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Anyone got osteopenia or osteoperosis and still ski?

 Poster: A snowHead
Poster: A snowHead
Unfortunately after 2 major bone, (humerus and femur) breaks in the last 18 months I've been diagnosed with osteopenia.
The specialist has said absolutely no skiing this season (will be the first time away for 27 years) - gutted! As I'm still recovering from a broken hip, this is understandable.

My problem is falling, so confidence will be a big issue now. I'm not the type to wrap myself in cotton wool, however now I really must be aware, this means skiing carefully and staying away from crowed pistes where I'm likely to be crashed into, which over the last 27 years has happened at least 5-6 times.

How do you cope?

Thank you
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@Mrs NBT, I can;t help with your osteopenia questions, but sympathies with the broken bones - all serious - I hope you are able to make a good recovery.
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@holidayloverxx, Thank you. It's a long slow process I'm afraid.
Although today I'm ecstatic as It's been the first time for 5.5 months I have been able to get out into the countryside and ride my mtbike. This I am banned from too, so it has to be flat easy stuff and slow going.
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@Mrs NBT, I was diagnosed with osteopenia after breaking my pelvis. Lots of people my age (nearly 6Cool) have the same degree of bone loss. I gave up snowboarding as spectacular crashes were the order of the day, but have no problem continuing skiing, being sensible. I wouldn't leap of cliffs, but then I never did. The orthopod who looked at my X rays advised me when I could get back to skiing - there was no suggestion of its being contra-indicated. I do a fair bit to keep strong and in particular to keep joints flexible - nothing too heroic, just try not to be too idle!

On the other hand I would definitely give up mountain biking (if I did it!) My fit, young, very athletic son in law does it and he and his mates seem to collect injuries with monotonous regularity. Collar bones seem particularly at risk.
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@Mrs NBT, my mum has osteoporsis and it doesn't stop her skiing and sailing. It's pretty common for women over a certain age to have low bone density, and it shouldn't stop you from having an active life. I had a DXA test a few years ago and was found to be close to the osteopenia line so I just changed my diet a little and started to do more weight bearing exercise, as per my GP.
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for those younger women reading this - the amount of calcium you need to eat in younger years, for optimum bone strength, is substantial. Don't think the occasional cheese sarnie and milk in your tea will do the trick. I wish now that I'd imbibed more!

Weight bearing exercise is great for your bones but bad for your joints. Being overweight is good for your bones but bad for your joints.... Sad
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pam w wrote:
Weight bearing exercise is great for your bones but bad for your joints. Being overweight is good for your bones but bad for your joints.... Sad

Sounds like a damned if you do, damned if you don't situation. What about swimming? Is there enough resistance for bone strength? I know it's gentle enough on the joints.
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Quote:


for those younger women reading this - the amount of calcium you need to eat in younger years, for optimum bone strength, is substantial


Calcium is definitely great for bone health but it doesn't necessarily prevent brittle bones - I would say maintaining a healthy weight when young is a more crucial factor. I've had a very calcium-heavy diet all my life but when I was younger I did a lot of sport that kept me pretty underweight with very low body fat and that was probably what did the damage. Models tend to suffer from it too as a result of being so underweight in their teens/twenties

Quote:

Weight bearing exercise is great for your bones but bad for your joints


I would disagree with this - doing a certain amount of weight bearing exercise is what builds up strength in your bones and joints. I try to find a medium in certain activites, for example long hikes/gently jogging on soft surfaces over long runs/sprinting on tarmac roads

@Mrs NBT, if you haven't already, I would advise talking to your GP about different ways you can work on your bone density in diet and exercise, and if you're really stressing out about skiing, maybe look into going to quieter resorts at off-peak times
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Snowboarding put less stress on joints when proper technique is used , as for crashing , again down to poor technique or incorrect snowboard/ binding/ boot set up .

The extra stress put on knee joints from skiing is immense
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Quote:

What about swimming? Is there enough resistance for bone strength?

I don't think so, swimming is the classic "non weight-bearing" exercise.

