As a Physical Therapist and licensed health professional, I frequently receive questions about OsteoStrong from my patients. Many women in their 40s, 50s, 60s, and 70s are understandably concerned about maintaining or improving their bone density, especially as the risk of osteoporosis increases with age. They specifically ask: Is OsteoStrong safe? Is it effective? Is there credible research supporting their claims?
As a clinician, I will only recommend a modality when it can demonstrate that it is an effective and safe way to improve bone health. Recently, Osteostrong identified a study out of Greece that it claimed supports that their devices improve bone health.
In the past, I’ve been hesitant to speak openly about the company. There was an unpleasant OsteoStrong lawsuit with a client who experienced a compression fracture (1) (2). However, a recent development has encouraged me to share my professional insights with you.
What is OsteoStrong?
Before diving further into the topic, let’s clarify what OsteoStrong actually is. OsteoStrong is a private company offering membership-based gym services specifically targeting individuals with osteoporosis. They operate through a franchise model, with “OsteoStrong Centers” located throughout the US, Canada, Europe, and other parts of the world.
The company claims their protocol involves “bone strengthening” through brief (12-minute), weekly, low-impact, high-intensity osteogenic loading sessions. This certainly sounds appealing, especially for those seeking efficient ways to improve bone health.
Review and Evaluation of The Recent OsteoStrong Study
In February 2025, a team of researchers in Greece published a study on OsteoStrong in the Journal of Clinical Endocrinology and Metabolism (3). This study, which was funded by OsteoStrong, claimed that the OsteoStrong protocol effectively increases bone mineral density, improves bone quality, and delivers other health benefits.
However, Dr. Lora Giangregorio, a leading researcher in osteoporosis and exercise from the University of Waterloo in Canada, has published a thorough review of this study (4). Dr. Giangregorio has published numerous studies on osteoporosis and exercise and is highly respected in her field. Her analysis reveals several concerning issues that anyone considering OsteoStrong should be aware of.
Major Shortcomings of the OsteoStrong Study
Dr. Giangregario identified seven significant shortcomings in the OsteoStrong study.
1. Failure to Meet Basic Scientific Standards
According to Dr. Giangregorio, the OsteoStrong study fails to meet even the most fundamental standards expected in scientific research:
- No clear objectives or hypotheses
- Inadequate information about ethical approval
- No clear statistical analysis plan describing how results were analyzed
- Incomplete description of how data was collected and analyzed for many outcomes
- No clear information about what the control group actually did
Scientific research follows internationally accepted standards and checklists for reporting. Alarmingly, this study is missing most of these essential elements.
2. Lack of Trial Registration
The scientific community agrees that all clinical trial protocols should be registered in a widely available online registry to ensure transparency. This registration number should be included in the published study.
Without a registered protocol, no one can confirm whether the researchers followed their original plan or if they changed their analysis or reporting methods to align with desired outcomes.
Interestingly, there is no information confirming that the OsteoStrong trial was registered. Dr. Giangregorio contacted both the authors and the university’s ethics board to determine if it was registered but received no response.
3. “Low Quality Study” with High Risk of Bias
From what Dr. Giangregorio could determine, this appears to be a very low-quality study with no efforts made to reduce the risk of bias.
Rather than using a randomized controlled trial (the gold standard in research), participants were allowed to choose whether they wanted to be in the control group or the OsteoStrong group. This self-selection creates an immediate bias, as people eager to participate in OsteoStrong may have had different health status or habits than those who opted out.
Additionally, there’s no indication that the study blinded the assessors – meaning the people evaluating outcomes knew which participants were in which group. This knowledge can significantly influence results, whether consciously or unconsciously.
4. Confounding Factors: Osteoporosis Medications
Dr. Giangregorio noted it was unusual that the study enrolled participants who were taking osteoporosis medications. These medications increase bone mineral density on their own, which confounds the results – especially if:
- The types of medications varied among participants
- Duration of medication use differed
- The number of participants was too small to separate medication effects from OsteoStrong effects
The study provides very little information about the types of osteoporosis medications participants were taking, how long they had been on them, or whether they took them consistently. This means the study wasn’t designed to accurately test the effects of OsteoStrong independent of medication effects.
