Table of Contents
Walking is a great exercise. It has many health benefits — both physical and mental. But is walking good for osteoporosis and your bones? How frequently should you walk? What is the best walking pace for osteoporosis? Does walking help with osteoporosis? I answer these questions and more in this blog post.
There is also a comprehensive on walking. I discuss proper walking, illustrate different warm ups before your walk, and stretches after your walk. I also provide techniques to boost your walk to make it more effective and we cover treadmill walking workouts.
At the end of this blog, I have a bonus section where I provide tips on how to keep walking (and build bone strength) even when the weather changes and getting out for a walk is challenging.
We have a lot of ground to cover. Let’s get moving!
Key Points Made in this Article
I encourage you to read this article in its entirety, however, I recognize that it is a long read. Here is a quick walk through of the key points made in this article. You can use these to explore the individual sub-topics in this article in more detail and at your leisure.
- Walking has been shown to improve bone density in the hip and femoral neck area.
- Recent research indicates that you need to walk at a fast pace to improve bone health and osteoporosis.
- If it has been awhile since you have been walking or you are a slow walker, do not be discouraged. You can gradually build up your walking pace and improve bone density.
- Frequent walks are better than a single long walk.
- It can take six months or more before you a noticeable improvement occurs.
- Supplement your walking regimen with other exercises that improve your osteoporosis.
Is Walking Good for Osteoporosis?
Clients and readers often ask if walking is good for osteoporosis does walking improve bone density? Let’s examine this question as it relates to bone density in the hip (the femoral neck),bone density in the spine and other parts of the skeletal system.
Walking and Femoral Neck Bone Density
Most of the research indicates that it is effective at increasing bone mineral density in the femoral neck and hip area. This is an area that is subject to fracture in many people so walking can be beneficial to most individuals.
A study published in late 2013 indicated that “BMD (bone mineral density) at the femoral neck increased [only] after long intervention durations (of six months to one to two years).” (1) In other words, do not expect a noticeable change in your bone mineral density in the femoral neck (as measured by the DEXA, for example) in less than six months.
Does Walking Increase Bone Density in the Spine?
Further, the effectiveness of walking on bones in other parts of the body is mixed.
The study, mentioned above, states that walking “has no significant effects on BMD (bone mineral density) at the lumbar spine and at the radius [forearm] in perimenopausal and postmenopausal women.” (1) A meta-analysis published in 2008 also concluded that walking does not provide enough stimulus for the spine or upper body. (2)
Other studies show an improvement in bone density in the calcaneus or heel bone (3) and the lumbar spine (4).
Does Walking Improve Bone Density?
I should mention that researchers who review other researchers work in this area find the methodologies and reported results to be, at times, wanting.
For example, one researcher states “findings must be interpreted with caution due to the low quality of available studies and the inclusion of non-randomized and observational studies.” (5)
In her 2005 meta-analysis of walking studies and bone health, Dr. Kerstin Palombaro of Widener University calls out the number of studies that rely upon self reporting – an issue that can corrupt research results. (6)
Having spent time reviewing the research, my conclusion is that we can confidently state that walking does improve bone density in the hip and femoral area while its effects in other areas, including the spine, might be limited.
With that behind us, how you walk matters when it comes to bone health. Since walking is generally accessible to most people, it would be good if the mere act of walking improved bone health and increased bone density. It turns out that to build bone while walking, you need to follow certain guidelines.
Let’s explore these in more detail.
Best Walking Pace for Osteoporosis
Your walking pace is likely the most significant variable that affects your bone health and osteoporosis. Dr Robin Daly points out that “regular walking for leisure in isolation and other forms of low or non-impact aerobic activities, such as cycling and swimming, have been shown to have little or no effect on preventing age-related bone loss in postmenopausal women.” (5) (1)
Brisk walking, on the other hand, “at intensities around 75% or greater of maximum oxygen uptake can provide some protection against bone loss.” (5)
Fortunately, a Dutch study published in 2018 provides specific guidance as to how fast you should walk to improve your bone health. (7)
Fourteen postmenopausal women participated in the study. The research team had the participants do three sets of exercises. They recorded the kinematics using a set of motion capture cameras. Further, the research team was able to measure and record hip contact forces (HCFs) for each of the exercise activities. The HCF score indicates the amount of force on the hip area.
