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Building bone mass through exercise: could less be more?
  1. T S Gross,
  2. S Srinivasan
  1. 1University of Washington, Seattle, WA, USA
  1. Correspondence to:
 Dr Gross
 Department of Orthopaedics and Sports Medicine, University of Washington, 1959 NE Pacific St, Box 356500, Seattle, WA 98195-6500, USA; tgross{at}u.washington.edu

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Insertion of a rest interval between loading events greatly amplifies the response of bone to loading

A vast literature supports the sensitivity of bone to mechanical loading. When mechanical loading is acutely diminished, as occurs with paralysis or other forms of disuse, bone mass is rapidly degraded.1 Alternatively, bone is also capable of substantial augmentation following long term exercise.2 In combination, these observations suggest that mechanical loading of the skeleton is essential for maintenance of bone homoeostasis and holds potential to serve as a substantial anabolic stimulus. Given the extremely debilitating nature of bone loss pathologies and nascent development stage of anabolic interventions capable of enhancing skeletal mass and morphology at both trabecular and cortical sites, examination of how mechanical loading induces bone formation continues to be an area of substantial study.

“…high magnitude loading is not practical for those seniors acutely in need of bone augmentation”

The most efficacious exercise interventions have exposed young developing skeletons to dynamic impact loads such as those induced by jumping.3 The success of such a regimen stems, in part, from the enhanced ability of the developing skeleton to respond to mechanical stimuli compared with an aged skeleton4 and, we would argue, the intermittent nature of activities such as jumping. However, although impact exercise interventions may serve to augment peak skeletal strength and thereby serve as a potential prophylaxis for future osteopenias, high magnitude loading is not practical for those seniors acutely in need of bone augmentation. …

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