Exercise for Bone Density: What Actually Works

BONE HEALTH · HEALTHY AGING

Bone is living tissue that responds to the loads you place on it. The right mix of exercise, food and screening can help you hold on to what you have, and in some cases build a little more.

Most people think about bone only after a scan or a fracture. Midlife is a better moment, because the habits you build now shape how strong your skeleton is in the decades ahead. This guide covers the types of exercise for bone density that have the best support, what a well-known trial of heavier lifting found, a weekly plan you can follow, the calcium and vitamin D targets that matter, and when to ask about a bone density test.

Why your bones need a plan in midlife

Bone constantly remodels itself, breaking down old tissue and laying down new. Mechanical load is one of the main signals that tells it to stay strong. The Physical Activity Guidelines for Americans define bone-strengthening activity as movement that produces a force on the bones that promotes bone growth and strength, and give examples such as jumping jacks, running, brisk walking and weight lifting.

Screening guidance also points to midlife. In January 2025 the US Preventive Services Task Force recommended osteoporosis screening for all women 65 and older and for postmenopausal women younger than 65 who are at increased risk based on a clinical risk assessment. For men, the task force found the evidence insufficient to recommend for or against routine screening. The years before those milestones are your window to build strength in your muscles and bones.

The three types of exercise for bone density

The National Institute of Arthritis and Musculoskeletal and Skin Diseases says a combination of exercise types is best for building and maintaining healthy bones. Each plays a different role.

• Weight-bearing exercise puts force on your bones as you move against gravity. Examples include brisk walking, jogging or running, racket sports, climbing stairs and dancing. Swimming and cycling are valuable for your heart, but they are not weight-bearing.
• Resistance training stresses bone through the pull of working muscles. Weight machines, free weights, resistance bands and bodyweight moves such as push-ups all count.
• Balance training is not mainly about bone. It helps you stay steady on your feet, which matters because a fall is often what turns fragile bone into a fracture. NIAMS lists tai chi, walking backward, step-ups and lunges as examples.

Bone appears to respond to loads that are greater than, or different from, what it handles every day. That is why a daily walk, valuable as it is, may not be enough on its own, and why progressive strength work matters. Our guide to progressive overload explains how to add load safely over time.

What the LIFTMOR trial showed about heavier lifting

For years, people with low bone mass were steered away from heavy lifting. The LIFTMOR trial, published in the Journal of Bone and Mineral Research in 2018, tested that caution. Researchers assigned 101 postmenopausal women with low bone mass, average age 65, either to a home program of low-intensity exercise or to supervised high-intensity resistance and impact training: two 30-minute sessions a week for eight months, with lifts performed for 5 sets of 5 repetitions at more than 85 percent of the maximum load each woman could lift once.

Bone density at the lumbar spine rose by 2.9 percent in the training group while it fell by 1.2 percent in the comparison group. At the femoral neck of the hip, it rose by 0.3 percent with training and fell by 1.9 percent without it. Every measure of physical function the researchers tested improved more in the training group, and the only adverse event reported was one minor lower-back spasm.

Two details matter before you copy it. The program was highly supervised, and every participant was screened for conditions and medications that affect bone or physical function. Heavy training for bone is something to build toward with good coaching, not something to jump into alone, especially if you already have a diagnosis of osteoporosis.

A weekly bone-building plan

The American College of Sports Medicine’s 2026 resistance training position stand recommends training all major muscle groups at least twice a week and, for strength, heavier loads of about 80 percent of your one-repetition maximum for 2 to 3 sets. A bone-friendly week builds on that foundation.

• Two strength sessions: focus on squats or sit-to-stands, deadlift or hip-hinge patterns, lunges or step-ups, rows and overhead presses. Work toward sets of 5 to 8 challenging repetitions as your technique allows. If you are new to lifting, start with the plan in our first-month strength guide.
• Short impact practice, two to three days: if your joints and your doctor allow it, add 10 to 20 small hops, heel drops or skips, building gradually. Stop if you feel joint pain.
• Weight-bearing cardio most days: brisk walks, hikes, stair climbing or dancing. See our walking guide for pace targets.
• Balance work, a few minutes daily: single-leg stands near a counter, heel-to-toe walking or a tai chi class.

If you have been diagnosed with osteoporosis or have had a fracture, talk with your doctor or a physical therapist before adding impact or heavy lifting. NIAMS advises anyone with low bone density, osteoporosis or other physical limitations to speak with a health care provider before starting an exercise program, and a provider can help you choose activities that are safe for you.

Calcium, vitamin D and protein

Exercise gives bone the signal to grow stronger; nutrition supplies the materials. The NIH Office of Dietary Supplements lists these daily targets for calcium and vitamin D.

Group	Calcium per day	Vitamin D per day
Adults 19 to 50	1,000 mg	15 mcg (600 IU)
Men 51 to 70	1,000 mg	15 mcg (600 IU)
Women 51 to 70	1,200 mg	15 mcg (600 IU)
Adults 71 and older	1,200 mg	20 mcg (800 IU)

Milk, yogurt and cheese supply most of the calcium in American diets, and canned sardines or salmon with bones, kale, broccoli and bok choy add more, as do fortified plant beverages, tofu and cereals. Very few foods naturally contain vitamin D; fatty fish such as salmon and trout are among the best, and fortified milk provides about 120 IU per cup.

Food first is the sensible approach. The Office of Dietary Supplements notes it is not clear whether calcium supplements help prevent fractures. If you do take one, the upper limit for adults 51 and older is 2,000 mg a day from all sources, and the body absorbs it best in doses of 500 mg or less at a time. The upper limit for vitamin D is 4,000 IU a day for adults. Ask your doctor before starting supplements. Protein matters as well, both for muscle and for the bone it pulls on; our protein guide covers daily targets.

Screening and personal advice

A bone density scan, usually a DXA test, is the standard way to measure where you stand. If you are a postmenopausal woman under 65, ask your doctor whether your personal risk factors make screening worthwhile now rather than later. Men with risk factors, or anyone who has broken a bone in a minor fall, should raise the question too, even though routine screening guidance for men is not settled.

A result in the low bone mass range is not a reason to stop exercising. It is a reason to train with more structure and better guidance. Talk with your doctor before starting or intensifying training if you have heart disease, diabetes, kidney disease, a recent injury or surgery, new symptoms or a known fracture, or if you are pregnant.