A Brisk Walking Pace for Osteoporosis
The Dutch team found that fast (or brisk) walking, at a pace of 5 to 6 km/hr or 3.1 to 3.7 mph, produced compressive and tensile strains at a level similar to hopping or running at 5 to 9 km/hour or 3.1 to 5.6 mph.
Brisk walking is classified as a weight-bearing, aerobic activity.
The research team concluded that “our results suggest that a training program including fast [or brisk] walking (above 5 km/h) and running exercises may increase or preserve the BMD (bone mineral density) at the femoral neck”. In other words, to improve bone health you need to walk pretty fast.
They considered a walking pace of 4 km/h or 2.5 mph the minimum pace for maintaining bone health.
Here is a tip on how to estimate your walking speed using step rate. The step rate for 3.1 mile per hour (or 5 km per hour) is approximately 120 steps per minute. You can estimate your step rate by counting every right foot step that you take. Ten right foot steps in 10 seconds equates to 120 steps/min or 3.1 mph (5 km/h).
How Long and How Many Miles Should You Walk?
If walking is your only aerobic (weight bearing impact) exercise, then you should aim for 21 to 42 minutes a day or 150 minutes to 300 minutes a week. (8)
(Note: These recommendations are based on guidelines provided by international health organizations. For a full list of these organizations by country, please read the section entitled Exercise Guidelines by Country, below.)
Researchers who study the benefits of walking on bone and brain health recommend 30 minutes a day.
Keep in mind that you need to walk at a brisk pace the whole duration of the walk.
New research suggest that short and intense bouts of exercise is associated with longevity. A study published in the Journal of the American Heart Association indicates that “that sporadic and bouted moderate‐to‐vigorous physical activity (MVPA) are … associated with substantially reduced mortality.” (9)
How Often Should You Walk for Your Osteoporosis?
Many individuals like to go for one long walk. But if you are able to break a longer walk into several shorter walks, your bones will reap the benefits.
Shorter walks allow you to make your walks faster and studies have shown that breaking up impact-loading results in better bone building.
If you currently plan your day around a single sixty minute walk, see if you could split it into two thirty minute walks, or even better, three twenty minute walks.
Walking and Osteoporosis Recommendations
If vigorous walking has not been part of your movement repertoire in the past six months or longer, be sure consult with your physician before you begin. Start slowly and build up your speed.
Build Up Your Strength and Balance
I encourage you to spend a few weeks building your strength and balance by following the Beginner exercises in Exercise for Better Bones. These exercises are designed to strengthen your whole body in preparation for more impact. The exercises within Exercise for Better Bones are a perfect complement to a brisk walking program.
Build Up Your Walking Pace Gradually
If you are not currently able to walk at 3.1 mph, gradually build-up with the goal to reach this speed. Here is an approach that incorporates High Intensity Interval Training or HIIT that has been shown to very beneficial.
- Begin your walk at the pace that is comfortable for you.
- After your first five minutes walk at your very fastest pace for 20 seconds then return to your comfortable pace for a 2-minute recovery.
- Repeat this four to five times, then complete your walk with your comfortable pace.
- Your comfortable walking pace will increase gradually, as will your fastest walking pace.
Is Walking a Weight Bearing Exercise?
Weight bearing exercise is an essential part of an osteoporosis exercise program. Is walking a weight bearing activity?
Do You Need to Do More Than Walking to Build Bone?
Walking is an inexpensive and convenient form of cardiovascular exercise. However, it is not enough to build bone and reduce your risk of fracture.
Walking does not make you more flexible or stronger (except if you regularly walk up hills). It does not directly improve your balance. Studies have shown that walking without strength or balance training actually increases your risk for falls and/or fractures.
With that in mind, I encourage all walkers to incorporate strength, balance, posture and flexibility training into their exercise program.
