Bones for Life Pilot Study – Movement Intelligence

Summary of Bones for Life Pilot Study

Bones for Life: A Study of its Bone Health Benefits from a Fascial Perspective
Gray, S.; Souza, F.; Macetti, G.; Freitas, E.A. (2024)

Objectives

To study the benefits derived from the practice of Bones for Life®
To assess how and how much regular practice of Bones for Life® could help to improve bone health or slow bone loss
To evaluate the impact on study participants’ perceptions of physical and overall well-being after incorporating the method into daily life
To investigate links between the fascial system and bone health benefits from the practice of Bones for Life®

Structure

Two groups of women volunteers, predominantly postmenopausal, in Brazil and England were instructed in and regularly practised Bones for Life over fourteen months. Six Brazilian participants undertook bone density tests on the lumbar region, femoral heads and femur at the start and end of the research time-window, providing a limited set of quantitative data. All participants also provided qualitative assessments of associated changes in their perceived physical and overall well-being. The study reviewed a number of related scientific studies, that support the hypothesis of a connection between fascial health and bone health. The fascial perspective contributes to an enriched analysis of how Bones for Life benefits both bone health and general well-being.

This summary briefly describes the Bones for Life method, the programme undertaken and the findings regarding quantitative and qualitative benefits. A longer, technical discussion from a fascial perspective comes at the end of this summary.

The full text of the study is available here. Further related information can be found on websites posted by the Foundation for Movement Intelligence at:
https://movementintelligence.org/bones-for-life/ and Movement Intelligence UK at:
https://movementintelligence.co.uk

Introduction

This study describes the Bones for Life method and the findings of a programme which explored the benefits deriving from its practice. The study also provides some background on osteoporosis, and presents a small sample of quantitative results along with a set of more extensive qualitative findings. A review of related studies and literature, particularly with particular regard to fascia, indicates how the movements proposed by Ruthy Alon’s Bones for Life method can benefit bone tissue health. This introductory section addresses the process of bone tissue remodelling at the cellular level and the metabolism of osteogenic cells.

Findings

The quantitative tests on six volunteers showed bone density gains among several of them, and better outcomes for most of them, compared with the progressive degeneration expected due to ageing and hormonal changes in postmenopausal women. Positive results were mainly observed in the lumbar region, where five volunteers showed some improvement in bone mineral density, while two volunteers showed improvement in the femoral neck. This limited observation set provides some encouragement for further research.

The qualitative aspect of the study identified some of the main benefits, including developing more refined body awareness and improved postural alignment. Participants also noted better coordination, reduced pain, better quality of sleep, increased circulatory efficiency, and an improved sense of confidence and well-being.

The discussion part explores plausible explanations for how Bones for Life benefits bone health, drawing from studies on fascia. Firstly, the specialized parts of fascia that cover and penetrate the bones (periosteum and endosteum), are responsible for nourishing bone tissue and supplying new osteogenic cells, essential for bone growth and repair. A number of processes (or lessons) in the Bones for Life method effectively benefit fascial tissue health and stimulate the production of collagen by specialized cells in this tissue. Collagen is a fundamental element that provides flexibility and resistance to the skeleton, and both enables the perception of body movements by osteogenic cells and stimulates bone remodeling.

Cyclical, multidirectional, and low-intensity stretching, found in various processes of the method, have a positive effect in this regard. Percussive processes that are also integral to Bones for Life provide important impact stimuli to osteogenic cells. Processes that involve visualisation and relaxation serve to activate the parasympathetic nervous system, which in turn is linked to bone formation. Improved body awareness, and refined attention to postural alignment and movement are strongly emphasized by Alon throughout her programme, underpinning movement safety and transmitting impact and movement stimuli efficiently through the bones.

Many benefits derive from the re-education of movement in Bones for Life, which encourages students to be more conscious, safe, and efficient. For individuals who are sedentary – whether due to pain, insecurity, fear of falling, motor coordination, or weakness – Bones for Life can promote bone health by introducing movement that respects the limits of each body while cultivating self-awareness and safe movement exploration. For others, the programme can provide a solid foundation for performing movement with better postural alignment and without undue effort or strain during sports practice and other activities. This helps to avoid injuries, posture-related overloads, and joint wear and tear that may lead to future complications.

