Welcome to the Bone Health Special Interest Group! Please visit this page often for access to numerous resources to support your practice in evidence based treatment and education related to bone health AND for SIG news and events.

The primary purpose of the Bone Health SIG is to:

  • Develop and apply research and knowledge to
    • Promote, maintain, and preserve bone health through the life span
    • Reduce age-related bone loss
    • Reduce fracture risk
  • Manage and treat bone loss, osteoporosis and fractures
  • Expand understanding of bone and its unique response to mechanical loading and exercise
  • Increase public awareness of the role of physical therapy in the promotion of bone- healthy exercise and lifestyle and the management and treatment of bone loss and fracture
  • Develop guidelines for successful clinical practice.
  • Inform all physical therapy practice to incorporate knowledge of bone into everyday practice and exercise prescription, with emphasis on bone building exercise in youth and safe, non- compressive core and balance exercises for older adults.

There are many opportunities for participation, so please consider getting involved! To participate or learn more about current SIG activities and projects, contact the SIG chair.


  • CHAIR: Lisa Hamilton, PT, DPT
  • VICE CHAIR: Kathlene Camp, PT, DPT
  • SECRETARY: Mary Milidonis, PT, MSPT, PhD
  • STUDENT LIAISONS: Paula Stonehouse SPT, Giulia Marsella SPT



BH SIG Events


Bone Health SIG Member Resources

Free Bone Health SIG Toolkit

This toolkit has been developed by members of the Bone Health Special Interest Group (BHSIG) of the Academy of Geriatric Physical Therapy (APTA Geriatrics), to assist clinicians screen, provide thorough assessment and essential interventions for patients with low bone density and history or risk for fracture.

Welcome Letter – October 2023

Welcome to the BHSIG and Fall 2023!

We are heading into the final stretches of 2023, and our focus continues on building the Bone Health Toolkit.  We are excited to bring this resource to life and feel that it will be an important resource for both clinicians and patients with osteoporosis and compromised bone health. This toolkit will include guidance for evidence based screening, evaluation and interventions that are based upon the CPG/Delphi Study, as well as a compendium of additional resources that are user friendly and accessible. We are excited to bring both the Toolkit and the KT from the CPG/Delphi to life as a resource for your practice and patients.

October 20 is World Osteoporosis Awareness day, and we invite you to check out the many resources through the International Osteoporosis Foundation.  This is a great opportunity as physical therapists to bring awareness and educate our clients and communities about Bone Health and steps to take to stay strong and healthy. 

CSM 2024 is in Boston, MA February 15-17, 2024. Registration is OPEN!  We are excited to present on Thursday, February 15: GR-17875 – Applying a Geriatrics 5Ms Framework to Osteoporosis Management. The Geriatric 5Ms model (What Matters Most, Mind, Mobility, Medications, Multi-complexity) provides a comprehensive approach to older adult care and has been associated with reduced institutionalization, greater independence, and higher levels of physical function.  This 5Ms model provides a framework to address factors impacting bone health and focuses on patient-centered care.   We hope to see you there!

Lastly, thank you to all who continue to contribute to our SIG and to the leadership team. We would not be successful as a volunteer organization without contributions from all of you!

Lisa Hamilton  PT, DPT, NCPT, CHWC

Chair, APTA Geriatrics Bone Health Special Interest Group


Bone Health Flash

April 2024 – Welcome to Spring and opportunities to grow your knowledge in bone health!

Osteoporosis Awareness and Prevention Month – May

Bone Health and Osteoporosis Foundation (BHOF)
Consider connecting your patients with some virtual options for learning more about primary and secondary fracture prevention in May: https://www.bonehealthandosteoporosis.org/awareness-month/.
On-demand webinars and podcasts are available at this link, as well, to provide your patients more information on exercise, nutrition, and mindfulness to address bone health.
Also, check back for additional resources, including a Social Media Toolkit, to share awareness about bone health in your community and network.
Steps to Strong Bones™ – Connect your patients, or even join yourself, to a monthly Zoom meeting (first Monday of the month, 12 pm ET) to learn from motivational speakers and like-minded individuals on how to manage and progress bone health.

Interdisciplinary Symposium in Osteoporosis (ISO2024) Join like-minded professionals June 13 – 15 in Washington DC to expand your knowledge, connect, and engage in interprofessional discussions on OP management. https://interdisciplinarysymposiumosteoporosis.org/2024-registration/.

