Your FRAX score estimates your chance of a hip fracture and a major osteoporotic fracture over the next 10 years. It helps your medical team discuss bone-health treatment. It does not tell you that a fracture is inevitable, or give you a list of exercises you must avoid.
If your DEXA report has left you with more questions than answers, we understand. A percentage can feel very personal when you are wondering whether to lift weights, join a class or keep doing the things you love. At Mindful Movement, we help you connect the report to a practical plan for getting stronger and moving with more confidence.
What does a FRAX score mean?
FRAX uses a combination of clinical risk factors and, when available, bone density at the femoral neck to estimate fracture probability. The two results answer different questions:
| Result on your report | What it estimates |
|---|---|
| Hip fracture | Your probability of breaking a hip within the next 10 years. |
| Major osteoporotic fracture | Your probability of a clinical spine, hip, forearm or shoulder fracture within the next 10 years. |
The major-fracture result already includes hip fractures. Do not add the two percentages together. You can find the original tool and its explanation on the official FRAX website.
An example that makes the percentages easier to read
Illustrative example, not a patient story: imagine a report shows 10% major osteoporotic fracture risk and 2% hip fracture risk. Among 100 people with a similar risk profile, the model estimates about 10 would experience a major osteoporotic fracture over the next decade, including about two who would have a hip fracture.
That does not mean a particular person will fracture in 10 years. It also does not mean there is a 12% total risk, a 10% chance every year, or a prediction about what will happen during your next walk. The percentages give you and your clinician a starting point for prevention decisions.
How is FRAX different from a DEXA T-score?
Your T-score describes bone density compared with a young-adult reference population. FRAX asks a different question: how likely is a fracture, considering bone density and other aspects of your history?
Two people can have similar T-scores and different treatment needs. Age and a previous low-trauma fracture, for example, can change the conversation. This is why “I only have osteopenia” is not always the whole story. The Bone Health and Osteoporosis Foundation’s patient guide explains how FRAX can help with treatment decisions in people with osteopenia.
If you are still getting familiar with the report, our DEXA results guide explains T-scores, Z-scores and the different sites measured.
What is a high FRAX score?
In the United States, the Bone Health and Osteoporosis Foundation’s Clinician’s Guide recommends considering medication for postmenopausal women and men age 50 or older with osteopenia at the femoral neck or total hip when the U.S. FRAX estimate reaches 3% or higher for hip fracture, or 20% or higher for major osteoporotic fracture. These are treatment thresholds used in that specific clinical context. They are not a universal grading scale for every person or country.
A hip or vertebral fracture can be a reason to consider treatment regardless of bone density. A T-score in the osteoporosis range can also support treatment independently of FRAX. Your prescribing clinician should interpret these findings together. The BHOF Clinician’s Guide sets out those recommendations.
Being below a threshold does not make strength and balance training unnecessary. Being above one does not mean you should stop moving. The useful question is: “What should my medical and exercise plan look like from here?”
What can FRAX miss?
The standard calculation simplifies a complicated history. It does not fully capture how recently a fracture happened, the number of previous fractures, fall history or a large difference between spine and femoral-neck bone density. These details can influence clinical decisions. FRAXplus offers additional adjustments for some factors; that is a conversation for your healthcare team rather than a reason to change calculator answers yourself.
FRAX is also not sensitive enough to monitor treatment progress. We would not expect a stronger lift or several weeks of balance practice to produce a useful change in that number. See the official FRAX FAQs for these limitations.
Tell your clinician about recent falls, fractures and new symptoms even if they are not obvious on the printed score. Your lived experience matters.
What should you do after getting your FRAX result?
1. Clarify the medical plan
Bring the complete DEXA report rather than just the lowest T-score. Ask:
- Were the correct bone-density site and medical history used for my calculation?
- Does my fracture history change the recommendation?
- Should we discuss medication, other testing or a bone-health specialist?
- When should I have follow-up testing, and how will we judge a meaningful change?
Exercise can work alongside your medical treatment. A class, a better balance test or feeling stronger is not a reason to stop prescribed medication on your own.
2. Choose a starting point for strength and balance
A FRAX result cannot tell us whether you feel steady on stairs, can get up from a low chair, or know how to lift without feeling afraid. Those are useful questions for a movement assessment.