Greater self-awareness and dynamic movement flowing freely through the body – “as Nature meant” – when integrated and incorporated into daily life, can bring lasting benefits. An enhanced vitality, feelings of well-being and readiness for movement promote what Ruthy Alon calls “Biological Optimism”.

About the Bones for Life Method

Bones for Life is an educational movement programme developed by Ruthy Alon [1930 – 2020]. It includes over 90 ‘processes’ (lessons, or movement explorations) aimed at improving postural alignment and reducing bone deterioration. Moshe Feldenkrais [1904 – 1984] created the Feldenkrais Method®. Ruthy Alon participated in his first training course in 1967 and worked directly with him for many years.

Intrigued by the high incidence of osteoporosis in the West, Alon explored, within the Feldenkrais Method, possible solutions to the process of bone deterioration. She faced the challenge of reconciling the basic protocols of building bone, through impact, with the slow, subtle movements employed in the Feldenkrais Method’s Awareness Through Movement® (ATM) lessons, which are often conducted in a supine position (laying on the back). To foster bone strength, Alon devised strategies that were to be enacted in the vertical plane and deal with gravity, and incorporated movements with moderate impact that include bouncing, vibration, percussion, walking, running in place and jumping. These were to be performed gently, and taught in progressive steps, to instil safety and self-confidence, and to refine a person’s awareness when performing them.

Bones for Life emphasizes postural alignment so that downward forces of gravity and upward forces from the ground [GRF] are transmitted cleanly and effectively throughout the entire skeleton. Postural awareness and self-exploration are at the core of the various processes that are practiced in all directions of movement proportionally, in order to distribute the range of motion and effort (with up to 20% effort) evenly across the joints and other involved parts. This prioritizes safe exploration of one’s range of movement, especially for individuals with compromised bone strength, unaccustomed to exercising or who feel vulnerable when practising impactful movement. Some processes use the wall as support for a more objective sensory perception of verticality, as well as to offer resistance. Body awareness is stimulated in some processes by use of a “wrap” – a fabric of up to seven meters in length wrapped around the body that promotes a sensation of support and greater joint stability.

The programme to explore the benefits of Bones for Life

Our study originated in 2019 following a Bones for Life teacher training course in Brazil led by Silvia Gray, with shared enthusiasm among Flávia de Souza and Dr Emerson Freitas to explore the benefits of the method. Silvia and Flávia then committed to teaching the Bones for Life method to two groups of women, 15 in England and 8 in Brazil respectively, over a 14 month programme from November 2019 to December 2020. Both groups received weekly instruction, structured into five modules drawn from Ruthy Alon’s teachings, which progressively covered a wide range of movement processes that encompassed all possible positions, directions, and regions of the body to be addressed. Instruction was initially in-person, but became virtual in 2020 due to Covid-19 pandemic. Participants committed to practising the processes for 15 to 20 minutes, six times per week, and to registering and sharing impressions about their practice, as requested for this project.

Most of the Brazilian group underwent blood tests and bone densitometry of the right femoral neck and lumbar spine – both before and after their 14 months of practice – to provide a small sample of quantitative data ¹. Brazilian volunteers also completed a questionnaire at the end of the practice period in order to also contribute to the qualitative analysis of their perceptions of the Bones for Life method, noting any changes or benefits they experienced as a result of their participation.

The women in England participated only in the qualitative study, through the completion of comprehensive questionnaires at the end of each of the five modules. The questionnaires explored perceptions relating to their sense of well-being, preferred processes, potential difficulties, and any observed benefits in their bodies – such as changes in movement patterns or posture, during and after the practice.

About Osteoporosis

Osteoporosis is a disease characterized by excessive loss of bone mass and deteriorating microarchitecture of bone tissue, causing bone fragility and increased risk of fractures. It accelerates in postmenopausal women, when the ovaries cease to produce oestrogen (an inhibitor of bone resorption, when bone tissue is broken down, leading to a loss of bone mass and density) and progesterone.

