Fracture Prevention
Strong bones and smart habits are your best defense against fractures. Learn how to assess your risk, build bone density, and prevent the falls and injuries that lead to breaks.
an osteoporotic fracture
caused by falls
with proper prevention
Bone Density Risk Assessment
Check the risk factors that apply to you. This informal screening can help you determine whether to discuss bone density testing with your doctor.
Your Risk Factors
Select all that apply to see your estimated risk level
- ✓ Age 65 or older (or 50+ with risk factors)
- ✓ Female sex (higher osteoporosis risk)
- ✓ Parent had a hip fracture
- ✓ Current smoker or quit within 5 years
- ✓ 3+ alcoholic drinks per day
- ✓ Long-term corticosteroid use (3+ months)
- ✓ Previous fracture after age 50
- ✓ BMI under 20 (low body weight)
- ✓ Rheumatoid arthritis diagnosis
- ✓ Early menopause (before age 45)
- ✓ Sedentary lifestyle or limited mobility
- ✓ Low calcium or vitamin D intake
This is an educational screening tool, not a clinical diagnosis. Share your results with a healthcare provider for personalized guidance.
Building Strong Bones
Bone density peaks around age 30. After that, you can slow bone loss and maintain strength through proper nutrition, vitamin D, and regular weight-bearing exercise.
Calcium Requirements by Age
| Age Group | Daily Calcium | Daily Vitamin D | Key Notes |
|---|---|---|---|
| Children (4-8) | 1,000 mg | 600 IU | Peak bone-building years |
| Teens (9-18) | 1,300 mg | 600 IU | Highest needs during growth spurts |
| Adults (19-50) | 1,000 mg | 600 IU | Maintain peak bone mass |
| Women (51-70) | 1,200 mg | 600 IU | Post-menopause increases loss rate |
| Men (51-70) | 1,000 mg | 600 IU | Loss accelerates after 65 |
| Adults (71+) | 1,200 mg | 800 IU | Higher D needed for absorption |
Vitamin D: The Essential Partner
Without adequate vitamin D, your body absorbs only 10-15% of dietary calcium. With sufficient vitamin D, absorption rises to 30-40%. Sources include sunlight exposure (10-15 minutes daily), fortified dairy and cereals, fatty fish (salmon, mackerel, sardines), egg yolks, and supplements when needed.
Weight-Bearing Exercises for Bone Health
These activities stimulate bone formation by placing stress on the skeleton. Aim for 30 minutes most days:
↑ High-Impact (Best for Building)
- Jogging or running
- Jumping rope or plyometrics
- Tennis, basketball, volleyball
- Hiking on uneven terrain
- Dancing (especially high-energy styles)
- Stair climbing
→ Low-Impact (Good for Maintaining)
- Brisk walking
- Elliptical training
- Resistance band exercises
- Weight machines or free weights
- Tai chi (also improves balance)
- Yoga (weight-bearing poses)
Foods That Help vs. Harm Bone Health
✓ Bone-Building Foods
- Dairy: milk, yogurt, cheese
- Leafy greens: kale, broccoli, bok choy
- Sardines and canned salmon (with bones)
- Fortified orange juice and cereals
- Almonds and sesame seeds
- Tofu made with calcium sulfate
- Dried figs and prunes
✗ Bone-Depleting Habits
- Excess sodium (over 2,300 mg/day)
- More than 3 caffeinated drinks daily
- Heavy alcohol consumption
- Excess soda (phosphoric acid)
- Very high-protein diets without calcium
- Excess vitamin A (retinol form)
- Crash diets or severe calorie restriction
Fall Prevention Guide
Falls are the leading cause of fractures in adults over 65. Most fall-related fractures happen at home. This practical checklist can help you identify and eliminate common hazards.
