Until recently, it was assumed that the only interaction between muscle and bone is mechanical, that the muscle acts as a pulley and the bone as a lever to move the organism. A relatively new concept is that muscle, especially contracted muscle, acts as a secretory organ, regulating metabolism. An even newer concept is that bone, especially the osteocytes in bone, act as endocrine cells targeting other organs such as kidney and more recently, muscle. These two new concepts logically led to the third concept: that muscle and bone communicate via soluble factors. Crosstalk occurs through muscle factors such as myostatin, irisin, and a muscle metabolite, βaminoisobutyric acid, BAIBA, and through bone factors such as osteocalcin, transforming growth factor beta, TGFβ, Prostaglandin E2, PGE 2 and Wnts. Some of these factors have positive and some negative effects on the opposing tissue. One feature both bone and muscle have in common is that their tissues are mechanically loaded and many of their secreted factors are regulated by load. This mechanical loading, also known as exercise, has beneficial effects on many systems leading to the hypothesis that muscle and bone factors can be responsible for the beneficial effects of exercise. Many of the characteristics of aging and diseases associated with aging such as sarcopenia and osteoporosis and neurological conditions such as Alzheimer's disease and dementia, are delayed by exercise. This beneficial effect has been ascribed to increased blood flow increasing oxygen and nutrients, but could also be due to the secretome of the musculoskeletal system as outlined in this review. Effects of aging on the Musculoskeletal system Aging has overwhelming effects on bone and skeletal muscle mass. Reduced movement due to increased periods of rest and reduced physical activity most likely explains much of the reduced bone and muscle phenotype in older individuals. About the same time of age-related bone loss, osteoporosis occurs, so does age-related muscle loss, referred to as 'sarcopenia'. Muscle loss, like bone loss, actually starts soon after age 30, but becomes a rapid, progressive, debilitating condition after age 60. It is projected that in 2050, 20% of the world's population over 60 will suffer from sarcopenia and by 2150, this percentage will increase to 33% of the population[1]. Sarcopenia is associated with metabolic abnormalities, including changes in insulin sensitivity, increased fat and connective tissue infiltration in the Publisher's Disclaimer: This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final citable form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain.