I am a 30-year-old woman who hates sports and is basically inactive. How big is my risk for osteoporosis?

Being active, especially with exercises for the weight-bearing joints, is only one way to avoid problems of osteoporosis. There are many other risk factors that can affect bone health, such as smoking, low vitamin D and calcium intake, and alcohol consumption. Since women begin to lose a greater amount of bone around 40 years of age, it is advisable to do things now that will boost your bone health before you hit 40. That way, you’ll have greater stores of bone when your body starts to lose bone content at a faster rate.

Is it helpful to take anti-inflammatories right after having a muscle strain?

Doctors commonly prescribe nonsteroidal anti-inflammatory drugs (NSAIDs) to help with the pain and swelling caused by muscle strain. But some health experts think that using these medications right after a muscle strain takes away the body’s natural ability to help the injury and actually delays healing.


When a muscle is strained, the body sends out inflammatory cells through the bloodstream to help the area start to heal. Once this critical step is well underway, NSAIDs become a valuable treatment for muscle strain.

I’ve heard that preventing bone problems later in life depends on how much calcium we get as children. What can I do for my children to improve their “bone banks” now?

Calcium intake at an early age is important for children, especially girls. Doctors recommend 1200-1500 milligrams of calcium per day during adolescence (ages 11-18). The best source of calcium is food, especially low-fat dairy products or calcium-fortified foods such as orange juice and cereal.


Calcium supplements are available for adults who can’t digest dairy products. Children can take calcium, but they should do so under a doctor’s supervision.


Getting enough sunshine (vitamin D) helps the body absorb calcium. Physical activity, especially sports that involve jumping, also helps increase bone deposits.

My 16-year-old daughter is very involved in a gymnastics club. She practices up to 20 hours a week. I’ve noticed she’s lost a lot of weight, but I thought this was normal for her level of activity. Then she broke a bone in her foot. When they X-rayed her foot, there were signs of early osteoporosis. The doctor has diagnosed her with “female athlete triad.” What is this?

Female athlete triad is a new term used to describe a combination of three things: (1) disordered eating, (2) menstrual problems, and (3) osteoporosis or loss of bone density. When girls are involved in sports such as ballet, figure skating, and gymnastics, there is a lot of pressure to be abnormally thin. Girls may stop eating or change their eating patterns to lose weight.  


This kind of diet and weight loss causes estrogen hormone levels to drop and menstrual cycles to stop. These two problems cause a third problem: bone loss. This puts girls at risk for fractures now and later in life, when more bone loss occurs during menopause.


It is very important for young athletes to receive adequate nutrition and emotional support to avoid these problems. Ask your doctor if there are any programs in your area that may help. Individual counseling may also be a good next step.

Are soccer players more likely to be injured during practice or competition?

Researchers recently looked at the first season of Major League Soccer in the United States to answer this question. There were 237 pro soccer players in the league. Each player spent about 241 hours in practice over the course of the season. That’s eight times the number of hours they spent in competition. Even so, most injuries happened during games.


During practice, players had three injuries per 1,000 hours of playing time. Meanwhile, they had 35 injuries per 1,000 hours of game time. That means players were 12 times more likely to get hurt during games as compared to practice!


One-third of the injuries were so minor they didn’t require any time off from the sport. Most of the remaining injuries kept players off the field no longer than a week. Still, these results show that competition may be more rigorous–and more risky–than practice.

I am 35 and have been playing soccer for years. Am I more likely to get injured now that I’m older?

Not necessarily. Researchers recently reviewed injury reports from the first season of Major League Soccer in the United States. There were 237 players on 10 teams. Players’ ages ranged from 18 to 38. Their average age was 27.


Three hundred ninety-nine injuries were recorded over the course of the season. Most of them resulted in brief or no lapses in playing time. In general, players were more likely to be injured in competition than in practice. But there were no differences between older and younger players in rate or severity of injury. Players’ positions also didn’t make them more prone to injury.


Time and intensity of playing seemed to take a toll over the course of the season, regardless of players’ ages. There were more injuries at the end of the season than at the beginning or middle, though this increase was fairly slight.