5. The Crucial Question: Does OsteoStrong Improve Bone Density Scores?
For many women considering OsteoStrong, the most important question is whether the study demonstrated that OsteoStrong increases bone mineral density compared to the control group.
Surprisingly, we don’t know the answer because the authors didn’t report any analyses of between-group differences in bone mineral density at the hip or spine. Instead, they reported other statistics that aren’t typically used or accepted in clinical trials, such as:
- Changes in bone mineral density within each group (but not compared between groups)
- T-scores
- The percentage of people who experienced an increase in bone mineral density
The scientific standard is to focus on whether the bone mineral density change in one group is statistically different from the other group. Without this comparison, we cannot draw conclusions about effectiveness.
6. Lack of Proper Statistical Analysis
The study reported changes within each group but did not report statistical analyses comparing between the groups. Without this critical between-group analysis, it’s inappropriate to make conclusions about the effectiveness of OsteoStrong compared to the control.
Dr. Giangregorio points out that the average bone mineral density was already different between groups at the start of the study – something that shouldn’t happen if the groups are properly balanced. There’s also no information about how the researchers handled:
- Baseline differences between groups
- Missing data
- Outliers (unusually large individual changes that can skew averages)
Some participants showed changes that seem implausibly large. Including these outliers can falsely increase the average change reported. Dr. Giangregorio noted several errors and outliers in the paper, suggesting that a closer examination of the data and statistical analysis is warranted.
7. Follow the Money: Who Funded the Study?
Just as we might be skeptical of research funded by pharmaceutical companies, it’s important to note that this study was funded by a private company that owns OsteoStrong franchises.
Although the authors disclosed this funding, there remains significant potential for conflict of interest that could influence how the study was designed, conducted, analyzed, and reported.
8. Scientific Community Response
Dr. Giangregorio believes that the peer reviewers who evaluated this paper before publication may have missed several critical issues. She notes that the paper doesn’t even meet all of the journal’s own authorship guidelines.
The Bone Health and Exercise Science Lab at the University of Waterloo and other scientists globally have made the journal editors aware of their concerns about this paper and have called for its retraction. Several researchers from multiple countries, including researchers at Harvard, have written letters calling for its retraction.
Importantly, the senior author of the study is an editor for the journal where it was published, raising additional questions about the review process.
Exercise and Osteoporosis
Exercise is an essential ingredient to bone health. If you have osteoporosis, therapeutic exercise needs to be part of your osteoporosis treatment program.
But what exercises should you do and which ones should you avoid? What exercises build bone and which ones reduce your chance of a fracture? Is Yoga good for your bones? Who should you trust when it comes to exercises for osteoporosis?
A great resource on exercise and osteoporosis is my free, seven day email course called Exercise Recommendations for Osteoporosis. After you provide your email address, you will receive seven consecutive online educational videos on bone health — one lesson each day. You can look at the videos at anytime and as often as you like.
I cover important topics related to osteoporosis exercise including:
- Can exercise reverse osteoporosis?
- Stop the stoop — how to avoid kyphosis and rounded shoulders.
- Key components of an osteoporosis exercise program.
- Key principles of bone building.
- Exercises you should avoid if you have osteoporosis.
- Yoga and osteoporosis — should you practice yoga if you have osteoporosis?
- Core strength and osteoporosis — why is core strength important if you have osteoporosis?
Enter your email address and I will start you on this free course. I do not SPAM or share your email address (or any information) with third parties. You can unsubscribe from my mail list at any time.
OsteoStrong Review: July 2025
Previously, we examined the “research” OsteoStrong promotes as evidence for its claims on increasing bone density and improving health. We highlighted how Dr. Lora Giangregorio from the University of Waterloo identified significant shortcomings in that research, concluding that its cornerstone—the “Greek study”—is not credible evidence.