@winterfunman, the problem for people with brittle bones is that even quite low-trauma impact can cause fractures. I rarely fall skiing (being moderately competent and not doing difficult stuff), but fell a lot snowboarding because I was a beginner. That's why I decided to stop.

I do agree that snowboarding puts a lot less stress on the knees with the important exception of times when you only have one foot strapped in. The torque created on that one knee, when the other end of the board digs in the snow, can be quite ouchy..... that's why I always tried to strap my back foot in, before getting off a chair lift.
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Mrs NBT wrote:
Unfortunately after 2 major bone, (humerus and femur) breaks in the last 18 months I've been diagnosed with osteopenia.
The specialist has said absolutely no skiing this season (will be the first time away for 27 years) - gutted! As I'm still recovering from a broken hip, this is understandable.

My problem is falling, so confidence will be a big issue now. I'm not the type to wrap myself in cotton wool, however now I really must be aware, this means skiing carefully and staying away from crowed pistes where I'm likely to be crashed into, which over the last 27 years has happened at least 5-6 times.

How do you cope?

Thank you


Osteopaenia/ Osteoporosis is a significant problem.

Once is has developed it is difficult to reverse.

Things that help are:-

-diet ( rich in calcium/ Vit D)

-drugs that reduce the loss of bone mineral

-exercise that also reduce speed of loss and can help to build stronger bones. The exercise has to be weightbearing.

- don't smoke

- obesity is protective but there are far more compelling reasons for keeping weight at a reasonable level.

- for more info on your bone health ask to be referred to a rheumatolgist with an interest in this area.

Skiing and snowboarding are both sports that can involve regular minor falls and unfortunately it is often a relatively minor fall that breaks osteoporotic bones.

If you are competent and don't fall, can keep out of the way of the most dangerous thing on the slopes - other skiers and boarders- then you will have minimised your risk.

So you will either have to accept that you risk a further fracture and ski or don't. I know that sounds a bit obvious but really what i'm saying is it comes down to how keen you are to ski/board vs your attitude towards risk. If you are someone comfortable to take risk then you will be happier to continue.

In reality i suspect it will come down to how nervous you are about going back on the slopes.

Boarding or skiing? I don't think it matters just do the one that you are more skilled at as ultimately you are trying to avoid falling.


Jonathan Bell
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And love to help out and answer questions and of course, read each other's snow reports.
Then there us the question if insurance I suppose
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@holidayloverxx, what question?
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You know it makes sense.
Definitely what do u put on your holiday insurance forms? or do u just pay the rather large premium
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moseyp wrote:
@holidayloverxx, what question?


I didn't mean a question as in asking a question, it was shorthand for "A matter of concern or difficulty or a problem"while I was using my phone.
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Thanks everyone.

I've seen a specialist and he's not putting me on any medication yet. However I am on an extra yogurt a day (his idea) and now taking vit D tablets. I've never smoked but have always done some form of exercise so remained slim. When I broke my hip the first thing the doctor asked was had I lost any weight recently. nbt and I had just finished the coast to coast and back on our bikes, which is hard to keep the calories up on a big ride such as that, so I did lose weight, which probably didn't help.

Skiing is something I really can't give up and mtbiking is something I'll have to get back to cautiously and be well padded up. Body armour is the first thing on the shopping list when I finally get back out onto the trails.

@pam w, I think you are so right in that many children today aren't getting the calcium they need at an early age, or running and jumping around as much as my generation did.
It's funny how all my non skiing friends just casually say, Oh you'll just have to find another hobby now - Ahhhh Although I have taken up knitting Smile
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Mrs NBT
just thought I'd add my 2pc worth - recently diagnosed with osteopenia and I'm a 40-something bloke.... currently on androlone (sp?) to mitigate further brittleness, and calcium and Vit D. and getting very fed up as I currently can't run until the verterbral fracture I got wakeboarding has healed. granted, there are worse problems to have, but for someone who is 'active' it's immensely frustrating.
I'll ski this season and see - last season I broke my wrist on week 1.... still managed the rest of the season both on and off piste, although some of the sharper guides observed assymetric pole planting... my days of riding rails are well and truly over, but it's the hidden rocks, sheets of ice etc that are the worry - and the question of what to declare.