Exercise and Osteoporosis
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 — 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 — 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 — should you practice yoga if you have osteoporosis?
- Core strength and osteoporosis — 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.
The Ultimate Walking Guide for Osteoporosis
Now that you know how walking can benefit your bones, what steps do you need to take to experience the perfect walk? I created this guide to help you achieve that goal. We will start with the right posture and proper walking form.
Now that you know good walking form, lets get into walking warm ups. We will cover these in the next section.
Warm Up Routines Before You Walk
This warm up routine is for beginner level walkers.
This warm up routine is for advanced level walkers.
Stretching Routine After Your Walk
The following routine includes six stretches to help you relax and recover after your walk. Enjoy!
How to Boost Your Walk
Want to get more out of your walk? Here are five tips on how to boost your walk.
Is Walking on a Treadmill Good for Osteoporosis?
Can’t get outside for a walk? Do you prefer to use a treadmill but wonder if it is effective for osteoporosis?
When clients ask me if walking on a treadmill is good for osteoporosis, I tell them that their bones will experience adequate compressive forces — provided they walk at the prescribed pace. This is good news for many people who live in colder climates or are unable to get outside to walk because of other constraints.
Beginner and Senior Treadmill Walking Osteoporosis Workout
Want a beginner level or senior treadmill walking workout that is good for osteoporosis? Look no further. I prepared this workout for you and your bones.
Active Level Treadmill Walking Osteoporosis Workout
Below is my active level treadmill walking workout that is good for osteoporosis.
Advanced Level Treadmill Walking Osteoporosis Workout
Below is my advanced level treadmill walking workout that is good for osteoporosis.
Tips for Your Treadmill Walking Workout
Top ten tips for how to get the most from your treadmill walking workout.
Walking Equipment Recommendations
I am often asked by readers and clients to recommend equipment that helps build bone while walking. Here is a quick summary of my thoughts on this question.
Weighted Walking Vest for Osteoporosis
A weighted vest provides a load through your spine and your lower body. If you have a rounded back (increased kyphosis) you can still wear a weighted vest. However, you should reduce the amount of weight in the vest and have the weight sit just below and between your shoulder blades. I have reviewed a number of weighted vests for osteoporosis and my recommended vest is the HyperVest Pro.
Ankle Weights and Walking
Ankle weights will slow you down when you walk. This is problematic because we want you to walk briskly in order to gain the most benefit for your bones.
In addition, ankle weights are more likely to throw off your balance and increase your risk of a fall. They will make it more likely that you catch your foot on a rise in the sidewalk or path. Finally, your ability to “catch your fall” will likely diminish because the ankle weights will slow you down as you side-step or step out as you fall.
Walking With Weights for Osteoporosis
Is it safe to walk with weights if you have osteoporosis, whether those weights are wrist weights or dumbbells?
I have reservations about using wrist weights or dumbbells when walking. Lets go through them one at a time. I explain each reservation in more detail in etc video below.
Because arm speed dictates walking pace, using wrist weights could slow you down. You need to be moving at a certain walking pace to improve bone health. As a result I discourage many people from using wrist weights for this reason alone.
Secondly, wrist weights can get in the way when you need to respond to a surprising event. When you reduce your reaction time, you increase your risk that you will be unable to catch or protect yourself in the case of a fall.
Wrist weights can increase your blood pressure and increase the risk of a cardiovascular event.
Best Walking Shoes for Osteoporosis
I have written guidelines of selecting the best walking shoes for osteoporosis. You should also read my have a detailed blog post on minimalist walking shoes. Also consider whether you should use lace up shoes or “slip ins”.
I recommend the Icebug boots for those of you who live in snowy or icy areas. The risk of a fall is alway present and boots with a grip can keep you safe.
Walking in Bad Weather
Just because it is getting cooler and wetter you should not stop your walking exercise program. In this video, I cover two tips to keep you moving and active outside during the Fall and Winter seasons.
Walking Exercise with Resistance Bands
Looking for a specific walking exercise for your hip bone and muscle strength? Exercise for Better Bones includes the Lateral Band Walks Exercise.