Now, I want to guide you through a far more definitive OsteoStrong review and analysis. The research team, including Dr. Giangregorio, published a comprehensive paper in the July 2025 issue of the prestigious journal Osteoporosis International (5). Titled “OsteoStrong and bone health: a scoping review,” this paper examines the available scientific literature to answer the critical questions that patients and their healthcare providers have about the program’s efficacy and safety, such as:
- Does OsteoStrong work?
- Are there any OsteoStrong side effects?
Let’s start with a discussion of how the research team approached these questions.
OsteoStrong Review Methodology
The research team cast a wide net to find all available evidence. They systematically searched five scientific databases for any study involving OsteoStrong machines. Their goal was to find any data related to the outcomes that matter most to bone health: changes in bone strength, risk of falls, and fracture rates.
OsteoStrong Review: General Concerns
The OsteoStrong review identified several significant methodological issues with the research:
- Conflicts of Interest: Of the four studies for which full texts were available, three have evidence of conflicts of interest. The first author of one study was also the sole participant in the study, and the third author of the same study was the inventor and medical science advisor of OsteoStrong.
- Publication Issues: One study was identified from a journal whose publisher appears on Beall’s list of predatory publishers, which are not typically indexed in major bibliographic databases.
- Small Sample Sizes: Most studies included 26 or fewer participants, limiting the ability to draw meaningful conclusions about effectiveness or safety.
Does OsteoStrong Work?
The research team examined the research to see if OsteoStrong does work as promised by the company. The evaluated OsteoStrong on several dimensions. Let’s discuss each one.
Fractures
The fracture data from OsteoStrong studies is extremely limited and concerning. None of the studies had sufficient sample size to properly test fracture outcomes, yet some troubling findings emerged.
In one of the studies, researchers identified multiple vertebral compression fractures in the OsteoStrong group:
- One T8 wedge fracture progressed from grade 1 (mild) to grade 2 (moderate)
- Five new incident wedge fractures at 8 months: T5 grade 1, T6 grade 1, T8 grade 1, and T9 grade 1
In contrast, no incident fractures were reported in the high-intensity resistance training (HiRIT) or control groups.
Another study reported three vertebral fractures in the OsteoStrong group compared to one in the exercise group.
Falls
Only one study reported comprehensive fall data. While the authors found no significant between-group differences in the number of falls or people who fell, the sample sizes were too small to draw meaningful conclusions.
Bone Mineral Density (BMD)
The research team evaluated OsteoStrong as it relates to effect on bone mineral density (BMD). They examined the results by area of anatomy.
Lumbar Spine BMD
Studies examined lumbar spine BMD with highly inconsistent results.
Femoral Neck BMD
Several studies reported femoral neck BMD outcomes but found no statistically significant between-group differences.
Total Hip BMD
Several studies examined total hip BMD but found no statistically significant between-group differences.
Femoral Neck and Total Hip Volumetric BMD (vBMD)
- Femoral Neck vBMD: No significant between-group or within-group differences were found for total, trabecular, or cortical vBMD at the femoral neck.
- Total Hip vBMD: Similarly, no significant differences were observed between groups for total hip vBMD measurements.
Bone Material Strength Index
The researchers used bone material strength index (BMSi) but found no significant difference was found between exercise and OsteoStrong groups.
OsteoStrong Side Effects and Adverse Events
The OsteoStrong side effects and adverse event reporting across studies was inadequate, but several concerning patterns emerged.
In one study, the OsteoStrong group experienced:
- Right knee discomfort during leg press
- Left shoulder muscle discomfort during chest press (caused 3 weeks of missed sessions)
- Low back discomfort after vertical lift (participant refused to perform vertical lift for four subsequent sessions)
Study Limitations in Safety Assessment
The researchers emphasized that none of the studies had sufficient sample sizes to properly assess safety, particularly for low-frequency but serious events like fractures. The small sample sizes make it difficult to determine the true safety profile of OsteoStrong interventions.
The Verdict: Is OsteoStrong a Hoax? Is OsteoStrong Legitimate?
