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3 Simple Tests Help Predict Hip Fracture Risk

By Dr. Susan E. Brown, PhD

Wouldn’t it be remarkable to have one way to predict future hip fracture risk?

Now, thanks to curious Finnish researchers, we have not just one, but three simple tests that can give us better insight into who is likely to break their hip down the road. After some study they settled on three physical tests, failure of which they thought might indicate that one was headed for a hip fracture. According to their findings presented at the recent ASBMR meeting, the highly predictive tests were:


Researchers had 2,791 women with the average age of 59 complete the tests — and then patiently waited 15 years to see who broke their hips.

What Researchers Discovered

Fifteen years later, researchers compared the rate of hip fracture from those women passing all tests to those women who had failed one or more of the tests. Here’s what they discovered:

• Women at age 59 failing any one of these tests had four times the risk for hip fracture, plus any fracture and even death.

• The strongest single determinant for hip fracture risk was the inability to stand on one leg for 10 seconds. In the study, failing this test at age 59 was associated with over eight times increase in hip fracture risk over the next 15 years.

• The inability to squat, touch the floor and stand back up was linked to a 5.2 times increase in hip fracture.

• Those with lowest grip strength at age 59 (or the bottom ¼ of women tested) ended up with over a four-fold increase in hip fracture as compared to women who passed the balance and squatting tests and were in the top ¾ of those tested.

What Does This Mean for You?

I’m encouraged that this research focuses on activities which suggest general fitness —and they are ones we can all practice to help minimize hip fracture risk. I suggest all women consider the following:

1. Balance is of utmost importance, if you do not fall you will not fracture a hip. If you can’t stand on one leg for 10 seconds at any age, I recommend look into exercise to enhance balance. For balance, I favor mindful exercises like Tai Chi and Qi Gong.

2. Leg strength and flexibility are hip-protective. Develop a leg strengthening exercise program. And the next time you are sitting on the floor or squatting, practice getting without using your hands. Full body strength can be enhanced with my Exercising for Bone Health DVD or the Skeletal Fitness DVD.

3. Diminished grip strength is repeatedly associated with vertebral fracture risk, and now we see it linked to hip fracture as well. If those jars are getting hard to open, it’s time to exercise your arms and hands. I like using the isometric OsteoBall exerciser to enhance arm and wrist strength.

For more information about exercise and bone health, read my article here.

Reference: Rikkonen, T. (Sept. 12, 2014) Simple functional tests predict hip fracture and mortality in postmenopausal women: 15 year follow-up. ASBMR abstract FRO455, ASBMR Annual Meeting.


You can try Dr. Brown’s comprehensive supplements in her at-home bone health program, developed with Women's Health Network. Get her exclusive formulations along with her detailed lifestyle and diet guidance, plus telephone support whenever you need it. Learn more about the Better Bones Health Program.

We created the Better Bones blog as our forum to express opinions and educate the public about natural means of supporting and improving bone health and overall wellness. As part of this forum, we sometimes discuss medical issues and medications, and their effects on bone health in general. However, we cannot advise readers about specific medical issues in this forum. If you wish to obtain advice from Susan E. Brown, PhD, about your specific bone health and nutritional concerns, please visit our Consultations page. Other specific medical questions should be referred to your healthcare provider.



November 18. 2014 13:08

Appreciate your kind research!


November 18. 2014 13:20

I've been receiving your newsletters, and I must say, this is very helpful information.  You've helped me identify the exercises that are most important for any bone weakness I may have and have helped alleviate my fears surrounding bone loss!  Thanks so much!

Patty Soza

November 18. 2014 13:40

My physical therapist has said these things to me, almost word for word over the last month. I am recovering from a back/neck injury but he tells me that this is what I need to do to really get on the road to recovery and to stay on my feet. I have been following his instructions and am already stronger than I was when I started- am I plan to stay that way!


November 21. 2014 14:42

Thank you for that insightful article.   What an encouragement to do ... or become able to do ... those 3 simple things.

May I comment on your statement that "if you do not fall, you will not fracture a hip".   It is my understanding this is not totally accurate.   Women with osteoporosis can have their hips fracture, CAUSING the fall.

Along with ensuring enough calcium (not from supplements due to the research of increased cardiovascular events) and vitamin D, should be considered a warning against the bisphosphonates, e.g. Fosamax, and the avoidance of diet drinks containing phosphorus.

Although we are all different, I can speak from experience and perhaps this could be an encouragement to others.  Diagnosed with osteopenia, I began a full glass of skim milk daily, combined with Muscle Milk powder or powdered milk.  (Also added are a few shakes of organic cinnamon.) Since I don't like the taste of milk, this works well. I also supplement with 5000 IU of vit. D/week.
DEXA scans have shown increased bone mass, and it is now normal.

Thank you for all you do in helping others!

Nina Lancaster

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