The Bone Clinic

24/08/2025

What the heck? Now denosumab (sold as Prolia - the 6 monthly injection for osteoporosis) is causing your ear canals to break down?! Osteonecrosis of the jaw (death of bone tissue) after oral surgery is a well-recognised complication of treatment with certain bone medications. But this recent paper reports two cases of denosumab-related osteonecrosis of the *external auditory canal* (the canal from your ear hole to your ear drum) !!
I say this often - I am not actively anti-drugs for osteoporosis - many people benefit from them. But you know what doesn't cause you to lose ear canal bone?
Targetted exercise for bone. a.k.a. ONERO

Abstract. Medication-related osteonecrosis of the jaw (MRONJ) is a rare but well-recognized complication of treatment with anti-resorptive agents. Medicati

22/08/2025

A good chat with Dr Jeremy Bettle from the Vitality Collective about bone health if anyone is interested.

Episode SummaryIn this episode, Dr. Jeremy Bettle is joined by Dr. Belinda Beck, professor and founder of The Bone Clinic, to explore the often-overlooked wo...

04/08/2025

Followers may have read my previous post about the muscle and bone loss that typically occurs during significant weight loss. There is some evidence that exercise can reduce the muscle loss but preventing bone loss has been found to be harder. I would argue that is because researchers are not testing the most effective (heavy resistance training, a.k.a. ONERO) exercise program for bone during weight loss. For example, the following study, published June 2025, showed neither wearing a weighted vest nor resistance training 3 days per week, involving 3 sets of 10 to 12 repetitions for 8 different upper and lower body exercises at 70% to 75% 1 repetition maximum prevented bone loss during weight loss.
https://pubmed.ncbi.nlm.nih.gov/40540267/

Come on folks, we can do better.

ClinicalTrials.gov Identifier: NCT04076618.

27/07/2025

We mostly talk about the physical benefits of resistance training., but of course mental health is equally important. This recent study of healthy active young adults examined the immediate effects of a single session of moderate-to-high-intensity resistance training on anxiety and depression. They observed reduced anxiety symptoms immediately after resistance training with a slightly more modest and variable effect on depressive symptoms. Probably no surprise to folks doing ONERO.

Background: Emerging evidence highlights the role of physical exercise as a non-pharmacological intervention for reducing symptoms of anxiety and depression. While most research has focused on aerobic modalities and chronic training programs, the acute psychological impact of resistance training (RT...

22/07/2025

I realise I am not telling The Bone Clinic followers anything they don't already know but it's always encouraging to see more evidence that people who are consistently and increasingly active have around 20–40% lower risk of death from any cause and 30-40% lower risk of death from cardiovascular disease (heart and vessels). Even increasing physical activity to less than the recommended guidelines showed benefit.
https://doi.org/10.1136/bjsports-2024-109122
Please note I do not have the ability to provide access to journal publications that are behind a paywall. If you do not have access I recommend visiting your local library which may subscribe.

Online ISSN: 1473-0480Print ISSN: 0306-3674 Copyright © 2025 BMJ Publishing Group Ltd & British Association of Sport and Exercise Medicine. All rights, including for text and data mining, AI training, and similar technologies, are reserved.

14/07/2025

After Baltimore it was on to Columbus Ohio to Precision Wellness where Todd and Kristin are going great guns. I did a quality assurance check of a couple of classes, ran an ONERO in-service and gave a community talk to a large and enthusiastic group. Lori from CorpStrength PT in Beachwood OH attended the in-service so she's all set to deliver high fidelity ONERO too. PS. Never have I seen a more aptly named business than Precision Wellness. The place is spotless! Kudos Todd.

10/07/2025

With apologies for the delay to post, had a great visit with another US licensee in May - this time in Baltimore where I ran an inservice, gave a community talk and did a quality assurance review of an ONERO class for Dan and Marquis at Summit PT. Shari from Sarasota Bonestrong in Florida came along for the in-service so she's all set to deliver high quality ONERO too!

02/07/2025

Nice little summary of ONERO and how it helps prevent osteoporotic fracture. Thanks to Dave Johnson, ONERO licensee at Evergreen in Pasadena, California for his advocacy.

[10-minute interview] ONERO™ founder, Belinda Beck, BMHS(Ed), MS, PhD, FACSM, discusses the science of Osteoporosis and exercise.

27/06/2025

Sorry about the long post but this is important.
I am often asked about the relative benefits of exercise and medications for osteoporosis (OP). The answer is multifactorial but in short, drugs can increase bone mass for many people with OP, but don't prevent the falls that cause fracture. Bone-targeted exercise (ONERO) improves bone AND reduces falls, and improves the health of virtually every other system in your body. Drugs have common side effects. Exercise does not. So on balance, exercise should always be first line therapy for OP regardless of whether you take the meds or not. The drug decision depends on many things - particularly how high your fracture risk is. The higher the risk, the more likely you need to take OP meds. But it's important to make an informed decision. An interesting study reported today of 447,208 patients with osteoporosis or osteopenia, found teriparitide (brand names: Forteo,Terrosa®) and denosumab (brand name: Prolia) increased cardiovascular events (heart attack and atrial fibrillation) considerably more than vitamin D and calcium but bisphosphonates (e.g. Fosamax, Alendronate, Aclasta/Reclast) slightly reduced risk of stroke. No increased or decreased risk of a cardiovascular event was observed for Abaloparitide (brand name: Eladynos) and Romosozumab (Evenity) but risk was highly variable for Evenity so it almost certainly depends on the individual. Food for thought if you have a family history of cardiovascular disease. (Ref: Stolcpart R, Higgs E, Bartelt K, Longo J. Some Bone Density Treatments Linked to Increased Likelihood of Heart Attack and Atrial Fibrillation. Epic Research.)

22/06/2025

Although it is well known that exercise reduces cognitive decline with aging, the type of exercise that most improves *overall cognition* was not known. Guess what it is? Resistance training 2-3 times per week, 45 min per session! Did someone say ONERO? They also report that 60 mins of aerobic exercise twice per week improves *memory* the most. More evidence that a dose of both types of exercise each week is best to keep brain and body healthy.

The protocol for this review was registered in PROSPERO (CRD42024597545).

20/06/2025

For those of you following the ongoing push for a retraction of the OsteoStrong paper recently published in JCEM...ABC have published the following story with expert opinion today. All are united in their opinion that it was both an extremely low quality study and very poor quality paper. Surely the Journal must retract!

A study that claims the popular OsteoStrong program can help strengthen bones in post-menopausal women is "misleading", and "should never have been published", say bone health researchers.

19/06/2025

Want to understand the background to and evidence for our ONERO program? Professor Belinda Beck will present the second in our annual 4-part series of educational seminars next week on just this topic with time for questions afterwards.
The talk will not be recorded or streamed.
Please call TBC reception to book your spot on 07 3391 5510
What: Seminar II - "Exercise for Bone Health"
Who: All welcome - clients of The Bone Clinic and other interested folk
When: 5:00 pm Wednesday 25 June, 2025
Where: Upper Mt Gravatt Progress Hall, 1873 Logan Rd, Upper Mt Gravatt.
NOTE: We have only given the seminar here once before and it is a little tricky to get into (the driveway is easy to miss) so please allow plenty of time to arrive and park as we will start on time.