“Trevis, hips don’t like to be sitting. In fact, none of your bones do.”
This is what my physiotherapist told me in a recent session to help me recover from a series of falls. We were speaking of rehabilitation strategies that would best suit my recovery while also fitting within the limitations that multiple sclerosis (MS) has placed on my life.
We decided on (all right, she prescribed) a course of exercises in the pool (a local hotel has a pool with nonresident access, so that’s sorted). The mild resistance of the water and the use of the body’s natural buoyancy to reduce stress on the joints should be just the ticket to gently strengthen the areas of concern.
That is to be an ongoing process for a good few weeks. But what stuck was her comment about bone health.
It’s a topic I am aware of in my own case because of a hip replacement surgery over a decade and a half ago due to a condition called avascular necrosis (death of bone tissue due to a lack of blood supply), brought on by high-dose corticosteroid use to combat MS attacks over the first years of my diagnosis.
But I also know that many of our readers are mobility challenged, so we do a good bit more sitting than may be helpful.
High Risk of Osteopenia and Osteoporosis
Bone health, it would seem, is a far greater concern for people with MS than I had realized. An article in Brain & Life speaks specifically to the issue and, according to the authors, I wasn’t the only one who was a bit surprised.
It appears that people with MS are at high risk of osteoporosis and osteopenia. Osteopenia refers to bone density that is lower than normal but not low enough to be classified as osteoporosis.
In consulting a reference tome, Complementary and Alternative Medicine and Multiple Sclerosis, by the neurologist Allen C. Bowling, MD, PhD, I found that the vitamin D that many of us take to support our immune systems is related to bone health, as it helps the body to properly absorb calcium, a building block of our skeletal system. Low vitamin D can contribute to osteoporosis, making this another good reason to have your vitamin D level checked.
Exercise, particularly weight-bearing exercises, are also known to contribute to good bone health. People with MS are often mobility- and strength-compromised, which makes it difficult to maintain or improve the health of our bones.
As if this equation needs more, the use of some medications (corticosteroids, for example) can cause a decrease in bone density as well. Then throw in that bit about “bones not liking sitting,” and it seems the cards are stacked against us in the bone health deck.
How Can We Protect Our Bone Strength and Density?
Where to start? It’s a complicated question to answer when it comes to improving bone health with MS.
We can all improve our intake of calcium-rich foods, like tinned fish with bones (sardines, mackerel, and salmon); dark green leafy vegetables (such as kale, collards, and broccoli); fortified breakfast cereals; calcium-fortified beverages; and nuts.
For those not limiting their intake of dairy foods for one reason or another, three to four servings can provide about 1,200 milligrams of calcium, with one serving equaling 1 cup of milk or yogurt, 1½ ounces of hard cheese, or ½ cup of cottage cheese.
But we should look to our medical team as well, and ask about having a bone mineral density scan. That can tell us where we stand in terms of bone health and help our team make individualized recommendations.
A Holistic Approach Looks Like the Way to Go
I’m happy to say that the X-ray scans of my bones after my falls showed strong and healthy bones, even where they had shown some concern in the past. I’ll chalk that up to dietary supplements (I take calcium, vitamin D, glucosamine, and chondroitin), a healthy diet, and trying to get out for a good walk on most days.
The lack of that bone-strengthening walk since my injuries has brought me back to understanding the importance of a holistic approach to my MS and overall health.
Mind your bones, and they’ll mind you. The thing is, with MS, we may have to mind them a bit closer, and the “minding” looks like it may be a bit more difficult.
Wishing you and your family the best of health.