Weighted Belt for Osteoporosis
If you have disc problems, shoulder, neck or back pain, a weighted belt might be a better choice than a weighted vest. A weighted belt adds to the intensity in your legs but not your back.
However, before you purchase a weighted belt, make sure that the belt (with the weights) fits your waist. Also keep in mind that the weighted belt will load your feet and knees. Too much weight through your feet could lead to plantar fasciitis.
Nordic Walking
Nordic walking is a great overall exercise routine. I encourage many clients to pick up this activity. In fact, I have written an extensive Guide to Nordic Walking for my readers and clients. Keep in mind that optimal bone building occurs when you walk at a rapid or fast pace and, unless you are an advanced Nordic Walker, you might have a difficult time hitting the prescribed speed limit.
Walking and the Brain
Walking is beneficial for our bones and also our brains. (10)
Researchers have found, using ultrasound to determine blood flow, that the acts of walking and running increases blood flow to the brain.
They also found that walking increases the amount of healthy protein in the brain. Like bones, the foot-to-ground impact was the key. The same benefit was not found in non-weight impact cardiovascular exercises, such as cycling.
Conclusion
Research shows that walking is beneficial for the femoral area and the hips. However, the walking pace needs to be brisk. Instead of one long walk for the day, people should break up that long walk into several shorter, more intense, walks. It will take a minimum of six months of regular brisk walking before you see the effect on your hip area.
Incorporate other exercises into your exercise program.
And if you cannot walk at a rapid pace, do not be discouraged. Gradually build up your speed over time and use an exercise program like the Exercise for better Bones program to help you build up your endurance.
Happy trails!
Further Readings
Exercise Guidelines by Country
- United Kingdom. National Health Service (NHS). https://www.nhs.uk/live-well/exercise/
- United States. President’s Council on Sports, Fitness & Nutrition. https://www.hhs.gov/fitness/be-active/physical-activity-guidelines-for-americans/index.html
- Canada. CSEP. https://csepguidelines.ca/wp-content/uploads/2018/03/CSEP_PAGuidelines_adults_en.pdf
- Canada. CSEP Guidelines. (The preamble is an important read). https://csepguidelines.ca/adults-65/
- Australia. Physical Activity Guidelines. https://www.eatmovelive.com.au/wp-content/uploads/2012/09/Physical-Activity-Guidelines-Australia.pdf
References
- Ma D, et al. Effects of walking on the preservation of bone mineral density in perimenopausal and postmenopausal women: a systematic review and meta-analysis. Menopause. 2013 Nov;20(11):1216-26. doi: 10.1097/GME.0000000000000100.
- Martyn-St James M, Carroll S. Meta-analysis of walking for preservation of bone mineral density in postmenopausal women. Bone. 2008 Sep 43(3):521-31.
- Brooke-Wavell K, Jones PRM, Hardman AE. Brisk walking reduces calcaneal bone loss in post-menopausal women. Clin Sci. 1997;92:75-80.
- Hatori M, Hasegawa A, Adachi H, et al. The effects of walking at the anaerobic threshold level on vertebral bone loss in postmenopausal women. Calcif Tissue Int. 1993;52:411-414.
- Daly, RM et al. Exercise for the prevention of osteoporosis in postmenopausal women: an evidence-based guide to the optimal prescription. Brazilian Journal of Physical Therapy 2019;23(2):170-180.
- Palombaro K. Effects of Walking-only Interventions on Bone Mineral Density at Various Skeletal Sites: A Meta-analysis. Journal of Geriatric Physical Therapy: December 2005 – Volume 28 – Issue 3 – p 102–107.
- Pellikaan P, et al. Ranking of osteogenic potential of physical exercises in postmenopausal women based on femoral neck strains. PLoS One. 2018; 13(4): e0195463.