Among the factors directly influencing bone loss and calcium fixation in bones over time are: diseases such as hyperthyroidism, hyperparathyroidism, inflammatory diseases and neoplasms or tumours; prolonged use of medications such as corticosteroids; poor dietary and lifestyle factors (including low intake of calcium, protein, and vitamin D; alcohol intake and tobacco use; physical inactivity); as well as perimenopause and menopause and genetic factors. Bones for Life seeks to inhibit the progression of osteoporosis and resultant risks of fractures, including vertebral microfractures, by promoting bone health through healthy movement. The demands made and types of movement imposed on bone tissue are important influences on the process of remodelling our skeleton.

Analysis of Quantitative Results

Our limited quantitative results point to some bone density benefits from regular practice of Bones for Life, particularly in the lumbar region. We hope this will encourage more comprehensive future study. Most of the pilot study participants were already in menopause. Within the first 5 to 10 years after the last menstruation, expected annual decreases in BMD are 2% to 4% for bones predominantly made of trabecular (high porosity) tissue, such as in the lumbar region, and around 1% for bones predominantly composed of cortical (low porosity) tissue, such as the femur (Radominski, 2004). The absence of important hormones for calcium fixation in the bones is an important factor in this typical decline.

The bone densitometry tests compared the patient’s bone mineral density (BMD) both to that of young adults of the same sex or ethnicity (the T-score²) and to that of people of the same age, sex, and ethnicity (the Z-score). In this study, we used the BMD data collected to analyse changes in bone mass in the femoral neck, total femur, and lumbar spine of six Brazilian volunteers who undertook the tests before and after the practice period.

Comparing bone densitometry tests before and after the practice period of the project demonstrated some positive results. Five out of six volunteers showed improvement in the lumbar region, and the one with a lower BMD result showed less than the expected decrease for her age. At the femoral neck, two showed improved BMD and only one experienced a loss above what is expected for their age. In total femur densitometry, one of four volunteers showed material improvement, while three showed a decline, with only one declining more than expected for their age. The charts with results can be found in the full article or here.

Qualitative Analysis

As part of the ageing process, the human body tends to lose both motor and cognitive abilities, increasing the risk of falling. Falls, in turn, can lead to periods of reduced mobility and a consequent loss of both muscle mass and balance. Regular practice of Bones for Life may slow this process and reduce fall risk – supporting bone health by promoting more conscious movement, better balance and improved motor abilities. Our qualitative study explored these potential benefits.

The Brazilian group of eight volunteers responded to a single questionnaire after fourteen months of practice. This questionnaire focused on the participants’ perceptions of physical and mental health benefits after completing the programme.

All Brazilian participants reported that practising Bones for Life contributed positively to greater body awareness, relating this to factors such as better posture and improved balance. Five Brazilian volunteers reported a reduction in pain after starting regular Bones for Life practice, also citing improvements in areas such as coordination. A similar proportion reported better sleep quality. Seven reported improved energy levels, with increased well-being and emotional health. Some noted improvements in the circulatory system, breathing, the urinary tract and the digestive tract, as well as increased libido.

The English group, consisting of fifteen participants, responded after each module to questionnaires addressing their perceptions of the processes practised, and giving information about changes in daily life, physical and general well-being. After fourteen months of practice, they were also asked about their preferred processes.

As in Brazil, all of the English participants mentioned increased body awareness, and 93% of the volunteers reported contributions to postural alignment. About 47% of English volunteers spontaneously reported experiencing a reduction in pain, around 60% reported improved balance or motor coordination, and 47% mentioned positive changes in their daily life tasks.

The discovery of new movement possibilities was also cited as a highly beneficial aspect, as certain initially challenging new movements became more fluid and natural over time. This expansion of movement possibilities helped improve self-confidence, balance, and motor coordination – fundamental to reducing fall risk.

Discussion

Though based on a small sample, the bone densitometry test results, particularly in the lumbar region, prompted us to seek possible explanations.

An important clue may be in the improved body awareness and postural alignment in daily tasks mentioned by all participants and reported in the qualitative part of our study. One inspiration that motivated Ruthy Alon to develop the Bones for Life method was the observation of the walking patterns of African women³ who often carry water containers balanced on their heads. Alon believed that bone building is stimulated by elastic and rhythmic pressure on bones when one walks and that there are efficient and economical movement configurations, determined by the evolution of the human body itself, that make the incidence of this pressure more fluid throughout the skeleton. Then, the transmission of forces or pressure, upward and downward between the body’s polarities – feet and head – occurs in a “domino effect”. “Bones become stronger as they are used to successfully sustain this bidirectional pressure.” (Alon, 2018)

For Ruthy Alon, safety in performing the movement and good balance are essential to minimize the risk of injury, and aligned posture is fundamental for this pressure to flow evenly through the body without disproportionately overloading and overworking any particular joints.

