The Best Exercise Type and Frequency for Bone Density

When it comes to bone health, it’s use it or lose it. Physical activity is considered a widely accessible, low-cost, and highly modifiable contributor to bone health. Exercise transmits forces through the skeleton, generating signals that are detected by your bone-building cells. This is why the National Osteoporosis Foundation, International Osteoporosis Foundation, and other agencies recommend weight-bearing exercises for the prevention of osteoporosis. These include high-impact exercises such as jumping, aerobics, and running, as well as lower impact exercises like walking and weight training to create those mechanical signals that spark bone growth, but sufficient intensity and frequency are critical. The large variation in bone benefit across different studies, from negligible changes to substantial improvements in bone mineral density, has been attributed to the adequacy of the exercise regime.

To improve measures of bone strength at the spine and hip, the most effective exercise training protocol appears to be a combination of progressive resistance and impact training at moderate to high intensity. Low intensity exercise does not appear to be sufficient. For example, while regular walking is often prescribed to prevent osteoporosis, it appears to offer limited benefit for bone loss prevention. On its own, walking has no significant effect on bone mineral density in the spine, wrist, or overall skeleton, but it has been shown to significantly improve hip bone density in studies that have lasted more than 6 months. More effective would be brisk walking, walking with a weighted vest, or combining walking with more vigorous exercises such as jogging, stepping, or stair-climbing. Non-impact activities such as cycling or swimming have been shown to have little or no effect.

An elegant study to determine the optimum frequency of high-impact exercise for bone health involved hopping on one randomly chosen foot, with the person’s other leg acting as the control. Women were randomized to hop 50 times on that one, same leg either seven days a week, four days a week, two days a week, or not at all for six months. And the brief, daily hopping increased hip bone density, but less frequent hopping was not effective. The only group who built significantly more bone in their hip on the jumping compared to non-jumping side within those 6 months was the seven-day-a-week group. If you jump 50 times with about a 10 pound weighted vest on, however, you may be able to preserve your hip bone density with just three sessions a week instead of every day.

Note, weight-bearing impact exercise may be contraindicated, meaning not advisable, in those with severe osteoporosis or recent history of fracture so make sure you check in with your medical professional before you get going.