- American College of Sports Medicine. June 14, 2019. https://www.acsm.org/all-blog-posts/certification-blog/acsm-certified-blog/2019/06/14/walking-10000-steps-a-day-physical-activity-guidelines
- Saint-Maurice, P. et al. Moderate‐to‐Vigorous Physical Activity and All‐Cause Mortality: Do Bouts Matter? Originally published 22 Mar 2018https://doi.org/10.1161/JAHA.117.007678Journal of the American Heart Association. 2018;7
- Science Daily. How walking benefits the brain. https://www.sciencedaily.com/releases/2017/04/170424141340.htm
Comments
March 25, 2011 at 7:16pm
Judy Gifford
Wanting to get further into the program however at the same time I was diagognosed with osteoporosis I injured my right knee. Then 2 weeks later found out that my heart was bad, and had to have 2 stents in. I purchased your book, now I am waiting for my health to improve so I can start exercising. Judy
March 26, 2011 at 8:37am
Margaret Martin replies
Hello Judy, You will most likely be given a cardiac rehab protocol to follow that includes walking. It will assist your bones as well as your heart. If your knee injury makes walking painful, you can either try the Nordic poles or a type of crutch referred to as either a forearm/Lofstrand or Canadian crutch. This type of crutch is just a little longer than a cane but allows you to transfer weight through it. You would use it in your left hand to take weight off your right knee. If this is not an option see if you get the green light to start water walking or using a stationary bicycle. Not as good for your bones but a great way to build up your endurance and strength until you can get stronger. You want to be sure than any incisions are fully healed before going into a pool. I hope you are working with a Physiotherapist/Physical Therapist who can provide you with the best recommendations for your situation. All the best!
December 29, 2013 at 9:20pm
Kathleen Miller
If I already power walk for an hour daily and use an elliptical trainer with resistance and do 30 minutes of resistance pilates using a ring, and was diagnosed with -2.8 osteoporosis in my LUMBAR SPINE ONLY, should I add a free weight routine found here, as well as a little jump rope (gradually), faux jumps, and some stomping during my walk? A little jog now and then (but my knees ache if I jog too much)? How about adding Nordic walking poles to the mix?
I am looking for safe ways to BUILD bone in the LUMBAR SPINE area only, since the hips and wrists are good. I read here that pounding (as in faux jumps, stomping, etc) are what work for the spine. How about Nordic poles?
December 29, 2013 at 9:28pm
Kathleen Miller
To add to this mix, I just started wearing a weighted vest, adding half pound weights ---one every two weeks, to build gradually. Would Nordic poles help the spine, most especially lumbar area also? Or does really only higher impact jumping, like jumping rope, faux jumps, or jumping jacks or jogging or stomping help in that area?
September 8, 2014 at 10:18am
fran
Just found out I have osteoporosis on left hip, so I should continue my walk daily? please respond asap 67 yrs old
September 8, 2014 at 10:31am
Richard Martin replies
Fran - Margaret is unable to comment on your situation without an assessment. You could either schedule a phone discussion with her or consult a Physical Therapist near you. Thanks and good luck.
September 22, 2014 at 8:17pm
Margaret Martin replies
Absolutely! With even more vim and vigor!!
Margaret
August 28, 2016 at 1:46am
esther
Hi,
SO if I wear my weighted vest and I walk briskly this is helping my spine?
August 6, 2019 at 6:45pm
StephanieM
Does this all apply to walking on a treadmill?
August 7, 2019 at 10:58am
Richard Martin replies
Hi Stephanie: The Dutch team used a treadmill for their research on walking and force. When clients ask Margaret if walking on a treadmill is good for osteoporosis, she tells them that their bones will experience adequate compressive forces - provided they walk at the prescribed pace. This is good news for many people who live in colder climates or are unable to get outside to walk because of other constraints. Thanks!
August 7, 2019 at 12:35pm
StephanieM
Great, thank you!
August 7, 2019 at 7:14pm
Richard Martin replies
You are welcome.
August 15, 2019 at 3:37pm
Bettybolafia-Rosenzweig
You mentioned difficulty reaching the prescribed speed for bone building with Nordic poles. Is the prescribed speed with poles the same as you described without them?
