Osteogenic dynamic loads delivered to the skeleton during exercise prevent aging-associated bone fragility. Moreover, because of its pleiotropic favourable effects on health, exercise improves quality of life, and specific types of exercise increase muscle strength, a known predictor of bone strength, and coordination and balance, and so reduce the risk of fall related fractures. Exercise should definitely be the mainstay of the prevention and treatment of osteoporosis; often however, physicians don’t have enough know-how for evidence based prescription of exercise. Moreover, the lack of facilities for safe implementation of the exercise programs compound the problem.