The decision on whether to get on drugs seems to depend on whether you've had 'accidental fractures'.... the problem is , you might break a wrist, a femur or a vertebrae - the consequences of those vary significantly.
@Jonathan Bell, do you have some specialist knowledge in this area?
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This is a subject close to my heart. My sister has osteoporosis. Aged 57 she slipped in a corridor at work and broke 3 vertebrae. This was the start of it. Eventually diagnosed as having osteoporosis she was given drugs. Unfortunately, she was never tested again so it wasn't until she fell again, a couple of years later, and broke a wrist, that it was found that that particular drug wasn't working rolling eyes . She was then prescribed something else. Again, not tested for effectiveness until another vertebral fracture, from being driven over a speed bump too fast, (by a friend, not me, before you ask), indicated that it hadn't improved her bone density. Upshot is, she is now injecting herself daily with yet another drug. She doesn't do much now, she's scared of breaking something else and her back is still painful.

Before this happened, we hadn't connected the fact that our mother, before her death, had had, what was termed then, a dowager's hump, in her sixties.

My niece, late 30s, a very slim ex dancer, has osteopenia already.

I've been on HRT patches for quite a few years but my doctors' practice has a thing about not prescribing it for women over 60. I had a really bad episode with them last time I went as I felt that they were being unreasonable. I had read all the research and felt that the risk/benefit was, for me, worth continuing with it. It's not just skiing, it's dancing, (contemporary has floor work and bruises!) and anything else that I do occasionally on holiday, (only just got rid of the bruises from windsurfing in September rolling eyes ). Anyway, I eventually got a prescription for another six months but looking at the internet, it's full of desperate, pleading women asking for websites where they can buy HRT as their doctors react like they were asking for heroin! Like them, I will buy it online if my doctor won't prescribe it. Not only for osteoporosis prevention but that is a major benefit.

Anyway, you, Mrs NTB, are younger than me, but have you been tested for oestrogen levels? You may wish to consider HRT patches if you are suitable. Whatever happens, I wish you well.
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@maggi, I hope you are also taking Calcium and Vitamin D?
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@Hells Bells, vit D yes. I was tested and it was low, probably due to me being nesh and only having exposed skin when it's really warm out. Calcium no. I monitor my diet and shouldn't need to. I'm fine at the moment but scared of the future. A woman, who was in my dance group but had to leave, was taken off HRT by her GP and seemed to crumble within a couple of years. She saw a consultant after having the results of her DEXA scan who told her, "It's ridiculous. GPs are putting women like you, very slim, and with a family history of osteoporosis, through torture, because of a minuscule risk in the circumstances. Change your doctor!" She went private and is now looking forward to the future.
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hamilton, you asked about Jonathan Bell.
He does have specialist knowledge. Orthopaedic Surgeon. See here
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hamilton wrote:
Mrs NBT
just thought I'd add my 2pc worth - recently diagnosed with osteopenia and I'm a 40-something bloke.... currently on androlone (sp?) to mitigate further brittleness, and calcium and Vit D. and getting very fed up as I currently can't run until the verterbral fracture I got wakeboarding has healed. granted, there are worse problems to have, but for someone who is 'active' it's immensely frustrating.
I'll ski this season and see - last season I broke my wrist on week 1.... still managed the rest of the season both on and off piste, although some of the sharper guides observed assymetric pole planting... my days of riding rails are well and truly over, but it's the hidden rocks, sheets of ice etc that are the worry - and the question of what to declare.

The decision on whether to get on drugs seems to depend on whether you've had 'accidental fractures'.... the problem is , you might break a wrist, a femur or a vertebrae - the consequences of those vary significantly.
@Jonathan Bell, do you have some specialist knowledge in this area?


Im probably not the best person to manage and treat osteoporosis as i just do knees.

I will not be as up to date on the latest techniques as a specialist in bone strength.

I understand the principles of treatment as orthopaedic surgeons come across osteoporosis when fractures occur.

