Your bone and joint health at age 60 will be very dependent on the practices you have developed in your 30s, 40s and 50s. This is no exaggeration. That is a fact of life. Bone density reaches its highest levels in the mid 20s and then slowly decreases, but at a higher rate after menopause in women and at 65 years of age in men. As the joints age and as they are subjected to the load, joint cartilage becomes thinner. Both of these processes are irreversible at the advanced stage, but highly modifiable at an early stage.
Patients go to the orthopedic hospital in Jaipur mainly for knee pain due to osteoarthritis, back pain due to degeneration of discs, shoulder pain due to degeneration of rotator cuffs, and hip pain due to joint space narrowing. Most of these conditions stemmed from years of activities, either destructive to the musculoskeletal system, or non-supportive of it. The best thing under 50 that anyone can do for their long-term mobility is to know what habits are harmful and what habits are helpful for bone and joint health.
Why Daily Habits Matter More for Bone and Joint Health
Bone is a living tissue. Bone is constantly broken down (by osteoclast cells) and rebuilt (by osteoblast cells) and this is known as bone remodelling. During childhood, the rate of bone formation exceeds the rate of bone loss and bone density rises. Once into the mid-twenties, however, the situation changes, and more and more units are damaged than are created. Any habit that promotes osteoblast activity (weight-bearing exercise, calcium, Vitamin D and protein) slows this net loss. All habits that are inhibitory to osteoblast activity contribute to its speed up smoking, excessive alcohol, long sitting, insufficient nutrition.
Joint cartilage is even more unforgiving. Cartilage has no blood supply and limited means of regeneration as compared to bone. After cartilage has worn down substantially (as seen in advanced osteoarthritis), this will not be able to be regrown. The wear on the cartilage that leads to a knee replacement at age 60 started to wear in the 30's and 40's. Prevention is not only easier than treatment; it is also more effective, since there is not much you can do for advanced joint disease other than try to reduce the symptoms and, eventually, replace the joint.
Daily Habits That Damage Bone and Joint Health
1. Continuous Sitting Especially With Crossed Legged
Sitting cross-legged for long periods of time, such as eating, praying and socializing, is a cultural practice in Rajasthan that puts a great amount of strain on the medial compartment of the knee joint. The cartilage in the inner portion of the knee is compressed in this position in a way that is biomechanically different from standing or conventional sitting. This adds up over years of repetitive exposure, especially in overweight people, in an important way to the development of medial compartment osteoarthritis.
Other factors, such as sitting at a desk for extended periods, which results in poor posture, also contribute to the rapid degeneration of the discs of the lower back, in a way that standing or walking would not. This is the sole reason for workers in Jaipur's IT and service sector and students who are studying long hours to be at higher risk of disc related back pain in early life.
Calcium and Vitamin D Deficiency
In India, adults require 1000 – 1200 mg of calcium a day. The International Osteoporosis Foundation says that the body will steal calcium from the bones to keep blood calcium level high, slowly and quietly over the course of years. Despite ample sunlight and covered dress, vitamin D deficiency is pandemic in India, as the angle of the sunlight in urban areas is not sufficient to enable the body to make enough vitamin D.
The result is that calcium and Vitamin D deficiency remains undetected for years, years, and years, and only shows up when you have a fracture or a DEXA scan shows loss of bone density. Hence, osteoporosis is considered a "silent disease" because the only symptom is a fracture, not a pre-warning.
Physical Inactivity
It has been estimated that an adult over 50 years old who is sedentary has up to 50% more risk of fracture compared to an active adult of the same age. Mechanical loading - when the body is under load, such as walking, climbing stairs, resistance training, yoga - signals the bone building cells to remain active. The absence of this stimulus will create a more negative osteoclast/osteoblast balance. Falls, the most important cause of fracture in most osteoporotic patients, are mainly prevented by muscle strength, another factor that is diminished by inactivity.
Obesity and Being Overweight
The mechanical advantage of the knee in gait biomechanics translates to an extra 4kg of load for every extra kg of body weight when walking. This translates to an additional 40 kg of force on the knee joint for the 10 kg excess weight person, with every step and 10,000 steps daily. This goes on over the years and causes osteoarthritis to happen a lot. The two most important modifiable risk factors for prevention and slowing knee OA are weight loss and exercise.
Smoking And Excessive Alcohol Use.
