Osteoporosis meds can be misused

Dear Dr. Roach: I am a 79-year-old woman with osteoporosis. My doctor has prescribed alendronate (Fosamax) for me. My understanding was that this medication was to prevent a hip fracture, but she now says that it will also strengthen other bones in my body. Is this true?

Answer: Your doctor is correct that when properly used — meaning, both in the right patient and for the right length of time — Fosamax and other medicines reduce the risk of both hip and spine fractures.

Part of the reason these drugs have gotten an undeservedly bad reputation is that they have not always been used correctly. Doctors who are not expert in treatment of osteoporosis have sometimes prescribed these drugs for women and men who do not have osteoporosis, but only low bone density, and for those who are not at a high risk for fracture. If a drug has little potential for benefit, then even a small risk of harm leads to the drug being worse than useless.

Women and men at high risk for fracture due to osteoporosis and other risk factors benefit from the reduced risk of hip and spine fractures with low risk of adverse events.

Dear Dr. Roach: A large number of sports injuries are reported every day. Body building is a focus of most athletes in sports. The injury rate seems to be getting higher. How does taking weight training “to the limit” affect the risk or odds of an injury?

Answer: Strength-building exercise using resistance, usually through weights, has many benefits to the body, including benefits that are difficult or impossible to attain through aerobic activity that does not involve resistance, which is why essentially elite athletes incorporate weight training.

The risk of injury in resistance training is low, on the order of one per 1,000 hours of training at the Olympic level. This is far lower than in contact sports. For nonelite athletes, the biggest risk is probably trying to lift too much, too soon. I strongly recommend getting a professional coach to help you with proper form and advice on the types and amounts of lifting. This will help to minimize injury risk.