Stronger bones and strength training: does it help?
Strength training measurably improves bone density, although the effect remains modest. For the strongest results, high-intensity training under supervision is recommended, even if you already have low bone mass.
Strength training increases bone mineral density, but the effect is modest. A meta-analysis and systematic review of dozens of studies show that bone density at trained sites increases by roughly 1 to 3 percent. That effect is larger at the spine than at the hip. Not every study finds the same result, and it remains unclear whether those bone gains actually translate into fewer fractures: a Cochrane review of 43 randomised studies found no statistical evidence for that, probably because the individual studies were too small and too short.
The heavier the load, the greater the effect appears to be. In the LIFTMOR trial, a randomised study involving 101 postmenopausal women with a mean age of 65, participants trained twice a week at high intensity under supervision. After 8 months, bone density in the spine rose by 2.9 percent, while the control group lost 1.2 percent. At the femoral head the difference was even greater: +0.3 percent versus -1.9 percent. Women who already had low bone mass (osteopenia or osteoporosis) also benefited. There was only one adverse event: a mild muscle cramp in the back. Ordinary walking does not reach that level: walking alone slows bone loss but does not build bone mass.
People who already have advanced bone loss do not necessarily need to avoid heavy lifting. The LIFTMOR trial shows that training at high intensity can be safe when it is carried out under expert supervision and the person is otherwise healthy. Without supervision, or in the presence of other health problems, caution is appropriate, because this is still just one study.
Creatine supplementation on top of strength training provided an additional benefit in one randomised 12-month study of postmenopausal women: the creatine group lost 1.2 percent of hip bone density, while the placebo group lost 3.9 percent. The femur also widened slightly, which may improve fracture resistance. No liver or kidney problems were found. Nevertheless, this is one study, and it is too early to recommend creatine as a standard bone intervention.
The strongest evidence for bone health applies to the earliest phase of life. Being physically active as a child and teenager builds peak bone mass, and that bone reserve determines 20 to 40 percent of how vulnerable your bones become later in life. Calcium and vitamin D support this process. Those who missed that window can still gain something through strength training in adulthood, but they cannot recover the early advantage.
Based on one meta-analysis/systematic review (PMID 21735380), two additional systematic reviews (PMID 9927006, 26856587), three RCTs (PMID 23287836, 25386713, 28975661) and two non-indexed reviews (PMID 22777332, 30671455). Fracture effect not demonstrated in randomised studies; bone density effect demonstrated but small.
Does strength training make your bones stronger after the menopause?
Strength training likely makes bones stronger after the menopause, but the effect on bone density is limited in size and the quality of the evidence is low to moderate. Training three times a week with sufficient load, preferably sustained for at least a year, offers the best chance of measurable bone gains.
Which supplements are proven to help strengthen bones?
For bone strengthening, the combination of calcium and vitamin D is the best supported by evidence, especially in cases of deficiency or elevated fracture risk. Vitamin K2 shows encouraging results in postmenopausal women, but discuss the right dose and combination with your doctor, as too much of any supplement also has downsides.
Do you really need calcium supplements for strong bones?
Whether you need calcium supplements depends strongly on your age and situation: for healthy women before the menopause there is no evidence of benefit, while women over 50 may benefit from calcium plus vitamin D, provided you weigh the increased risk of kidney stones and the uncertain cardiac risk with your doctor.
Does strength training help against bone loss (osteoporosis)?
Strength training helps to increase or maintain bone density, but the effect is modest and a reduction in fractures has not yet been demonstrated. Train at high intensity and under supervision for the best results.
How do I know whether my bones are strong enough (osteoporosis)?
With a bone density scan and, where appropriate, a fracture risk calculation, your GP can check whether your bones are strong enough, especially if you have risk factors or have previously broken a bone from a minor fall.
Can zinc contribute to stronger bones?
Getting enough zinc appears to be good for your bones: people with a low zinc intake are more likely to experience bone loss, and supplementation improves bone density, particularly at the hip. Make sure you get enough zinc every day through your diet or, if that is not possible, a supplement.