By Jane Elliott
Health reporter, BBC News
When Robert Rees shattered a vertebrae in his back, due to osteoporosis, doctors told him that his spine was badly damaged.
Robert has broken ribs coughing
The fracture was so severe they said it was as if Robert, from south Wales, had fallen the equivalent of three stories into an empty swimming pool.
Robert, 47, said that prior to his injury he had been completely unaware that his bones were at risk. He thought himself active, busy and health aware.
But all that changed on a family holiday to the Dominican Republic when Robert's back collapsed after taking part in a dance competition.
"One minute I was holding my wife Jean, the next I was in absolute agony.
"The pain in my back was like being hit with a sledgehammer.
"The pain was excruciating, the noise in my head was like a gun going off and I collapsed to the floor.
"The next thing I remember was waking up unable to feel my legs.
"I was in hospital in the Dominican Republic for a week, flown home, underwent a series of tests and operations and finally was given the diagnosis of severe osteoporosis.
"The first doctor who saw me said that there was only 25% of the bone left in one part of my spine."
His injuries were so severe there were worries that he might have some form of cancer.
Robert's bones were badly damaged
But a CT scan revealed that the numbness and paralysis was caused by the broken bone touching the spinal cord.
"The doctor said I was lucky it exploded forward and not through the spinal cord or I wouldn't have survived."
Robert was just 43 years old, but doctors said he had the bones of an 80-year-old man.
He was in chronic pain and has had to retire from his busy job as a sales director.
He has a titanium cage bolted to his spine, which makes sleeping uncomfortable.
Since his diagnosis he has fractured his ribs 14 times just by coughing or turning in bed.
"My life has changed completely. I am four inches shorter now than I was," he said.
MALE OSTEOPOROSIS CAUSES
45% of cases have no known causes
20% of cases are as a result of hypogonadism (low levels of testosterone)
20% of cases are due to corticosteroid use (for conditions such as asthma and arthritis)
10% of cases related to other health problems (such as coeliac or Crohn's disease, hyperthyroidism, hyperparathyroidism)
5% of cases are because of excessive alcohol consumption
Robert admitted that he had not suspected osteoporosis might affect him, wrongly believing this was mainly a condition affecting just women.
Now he helps campaign for the National Osteoporosis Society (NOS) and urges teenage boys to look after their bones by eating as much fruit and vegetables as possible while their bone mass is still developing.
"Men seem genuinely surprised that this condition can and will affect them - I think the general perception is of little old women with bent backs - but one in five men aged over 50 will break a bone, mainly because of the disease."
Pauline Davey, of NOS, agreed: "It is a difficult area to tackle because many men are not very health aware."
She said that adapting lifestyle and diet during the years up to early adulthood should protect the bones from osteoporosis - which literally means porous bones.
Dr Susan Lanham-New, reader in nutrition at the University of Surrey, said one way to ensure healthy bones was to have a well-balanced diet.
She said incorporating minerals and vitamins from different food groups was the best way.
She added that people needed to ensure their diet was rich in calcium, obtained from milk and other dairy products, as well as green leafy vegetables, baked beans, bony fish and dried fruit.
She said that although women were aware of their risk factors, particularly during the menopause, that many men still remained ignorant.
"As they get older they too will suffer bones loss and there are certain additional risk factors such as if they have been taking steroids for conditions like arthritis or asthma."