Exercise is one of the most important things we can do for our bones as we age. But when it comes to bone health, not all exercise has the same effect.
Walking, cycling, swimming, Pilates and yoga can all have important health benefits. But if your goal is to maintain—or potentially improve—bone strength, your skeleton needs something more.
It needs to be challenged.
Why strong muscles matter for strong bones
When we talk about exercise and osteoporosis prevention, we need to think about both bone and muscle.
Strong muscles help us maintain balance, react when we trip and perform everyday movements safely. This matters because many fractures occur as a result of falls.
But muscles and bones also work together. When muscles contract against resistance, they place mechanical forces on the skeleton. Bone is living tissue and responds to appropriate mechanical loading by adapting to the demands placed upon it.
This is one of the reasons resistance training is such an important part of a bone-health exercise program.
Walking is excellent exercise—but is it enough for your bones?
I often hear people say, “But I walk every day.”
Please keep walking!
Walking is fantastic for cardiovascular and metabolic health, and walking outdoors can also benefit mood and wellbeing. It is weight-bearing exercise and may help maintain bone health to some extent.
But walking alone generally doesn’t provide a strong enough or sufficiently varied stimulus to substantially build bone.
The same applies to cycling and swimming. They can be excellent forms of cardiovascular exercise, but because the skeleton isn’t exposed to substantial weight-bearing impact, they shouldn’t be relied upon as your primary bone-building exercise.
Yoga and Pilates also have a place. They can improve strength, posture, mobility and balance—all important for reducing falls and maintaining physical function.
But for most people, a comprehensive bone-health program should also include progressive resistance training and, where appropriate, impact exercise.
Your bones need load
Bone adapts to the loads placed upon it.
To stimulate adaptation, the load needs to be challenging enough. This is why endlessly lifting the same light weights may eventually stop providing much of a training stimulus.
Progressive overload means gradually increasing the challenge as you become stronger. This might involve increasing the weight, changing the exercise or progressing the movement over time.
And this is where research into high-intensity resistance training becomes particularly interesting.
What did the LIFTMOR trial find?
One of the most important studies in this area is the LIFTMOR trial, conducted by Professor Belinda Beck and colleagues at Griffith University in Australia.
The researchers studied 101 postmenopausal women with low bone mass. Women undertaking the high-intensity program completed two supervised 30-minute sessions each week for eight months.
The program combined high-intensity resistance training with impact exercise. Resistance exercises were performed using heavy loads, and the program included exercises such as deadlifts, overhead presses and back squats, together with jumping impact.
Compared with the low-intensity exercise group, women undertaking the high-intensity program showed improvements in bone mineral density at clinically important sites, including the lumbar spine and femoral neck, as well as improvements in strength and physical function.
Importantly, the intervention was closely supervised and was well tolerated by the women taking part.
LIFTMOR is particularly interesting because people with low bone density have historically often been advised to be cautious about lifting heavy weights. The study demonstrated that appropriately prescribed, supervised high-intensity resistance and impact training can be both feasible and beneficial for selected postmenopausal women with osteopenia or osteoporosis.
And LIFTMOR isn’t the only evidence. A large 2023 systematic review and meta-analysis involving more than 5,500 postmenopausal women found that exercise training had positive effects on bone mineral density at the lumbar spine, femoral neck and total hip.
Does that mean everyone with osteoporosis should start lifting heavy weights?
No.
This is an important point.
The appropriate type and intensity of exercise depends on the individual. Your bone density, fracture history, existing injuries, strength, balance, exercise experience and other health conditions all need to be considered.
Someone who has never lifted weights before shouldn’t walk into a gym tomorrow and attempt a heavy deadlift because they have read that heavy lifting is good for bones.
And if you have osteoporosis—particularly if you have had vertebral or other fragility fractures—exercise selection and technique become even more important.
This is why I strongly recommend working with a suitably qualified exercise professional or physiotherapist when starting or progressing a bone-focused resistance program.
Some useful questions to ask include:
- Do you have experience working with people with osteopenia or osteoporosis?
- Do you have specific training in osteoporosis and bone-health exercise?
- Can you adapt my program to my bone density, fracture history, injuries and current ability?
- Can you teach and supervise appropriate lifting technique and progression?
The aim isn’t simply to lift as heavily as possible. It is to provide your bones and muscles with an appropriate, progressive stimulus while managing your individual risk.
What about impact exercise?
Bones also respond to impact.
Depending on the individual, this might include jumping, hopping, bounding or other activities that generate higher forces through the skeleton.
But again, appropriate is the key word.
Impact exercise isn’t suitable for everybody, and the type and intensity should be matched to someone’s bone health, physical capacity and fracture risk.
This is another reason an individualised exercise prescription is so valuable.
Don’t forget balance
Bone density is only one part of fracture prevention.
We also want to reduce the likelihood of falling in the first place.
Balance training becomes increasingly important as we age, and research-based osteoporosis exercise recommendations therefore generally combine resistance training with balance exercise, rather than relying on aerobic activity alone.
Pilates, yoga and specific balance exercises can all have a useful role here.
So rather than thinking:
Walking OR weights OR Pilates
think:
cardiovascular fitness + resistance training + appropriate impact + balance
Each serves a different purpose.
Women don’t need to be afraid of weights
I still meet many women who are reluctant to lift weights.
Some worry they’ll become bulky. Others simply don’t feel comfortable in a gym and prefer walking, Pilates or yoga.
But maintaining muscle becomes increasingly important through midlife and beyond.
Resistance training doesn’t just support our bones. It helps preserve muscle mass and strength, supports metabolic health and glucose regulation, and helps us maintain the physical capacity we need for everyday life.
And that’s ultimately why all of this matters.
We’re training for our future life
We’re not building muscle and bone simply to improve measurements on a DEXA scan.
We’re training so that we can:
- carry our own luggage when we travel
- climb stairs confidently
- carry the shopping
- get up from the floor
- lift and play with our grandchildren
- continue gardening, hiking and doing the activities we love
- maintain our balance and confidence
- live independently for as long as possible
Strong bones and strong muscles give us options.
The exercise we do in our 40s, 50s and 60s is an investment in what our bodies will still be capable of doing in our 70s, 80s and beyond.
Want to take a more comprehensive approach to your bone health?
Exercise is an essential part of protecting your bones—but it is only one piece of the picture. Nutrition, protein intake, gut health and nutrient absorption, hormones, sleep, metabolic health and individual risk factors matter too.
My Bone Health Program brings these different pieces together to create an individualised approach to supporting stronger bones and healthy ageing.
Learn more about my Bone Health Program or book a free discovery call.
References
Watson SL, Weeks BK, Weis LJ, Harding AT, Horan SA, Beck BR. High-Intensity Resistance and Impact Training Improves Bone Mineral Density and Physical Function in Postmenopausal Women With Osteopenia and Osteoporosis: The LIFTMOR Randomized Controlled Trial. Journal of Bone and Mineral Research. 2018;33(2):211–220.
Mohebbi R, Shojaa M, Kohl M, et al. Exercise training and bone mineral density in postmenopausal women: an updated systematic review and meta-analysis of intervention studies with emphasis on potential moderators. Osteoporosis International. 2023;34:1145–1178.
Giangregorio LM, Papaioannou A, Macintyre NJ, et al. Too Fit To Fracture: exercise recommendations for individuals with osteoporosis or osteoporotic vertebral fracture. Osteoporosis International. 2014;25:821–835.
