Current Osteoporosis Reports

, Volume 15, Issue 1, pp 43–52 | Cite as

Physical Activity for Strengthening Fracture Prone Regions of the Proximal Femur

  • Robyn K. Fuchs
  • Mariana E. Kersh
  • Julio Carballido-Gamio
  • William R. Thompson
  • Joyce H. Keyak
  • Stuart J. WardenEmail author
Biomechanics (M Silva and K Jepsen, Section Editors)
Part of the following topical collections:
  1. Topical Collection on Biomechanics


Purpose of Review

Physical activity improves proximal femoral bone health; however, it remains unclear whether changes translate into a reduction in fracture risk. To enhance any fracture-protective effects of physical activity, fracture prone regions within the proximal femur need to be targeted.

Recent Findings

The proximal femur is designed to withstand forces in the weight-bearing direction, but less so forces associated with falls in a sideways direction. Sideways falls heighten femoral neck fracture risk by loading the relatively weak superolateral region of femoral neck. Recent studies exploring regional adaptation of the femoral neck to physical activity have identified heterogeneous adaptation, with adaptation principally occurring within inferomedial weight-bearing regions and little to no adaptation occurring in the superolateral femoral neck.


There is a need to develop novel physical activities that better target and strengthen the superolateral femoral neck within the proximal femur. Design of these activities may be guided by subject-specific musculoskeletal modeling and finite-element modeling approaches.


Bone density Bone mass Bone structure Exercise Femoral neck Osteoporosis 


Compliance with Ethical Standards

Conflict of Interest

R.K., W.T., J.C.-G., M.K., and S.W. declare no conflict of interest. J.K. declares a patent issued (#9245069).

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.


Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

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Copyright information

© Springer Science+Business Media New York 2017

Authors and Affiliations

  • Robyn K. Fuchs
    • 1
  • Mariana E. Kersh
    • 2
  • Julio Carballido-Gamio
    • 3
  • William R. Thompson
    • 1
  • Joyce H. Keyak
    • 4
  • Stuart J. Warden
    • 1
    Email author
  1. 1.Department of Physical Therapy and Center for Translational Musculoskeletal Research, School of Health and Rehabilitation SciencesIndiana UniversityIndianapolisUSA
  2. 2.Department of Mechanical Science and Engineering, College of EngineeringUniversity of Illinois at Urbana-ChampaignUrbana-ChampaignUSA
  3. 3.Department of Radiology, School of MedicineUniversity of Colorado DenverDenverUSA
  4. 4.Departments of Radiological Sciences, Mechanical and Aerospace Engineering, and Biomedical EngineeringUniversity of CaliforniaIrvineUSA

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