By June Price

(Updated April 2011)

Break a leg!” Thespians may consider that phrase good luck, but to us it’s anything but. A broken leg — any broken bone — can mean months if not years of problems. The normal six- to eight-week mending period can easily double for wheelchair-using adults due to the bone-weakening disease called osteoporosis.

Osteoporosis is a skeletal disease characterized by decreased bone mass, deterioration of bone tissue and increased susceptibility to fractures. The National Osteoporosis Foundation reports there are 10 million people with osteoporosis in the United States, and an additional 34 million with low bone density. Two million of these are men, although the risk for osteoporosis in men is much lower.

Immobility coupled with aging is a blueprint for osteoporosis. For example, one study shows a 30 percent decrease in bone mass within the first 18 months after spinal cord injury, men included. But one single factor — menopause — sends osteoporosis into overdrive.

Our physicians recommend treatment — calcium supplementation, estrogen replacement therapy or non-estrogen therapy. These sound like good options, but are they? Are there any studies to show the effects of these drugs on women who haven’t walked or stood for many years? Or who have never walked? How do these drugs play out with our bodies?

Sadly, little data exists. Once again we must educate ourselves as to what is right for us. Margaret Nosek, executive director at the Center for Research on Women with Disabilities at Baylor College of Medicine in Houston, Texas, couldn’t agree more. She says, “The available advice is so conflicting and confusing on this that I think the best advice would be to read up on it as much as you can and consult other women in your immediate family.”

Calcium
When we think of building strong bones, we think of drinking milk. This works just fine for the first three decades of our lives when more bone is formed than lost. At about age 30, replenishing slows and deterioration begins. Many factors affect the speed at which this occurs, including gender, race, age, genetics, smoking, diet and exercise. Osteoporosis can also result from a number of other conditions, notably immobilization.

A 2005 Archives of Physical Medicine and Rehabilitation article offers greater evidence on the issue of low bone mineral density and risks for osteoporosis in women with physical disabilities. Suzanne Smeltzer, one of the article’s authors and Professor and Director at the Center for Nursing Research at Villanova University’s College of Nursing, explains, “Osteoporosis is not on the radar of many health care providers caring for women with disabilities; as a result, they are screened less often that women without disabilities. They also develop osteoporosis at a younger age than th