The reduction in bone strength and resultant increase in low trauma fractures associated with aging represents a prominent and growing societal problem. Although numerous pharmacological agents have been developed to prevent and treat reductions in bone strength, a commonly advocated intervention is the prescription of load-bearing exercise. The skeleton is mechanosensitive, and responds and adapts to its prevailing mechanical environment. This concept is supported by two independent, yet related, papers in this issue of the BJSM. These papers highlight the potential role of exercise on bone health at two differing stages of the lifespan. Kato et al. performed a cross-sectional study to show that exercise when young may have lasting effects on bone health during aging, whereas Martyn-St James & Carroll performed a systematic review and meta-analysis to demonstrate that exercise can have beneficial effects on the post-menopausal skeleton.