Factoring in Fascia

How forces are transmitted through the body was often emphasized by Alon. Several studies on fascia provide valuable insights into how Bones for Life can benefit bone health. The term “fascia” refers to various types of connective tissue that cover and continuously connect all structures of our body (such as muscles, bones, tendons, and organs), and provide support, fill spaces between tissues, and supply them with nutrients. Bone tissue is a special type of connective tissue, and, as shown later, some consider it part of the fascial system.

→ Transmission of Forces and Fascial Biotensegrity

According to Schleip, fascia is a “fibrous collagenous tissue that is part of a broad tensile force transmission system in the body” (Schleip, 2012b, as cited in Chaitow, 2017). It combines strength and elasticity in order to adapt to different movements, or forces, and is then able to restore itself, and return to its initial position. The dynamic tension of this connective tissue throughout the body causes a movement in one part, such as the arm, to reverberate throughout various other parts of the body. Fascia is also a mechanosensory organ, with many mechanoreceptors that inform us of where and how our body is positioned in space – integrating and organizing our posture and movement. Fascial dysfunctions can interfere with posture, and fascia can adapt to poor posture and movement habits, or even lack of movement, which can harm this tissue’s long-term health.

The Bones for Life method was formulated before studies on fascia became widespread. However, several Bones for Life processes are highly beneficial to the health of fascial tissue, by positively stimulating the fascial network; helping to develop greater body awareness; and reducing poor posture and movement habits. As discussed below, the health of fascial tissue has a direct influence on the health of our bones, as it is closely related to bone remodelling, a continuous process of osteogenesis during which osteoclasts remove old, damaged bone, that is, in turn, replaced with new bone by osteoblasts.

→ Histology of Bone Tissue and Its Correlation with Fascial Tissue

Bone tissue is a specialized type of connective tissue, highly vascularized and innervated, formed by specific cells and calcified extracellular material called bone matrix. There are three types of specialized cells in bone tissue: osteoblasts (responsible for producing the organic part of the matrix and participating in the mineralization process), osteoclasts (which reabsorb bone tissue, participating in bone remodelling processes), and osteocytes (which have mechanosensory functions monitored by a complex neuronal network). The bone matrix is composed of an organic part (called osteoid, which is produced by osteoblasts and mainly composed of collagen fibers) and an inorganic part (formed during a process of mineralization and mainly composed of phosphate ions and calcium). Calcium and phosphorus form crystals called hydroxyapatite⁴ that fill the spaces between collagen fibres during the mineralization process. The inorganic part of the matrix provides strength, while collagen fibres (the organic part) provide flexibility to bone tissue (Junqueira & Carneiro, 2008, p.137).

Type I collagen is the most prevalent in bone tissue and this protein possesses important thixotropic⁵ characteristics that allow it to adapt to mechanical stresses and thus to functional demands. Because collagen fibres are resistant to tension and traction, they enable the absorption of energy after an impact. Changes in collagen properties directly affect the mechanical quality of bone and can increase its susceptibility to fracture. Collagen also exhibits piezoelectric⁶ characteristics, meaning that mechanical loads imposed on bone tissue are transformed into electrical stimuli, which, in turn, aid in the modulation of specialized cells. (Bicalho, 2020).

Bone tissue is highly dynamic and continuously undergoes modelling and remodelling. Although bones grow in size until adolescence, they continuously change in density throughout life. In 1892, surgeon/anatomist Julius Wolff was the first to remark that bone density changes according to the intensity and direction of mechanical forces acting upon the bones. According to Wolff’s Law, the greater the impact, the greater the deformation and stimulation for bone to gain mass during the remodelling process (Hall, 2016, p.123). The remodelling process is also influenced by nutrition and the action of various hormones such as parathyroid hormone (PTH), calcitonin (CT), vitamin D, and estrogen.

