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Worried about breaking a bone? 5 tips you should know before it happens

The Bottom Line

  • Older adults are more likely to suffer broken bones when they fall or are injured.
  • Breaking a bone is an indicator that you’re more likely to break another.
  • It doesn’t have to happen to you! Precautions, prompt treatment, rehabilitation and lifestyle changes all help prevent future breaks.
  • A risk assessment is a good first step to developing a personalized prevention plan.

If you’ve ever broken a bone you know how scary, painful and disruptive the whole episode is. Our bones become more fragile as we age, and breaking a bone is an indicator that you’re more likely to break another. For example, breaking a hip increases your risk of another break by 2.5 times (1).


Before a nasty fall or accident has you cooped up, prepare yourself. Below are five recommendations from a new report on best practices for treating broken bones and preventing future fractures in people over the age of 50 (2). These tips can help you reduce your risk of breaking a bone, and give you the “inside scoop” on how to ensure the best possible recovery if it does happen.


1. Don’t “wait and see” – get medical help!

You’ve heard the saying: If it ain’t broke, don’t fix it. However when it comes to major bumps and bruises, it’s actually good advice to get medical attention as soon as possible! Maybe you dread the hassle of an emergency room visit for a twisted ankle or bruised wrist, but you’re best to play it safe. If it is a broken bone or “fragility fracture” (particularly common in people over the age of 50 who are at greater risk of osteoporosis), getting surgery or other treatment within 48 hours leads to the best results and shorter recovery (2).


2. Find the right treatment for you

There’s usually more than one way to do anything, and that includes treating broken bones. So while surgery is often performed, in some cases it’s not the recommended course of action. For example, studies have found that older adults who suffer upper arm breaks at the shoulder (the humerus) may be treated just as effectively with non-surgical procedures (3).


Ask for patient education materials to find out your options and work with your health care providers to determine the best one for your individual circumstances. Online tools, such as Patient Decision Aids, are a great starting point for learning the pros and cons of different treatments. Check out these Decision Aids on the McMaster Optimal Aging Portal:


3. Do your rehabilitation and prevention exercises

You suffered a fall and broke a bone or two. But you’ve had treatment and rested for the recommended amount of time so that’s the end of it, right? Nope. Actually, now the real work begins. Work with your care providers to develop a program that will both speed recovery and help prevent future falls and fractures. Depending on your situation and needs, it may include physical therapy, balance exercises and/or strength training, among other activities (4;5).


4. Some supplements and medications can help build healthier bones

No one likes to admit they’re getting older and can’t do the same things they did in their 20s and 30s. The good news is we can remain active and enjoy a full life as we age. A few lifestyle changes – such as quitting smoking, reducing alcohol consumption and getting beneficial minerals and vitamins including calcium and vitamin D – can promote overall health while helping to strengthen bones and prevent breaks (2;6;7;8). 


Bisphosphonates are a class of drug that help maintain bone mass and are used to treat osteoporosis among other conditions. There is evidence they reduce the risk of fractures, with different types appearing to be more effective for women and men and for specific kinds of fractures (9). In women with osteoporosis, denosumab, teriparatide, and some bisphosphonates reduce spinal and non-spinal fractures (9).


5. Know your risk, plan ahead

The information and suggestions above are a good starting point for everyone. What else can you do? One of the best ways to protect yourself is to be proactive (2). Make an appointment with a health care professional who specializes in osteoporosis and who can assess your risk based on your age, health, mobility, previous falls and/or fractures, medications and other factors (10;11).

Featured Resources

  1. Web Resource Rating: Bone health: Tips to keep your bones healthy
  2. Web Resource Rating: Osteoporosis: Topic overview

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References

  1. Colon-Emeric C, Kuchibhatla M, Pieper C, et al. The contribution of hip fracture to risk of subsequent fractures: data from two longituninal studies. Osteoporos Int, 2003; 14(11): 879-883.
  2. Lems WF, Dreinhofer KE, Bischoff-Ferrari H, et al. EULAR/EFORT recommendations for management of patients older than 50 years with a fragility fracture and prevention of subsequent fractures. Ann Rheum Dis. 2017; 76(5):802-810., doi: 10.1136/annrheumdis-2016-210289.
  3. Launonen AP, Lepola C, Flinkkila T, et al. Treatment of proximal humerus fractures in the elderly: A systematic review of 409 patients. Acta orthop. 2015; 86(3):280-285. Doi: 10.3109/17453674.2014.
  4. Raymond MJ, Bramley-Tzerefos RE, Jeffs KJ, et al. Systematic review of high-intensity progressive resistance strength training of the lower limb compared with other intensities of strength training in older adults. Arch Phys Med Rehabil. 2013; 94(8):1458-1472. doi: 10.1016/j.apmr.2013.02.022.
  5. Gillespie LD, Robertson MC, Gillespie WJ, et al. Interventions for preventing falls in older people living in the community. Cochrane Database Syst Rev. 2012; (9):CD007146. doi: 10.1002/14651858.CD007146.pub3.
  6. Bolland MJ, Leung W, Tai V, et al. Calcium intake and risk of fracture: Systematic review. BMJ. 2015; 351:h4580.  doi: 10.1136/bmj.h4580.
  7. Avenell A, Mak JC, O’Connell D. Vitamin D and vitamin D analogues for preventing fractures in post-menopausal women and older men. Cochrane Database Syst Rev. 2014; (4):CD00227. doi: 10.1002/14651858.CD000227.
  8. Weaver CM, Alexander DD, Boushey CJ, et al. Calcium plus vitamin D supplementation and risk of fractures: An updated meta-analysis from the National Osteoporosis Foundation. Osteoporosis Int. 2016; (1):367-376. doi: 10.1007/s00198-015-3386-5.
  9. Crandall CJ, Newberry SJ, Diamant A, et al. Comparative effectiveness of pharmacologic treatments to prevent fracutres: An updated systematic review. Ann Intern Med. 2014; 161(10):711-732. doi: 10.7326/M14-0317.
  10. Bell K, Strand H, Inder WJ. Effect of a dedicated osteoporosis health professional on screening and treatment in outpatients presenting with acute low trauma non-hip fracture: A systematic review. Arch Osteoporos. 2014;9:167. doi: 10.1007/s11657-013-0167-7.
  11. Grigoryan KV, Javedan H, Rudolph JL. Orthogeriatric care models and outcomes in hip fracture patients: A systematic review and meta-analysis. J Orthop Trauma. 2014; 28(3):e49-55. doi: 10.1097/BOT.0b013e3182a5a045.

DISCLAIMER: The blogs are provided for informational purposes only. They are not a substitute for advice from your own healthcare professionals.

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