How many people do you know who’ve broken a wrist?

Many of our members first found us after a wrist fracture. When I think about friends and family, I can count at least ten.

And it’s not just coincidence, wrist fractures (distal radius fractures) are the most common fracture in women over 50 (Svedbom et al., 2013). Most of these come from a simple fall onto an outstretched hand, so common it has its own acronym, a FOOSH.

A large Swedish study of more than 23,000 people found that around 75% of distal radius fractures happened from a FOOSH, and most were in women. The average age was mid-60s, but the risk starts to rise in the 50s as bone loss speeds up around menopause (Owen et al., 2011).

It’s tempting to write a wrist fracture off as “just bad luck” but they are often the first visible warning sign of a bigger underlying problem. One study found that breaking your wrist once raises the risk of a future hip fracture by about 43% (Johansson et al., 2017). 

So while a wrist fracture may not be as devastating as a hip fracture in the short term, it’s a chance to take action before the stakes get higher.

This was one of the many reasons we developed our Strong for Life course. We’d seen the pattern and we’d received so many messages from you. We’d made educated guesses about what could improve wrist strength and distal bone density, but we wanted to see what the science points to.

We looked to the Royal Osteoporosis Society, Osteoporosis Canada, and Healthy Bones Australia, as they are leading organisations globally. Then we trawled through peer-reviewed studies.

What we found is that there isn’t a huge amount of research that looks specifically at wrist strength or distal radius bone density, particularly in older populations.

We came across some data that’s part of a much bigger study (co-authored by one of the researchers behind the LIFTMOR trial - a landmark osteoporosis study) that compared impact-style loading with resistance training in young adult women, not just for hips and spines, but for the upper limbs too.

In brief: both impact and resistance training improve bone, but in different ways and at different sites. That’s important, because the wrist often gets left out of “bone-loading” advice, despite being where many people first run into trouble.

(Full summary of that paper is below if you’d like the detail.)

What you can do now

• If you’ve fractured a wrist: ask your GP for a DEXA scan. A distal radius fracture is a warning sign, not just bad luck.

• Train your wrists and forearms specifically. Just like hips and spines, they need load. You can prepare them gradually:

• Start at the wall, leaning and shifting weight through your hands.

• Play with gently pushing off and receiving the force by bending your arms.

• Over time, progress down to the floor, slowly adding more bodyweight onto your wrists in all-fours positions.

• Work up to crawling and other quadrupedal movements - brilliant for wrists, shoulders, balance, and confidence close to the ground.

These “in-between positions” are often what make the difference between catching a fall and turning it into a fracture.

We’re working on a series of long-form tools to show you exactly what this looks like, bear with us, they’re coming soon.

Research Appendix: Impact vs Resistance Training

Some recent data from the OPTIMA-Ex (Osteoporosis Prevention Through Impact and Muscle-loading Approaches to Exercise) study have been released. The study, which was co-authored by Belinda Beck, one of the LIFTMOR researchers, directly compared high-intensity impact training (IT)and high-intensity resistance training (RT) over 10 months in young adult women (Lambert et al., 2022).

• Impact training: upper-limb punching (jab, cross, hook) + lower-limb landings (jumps, hops, drop jumps).

• Resistance training: high-intensity lifting, twice per week.

Findings:

• Impact training → greater improvements at the distal ends of long bones (e.g. distal radius, distal tibia).

• Resistance training → greater effects on the shafts of long bones and at the femoral neck.

In other words, the type of load matters. Punching and landing helped strengthen bone where fractures often occur (wrists, ankles), while heavy lifting targeted hip and shaft regions.

This is one of the first direct comparisons of its kind, and it reinforces why combining impact and resistance is such a powerful strategy for long-term bone health.

References

• Svedbom, A., Hernlund, E., Ivergård, M. et al. (2013). Osteoporosis in the European Union: a compendium of country-specific reports. Archives of Osteoporosis, 8, 137. https://doi.org/10.1007/s11657-013-0137-0

• Owen, R. A., Melton, L. J., Ilstrup, D. M., Johnson, K. A., & Riggs, B. L. (2011). Colles’ fracture and subsequent hip fracture risk. Clinical Orthopaedics and Related Research, 467(6), 1576–1581. https://doi.org/10.1007/s11999-008-0621-4

• Johansson, H., Siggeirsdottir, K., Harvey, N. C. et al. (2017). Imminent risk of fracture after fracture. Osteoporosis International, 28, 775–780. https://doi.org/10.1007/s00198-016-3868-0

• Watson, S. L., Weeks, B. K., Weis, L. J., Harding, A. T., Horan, S. A., & Beck, B. R. (2018). High-Intensity Resistance and Impact Training Improves Bone Mineral Density and Physical Function in Postmenopausal Women With Osteopenia and Osteoporosis: The LIFTMOR Randomized Controlled Trial. Journal of Bone and Mineral Research, 33(2), 211–220. https://doi.org/10.1002/jbmr.3284

• Lambert, C., Beck, B. R., Harding, A. T., Watson, S. L., & Weeks, B. K. (2022). Regional changes in indices of bone strength of upper and lower limbs in response to high-intensity impact loading or high-intensity resistance training. Bone Reports, 16, 101172. https://doi.org/10.1016/j.bonr.2022.101172