If you’re still concerned about injury, talk with a doctor or trainer. He or she may be able to suggest some preventive measures.

How dangerous is soccer when it comes to injuries?

Like most sports, soccer poses some risks. But according to a recent article, the level of risk may be relatively small.


Two hundred thirty-seven athletes participated in the first season of US Major League Soccer. They had roughly six injuries for every 1,000 hours of playing time. Most injuries involved the knee or ankle. Injuries were 12 times more common during games as they were during practice.


Notably, however, one-third of the injuries didn’t result in any loss of playing time. Of the remaining 256 injuries, most (59 percent) put players out for less than a week. Only 13 percent were major injuries that kept players off the field for more than one month.


Obviously, soccer does cause injuries. But according to these figures, pro soccer players aren’t likely to be kept out of the game for long.

My son is involved in water polo and track. He recently broke his arm in an accident which made me wonder. Is one sport better for bones than the other?

One recent study found that overall bone density was better in impact sport athletes (those who play basketball, tennis, and so on) when compared to water sport athletes. No other differences were found between these two groups. However, both groups of athletes showed better bone health when compared to other kids the same age who weren’t physically active.

What is the difference between an autograft and an allograft?

An autograft is tissue taken from one part of a patient’s body in order to repair or replace injured tissue in another part of the same patient’s body. An allograft is tissue taken from one patient (the donor) to be used in another, such as for a heart or kidney transplant.

I recently read that hormone and growth levels in swimmers are less than in basketball players or runners. Our swim-team workouts are much more strenuous than the workouts for these other sports. What gives?

Some researchers have found higher levels of testosterone in athletes who do impact sports (running, basketball) compared to athletes in water sports. But other studies have not confirmed this difference. Research has also failed to show a difference between these two groups of athletes in regard to growth and development.

I am a sophomore in high school. My friends and I don’t play sports. We seem to be much smaller than the “jocks” our age. Is this just a coincidence?

There is a correlation between physical activity and physical development in young men your age. A recent study found that boys involved in sports of any kind (swimming, tennis, football) were taller, heavier, and leaner than their less physically active peers. They also had better bone mineral content.


Perhaps you and your friends could get your own sports group going. The study made no distinction between those who excel at sports versus those who were just out there trying! Your efforts to become more physically active can improve the health of your bones today, establishing a better reserve of bone for your future years.

I’ve been a baseball fan for years. Is it my imagination, or are more players out of the game due to injuries now than ever before?

According to a recent study, you’re not imagining things. Researchers looked at injuries in Major League Baseball between 1989 and 1999. Results showed that the number of injuries has actually increased over time. And these injuries tend to keep players out of the game longer.


Why the increase? There are several possibilities. One is that sports medicine isn’t working as well as expected. Or maybe some kinds of injuries have decreased while others are still on the rise.


A few other changes also merit consideration. For instance, players who would have already retired in the old days are still playing the game. These athletes may be more prone to injury. Also, players with severe injuries may be returning to the sport more quickly, with a higher risk of re-injury.


More research is needed to learn about the increase in baseball injuries and what to do about it.

What is “endurance training?”

Endurance training is physical training that requires prolonged effort. Unlike repeated sprinting, which eventually causes you to have to stop and catch your breath, endurance activities allow the body to keep enough oxygen going to the muscles so the activity can be done for long periods.


Endurance training conditions muscles to become better able to obtain the nutrients and oxygen they need from the blood. Athletes who use endurance training show an improved ability to get more blood to the working muscles with each heart beat. And the muscles are able to make better use of the oxygen in the blood. The end result is improved efficiency, leading to better performance. Examples of endurance sports include long-distance running, cycling, and swimming.

The pain and swelling in my leg have gotten worse since I strained my calf muscle yesterday. Is it true that wrapping it and keeping the leg elevated can help the swelling go down?

For anything more than a simple strain, you should see your doctor or physical therapist before treating it yourself. Wrapping the sore muscle with an elastic wrap can often provide some relief from pain and swelling. Even though there are no formal studies to confirm the benefits, most health care providers would recommend using these measures because they seem to help with pain and swelling. Be sure not to put the wrap on too tightly. If you feel extra throbbing or pain and your toes start to feel cold, it could mean you’ve got the wrap on too tightly. 

