IBMS BoneKEy | Perspective

Exercise and the skeleton: How it works and what it really does

Nicolas Bonnet
Serge L Ferrari

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DOI:10.1138/20100454

Abstract

Exercise and nutrition are among the most commonly advocated lifestyle measures to improve skeletal health. A variety of exercise regimens has emphasized the beneficial role of speed, strength, power, endurance and coordination in improving bone mass and structure, and the effects of these regimens vary depending on age and are maximized during childhood and adolescence. Exercise influences the skeleton primarily by its direct impact on bone and by improving muscle mass and strength, which exerts further strains on the skeleton. These strains are sensed by mechanoreceptors, primarily on osteocytes, whose nature remains incompletely understood but which ultimately transduce the mechanical signals into biological signals, a process that involves the Wnt-β-catenin canonical signaling pathway. This biological signal is able to trigger bone remodeling by directing osteoblast activity and osteoclastic resorption. The role of microcracks in the mechanotransduction pathway and in the initiation of bone repair remains to be elucidated. Moreover, exercise induces changes in circulating levels of hormones such as growth hormone (GH) and insulin-like growth factor (IGF)-1, which exert anabolic effects on muscle and bone. A better understanding of the potential and limitations of the effects of physical activity on the skeleton, and of the molecular mechanisms mediating these effects, will lead to the development of new bone anabolic agents.

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