How to Improve Bone Health Through Exercise: What the Research Says

Why is bone health important?

Having healthy bones will allow us to stay fit, healthy and active into our older years. As we age, if we don’t take care of our bones, their resilience may wane, increasing our risk of fractures, including bone stress injuries.

A loss of bone mineral density is referred to as osteopenia, and in more severe cases, osteoporosis.

Who can benefit from improving their bone health?

Improving bone health is particularly important for people with osteoporosis or osteopenia, however, improving bone health is beneficial for a wide range of populations.

You may wish to increase your bone mineral density to build a buffer to reduce your chance of low bone mineral density. This may be particularly important if you’ve led a sedentary lifestyle, are undergoing medical treatment, are at a life stage that affects your bones, or are involved in non-weight-bearing sports such as swimming or cycling.

Improving bone mineral density is useful at any age, as younger people are experiencing osteopenia, but the benefits may be most evident in biological women going through menopause.

What is the best exercise to improve bone mineral density?

Combining resistance training and impact exercises is one of the best ways to improve bone health.

Intensity for these exercises should be based on the individual’s current abilities.

How is intensity defined for bone loading?

Resistance training commonly uses one repetition maximum to individualise the training intensity. A one repetition maximum (1RM) is typically the heaviest load that can be used to perform the exercise. It is important to note that when starting exercise, it is not essential to incorporate this test.

Impact exercises are commonly defined by the ground reaction force (GRF). For context, walking will have less than 2 times body weight GRF, skipping will have 2-4 times body weight GRF and sprinting will have greater than 4 times body weight GRF.

Bone training can be grouped into three intensity categories: 1) low, 2) moderate, and 3) high.

Intensity	Resistance Training	Impact Exercise (GRF)
Low	15+ reps, <65% 1RM	<2× body weight
Moderate	8–15 reps, 65–80% 1RM	2–4× body weight
High	6 reps or less, 80% 1RM or more	4+ × body weight

What is the best intensity for improving bone mineral density?

It depends. Resistance training across low, moderate and high intensity has been found to be beneficial for the majority of body sites. However, the response to load and intensity may be site specific. For example, high intensity may improve the lumbar spine more than other intensities. In contrast, high intensity is not as effective as a moderate intensity for both neck of femur and total hip. Overall, moderate intensity loading appears to have the largest research body behind it for the majority of body sites.

Why is moderate intensity the best?

As noted above, impact and power-based exercises are important in improving bone mineral density. To increase power, you typically lift a submaximal load fast and build up to moving it as quickly as possible. Moving the submaximal weight faster increases the ground reaction force and loading rate, both of which are important factors for improving bone mineral density.

In summary

Resistance training and impact exercise at low, moderate and high intensities can improve bone mineral density. You may wish to vary your training intensities to improve bone mineral density at different sites. Moderate intensity may be useful for training power, and it has the most research supporting it.

If you’re interested in increasing your bone mineral density please reach out to the team at Complete Physio Richmond to discuss if our bone health class may be suitable for you.

• Written by James Ross

  James is a highly qualified and experienced coach with 22 years of experience working with a wide range of clientele. He has completed two Masters degrees in exercise science and published articles in the scientific literature.