Un hueso es el resultado del trabajo conjunto de diferentes tejidos: hueso (o tejido óseo), cartílago, tejido conectivo denso, epitelio, tejido adiposo y tejido nervioso. Por tal motivo, se considera que cada
hueso es un órgano.
El tejido óseo es un tejido vivo complejo y dinámico que experimenta un proceso continuo llamado
remodelación (formación de tejido óseo nuevo y destrucción simultánea del hueso precedente). Todo el armazón de huesos con sus cartílagos, así como con los ligamentos y los tendones, constituye el sistema esquelético.
Veremos brevemente los componentes, formación de los huesos, y como la actividad física influye en su densidad y resistencia.
Funciones del hueso y sistema esquelético
![Mapa conceptual y breve resumen del sistema esquelético](http://vultur.com.ar/wp-content/uploads/2023/05/Mapa-conceptual-sistema-esqueletico.webp)
El tejido óseo constituye aproximadamente el 18% del peso corporal y desempeña seis funciones básicas:
1. Sostén. El esqueleto es la estructura del organismo que da sostén a los tejidos blandos y brinda los puntos de inserción para los tendones de la mayoría de los músculos esqueléticos.
2. Protección. El esqueleto protege de lesiones a los órganos internos más importantes. Por ejemplo, los huesos del cráneo protegen el cerebro; las vértebras, la médula espinal y la caja torácica, el corazón y los pulmones.
3. Asistencia en el movimiento. La mayoría de los músculos esqueléticos se fijan a los huesos; cuando se contraen, traccionan de ellos para producir el movimiento.
4. Homeostasis mineral (almacenamiento y liberación). El tejido óseo almacena diversos minerales, especialmente calcio y fósforo, lo que contribuye a la resistencia del hueso. Según los requerimientos, el hueso libera minerales a la circulación para mantener el equilibrio de algunos componentes esenciales de la sangre (homeostasis) y para distribuir esos minerales en otros sectores del organismo.
5. Producción de células sanguíneas. Dentro de algunos huesos, un tejido conectivo denominado médula ósea roja produce glóbulos rojos, glóbulos blancos y plaquetas. Este proceso se denomina
hemopoyesis (hemo- de háima, sangre, y -poiesis, formación). La médula ósea roja consta de células sanguíneas en desarrollo, adipocitos, fibroblastos y macrófagos, que están inmersos en un tejido de sostén (estroma) formado por fibras reticulares. Se encuentra en los huesos fetales en desarrollo y en algunos huesos del adulto, como la pelvis, las costillas, el esternón, las vértebras, el cráneo y los extremos proximales de los huesos largos del brazo (húmero) y del muslo (fémur). En el recién nacido, toda la médula ósea es roja y participa de la hemopoyesis. Con el paso del tiempo, gran parte de la médula ósea roja se convierte en médula ósea amarilla.
6. Almacenamiento de triglicéridos. La médula ósea amarilla está constituida principalmente por adipocitos, en los que se almacenan triglicéridos. Dichos adipocitos constituyen una posible fuente de
energía química.
Factores que afectan el crecimiento y la
remodelación óseos
![Principales factores hormonales reguladores de la densidad mineral ósea. GH: hormona de crecimiento; IGF-1: factor de crecimiento insulínico tipo 1; PTH: parathormona; T3: triyodotironina.](http://vultur.com.ar/wp-content/uploads/2023/05/292-Imagen-5841-1-17-20220825.png)
El metabolismo óseo normal (crecimiento de los jóvenes y remodelación ósea de los adultos) depende de una serie de factores, entre los que se incluye el consumo adecuado de minerales y vitaminas, y también los niveles suficientes de diversas hormonas.
1. Minerales. Durante el período de crecimiento de los huesos, se necesitan grandes cantidades de calcio y de fósforo y, en menor proporción, magnesio, flúor y manganeso. Estos minerales también
son necesarios para la remodelación ósea.
2. Vitaminas. La vitamina A estimula la actividad de los osteoblastos. La vitamina C es necesaria para la síntesis de colágeno, principal proteína del hueso. La vitamina D participa en la formación ósea, al estimular la absorción sanguínea del calcio de la dieta en el tracto gastrointestinal. Las vitaminas K y B12 también se requieren para la síntesis de las proteínas del hueso.
3. Hormonas. Durante la infancia, las hormonas más importantes para el crecimiento del hueso son los factores de crecimiento tipo insulina (IGF, por su sigla en inglés), producidos por el hígado y el tejido óseo. Los IGF estimulan a los osteoblastos (células del hueso encargadas de sintetizar la matriz ósea), promueven la división celular en la placa epifisaria, en el periostio y estimulan la síntesis de las proteínas que se necesitan para formar hueso nuevo.
Los IGF se producen en respuesta a la secreción de la hormona de crecimiento (GH, por su sigla en inglés) en el lóbulo anterior de la glándula hipófisis. Las hormonas tiroideas (T3 y T4), secretadas por la glándula tiroides, promueven el crecimiento óseo por medio de la estimulación de los osteoblastos. Además, la insulina pancreática (hormona producida por el páncreas encargada de regular la glucosa en sangre) promueve el crecimiento óseo mediante el incremento de la síntesis de proteínas óseas.
