If you’ve had a fragility fracture—from falling or losing your balance—your doctor has probably told you that there is a good chance you might break a bone again. You may wonder how to prevent that from happening. Mount Sinai’s Own The Bone® Program is here for you. We identify, evaluate, and treat people who have lost bone mass or who have a fragility fracture—and help keep you safe.

Our program is one of more than 300 programs nationwide. The American Orthopaedic Association is partnering with health care institutions to change the way health care providers and patients react after the bone heals. The goal is to reduce repeat fractures and improve bone health treatment.

Services We Offer

The Own the Bone Program provides bone health management. Our care, provided by a physician assistant, supplements the treatment you receive from the surgeon treating your fracture.

We will work together to improve the health of your bones and reduce your risk of another break by discussing the following:

• Reducing your risk of another broken bone
• Evaluating and monitoring your bone density
• Increasing your calcium and vitamin intake
• Using weight-bearing and muscle-strengthening exercise
• Making lifestyle adjustments, including preventing falls and addressing smoking and alcohol habits
• Prescribing medication to reduce fracture risk

Fragility Fractures

After age 50, bone health becomes more of a challenge. Up to half of all women and a quarter of all men over 50 will break a bone from something that wouldn’t have caused a break (fracture) a few years earlier, such as falling from standing height or lower. We call this type of injury a fragility fracture. Once you have had a fragility fracture, you are much more likely—two to four times as likely—to have another.

Your bones may have become weak and more likely to break due to a disease called osteoporosis. This condition means your bones have holes (are porous) and therefore weigh less (low bone mass). Osteopenia is a loss of bone mass that often—but not always—develops into osteoporosis. Both of these conditions are “silent”. You don’t know you have them until you have a bone density test or fracture a bone.

Preventing Falls

There are some ways to prevent fragility fractures. The first step is to take measures to prevent falling. To that end, you can work on your balance, flexibility, and strength. This can help you keep your body stable while you move or even just stand still. Activities such as tai chi, swimming, and stretching can help.

In addition, here are some suggestions for preventing falls inside the home:

• Use nightlights.
• Keep floors clear of clutter.
• Don’t walk around in socks or floppy slippers.
• Keep electrical cords out of the way.
• Use a rubber mat in the shower or tub.

When you head outside, remember to:

• Wear shoes that offer good traction.
• Be careful about floors and sidewalks that can be slippery.
• Check out curbs before stepping up or down.
• In bad weather, use a cane or walker if you feel unstable.

Keeping Your Bones Strong

It is also important to keep your bones as strong as possible. Here are some suggestions:

Talk with your health care provider. See if you can get tested for low bone density, which could leave you vulnerable to bone fractures. The bone mineral density test is often called a DXA test. You can also discuss whether there is medication approved by the U.S. Food and Drug Administration that is right for you.

Get enough calcium. Calcium is one of the ingredients of human bone. But our bodies cannot produce calcium, so we need to get it from food or supplements. The National Institutes of Health recommends that after age 50, men increase their calcium intake to 1,000 milligrams per day and women increase to 1,200 milligrams per day. It’s best if you can get it from calcium-rich foods like milk, cheese, broccoli, or almonds. But if that isn’t getting you enough calcium, calcium supplements also work.

Get enough vitamin D. Vitamin D helps our bodies absorb the calcium we take in from food or supplements. The Bone Health and Osteoporosis Foundation recommends 800 to 1,000 International Units of vitamin D per day. Sunshine and vitamin-D fortified foods, like milk, can help, and vitamin D supplements are also useful.

Limit alcohol. Heavy drinking makes it harder for your body to absorb calcium and vitamin D. The U.S. Department of Agriculture and the U.S. Department of Health and Human Services Dietary Guidelines for Americans recommend no more than one drink per day for women, and two drinks per day for men. This will help protect you from bone loss and make it less likely you’ll have a fragility fracture if you fall.

Don’t smoke. Tobacco increases your risk of low bone density. That means if you do fall, a fracture is more likely.

If You Do Break a Bone

Sometimes, despite your best efforts, you might fall and fracture a bone. If that happens, be aware that fractures can be painful while your bone and the surrounding tissue and muscles heal. Here are some suggestions:

• Get enough rest. Ongoing pain can make it hard to sleep, and you may tire more easily, so make sure to get extra rest as you recover.
• Follow your treatment plan. Attend all your follow-up appointments, so your health care provider can help you manage your pain and monitor your progress.
• Eat nutritious foods. Be sure to get plenty of calcium and vitamin D to help your body recover and build new bone.
• Seek emotional support. Breaking a bone can cause worry and frustration. Take time to talk with a friend, listen to music, enjoy a massage, or try guided meditation to help you relax and stay positive as you heal.

Recuperating From a Fracture

As you recuperate, exercise can help you regain your strength and mobility and get back to your regular activities. But it is important to perform the right exercises. Here are some suggestions:

• Let a physical therapist direct you. Ask your health care provider to refer you to a physical therapist who can help guide your recovery. Check with your insurance plan to understand your coverage.
• Do your physical therapy. When you do it every day, physical therapy can help reduce pain and swelling. These exercises can also help you regain your strength and range of motion.
• See an occupational therapist. An occupational therapy specialist can help you figure out when and how to return to your daily activities. They can advise you on ways to reduce your risk of falls, so you can live more independently as you recover.
• Be patient. Try not to be frustrated by slow progress or small gains. It takes a long time to heal your bones and regain strength and movement.
• Use heat or cold. Your health care provider can let you know which would help relieve your symptoms.

Preventing Another Fracture  

Once you break a bone, you are more likely to have another fracture. There are things you can do to try to avoid another fracture.  

• Tell your primary care doctor. Report any broken bones right away.
• Find a health care provider who focuses on bone health. This provider can help you with nutrition, exercise, and effective medications to strengthen your bones. Let the provider know if you are worried about your balance or falling.
• Keep exercising. This will help you improve your balance and strength.
• Have your eyes and feet checked.
• Try to prevent falls. Follow the above suggestions to keep safe and prevent falls.