All bones are covered on their external and internal surfaces by connective tissue membranes called periosteum and endosteum respectively, which contain osteogenic cells, i.e., cells involved in bone formation. The periosteum protects, nourishes, and assists in both bone formation and fracture repair. The endosteum covers the inner layer of cortical bone and is thinner, composed of one layer of loose connective tissue.

The periosteum contains collagen fibres, called Sharpey’s fibres, which penetrate the tissue and connect with the innermost layer of compact bone tissue, the endosteum. These fibres are essentially an extension of the outer bone envelope into the interior of bone tissue. Thus, through these fibres, there is direct communication between the external covering of the bone and its inner envelope. Sharpey’s fibres are more present in areas where the bone is subjected to greater functional demand, such as areas of fascia, ligament, and tendon insertion. Therefore, functional demand is crucial regarding the presence of these fibres. According to Junqueira and Carneiro, the nutrition of bone tissue and the supply of new osteoblasts are the main functions of the periosteum and endosteum.

When movement takes place, mechanical stimuli placed on bone or fascial tissues are converted into biological signals through a process called mechanotransduction that promotes structural and tissue changes. Collagen is closely linked to this process due to its adaptive and piezoelectric characteristics. In bone tissue, collagen fibres or Sharpey’s fibres are connected to proteins called integrins that penetrate into the cells. Therefore, tension imposed on these fibres causes integrins to alter the electrical charges of the cell membrane, modifying cell metabolism. In this sense, osteocytes – affected by mechanical tension from collagen fibres – regulate the behaviour of osteoblasts by increasing bone formation and the behaviour of osteoclasts by increasing bone resorption.

The periosteum is included as part of the fascial tissue by several authors, while others go further and include the bone tissue itself as part of the fascial system. For example, Bicalho comments that, according to Sharkey (2019), definitions which do not include other components of bone tissue as part of the fascial system are incomplete since bones are vital elements for musculoskeletal continuity. He emphasizes that ligaments and tendons are connected to the periosteum, which, in turn, attaches to the bone matrix through Sharpey’s fibres. Bordoni and Lagana (2019) also consider bone tissue as part of the fascial system and demonstrate that, in addition to the anatomical continuity of these tissues, there is the same embryological origin between them, as well as autocrine and paracrine⁷ activity between these tissues that influence each other and generate mechano-metabolic responses in bone cells (Bicalho, 2020).

As noted above, the collagen present in Sharpey’s fibres of the periosteum, with its piezoelectric characteristics, plays a role in the mechanotransduction process that promotes bone remodelling. Collagen also provides flexibility to bone, making it more resistant to impact, which is essential for its health.

There is substantial literature addressing the importance of impact exercise in combating the loss of bone density. More recent studies on fascial tissue suggest that stimulating this tissue efficiently can also benefit bone health since, when stimulated correctly, it can enhance collagen production. Bones for Life combines movements involving impact, such as moderate degrees of percussion, with others that stimulate the fascial network in various ways. These do not necessarily involve impact but are also believed to benefit bone remodelling by improving the transmission of forces through the body. This hypothesis may help us understand why better bone densitometry results were obtained in the lumbar region of our volunteers after fourteen months of practice of Bones for Life, when compared with the results of bone densitometry tests performed on the femur. The passage of certain fascial anatomical lines⁸ through the lumbar region and connecting it to various areas of the body results in the presence of a large quantity of collagen-producing fibroblasts. This enables the lumbar area to receive stimuli from movements performed by many body parts, such as the arms, hands, legs, and feet, especially when the transmission of forces flows efficiently through the fascial tissue network.

→ Bones for Life and the Health of Fascia and Bone Tissue

During the ageing process, fascial tissue loses its elasticity and its ability to slide, but this process can be delayed and even reversed with various movement practices that stimulate collagen production, flexibility, and mobility of this tissue (Schleip, 2012, p.3). Several Bones for Life processes correspond with movement practices that various authors identify as benefiting fascial health.

