What Every Adult Should Know About Bone Health and Osteoporosis
What Every Adult Should Know About Bone Health and Osteoporosis
When people hear the word osteoporosis, they often picture a distant future—something to worry about “later,” after menopause, after retirement, or after a fracture happens. However, bone health is not a switch that flips overnight. It is something that changes gradually across the lifespan, influenced by hormones, movement, nutrition, stress, medical history, and yes—pelvic floor health.
Osteoporosis awareness often focuses on bones alone, but the reality is far more interconnected. Bones, muscles, nerves, balance systems, and the pelvic floor all age together. Understanding how these systems interact empowers people to take meaningful action long before a diagnosis ever appears on a bone density scan.
What Osteoporosis Really Is (and What It Isn’t)
Osteoporosis is a condition characterized by decreased bone density and structural deterioration of bone tissue, increasing the risk of fractures. Osteopenia, often a precursor, reflects lower-than-normal bone density but not yet at the threshold for osteoporosis.
What osteoporosis is NOT:
It is not an inevitable part of aging
It is not limited to older adults
It is not only about calcium
Bone tissue is living, dynamic tissue. It responds to load, hormones, nutrition, and movement patterns throughout life.
Bone Health Starts Earlier Than You Think
Peak bone mass is typically achieved in early adulthood. After that, bone remodeling continues, but the balance between bone formation and resorption begins to shift—especially during times of hormonal change.
Key life phases that affect bone health include:
Adolescence and early adulthood (bone building years)
Pregnancy and lactation
Perimenopause and menopause
Periods of inactivity, illness, or injury
Aging with chronic conditions or neurologic changes
The goal is not perfection—it is preservation and adaptability.
The Estrogen Connection: Menopause, Bones, and the Pelvic Floor
Estrogen plays a protective role in maintaining bone density. During perimenopause and menopause, declining estrogen levels contribute to accelerated bone loss.
This same hormonal shift also affects:
Pelvic floor tissue elasticity
Muscle strength and recovery
Joint health and connective tissue integrity
Bladder and bowel function
This is why it is common to see osteoporosis, pelvic floor symptoms, and balance changes overlap—they are influenced by the same systemic changes.
Why the Pelvic Floor Matters in Bone Health Conversations
The pelvic floor is not separate from the rest of the musculoskeletal system. It is a foundational component of posture, balance, continence, and force transfer.
Pelvic floor dysfunction can contribute to:
Fear of movement or exercise avoidance
Increased fall risk due to instability
Changes in gait or posture
Difficulty tolerating impact or resistance training
Urinary or bowel symptoms that limit activity participation
When people avoid movement because of leakage, pain, or prolapse symptoms, bone-loading opportunities decrease, accelerating bone loss.
Falls, Fractures, and the Bigger Picture
Falls are one of the leading causes of fractures in individuals with low bone density. But falls are rarely random.
They are often linked to:
Reduced balance reactions
Decreased lower extremity strength
Core and pelvic floor coordination deficits
Vision or vestibular changes
Fear of falling itself
This is where physical therapy becomes a critical prevention tool.
The Role of Physical Therapy in Osteoporosis Care
Evidence-based physical therapy for bone health focuses on:
Progressive resistance training
Weight-bearing and impact-appropriate loading
Postural alignment and spinal protection strategies
Balance and fall prevention training
Pelvic floor coordination during functional tasks
Education on safe movement patterns for daily life
PT helps individuals learn how to move confidently and safely—without fear, avoidance, or misinformation.
Pelvic Floor Therapy and Osteoporosis: A Critical Intersection
Pelvic health physical therapy addresses issues that often limit participation in bone-strengthening activity, including:
Urinary or fecal incontinence
Pelvic pain
Prolapse symptoms
Core weakness or pressure management challenges
By improving pelvic floor function, therapy can:
Reduce exercise avoidance
Improve tolerance to resistance and impact
Enhance balance and trunk stability
Support safer lifting and movement strategies
Increase confidence with daily and recreational activities
This integrated approach allows folks to keep moving, which is one of the most powerful (and free) tools for maintaining bone density.
Osteoporosis Is Not Just a “Women’s Issue”
While osteoporosis is more commonly diagnosed in women, men are not immune. Men can also experience fractures later in life—and with more severe consequences—partly because osteoporosis screening and education are less emphasized with male patients.
Bone health education, fall prevention, and strength training are important for all adults, regardless of gender.
What You Can Do—At Any Age
You do not need a diagnosis to start caring for your bones.
Actionable steps include:
Engaging in regular weight-bearing and resistance exercise
Addressing balance concerns early
Seeking pelvic floor care for bladder, bowel, or pain symptoms
Learning safe lifting and movement mechanics
Discussing bone density screening with your healthcare provider
Prioritizing nutrition that supports bone health
Avoiding prolonged inactivity whenever possible
Early intervention does not just prevent fractures—it supports long-term independence and a higher quality of life.
Reframing the Narrative Around Aging
When bone health, pelvic floor function, balance, and strength are addressed together, people can remain active, confident, and capable across the lifespan. Osteoporosis care is not about restriction—it is about resilience.
Workshops, group programs, and interdisciplinary care models provide education that empowers individuals to make informed choices. Learning how to move well, load safely, and manage symptoms reduces fear and builds confidence.
Join us for our FREE Stronger Foundations Osteoporosis Workshops: 1/14/26, 4/8/26, 7/8/26, 10/14/26.
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References
American College of Obstetricians and Gynecologists (ACOG). Osteoporosis. https://www.acog.org/womens-health/faqs/osteoporosis
National Osteoporosis Foundation. What Is Osteoporosis? https://www.nof.org
National Institutes of Health (NIH). Osteoporosis and Related Bone Diseases National Resource Center. https://www.niams.nih.gov
Centers for Disease Control and Prevention (CDC). Osteoporosis Data & Statistics. https://www.cdc.gov
World Health Organization (WHO). Assessment of Fracture Risk and Its Application to Screening for Postmenopausal Osteoporosis. https://www.who.int
