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The bone-thinning disease that affects so many in their older years may be helped by ensuring one is actually putting weight through the bones while standing or sitting.

Before I get into this topic, I want to let you know that I have created a
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We have probably all seen photos of what the inside of bone looks like – kind of like honeycomb with lots of tiny holes. This keeps bone light and strong, with the boney web lining itself up according to the forces put through the bone. In someone with osteoporosis the holes in the web of bone become bigger, and the bone that forms the web becomes thinner making the bone more prone to fracture.

In the upper spine where fractures are common, a vertebrae may simply crush through the weakest area of the bone web, usually changing the shape of the vertebrae to a wedge forcing more roundness in the upper back and the head to come forward. Unfortunately, when one vertebrae is crushed, it makes the others more prone due to the change in forces going through the area. These vertebrae fractures can be excruciatingly painful. The other common fracture sites are the neck of the femur (the long bone in our thigh at the top close to where it attaches to the pelvis) and the wrist.

Mechanical stress going through the bones helps the boney matrix create bone to counteract those stresses, which is why “weight-bearing exercise” is strongly suggested to keep bones strong. Exercise aside, I have noticed that many people’s natural standing posture does not actually put much weight through the bones. The pelvis is often shifted forward, the ribcage is tilted back, and the head is forward. When I stand behind a person standing this way and push slowly but forcefully down both shoulders, the body tends to buckle sending the pelvis even further forward and the ribs further back. This suggests that the weight is going through the soft tissue rather than through the bones. Maybe the first step to maintaining and building bone mass is to make sure one is standing in a way that actually loads the bones!

The goal is to stack the bricks by trying to become as tall as possible, reaching the base of the skull up. Most people will need to bring their pelvis back to find their full height, which will in turn straighten ribcage. The pelvis should be directly over the legs in such a way that the thigh and buttock muscles are not contracting. You know you've got it right when there is no buckling in the body when someone pushes slowly but forcefully down on the shoulders. I find I can actually feel the pressure going through the bones when this is done to me.

This concept is important in sitting as well. We often tend to sit behind our sit bones instead of on them, which rounds our back so the weight of our trunk and head is no longer going through the ideal load-bearing parts of the spine. So, sit tall on your sit-bones so that there is a little arch in the low back, and figure out where to keep your ribcage so that when someone pushes on your shoulders nothing buckles in the trunk. You can even have someone push slowly yet with some force on the top of your head to see if your neck is lined up correctly. Nothing should buckle anywhere if the forces are being carried by the bones instead of the soft tissue.

Because we spend the majority of our day sitting, standing and walking, it makes sense to ensure that we are loading our bones while doing these activities. Weight training in the gym will be that much more effective if one starts from a place of good posture. And spending some time regularly on all 4s can help load the arm bones in order to prevent wrist fractures.

As for the belief that calcium supplementation is the key for preventing or reversing osteoporosis, Charles Poliquin had a good analogy in his article on the topic, where he suggested that when building a building, one can keep supplying 2 by 4s to the building site, but unless you also supply all the other stuff needed to build the building including the workers to put it together, those 2 by 4s will remain on the ground. They don't magically turn into a building. We need a functioning endocrine system (the workers) to get the calcium into the bones. A dysfunctional endocrine system is probably the most important cause of osteoporosis, and is most frequently completely overlooked. I wrote about it in more detail in my other post on osteoporosis.

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