The most common cells found in fascial tissue are fibroblasts⁹. These are cells that secrete the collagen proteins that make up the extracellular matrix. This collagen production can be stimulated according to the movement to which these cells are subjected. According to Chaitow, based on Kumka and Bonar (2012): “Fibroblasts are highly adaptable to their environment and show an ability to remodel in response to various mechanical stimuli, producing biochemical responses.” Chaitow (2017) explains that when fibroblasts are subjected to a continuous or cyclic stretching load, they secrete collagenases, enzymes that break peptide bonds in collagen. Based on the in vitro study conducted by Carano and Sicliani (1996), the author also states that cyclic stretches – involving 10% of available elasticity – are considerably more efficient in this regard, as they can double the production of collagenase. Continuous stretching, on the other hand, is only half as effective. “The observation that intermittent loading has a greater influence on collagenase production than sustained loading is also clinically relevant”¹⁰. (Chaitow, 2017)

Bones for Life incorporates various processes that provide stimuli with effects similar to cyclic or intermittent stretching of low intensity, as if there were springs in the body. Movements such as the “Wave” and “Axis” are excellent examples that involve rhythmic and elastic swings. Schleip is another author who highlights the benefits of dynamic stretching¹¹, especially for long-term effects, as it can positively influence the architecture of connective tissue when performed correctly (Schleip & Müller, 2012, p.4). Quoting the author Magnusson, Schleip and Müller explain:

“A dynamic muscular loading pattern in which the muscle is briefly activated in its lengthened position promises the most comprehensive stimulation of fascial tissues… the resultant increase in collagen production tends to be largely independent of exercise volume (repetitions); meaning that only few repetitions are necessary to yield an optimum effect (Magnusson et al., 2010, as cited in Schleip & Müller, 2012, p. 6). The proposed fascia training therefore recommends soft elastic bounces in the end ranges of available motion.” (Schleip & Müller, 2012, p.6)

In Bones for Life, with proportional movement initially focused on using just 20% effort, one can comfortably go towards the end range of available motion, without forcing. Having a full range of motion available is important for various activities in everyday life.

Fascia is fibrous tissue that branches out in multiple directions, whether superficially, covering organs, muscles, or bones, or penetrating more deeply into these structures. This multidirectional characteristic is also stimulated more efficiently with multidirectional movements and soft elastic bounces, because they reach a greater number of fibroblasts, enhancing collagen production in the body. Spiral movements are excellent examples that promote multidirectional stimuli. This type of movement was extensively studied by Moshe Feldenkrais and is also prevalent in Ruthy Alon’s work.

One fascinating characteristic of fascial tissue is its proprioceptive capacity, due to the large number of sensory receptors transmitting information about the body’s positioning that underlies motor coordination and balance. Schleip (2012) emphasizes the importance of stimulating proprioception through refining one’s sensitivity to the subtleties of movement. This is extensively explored by Alon in Bones for Life through various processes that enhance body awareness, balance, and motor coordination. This is key for improving force transmission throughout the body, by allowing self-correction and promoting efficiency through developing greater “Movement Intelligence”. In daily life, improved proprioception aids balance, posture, and motor coordination, and helps to reduce susceptibility to falls and injuries.

Self-massage is also explored by Alon at certain moments, such as when a cloth “Wrap” with one or two knots is pressed between the back and a wall, providing tension relief in the tissues around the spinal column, and potentially improving tissue glide and fascial tissue health.

Bones for Life incorporates various percussive and tapping movements in several of its 90 processes to create impacts on different body regions, while exploring variations in direction and angle. Many studies on osteoporosis prevention emphasize the importance of performing impact exercises at different angles to stimulate bone strengthening. However, osteoporosis occurs predominantly among seniors – many of whom face difficulties when engaging in high-impact activities, whether from muscle-skeletal pain, fear of movement, inadequate muscle strength, or the risk of fracture from falling. Bones for Life addresses this dilemma with processes that safely promote impact by encouraging body awareness so movements can be performed without fear, with respect to sensed limits – physical or psychological. ‘Bouncing on Heels’ is one of the most important and characteristic processes of the method, acting to stimulate the venous return circulation to the heart, benefit the nutrition of all tissues and expedite the elimination of toxins. It also contributes to the formation of new bone cells. Proper postural alignment is emphasized during the execution of all Bones for Life processes to ensure joint stability during this percussive process and to promote streamlined force transmission. Alon explores the most appropriate muscle involvement and optimal physical alignment, and some practices also involve use of weights on ankles and wrists, or held by hands.

