THE BEST EXERCISES FOR OSTEOPOROSIS – WHAT ACTUALLY WORKS & WHY
Written by: Dr. Ilma Imtiaz
You probably already know that you need to move to support your bones, but not all movement is equal. If you have osteoporosis or reduced bone density, you've likely been frustrated by general advice.
The real question is one of precision: which type of exercise, at what intensity, and in what priority order actually works at the level of bone biology? Walking is better than sitting, yes, but if that's all you're doing, you are leaving significant bone-building potential on the table.
This isn't about looking younger or fit; it's about optimizing your function and building the resilience needed for a vibrant midlife. We cut through the noise and put the research first. Here is what the research says.
How does exercise build bone?
Exercise supports far more than heart and muscle health; it also plays a key role in building and maintaining bone density, particularly during perimenopause and later life. Weight-bearing and resistance-based movements place gentle stress on bones, triggering signals that help them stay strong and counteract age- and hormone-related bone loss.
Regular exercise helps maintain healthy bones by stimulating bone strength and bone formation through mechanical loading, even when changes in bone mineral density (BMD) are modest.1
When bones experience this small amount of strain during activities such as walking, jumping or strength training, specialized bone cells called osteocytes detect the load and signal bone-forming osteoblasts to become more active, while slowing the activity of bone-resorbing osteoclasts.1 Over time, this can help support bone formation and reduce bone loss, particularly in areas such as the hips and spine.
The best exercises for osteoporosis — ranked by evidence
1. Resistance Training: Does weight training help with osteoporosis?
Yes. Resistance (strength) training has the strongest and most consistent evidence for helping maintain or improve bone mineral density in postmenopausal women with osteopenia or osteoporosis. Studies show that exercises such as weightlifting, resistance bands, and bodyweight training place healthy stress on bones, helping stimulate bone strength over time.1,2,3
One randomized controlled trial found a significant 1.82% increase in lumbar spine bone mineral density after 6 months of supervised strength training in postmenopausal women with osteopenia or osteoporosis, while the non-exercising group showed no significant change.2
A larger meta-analysis involving 17 randomized controlled trials and 919 postmenopausal women also found that moderate- to high-intensity resistance training performed 3 days per week was particularly effective for supporting bone mineral density in the spine and hips.3
How heavy should you lift to help prevent bone loss?
Research suggests that moderate- to high-intensity strength training is most effective for supporting bone health, with many studies using loads of around 70% or more of a person’s one-repetition maximum (1RM) in roughly 40-minute sessions, 2–3 times weekly for 3–12 months, can improve bone mineral density in women with osteoporosis.4 In practical terms, this usually means lifting a weight that feels challenging for around 8–12 repetitions.
Exercises that load the spine and hips appear to provide the greatest benefit for areas most vulnerable to fracture. This can include exercises such as squats, deadlifts, and upper-body pushing and pulling movements.
Exercises should always be performed with controlled technique and adapted to individual needs, particularly for those with osteoporosis or previous vertebral fractures.
If free weights feel intimidating, resistance machines can be an excellent starting point. They still provide the mechanical loading needed to support bone health, especially for beginners.
2. High-impact exercise: Does running help with osteoporosis?
For women who can do it safely, high-impact exercise, including running, jumping, hopping and stair climbing, places a greater mechanical load on the skeleton than many other forms of exercise. This creates strong signals that encourage bones to adapt and maintain strength over time.
Research suggests that high-intensity and high-impact exercise programs may help improve or maintain bone density at the lumbar spine and femur in postmenopausal women5.
Studies also suggest that combining high-impact exercise with resistance training may provide greater overall benefits than either approach alone.5,6,7 Variety also appears to matter, as bones tend to adapt more effectively when movement patterns, direction, speed, and impact levels are varied over time.
What if I cannot do high-impact exercise?
If you have existing osteoporosis, vertebral fractures, significant joint issues or severely reduced bone density, high-impact exercise may not be suitable. These activities should be introduced gradually and ideally under the guidance of a physiotherapist or other qualified healthcare professional.
3. Weighted vest walking
Weighted vest walking has gained a lot of attention for bone health, but the research is more nuanced than social media often suggests. Studies have found that wearing a weighted vest equal to around 5–8% of body weight during walking for 30–60 minutes per day, 3 days per week, can increase mechanical loading on the skeleton and may help slow hip bone density loss compared with walking alone, particularly in sedentary individuals or during periods of weight loss.8,9,10
This may be important because weight loss can reduce some of the normal mechanical stimuli needed to maintain bone strength.