While the authors do not question the legitimacy of the business venture, they do share their concerns with the potential for conflict between client care and profit maximization.
OsteoStrong is a for-profit company that sells franchises where members pay to access OsteoStrong proprietary equipment. The company and franchisees stand to benefit from being able to point to research that their intervention is effective while keeping research questioning the efficacy of the modality.
The company’s social media channels and website highlight published research that aligns with claims on their website but does not include the independent trials that reports incident fractures and no between-group differences in favour of OsteoStrong.
This does not suggest that OsteoStrong is hoax or is not legitimate. OsteoStrong is not a hoax, by any measure.
However, the review is more of warning for you, the reader, and that you should tread cautiously with OsteoStrong and their claims.
Individuals considering OsteoStrong as a treatment should be cautioned that claims that it has been shown to be safe or that it increases bone mineral density have not been substantiated by well-designed, published randomized controlled trials.
Discussion
The research on OsteoStrong is mainly limited to small observational studies that are at risk of bias because of conflict of interest, imprecision, publication in a predatory journal, participants on anti-resorptive medications, or poor-quality research reporting. The effects of OsteoStrong on bone strength outcomes are inconsistent, and currently there is little data on safety of this intervention.
The researchers emphasize that individuals considering OsteoStrong as a treatment should be cautioned that claims that it has been shown to be safe or that it increases bone mineral density have not been substantiated by well-designed, published randomized controlled trials.
OsteoStrong Efficacy and Effectiveness
If you’re a woman concerned about your bone health and considering OsteoStrong, what does all this mean?
In Dr. Giangregorio’s professional opinion – which I share – it is not possible to draw any meaningful conclusions from this study regarding the efficacy and effectiveness of OsteoStrong or from any of the published research on OsteoStrong to date.
The Bone Health and Exercise Science Lab and their international colleagues do not recommend making decisions to participate in OsteoStrong based on this new study. The serious methodological flaws, potential conflicts of interest, and lack of proper statistical analysis mean that the reported benefits cannot be trusted.
Conclusion: Looking Forward
There are reportedly two other studies about OsteoStrong that have not been published yet. These may provide more insight into whether OsteoStrong is truly effective. Until then, I recommend approaching claims about OsteoStrong with healthy skepticism.
Bone health is too important to entrust to interventions without solid scientific backing. As we learn more about OsteoStrong through future research, I’ll continue to share updates and insights with you.
Remember, improving and maintaining bone health is a long-term commitment that typically involves multiple approaches working together.
There are no quick fixes or miracle solutions, but there are evidence-based strategies, such as my Exercise for Better Bones program, that can help you maintain your bone density and reduce fracture risk as you age.
Margaret Martin
Further Readings
References
- Oliveri v. Osteostrong, 2021 Ohio 1694, 171 N.E.3d 386 (Ohio Ct. App. 2021), Casetext. https://casetext.com/case/oliveri-v-osteostrong
- “Anguish” Failed to be an Effective Substitute for “Negligence” in Ohio Case, Doric Cotten, Sport Waiver July 21, 2021 https://www.sportwaiver.com/anguish-failed-to-be-an-effective-substitute-for-negligence-in-ohio-case/
- Nektaria Papadopoulou–Marketou, Anna Papageorgiou, Nikolaos Marketos, Panagiotis Tsiamyrtzis, Georgios Vavetsis, George P Chrousos, Effective Brief, Low-impact, High-intensity Osteogenic Loading in Postmenopausal Osteoporosis, The Journal of Clinical Endocrinology & Metabolism, 2025;, dgaf077, https://doi.org/10.1210/clinem/dgaf077
- Osteostrong and Osteoporosis: BonES lab review of new study. https://youtu.be/fI3s_bbqrKQ?si=cNS4CwmGYZr4iXj5
- Kabra A, Katzman WB, Lane NE, Giangregorio LM. OsteoStrong and bone health: a scoping review. Osteoporos Int. 2025 Jul 21. doi: 10.1007/s00198-025-07614-x. Epub ahead of print. PMID: 40691713.
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