Editor’s Note: See part 1 of this article in the November 2024 issue, which introduces “Tommy’s” case and the potential cause of his symptoms. The web version of this article includes a sample workout program not featured in the print version.
A Foods-First Approach
Acid-promoting diets increase excretion of both calcium and bone matrix protein (BMP), a urine marker used to estimate the rate of bone loss. Only when calcium intake is low does calcium loss caused by animal protein become a problem.8
Supplement Recommendations
I started Tommy on a good multivitamin with minerals (calcium lactate, etc.), vitamin C (not ascorbic acid), vitamin D with K2. I also recommended whole vitamin D complex from real cod liver oil. Nutrient insufficiencies and supplements that could potentially be used to treat bone health include:
Blood levels should fall within the lab ranges for vitamin A (serum retinol), magnesium (RBC), selenium (RBC), B vitamins, homocysteine (if elevated, may indicate folate, B6, or B12 deficiency), RBC folate, serum B11, methylmalonic acid (MMA), and essential fatty acids (EPA and DHA).
Weight-Bearing Exercise
Tommy’s exercise is basketball and weightlifting, hours every day. For most patients I need them to put strong, heavier-than-you-think weight-bearing stress on bones for 45-60 minutes every 5-6 days. If a patient is not working out already, I provide in-office training (~4-5 sessions) to teach them a DIY, at-home free-weight lifting program. This is something they can do for the rest of their life. Tommy has an excellent trainer and was working out “hard’.”
The National Osteoporosis Foundation says there are two types of exercise for building and maintaining bone strength and density:
Treatment Goals: reducing, then eliminating joint pain; increased “play all out” and confidence on the court; and drugless therapy.
Best Exercises for Low Bone Density
Based on experience, some of the best exercises for preventing and managing bone loss include:
Key points about exercising for bone health include the following:
A Sample Weight-Lifting Workout
Here’s is an example of a weight-lifting workout for a young adult to focus on exercises that enhance bone density, improve muscle strength, and reduce the risk of fractures. It incorporates resistance training, weight-bearing exercises, and balance exercises.
Frequency
Warm-Up (5-10 minutes)
Resistance Training (2-3 times per week)
Upper Body
1. Chest Press
2. Seated Row
3. Shoulder Press
4. Biceps Curls
5. Triceps Extensions
Lower Body
1. Leg Press
2. Squats
3. Lunges
4. Calf Raises
5. Hip Abduction
Weight-Bearing Aerobic Exercise (Most Days)
Balance Exercises (Daily)
1. Single-Leg Stand (knee locked out and knee bent)
2. Heel-to-Toe Walk
3. Tai Chi or Yoga
Cooldown (5-10 minutes)
Look for Underlying Causes
Taking antacids for many years for GERD or indigestion is a fast track to osteoporosis. These drugs are not compatible with good gut health. The reduced stomach acid will prevent your body from digesting and utilizing the very nutrition your skeleton needs to stay strong.
Most people with GERD and heartburn are actually suffering from insufficient stomach acid. Instead of taking acid stoppers, they need supplemental digestive acids and enzymes. So, indigestion and GERD from too little digestive enzymes, bizarre combinations of foods, processed and artificial foods, too much wheat, a flexible hiatal hernia, or something else gets symptom treatment with antacids instead of treatment of the cause.
Where does this lead to? Malabsorption of minerals and essentials for your joints; arthritis and osteoporosis; symptom treatment with painkillers and/or bisphosphonate drugs; and treatment that leaves the underlying cause ignored while causing a weakened skeleton, perhaps spontaneous femur fracture or osteonecrosis of the jaw, and maybe even Barrett’s esophagus. These could even lead to invalidism, drug addition, a nursing home, cancer, and death.
Discussion Points
Bone health (loss) is just one more thing we must worry about as we get older. Our goal is to help people know what to do at every stage of life to build and maintain strong bones and prevent fractures. Chiropractors often represent people throughout their lifespan, sorting out patients with comorbidities.
By the time Medicare covers the cost of a DEXA, it’s late in life and a difficult challenge to increase bone density. The cost of screenings, which is now under $90 for private pay in Los Angeles, is worth it for all ages – even starting in the age range of 20-30. If you exercise properly and use real nutrition, your bones will begin to strengthen. In fact, you get a brand-new skeleton every 10 years!
Tommy is headed back to college to continue his basketball career and will follow up.
References
When sports chiropractors first appeared at the Olympic Games in the 1980s, it was alongside individual athletes who had experienced the benefits of chiropractic care in their training and recovery processes at home. Fast forward to Paris 2024, where chiropractic care was available in the polyclinic for all athletes, and the attitude has now evolved to recognize that “every athlete deserves access to sports chiropractic."
It is estimated that 61% of patients with CTS avoid taking surgical options due to postoperative complications and costly surgical procedures. Chiropractic care offers a comprehensive and effective treatment for carpal tunnel syndrome, addressing the condition from multiple angles. Recent studies also have unveiled a game-changing adjunct to chiropractic treatments for CTS: nerve flossing.
Some doctors thrive in a personality-based clinic and have a loyal following no matter what services or equipment they offer, but for most chiropractic offices who are trying to grow and expand, new equipment purchases help us stay relevant and continue to service our client base in the best, most up-to-date manner possible. So, regarding equipment purchasing: should you lease, get a bank loan, or pay cash?
