Sarcopenia and osteoporosis have recently become increasingly significant as the population as people pass through their chronological and physiologic age. In skeletal tissue, muscle and bone interact mechanically and functionally. Numerous studies suggest the remote interactions between muscle and bone as well as their interactions.

Genetic, endocrine, mechanical and age-related factors influence both muscle and bone simultaneously. However, the physiological and pathological mechanisms related to both muscle and bone are unclear.

Sarcopenia is a condition involving decreases in muscle mass and function, which is related to  frailty. Sarcopenia may lead to decreased physical functioning, decreased quality of life and increased mortality of patients. It is common in older people, with a reported prevalence in 60 – 70 year olds of 5-13% and prevalence in those approximately 80 years old of 11-50%. Sarcopenia is also significantly associated with osteopenia and osteoporosis in women. Men aren’t exempt. They can also develop this condition.

While not always related to aging, muscle mass decline appears to occur before bone mass decline. Neurological mechanisms may also be related to common deficits in physical performance attributed to sarcopenia and osteoporosis.

Osteoporosis causes bones to become weak and brittle – so brittle that a fall or even mild pressure, such as bending over or coughing can cause a fracture. Osteoporosis-related factors most commonly occur in the hip, wrist, or spine.

Bone is living tissue that is constantly being broken down and replaced. Osteoporosis occurs when the creation of new bone doesn’t keep up with the loss of old bone.

Osteoporosis affects men and women of all races. But white and Asian women, especially older women who are past menopause, are at highest risk. Medications, healthy diet and weight-bearing exercise can help prevent bone loss or strengthen already weak bones.

A combination of age-related changes, inactivity, and inadequate nutrition conspire to gradually steal bone mass, at the rate of 1% per year after age 40. As bones grow more fragile and susceptible to fracture, they are more likely to break after even a minor fall or a far less obvious factors, such as bending over to tie a shoelace. 

Menopause significantly speeds bone loss and increases the risk of osteoporosis. Research indicates that up to 20% of bone loss can happen during these states and approximately 1 in 10 women over the age of 60 are affected by osteoporosis worldwide.

As hormones change to accommodate normal menopausal changes, estrogen levels start to fluctuate and then drop. Since estrogen helps prevent bones from getting weaker by slowing the natural breakdown of bone, its reduction during menopause significantly speeds up bone loss.

Please see my article on compounded bioidentical hormones on my website. https://hormoneshealthandfitness.com.

Most of us know that strength training (with free weights, weight machines, or resistance bands) can help build and maintain muscle mass and strength. What many people don’t know is that strong muscles lead to strong bones. Strong bones can help minimize the risk of fracture due to osteoporosis.

Osteoporosis should be a concern for everyone. An estimated eight million women and two million men in the United States have osteoporosis. It is now responsible for more than two million fractures each year, and experts expect that number will rise. Hip fractures are usually the most serious. Six out of 10 people who break a hip never fully regain their former level of independence. Even walking across a room without help may become impossible.

In one study, postmenopausal women who participated in a strength training program for a year saw significant increases in their bone density in the spine and hips, areas affected most by osteoporosis in older women. 

Maintaining strong muscles through weight training helps to keep up your balance and coordination. This is a critical element in preventing falls, which can lead to osteoporosis-related fractures.

“We lose so much muscle as we age that by the time we’re 70, we only have about 50% to 55% of our muscle mass left,” says Beatrice Edwards, MD, MPH, associate professor of medicine and director of the Bone Health and Osteoporosis Center at Northwestern University Feinberg School of Medicine. “That explains why we feel weak and tired as we age, and we can prevent some of that with weight training.”

How should you start weight training for osteoporosis? Focus on the back and the hip, says Don Lein, MS, PT, a physical therapist at the University of Alabama-Birmingham’s Spain Rehabilitation Center and its Osteoporosis Prevention and Treatment Clinic. Those are the areas most damaged by bone loss, and the areas most at risk from osteoporosis-related fractures.

There are many exercises available online and in books. One is below:

• Sit on a bench or chair with  low weights or ankle weights secured onto each ankle.
• Then “march” in place, lifting the knees alternatively. 
• This allows you to strengthen your hip flexor muscles, which are attached to both the back and hip, which leads to improved bone and muscle in both areas,” explains Lein.

Getting started with the help of a good physical therapist is a great place to start. Simple exercises you can do at home with simple strengthening tools are easy to do. You don’t need a gym. It only takes two or three times a week to see advances. 

Do one exercise for each major muscle group, for a total of eight to 12 different exercises. Do one or two sets of eight to ten repetitions for each session. 

Lift the weight slowly; lift to a count of four and lower to a count of four, says Lein. “this decreases the likelihood of injury while helping to recruit the muscle better.”

Don’t use other muscles to compensate. You should only be moving the muscle you are supposed to be moving.

Tighten abdominal muscles to help protect your spine.

Periodically consult with a trainer about increasing the amount of weight you life as you become stronger.