What Type of Exercise Is Recommended for Bone Health?

Written By Jenni Dowley

People are often told to exercise to improve their health, but many people are not familiar with how exercise impacts their bones. Additionally, if you have been told you have low bone density or osteoporosis, you may be wondering what type of exercise is recommended and safe.

The good news is that the right type of exercise can help you improve your bone health, reduce your risk of falls, decrease pain associated with fractures and help you to stay independent and stronger for longer.

But not all movement is equal when it comes to bone health. Walking and swimming can have great benefits to your health - but are not enough to improve your bone health on their own. Let’s break down the types of exercise your bones need, what the current guidelines say, and why it’s never too late to start.

*Note: This blog post is for general informational purposes only and does not constitute medical advice. Exercise should be always be tailored to the individual, their history and their needs.

🔍 Firstly, four key terms you to understand

Understanding these terms is essential to understanding the effect of exercise on bone health:

  • Resistance Exercises - Exercises that make your muscles work against a force (like weights, bands, or body weight). This can help to stimulate bone growth by putting load on your muscles and skeleton.

  • Progressive - Gradually increasing the challenge or difficulty of the exercise (going from bodyweight to lifting weights, increasing weights, more repetitions, harder movements) so that your body (and bones) keep adapting.

  • Impact - Movements that involve a controlled ‘jolts’ or extra force through your bones, like heel drops, stamping, jumping, skipping, or hopping.

  • Balance - Exercises that challenge your stability, helping reduce the risk of falls and related fractures.

💪 Resistance Training

Progressive resistance training is the cornerstone of strong bones. When you load your muscles, they pull on your bones, this causes a physiological response which stimulates bone formation.
Resistance exercise is especially important for strengthening around the spine and hips, (both common osteoporotic fracture sites).
It is important however that exercise is progressive - changing over time, gradually becoming more challenging to ensure we continue to get skeletal adaptations.

Depending on your level examples can include:

  • Bodyweight exercises like squats, lunges, and press-ups

  • Exercises with resistance bands

  • Using weights or machines to complete exercises like a weighted squat

Generally we recommend aiming for 2-3 sessions per week, working all major muscle groups, and progressively increasing the difficulty over time.

🏃 Impact Loading

Changes to bone and the skeleton require load - and impact exercise does that. While high-impact exercise (like running or jumping) may not be suitable for everyone, there are also moderate or low-impact activities that can be done safely. Similar to resistance exercises, impacts need to change regularly including changing direction and type.

Examples:

  • Heel drops

  • Hopping or jumping

  • Skipping

These are most effective when done regularly, ideally 30-50 impacts, on most days of the week. People may need to build up to this amount and to certain levels of impact gradually.

⚖️ Balance Training

Falls are a leading cause of fractures. Balance exercises can help you stay steady, react faster if you trip and reduce your fall risk. They can also help to strengthen the smaller stabilising muscles around your joints. It’s important to practice these exercises near something stable like a kitchen counter incase you lose your balance.

Examples:

  • Tai Chi or certain types of dance

  • Standing on one leg

  • Heel-to-toe walking

Balance exercises are very dependent on your need. While it is recommended everyone challenge their balance regularly some people may require specific balance training regularly during the week. It can be helpful to build balance exercises into your daily activities - like practicing a balance exercise while brushing your teeth!

🏋️ High-intensity Resistance and Impact Training: The Gold Standard?

A recent 2025 review looked at the latest available evidence on high-intensity resistance with impact training (HiRIT) programs for bone health.
It found that tailored HiRIT programs were the most effective for increasing bone mineral density (BMD), particularly at the lumbar spine.
Studies lasting 8 months or longer were shown to increase BMD in the lumbar spine and femoral neck. While positive changes have been noted at the lumbar spine and femoral neck, the studies did not show significant improvements for total hip BMD.

While current research shows promising results for the positive effect of exercise on bone health in individuals with osteoporosis, many studies only included individuals who have ‘normal’ bone density or mild bone loss. More high-quality research is needed to fully understand the effects of different exercise types on osteoporotic bone.

⚠️ Safety Considerations

Studies have shown that participating in exercise with osteoporosis is safe, has a low risk of serious adverse events and that benefits of exercise outweigh potential risks. However, it is important to be aware of specific safety considerations to ensure you reduce the likelihood of injury.

  • The program and exercises should be individualised to the persons level and history

  • Exercise technique is important, especially in those with a history of vertebral fractures or those at a high fracture risk

  • Be careful not to have a fall while carrying out balance exercises - stand near a wall or something to support yourself incase you lose your balance

  • Spine-safe movement techniques are especially important for individuals at high fracture risk or with a history of vertebral fractures. According to clinical guidelines, these individuals should take extra care to move in ways that reduce spinal loading and the risk of further injury. This may include avoiding or modifying certain movements, such as:

    • Bending all the way forward, rounding the spine, or bending to the side

    • Twisting to the side

    • Bending or twisting at a rapid pace or with a heavy weight

🦴 Key Takeaways

  • Exercise programs for bone health should include a mix of resistance, impact and balance exercises.

  • Progressive overload is key: gradually increase difficulty to keep bones adapting.

  • High-impact resistance training can meaningfully increase bone density.

  • Exercise should be tailored to the individual, their level and history.

  • Ensuring good technique is important to reduce injury risk.

  • Exercise helps your whole body thrive - not just your bones.

The information contained in this blog is not medical advice and is not intended to replace your health professionals advice. Please consult a chartered physiotherapist or healthcare professional who has experience in prescribing exercise for osteoporosis.

 

Reference list:

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  • Babatunde, OO., Bourton, AL., Hind, K., Paskins, Z., Forsyth, JJ. (2020) ‘Exercise Interventions for Preventing and Treating Low Bone Mass in the Forearm: A Systematic Review and Meta- analysis.’ Arch Phys Med Rehabil, 101(3), pp. 487-511. doi: 10.1016/j.apmr.2019.07.007

  • Bae, S., Lee, S., Park, H., Ju, Y., Min, S. K., Cho, J., Kim, H., Ha, Y. C., Rhee, Y., Kim, Y. P. & Kim, C. 2023. Position Statement: Exercise Guidelines for Osteoporosis Management and Fall Prevention in Osteoporosis Patients. J Bone Metab, 30, 149-165.

  • Beck, B. R., Daly, R. M., Singh, M. A. & Taaffe, D. R. 2017. Exercise and Sports Science Australia (ESSA) position statement on exercise prescription for the prevention and management of osteoporosis. J Sci Med Sport, 20, 438-445.

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  • Giangregorio, L. M., Papaioannou, A., Macintyre, N. J., Ashe, M. C., Heinonen, A., Shipp, K., Wark, J., McGill, S., Keller, H., Jain, R., Laprade, J. & Cheung, A. M. 2014. Too Fit To Fracture: exercise recommendations for individuals with osteoporosis or osteoporotic vertebral fracture. Osteoporosis International, 25, 821-835.

  • Howe, TE., Shea, B., Dawson, LJ., Downie, F., Murray, A., Ross, C., Harbour, RT., Caldwell, LM., Creed, G. (2011). ‘Exercise for preventing and treating osteoporosis in postmenopausal women’. Cochrane Database Syst Rev, 7. doi:10.1002/14651858.CD000333.pub2.

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  • National Institute for Health and Care Excellence (NICE). (2023) ‘Osteoporosis - prevention of fragility fractures’. Available at: https://cks.nice.org.uk/topics/osteoporosis-prevention-of-fragility-fractures/management/management/

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Jenni Dowley
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Understanding your Bone Health