Understanding Bone Density

Understanding Bone Density

Have you recently been diagnosed with low bone density? What does this mean? Will low bone density affect your strength and quality of life?

Let’s start with understanding the makeup of our bones.

We might think of our skeleton as a solid and fixed structure like the metal frame of a vehicle or the rebar in concrete. In fact, our bones are a system of active cells, hormones, and minerals, such as calcium and phosphate, that are constantly reshaping and remodelling. Instead of a stiff and immovable structure, the skeletal system can bend, rebound, and absorb much like the vital branches of a tree in the spring and summertime.

How low bone density affects you

The majority of a bone’s strength is in the solid outer layer called the cortex (compact bone). 70-80% of bone mass is compact. The inner layer is highly porous and full of holes. This is called the trabecular (spongy or cancellous) bone. The trabecular compartment is only composed of 20% bone, while the rest of the volume consists of marrow and fat. We find more calcium contained in the outer cortical layer, while the trabecular layer carries more fluid. When we walk, run, or jump, the hydraulic properties of the fluid absorb the shock and transmit the force to the solid cortical layer of bone.

The strength of bone becomes a cause of concern the lower bone density gets. Both the cortical and trabecular layers of bone are essential for bone strength. The hip, for example, is primarily a cortical site. Also, the femur gets its stability from both layers. Most hip fractures occur at the proximal end, where the neck and head of the femur are. This area can bend and carry much of the body’s load, so it is crucial to maintain bone density and strength. In the spine, the vertebral body is a primarily trabecular site. It is common to find vertebral compression fractures in those with osteoporosis.

The effect of age on bones

With aging or disease, the cortex becomes more porous, meaning the surface of bone becomes thin, spongy, and strength decreases. In the long bones found in the body’s extremities, porous bone near the periosteal surface can cause more loss of strength and stability than increased porosity near the endocortical surface. Porous bones significantly increase the risk of fracture and injury, even with very little force.

A bone density test can determine where the bone lies on the scale from healthy and robust to porous and weak. A healthcare provider may recommend a test if you are:

  • a woman, age 65 or older
  • a man, age 70 or older
  • over age 50 and break a bone
  • a woman of menopausal age with risk factors
  • postmenopausal, under age 65 with risk factors
  • a man, age 50-69 with risk factors

How do you find out your bone density?

A dual-energy x-ray absorptiometry (DXA) machine will measure the bone mass, or density, of the hip, spine, or extremities. The results will show up as a T-score. According to the World Health Organization (WHO);

  • Average bone density: T-score of -1.0 or above
  • Low bone density or osteopenia: T-score between -1.0 and -2.5
  • Osteoporosis: T-score of -2.5 or below

Low bone density does increase the chance of developing osteoporosis in the future. The most common recommendations in prevention or reversal of low bone density are;

  • maintaining a healthy diet that supports bone health
  • osteoporosis medication (if prescribed by your healthcare provider)
  • resistance exercise (such as osteogenic loading)

Are you looking for a drug-free way to increase your bone density? Our professionals are ready to help you. Book your free session today and see how BioStrong can help you!

By BioStrong | Dec 13, 2021 |




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