It’s official: I let go of my beloved roller skates. I quit skating over a year ago, but letting go of the skates themselves was hard. The other day, while standing in my driveway, I was holding my skates in my hands, debating what to do with them, when a man walked by my home. He looked at me and said, “are you going to throw those out?” Up to that point, I hadn't been able to bring myself to get rid of them, although they were in pretty bad shape after 25 years of street skating. I responded, “why? What would you do with them?” He said, “I will repurpose them and use the wheels to make something else.” I love Berkeley!
So, with that, I handed him my skates. Honestly, as I'm writing these words tears are rolling down my face. My history with skating is a long one. I started when I was four years old. My first pair of skates was the kind that attached to my shoes with a key to tighten the grip. There was a painful learning curve – lots of scrapped knees and bruises. When I was about five years old, I fell so hard on my rear that my tailbone was significantly bruised. I wanted to continue, so, my mother tied a pillow to my butt, just in case I fell again.
Growing up I was part of a pack of neighborhood kids that would gather and we’d play roller derby on a circular, cement track in a friends yard. When we were street skating we built ramps to jump over, or we would tow each other with bikes, screaming down the street. I absolutely loved the feeling of skating and skating fast: forward, backward and spinning.
In my early teens my ambition was to join the rough and tumble roller derby with my favorite women skaters of the day: Ann Calvello and Joan Weston. These women were tough, and the games were exciting. Fights would break out during every game—high drama and theatrics. Thankfully, I never joined a roller derby team, where I undoubtedly would have sustained multiple injuries that would have plagued me later in life.
In my late teens I stopped skating; then, in my early 30’s, I ran across a pair of roller skates at the Berkeley flea market. From that point, until the age of 63, I skated all around Berkeley. I knew every smooth street in town. When my son was in grade school he would ride his bike to school and I would skate next to him and let him tow me – what exhilarating fun that was.
When I was 60, I made a video of me skating and, in the same clip, diving for a Frisbee. I took a lot of flak for that video because I wasn't wearing knee pads or a helmet while I was filmed flying down a steep hill. While it is true that the skating was reckless and now something I don’t recommend, I was really trying to make a point: not everyone with a diagnosis of osteoporosis is fragile. I was then, and still am, physically strong and I have very good balance.
Fortunately I have never sustained a fracture. So was it just luck that I hadn’t sustained a fracture as some of my bone specialist colleagues suggest? After all, even though I am good on skates, I did take at least one hard fall each year on cement, and still I did not fracture. Some of that was probably luck. But, whatever role luck played, I had to accept an important truth about my bones and the aging process: even if my bone density stays the same, at borderline osteoporosis, the older I get, the more fragile my bones become. However, I also know that I can minimize that decline, to some extent, with a bone healthy nutrition and exercise program. I can also lower my fracture risk by reducing my chance of falling through maintaining good balance, muscle strength and picking my sporting activities wisely.
When patients tell me that they fractured a bone, I always question them carefully about how they sustained their fracture. Did they fracture with significant impact or was it a tumble on the grass? Make no mistake, sustaining a fracture, especially low trauma fractures, can point to an underlying bone problem such as osteoporosis. On the other hand, fracturing a bone following a significant accident does not necessarily mean that your bones are fragile.
Many people who have either sustained fractures, or have osteoporosis, ask me for advice regarding whether or not they should continue a particular sport or activity. What I advise is to think carefully about the sports and physical activities that you participate in. For instance, if you are a downhill skier, even if you have been one all your life and if you have significant osteoporosis, I would strongly recommend that you consider stopping this sport, especially if you have sustained a low trauma fracture. Similarly if you are a gardener used to climbing up latters to prune trees you may want to hire someone for the more risky jobs. I know that each of us has to make our own decision about what risks we are willing to take. Sometimes, a little compromise is all that’s needed to reduce your risk of falling.
The important thing to know is this: Understand your individual fracture risk, and decide whether or not those risks are worth taking. When I was younger, I was willing to risk more. Now, the idea of being sidelined with a hip fracture is very unappealing. So today I hike, bike and I'm going to go back to playing tennis. I'm not going to dive for those balls anymore, but I still intend to be a worthy opponent.
My new book, Dr. Lani’s No-Nonsense Bone Health Guide, is devoted to teaching you how to assess your individual fracture risk, how to reduce that risk through diet and exercise, and how to improve your overall bone health, starting with a good understanding of what’s involved.
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