September 8, 2019 at 3:59pm
Margaret Martin replies
Hi Betty, I have not seen a study showing otherwise. I would aim for 3.1 mph as your base speed. The reason for my comment is that when poling you are getting a greater cardiovascular workout. The equivalent walking speed with poles results in an increase in overall muscle activity, exertion and heart rate. I love the use of poles in that they improve most walkers' posture and once you are comfortable with the poles they provide more stability.
Enjoy your walks!
Margaret
August 15, 2019 at 4:38pm
Wendy Norman
For those living in Ottawa, Place d'Orleans Shopping Centre is an excellent location to do your walking during inclement or cold weather. They have an underground parking area so you can leave your winter coats and boots in your car and just lock it and take the key. You can usually access the underground parking as well as the mall interior as early as 7:30 AM even though the stores don't open till much later. There is a walking club that meets on Thursdays upstairs near The Bay. And quite a few people use Nordic Poles while walking. From November till March or April, it's a great spot to walk and safer than slippery sidewalks and roads in Ottawa! Technically the terrazo floor might be problematic for some knees since it is harder than asphalt or dirt, etc but after a week or so, it seems fine.
August 15, 2019 at 6:38pm
Richard Martin replies
Hi Wendy. Thanks you for sharing this.
March 5, 2020 at 7:40am
Claire
Hi
What is a good distance to walk
A patient of mine has been told that 4 km a day is too much even though she does it in a few sessions a day,regularly and with little effort
Many thanks
March 5, 2020 at 8:38am
Richard Martin replies
Hi Claire. Thanks for reading our post.
Duration and intensity of the walk matters more than distance. Margaret provides guidelines in her post:
If walking is your only aerobic (weight bearing impact) exercise, then you should aim for 21 to 42 minutes a day or 150 minutes to 300 minutes a week.
(Note: These recommendations are based on guidelines provided by international health organizations. For a full list of these organizations by country, please read the section entitled Exercise Guidelines by Country.)
Researchers who study the benefits of walking on bone and brain health recommend 30 minutes a day. Keep in mind that you need to walk at a brisk pace the whole duration of the walk.
New research suggest that short and intense bouts of exercise is associated with longevity. A study published in the Journal of the American Heart Association indicates that “that sporadic and bouted moderate‐to‐vigorous physical activity (MVPA) are … associated with substantially reduced mortality.” (9)
April 18, 2021 at 9:10am
Irene Phillips
I enjoyed these communications and was just diagnosed with osteoporosis. I was surprised to see the woman in the picture carrying what appears to be a very heavy backpack if she has ssteoporosis. Is this an okay thing to do for us outdoor people with osteoporosis?
April 18, 2021 at 10:35am
Richard Martin replies
Hi Irene. Margaret discusses this topic here. http://melioguide.com/osteoporosis-exercises/nordic-walking/#Nordic_Walking_With_Weighted_Vest_or_Backpack
May 20, 2021 at 1:28pm
Lee A. Johnson
I would like to know how video rates with a recommended walk. I have been using the intermediate brisk 30 minute walk 3-5 times a week for several years. It incorporates leg raises, kicks, hamstring pull, side steps, forward and backward walking along with lots of arm movements during the walk time span. I walk outdoors also. But the video is good for bad weather or allergy season. It is produced in coop with American Heart Asso. I had my first DEXA last month and I have OP in lumbar and Penia in femoral necks. I have your book now. Would your video be a better one?
July 7, 2021 at 2:46pm
Lee Ann Johnson
I have watched your Flexion and Extension video where demonstrate all the body areas. Is that something a person with osteoporosis should do? Or should we only do the extension movements for those areas? Sometimes my lower back gets sore. I am in week 5 of your Exercise For Better Bones program.
January 11, 2022 at 5:00pm
Lise Toenr
Hello,
I am wondering about incline and pace. Would steep inclines reduce the benefit of walking if you can't keep up the pace?
Thanks,
...Lise
January 19, 2022 at 10:53am
Richard Martin replies
Hi Lise,
You will gain cardiovascular and muscle strength by going uphill, even if your pace slows. Hopefully there is a downhill on the other side that will provide you with an opportunity for a faster pace and more ground reaction (weight bearing) forces.
All the best,
Margaret