In one-on-one bone-health physical therapy, we look at your fracture history, current symptoms, lifting experience, balance and goals. We can practice the movements that feel uncertain and decide how to progress them. If you are comfortable joining a group and do not need individual rehabilitation first, our Bone Builder classes offer guided strength training in Holladay on Tuesday and Thursday, noon–1 p.m.
3. Track changes you can use in daily life
We want your exercise plan to mean more than waiting for another scan. Depending on your starting point, useful markers can include:
- Getting up from a chair with more control.
- Carrying groceries with a technique you understand.
- Managing stairs with less hesitation.
- Increasing resistance while keeping good form.
- Feeling steadier during turns or on uneven ground.
- Returning to a valued activity, such as gardening or hiking.
These changes do not prove a particular reduction in fracture risk. They do show whether your plan is helping you function better while your medical team monitors bone health.
What does this look like at Mindful Movement?
We start by hearing what you want to feel comfortable doing again. Then we choose a level of exercise that fits where you are today, teach the movement and build the challenge as your ability improves. Dr. Emily is BoneFit trained; our bone-health approach draws on evidence-informed strength, balance and safe-movement guidance.
We also discuss what research such as the LIFTMOR trial can teach us about supervised progressive strength training. A research protocol is not a reason to assign everyone the same weights or exercises. Your plan needs to fit you.
A patient’s perspective: feeling stronger and able to do more
Rebecca describes working with Dr. Emily through debilitating back pain, then joining the bone-strengthening class. She says she feels stronger, more able and able to move more. Her experience speaks to daily function and confidence; it is not a measured FRAX or DEXA outcome.
Video summary: Rebecca began with back-pain care, later joined class and describes feeling stronger and able to do more. Hear the experience in Rebecca’s own words.
Common questions about FRAX and exercise
Can I have osteopenia and still have a high fracture risk?
Yes. Bone density is only part of the picture. Your age, fracture history and other clinical factors can lead your medical team to recommend treatment even when your report uses the term osteopenia.
Can I calculate FRAX myself?
You can view the official FRAX tool, but have your healthcare provider interpret the result and confirm the inputs. Do not substitute a spine T-score for the femoral-neck value. A calculator cannot replace a review of your full history.
Does a high FRAX score mean I should avoid lifting weights?
It means your fracture risk deserves a thoughtful plan. We consider the score alongside any fractures, symptoms and medical guidance, then teach suitable movement and loading. Individual PT can be a helpful first step if you are unsure what is appropriate.
Should I wait for another DEXA before starting?
You can discuss an exercise plan now. Strength, balance and movement confidence are useful goals between scans. Your clinician determines the timing of repeat bone-density testing; we help you make the time between tests useful.
What if I have new back pain or a previous compression fracture?
New or sudden back pain with osteoporosis deserves medical review, especially after a fall or lifting incident. A previous fracture also helps us choose your starting exercises. Read our compression-fracture recovery guide for questions to bring to your care team.
Do I need a referral, and is virtual coaching available?
No referral is needed to begin in-person PT with us. We offer dedicated one-on-one care with Dr. Emily in Holladay, serving Greater Salt Lake City. Virtual coaching from anywhere can support exercise education and wellness goals; we will help you understand whether coaching or an in-person assessment fits your needs.
What does your fracture-risk score mean for staying active?
We help you connect the numbers with useful questions and a practical exercise conversation. You can learn strength work with guidance while your medical clinician considers the full picture of your fracture risk.
Google review summary
Valerie appreciates one-on-one osteoporosis strength training with Dr. Emily.
Let’s make your next step clearer
You do not need to understand every number before you reach out. In a free 15-minute consultation, we can hear your concerns and explain whether individual PT, Bone Builder classes or virtual coaching is a useful next step.
Dedicated one-on-one care with Dr. Emily Warren, DPT, Cert. MDT, BoneFit trained. No referral needed.
About this guide: Our approach at Mindful Movement PT combines clear education with individualized movement guidance. Your prescribing clinician interprets fracture risk and medical treatment; we help you build a practical strength and movement plan.
Meet Dr. Emily Warren, DPT, Cert. MDT, our McKenzie-certified Doctor of Physical Therapy and BoneFit-trained clinician.