Osteoporosis and Riding? Other Ways To Address It?

[MysticOakRanch]

I am feeling like I can’t take much more bad news. Shattered my leg this Spring (not riding - rotational fractures, pretty ugly, 14 screws and a plate holding me together), some other pretty bad stuff this year including neck and upper back osteoarthritis, and to cap it all off, I asked for a bone density test, and it came back as full blown osteoporosis.

I am mid 50s, don’t drink, don’t smoke, eat healthy, exercise and VERY active (although that changed drastically with the leg destruction this past Spring), take Vit D/Calcium supps - pretty much have done everything right. So a bit stunned at this latest set back. AND my doctor said I should sell my horse. Riding is too risky - or buy something old, slow, and lazy - which is NOT my style at all.

So - anyone here with advice - on riding, on health, on supplements, on treatments? I’m grasping at straws!

[NaturallyHappy]

I bought myself a body vest like eventers wear. I first purchased the air kind but learned it can cause injuries when it goes off. I figure if Sandy Ferrell can weather one, I can too. I’m very empathetic w your situation.

[jeano]

Has your Dr not suggested biophosphate therapy for your bones?

I was diagnosed with osteopenia in my mid 50s. Also not a poster child for low bone density. Not thin, not petite, not blonde haired/blue-eyed. Diet rich in dairy, sardines, dark green leafy vegetables. Tons of weight bearing exercise. And my mother’s back was straight as could be.On the paternal side the inheritance not so good. That grandma had a world class dowager’s hump.

Ob Gyn put me on HRT, then Evista, but numbers kept slipping and I had osteoporosis. Took Fosamax for years, numbers improved, off Fosamax for several years with no further decline til last year. Now I’m on the IV treatment that only needs to happen once a year if needed.

I never quit riding. Never had ANY trouble tolerating treatment. Had 2 partial knee replacements, back in the saddle 4 weeks post op. Had some bones fused in one foot. Healed beautifully. I have fallen off. A lot. And fall a fair amount without equine assistance because aging klutz. Only serious injury was the first broken bone of my life at age 60. Horse rolled on me. That was 6 years ago. As my NP osteoporosis specialist said, anybody’s ankle would’ve broken.

[kande04]

I’m older, and am now in the osteoporosis group, too.

So now my strategy is to keep riding the same horses, but under safer conditions. So I do more prep before I get on, and if horsie poo just doesn’t seem calm enough then I don’t get on that horse that day. Nor do I hesitate to get off if it looks like things are about to go south.

I do keep a couple of older packers around for the days when I want to ride but my first choice isn’t a good choice, because I know how easy it is to misjudge and get dumped and then have no choice at all about whether it’s a good day/week/month to ride any horse. :-/

[MysticOakRanch]

Jeano, you give me hope! Yes, she mentioned biophosphates, but I know two people who have had destruction of the jawbone (one lost all her teeth too), so I’m a bit scared by those. I understand people’s femurs also sometimes crumble with those. I can’t do them orally do to horrible acid reflux, but I’m going to talk to a specialist about the injection options.

I am genetically, screwed, I’ll admit. Family history, and a few other health issues, but also a (long term) lifestyle that SHOULD have helped at least delay the problem. Mid 50s and full blown osteoporosis, what are the odds? Rhetorical question, I looked it up, less then 15% of women experience it in their 50s. And most had dietary issues that contributed.

I’m not ready to sell my pony, so thank you for giving me that hope! I may just need to keep him in training so I’m not the one that has to take his edge off (he’s not the most quiet of characters, but I LIKE my horses to be a bit brilliant).

[jeano]

Not 100 percent sure but I think the dental issues are more frequent in folks who have poor dental health to start with. I’ve never heard of femurs crumbling but rather possible higher incident of leg fractures due to bones becoming more brittle. If it’s any additional comfort, I could absolutely feel my ankle bones s…t…r.e…tching before the SNAP. It was a clean hairline break that I walked on for half a day before throwing in the towel and getting it x-rayed. Then only my orthopedist had a fit because I was actually scheduled for my 2nd knee replacement that day! No displacement, no surgery, just 8 weeks in a boot, four non weight bearing.

So, yeah, I’m a happy camper with biophosphate.
As regards the IV, they will warn you, you might have flu like symptoms that you can treat with Tylenol. I felt like I was coming down with bubonic plague. But only for a day.

[Maythehorsebewithme]

I am 72, and have pretty severe osteoporosis. (Inherited from both my parents–small, fine-boned people.) . I exercise a lot and eat well, never smoked, take vitamin D and calcium, but my genes are against me.

My doctor is concerned about the riding, but luckily he is an athlete, and although a runner, not a rider, he get it, and does not waste his breath telling me to stop riding.

I am currently on fosamax, taking the risk for the benefits. Tried Prolia (one shot every 6 months). Had awful vertigo every time I sat up or lay down for five and one-half months after the first shot, and never got the second.

My horse is an easy-going sort (but of course still a horse!) . I don’t jump more than x-rails anymore. Try to be careful, but…

I just enjoy riding too much to give it up.

