WOMEN’S FOOT HEALTH PART II: Bone Health
An Article Written by Yen-Chii Wong
Podiatrist – New Step Podiatry
Over four articles we will explore women’s health considerations in podiatry. We will discuss bone health for women in this article, considerations for a female athlete here, foot changes during pregnancy here and foot changes during menopause here. Click on the links to access these articles.
Women’s Bone Health
We often think of our bones as hard structures that are stiff and rigid, but they are alive and constantly building, breaking down, and remodelling in response to our environment. Bone can flex when physically loaded through daily activities (this increases with higher impact activities like running) and consistent bone remodelling helps to repair these areas to keep your bone healthy and strong. This is great because it means that bone can adapt to different demands!
Bone density and strength can decrease if your bone is breaking down at a higher rate to it remodelling. Having decreased bone density can lead to an increased risk of bone stress injuries which can include bone fractures. Factors that can affect bone remodelling include calcium and vitamin D levels, disruption to parathyroid and estrogen hormone levels, body weight, sleep, stress levels, and activity levels. A family history of low bone density or health conditions that affect bone health can also contribute to a higher risk of low bone density.
Bone health is important for everyone, but studies have shown that there is a greater incidence of bone stress injuries in females compared to males at a high school and collegiate levels (Beck & Drysdale, 2021). This is likely due to the female body having physically lower muscle mass and strength, smaller bone sizes, and fluctuating hormone levels throughout the menstrual cycle. Women also generally have lower levels of testosterone which contributes to greater muscle development and larger bone mass. Low bone density often affects women in the post-menopausal period due to a deficiency in oestrogen levels, which play an important role in how quickly the cells that make new bone (osteoblasts) do their job.
Management for low bone density will vary from person to person, but can involve medication or supplements, addressing biomechanical factors, changes to diet, and the introduction of a strength-based exercise program. If your podiatrist is concerned about your bone density levels, they may refer you to your GP or specialist for a bone density scan. This is a non-invasive scan that takes around 30 minutes and can be done through various radiology clinics in Canberra. Your GP or podiatrist may also recommend a chat with a dietician for any modifications to your diet. An exercise physiologist could help you with an exercise program to build muscle strength which may be protective against low bone density.
Heidari, B., Hosseini, R., Javadian, Y., Bijani, A., Sateri, M. H., & Nouroddini, H. G. (2015). Factors affecting bone mineral density in postmenopausal women. Archives of Osteoporosis, 10(15). https://doi.org/10.1007/s11657-015-0217-4
Siddiqui, J. A., & Partridge, N. C. (2016). Physiological Bone Remodeling: Systemic Regulation and Growth Factor Involvement. Physiology, 31(3), 233-245. https://doi.org/10.1152/physiol.00061.2014
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