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Want to know more about osteoporosis and osteopenia? We'll dive into these conditions and give you some handy tips on preventing future problems and taking care of your bones. What is Osteopenia? Osteopenia (low bone density) is the initial stage of bone mineral density loss, which can eventually progress to osteoporosis if steps are not taken to prevent it. What is Osteoporosis? Osteoporosis is a condition that weakens our bones. While it literally means “porous bone," it doesn’t mean that our bones are doomed to succumb to the changes that can happen to us silently over time. Our bones are living tissues that are constantly breaking down and remodeling themselves.  Osteoporosis and osteopenia are typically diagnosed by testing bone mineral density using scans that your primary care provider can easily order. This is important testing because it dictates your risk of breaking a bone in common areas like your hip, wrist or spine. It also helps set the stage for talking with your healthcare team to develop a treatment plan. Most people will reach their peak bone mass in their mid to late twenties. There are several factors that increase our risk of osteoporosis or osteopenia as we age, such as menopause, genetics and other lifestyle factors. However, there are several things you can do to mitigate this breakdown and assist your body in the constant remodeling it does to our bones. 3 Controllable Factors to Build Strong Bones 1. Talk to your primary care provider They can go over a plan and prescribe things such as vitamin D, calcium and medications that can help if you are at risk or have osteoporosis or osteopenia. 2. Maintain a healthy diet Talk to a dietician if you need further help as they can be an invaluable resource to develop a plan.  Eat foods rich in calcium, vitamin D and vitamin C. These assist with the rebuilding of bone. Examples include but aren’t limited to leafy greens, legumes, salmon and healthy dairy products.  Don’t smoke — it directly correlates with a decrease in bone mass. Smokers also take longer to heal from a fracture.  Limit alcohol to two to three beverages per week. Alcohol interferes with the production of vitamins needed to absorb calcium and the hormones that help protect bones. 3. Exercise Talk to your primary care provider to get a referral to physical therapy if you need help with exercise.  Our bones adapt to the stresses we put them through. Therefore, exercise should be tailored to putting the right stress on our bones. There is good quality research that most exercise is safe when dealing with less bone mineral density.  The exercises should be progressively challenging and increase the load for resistance and weight training at least two to three days a week. Examples include squats, step-ups, chest presses and rows.  Exercises higher in velocity will lead to more power and bone adaptation. Examples include quicker push-ups, marching and quicker walks.  Exercises that are weight-bearing will lead bones to adapt to the stress placed on them. Movements such as mini stomps, step-ups, jumping, jogging and so forth may be used depending on how your body tolerates these things to really stimulate bone adaptation. There are aspects of aging and bone health we can’t control, but we can take steps to minimize the chances of bone loss and osteoporosis. Talk to your healthcare team to determine your risk and don’t forget to show your bones a little TLC – you’re going to need them.