[walkers60]

biophosphates have a high rate of femur fractures which have nothing to do with pre existing conditions. These drugs only work at building bone , much discussion now on the dangers of this process as they may contribute to tumor growth… Also they have to be taken for the rest of your life or as soon as you stop them bone loss begins again.
Look at Cochrane reports for valid scientific reports on medications as most of what you goggle will be “research” funded by the drug companies.Unfortunately most doctors rely on drug reps to learn about all drugs ,they don’t have the time to do the research that you can do.
The use of Vit D without a deficiency may actually increase bone loss and the use of calcium supplements are no longer recommended.
As you can tell I do a lot of research and sadly what you’ll find is a lack of longitudinal data for most drugs .
I have osteopenia on my last bone density and haven’t had another in 5 years because there is no treatment and I don’t want to lose my jaw or break my femur.
Be very careful the FDA is now staffed by people associated and rewarded by big Pharm. we no longer have consumer protection in this country. Look at EU data as it’s much more rigorous than anything done in the US especially as now as any real scientist has left this sinking ship(FDA) or been driven out.

[MysticOakRanch]

@jeano

Not 100 percent sure but I think the dental issues are more frequent in folks who have poor dental health to start with. I’ve never heard of femurs crumbling but rather possible higher incident of leg fractures due to bones becoming more brittle.

As regards the IV, they will warn you, you might have flu like symptoms that you can treat with Tylenol. I felt like I was coming down with bubonic plague. But only for a day.

My mother had dental issues from biophosphates - and she started out with average dental health. And a friend of a friend (who had no major dental issues to start with) lost ALL her teeth - that is why I’m a bit spooked.

And yes, there are documented side effects of other large bones (most often femur) just disintegrating. Which really scares me - although rare, I seem to be that person that rare things happens to…

Doing research - there are some new drugs (of course, also with side effects) - and will be talking to an endocronologist next week, so starting my list of questions.

I am NOT ready to give up my pony! Not yet… And I’m NOT ready to get an old, slow, lazy horse - that doesn’t appeal to me at all…

I could handle a day of flu-like symptoms once or twice/year! If that was all the side affects, I’m good with that.

@walkers60 , I’ve been reading up on the risks - as I’ve mentioned above. None are labeled as high risk - most seem to be rare, but I’m cautious because of those risks. I am not all that trusting of Big Pharma either - but I also recognize that medicine can make our lives better. So at this point, I’m gathering information to help make an informed decision - AND to see how drastically this is going to change my life…

[Jackie_Cochran]

I have osteoporosis too.

Since I have MS I am not very venturesome riding any more, and I mostly ride at the walk. I will ride Arabs since with a lot of them I can make a deal of I won’t hurt you and you will take care of me (that did work with an pretty explosive Arab gelding.)

I will NOT take the biophosphates. From what I’ve read, on the COTH Forum, is that micro-fractures still happen, and they DO NOT HEAL leading to the thigh fractures. Well ever since I read that it has been a NO, NO, NO to any doctor that tries to put me on them. I see no way that I can ride without getting those pesky little microfractures on my femurs. I started imagining little nightmares of my thigh snapping in the saddle from a sudden move of the horse causing me to grip hard with my legs, and not being able to get off with a broken femur. Plus I read that fractures can take twice as long to heal on the biophosphates and that the bone never heals completely leaving a cyst of unresolved bone tissue. The true kicker was that the biophosphates they prescribe stay in the body for years even if you stop taking them.

Unless there is a million percent guarantee that my hip bones would never break I really cannot see taking the risk. I was almost sucked in, and I am so glad that I read the Forum here. Twice as long for fracture healing means around 3 months, and I would totally loose my ability to walk, maybe forever (MS weakness.) Before I got back in the saddle I had degraded to needing a power wheelchair, but after I started riding again my wheelchair wore out finally and I never had to replace it. If I do not ride I would probably be in a nursing home, a total burden on my family and society.

So when it is cool enough I use a protective vest. I wear pads over my hip joints. I have the Rider Grips on my saddle, the RS-tor riding aid, and Tech Venice safety stirrups, as well as the Trauma Void helmet which helps protect my neck from getting twisted. Nowadays I always ride in silicon full seat breeches to help keep me centered in the saddle. I ride in a ring with deep sand.

OP, I am sorry you got diagnosed so young, that is a true bummer. I was diagnosed with osteopoenia (sp?) in my 40s, and I was diagnosed with full osteoporosis a year or two ago. I just decided I had a new goal in life over all others, to keep riding horses until the day I die.

One of the problems is that the MDs either do not know or do not care (kickbacks?) of these side effects of the biophosphates, and they will unrelentingly terrorize you into taking them.

[Wicky]

My endocrinologist had me do a 24 hour urine for calcium (loss). Turned out that I was excreting calcium. The treatment is a low dose of an old diruetic. This has blocked the calcium excretion and my last two bone densities showed a slight improvement, not the plummeting values of the previous few years.

