Exercise, sclerostin and bone health what do they have in common?

Exercise is probably one, if not the greatest medicine, we can give our bodies. The benefit list is almost endless and the side effects are minimal to none when done appropriately. This week we will highlight one specific benefit that some new research showing how exercise benefits bone health in pre-menopausal women.

A study that will be coming out in the October issue of Journal of Clinical Endocrinology and Metabolism details some of the specific effects of how exercise improves bone health in pre-menopausal women. Bone, just like your muscles and other tissues in your body, is living tissue and constantly changing. Also just like muscles the more you exercise the stronger and healthier they become. Bone loss is a major concern with pre-menopause and menopause for women, which can lead to osteopenia and osteoporosis. Weakened bones (osteopenia and osteoporosis) can play a role in increasing your fracture risk as you age; they are not the only factor but an important one we need to be aware of. Sclerostin is a known bone growth inhibitor, by its action on a hormone IGF-1 (Insulin-like growth factor 1). Our bodies when working properly have a steady balance of hormones and proteins to assist metabolic pathways to keep our various systems in check and balance between anabolism and catabolism. Anabolism is the process of building up new tissue; while catabolism is the breaking down older tissue. During injuries, illnesses or other body changes such as menopause these systems might not stay as balanced and we can get an increase in catabolism.

The study showed that over an 8 week period those pre-menopausal women that performed in a supervised exercise routine of more than 2 hours per week had "significantly" lower sclerostin levels and higher IGF-1 levels. So even relatively low levels of exercise, normal exercise guidelines of 30 minutes a day 5-6 days per week, was enough to start seeing biological changes in crucial markers in just 2 months’ time to assist with normalizing hormonal controls of bone formation.

So what type of exercise do you need to do? Simple weight bearing exercises (any exercise that you move against gravity) such as walking and weight lifting. Things like swimming and bike riding; while great exercises for your cardiovascular system are not weight bearing exercises so will not help as much to build your bones.

So the research shows that exercise is an important part of long term bone health, but don’t forget some of the other things you can do for a complete program. Make sure you have a good diet rich in calcium and Vitamin D along with avoiding lifestyle choices such as smoking and excessive alcohol intake.

Ergonomics

Ergonomics is defined as: the applied science of equipment design, as for the workplace, intended to maximize productivity by reducing operator fatigue and discomfort. It is interesting how posture, lifting techniques and body mechanics have often times drifted into ergonomic analysis. There have actually been a fairly large number of research articles that point out there is no causality relationship between awkward postures in the work place to pain or injury and that training on lifting techniques and body mechanics have no reduction on injuries or pain in the work place. So if ergonomics is truly about applying science, then we need to get rid of old dogma and established beliefs about posture and body mechanics that have not held up to the rigors of science and study.

How can that be you might ask? You mean I won’t get pain in my neck or hands if I sit at the computer with poor posture, and that if I lift with poor body mechanics that I won’t injure my back? No, what the research/science is telling us is that for the entire population of people those that use proper posture and body mechanics have just as much risk for injury or pain as those that don’t. This is in part because the entire population of people has large variability (tall/short, thin/wide, strong/weak, etc.) we cannot predict what "proper" posture or body mechanics are for any one specific individual and thus relate that to a direct cause of their pain or injury. There are lots of variables that come into play with injury or pain and picking out just posture or body mechanics is rather useless in preventing pain or injury.

So what should you do when it comes to posture and lifting techniques when it comes to the ergonomics of your job? Do I need good posture or not? Do I need to lift with good body mechanics or not? Dr. Nortin Hadler, an expert in work related musculoskeletal disorders and author of many research articles and books including Occupational Musculoskeletal Disorders puts it best:

“Work should be comfortable when you are well and accommodating when you are ill.”

Basically the posture or lifting mechanics you choose to do your job should be comfortable to you. If they are not then you need to adjust and accommodate to a new position that you find comfortable. If good posture and body mechanics feels comfortable, use it. But if it is uncomfortable, accommodate to something different. If what some call poor posture or body mechanics feels comfortable to you, use it. But if it starts to be uncomfortable, accommodate to something different.

We have all seen the posters and info on “proper” lifting or sitting posture, which can work for many and probably a good starting point if you don’t know how to set up a work station. But remember even if those “proper” positions feel uncomfortable or awkward to you; then change them to a new more comfortable less awkward position for you. If your work station is comfortable, even if you have what some might consider poor posture or body mechanics, don’t worry about. That set up is right for you, even though it might not be right for someone else. But realize also, what feels right today, may not be right tomorrow and if something becomes uncomfortable then change to a new position.