Nicotine constricts blood vessels and decreases the nutrients that reach the bone-forming cells, which slows down the healing of broken bones. Multiple large studies have found a correlation between smoking and decreased bone density and increased fracture risk. Excessive amounts of alcohol inhibit the absorption of calcium and inhibit the activity of osteoblasts, cells that form new bone. Both habits have a progressive and insidious effect on bone and only become clinically apparent years or decades later.
Tips To Keep Bones And Joints Healthy
Weight-Bearing Exercise: The Most Important Habit
Activity that involves the bones supporting the body against gravity (weight-bearing) is directly stimulating the formation of bones. Just about any walking, jogging, dancing, climbing stairs or resistance training is acceptable. Exercises that do not involve bearing body weight, such as swimming and cycling, are beneficial for the cardiovascular system and are great for joint mobility but are not the same as weight bearing exercises in building bone density. The orthopaedic expert's advice is to exercise 30 minutes most days, and resistance training 2 times a week if you can.
In the case of joint health, it's not about the intensity of the repetition but the variety of movements. A runner doing a single activity, running, will create repetitive strain on the same wear and tear surfaces. Swimming, yoga, or bicycling help to support the joints, minimize wear on one area, and offer greater range of motion that running cannot provide.
Essential Nutrients For Bone And Joint Health
The nutrients directly related to bone and joint health and their best Indian sources:
| Nutrient | Daily Requirement (Adult) | Best Indian Sources | Role in bone and joint health. |
|---|---|---|---|
| Calcium | 1,000 - 1,200 mg | Milk, curd, paneer, ragi, sesame seeds, drumstick leaves | Bone mineral (structural) that, when deficient, allows bone loss. |
| Vitamin D | 600 - 800 IU | egg yolk, fortified milk, fatty fish during the morning sun (15-20 min.). | India has been a place with a Vitamin D deficiency for ages as calcium is not absorbed if there is no Vitamin D. |
| Magnesium | 310 - 420 mg | Nuts and seeds, whole grains, bajra, jowar, dark leafy greens | Activates Vitamin D, contributes to bone crystal structure |
| Vitamin K | 90 - 120 mcg | Fresh vegetables like spinach, methi, broccoli and mustard greens. | Ensures calcium is deposited in bones not in arteries; plays a role in bone mineralisation |
| Protein | 0.8 - 1.0 g/kg body weight | All cereals, eggs, paneer, chicken, fish and soya | Proteins make up 35% of bone (collagen) and protein deficiency in the body weakens the bone matrix. |
| Omega-3 | Varied by source | The foods mentioned above are used to treat angina pectoris. | Helps to reduce inflammation in joints; decreases the likelihood of the progression of rheumatoid arthritis |
One unique mention needs to be made about turmeric and its beneficial effects on proper working of joints. Turmeric's active compound, called curcumin, has been shown to have anti-inflammatory effects that are relevant to joint health. One of the most evidence-based dietary practices is the traditional Indian habit of cooking with turmeric every day, which helps prevent joint inflammation.
Posture and Ergonomics
One of the most overlooked bone and joint health habits is good posture during everyday activities. The lower back is supported, the screen is at eye level and the feet are flat on the floor, distributing the weight of the spine evenly throughout the disc surfaces. Slouching, with head forward, shoulders rounded, low back unsupported will focus the load on certain areas of the discs, and will cause degeneration to progress more quickly in those areas. An ergonomic chair and proper screen placement can eliminate more orthopaedic issues than any other intervention for the majority of the Jaipur population that work in their office on desks.
A break while sitting even for 2 to 3 minutes is actually beneficial to your disc, as it can help to stimulate blood flow to the joint tissues and help to relieve disc pressure. No money, no equipment is needed for this habit.
Maintaining Healthy Body Weight
The problem of maintaining a healthy body weight.Issues with maintaining healthy body weight.
As a direct joint protection strategy, controlling weight is important, since there is a 4:1 increase in stress on the knees with every increased pound of weight. For an overweight person experiencing knee OA, every 5 kg of weight lost is associated with a measurable improvement in the symptoms of knee OA. This isn't about looks, it's about joint mechanics.
When to See an Orthopedic Doctor
- Pain that persists for over a week in the joint, even when they're at rest and there's no obvious way the joint got hurt.
Orthopedic and physiotherapy care at Jaipur Vatika Hospital.