[Garythesquirrel]

There are some interesting studies on vitamin K2 and its effect on bones and high doses are used as a treatment for osteoporosis in Japan. Here’s a link for one study:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6040265/
10. Conclusion

There is burden of evidence supporting the osteoprotective effects of vitamin K2 in bone metabolisms. Vitamins K2, especially MK-4, promotes bone formation by stimulating the differentiation of the osteoblast, regulating the mineralization of the extracellular matrix, upregulating the expression of the bone marker genes, and inhibiting the osteoclastogenesis. Based on these anabolic properties of vitamin k, it could be suggested that adding vitamin k as an adjunct to the bone materials may stimulate bone cells and their progenitors to produce native bone with promising results.

[MsB]

I am in my mid 70’s and was diagnosed with Osteopenia when in my early 50’s. I still ride but switched from English and jumping to a western broke unicorn about 8 years ago and haven’t looked back. Between us we will total 96 years of age this year.

[Room_for_a_Pony]

I would post a link, but sometimes the forum gets cranky and disapproves.

I urge you to go over to YouTube and search for Dr. James Warson osteoporosis Equicizer. Even just searching for “osteoporosis” and “equicizer” will get you to the short video. I am not trying to sell an Equicizer (although I do have one and it is fabulous).

Dr. Warson is an orthopedic surgeon who also rides and understands what it takes. His video will be very reassuring for you. It turns out that riding is a perfect exercise for osteoporosis and he will explain why.

I did not begin to ride until in my 50s…and prevention of osteoporosis is a tremendous part of why I took it up.

[kande04]

Very good to hear that riding is good for osteoporosis, because it’s about the only exercise I get other than some walking.

[MysticOakRanch]

I talked to an endocronologist, which also gave me some hope - she does recommend the bisphosponates (however you spell it), and we talked about the various options AND the risks. She recommends a drug holiday - to NOT stay on them for too long - 3 to 5 years, then a year off. More recent research shows this to be quite effective in mitigating risk of femur fractures and jaw issues. And of course, we talked about risk - including risk of riding. She was very realistic - she said the goal is to allow me to continue to live a normal life, and just be aware of the risks of certain activities.

So, what I got out of this is - don’t give up my life and passion, and possibly look for a new primary care physician (she didn’t say that, but my PCP has been so non-supportive and non-empathetic).

So that is my latest update - along with a lot of lab tests to make sure nothing else is going on.

Interestingly, she had also had a serious leg break, and reassured me that it can take 2 years to recover, and not to give up hope in that area either. Chronic pain and reduced capacity is pretty common for 2 years in such an injury… I’m one year out - maybe I WILL be able to ride normally in another 6 months to a year.

So I rewarded myself with a new pair of boots:lol::eek: Partly because my stiff boots cause me horrible pain now. Got some soft hunter boots - and they don’t hurt! Zip and lace, so I can loosen them around my ankle.

[jeano]

Glad to hear you got up with someone who has a more nuanced approach. My own PCP has pointed out that increases in risk often sound more horrendous than they are. Something that doubles a miniscule risk means a still very small amount of risk. And there are other factors in play. At this life stage I can reasonably manage my fracture risk by taking my meds and refraining from getting on rank horses.

[appybeads]

I am 55 with PsA and OA, I can’t ride anymore so I now drive. I have One miniature appaloosa (19) and a 4 year old shetland pony. When I was told not to ride anymore or end up in a wheelchair I was like no way am I giving up horses. The ponies saved my bacon! Still involved in them and easier to manage etc.

[MysticOakRanch]

@appybeads

I am 55 with PsA and OA, I can’t ride anymore so I now drive. I have One miniature appaloosa (19) and a 4 year old shetland pony. When I was told not to ride anymore or end up in a wheelchair I was like no way am I giving up horses. The ponies saved my bacon! Still involved in them and easier to manage etc.

Yeah, someone else recommended driving - to be honest, I’m just not up to changing disciplines. I love my Pony (and he’s not a driving candidate), I’ve already had to downsize from several horses and my own ranch to a single pony at a boarding stables, and I’m just not quite ready (both mentally AND financially) to make another change. Plus, the time required - the nearest stables with any kind of driving options is another 20 minutes (each way) away, and for most options, it requires hauling out - I don’t have that ability. I suspect when I have to quit riding, I am going to quit horses totally This is my last horse…

I’ve made the decision to try Reclast - the infusion/injection bisphosphonate. It scares me a bit, but all parts of this scare me. My whole life has been one terrifying downward spiral in the past year…

[Calvincrowe]

I have hypocalcuria (spelling?) and urinate out my calcium as well. I had a terrible time with the old school diuretic that I was prescribed-- constant peeing and in my job (teacher) I just couldn’t to it. Doctor agreed to not have me do it, but take lots of vitamin D instead. I have very low D which has interfered in bone healing during an non-horse related surgery.
I have actually added back bone density and the only spot I’m thinning enough to be concerning is my left hip. It has stabilized over the last 8 years.

My mom and grandma had osteoporosis too, and my doctor and I are going to revisit treatment if my next bone scan is not more positive.