Stressed out? You may be at higher risk for a bone injury

Last updated: 09-30-2020

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Stressed out? You may be at higher risk for a bone injury

The connection between low bone mineral density (BMD) and increased injury risk from stress fractures are well established. Although there are tactics that help keep bones healthy—weight-bearing exercise like running is one—recent research suggests stress could be thwarting some of those efforts.

In a study published in the Journal of Clinical Investigation, researchers looked at the connection between stress caused by isolation and the concentration in the blood of norepinephrine, a neurotransmitter and hormone that’s part of the body’s stress response and plays a role in heart rate and blood pressure.

When norepinephrine stays elevated, it decreases osteogenic markers—the natural compounds in your system affecting bone tissue development, such as collagen—and that can lead to reduced bone formation, the researchers noted.

Drawing on research from mouse models, they looked at data on people put into an isolated habitat that mimicked a space station, and found that as anxiety became elevated, bone density started decreasing.

A takeaway here is that taking measures to reduce the amount of stress in your daily life can bring about better bone health, in addition to all the other benefits of lower stress like emotional resiliency, improved cardiovascular and cognitive function, and stronger immunity.

There are plenty of ways to take stress levels down, but with this recent study in mind, perhaps the best is to focus first on sleep quality. That’s because norepinephrine plays a significant role in the sleep-wake cycle, and getting more sleep can help regulate that hormone as well as others, such as cortisol and melatonin that all work together to keep you on track. (For reference, adults should get seven to nine hours of sleep per night, according to the Mayo Clinic.)

'Our internal clocks, and keeping them set properly, affects more than how well we sleep,' Madelyn Rosenthal, M.D., sleep medicine expert at The Ohio State University’s Wexner Medical Center, toldRunner’s World. 'It can have an effect on digestion, mood, exercise performance, and other factors.'

All of that becomes a ripple effect, she adds. For example, running and other exercise has been shown to be a major stress buster, and the same is true with gut health. Sleep can improve both of those, Rosenthal says, and that becomes a loop—as you boost exercise and digestion, you sleep better, which helps you have more energy for your next run and improves gut function. And along the way, you’ll build stronger bones and reduce injury risk.

'The de-stress benefits of a good sleep schedule can’t be overstated,' says Rosenthal. 'If you need a starting point for feeling better physically and mentally, start there.'

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