Mechanical loading is a crucial factor for maintaining skeletal health. Physical activities, exercise, and sports provide a wealth and variety of mechanical loads to bones, through muscle forces, ground reaction forces, and other contact or impact forces. Weightbearing activities can be effective exercises to enhance bone healthāparticularly, those that involve jumping and impact loads (with greater strain magnitudes, rates, and frequencies). Physical activity appears to be acutely beneficial for enhancing bone health in the early pubertal period and in older age, such as in postmenopausal women. In preparing this article, PubMed, Web of Science, and relevant edited books (English language) were reviewed from 1961 to present.
BaileyDAMartinADMcKayHAWhitingSMirwaldR. Calcium accretion in girls and boys during puberty: a longitudinal analysis. J Bone Miner Res. 2000;15(11):2245-2250.
2.
BaronRTrossRVigneryA. Evidence of sequential remodeling in rat trabecular bone: morphology, dynamic histomorphometry, and changes during skeletal maturation. Anat Rec. 1984;208(1):137-145.
3.
BonaiutiDSheaBIovineR. Exercise for preventing and treating osteoporosis in postmenopausal women. Cochrane Database Syst Rev. 2002;3:CD000333.
4.
BorerKT. Physical activity in the prevention and amelioration of osteoporosis in women: interaction of mechanical, hormonal and dietary factors. Sports Med. 2005;35(9):779-830.
5.
CarterDRFyhrieDPWhalenRT. Trabecular bone density and loading history: regulation of connective tissue biology by mechanical energy. J Biomech. 1987;20(8):785-794.
6.
ChevalleyTBonjourJPFerrariSRizzoliR. Influence of age at menarche on forearm bone microstructure in healthy young women. J Clin Endocrinol Metab. 2008;93(7):2594-601.
7.
CourteixDJaffreCLespessaillesEBenhamouL. Cumulative effects of calcium supplementation and physical activity on bone accretion in premenarchal children: a double-blind randomised placebo-controlled trial. Int J Sports Med. 2005;26(5):332-338.
8.
DuncanCSBlimkieCJCowellCTBurkeSTBriodyJNHowman-GilesR. Bone mineral density in adolescent female athletes: relationship to exercise type and muscle strength. Med Sci Sports Exerc. 2002;34(2):286-294.
9.
EbellMHSiwekJWeissBD. Strength of recommendation taxonomy (SORT): a patient-centered approach to grading evidence in the medical literature. Am Fam Physician. 2004;69(3):548-556.
10.
FeskanichDWillettWColditzG. Walking and leisure-time activity and risk of hip fracture in postmenopausal women. JAMA. 2002;288(18):2300-2306.
11.
FrenchSAFulkersonJAStoryM. Increasing weight-bearing physical activity and calcium intake for bone mass growth in children and adolescents: a review of intervention trials. Prev Med. 2000;31(6):722-731.
12.
FrostHM. On our age-related bone loss: insights from a new paradigm. J Bone Miner Res. 1997;12(10):1539-1546.
13.
FuchsRKBauerJJSnowCM. Jumping improves hip and lumbar spine bone mass in prepubescent children: a randomized controlled trial. J Bone Miner Res. 2001;16(1):148-156.
14.
GilsanzVWrenTASanchezMDoreyFJudexSRubinC. Low-level, high-frequency mechanical signals enhance musculoskeletal development of young women with low BMD. J Bone Miner Res. 2006;21(9):1464-1474.
15.
GreggEWCauleyJASeeleyDGEnsrudKEBauerDC. Physical activity and osteoporotic fracture risk in older women. Study of Osteoporotic Fractures Research Group. Ann Intern Med. 1998;129(2):81-88.
16.
HaapasaloHKannusPSievanenH. Development of mass, density, and estimated mechanical characteristics of bones in Caucasian females. J Bone Miner Res. 1996;11(11):1751-1760.
17.
HaapasaloHKannusPSievanenH. Effect of long-term unilateral activity on bone mineral density of female junior tennis players. J Bone Miner Res. 1998;13(2):310-319.
18.
HaapasaloHKontulainenSSievanenHKannusPJarvinenMVuoriI. Exercise-induced bone gain is due to enlargement in bone size without a change in volumetric bone density: a peripheral quantitative computed tomography study of the upper arms of male tennis players. Bone. 2000;27(3):351-357.
19.
HeaneyRPAbramsSDawson-HughesB. Peak bone mass. Osteoporos Int. 2000;11(12):985-1009.
20.
Hind Kand BurrowsM. Weight-bearing exercise and bone mineral accrual in children and adolescents: a review of controlled trials. Bone. 2007;40(1):14-27.
21.
HuangRPRubinCTMcLeodKJ. Changes in postural muscle dynamics as a function of age. J Gerontol A Biol Sci Med Sci. 1999;54(8):B352-B357.
