Strenuous walking exercise and spontaneous fracture of the femoral neck in the elderly.

Spontaneous fractures of the hip which developed after strenuous walking exercise in 8 elderly people are reported. All patients had Singh hip index 4 or below at the time of initial examination and walked from 8,000 to 10,000 steps per day. This presentation aims to arouse the attention of physicians, recreational sports coaches, and elderly people to the deleterious effects of strenuous walking exercise on bone, and it looks for an optimal level of walking exercise according to the elderly patient"s bone quality. Walking exercise should be stopped immediately if pain in the hip develops and continues without relief for several days or more. The optimal walking frequency per day should be prescribed on the basis of the Singh index or T-score of BMD. If the BMD is 1/3 to 1/2 of normal, walking frequency should be adjusted to 1/3 to 1/2 of those of the normal adult with good bone quality.