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© Niyazz via Canva.com Every patient, regardless of how they may identify, greatly benefits from preventive healthcare and early detection. Members of the LGBTQIA+ community face unique considerations when it comes to their health, and a proactive approach to preventive screenings and vaccines is important in order to address their individual health needs.  Dr. Karen Thiele, Family Medicine Physician with University Health and Assistant Professor of Family and Community Medicine at the University of Nevada, Reno School of Medicine, breaks down key steps that LGBTQIA+ patients should take to safeguard their health.  PrEP and PEP  Pre-exposure prophylaxis (PrEP) is a strategy to prevent human immunodeficiency virus (HIV) infection. It is an important measure for those who are HIV-negative but may be at risk of contracting it. The highest risk sexual practice is receptive anal intercourse, due to the relative fragility of rectal tissue. This medication can stop HIV from spreading in the body and help patients maintain their HIV-negative status. PrEP is available in both pill form, which is taken every day, and injection form, of which the first two injections are initiated one month after another while all other injections are initiated every two months.  Post-exposure prophylaxis (PEP) is an antiretroviral drug regimen taken after potential HIV exposure to prevent an HIV-negative individual from converting to HIV-positive status. PEP is only for emergency situations and must be started within 72 hours of exposure – sooner is always better than later – and must be taken for 28 days.  PrEP and PEP are available in many ways, including visiting your primary care provider (PCP) or an urgent care location.   HPV Immunization  All genders and identities can protect themselves against human papillomavirus (HPV), a sexually transmitted infection (STI) that can lead to the risk of cervical, mouth, head, neck, throat, anal, vaginal, penile and vulvar cancers. HPV is so common that nearly all sexually active people, regardless of sexual orientation and practices, will be exposed at some point in their lifetime.  The HPV vaccine (common brands include Gardasil and Cervarix) is a safe and effective method to prevent HPV, according to the Centers for Disease Control and Prevention (CDC). This vaccine protects against infections that can lead to HPV-related cancers and precancers, as well as genital warts. While patients should start receiving the vaccine at 9 years old years old, unvaccinated adults up to the age of 45 can also receive the vaccine through their PCP – better late than never!  STI Testing  Sexually-transmitted infections form from bacteria, viruses or parasites that can be transmitted by person-to-person sexual contact through semen, vaginal, blood and other bodily fluids. According to the U.S. Department of Health and Human Services, there are more than 20 million estimated new STI cases across the nation each year.   Luckily, most STIs are preventable. Annual STI testing for HIV, gonorrhea, chlamydia and syphilis is important to stay on top of your sexual health. Because these STIs may sometimes have no symptoms, screening is recommended regularly and with any change in sexual partners. Depending on the specific condition, tests for these infections include urine, swab and blood tests. Speak with your primary care provider on a screening schedule that works best for you.  Prostate Exams  Prostate exams look for early signs of prostate cancer in patients who still have a prostate. The CDC recommends those who are at least 55 years old get regular prostate screenings; however, for patients with a family history of prostate cancer, screenings may be recommended as early as 45 years old.  These exams are done via two common methods – a prostate specific antigen (PSA) blood test and a digital rectal examination (DRE). Your provider can help you determine your risk and when you should start getting screened.  Pap Tests and Pelvic Exams  Patients of all genders who have a cervix, uterus, vagina and/or ovaries will benefit from regular pelvic exams and Pap screenings. A pelvic exam consists of a provider looking inside the vagina and at the cervix for anything unusual. A Pap test, also known as a Pap smear, involves your provider using a small, soft swab to collect cervical cells to check for early signs of cancer.  Generally speaking, people with these organs should have a Pap test every three years starting at age 21 through the age of 30. After age 30, patients should receive a Pap test with HPV co-testing every five years until age 65. These recommendations are changing based on new research, so it is important to have a conversation with your PCP about the current guidelines so you can make an informed choice about what schedule you should follow. A gynecologist or your primary care provider can counsel you and perform these screenings.  Mammograms and Breast Exams  People with breast tissue, especially dense breast tissue, are at risk for breast cancer, and regular breast screenings are your best line of defense. At-home breast self-exams are the first step – you will want to check your breasts for any lumps, changes, fluid leaks, irregular tissue thickening or anything else that feels unusual.  The Breast Cancer Risk Assessment tool, provided by the National Cancer Institute, is a good place to start to identify your risk. Talk with your primary care provider about the risks and benefits of starting screening at age 40 so you can make an informed decision about when to start. If you have any family history of breast or ovarian cancer, your PCP will offer you genetic testing for BRCA 1 and 2 mutations. Nevadans over the age of 18 can also get BRCA genetic test for free by enrolling in the Healthy Nevada Project.  Mammograms are important screening tools, but for a significant portion of people with breast tissue, density of the breast tissue may make mammograms less helpful in detecting cancer. Your primary care provider can help you decide what additional imaging (such as breast ultrasound) might be best for you.

