Healthy bones and joints are essential for growing, moving and staying active. Our bones support the body, protect our organs and store important minerals such as calcium. They also work with muscles and tendons, helping us move. For young people with CP, changes in mobility, muscle use and nutrition can affect how bones develop. This can lead to lower bone density, which makes fractures more likely.

Australian research has shown that several therapies can help improve bone strength in children and teenagers with CP. Supporting bone health early can make a real difference to physical independence as a young person moves towards adulthood. 

Puberty is a key time for building bone mass. Around a quarter of total bone mass is gained during adolescence, so young people with CP need the right support during these years. Achieving good bone growth can be difficult for a number of reasons, including:

•    limited weight-bearing
•    feeding difficulties 
•    hormonal changes 
•    medication side effects

However, there are effective ways to manage these issues.

Weight-bearing programme
Our bones need regular loading to stay strong. Because CP can affect mobility and make it harder to use leg muscles, bones and joints may weaken over time. A physiotherapist can assess your physical ability and create a weight-bearing exercise programme to strengthen muscles and improve joint movement. This may include the use of aids such as a standing frame.

Nutrition for bone health
Nutrition plays an important role in bone development. If feeding difficulties make it challenging to get enough nutrients, focusing on vitamin D and calcium can help. Foods rich in vitamin D include fatty fish, egg yolks and mushrooms. Milk, yoghurt, cheese, leafy greens and tofu provide good amounts of calcium. Most people also get much of their vitamin D from exposure to sunlight.
If needed, your doctor can refer you to a dietitian who can review your nutritional intake and develop a feeding plan that supports your bone health.

Hormonal changes
Hormone levels rise before and during puberty, and this helps drive bone formation. It is important that your healthcare team monitors your hormone levels to make sure they are supporting healthy growth. Some young people with CP may benefit from treatments such as growth hormone, which has been shown to improve bone mineral density.

Medication effects
Some medications can affect bone density. It is worth discussing your current medicines with your doctor to check they may be having an impact. In some cases, treatments such as bisphosphonates can help slow bone loss, although they are not suitable for everyone and depend on age.

Bone scans
A bone scan, often called a DEXA (dual-energy X-ray absorptiometry) scan, is a simple and painless test that measures bone density. It helps identify whether bones are developing as expected or whether additional support is needed. For young people with CP, regular bone scans can be especially helpful because changes in mobility, nutrition and growth may increase the risk of low bone mass. The scan results guide your healthcare team in planning treatments, monitoring progress and preventing fractures as you grow.