Among the best orthopedic doctors in Jaipur is Dr. Vijay Krishan Tiwari (MBBS, MS Orthopaedics). His 45 years of specialist experience in bone surgery makes him the best Orthopedic surgeon in Jaipur.
Services related to bone and joint health:
- Assessment and diagnosis of the orthopaedics - Clinical examination, in-house X-ray and diagnostic coordination of the following conditions: knee, hip, spine and shoulder
- Conservative management: Administration of medication, referral to physiotherapist and graduated activity modification for early arthritis, tendinitis and musculoskeletal pain.
- Joint replacement surgery: 24/7 surgical capability, anaesthetic services and post surgical care in the hospital for total knee and hip replacement surgery
- Physiotherapy and rehabilitation: integrated with Orthopaedics, post-operative rehabilitation started in 24-48 hours, dry needling, manual therapy and exercise prescription provided.
- 24/7 trauma care: Road accident fractures, dislocations and major trauma managed with ATLS protocols on Ajmer Expressway corridor without transfer to city-centre facilities
- Accessibility: It is located in the Jaipur-Ajmer Expressway at Thikariya with access from Bagru and Dudu within 15 minutes.
Seeing a leading bone specialist in Jaipur will surely help you get correct guidance.
Conclusion
Over the years you may have made so many decisions that have influenced the condition of your bones and joints that you would not have given it a second thought. For the good news, the habits that help protect the health of your bones and joints are the same as those that help you to maintain overall health: Eating enough calcium, getting Vitamin D, staying active and maintaining good posture, and controlling weight. It makes a difference if they begin at 35 or 40. It's not too late to start them at 55.
The Orthopaedics department in Jaipur Vatika Hospital one of the best hospital in Jaipur for orthopedic treatment along with the integrated department of Physiotherapy offers detailed assessment and treatment to the residents of western Jaipur, along with the residents of Ajmer Highway, who are suffering from joint pain, those who are keen on knowing their bone health in advance, or those who require trauma treatment. Book via the JVH E-Consultation App or call the Jaipur Vatika Hospital emergency department at +91-8209809753.
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In India, adults require 1,000 to 1,200 mg of calcium daily, but a higher amount is recommended when people are over 65 years old or post-menopause, as they are at risk of losing their bones. Milk (about 300mg in one glass), curd, paneer, ragi (one of the best plant food sources of calcium), sesame seeds and drumstick leaves are good sources. The majority of Indians are far from getting a sufficient amount of it, and calcium rich foods are a key priority in their daily diet for bone and joint health.
For most, it isn't a problem to cross-leg sit occasionally. Over the years, however, repeated and prolonged cross-legged sitting puts mechanical stress on the medial (inner) compartment of the knee joint, especially in those who are overweight or those who engage in heavy manual labour. This eventually leads to medial compartment cartilage wear and early osteoarthritis. This risk can be substantially reduced by changing the type of sitting position, breaking up sitting time with standing and doing strength training for the leg muscles.
Walking is a low impact activity that benefits bone density and can be done nearly by anyone. It's a solid start. But, for maximum bone-building stimulus (maximum benefit especially for women over 40) adding resistance training 2-3 times a week will provide extra bone-building stimulus not provided by walking alone. The best evidence-supported exercise addition to a walking bone health plan is resistance exercise, which are exercises that can be performed at home using no equipment such as bodyweight squats, lunges and stair climbing.
The most accurate test for bone density is a DEXA (dual-energy X-ray absorptiometry) scan. It lasts about 15 to 30 minutes, exposes the body to only a small amount of radiation (in fact, just a few days of background radiation), and measures bone density at the spine, hip and in some cases, the wrist. A result is given as a T Score, which represents normal above -1.0, osteopenia (low bone density) between -1.0 and -2.5 and osteoporosis below -2.5. All women aged 65 years or older are recommended to receive it, and earlier in the event of risk factors.
It is important to note that for many cases of joint pain, physiotherapy and conservative treatment are the first line of management, such as in the early and moderate stages of osteoarthritis, tendinitis, ligament sprains and after injury (rehabilitation). Surgery is indicated when: Functional goals are not met with conservative treatment over time (usually 3 to 6 months); There is a structural injury that will not heal without surgery (complete tear of the knee ligament, complete tear of the meniscus that causes the knee to lock); The osteoarthritis is so advanced that the bone-on-bone pain causes a lot of functional disability. This is determined by a best orthopedic doctor in Jaipur after performing clinical examinations and imaging.