Actividad física y el tejido óseo
![El ejercicio físico mejora el tejido óseo.](http://vultur.com.ar/wp-content/uploads/2023/05/tercera-edad.jpg)
Dentro de ciertos límites, el tejido óseo tiene la capacidad de ganar o perder consistencia, en respuesta a variaciones de la tensión mecánica que soporta. Cuando se lo somete a tensión, el tejido óseo se fortalece debido al aumento del depósito de sales minerales y de la producción osteoblástica de fibras colágenas. Sin tensión mecánica, el hueso no se remodela normalmente, puesto que la velocidad de resorción ósea excede la de formación de hueso. Está demostrado que la tensión intermitente de alto impacto tiene mayor influencia sobre el hueso que la tensión constante de bajo impacto. Es decir, correr y saltar estimula el crecimiento óseo en forma mucho más contundente que
caminar.
Las principales tensiones mecánicas que soporta el hueso son las consecutivas a la tracción de los músculos esqueléticos y a la tracción de la gravedad. Si una persona guarda reposo en cama o está enyesada por una fractura, el hueso no soporta tensiones y, por lo tanto, se debilita a causa de la pérdida de minerales óseos y de la disminución de fibras colágenas. Los astronautas, sometidos a la microgravedad del espacio, también pierden masa ósea. En cualquiera de estos casos, la
pérdida de hueso puede ser extraordinaria: tanto como el 1% por semana. Por el contrario, el hueso de los deportistas, que está sometido a tensiones altas y repetitivas, se consolida y se fortalece notablemente en comparación con el de los astronautas y el de los individuos sedentarios. Las actividades que implican cargar peso, como caminar o levantar pesas con moderación, contribuyen a la formación y retención de masa ósea.
Los adolescentes y los adultos jóvenes deben realizar actividad física regular que implique carga del propio peso antes del cierre de las placas epifisarias (en el caso de las niñas, esto suele ocurrir cuando tienen entre 13 y 15 años; en los niños, cuando tienen entre 15 y 17 años), como estímulo para la formación de masa ósea y antes de la reducción que inevitablemente sobreviene con la edad. En realidad, personas de todas las edades pueden y deben fortalecer sus huesos mediante cualquier tipo de actividad física que implique carga del propio peso o peso extra.
Los estudios avalan que ejercicio físico con cargas progresivas a largo plazo tiene efectos benéficos demostrados para la salud ósea, en especial, para disminuir el riesgo de fracturas en personas mayores.
Solicitaciones mecánicas en el hueso que estimulan su crecimiento
![El Deporte Favorece El Crecimiento Óseo En Los Niños](http://vultur.com.ar/wp-content/uploads/2023/05/Banco-sueco-5-e1684173474423.jpg)
Cuando practicamos deporte se producen una serie de solicitaciones mecánicas en el hueso que estimulan su crecimiento. Esta solicitaciones pueden ser por flexión, comprensión, tracción, cizallamiento o torsión, tal como se ve en la imagen destacada. Las áreas del hueso que soportan mayores solicitaciones presentan mayor densidad ósea. La intensidad y duración de la carga de entrenamiento deportivo puede ser relevante para estimular la osificación. Pero si estas cargas son muy elevadas en la infancia o niñez pueden inhibir el proceso normal de crecimiento. Es decir, la adaptación a las solicitaciones mecánicas es ideal para favorecer la osificación, pero si el hueso no logra adaptarse a las solicitaciones más exigentes o no se produce un descanso adecuado puede afectar al proceso de osificación.
La formación ósea es un ciclo constante donde diferentes células, osteocitos-osteoblastos y osteclastos permanecen en continuo estado de cambio favoreciendo el mantenimiento o remodelación de la masa ósea. Cuando somos pequeños predomina la actividad de osteocitos y osteoblastos frente a la de osteoclastos, invirtiéndose este proceso conforme avanzamos en edad. El ejercicio físico puede favorecer el retraso de la pérdida de la actividad de los osteocitos y osteoblastos. Cada año se renueva apropiadamente un 10% del tejido óseo, un proceso imprescindible para mantener las funciones normales del sistema esquelético.
Conclusiones
![TEJIDO ÓSEO Y DEPORTE](http://vultur.com.ar/wp-content/uploads/2023/05/TEJIDO-OSEO-COMPACTO-819x1024-1.png)
Los efectos principales del envejecimiento sobre el tejido óseo son: la pérdida de la masa ósea y la fragilidad. La pérdida de masa ósea es consecuencia de la desmineralización; es decir, de la pérdida
de calcio y demás minerales de la matriz osteoide.
Entre las mujeres, en general, esta pérdida comienza después de los 30 años, se acelera en gran medida alrededor de los 45 –cuando disminuyen los niveles de estrógenos– y continúa hasta perderse hasta el 30% del calcio óseo, alrededor de los 70 años. Una vez que las mujeres comienzan a perder hueso, cada 10 años se pierde aproximadamente el 8% de la masa ósea.
Entre los varones, en general, la pérdida de calcio no se inicia antes de los 60 años, y cada 10 años se pierde alrededor del 3%. La pérdida de calcio óseo es uno de los problemas asociados con la osteoporosis (es una enfermedad que se caracteriza por una disminución de la densidad de los huesos a causa de la pérdida del tejido óseo normal).
Para disminuir y prevenir la pérdida excesiva de tejido óseo es fundamental la práctica de ejercicio físico, centrada en la postura, el equilibrio, la caminata o trote, coordinación, estabilización de cadera y tronco, y lo más importante la contracción muscular estructurada y progresiva. Para esto es fundamental encontrar un tipo de ejercicio que te guste realizar para poder hacerlo a largo plazo. Gracias por llegar hasta aquí y leer!
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