It’s been three weeks since I had a minor strain in my calf muscle. I’m feeling pretty good and want to get back to playing tennis. Am I safe to go back to playing? How can I be sure to avoid hurting my calf again while I’m out on the court?

Before heading back onto the court, it is important that you’ve given your sore muscle a chance to heal. Getting good flexibility and strength before resuming high-level activity is a must to help prevent further problems. Also, be sure to get a good warm up before doing any strenuous activity. You can get better results with your warm up by using a heating pad for up to 15 minutes, followed by a short walk and gentle calf stretching. Then ease into your activity. For the first few outings, be sure not to overdo to the point that the muscle really starts to fatigue. Also, be sure to take some time to cool down afterward by doing more stretching. You may also want to put a cold pack on the muscle for up to 15 minutes.

Should I use heat or ice for the muscle I strained last night?

Ice is generally prescribed in the acute stages of healing, the period occurring right after the onset of pain or injury and lasting up to three days. The cold temperature makes the blood vessels in the sore area vasoconstrict (become narrower), assisting with the initial stages of healing. Putting cold on the sore muscle is known to ease pain, but it doesn’t always take away swelling. If the temperature is too cold, the body may be triggered to actually pump extra blood to the sore spot, making the swelling worse. To prevent this, layer a towel over your skin before applying the cold treatment. In general, cold treatments can include cold packs or ice bags, which are generally put on the sore muscle for 10 to 15 minutes.

My older sister who is in college (and therefore thinks she knows everything) told me my bones are constantly rebuilding themselves and that now is the time to get lots of calcium. (I’m 16.) Should my parents get their money back, or did her college anatomy class teach her something?

No refund necessary–so far. By the time you’re 18, you should have about 92 percent of the bone mineral content for all the bones in your body. And though your bones are constantly remodeling themselves, they can’t add much to what has been added in these crucial teen years. After about 30 or so, the amount of bone you’ve stored will begin to steadily drop. So be sure you’re getting the right amount of calcium now. Your bones will thank you later in life.

I’ve been taking birth control pills for a year. My mom is going through “the change” and has started taking some kind of hormone, too. It has helped her get back to normal. (Mr. Hyde is definitely making fewer appearances.) Besides that, she said it will help keep her bones strong. Will my pills do that too? If it makes any difference, I am a long distance runner. (I heard this is supposed to build strong bones.)

Recent evidence suggests that the pill may have a negative effect on bone health. If you are in your late teens or early twenties, you are still building bone. One study has shown that women in this age group who exercised while taking the pill ended up with less improvement in bone density than women who exercised and didn’t use the pill. Normally, exercise is helpful for improving bone density, so this finding was surprising. However, taking 1,000 mg of calcium per day may counteract this negative effect of the pill on bone density. The verdict is still out.

I am about 50 pounds overweight, and it’s killing my knees. I’m trying to loose weight. I swim laps three or four days a week. I usually swim for 45 minutes but have to admit sometimes my laps lack “oomph.” Some workouts I swim twice as many laps in that 45 minutes as I do on the days when my energy is low. Does the added intensity make much difference?

There are two parts of calorie burning with exercise: those burned during exercise and those burned after exercise. You burn close to the same number of calories swimming one mile fast or slow. However, the calories burned after exercise respond more to how intensively you swam, rather than how long. The calories you burn after exercise are mostly fat, because your body is attempting to replace sugars used during exercise. To do this, it turns to fat calories to restock energy stores. Take this for what it’s worth. The most important thing is that you are consistent with your exercise program.

I work for a construction company that builds skyscrapers. This involves a lot of heavy lifting and hard work. I’m the only woman on the crew and have a hard time keeping up with the guys. (Most are twice my weight.) I keep in good shape by running and stretching regularly. Any other suggestions?

Have you tried resistance training? This is the key to closing the physical gender gap in a work setting like yours. Seek the help of a competent trainer at your gym, someone who can guide you in a strength training program. The gains you make will likely help you perform your job duties more easily, while reducing your chances of getting hurt.