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Michael Elliott, MD, head of the Department of Pediatric Orthopedics and Scoliosis, answers some common questions about bone fractures. Is there a difference between broken bones and fractures? No, these are two different names for the same injury. Of course the common term is a broken bone. Using either name will describe your concerns. Medical personnel typically describe a broken bone as a fracture to a specific bone. For example, a broken wrist is also a fractured distal radius. To clarify, this describes the injured bone and the precise location. How do I know  if my child has broken their bone? Many times children will fall and complain of their arm or leg hurting. In most cases the pain goes away and the child will return to their activities. When there is a deformity to the limb (curve in arm) and the child is complaining of pain, it is probably a fracture. If the arm or leg looks straight, look to see if there is any swelling or bruising. Both are signs of a possible fracture. Finally, if the limb looks normal but the child continues to complain, gently push on the bone. Likewise if it causes the same pain, then they likely have a fracture and should have an x-ray. My child fractured their growth plate, what does this mean? Growth comes from this area of the bone. In detail, these are located all over the body but typically at the end of the bones. With this in mind, fractures to these areas can result in the bone growing abnormally. Because of potential shortening of the arm or leg, or bones growing crooked, it is important to follow fractures closely (up to 1-2 years or longer). It is better to identify a problem early. Small problems can be treated with small surgeries. What if the bones of the x-ray do not line up? Because children are growing, unlike adults, their bones will remodel and straighten with growth. The amount of remodeling occurring depends on a child’s age, the bone fractured and the location. In many cases an angled bone will grow straight over the course of a year. For this reason, someone with experience in caring for children needs to follow bone growth. How long does it take fractures to heal? Factors deciding when a cast can come off include: Child’s age. Bone fractured. Fracture location. Young children heal faster than teens, teens heal faster than young adults, who heal faster than older adults. In young children most fractures heal in 4-6 weeks. However, teens generally take 6 weeks to heal, and adults can take much longer. Although your child  is out of their cast, it may not be healed completely to return to all activities. Placing a splint is during this time is common. This typically gives them added protection for several weeks after their cast is removed -  in case they forget their limitations. What if my child is still limping? Whether a child is in a walking or non-weight bearing cast, removing it often leaves them stiff and sore. Therefore many children will walk as though they still have a cast in place. In most cases this resolves in about three weeks. Regardless, if your child is still limping or walking abnormally after three weeks, contact the treating doctor. They may benefit from physical therapy or a repeat evaluation.  (This article was original published in the July 2019 issue of South Reno Kids & Sports.)

Read More About Bone Fractures in Children Honest Expert Advice

Experiencing knee pain during exercise or while undertaking daily activities? The knee is the largest joint in our body, so it goes without saying a lot hinges on its functionality. Here are a few exercises to help.   Is exercise a real pain in the knee for you? Does getting up in the morning require a few minutes for your knees to adjust to walking around? As it turns out, knee pain is common, and it can result from injury, overuse or the breakdown of cartilage over time. Often, this pain is a result of faulty mechanics in your body, according to Jessica Ryder, a physical therapist with Renown Physical Therapy and Rehab. “We see weakness at the hips causing a lot of stresses at the knee,” she says. Exercises that Alleviate Knee Pain Try these three exercise to strengthen your glute muscles and maintain proper alignment in your knees. Hip Lift Lie flat on your back with your knees bent and feet flat against the floor. Lift your hips into the air until your body is in a neutral position, then lower your hips back down. Repeat this motion several times until you feel a gentle burn in your glute muscles. Step Down Stand with one foot on a stair or step. Slowly bend your knee and drop the other foot toward the floor. Slowly extend back up to your starting position. While doing this exercise, it’s important to move slowly, maintain control and ensure that your knee is in line with your toes. Do as many reps as needed until you feel a small fatigue in your muscles. Repeat this exercise on the opposite leg. Side Step with Exercise Band Place an exercise band around your ankles. Stand in a slight squat and then take several steps to the side until you feel a small fatigue on the outside of your hips. While doing this exercise, keep your upper body still and focus the exercise to your hips. The band will try to move your knees toward each other Repeat in both directions. Hometown Health and Renown Health are proud to be the official insurance plan and healthcare partners of the Nevada Wolf Pack. Renown Physical Therapy and Rehab | 775-982-5001 Through outpatient physical, occupational and also speech therapy, Renown Physical Therapy and Rehab gives patients hands-on, individualized treatment. Our therapists use evidence-based methods to help patients return to an active, productive lifestyle. Learn More About Physical Therapy

Read More About A True Joint Effort: Exercises to Prevent Knee Pain