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Normal Bone
Osteoporotic Bone
Bone mineral density accounts for 70% of bone strength
Bone mineral density accounts for 70% of bone strength
Types of Bone
Types of Bone
cortical (compact)-outer, dense shell around bones; thick shafts of long bones
Trabecular
(spongy)-found in vertebrae and ends of long bones; forms a lattice-like network increasing its surface area for metabolic activity
Types of BoneTypes of Bone
Dowager’s HumpDowager’s Hump
Remodeling Cycle
Bone Resorption (bone removal)
Bone Formation
Remodeling Cycle
Osteoclast
Osteoblasts
From: Geriatric Consultant Resources LLC http://www.gcrweb.com/OsteoDSS/clinical/path/pages/path-bone-rem.html
Remodeling Cycle
Osteoclast: Bone Resorption
Osteoblasts: Bone Formation
Remodeling Cycle
Osteoclast
Osteoblasts
EstrogenEstrogen
Amen
orrh
eaEating Disorders
Osteoporosis
Series10
10
20
30
40
50
60
70
Perc
ent
of
Ath
lete
sPe
rcent
of
Ath
lete
s
HSHS Colle
ge
Colle
ge
Speci
fic
Sp
ort
sS
peci
fic
Sp
ort
s
INCIDENCE OF ANOREXIA & BULIMAINCIDENCE OF ANOREXIA & BULIMA
Series10
10
20
30
40
50
60
70
Perc
ent
of
Pop
ula
tion
(%
)Pe
rcent
of
Pop
ula
tion
(%
)
General
AthletesAthletes
AMENORRHEAAMENORRHEA
Series10
5
10
15
20
25
30
35
Marcus eat al, Ann Int Med 102:158-163, 1985
ControlControlAc
tive
Amen
orrh
icAc
tive
Amen
orrh
ic
OSTEOPOROSISOSTEOPOROSISIn
cid
en
ce o
f B
on
e F
ract
ure
s (%
)In
cid
en
ce o
f B
one F
ract
ure
s (%
)
Active Regular Cycling
Tennis PlayersTennis Players SoldiersSoldiers
Exercise and Bone Health
Epicondylar Width
6.69 vs. 6.59
Epicondylar Width
6.46 vs. 6.41
Ulnar Width
1.86 vs 1.79
Ulnar Width
1.65 vs 1.62
Gravity and Bone Health
Space travel
Space Station crew lost
• interior bone @ 2.2 -2.7% per month in space
• outer bone @ 1.6 - 1.7% per month.
• hipbone strength declined by 2.5% per month of flight.
• vertebral bone @ 0.8 to 0.9% per month,
http://www.spacedaily.com/news/spacetravel-04h.html
Exercise and Bone Health
120 days 196 days-30
-25
-20
-15
-10
-5
0
Bo
ne
Min
eral
Den
sity
(%
)
ACSM Resource Manual, page 200
Calcaneous Bone Loss from Bed rest
Exercise and Bone Health
120 days 180 days-7
-6
-5
-4
-3
-2
-1
0
Bone Mineral Density
(%)
Femoral Neck Bone Loss from Bed rest
ACSM Resource Manual, page 200
4 Months-12
-10
-8
-6
-4
-2
0
2
Radius
Tibia
Spine
Calcaneous
Ch
an
ge
in B
on
e M
ine
ral
De
ns
ity
(%
)
Bone Loss from Bed Rest
Exercise and Bone Health
0 4 months 6 months-12
-10
-8
-6
-4
-2
0
2
Radius
Tibia
Spine
Calcaneous
Ch
ang
e in
BM
D (
%)
Re-ambulation following bed rest
Exercise and Bone Health
0 5 10 15 20 25 30 35 40
-3
-2
-1
0
1
2
3
4
Control
Exercise
Months
Per
cen
t C
han
ge
(%)
Smith, E. et al. Med Sci Sports Exerc 13, 80, 1981.
Exercise and Bone Health
Cavanaugh Dj & CE Cann, Bone 9:201-204, 1988.
Spine-6
-5
-4
-3
-2
-1
0
Exercise
ExerciseBMD (%)
Exercise and Bone Health
Dalsky et al., Ann Int Med 108:824, 1988Dalsky et al., Ann Int Med 108:824, 1988
Control (n=18)
Control (n=18)
Exercise n=17
Exercise n=17
9 months9 months
n= 14 Detraining (n=6)
Detraining (n=6)
Exercise (n=11)
Exercise (n=11)
13 months13 months18 months18 months
Detraining (n=9)
Detraining (n=9)
12 months12 months
Exercise and Bone Health
Dalsky et al., Ann Int Med 108:824, 1988
0 9 240.96
0.98
1
1.02
1.04
1.06
1.08
Control
Exercise
Time (Months)
Lu
mb
ar
Bo
ne
Min
era
l (g
/cm
2)
Detraining
Exercise and Bone Health
Pruitt, LA et al, J Bone & Min Res 7:179-185, 1992
Lumbar -4
-3
-2
-1
0
1
2
Control
ExerciseBMD (%)
Eyes Open
Eyes Closed
Foam - Eyes Open
Foam - Eyes
Closed
-15
-10
-5
0
5
10
15
20
25
30
ControlExercise
Per
cen
t C
han
ge
in S
way
(%
)BALANCE AND FALLS
Hourigan, SR, et al Osteoporosis International DOI 10.1007/s00198-0541-7
Piezeoelectric Effect
MuscleMuscleBone
GrowthBone
Growth
+
+
+
+
+
+
+
+
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