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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

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

1. 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.

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

3. 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

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

2. 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.

3. Do as many repetitions as you can.

• The drinking bird

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

2. 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.

3. Repeat a few times and then switch legs.

• Chair squat

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

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

3. Return to starting position.

• One-leg balance

1. 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.

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

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

4. 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

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

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

3. Slowly lower the dumbbells to the starting position.

• Upright rows

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

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

3. 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.

4. 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.

5. Pause before returning the dumbbells back down.