After a practice, Ruthy Alon incorporates processes that promote relaxation of the body and mind after the practice, such as visualizations, guided meditations and encouragement to breathe deeply and yawn. Activating the parasympathetic system following physical activity is essential for maintaining the body’s self-regulatory capacity, including that of the fascia and bone tissue. Eduardo Bicalho mentions some studies indicating that parasympathetic innervation in the skeleton assists in regulating bone mass accumulation (Bajayo, 2012, as cited in Bicalho, 2020). He also points out the influence of the circadian rhythm on the bone remodelling process, suggesting that bone resorption peaks during the day – when sympathetic activity is dominant – while bone formation is more active at night, when parasympathetic activity predominates (Shao, 2003, as cited in Bicalho, 2020). Therefore, relaxation practices that stimulate the parasympathetic system after physical activity tend to be beneficial for overall body health, including bone health.

Final thoughts from Ruthy Alon

“You may remind yourself that Nature always strives towards Healing – that is its initial intention. Through a slow gravitation towards well-being, Nature bestows upon you, minute by minute, the choice of helping it help you.”

“Achieving dynamic movement that streams throughout a well aligned body gives pleasure, promises readiness to move, inspires biological optimism and strengthens bone.”

Footnotes

Due to the differences between the healthcare systems of the two countries, these tests were not taken by the pilot study participants in England.
The T-score (referring to the number of standard deviations above or below the average for young adults) recognizes three categories: normal (T-score ≥ -1), osteopenia (T-score < -1 and > -2,5) and osteoporosis (T-score ≤ -2.5).
Ruthy Alon visited some African countries, and these encounters with different cultures resulted in many insights that influenced the development of her Bones for Life method. She closely observed the walking patterns of women carrying water on their heads. In Ethiopia, she had the opportunity to witness traditional movements in ceremonies that inspired the chest tapping used in the method.
The composition of hydroxyapatite is: Ca10(PO4)6(OH)2.
Thixotropic properties refer to substances that, when agitated, transition from a gel-like state to a liquid state.
Piezoelectricity is an electric polarization produced by certain materials, such as some molecules and crystals, when subjected to mechanical deformation. The structure of bone collagen fulfils the characteristics of a piezoelectric material, which, under mechanical deformation (such as that produced by tension, compression, or torsion), can undergo spatial changes, that result in electric polarization (LIRANI, 2005).
In paracrine communication, the signalling molecules act on neighbouring cells. In autocrine signalling, the signalling molecule acts on the signalling cell itself, meaning that the target cell is the secreting cell.
The fascial anatomical lines are a concept developed and extensively studied by Thomas Myers. As described by Myers, among the anatomical lines that pass through the lumbar region, we can mention the Superficial Posterior Line, the Deep Anterior Line, and the Posterior Functional Line (Chaitow, 2017).
According to Junqueira and Carneiro, osteoclasts found in bone tissue, responsible for bone remodelling, have a morphological similarity to fibroblasts found in fascia. (Junqueira & Carneiro, p.139, 2008).
According to Bonewald and Mundy (1990), transforming growth factor-beta (TGF-β1) plays an important role in bone remodelling by stimulating the synthesis of proteins that have effects on bone cells such as osteoblasts and osteoclasts, which are responsible for bone formation and resorption.
The literature that was reviewed showed that dynamic, cyclic, or intermittent stretches, all involving movement, are more effective than continuous stretches in stimulating the production of collagen by specialized fascial cells.

Acknowledgements

This pilot study is the result of a multi-disciplinary collaboration combining the varied experiences of Silvia Gray (Bones for Life and other movement practices), Flávia de Souza (bodywork and physiotherapy), Dr. Emerson Antonio Freitas (geriatric medicine and gerontology) and Gabriela Macetti de Godoy Oliveira (research and literature review).

Ruthy Alon Ph.D. [1930 – 2020] inspired us to undertake this work. Bones for Life® was the first of her five Movement Intelligence programmes which address concerns about loss of mobility, balance, coordination and bone strength by providing practical self-care strategies for optimal movement.

Many others freely gave help, guidance, and support (referenced in the full paper) and our dedicated volunteers provided invaluable feedback. The Foundation for Movement Intelligence (FMI), a non-profit organization, based in North America, provided a generous grant and encouragement for this work.

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UK/Feb 2025