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Prevention
By Mayo Clinic staffYou can reduce your risk of a hip fracture by taking steps to prevent osteoporosis and to reduce your risk of falling. Women are more likely than men are to develop osteoporosis, particularly after menopause; however, both women and men can take steps to prevent osteoporosis.
Knowing your bone density
If you're a woman, you may want to have a baseline bone density test at menopause. Women are at a considerably higher risk of low bone density than men are because women lose bone density at a greater rate than men do and because they have a lower starting bone mass. Knowing that your bone density is low can lead you to take steps to increase your bone density and prevent complications such as a hip fracture.
The higher your peak bone mass, the less likely you'll be to have fractures later in life. Maximum peak bone mass depends partly on:
- Your inherited ability to make bone
- The amount of calcium you consume
- Your exercise level
Making the right choices
The process of building bone mass usually peaks in your 30s. After that, you start to lose bone mass. Making the right lifestyle choices during peak bone-mass-building years and afterward contributes to a higher peak bone mass and reduces your risk of osteoporosis in later years.
These steps can help you prevent a hip fracture by slowing bone loss:
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Ensure adequate calcium and vitamin D in your diet. These two substances are important in the process of building bone mass, which peaks around age 30. Calcium can also protect against bone loss. Be sure to get enough calcium and vitamin D. Foods containing calcium include milk and other dairy products; dark green vegetables such as broccoli; citrus fruits; shrimp; canned salmon or sardines; and almonds. Vitamin D helps your body absorb calcium. Your body manufactures vitamin D in your skin using the sun's energy. Fortified foods, such as milk, are another common source of vitamin D.
If you're considering calcium or vitamin D supplements, ask your doctor about what's an appropriate dose for you. The Recommended Dietary Allowance (RDA) for calcium for men and women age 50 and older is 1,200 milligrams (mg) a day. The RDA for vitamin D is 400 to 600 international units (IU) a day for adults older than 50. The amount of extra calcium you need depends on your age, whether you're taking medications such as corticosteroids, how much milk you drink and other factors. How much supplemental vitamin D you need varies depending on your age, whether or not you have certain chronic medical conditions, how much sunlight exposure you're getting and your intake of vitamin D in foods. Experts suggest getting 10 to 15 minutes twice a week of unprotected sun exposure to ensure adequate levels of vitamin D.
- Exercise to strengthen bones and prevent falls. Weight-bearing exercises, such as walking, apply tension and pressure to your muscles and bones, encouraging your body to increase bone density to meet the additional stress. Exercise also increases your overall balance and strength, making you less likely to fall. High-impact exercises, such as those involving running or jumping, aren't recommended if you have weak bones, as they may increase your risk of a fracture or injury. To prevent osteoporosis, exercise at least three times a week for 30 minutes a session.
- Don't drink excessively or smoke. Preserve your bone density by avoiding the excessive use of alcohol and by not smoking.
- Medical treatment of osteoporosis. Your doctor may prescribe a bisphosphonate — such as alendronate (Fosamax), risedronate (Actonel), ibandronate (Boniva) or zoledronic acid (Zometa, Reclast) — to prevent or treat postmenopausal osteoporosis. Raloxifene (Evista) is a selective estrogen receptor modulator and can also be used to prevent or treat postmenopausal osteoporosis. Calcitonin is a naturally occurring hormone involved in bone growth, and when taken as an injection or nasal spray, can be used to treat osteoporosis. Teriparatide (Forteo), an injectable form of human parathyroid hormone, stimulates new bone growth in the spine and hips. It also reduces the risk of vertebral and nonvertebral fractures in women and vertebral fractures in men.
Falls: Reduce your risk
These steps can help you guard against hip fracture by reducing your risk of falls:
- Fall-proof your home. Keep your home well lit and free of hazards that might cause you to trip and fall. Avoid area rugs and exposed electrical cords. Place furniture where you're unlikely to bump into it. Consider installing grab bars in your bathroom, stair treads on steps and handrails along stairways. Use nonslip mats on the bathtub and on shower floors.
- Wear sensible shoes. If you're older, wear thinner, hard-soled, flat shoes. Resilient-soled athletic shoes may impair your balance and contribute to falls. Avoid wearing high heels or sandals with light straps. Avoid wearing shoes that are either too slippery or too sticky.
- Avoid strenuous and dangerous activities. Don't stretch to reach high places. Use a stepladder or ask for help. Avoid lifting heavy objects, climbing and engaging in unusually vigorous activities.
- See your eye doctor. Poor eyesight is a possible cause of falls. Have your eyes checked at least once a year, or sooner if you're having trouble seeing. Wearing proper glasses and being able to see well around your home makes it more likely that you'll see objects that you might trip over.
- Be mindful of side effects of medications. Feeling weak and dizzy, which are possible side effects of many medications, can increase your risk of falling. Talk to your doctor about side effects caused by your medications.
Hip protectors
Another step that won't prevent you from falling but may protect you if you do is to wear a hip protector. These padded, externally worn protectors are similar to what hockey players wear to avoid injury. However, one study found that these devices probably weren't effective at preventing hip fractures.