Expand your Library and Knowledge:

FRAX®…updating the fracture risk assessment tool
Osteoporosis management is often measured by assessing bone mineral density (BMD) with the use of dual energy absorptiometry x-rays (DXA). But, the FRAX® online resource tool can guide intervention decisions by providing more information on fracture risk. However, the FRAX® tool has been criticized for not recognizing additional risk factors (i.e. falls), additional medical conditions associated with fracture risk (i.e. type 1 and 2 diabetes), duration of exposure with risk factors (i.e. glucocorticoids), and greater representation of gender and ethnicity in data. A systematic review was performed using 64 cohort studies to determine quality of findings for integration into the current algorithm.1
A history of falls was addressed in 46 of these cohorts. Findings indicate a fall in the past year is associated with a significant increase risk of any subsequent fracture, with men having a 10-30% higher risk than women, despite the fact women fall more frequently than men. The risk varied between 36 and 59% dependent on fracture outcome and sex. But fracture risk was also shown to decrease with age, HR of 2.63 at age 40 to HR 1.09 at age of 90.2 And one or more previous falls was associated with an increased risk of death for both genders.
It appears we may see the integration of fall risk into the FRAX® risk assessment tool in the near future. Watch for further analysis of additional risk factors to be considered in the update.
1. Vandenput L, et al. 2022. Update of the fracture risk prediction tool FRAX: a systematic review of potential cohorts and analysis plan. Osteoporos Int. 2022 Oct;33(10):2103-2136. doi: 10.1007/s00198-022-06435-6. Epub 2022 May 31. PMID: 35639106. https://pubmed.ncbi.nlm.nih.gov/35639106//
2. Vandenput L, et al, 2024. A meta-analysis of previous falls and subsequent fracture risk in cohort studies. Osteoporos Int. 2024 Mar;35(3):469-494. doi: 10.1007/s00198-023-07012-1. Epub 2024 Jan 17. PMID: 38228807. https://pubmed.ncbi.nlm.nih.gov/38228807/.

What’s Happening in the SIG

General Body Meeting
We held our last meeting on April 2 and addressed the following topics:
CSM: Brief recap of CSM topics and opportunities for future CSM bone health topics.
Bone Health Toolkit: Sneak peek toolkit, available now on the BHSIG website.
Survey: review of findings from survey to find out a bit more about our members and interests to guide future action steps and develop collaborations.
Journal Club: Plan to highlight APTA CPG for OP management. Interested in providing a complimentary Case Study to be highlighted in the January GeriNotes
Opportunities to Collaborate: To find out how you can contribute or for you to provide suggestions or your expertise, contact lisahamiltonpt@gmail.com.

In the Spotlight

Joanne Fagerstrom, PT, CFP, has been a practicing PT since 1978, (Hunter College, NY), and worked in various Philadelphia area teaching hospitals before launching her private practice, Mindful Physical Therapy, LLC, in 2012.
After being diagnosed with osteoporosis in 2009, Joanne began the research and development of her comprehensive bone health program, Strong Bones, where she specializes in working with active adults with osteoporosis or low bone mass. Joanne places a strong emphasis on wellness and prevention in her treatment programs, and her certification in the Feldenkrais Method (2004) adds a unique dimension to her practice of physical therapy. In 2018, she augmented her work by completing a certificate program in nutrition through Cornell University.
In addition to private consultations, Joanne teaches weekly Strong Bones exercise classes both online and in-person and regularly offers public bone health workshops. In 2015, she produced and released her educational Strong Bones exercise video; the second edition was released in 2021.

Educational Offering

In 2023, Joanne launched her bone health course that she created not only for PTs seeking to earn CEUs while expanding their own practice in the field, but also for anyone interested in finding evidence-based answers about their bone health. This course, titled Comprehensive and Holistic Physical Therapy Management of the Active Adult with Osteoporosis/Low Bone Mass: A Whole-Body Approach, has been approved by the Pennsylvania State Board of Physical Therapy for 7 contact hours. It is a recorded webinar designed to be self-paced. She is currently applying to several additional states for CEU approval.

To learn more, please go to: ced.ourstrongbones.com

Want to be featured in the next Flash? send information to: Kathlene.camp@unthsc.edu

Join the SIG

To receive regular updates and access to all resources, join our SIG.
Kathlene Camp, PT, DPT
Board Certified Specialist in Geriatric Physical Therapy
Vice Chair, BHSIG

BoneFit™ USA

Register for the new workshop here.

What Is BoneFit™?
BoneFit™ is an evidence-informed exercise training workshop, designed for healthcare professionals and exercise specialists to provide training on the most appropriate, safe and effective methods to prescribe and progress exercise for people with osteoporosis. BoneFit™ includes two different levels of workshops – BoneFit™ Basics and BoneFit™ Clinical. BoneFit™ Basics workshops are aimed at exercise and fitness professionals. BoneFit™ Clinical workshops are aimed at rehabilitation professionals. BoneFit™ was created and launched by Osteoporosis Canada in 2010. BHOF is working with Osteoporosis Canada and the founders of BoneFit™ to bring this training program to the United States.

Get BoneFit™ Trained

Exercise and fitness professionals that work with uncomplicated osteoporosis clients are eligible to participate in BoneFit™ Basics workshops. Rehabilitation professionals working in a clinical environment with simple or complex osteoporosis patients are eligible to participate in the BoneFit™ Clinical workshops. Students in both fields are also welcome to participate.

Each workshop includes two components – online learning modules that need to be completed in advance and in-person training. After completing the online modules and the in-person training, attendees must pass an online quiz with 70% to be officially BoneFit™ Trained. Healthcare professionals may be eligible for continuing education credits for participating in a workshop.

If you are interested in helping grow the BoneFit™ USA initiative by partnering for future workshops or being a BoneFit™ trainer, please contact us at education@bonehealthandosteoporosis.org.

Bone Health References – 2021 Update

Secondary Fracture Prevention – a Multi-stakeholder Coalition Solution for a Current Gap in Treatment

The American Society for Bone and Mineral Research (ASBMR) assembled a multi-stakeholder coalition including representation from the American Physical Therapy Association to develop clinical recommendations for the optimal prevention of secondary fracture among people aged 65 years and older with a hip or vertebral fracture. Review of this document describes essential strategies requiring collaboration within care management teams addressing education, communication and interventions. “Emphasizing the connection between fracture and osteoporosis elevates the fracture from an unfortunate accident to a sentinel event indicative of an important underlying chronic disorder.” There is frequent failure to investigate the diagnosis of osteoporosis and provide the long-term integrated care that this chronic condition requires. Following the first fracture it is imperative to initiate immediate interventions to increase the number of patients receiving appropriate osteoporosis treatment. Physical therapists have a long history of successful intervention for acute osteoporotic fractures, but often do not continue care for lifelong management of these patients. Additionally, the medical management across specialties is frequently inconsistent. Given the treatment gap for comprehensive management of this condition, there are predictable complications which will have lifelong impact on function and quality of life. Therefore, physical therapists must actively embrace this call to action. We are vital members of the multidisciplinary team, and with aggressive evidence based approach to encompass the full scope of therapy interventions throughout the lives of these patients, we can fully support the overall strategies presented by the coalition.

Review the full article: Conley RB, Adib G, et al. (2020). “Secondary Fracture Prevention: Consensus Clinical Recommendations from a Multistakeholder Coalition.” J Bone Miner Res 35(1): 36-52. PMID: 31538675 DOI: 10.1002/jbmr.3877

Osteoporosis & Aquatic Exercise: New Concepts, Updated Research, Novel Techniques

Community Bone Health Presentation

Why Start A Community Exercise Program

Please watch Sherri Betz, PT DPT, former chair of the BGSIG in this featured podcast.

Stand TallTM DVD

A new Stand TallTM DVD by Wendy Katzman, DSc, PT, OCS has been produced the UCSF Department of Physical Therapy and Rehabilitation Center. To order the video, contact Anthony.Casino@ucsf.edu

What Are Evidence-Based Exercise Programs and Why Are They Important?

Do It RIGHT! and Prevent Fractures!
The Bone-Healthy Way of Life and Exercise

American Bone Health would like to acknowledge the hard work and determination of the author Sherri Betz, PT, GCS, in bringing this important information to the public. We thank the models Jan and Lee Prawitz, Sue Walters and Joan White, who donated their time to show others how to keep their bones fracture free. We recognize and thank Nancy Abodeely, PT, OCS, for reviewing the final content to ensure we communicated safe and effective activities and exercises. American Bone Health is proud to have the endorsement of the Bone Health Special Interest Group of the APTA Geriatrics, American Physical Therapy Association, for this work.

Sherri Betz presentation of the National Osteoporosis Foundation Webinar: Safe Pilates and Yoga for Bone Health now available.