Healthy Aging: Preserving Your Bones and Joints

Whether you’re a young adult, baby boomer or senior, here’s what you can do now.

A cropped view of a female jogger on the road experiencing joint inflammation

“Physical activity is important for loading the bones and helping them develop​ as strong as they can.”

Paul Schneider, 90, of Palm Harbor, Florida, starts his morning exercise with 100 sit-ups. A couple golf matches a week, plus weight and aerobic workouts at his fitness club, also keep him flexible and strong.

Schneider stays slender and watches what he eats. He drinks water, not soda. He takes Tums for calcium, as well as fish oil and vitamin D supplements. He was never sedentary, either as a sales manager in the emerging computer industry or as a father of four. “I have fortunately – knock on wood – never broken a bone,” he says.

As aging conspires to chip away at your bone and joint health, experts explain what you can do to maintain these through every phase of life:

Start Early

Bone and joint health begin in childhood, says Dr. Sundeep Khosla, director of the Aging Bone, Muscle and Joint Program within the Mayo Clinic’s Kogod Center on Aging.

“Physical activity is important for loading the bones and helping them develop as strong as they can,” Khosla says. Parents can watch that kids don’t replace milk with sodas, thereby missing out on calcium. And it’s never too soon to discourage smoking, which can affect bone mass.

The adolescent growth spurt brings a marked rise in fractures, Khosla says. It’s believed when the skeleton is rapidly growing, an increased need for calcium may cause thinning, especially in delicate wrist bones. “So when these kids fall, they get wrist fractures,” he says.

If these fractures occur with mild injuries, like falling from a low height, that’s a sign kids have skeletal defects tied to low bone mass, Khosla says. “And that low bone mass tracks into young adulthood.”

Pillars of Bone Health

When it comes to healthy aging, Paul Schneider has an expert in his corner. His daughter, Dr. Diane Schneider,​ is a geriatrician, osteoporosis expert and author of “The Complete Book of Bone Health.”

Calcium, vitamin D, diet and exercise are the cornerstones of bone health, she says. Staying at a healthy weight is important: “You don’t want to be carrying around extra weight because that’s what’s going to start wearing out your hips and knees.”

What’s good for the bones isn’t necessarily good for the joints. “For your skeleton, you want weight-bearing exercises,” Schneider says. “But for your joints, weight-bearing exercises may also contribute to wearing them out.” She advises moderation and variety: If you’re a dedicated runner, for instance, work out with weights at the gym for a change.

Young Adult Challenges

“Your late 20s, early 30s is when you achieve what is called peak bone mass,” Schneider says. But college and career demands can disrupt health and exercise regimens, even for people who were active as teens.

Diet also changes for young adults, like drinking less milk. Schneider advises limiting caffeinated beverages – soda and coffee – particularly if your calcium intake is low. She recommends water instead. Alcohol consumption can affect bone health. “Moderate drinking, which would be one or two alcoholic beverages, is OK,” Schneider says. “More than that is too much.”

If you can’t cover the recommended calcium intake for your age group, Schneider says, either do a “menu makeover” to put calcium-rich food in your diet, or use a calcium supplement.

“Try to limit meals on the go,” she says. “They tend to be higher in sodium and carbohydrates and scant on vegetables.” And like alcohol, they can lead to putting on pounds.

Staying active isn’t always easy. “Try to schedule your exercise time and spend more time on your feet,” Schneider says. In the workplace, innovations like standing desks let employees sit less.

Maintain Bone Mass in Midlife

Middle age is a critical period for bone and joint health. After 50, calcium requirements for post-menopausal women rise from 1,000 to 1,200 milligrams,​ Schneider notes – but calorie requirements don’t. As metabolism slows, weight can creep up. “So women may need more time to maintain their fitness,” Schneider says.

Making time to exercise isn’t easy for the sandwich generation. Try working fitness into your day: strapping on a pedometer for 10,000 steps, parking farther from your building, taking the stairs instead of the elevator.

Exercises to strengthen muscles also help protect the joints they support, Schneider says, which is important when arthritis shows up in middle age.

“With women, of course, the menopausal transition is when you really start accelerating bone loss because of the hormonal level fluctuations,” she says. Men also experience hormonal changes, with both testosterone and estrogen, but their bone loss is more gradual and less marked, Schneider says.

Avoiding osteoporosis the silent condition that eats away at bones, leaving them thin, weak and vulnerable to breaks – is paramount. The National Osteoporosis Foundation offers guidelines for when people should undergo a bone-density test (dual-energy X-ray absorptiometry or DEXA scan) based on their age, gender and risk factors – such as family history, smoking and certain medications.

Senior Strong

Faye Strum, 75, a retired teacher in La Jolla, California, hasn’t let osteoporosis disrupt her active life. About 18 years ago, she learned she had the condition after undergoing a bone scan during a routine checkup. Until then, Strum had no idea her bones were at risk. “I am of small stature,” she says. With the diagnosis, “I didn’t want to lose any height. And I’ve always been active, so I wanted to keep my muscles strong.”

Strum has taken bone-building medications and safeguards her bones while staying active. “I do more specialized exercise. I take in plenty of calcium. And I’m careful in how much I do in terms of lifting,” she says. “I don’t pick up little grandchildren and hold them up high.” She continues to walk and play tennis, and attends a healthy-bone class twice a week at a nearby sport-and-health center, where she works out with weights and bands and does balance exercise. And she attends a weekly gentle-yoga class.

Balance and core-strength exercise such as yoga and Tai Chi reduce your risk of falls and resulting fractures, Schneider says.

Improve Your ‘Health Span’

It’s never too late to optimize your bone health, Khosla says. “There are now drugs – and more drugs on the horizon – that can build your bone back up,” he says. “So you can at least partially reverse the bone loss.”

His group is working to better understand the underlying causes of bone aging and pinpoint people at higher risk of fractures. While DEXA is an “excellent” diagnostic tool, he says, upcoming imaging tools can provide detailed information on bone structure. And researchers are working on new tests to determine the quality of a patient’s bone.

“While extending lifespan is important, it doesn’t really help if that lifespan you extend is full of disability and pain,” Khosla says. In the aging-research community, the newer concept is extending “health span,” he says. “So you may not necessarily extend the actual life from 95 or 100 or whatever. But within that time frame, you’ll have more years of the better quality of life and healthier life.”