Good habits begin in childhood
With the end of summer heralding the return to school and more consistent family schedules, the AAOS is again offering numerous resources, information, and tips to educate patients, their families, and communities about the importance of nutrition and exercise in building and maintaining bone health.

We as orthopaedic surgeons need to remind patients that the road to building better bones begins in childhood, with a diet rich in calcium and Vitamin D, along with regular physical activity. These habits are the bare minimum necessary to reach optimum bone health and prevent osteoporosis and related injuries during adulthood.

Patients also need to be reminded of the growing obesity epidemic among children that too often is carried into adulthood. Over the past three decades, the number of obese children in the United States has doubled and obesity among adolescents has tripled. Weight gain places abnormal stress on growth plates and can lead to serious orthopaedic conditions such as slipped capital femoral epiphysis (SCFE) and Blount's disease. It is also associated with early arthritis and a greater risk for broken bones.

Spread the word
How can you help encourage daily physical activity in children to maximize strong bone and muscle potential? Post information, tips, and reminders on bone health, exercise, and nutrition in your office waiting room and/or on your social media accounts and websites. Remind your patients and their families about the impact of obesity on bone, joint, and muscle health. Share the following tips with your patients:

• Children should have at least 30 to 60 minutes of physical activity each day.
• Parents should model active behavior. Join children for a bike ride, ball game, or long walk.
• Children's participation on sports teams should be limited. Kids who play on more than one team are at increased risk for overuse injuries.
• Children should never be encouraged to play through pain. Tell them it is important to take a break if they are tired.
• A healthy diet in adolescents is important to maintain strong bones and lower the risk of excessive weight gain.
• Children need sufficient calcium to keep their bones strong. Parents should speak with their family physician about an appropriate diet and vitamin dosing, based on age and body size, for their children.
• Make sure children are evaluated by a physician whenever they have an unexplained limp or bone or joint pain/discomfort.

The AAOS also offers the following resources to encourage parents to get up, get out, and get moving with their children: 

• OrthoInfo.org
• "Vitamin D for Good Bone Health" 
• "The Impact of Childhood Obesity on Bone, Joint and Muscle Health"
• "Healthy Bones at Every Age"  
• "Seniors and Exercise"
• Get Up! Get Out! Get Moving! children's work book
• Public service announcements on obesity and exercise, including "Lazy Bones," "Sedentary," and "Grim"

Alan S. Hilibrand, MD, chairs the AAOS Communications Cabinet.

References:

• http://orthoinfo.aaos.org/topic.cfm?topic=A00567
• http://orthoinfo.aaos.org/topic.cfm?topic=A00679
• http://orthoinfo.aaos.org/topic.cfm?topic=A00127
• http://orthoinfo.aaos.org/topic.cfm?topic=A00380
• http://www.anationinmotion.org/staff-article/get-up-get-out-get-moving-childrens-workbook/
• http://newsroom.aaos.org/PSA/television/