Strong Advice

Sit up straight. Drink your milk. Go outside and play. The same advice we give to children is equally applicable to adult orthopedic health. The language may be a bit more technical, but good posture, proper nutrition and the right approach to exercise can keep bones strong, joints limber, and the entire body more healthy and pain-free.

In fact, our bones and joints would have a lot to say, if we took the time to listen. Here’s what they’d want us to know to keep them in tiptop shape.


“This is something that we can do in our everyday lives to prevent developing back pain,” says Patrick Sonser, MD, interventional spine specialist and medical director of Parrish Medical Center’s rehabilitation medicine department. “However, when we let our stomachs sag and slouch forward, this can put a lot of pulling strain on the spine.” Imagine the spine as a stack of interconnected blocks. If one of the lower blocks gets pulled out of place, Dr. Sonser says, “you lose that good foundation, and it can start causing you pain somewhere along the chain.” Focus on keeping your abdominal muscles taut (which holds the stomach in), and keep a slight inner curve to the lower back.

Slouching is another issue. It turns the back into one big C curve and can put strain on the lower spine and neck. “If we sit in a slouched position, it’s like standing and walking with the waist bent about 90 degrees forward,” Dr. Sonser says. “If you walked around like that all day, don’t you think it could cause you to have some back pain?”


Bone strength is like a retirement plan: The earlier you start saving, the more benefits you’ll have when you really need them. “Think of the concept of a ‘bone bank’—one that we have to pay forward,” says sports medicine specialist Anthony Allotta, DO. Adults begin a gradual decline in bone strength after their mid-20s, and women get a “double hit” during menopause, Dr. Allotta adds. Regularly consuming foods or supplements that are high in calcium can slow the rate at which the mineral is leached from bones. In general, aim for at least 1,000 milligrams of calcium a day, Dr. Allotta says. Pregnant or lactating women and those 40 and older should get 1,200 to 1,300 milligrams.

And don’t forget the vitamin D. Without sufficient amounts of this vitamin—up to 1,000 international units daily—“you won’t absorb the calcium,” Dr. Allotta says.


“Americans tend to use bones, joints and muscles in the same direction repetitively,” Dr. Allotta explains. We sit at a desk at the office, and to relax after a long day at work we … plop down in front of a computer or TV screen.

Tennis elbow is usually caused by repetitive overuse of the wrist muscles, which attach at the elbow, Dr. Allotta says. This is why tennis elbow also strikes golfers, keyboard users, auto mechanics and people who engage in leisure activities such as gardening and bowling. Give those muscles a stretch by using your other hand to press your wrist all the way back, then all the way down, a few times a day. Or extend your arms outward and then turn your palms to face the ceiling.

As for the rest of the body, find hobbies or leisure activities such as dance or yoga that challenge and use muscles in different ways. At the health club, bypass the weight machines that limit direction of movement, and try free weights instead.


When you perform weight-bearing exercise, your body says, “I need to make my bones bigger and stronger to support that.”

“You don’t need to be bench-pressing 500 pounds,” Dr. Allotta says. “Light resistance weights, resistance bands, even walking counts as weight-bearing exercise.” (Swimming, however, does not, because the water buoys your body weight.) Even 20 minutes a day, three times a week, will have an impact.

“By doing so, we’re telling our bodies, ‘Be active, let’s maintain this bone bank, so we don’t start to lose any of it,’ ” Dr. Allotta continues. Stronger bones and muscles mean less stress and strain on your joints and less chance of a devastating injury such as a hip fracture.


Podiatry specialist Jonathan Lubitz, DPM, advises people to make sure they’re wearing shoes that match their activity. The wrong footwear can lead to arch pain, heel pain, shin splints and arthritis between joints. A running shoe, for example, has more cushion in the heel for shock absorption and is designed to propel you forward. A walking shoe is designed with a stiffer sole, which if worn for running could overwork the muscles and cause injury or strain. Feet swell throughout the day, so for the best fit, shop for shoes in the late afternoon or evening. To be sure you get the right shoe, Dr. Lubitz suggests discussing your activities with the shoe salesperson. 

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Parrish Medical Center’s physical and occupational rehabilitation team designs, implements and manages a care plan with you and your primary care physician to maximize the success of your recovery from an injury or a musculoskeletal problem.