You need to find a Rheumatologist, there are some who sub specialise in this area.

You should be able to find someone in your area.

If not let me know

Jonathan Bell
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@Jonpim,

Thank you
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@maggi, I know many GPs are very cautious. The female GPs in the practice I work in are much more receptive to requests for HRT, but even then will balance risks of heart disease and strokes against risk of fracture. Smokers are less likely to get HRT treatment for example, and those reaching menopause at a later age.
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Is there any reliable research about osteoporosis and HRT? Osteoporosis is a terrible disease which ravages lives but is maybe not "top of the pops " when it comes to priorities for research.

The only drug to which I've had any adverse reaction was the one you take weekly and have to stand up after.
Forgot the name. alendronic acid or something like that? So I was taken off it, given calcium /vital D and advised about weight bearing exercise. I will have another DEXA scan in about 3 years time. I had HRT for years after oophorectomy (?spelling) but stopped taking it some years ago now.

When I looked up the numbers about calcium in the diet I was quite surprised at how much you need. I've always had milk and cheese but almost certainly not to recommended levels and with current fashions about low fat diets I suspect loads of young women don't get anything like enough
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@pam w, I think there is but it is too late for me to go and find it now. I think the benefits on bone strength diminish once the HRT is stopped. I did try and find a UK site with good advice, but I think this one did it best from Osteoporosis Canada http://www.osteoporosis.ca/osteoporosis-and-you/nutrition/calcium-requirements/
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Thanks for all the informative replies.
I'm 4 weeks into the recovery period after having an op for a total hip replacement. This was done quickly because my doctor had advised me to give up everything exercise wise. This was not good and has caused mild depression.

Now I see light at the end of the tunnel and very much hope to return to skiing in 2017.

Good luck to everyone else.
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@Mrs NBT, good news Very Happy Very Happy , here's to a speedy recovery.
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@Mrs NBT, what Hells Bells said! Very Happy
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@Mrs NBT, what they said! Very Happy
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@pam w, there are other options to Alendronic acid - ymmv, but my new best friend the rheumatologist observed that there are several different drugs in that group ('bisphosphonates'), and that there are other groups/types for people who's needs differ (e.g. post chemotherapy).
Ask the doc what else you can try - or change your doctor!
The Rheumy also observed that 'intake' and 'use' are not the same - just 'cos one's diet is rich in Vit D /Calcium doesn't mean it's getting absorbed - I'm on 2000xRDA of Vit D at the moment, until such time as we work out where it's going.

From a personal perspective, I'd also suggest don't just rely on one opinion - for example, there is a widely used tool (the FRAX index) which purports to give a good idea of the level of likelihood and impact of a major fracture.... which is fine, unless you've already _had_ some fractures). There is also debate over what constitutes a 'casual' fracture - when does a fracture from 'just falling over' become casual (and thus indicative of actual bone brittleness). and that's before you start looking at the survival stats post hip/femur fracture, which _generally_ aren't great... but that's probably because _most_ fractures of that type are in 'old' people, for whom the impact of any major fracture is large.


positive mental attitude and a good diet... you only live once, etc.
best wishes to those recovering...
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There are other bisphosphonates, but there is very little difference in the side-effect profile from one to the other. If you get them from alendronate you are also likely to get them from risedronate. Tibolone, a synthetic steroid, prevents bone loss, but it's effect on fracture reduction isn't certain.
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@Mrs NBT, Wishing you a speedy recovery. Smile
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@Hells Bells, thanks for that. Wouldn't want to risk anything like the side effects I got from alendronate (swollen and painful finger and wrist joints - I couldn't get the lid off my shampoo bottle).

@Mrs NBT, not a bit surprised that being told to give up all exercise you decided to go for the op. All the best with recovery. snowHead
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Link to calculate your FRAX score http://www.shef.ac.uk/FRAX/tool.aspx?country=1
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Following this morning's news report on the latest NICE guidelines for HRT therapy, I also read this in the Guardian http://www.theguardian.com/commentisfree/2015/nov/12/hrt-menopause-hot-flushes-nice-advice
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