A Fragility Fracture is nowadays looked upon to be the most important clinical symptom of osteoporosis. The sportive elderly have a limited risk to suffer from this event. Mechanical loading of the skeleton which is associated with most sporty activities prevents age related bone loss. Furthermore, if a fracture happens as a result from sporty activity, the criterion of a fragility fracture is usually not met.
Elderly sportsmen who want to be reassured or who are going to restart activity after a break can be offered a fracture risk calculation by means of FRAX. Correct interpretation of the risk scores needs knowledge of the boundary conditions the algorithm is based on. In contrast a DEXA scan is rarely indicated in this situation.
Vitamin D Supplementation can generally be adviced for every elderly person in our region, especially for the sportive ones. Sufficient intake of calcium and protein shall be achieved by a healthy diet.
Despite of the risk of falling that is usually associated with any sportive activity it may be summarized, that there is less fractures in active people. As long as human beings stay mobile and active, pharmacological prevention or treatment of osteoporosis is rarely indicated.
An exeption from this is osteoanabolic treatment of insufficiency and stress fractures. This shall be mentioned here even though it is an “off-label” use of the drugs.
Combination therapy of anabolic and nonbisphosphonates antiresorptive agents for the treatment of osteoporosis