How Exercise Protects You from Osteoporosis

You won't feel the moment they begin to thin - not the tiny fractures forming, or the quiet surrender deep inside the marrow. But it's happening all the same.

STORY AT-A-GLANCE

• Osteoporosis affects 10 million Americans, and research shows resistance training effectively builds bone density by creating mechanical stress that signals bone-building cells to strengthen skeletal structure

• Weightlifting (80% to 85% of your 1 rep max) performed two to three times weekly produces the greatest bone density gains, while walking and swimming provide insufficient force for bone strengthening

• Essential exercises include squats, deadlifts, incline pushups, hip rotations, and chair squats, progressing gradually in intensity while maintaining proper form to minimize injury risk

• Blood flow restriction (BFR) training, also known as KAATSU in Japan, enhances bone formation markers even at low intensities, allowing effective muscle and bone strengthening without heavy weights or pain

• Consistency matters most. Research shows that training for one year or more significantly improves bone mineral density, cortical thickness, and overall bone geometry across all ages and genders

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According to Harvard Health Publishing, around 10 million Americans are now diagnosed with osteoporosis. From that population, around 80% are women. It’s considered to be a silent disease because most people don’t know they have it until they suffer from a simple fall that spontaneously fractures their bones.¹

That said, a report from The Conversation noted that one of the best ways to improve bone strength without resorting to drugs is getting regular exercise.² Simply put, the more you move your body, the more it becomes stronger from a structural point of view.

Resistance Training Sends a Powerful Signal to Your Bones

In a study published in Endocrinology and Metabolism, researchers noted how resistance exercise, commonly known as weightlifting, benefits both bone and muscle health, especially for older adults who are at higher risk for osteoporosis and sarcopenia — two conditions that often occur together and drastically raise the odds of falls and fractures.³

One effective solution that the team highlighted is resistance exercise, which is not only safe, but also highly beneficial for middle aged individuals. Even better, it’s also recommended for frail individuals and those who have already experienced fractures — but safety needs to be kept in mind.

• Most forms of weightlifting are good for you — Using free weights, machines, or bands and doing movements like squats, deadlifts, lunges, and back extensions showed consistent results in maintaining or even increasing bone mineral density at key sites like the hip and spine.

• Not all exercise types stimulate bone in the same way — Walking, swimming, and cycling provide benefits for your overall fitness, but they do not produce the kind of intensity needed to catalyze your body’s bone-building mechanisms.

  In fact, the review points out that “Regular walking, which is frequently prescribed to prevent osteoporosis, also has little or no effect on prevention of bone loss.” That’s because bones become stronger and reform only when they’re loaded with forces greater than what you experience in daily living. In short, upping the intensity by adding weights or through impact-based exercise is the missing ingredient that flips the switch for bone growth.

• Best frequency for building strong bones — The authors noted that the most effective programs involved weight training at least two to three times per week, progressively increasing the resistance over time. From their research, high-intensity programs, using around 80% to 85% of a person’s one-repetition maximum (1RM), produced the greatest gains in bone density.

  In other words, simply lifting the same weight week after week is not enough. Your bones and muscles need a gradually increasing challenge to adapt. Interestingly, the spine often responded better to resistance exercise than the hip, showing that different parts of the skeleton adapt differently depending on the training.

• Intensity is key — Another noteworthy finding is that power training — lifting weights with more speed and explosive movement — maintained bone density in postmenopausal women without increasing risk of injury. This challenges the longstanding idea that older adults need to stick to slow, cautious lifting.

  Under proper supervision, training with speed not only strengthens muscles faster but also improves balance and reaction time, which reduces fall risk. For someone worried about frailty, this means that the benefits are double-sided — resistance training keeps your movements sharp and reduces the chances of falls in the first place.

• Safety first — While engaging in power training and other forms of medium- and high-intensity exercise stimulates bone growth, it’s important to practice safety, especially if you’ve been diagnosed with osteoporosis already. According to the researchers:⁴

  “[C]urrent exercise guidelines for osteoporosis recommend only moderate-intensity exercises (70% to 80% one RM, eight to 15 repetitions) for individual muscle groups which are insufficient to generate mechanical strain to stimulate an osteogenic response.”

• Why bones become stronger through exercise — Bones have specialized cells called osteocytes that act like strain sensors. When you load your skeleton with resistance, those cells detect the impact and send out signals that activate osteoblasts, which are cells responsible for restrengthening bones.

  At the same time, the impact also reduces the activity of a protein called sclerostin, which normally acts as a brake on bone growth. By lowering sclerostin, resistance exercise allows the Wnt/β-catenin pathway to stay active, keeping bone-building cells alive longer and ramping up bone formation.

