I am often asked which high impact exercises are most effective for maintaining and improving bone density. This question has become increasingly important as we understand more about osteoporosisāa condition that affects millions of women worldwide, particularly after menopause.
Recent research provides fascinating insights into how different types of high impact exercises affect our lower limb joints and, consequently, bone density and osteoporosis. Today, I’ll share findings from a groundbreaking study (1) that examined the effects of various high impact exercises on bone loading and what this means for your osteoporosis exercise routine.
What is High Impact Exercise?
High impact exercise refers to activities that involve both feet leaving the ground simultaneously, which puts a greater amount of force on your joints and body than when you stand motionless.
High impact exercise is sometimes called high intensity impact exercise. It is also referred to as weight bearing exercise. However, high impact exercise is different from high intensity resistance or strength training. Both are important exercise categories for building bone quality and bone density.
High Impact Exercise Examples
High impact exercise examples include running, brisk walking, jumping, jumping rope, jumping jacks, hopping, squat jumps, and skipping. Many of these occur during high intensity interval training (HIIT).
High Impact Exercise for Osteoporosis
High impact exercise plays a crucial role in increasing bone density and managing osteoporosis. It positively influences the bone remodeling process.
Bones adapt their structure based on the mechanical forces applied to them.(2) When these forces exceed a certain threshold, bone formation occurs faster than bone breakdown, ultimately leading to stronger bones.
Your bones are unique compared to other organs. They possess the remarkable ability to repair and rejuvenate themselves to combat declineāa capability most other organs lack.
The cells responsible for bone resorption (osteoclasts) and bone formation (osteoblasts) remain active throughout adulthood. However, their function and quantity naturally diminish as you age.
Mesenchymal stem cells (MSCs) are undifferentiated cells destined to develop into bones, muscles, and ligaments. Our bone marrow produces these stem cells daily, and their primary nourishment comes from mechanical stimulation.
When muscles vibrate, they stimulate stem cells into action to create bone, muscle, and ligament cells. High impact training exercises specifically cause our muscles to vibrate.
This muscle vibration, in turn, stimulates our mesenchymal stem cells to differentiate into bone cells, thereby enhancing overall bone health and density.
This is why high impact exercises are particularly importantāthey create larger forces on our bones, stimulating greater bone formation. But as the study reveals, not all high impact exercises affect our joints equally, which is crucial to understand when designing an exercise program for bone health.
Different High Impact Exercises Yield Different Results
The research examined 40 healthy, active adults (average age 40) performing six different high impact exercises:
- Walking (at self-selected speed)
- Running (at different intensities)
- Countermovement jumps
- Squat jumps
- Unilateral hopping (one leg)
- Bilateral hopping (two legs)
Using sophisticated measurement techniques, researchers calculated the forces experienced at the hip, knee, and ankle joints during these activities. The results were eye-opening and provided us with valuable guidance for exercise prescription.
Best High Impact Exercises for Each Joint
The study examined the effects of high impact exercise on each major joint. Here is a summary of their findings.
Hip Joint
The hip joint is particularly vulnerable to osteoporotic fractures, making it a priority area for bone-strengthening exercise. According to the study:
- Running created the highest forces at the hip jointāup to 83% greater than walking. Fast running (sprinting) generated even higher hip forces than moderate-paced running.
- Unilateral hopping (on one leg) also provided significant loadingā21% higher than walking.
- Interestingly, jumping exercises and bilateral hopping actually provided less force at the hip than walking.
Hip-Focused Recommendation: If your goal is to strengthen hip bones, running should be your primary activity, with faster running creating greater bone-building stimulus. One-legged hopping exercises also provide excellent hip loading.
Knee Joint
For the knee joint, the study revealed:
- All exercises tested provided higher forces at the knee compared to walking.
- Running again led the way, with forces 134% higher than walking.
- Countermovement jumps (97% higher) and unilateral hopping (94% higher) were also very effective.
- Squat jumps created forces 85% higher than walking.
- Bilateral hopping showed the smallest increase (42%).
Knee-Focused Recommendation: All the high-impact exercises were beneficial for knee loading, with running providing the greatest stimulus, followed closely by jumping and one-legged hopping.
Ankle Joint
For the ankle joint:
- Running increased forces by 94% compared to walking.
- Unilateral hopping increased forces by 77%.
- Bilateral hopping increased forces by 30%.
- Interestingly, jump exercises actually reduced ankle loading compared to walking (19% less for squat jumps and 3% less for countermovement jumps).
Ankle-Focused Recommendation: Running and hopping exercises (especially on one leg) provide excellent loading for ankle bones, while jumping exercises may not be as effective for this joint.
Exercise for Osteoporosis Course
Exercise is an essential ingredient to bone health. If you have osteoporosis, therapeutic exercise needs to be part of your osteoporosis treatment program.
But what exercises should you do and which ones should you avoid? What exercises build bone and which ones reduce your chance of a fracture? Is Yoga good for your bones? Who should you trust when it comes to exercises for osteoporosis?
