@nycmusic I’ll give it a try.

Here’s how one reputable paper explains the coupling concept in bone remodeling: “Coupling refers to the cellular and molecular mechanisms that ensure the spatial and temporal linking of bone resorption by osteoclasts to the formation of bone by osteoblasts at the same remodeling site.”

The main purpose of the TRIO clinical study was to compare the efficacy and safety of three oral bisphosphonates. Bone turnover markers were measured during the study, and the results showed that resorption and formation are tightly connected. In the authors’ words “Bisphosphonates reduce bone turnover beginning with inhibition of osteoclastic resorption, which leads to a delayed but corresponding reduction in bone formation, consistent with the concept of coupling where bone formation is dependent on prior resorption activity.”

In simpler terms, during bisphosphonate’s treatment, osteoclasts slow down first, and the osteoblasts soon follow - one process leads to the other -that’s coupling in action. I think that’s the easiest way to picture it.

@nycmusic thanks for the info.clarifies one of my questions.