Exercise Early In Life Prevents Fractures In The Elderly     Fractured Hip Repaired Hip     Many scientific studies over the years have helped us understand clearly that exercise has a potent effect on bone mineral density. This is true, not only in older persons but also in the young. It is well known that the more active young people are, the higher bone mass they attain at weight bearing sites. Youths who exercise experience a high and biologically important benefit in peak bone mineral density.     Studies have been done on athletes comparing their bone mineral density with other subjects matched for age who were mostly sedentary.     To maintain this advantage, persons need to maintain a level of exercise and physical fitness. The best combination seems to be vigorous past activities during one's youth and moderate activities as the person ages.     If a person in their youth had built up their bone mineral density, the advantage of that is lost by becoming sedentary over the years as one enters middle age and beyond.     After 35 years it was noted that the residual benefit of exercise and building up bone mineral density tapered into non-significance if the person had become sedentary.     There is certainly very good scientific support for the recommendation that continued moderate exercise through middle age into old age will preserve bone gained in youth.     Although the effect of exercise in preventing falls and fractures in elderly people has not been totally worked out, epidemiologic studies consistently have shown that both past and current physical activities do prevent and reduce the risk of hip fracture.     Of all the methods of fracture prevention in older life, regular physical activity is the only one that provides considerable other health related benefits and reduces the risk of fracture, as well.     Trying to encourage and increase the activity level of young people, middle aged people and the elderly is one of our largest public health problems. Perhaps it is because of all of the modern conveniences we have in our homes, our work and transportation.     I experience this on almost a daily basis as a practicing orthopaedic surgeon in trying to get people to exercise after certain types of surgery that we perform. People often just will not exercise, even though they know that this will help. How to change this mind set in our population is one of the great unsolved problems of modern medical practice and health care, in general.     There are major positive health benefits to exercise, not only in young and middle aged persons, but in the very elderly as well. It was never intended that we use our muscles and bones in the least strenuous way possible. It was supposed to be the other way around.