• Consistency is key to maximizing benefits — The researchers noted that previously published studies showed that doing resistance exercise consistently for a year or more resulted in significant improvements in bone mineral density.

• Basic protocol tests won’t tell the whole picture — The researchers also pointed out that relying only on bone mineral density scans (such as dual-energy X-ray absorptiometry) underestimates the benefits of training, because bone strength depends not just on mineral density but also on bone geometry and microstructure.

  In some trials, even when density numbers did not improve significantly, cortical thickness (the outer shell of bone) and bone geometry did improve, meaning the bones became structurally stronger.

• Everyone benefits from resistance training — Findings showed that lifting weights showed benefits across both men and women, not only postmenopausal women, which are often the focus of osteoporosis research. Middle-aged men, older adults, and even those already living with fractures benefited from structured resistance programs.

Try These 5 Exercises to Strengthen Your Bones

Now that you’ve read the research, it’s time to get down to the business of strengthening your bones. If routine health scans show that you’re inching closer to osteoporosis, it’s best to get your body moving now. If you’re new to lifting weights, take it slow and learn the correct technique to minimize injuries.⁵ That said, here are five exercises by Carrell Clinic to get you started:⁶

• Outward hip rotation

  • Lift your knee up in front of you till it is about the same height as your hip and hold for 3 to 4 seconds.

  • Next, slowly rotate your hip outwards and hold for 3 to 4 seconds.

  • Repeat a few times as comfort allows and then switch legs. You can also use a resistance band, as shown in the video above, to increase the intensity.

• Incline pushup

  • Start with your hands resting on a chair or bench.

  • Keeping your body in a straight line, bend your arms to bring your chest as close to your hands as possible. Then straighten your arms out again.

  • Do as many repetitions as you can.

• The drinking bird

  • Raise one leg slightly off the floor while holding onto something for support.

  • Bend your torso forward and at the same time swing your raised leg slowly backwards. You should feel the tension in your glutes and hamstrings, not your lower back.

  • Repeat a few times and then switch legs.

• Chair squat

  • Stand with your feet slightly apart with a chair behind you.

  • Slowly bend at the knees in a controlled manner until your rear barely touches the chair.

  • Return to starting position.

• One-leg balance

  • From a standing position, lift one leg in front of you keeping the lifted leg as straight as possible with the toe pointed and hold the position for 2 to 3 seconds.

  • Move your leg to your side and again hold position.

  • Finally, move the leg behind you and hold for a few seconds.

  • Repeat a couple of times and then switch legs.

More Exercises to Supplement Your Training Regimen

Aside from the ones mentioned above, here are five additional exercises by Rehab Concepts Physical Therapy to help boost your bone mineral density:⁷

• Shoulder press

  • Stand while holding a pair of dumbbells just outside your shoulders, your arms bent, and your palms facing each other.

  • Press the weights directly over your shoulders until your arms are straight.

  • Slowly lower the dumbbells to the starting position.

• Upright rows

  • Stand with your feet around hip-width apart, shoulders back, and core braced.

  • Hold a dumbbell in each hand, palms facing towards your body, around hip-width apart.

  • Raise your elbows out to the sides to lift the dumbbells, focusing on pulling through the shoulders. As you bring the dumbbells up, maintain the same distance between each dumbbell.

  • Your shoulder mobility and anatomy can dictate how high you go. If you feel a pinch taking your elbows higher than in line with your shoulders, stop there.

  • Pause before returning the dumbbells back down.

• Bicep curls

  • While holding a pair of dumbbells down by your sides, open your hands so your palms face forwards.

  • Bending at the elbows, slowly bring the dumbbells up towards your shoulders.

  • Lower them back down until your arms are almost fully extended.

• Wall squats

  • Find a clear wall space and stand with your back against the wall. Slowly slide down the wall until your knees are bent at a 90-degree angle, or as close to it as possible. Your thighs should be parallel to the floor, and your knees should be directly above your ankles.

  • Keep your back flat against the wall and your feet planted firmly on the ground about hip-width apart. Engage your core muscles to maintain stability and support your lower back.

  • Hold this position for as long as you can, aiming for at least 30 seconds to start. As you build strength and endurance, gradually increase the duration of the hold.

  • Focus on breathing deeply and evenly throughout the exercise to help maintain endurance and relaxation.

  • When you're ready to finish, slowly push yourself back up to a standing position, using your leg muscles to push against the wall.

• Hamstring curls

  • Use a sturdy chair or countertop for balance. Keep your upper body straight and try not to swing your body.

  • Keep your upper leg in one spot and don't move your hip. Bend at your knee and bring your foot towards your bottom.

