Osteoporosis in Female Golfers
What is it?
Osteoporosis is bone loss that often occurs in menopausal and post menopausal women. It can be beginning, middle or end stage. This bone softening disease can lead to fracture, disability, and eventually, even death.
How is it diagnosed?
It can be seen on X-ray, and that X-ray finding is called Osteopenia. Osteopenia is not a diagnosis of early stage osteoporosis, it is merely the name for the x-ray finding. Many doctors may call it that- but it is a misnomer. By the time it is visible on X-ray, you have lost 20% or more of your bone density! At that point, you are already in a fracturable state!
Who gets it?
Mostly Caucasian women of slight build. But, others are susceptible too! Women of all shapes, sizes, and ethnic backgrounds get it. It appears to be linked to the reduced levels of estrogen associated with entering menopause.
How bad can it actually get?
The first fractures are usually spinal compression fractures, then later hip fractures. If the hips both become fractured at one time, the person will become bedridden, and that’s when the ribcage can start to deteriorate. Close to home: my grandmother died from this awful disease. Do I have your attention yet?
Spinal Fracture? Golfers Beware!
The forward leaning posture used in opening a window, or in the sport of golf can be the proverbial “straw that broke the camel’s back”! If you want to keep playing golf, then you are going to need to keep leaning forward. So: increasing calcium uptake into your bones, and thus increasing your bone density is the only answer!
Dietary and Lifestyle Issues:
Caffeine, Carbonation, Smoking, Alcohol, High Protein Diets! All of these things cause the leeching of calcium from the bones. Decrease or eliminate these things from your diet, and you will be a lot better off.
Weight bearing exercise:
The idea that walking qualifies as weight bearing exercise is preposterous. Sure- it has the effect of gravity on your spine! But, you have that amount of weight on your spine all day every day. The idea is to slightly challenge the bone’s strength on a regular basis (more than it is with gravity) to increase osteoblastic activity. That is to say, if you push the envelop with regards to the body’s capabilities, it will compensate and rise to the occasion, produce more bone cells, and increase bone density.
There are many Treatments:
In some people’s minds, the jury is out on estrogen replacement. In my mind, it is not still out. I will not take them when the time comes. I will continue eat soy products every day, as that has been shown to level out estrogen fluxes and smooth the decent into eventual lowered production. Many people find that the soy products seem to reduce or eliminate hot flashes. It’s worth a try, I think!
Some people use plant estrogen (cream) products that are available at health food stores. I have no opinion on that, other than each person should investigate that and make their own decision. I do have a strong opinion on synthetic estrogens, and that is that they will never enter my system. Again, that is a personal decision.
Estrogen replacement with Premarin elicits a strong opinion from this female doctor too. It is made from the urine of pregnant mares. I am not a pregnant horse. Therefore, I do not think it is appropriate that I ingest a product made from it. Once more, that is a personal decision. I would advise anyone who is put on that to thoroughly investigate what the side effects might be for them, and act accordingly.
There are prescription medications that are said to increase calcium absorption. But don’t be fooled, once you go on it, you need to have your liver enzymes checked every 6 months. That means it can cause liver problems. But, if your liver is otherwise healthy ie: you are not a heavy drinker, smoker, or prescription drug user, try to choose the lesser of the 2 evils. As I mentioned earlier, my grandmother actually died of osteoporosis. She had listened to some chiropractor who advised her against the medication. Her liver was otherwise very healthy, and her lifestyle very clean. There was no reason to protect her from challenging her liver a little bit. And, bottom line, she died of osteoporosis with completely normal liver enzymes. Just try to make an informed choice, and do it on an individual basis, with a doctor to takes the time to listen to your concerns.
Calcium Supplementation.
Eating foods “rich in calcium” is not enough. Our soils are depleted from years of commercial farming to support the processed food industries. Whole foods and fresh, raw fruits and vegetables are key. (Especially fruits, I hear, in a recent study!). You really do need to take a calcium supplement.
Little known fact: Calcium in the chemical form: Microcrystaline Hydroxiappetite is the most absorbable. You should take 1200mg/day. You should be able to find that in a health food store near you, or through Metagenics.