A great resource on exercise and osteoporosis is my free, seven day email course called Exercise Recommendations for Osteoporosis. After you provide your email address, you will receive seven consecutive online educational videos on bone health ā one lesson each day. You can look at the videos at anytime and as often as you like.
I cover important topics related to osteoporosis exercise including:
- Can exercise reverse osteoporosis?
- Stop the stoop ā how to avoid kyphosis and rounded shoulders.
- Key components of an osteoporosis exercise program.
- Key principles of bone building.
- Exercises you should avoid if you have osteoporosis.
- Yoga and osteoporosis ā should you practice yoga if you have osteoporosis?
- Core strength and osteoporosis ā why is core strength important if you have osteoporosis?
Enter your email address and I will start you on this free course. I do not SPAM or share your email address (or any information) with third parties. You can unsubscribe from my mail list at any time.
How High Impact Exercise Affects Joint Loading
The researchers also examined how varying the intensity of each exercise affected joint loading. These findings are particularly valuable for creating progressive osteoporosis exercise programs:
Running Intensity
- Increasing running speed from jogging to moderate speed increased forces at all joints.
- Sprinting (maximum speed) dramatically increased hip joint forces but actually decreased forces at the knee and ankle.
Jumping Intensity
- Higher jumps increased forces at all lower limb joints.
Hopping Intensity
- Interestingly, faster hopping frequency actually reduced forces at all joints.
How to Choose a High Impact Exercise
Osteopenia and osteoporosis is a systemic disease, affecting all the bones in your body. Applying an appropriate amount of stress to all different bones is important for stimulating those bones.
However, individuals with osteoarthritis or joint replacements should consider the amount of load on their lower body joints. Not every activity is safe for every joint.
If you have significant arthritic changes in a particular joint, you want to be selective about the high impact exercise you choose. For example, if you have advanced arthritis in your knee(s) running will add 50% more force on your knee joint than squat jumps. In this situation, you might want to pass on the running and instead use squat jumps.
High Impact Exercise Program for Osteoporosis and Bone Density
Based on these findings, here’s my recommended approach for women looking to maintain or improve bone density:
For Overall Bone Health
The research clearly shows that a varied exercise program that includes multiple types of high impact exercises is ideal. No single exercise optimally loads all joints, so incorporating a mix of activities ensures comprehensive bone strengthening.
A Balanced Weekly Routine Might Include:
- Running 2 to 3 times per week (varying between moderate pace and shorter sprint intervals)
- Hopping exercises 2 times per week (both one-legged and two-legged variations)
- Jumping exercises 1 to 2 times per week
For Those New to High Impact Exercise
If you’re just beginning with high impact exercise or returning after a break:
- Start with walking at a brisk pace
- Gradually introduce bilateral (two-legged) hopping
- Progress to gentle jogging intervals
- Add jumping exercises once comfortable with the above
- Eventually incorporate unilateral (one-legged) hopping and faster running
For Those with Joint Concerns
If you have existing joint issues:
- Hip concerns: Focus on bilateral hopping and jumping exercises, which provide less hip loading than running
- Knee concerns: Bilateral hopping provides the lowest additional load among high-impact exercises
- Ankle concerns: Jumping exercises, particularly squat jumps, may be preferred as they actually reduce ankle loading compared to walking
Key Takeaways for Bone Health
- Mix it up: Different exercises affect different joints. A varied routine ensures all your bones receive appropriate stimulus.
- Progressive loading: Begin with lower-intensity versions and gradually increase as your fitness improves.
- Consistency matters: The bone-building response happens over time with regular stimulus, so aim for consistency rather than occasional intense workouts.
- Listen to your body: While some discomfort during new exercise is normal, pain is not. Modify or seek guidance if exercises cause pain.
- Consider your whole body: While this research focused on lower body joints, remember that upper body resistance training is also crucial for overall bone health.
Beyond High Impact Exercise: A Holistic Approach
While high impact exercise is crucial for bone health, remember that it’s just one component of a comprehensive approach. Balanced nutrition and appropriate medical care are all essential partners to your exercise program.
I encourage you to establish your baseline performance before starting high impact exercises. Record how much high impact exercise you have been doing over the past six months and gradually increase the load level. Advancing too quickly can lead to injury and set backs.
By applying these evidence-based findings to your exercise routine, you’re taking a significant step toward maintaining strong, resilient bones for years to come.
Remember: Before beginning any new exercise program, especially if you have been diagnosed with osteoporosis or have other health concerns, consult with your healthcare provider or a physical therapist who can provide personalized guidance.
Margaret Martin
Further Readings
References
- Altai Z, Hayford CF, Phillips ATM, Moran J, Zhai X, Liew BXW. Lower limb joint loading during high-impact activities: implication for bone health. JBMR Plus. 2024 Sep 14;8(11):ziae119. doi: 10.1093/jbmrpl/ziae119. PMID: 39415962; PMCID: PMC11481284.
- ChloƩ Lerebours, Pascal R. Buenzli,Towards a cell-based mechanostat theory of bone: the need to account for osteocyte desensitisation and osteocyte replacement,Journal of Biomechanics,Volume 49, Issue 13, 2016.
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