🏠 Home Safety
- Remove loose rugs or secure with non-slip backing
- Install grab bars in bathroom (shower, toilet, tub)
- Use non-slip mats in shower and bathtub
- Keep walkways clear of clutter and cords
- Add nightlights in hallways and bathrooms
- Ensure all staircases have secure handrails
- Keep frequently used items within easy reach
💪 Balance and Strength
- Practice single-leg stands (hold a chair if needed)
- Heel-to-toe walking in a straight line
- Seated leg raises and ankle circles
- Tai chi classes (proven 20-40% fall reduction)
- Chair squats to maintain leg strength
- Side leg lifts while holding a counter
- Regular walking (aim for 30 minutes daily)
💊 Medication Awareness
- Review all medications with your doctor annually
- Ask about dizziness as a side effect
- Be cautious with sleep aids and sedatives
- Blood pressure medications may cause lightheadedness
- Some antihistamines impair balance
- Opioid pain medications increase fall risk
- Rise slowly from sitting or lying positions
👁 Vision and Footwear
- Annual eye exams (update prescriptions promptly)
- Use bifocals carefully on stairs
- Wear well-fitting shoes with non-slip soles
- Avoid walking in socks or smooth-soled slippers
- Consider occupational therapy assessment
- Use a cane or walker if balance is unsteady
- Ensure adequate lighting in all areas of home
Sports Injury Prevention
Whether you are a competitive athlete or a weekend warrior, the right preparation and equipment can dramatically reduce your fracture risk during physical activity.
Running and Jogging
- Replace shoes every 300-500 miles
- Increase weekly mileage by no more than 10%
- Run on softer surfaces when possible
- Strengthen hip and core muscles
- Include rest days for bone recovery
Cycling
- Always wear a properly fitted helmet
- Use wrist guards for mountain biking
- Add weight-bearing cross-training (cycling alone does not build bone)
- Ensure correct bike fit to avoid overuse injury
- Use reflective gear and lights for visibility
Contact Sports
- Wear sport-specific protective gear
- Learn and practice proper falling techniques
- Condition muscles around vulnerable joints
- Follow return-to-play protocols after injury
- Warm up thoroughly before competition
Stress Fracture Prevention for Athletes
Stress fractures are tiny cracks caused by repetitive force. They are the most common overuse injury in runners and military recruits, accounting for up to 20% of all sports medicine clinic visits.
- Gradually increase training intensity and duration
- Follow the 10% rule for weekly mileage increases
- Cross-train to distribute impact across different bones
- Maintain adequate calorie intake for activity level
Warning Signs to Watch For
Stop activity and see a doctor if you experience any of these symptoms that worsen with exercise and improve with rest:
- Localized pain that worsens during weight-bearing
- Pain that starts during activity and persists afterward
- Tenderness at a specific spot on a bone
- Mild swelling on top of the foot or outer shin
- Pain that increases over days or weeks despite rest
The Osteoporosis Connection
Osteoporosis weakens bones until they become fragile enough to fracture from minor falls or even coughing. A DEXA scan measures bone mineral density and helps determine your fracture risk.
Understanding DEXA Scans
A dual-energy X-ray absorptiometry (DEXA) scan is a quick, painless test that measures bone mineral density at the hip and spine. The scan takes about 10-15 minutes and exposes you to very low radiation. Results are reported as a T-score, which compares your bone density to that of a healthy 30-year-old.
T-Score Interpretation
Treatment Options
Bisphosphonates
The most commonly prescribed class. Alendronate (Fosamax) and risedronate (Actonel) slow bone breakdown. Available as weekly or monthly tablets, or annual IV infusion (zoledronic acid). Typically the first-line treatment.
Denosumab (Prolia)
An injection given every 6 months that blocks bone-resorbing cells. Often used when bisphosphonates are not tolerated. Important: stopping denosumab can cause rapid bone loss and rebound fractures.
Hormone Therapy
Estrogen therapy can slow bone loss in postmenopausal women. Raloxifene (Evista) mimics estrogen in bones without breast/uterine effects. Typically considered when other benefits of hormone therapy are needed.
Bone-Building Agents
Teriparatide (Forteo) and romosozumab (Evenity) actively stimulate new bone growth. Reserved for severe osteoporosis or when other treatments fail. Given as injections for a limited treatment period.
Who Should Be Screened?
All Women Age 65+
Universal screening is recommended regardless of risk factors. Earlier screening at 50 if additional risk factors are present.
All Men Age 70+
Routine screening recommended. Earlier if risk factors such as steroid use, low testosterone, or prior fracture exist.
Adults With Fractures After 50
Any fragility fracture (from a fall at standing height or less) warrants bone density testing regardless of age or sex.
Long-Term Steroid Users
Anyone taking glucocorticoids (prednisone, etc.) for 3 months or more should have baseline and follow-up DEXA scans.