Skip to main content

[@PeterAttiaMD] What Happens to Bones When You Stop Moving | Peter Attia AMA 37

· 4 min read
[@PeterAttiaMD] Summarizer
Video Bot

@PeterAttiaMD - "What Happens to Bones When You Stop Moving | Peter Attia AMA 37"

Link: https://youtu.be/arub7Rhn3tY

Short Summary​

Number One Action Item/Takeaway:

Even during periods of necessary immobility (bed rest, paralysis, etc.), it's crucial to find ways to actively load muscles, even isometrically or in unaffected areas of the body, to mitigate bone loss.

Executive Summary:

Disuse osteopenia, accelerated bone loss due to lack of weight-bearing, is a serious concern during immobility. While bisphosphonates show promise in animal studies, the key action is to actively engage and load muscles wherever possible, through physical therapy or isometric exercises, to help minimize bone density decline during periods of inactivity.

Key Quotes​

Okay, here are four quotes extracted from the transcript that I found to be valuable or interesting:

  1. "Disuse osteopenia occurs when bones are chronically unloaded leading to a very unfavorable combination of high bone uh resorption and low bone formation. So it's the same thing that's happening with the osteopenia from aging. It's just much more accelerated and much more extreme."

  2. "...bone loss due to you know disuse osteopenia is incremental and it's progressive with time and it occurs more rapidly as you would guess in the tracular bone than in the cortical bone...it can be about 2% per month in microgravity partial paralysis...and in the most extreme setting with complete paralysis it can be up to 7% per month."

  3. "If let's say you're bedridden with a certain injury, there are still other muscles in your body that don't pertain to that injury that can still be moved and put under load. And even if you're doing these things isomemmetrically, right? So a person is holding you and you're resisting against them without actually moving in the bed. That's important."

  4. "How many times have we talked about that study where um you know a group of 65 year olds I believe were immobilized for 2 weeks and lost if I'm not mistaken something of the neighborhood of about four pounds of lean mass in two weeks. And that, you know, we talked about that through the lens of how much you lose lean mass, but think about what that's doing to to BMD. And think about how long people are immobilized beyond 2 weeks, um, especially as they're older."

Detailed Summary​

Here's a detailed summary of the YouTube video transcript, focusing on the key points and excluding advertisements:

  • Disuse Osteopenia Explained:

    • Disuse osteopenia occurs when bones are chronically unloaded, leading to increased bone resorption and decreased bone formation.
    • It's similar to age-related osteopenia, but much faster and more extreme.
    • Space travel is the most extreme example of this.

  • Relevance for General Population:

    • Bed rest is a common scenario where disuse osteopenia becomes relevant.
    • Examples include pregnant women (with fetal growth retardation) and individuals recovering from injuries.
    • Prolonged bed rest is detrimental and should be avoided when possible.

  • Bone Loss Progression:

    • Bone loss due to disuse osteopenia is incremental and progressive.
    • Trabecular bone is affected more rapidly than cortical bone.
    • Bone loss rates vary: 2% per month in microgravity or partial paralysis and up to 7% per month in complete paralysis.

  • Potential Interventions:

    • Any form of physical therapy (PT) that actively loads muscles can help.
    • Cyclic Blood Flow Restriction (BFR) could be beneficial to stress muscles, even during immobilization (careful consideration is needed and medical advice sought if there are injuries that this could affect).
    • Isometric exercises (resisting against pressure without movement) can be performed even when bedridden to stimulate muscles.
    • Moving muscles not related to the injury is also benificial.

  • Mouse Study on Botulinum Toxin and Bisphosphonates:

    • A study using mice paralyzed with botulinum toxin showed that bisphosphonates (which inhibit bone resorption) could prevent bone loss.
    • The mice treated with botulinum toxin and bisphosphonates had similar bone density to the control group.
    • This research is considered interesting but may not be directly applicable to humans.

  • Immobility in Aging:

    • Immobility is a significant problem, especially in the aging population.
    • A study showed that 65-year-olds immobilized for two weeks lost a significant amount of lean mass.
    • This lean mass loss negatively impacts bone mineral density (BMD).
    • The duration of immobility is often longer than two weeks, making the issue even more serious in older adults.