Antiosteoporotic medications are often used to reduce fracture risk and treat osteoporosis. Similarly, regular physical activity also plays an important role in both maintaining and improving bone density. Recently, it has been shown that exercise combined with osteoporosis medications may produce greater benefits on bone associated with osteoporosis than either intervention alone. This commentary evaluates the current literature mostly produced in our laboratory from animal models to determine the optimal combination of physical exercise and medications on osteoporosis induced by ovariectomy and exogenous glucocorticoids. The data suggest that both approaches enhance bone healing, however the combined effects of these two therapies do not appear to produce any remarkable synergetic or additive effects. Clinical studies are needed to fully understand the effects of exercise and selective medications on bone remodelling in order to optimise treatment of fragility fractures in patients with underlying osteoporosis.