However, a 2025 randomized clinical trial found that, while using a weighted vest during weight loss helped offset some bone loss compared with diet alone, it was resistance training, not the vest, that produced the most meaningful preservation of bone mineral density over 12 months.11 The vest can be a helpful adjunct, but it is not a substitute for supervised resistance training in people at risk of osteoporosis.
How much weight should I use in a weighted vest for osteoporosis?
If using a weighted vest under medical or physiotherapy guidance, research has generally used loads of around 5–8% of body weight. It’s best to start gradually, usually closer to 5%, and increase slowly only if the weight feels comfortable. Weighted vests are typically worn during walking, everyday movement, or alongside light resistance exercise, with the goal of providing consistent mechanical loading rather than carrying maximal weight.
Does yoga help with osteoporosis?
Yoga and tai chi may both support bone health, although they appear to work in different ways. A systematic review including two randomized controlled trials and one prospective cohort study found that women who were new to tai chi experienced slower rates of postmenopausal bone mineral density decline after participating in regular tai chi practice [12].
Tai chi has also been associated with improvements in balance and a reduced risk of falls in older adults, with studies suggesting that practising consistently for more than six months may provide the greatest benefits.13
Yoga may also support bone health by improving flexibility, balance, posture and functional strength. However, it generally provides less mechanical loading than resistance training or higher-impact exercise. A systematic review found that yoga and Pilates did not consistently increase bone mineral density, although they may help maintain bone mass and improve strength and balance in postmenopausal women.14
Overall, yoga and tai chi are best viewed as complementary approaches that support balance, mobility, and functional strength alongside more bone-loading forms of exercise.
What exercises should you avoid if you have osteoporosis?
This depends on how severe your bone loss is and whether you have had prior fractures. In general, the movements most often flagged for caution are repeated forward bending of the spine, deep twisting under load and jerky or high-fall-risk activities.
Sit-ups, crunches, toe-touching and some yoga poses that round or twist the spine can increase strain on the vertebrae and may raise the risk of compression fractures, especially in people at higher fracture risk.
If you have osteoporosis, the goal is not to avoid exercise altogether, but to choose safe, controlled, spine-sparing movement and build from there. A physiotherapist with osteoporosis experience is the best person to review or design your program.
Does collagen help osteoporosis? Why exercise alone is not enough
Exercise is the signal that encourages bones to adapt and strengthen, but bones also require adequate nutritional building blocks to support this process. In this context, sufficient protein intake and specific collagen peptides may play a supportive role in bone remodeling, particularly when combined with resistance training.
In a 12-month randomized trial, postmenopausal women taking 5 g/day of specific collagen peptides experienced greater improvements in spine and femoral neck bone mineral density compared with placebo, along with favorable changes in markers of bone formation and breakdown.15
Importantly, collagen peptides should be viewed as a complement to exercise rather than a stand-alone solution. Together, regular resistance training and targeted nutrition may help support the body’s natural bone-remodeling process.
Putting it together — a practical starting point
Optimizing your bone health doesn’t require a complex overhaul — it requires consistency, progressive loading and the right mix of movement. Here is a practical starting point:
- Targeted resistance: Incorporate lower-body and spine-loading exercises, such as squats, hip hinges and rows, two to three times per week. This provides one of the strongest bone-loading signals.
- Weight-bearing activity: On alternating days, add walking, stair climbing or other weight-bearing movement to keep your skeleton regularly challenged.
- Balance and resilience: Include tai chi or balance work once or twice weekly to help reduce fall risk and improve stability.
- Strategic support: If you use a weighted vest, treat it as an adjunct to daily movement, not a substitute for resistance training.
- Nutritional support: To support the body’s natural bone-remodeling process, pair exercise with adequate protein, calcium, vitamin D, and, where appropriate, collagen peptides and vitamin C.
Want to support your bone collagen alongside your exercise routine? Explore Bone Mineral Boost.
Dr. Ilma Imtiaz has a background in biomedical and naturopathic research and recently completed her PhD at the National Centre for Naturopathic Medicine, Southern Cross University, Australia. She is a lead and co-author of multiple peer-reviewed publications, including experimental and review papers across herbal medicine, cancer biology and molecular mechanisms.
At the heart of her work is a passion for science communication, translating complex evidence into clear, engaging, and accessible insights. She is committed to evidence-led wellness and supporting informed, balanced health decisions.
References
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