  • Come back down slowly.

Incorporate Blood Flow Restriction Training

While resistance training already provides many benefits to your health, you can take it to another level for even greater results by putting bands around your muscles. Known as blood flow restriction (BFR) training, it is a form of exercise that involves partially obstructing blood flow to your limbs while exercising. In Japan, it is known as KAATSU.

• How KAATSU works — Restricting blood flow to the muscles during exercise creates anti-inflammatory myokines that help build muscle, which is a huge benefit for senior citizens looking to stay fit and don’t want to lift heavy weights. Steven Munatones, an expert KAATSU practitioner, further explains how it works:

  "KAATSU cycle is basically a very clever biohack that will allow the muscles to work and allow the vascular tissue to become more elastic. You don't perceive the pain of heavy lifting, but your vascular tissue and muscle fibers are being worked out just as effectively, and you can do it for a longer period of time."

• KAATSU boosts bone mineral density — In a study published in Frontiers in Physiology,⁸ researchers tasked participants with BFR training three times a week for a total of six weeks. After monitoring bone formation biomarkers, the team noted that BFR helped improve density even at low-intensity training. "BFR resistance training was effective for stimulating acute bone formation marker and hormone responses," they emphasized.

  In a different study, similar benefits were identified among the study population, which consisted of inactive adolescent women. According to the team, low-intensity BFR training was just as beneficial as doing high-intensity exercises. Specifically, it significantly reduced C-terminal telopeptide (CTX), which is a known biomarker of bone destruction.

• KAATSU-specific exercises — For a detailed guide on how you can incorporate BFR training into your exercise schedule, read “How to Stay Fit for Life.” There, I outline several BFR-specific exercises, especially for first-timers who are unfamiliar with this system.

• You can use KAATSU everywhere — If you’re busy and can’t find the time to fit in a dedicated exercise schedule, you can actually use KAATSU bands while moving around the house. Munatones explains:

  "Putting the KAATSU bands on your legs and walking down to the beach, walking your dog or just walking around the neighborhood, standing, cleaning your windows of your house, folding your clothes, banging out emails, all of these things can be done with the KAATSU bands on your arms or legs. You're getting the benefit of exercise.”

Frequently Asked Questions (FAQs) About Exercising for Better Bone Health

Q: What is osteoporosis and why is it considered a “silent disease”?

A: Osteoporosis is a condition in which bones gradually lose strength and density, becoming fragile and more prone to fractures. It affects about 10 million Americans, with women accounting for nearly 80% of cases. Because it typically has no obvious symptoms until a fracture occurs from something as simple as a minor fall, it is often described as a “silent disease.”

Q: How does exercise help prevent and manage osteoporosis?

A: Exercise plays a crucial role in building and maintaining strong bones, with resistance training in particular offering the greatest benefits. Unlike activities such as walking, swimming, or cycling, which primarily support cardiovascular health, resistance training and impact-based movements provide the force necessary to activate bone-building cells. When performed consistently, these exercises continue to improve bone structure, increase bone density, and reduce the risk of fractures as you age.

Q: What types of exercises are most effective for bone health?

A: The most effective exercises for bone health are those that stress the skeleton enough to trigger adaptation. Resistance training, including weightlifting movements such as squats, deadlifts, lunges, and back extensions, has been shown to preserve or even improve bone density.

Q: How often and at what intensity should resistance exercise be done?

A: Research suggests that the most effective resistance training programs are performed two to three times per week and gradually increase in difficulty over time. Simply lifting the same weight week after week is not enough, since bones and muscles need progressive overload to continue adapting.

Q: What is blood flow restriction (BFR) training and how does it help bones?

A: BFR training, also known as KAATSU in Japan, is a technique where bands are placed around the limbs to partially restrict circulation during exercise. This method allows people to achieve benefits similar to heavy lifting while using much lighter weights, making it especially appealing for older adults or those unable to train intensely. Studies have shown that KAATSU not only stimulates muscle growth but also improves bone mineral density and reduces bone breakdown.

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1. Harvard Health Publishing, January 16, 2024

2. The Conversation, August 19, 2025

3. Endocrinol Metab (Seoul). 2018 Nov 30;33(4):435-444

4. Endocrinol Metab (Seoul). 2018 Nov 30;33(4):435-444

5. Mayo Clinic, “Strength Training: Get Stronger, Leaner, Healthier”

6. Carrell Clinic, “7 Exercises to Strengthen Your Bones”

7. Rehab Concepts Physical Therapy, “Bone Health Series, Part Two of Four: Exercise for Bone Health”

8. Front Physiol. 2022 Mar 17;13:837631