Go to this website for great prices on these great products:
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Then search on that page for this product:
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I am not associated in any way with this website, and not their affiliate. It was just an easy to find source that offers great prices!
But, don’t be fooled by advertisement: Tums is not absorbable calcium. These commercials say, “… and Tums has calcium for your bones!” Funny, they forget to mention that the form of calcium in tums might make a great buffer for stomach acid, but, it is not bio-available, and cannot be absorbed into your bones! How they get away with this, I don’t know! Truth in advertising is supposed to be a law!
Oyster Shell Calcium (Calcium Carbonate) is not absorbable by the body either. In health food and drug store, this form of calcium is the cheapest. There are things in life where you get what you pay for. This is NOT one of those cases! You get NOTHING for your money here. What a coincidence- Tums is made with calcium carbonate. Go figure!
Calcium Citrate is moderately absorbable by the human body. Let’s look at the numbers, though. Out of every 10 molecules of Microcrystaline Hydroxyappetite that is ingested, about 8 can be absorbed. Out of 10 molecules of Calcium Citrate ingested, 5-6 can be absorbed. Out of 10 molecules of Calcium Carbonate (Tums) not even 1 can be absorbed. So- spend your money however you like. Just be informed about your choice!
Training with weights.
This extra load bearing will increase the formation of bone. It should be started early, though. And keep in mind this: unlike sleep, you do get to save up bone density! I have trained with weights for 25 years; my bone density is about 15% higher than an average woman my age. If I lose 20%, I will still have 95% of what’s “normal”. I am a very long way from a factorable state! Say I had walked for 25 years; my bone density would be average for a woman of my age. If I’d lose 20%, I’d have 80% of what’s normal. I would be a whole lot closer to a factorable state than if I had trained with weights. So why are so few women training with weights? My advice: get a trainer, and do it! Prevent those hip fractures while you are young. In golfers, prevent the spinal fractures, and we will be way ahead!
Make no mistake about this! Choose exercises that do not compress your spine axially (from the top of your head). And increase your weights gradually so as not to injure yourself! Using a personal trainer is the best idea. The increased strength will improve your golf game. You’ll be able to hit the ball further with your increased upper body strength!
Make sure that your trainer knows that you golf, and that you are trying to prevent osteoporosis. He or she will want to do posture maintaining, or posture improving exercises. This will include a bit of rhomboid , lat, and spinal extensor work.
Won’t weight lifting make me muscular and bulky?
This is an old wives tail. At first, the additional muscle might make you appear a little bit bigger. But that muscle will cause a rise in your metabolism, and your body will start to burn off the fat that covers those muscles. In time, the net effect will be that you are denser and leaner, and even athletically feminine. I have lifted weights for 27 years now, even lifting extremely heavy weights at times, and I still look very much like a girl, muscles and all. Genetics vary, and there are no guarantees, but I have not heard of women becoming masculine looking unless they took male hormones, or human growth hormone. Since you probably won’t be taking that, I’d say your worries are slim to none.
Warning! Be very careful!
Spinal Fracture is often misdiagnosed as simple back pain! As the individual trabeculae (bone cells) give way, and we to lose height, it is largely invisible! What to do? Well, be very careful. Focus on the things that will not load the spine. Weight training by someone who has osteoporosis needs to be done with an expert. Otherwise you put yourself at risk.
What about us?
The younger women who have not yet been diagnosed with this horrible disease? Those of us who see it in our family history would have to be crazy not to make the changes listed above. Once it happens, it’s really too late! Let’s re-cap what can be done:
- Start prevention young. Start in your teens, 20’s or 30’s.
- Train with weights. Learn how to do it properly, and train hard.
- Focus on working the postural muscles that prevent forward leaning. This will decrease the compressive forces of forward leaning posture in golf.
- Take the proper Calcium: Microcrystaline Hydroxiappetite: 1200 mg/day
- Reduce or eliminate: Caffeine, Carbonation, smoking, and alcohol.
Best Wishes,
Dr. Jen Milus, DC
http://www.backsafegolf.com
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