become less active, do less aerobic andanaerobic weight bearing exercising, consequently, bone and muscle atrophyoccurs. This is not the destiny of all aging people however! It is a matter ofeducation and choice. Numerous well designed human studies have clearlydemonstrated the reversal of bone loss by mechanical loading the skeleton, i.e.,weight resistance exercises. Most exercises which require your muscles to carryyour body weight or lift weight will build muscle, therefore will build bonemass!

Nutritional and lifestyle factors - Soft drinks containlarge amounts of phosphorous as do tea and coffee, which decrease intestinalabsorption of calcium. Alcohol inhibits osteoblastic activity. Smoking ofcigarettes is a known high risk behavior for developing osteoporosis. Becausebone strength depends on adequate weight bearing, women or men who looseexcessive amounts of weight are at higher risk for developing weak bones.Vitamin and minerals such as K,D,C, calcium, magnesium, potassium, zinc,manganese, phosphorus, copper, boron, silica, and chromium are nutrient whichtend to fortify and nutritionally support bone development. These nutrients areusually contained in a healthy daily diet, if not supplementation may berequired.

Clinical features of Osteoporosis
Hip fractures - generally occur in the intertrochanteric region or femoral neck of theleg bone. These fractures are a major cause of loss of independence in olderwomen. Many patients are discharged from hospitals into nursing homes instead ofback to their previous living situation.

Vertebral fractures. Manywomen with compression fractures do not realize they heave had a fracture. It ispossible that some of the fractures occurred gradually and therefore did notcause pain. In the thoracic spine, these fractures produce a kyphosis or"Dowager’s hump’. This hump can worsen to the point of causing the ribsto contact the iliac crest and movement causes pain. Height loss is also afeature of vertebral fractures. Also protruding abdomen is a consequence ofkyphosis not weight gain as many kyphotic women may think. Vertebral fracturescan cause decreased pulmonary capacity with severe kyphosis which decreases thelung volume. Also reflux esophagitis can be a complication from kyphosis due tochanges in the abdominal space.

Wrist fractures are more common in women who are50 to 60 years old These are caused by falls or trauma. Osteoporosis does notappear to impair the healing of the wrist fractures.

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