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001 to 0.043). After adjustments for sex, age, height, and weight, serum osteocalcin levels were significantly lower in subjects with MS than those without (P levels by MS status was noted in both normal glucose tolerance (NGT) and abnormal glucose tolerance (impaired fasting glucose (IFG) or diabetes) group (P = 0.034 and P known OP who developed VCF's after spine flexion exercises (SFE's), and recommended that SFE's not to be prescribed in patients with OP of the spine. Here, we report four previously healthy individuals with low bone mass and exercise-induced fractures. Patient #1 An 87 yo F had severe back pain while performing SFE's during strenuous yoga with instructor supervision: Spine x-rays: L2 VCF and mild anterior wedging of several thoracic vertebrae Lumbar spine (LS) OP with T Score - 4.3 Physical examination: tandem test -3, LS pain with extension, and 3/4 inch leg length discrepancy with lumbar curve. Patient #2 A 61 yo F with osteopenia had severe back pain with strenuous SFE's during yoga: Spine x-rays: T4 VCF LS BMD T Score -1.8. Patient #3 A 76 yo M with osteopenia had severe back pain while lifting 35-40 lbs using an exercise machine anterior to his chest with spine flexion at his local physical therapy facility: Spine x-rays: L1, L2, and L5 VCF's Hip T-score -1.2. Patient #4 A 73 yo M had acute back pain while jogging in preparation for a triathlon: Spine x-rays: T7 VCF LS BMD T Score -1.9. SUMMARY: OP is characterized by low bone mass, loss of bone microstructure and fracture risk. OP musculoskeletal rehabilitation is a non-pharmacologic approach to limit bone loss. Although exercise has been shown to be an effective method for improving BMD and fracture risk, our subjects developed VCF's while engaged in exercise.