BAD TO THE BONE
Josh Rajan
Intern/Mentor
18 January 2017
Musculoskeletal diseases have caused around $461.5 billion loss in revenue for
individuals each year (Middlesworth, 2011). A musculoskeletal disease is an injury of any joint
or bone in the body that reduces movement and causes pain in the region. Even though not life
threatening, musculoskeletal diseases are fatal and have caused individuals to endure lives of
dependence on others as they lose function of their crucial body parts. Various predictions have
stated that musculoskeletal diseases are not only a current problem, but will grow in prevalence
and will become an overwhelming problem for societies and economies to deal with in the
elderly populations in the future. In order to prevent such an increase in cases of musculoskeletal
diseases, medical professionals have recommended a continuous practice of lifestyle throughout
an individual's lifetime, which promotes bone mass and prevent such diseases from occurring
within elderly populations. Thus, exercise can have a positive impact on a person's bone density,
thereby improving their bone health throughout their lives.
I) There are numerous physical ramifications from musculoskeletal diseases.
A) Bones grow weaker as a person ages because of hormone reduction and less
nutrient absorption.
1) Throughout a persons life, their bones are grown and developed
by a balance of the process of bone formation and bone resorption of nutrients
such as calcium and vitamin D. As an individual ages, their bones progressively
become more involved in bone formation and less with bone resorption
(Demonitero, Vidal, & Duque, 2012).
2) Sex steroids aid in bone development by producing hormones
which simulate bone mineral growth. These steroids are inefficient to operate in a
persons elderly years, causing less bone mineral to develop (Demonitero, Vidal,
& Duque, 2012).
3) As individuals age, the cortical and trabecular bone layers begins
to deteriorate gradually, as this proceeds at a faster rate than bone formation
(Allison et al, 2015).
B) Musculoskeletal diseases have made individuals more dependent on others,
decreasing their respective qualities of life.
1) The Surgeon General Richard Carmona (2004) stated that
musculoskeletal diseases have a great chance to disable individuals and remove
their simple motor functions, as at most 79% of patients are only able to conduct
their independent, regular lifestyle practices such as dressing themselves or
walking.
2) The primary aim of orthopedic treatment for these elderly patients
must be the return of function, yet in certain patients who have severe
BAD TO THE BONE
comorbidities, the aim of treatment can be a return to independent life...This
independency should be provided to maintain the dignity of human beings...
When patients can not achieve independency, they may lose their will to continue
life (Baek, 2010, para. 4 ).
C) The problem of musculoskeletal diseases are becoming an overwhelming problem
because of the increased life expectancy.
1) Studies in Sweden have reported that individuals with greater
lifespans have a greater chance to fracture bones such as the hip, as it is increased
to 23% in women and 11% in men (Carmona, 2004).
2) Elderly people are reported to become 22.7% of the male
population and 27.7% of the women population in 2050. This is an increase from
being 11% of the male population and 15.1% of the female population in 2000
(Baek, 2010).
II) There are numerous fiscal ramifications from musculoskeletal diseases.
A) Musculoskeletal diseases can become a financial burden on individuals due to
costs in treatment and care.
1) Musculoskeletal diseases have cost Canada a total of $25.6 billion,
as this is 3.4% of the countrys GDP, in 1994 (Coyte, Asche, Croxford, & Chan,
1998).
2) According to an infographic, Direct costs of MSDs are $20 billion
a year. Total costs are estimated to be between $45-54 billion. Indirect costs (lost
productivity, product defects, etc.) of an MSD case can be up to five times the
direct costs (Middlesworth, 2011).
3) The Bone and Joint Initiative (2013) stated that musculoskeletal
diseases have gone up in prices for an individual, as it was $4,832 in 1998 and
increased to $7,768 in 2011. This price has increased by 60%.
B) Economies can be negatively affected by musculoskeletal diseases due to costs
and workplace absences.
1) The Bone and Joint Initiative (2013) stated 70% of respondents
from the 2012 National Health Interview Survey stated that their absence from
their profession was caused by a musculoskeletal related illness.
