Osteoporosis, a condition characterized by weakened and fragile bones, affects millions of people worldwide, particularly as they age. Finding ways to maintain bone integrity and prevent fractures is of paramount concern for those living with this condition. While many forms of physical activity, particularly weight-bearing activities and resistance exercises, are promoted as beneficial for building bone density, running often stands out as a high-impact exercise that raises questions about its suitability for individuals with osteoporosis.
In this article, we will explore the complex relationship between running and osteoporosis, and help you determine if running is right for you. The answer is more complicated than you’d think.
Benefits of running and bone health
As a high-impact weight-bearing activity, the mechanical loading and impact forces generated during running could be enough to stimulate new bone growth (Daly, 2019). But, while there is enough force, there are other factors that affect whether running is enough to stimulate new bone growth.
Research findings are mixed. A major study from 1999 suggests that running, as an aerobic endurance sport, does not actually increase bone density if done consistently and long-term (1999 study). More recent findings have suggested that running can increase bone density in postmenopausal women in the lumbar spine (Sañudo, 2017).
Why is there a discrepancy? One of the key elements of an effective exercise program designed to increase bone and muscle strength is progressive loading. Progressive loading is when you continuously increase the load/forces on the body during your workout by increasing them as the body adapts to the new stimulus. If you are running on the same surfaces, for the same distance, at the same speed, this is not progressive loading, and may not provide enough stimulus to trigger the body to produce new bone. However, changing some elements of your run may help increase the stress or load on your body and, in turn, increase bone density (Beck, 2017).
How to make running more effective at building bone
In order for running to be most effective at building bone, it has to have variety. According to a 2015 study, the first few minutes of impact exercise stimulates bone formation, but because bone is a living tissue, it can fatigue quickly (Arnaud, 2015).
If you run the same distances on the same terrain repeatedly, this may not introduce a new stimulus to your body. Here are some tips for how to make running more effective at building bone:
- Add bursts of speed or interval training. Alternating between a rest and sprint can challenge your body in a way that helps boost bone production. Interval training – alternating between work and recovery periods – seems to be more effective at building bone than continuous steady state runs (Arnaud, 2015). Long distance runners seem to lose bone, whereas sprinters gain bone from running.
- Run downhill. Running downhill, as opposed to on flat surfaces or going uphill, puts an increased load on your bones thanks to increased ground reaction forces while also requiring eccentric muscle contractions, which are particularly effective at building bone (Arnaud, 2015). In other words, running downhill helps increase the bone building potential of a run.
- Try trail running. Trail running can involve multi-directional changes, changes in incline and terrain, and changes in speed. All these different elements give your bones more of a challenge than a steady state on a flat running path.
Does running prevent osteoporosis?
Running alone will not prevent osteoporosis. While running can have a positive impact on bone health by increasing biochemical markers of bone formation (Lee, 2019), there are controllable and uncontrollable risk factors for developing osteoporosis. Preventing osteoporosis requires a more holistic and comprehensive plan. Usually this includes maintaining a balanced diet rich in calcium, vitamin D and other important vitamins and minerals for bone health, participating in regular weight-bearing activities, resistance exercises, and avoiding certain things like smoking and excessive alcohol consumption. The best thing you can do to stay on top of your bone health is to monitor your bone density through medical assessments with your doctor.
Running can be a valuable component of an overall strategy to maintain bone health, especially when combined with other healthy lifestyle choices, but it should not be relied upon as the sole preventive measure for osteoporosis.
Concerns for running and osteoporosis
As you have read, running can be an effective activity to foster and maintain strong bones in young and healthy individuals, but only if they combine it with other activities or strategies. When it comes to someone with osteoporosis, it’s important to weigh the risks with the benefits.
Is running a safe exercise for osteoporosis?
According to recent research, running may be beneficial for hip bone mineral density (BMD), but can be dangerous for low spine BMD (LeBoff, 2022). According to one study, it is considered unsafe for people who have had compression fractures or multiple low trauma fractures (Brooke-Wavell, 2022).
For anyone looking to add running into their exercise program, it’s important to properly prepare the body for high-impact exercises by strengthening certain muscles, addressing single leg balance, incorporating agility exercises and focusing on maintaining good joint mobility and cardiovascular health. If one’s body is adequately prepared to take on the increased forces of running, and they have no history of spinal fractures or recent falls, then it can be a wonderful and enjoyable way to build cardiovascular endurance while also potentially strengthening your bones.
As always, you should check with your doctor or physical therapist who knows your fitness level, health status and medical history to determine whether or not running is appropriate for you.
Running alternatives for people with osteoporosis
Running isn’t for everyone. If running isn’t for you, due to any of the reasons mentioned above or simply due to personal preference, there are plenty of low-impact forms of exercise that can improve your bone health. Here are just a few:
- Weight-bearing aerobics: Low-impact aerobics that use weights or body-weight alone can increase your heart rate, improving cardiovascular fitness, while also giving you the benefit of building bone. Weight-bearing exercises are important for bone health because they stimulate the bones to become stronger by applying mechanical stress, which encourages bone remodeling and increased bone density.
- Walking: Walking has a lot of potential bone-building benefits. Just make sure you put a pep in your step, incorporate some inclines or directional changes, or add some resistance with a backpack or weighted vest to get a little more out of your daily walk.
- Resistance training: Resistance training exercises are important for bone health as they promote bone density by subjecting bones to increased load and tension, stimulating bone growth and remodeling. They can involve free weights, kettlebells, weight machines and resistance bands.
As you can see, running and osteoporosis have a complicated relationship. Depending on your bone health and how you run, it may help strengthen your bones or it may work against you. A lot of factors can impact how effective running is at building strong bones. Make sure you check with your doctor to learn if running is healthy and safe for you.
