Bone Injury Healing is Delayed: Think about Testing for Normal Bone Density

Normal bone density is important. Here is an example of Bone Density Screening showing good bone density in this 54 year old woman. The low back(L1-L4) and hip (Total) areas are used in the screening. I was extremely happy about this great test, since she had a problem healing an ankle injury involving the cartilage, and a low bone density would have been treatment even more complex. Even in the face of normal bone density, the recommended 1500 mg Calcium and 1000 units Vit D3 daily are important with any bone/cartilage injury.

 But what if you are low? The video below highlights that simple weight bearing exercises like toe drops and walking is crucial at improving (premenopausal) or maintaining (postmenopausal). With a gradual program, most patients can increase the stress to their weight bearing bones carefully enough to help when bone density needs improvement. Injuries to bone definitely heal slower when bone density is compromised.

Developed a Stress Fracture: Consider Bone Density Screening

Bone Density Screening can begin can begin probably around 20 years old and normally tests the hip area and the lower back area. This image and graph is of one spot on the neck of the femur near the hip joint. The screening is calibrated by 2 methods for accuracy--- T scores and Z scores. Above the middle line for your age is normal density for age, height and weight. This patient score was right on the line, so borderline bone weakness. 

Before classifying a patient, 5 spots on the hip are used. The above image is a summation of these 5 spots indicating the bone density of the hip area is osteopenic (weakness) with a higher likelihood of fracture. I want my athletes well above the middle line. 

The lower back bone density screen uses 4 spots from L1 disc to L4. This is a different patient (my wife Pat) that is off the charts strong. I could not resist bragging!! Go Girl!!

The patient seen in the first two images had a low bone density at the hip and also a low bone density at the spine shown above. Compare her back bone density to my wife Pat's bone density. Pat works out 6 days a week and uses muscles in the low back doing her Pilates, Yoga, running, and spin classes. It is muscle contraction that pulls on the bones of the low back that give it strength.