2) Musculoskeletal diseases have been the reason for one third of all
job absences each year (Middlesworth, 2011).
III) Mitigating the health and fiscal issues can be done through increasing exercise throughout
the course of an individuals lifetime.
A) Weight bearing exercises are particularly effective in increasing bone mass.
1) It is not clear which training method is superior for bone
stimulation in adults, although scientific evidence points to a combination of highimpact (i.e. jumping) and weightlifting exercises... Several types of resistance
exercise have been tested also with positive results, especially when the intensity
BAD TO THE BONE
of the exercise is high and the speed of movement elevated (Guadalupe-Grau,
Fuentes, Guerra, & Calbet, 2009, para.1).
2) Bone formation is simulated by workouts that promote stress on
certain bone sites. Weight- bearing workouts promote that greatest amount of
stress on such sites, more than workouts that promote zero weight, such as
swimming (Brien, 2010).
B) Exercising during puberty can have a positive, long term effect during
adolescence.
1) A study reported that gymnasts who did gymnastics before their
adolescent years had 7% higher bone mineral density than non gymnasts during
their middle aged years (Bass et al, 1998).
2) Prepubescent tennis players had recorded a 24% higher bone
mineral density in the playing arm compared to the non playing arm. The cortical
bone layer of the tennis players humerus was 35% higher than the nonplaying
humerus (Bass et al, 1998).
References
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Allison, S., Poole, K., Treece, G., Gee, A., Tonkin, C., Rennie, W., . . . Brooke-Wavell, K.
(2015). The influence of high-impact exercise on cortical and trabecular bone mineral
content and 3D distribution across the proximal femur in older men: A randomized
controlled unilateral intervention. Journal of Bone and Mineral Research, 30(9), 17091716. http://dx.doi.org/10.1002/jbmr.2499
Baek, G. H. (2010). Are we prepared for geriatric orthopedics? Clinics in Orthopedic
Surgery, 2(3). http://dx.doi.org/10.4055/cios.2010.2.3.129
Bass, S., Pearce, G., Bradney, M., Henricks, E., Delmas, P. D., Harding, A., & Seemar, E.
(1998). Exercise before puberty may confer residual benefits in bone density in
adulthood: Studies in active prepubertal and retired female gymnasts. J Bone Miner Res
Journal of Bone and Mineral Research, 13(3).
http://dx.doi.org/10.1359/jbmr.1998.13.3.500
Brien, M. O. (2010, March 24). Osteoporosis in athletes. Retrieved December 1, 2016,
from Irish Osteoporosis Society website:
http://www.irishosteoporosis.ie/index.php/expert_views/osteoporosis_in_athletes/
The burden of musculoskeletal diseases in the united states. (2013). Retrieved October
27, 2016, from The Bone and Joint Iniative website:
http://www.boneandjointburden.org/facts-brief
Carmona, R. H. (2004). Bone health and osteoporosis: A report of the surgeon general.
Retrieved from https://www.ncbi.nlm.nih.gov/books/NBK45502/
Coyte, P. C., Asche, C. V., Croxford, R., & Chan, B. (1998). The economic cost of
musculoskeletal disorders. Arthritis & Rheumatology, 11(5), 315-325.
http://dx.doi.org/10.1002/art.1790110503
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Demonitero, O., Vidal, C., & Duque, G. (2012). Aging and bone loss: New insights for
the clinician. Therapeutic Advances in Musculoskeletal Disease, 4(2), 61-76.
http://dx.doi.org/10.1177/1759720X11430858
Guadalupe-Grau, A., Fuentes, T., Guerra, B., & Calbet, J. (2009). Exercise and bone mass
in adults. Sports Medicine, 39(6), 439-468. http://dx.doi.org/10.2165/00007256200939060-00002
Middlesworth, M. (2011, July 23). The cost of musculoskeletal disorders (MSDs)
[Infographic]. Retrieved from http://ergo-plus.com/cost-of-musculoskeletal-disordersinfographic/