22.
Judex Sand ZernickeRF. Does the mechanical milieu associated with high-speed running lead to adaptive changes in diaphyseal growing bone?Bone. 2000;26(2):153-159.
23.
Judex Sand ZernickeRF. High-impact exercise and growing bone: relation between high strain rates and enhanced bone formation. J Appl Physiol. 2000;88(6):2183-2191.
24.
KannusPHaapasaloHSankeloM. Effect of starting age of physical activity on bone mass in the dominant arm of tennis and squash players. Ann Intern Med. 1995;123(1):27-31.
25.
KelleyGA. Aerobic exercise and bone density at the hip in postmenopausal women: a meta-analysis. Prev Med. 1998;27(6):798-807.
26.
KelleyGAKelleyKS. Efficacy of resistance exercise on lumbar spine and femoral neck bone mineral density in premenopausal women: a meta-analysis of individual patient data. J Womens Health (Larchmt). 2004;13(3):293-300.
27.
KelleyGAKelleyKS. Exercise and bone mineral density at the femoral neck in postmenopausal women: a meta-analysis of controlled clinical trials with individual patient data. Am J Obstet Gynecol. 2006;194(3):760-767.
28.
KelleyGAKelleyKSTranZV. Exercise and bone mineral density in men: a meta-analysis. J Appl Physiol. 2000;88(5):1730-1736.
29.
KelleyGAKelleyKSTranZV. Resistance training and bone mineral density in women: a meta-analysis of controlled trials. Am J Phys Med Rehabil. 2001;80(1):65-77.
30.
KhanKMcKayHAHaapasaloH. Does childhood and adolescence provide a unique opportunity for exercise to strengthen the skeleton?J Sci Med Sport. 2000;3(2):150-164.
31.
KontulainenSSievanenHKannusPPasanenMVuoriI. Effect of long-term impact-loading on mass, size, and estimated strength of humerus and radius of female racquet-sports players: a peripheral quantitative computed tomography study between young and old starters and controls. J Bone Miner Res. 2002;17(12):2281-2289.
32.
KriemlerSZahnerLPuderJJ. Weight-bearing bones are more sensitive to physical exercise in boys than in girls during pre- and early puberty: a cross-sectional study. Osteoporos Int. 2008;19(12):1749-1758.
33.
LaMotheJMHamiltonNHZernickeRF. Strain rate influences periosteal adaptation in mature bone. Med Eng Phys. 2005;27(4):277-284.
LorentzonMMellstromDOhlssonC. Association of amount of physical activity with cortical bone size and trabecular volumetric BMD in young adult men: the GOOD study. J Bone Miner Res. 2005;20(11):1936-1943.
36.
MacdonaldHMKontulainenSAKhanKMMcKayHA. Is a school-based physical activity intervention effective for increasing tibial bone strength in boys and girls?J Bone Miner Res. 2007;22(3):434-446.
37.
MacKelvieKJKhanKMMcKayHA. Is there a critical period for bone response to weight-bearing exercise in children and adolescents? A systematic review. Br J Sports Med. 2002;36(4):250-257.
38.
MacKelvieKJKhanKMPetitMAJanssenPAMcKayHA. A school-based exercise intervention elicits substantial bone health benefits: a 2-year randomized controlled trial in girls. Pediatrics. 2003;112(6, pt 1):e447.
39.
MacKelvieKJPetitMAKhanKMBeckTJMcKayHA. Bone mass and structure are enhanced following a 2-year randomized controlled trial of exercise in prepubertal boys. Bone. 2004;34(4):755-764.
40.
MartinEARitmanELTurnerRT. Time course of epiphyseal growth plate fusion in rat tibiae. Bone. 2003;32(3):261-267.
41.
Martyn-St JamesMCarrollS. High-intensity resistance training and postmenopausal bone loss: a meta-analysis. Osteoporos Int. 2006;17(8):1225-1240.
42.
Martyn-St JamesMCarrollS. Meta-analysis of walking for preservation of bone mineral density in postmenopausal women. Bone. 2008;43(3):521-531.
43.
MatthewsBLBennellKLMcKayHA. Dancing for bone health: a 3-year longitudinal study of bone mineral accrual across puberty in female non-elite dancers and controls. Osteoporos Int. 2006;17(7):1043-1054.
44.
MussolinoMELookerACOrwollES. Jogging and bone mineral density in men: results from NHANES III. Am J Public Health. 2001;91(7):1056-1059.
45.
NikanderRSievanenHHeinonenAKannusP. Femoral neck structure in adult female athletes subjected to different loading modalities. J Bone Miner Res. 2005;20(3):520-528.
46.
NikanderRSievanenHUusi-RasiKHeinonenAKannusP. Loading modalities and bone structures at nonweight-bearing upper extremity and weight-bearing lower extremity: a pQCT study of adult female athletes. Bone. 2006;39(4):886-894.
47.
NilssonMOhlssonCMellstromDLorentzonM. Previous sport activity during childhood and adolescence is associated with increased cortical bone size in young adult men. J Bone Miner Res. 2009;24(1):125-133.
48.
Nurmi-LawtonJABaxter-JonesADMirwaldRL. Evidence of sustained skeletal benefits from impact-loading exercise in young females: a 3-year longitudinal study. J Bone Miner Res. 2004;19(2):314-322.
49.
PetterssonUNordstromPAlfredsonHHenriksson-LarsenKLorentzonR. Effect of high impact activity on bone mass and size in adolescent females: a comparative study between two different types of sports. Calcif Tissue Int. 2000;67(3):207-214.
50.
QinYXRubinCTMcLeodKJ. Nonlinear dependence of loading intensity and cycle number in the maintenance of bone mass and morphology. J Orthop Res. 1998;16(4):482-489.
51.
RoblingAGBurrDBTurnerCH. Partitioning a daily mechanical stimulus into discrete loading bouts improves the osteogenic response to loading. J Bone Miner Res. 2000;15(8):1596-1602.
52.
RubinCReckerRCullenDRyabyJMcCabeJMcLeodK. Prevention of postmenopausal bone loss by a low-magnitude, high-frequency mechanical stimuli: a clinical trial assessing compliance, efficacy, and safety. J Bone Miner Res. 2004;19(3):343-351.
53.
RubinCT. Skeletal strain and the functional significance of bone architecture. Calcif Tissue Int. 1984;36(suppl 1):S11-S18.
54.
RubinCTLanyonLE. Dynamic strain similarity in vertebrates: an alternative to allometric limb bone scaling. J Theor Biol. 1984;107(2):321-327.
55.
RubinCTLanyonLE. Regulation of bone formation by applied dynamic loads. J Bone Joint Surg Am. 1984;66(3):397-402.
56.
RubinCTLanyonLE. Regulation of bone mass by mechanical strain magnitude. Calcif Tissue Int. 1985;37(4):411-417.
57.
RubinCTSommerfeldtDWJudexSQinY. Inhibition of osteopenia by low magnitude, high-frequency mechanical stimuli. Drug Discov Today. 2001;6(16):848-858.
SchrieferJLWardenSJSaxonLKRoblingAGTurnerCH. Cellular accommodation and the response of bone to mechanical loading. J Biomech. 2005;38(9):1838-1845.
60.
SrinivasanSGrossTS. Canalicular fluid flow induced by bending of a long bone. Med Eng Phys. 2000;22(2):127-133.
61.
SrinivasanSGrossTS. Intermittent rest enhances osteoblastic activation induced by mechanical loading. Trans Orthop Res Soc. 2000;46:628.
62.
StengelSVKemmlerWPintagR. Power training is more effective than strength training for maintaining bone mineral density in postmenopausal women. J Appl Physiol. 2005;99(1):181-188.
63.
TaaffeDRRobinsonTLSnowCMMarcusR. High-impact exercise promotes bone gain in well-trained female athletes. J Bone Miner Res. 1997;12(2):255-260.
64.
TheintzGBuchsBRizzoliR. Longitudinal monitoring of bone mass accumulation in healthy adolescents: evidence for a marked reduction after 16 years of age at the levels of lumbar spine and femoral neck in female subjects. J Clin Endocrinol Metab. 1992;75(4):1060-1065.
65.
ThompsonDW. On growth and form. Abridged ed. BonnerJT, ed. Cambridge, UK: Cambridge University Press; 1961.
66.
TurnerCHOwanITakanoY. Mechanotransduction in bone: role of strain rate. Am J Physiol. 1995. 269(3, pt 1):E438-E442.
67.
UmemuraYIshikoTYamauchiTKuronoMMashikoS. Five jumps per day increase bone mass and breaking force in rats. J Bone Miner Res. 1997;12(9):1480-1485.
68.
Uusi-RasiKSievanenHVuoriIPasanenMHeinonenAOjaP. Associations of physical activity and calcium intake with bone mass and size in healthy women at different ages. J Bone Miner Res. 1998;13(1):133-142.
69.
WallaceBACummingRG. Systematic review of randomized trials of the effect of exercise on bone mass in pre- and postmenopausal women. Calcif Tissue Int. 2000;67(1):10-18.
70.
WolffIvan CroonenborgJJKemperHCKostensePJTwiskJW. The effect of exercise training programs on bone mass: a meta-analysis of published controlled trials in pre- and postmenopausal women. Osteoporos Int. 1999;9(1):1-12.
