Impact Training for Bone Density & Quality

Written By Gillian Erskine

Most of us grow up hearing that “low-impact exercise” is the safe option, especially as we get older. But when it comes to bone health, our bones need impact and purposeful, progressive loading.

In our recent webinar on upper and lower body impact training, we looked at what the evidence says: why impact matters, what kinds of movements stimulate bone growth, how upper-body sites around the wrist respond to loading, and how to start safely if you’ve not done any impact for a while. 

And when we combine strength + balance + impact + movement skill, we create a system that not only reduces fracture risk, but also builds confidence in how we move.

Why We Need Impact

Bones are living tissue, they respond to the force and loading patterns we put through them. We generally want a mixture of:

  • Progressive Strength training and impact as they strengthen and improve the quality of the bone (they both target slightly different sites which is why you need both).

  • Balance training improves the way we control our bodies and practical movement skills provide us with more movement options.  

Research consistently shows that even small amounts of well-directed impact can improve the internal structure of the bone, sometimes before any changes show up on a scan.

Lower-Body Impact

Lower-body impact is where we have the clearest research - and the message is relatively simple: bones respond well to short, sharp, low-volume moderate frequency impact, especially around the hips, spine, and distal tibia.

A range of studies shows how effective lower-body impact can be:

  • You don’t need to do a lot

  • You don’t need to jump high

  • You just need small amounts of rapid loading a few times a week

The key is the rate of force, not the height of the jump.

For many people, the idea of “impact” brings up images of box jumps but effective, approachable lower-body impact can look like:

  • heel drops

  • marches

  • hops

  • rebounds

  • skipping 

If you haven’t experienced impact in years, what matters is that the movement feels manageable for you right now. You can work up slowly over months, not weeks.

Upper-Body Impact

Most people know impact helps the hips and spine, but fewer realise how important it is for the wrist and forearm - the areas most commonly fractured in midlife and older age, especially in women.

Most wrist fractures happen at the distal radius and this site responds well to small, controlled upper-body impact. The challenge is that over the course of our adult lives, most of us stop putting any kind of loading through our hands and wrists..

This does not mean throwing yourself into handstands or push-ups, it means re-introducing the hands to the world in small, safe, familiar ways - the same principle we use in the lower body.

Upper-body impact can begin with:

  • a gentle push-off from a wall and (over time) the floor

  • shifting weight through the hands in a quadruped position

  • small hand “drops” where you let the hands meet the ground softly

The goal is not to create big forces but to remind the bones of the wrist that they are still needed.

Start Where You Are

Most people think impact is risky because they imagine doing too much, too soon. But impact doesn’t need to start with jumping, you can start with movements you feel comfortable with right now and progress slowly over months not weeks.

And just like strength training, bones respond best when the load increases gradually and remains consistent.

Your capacity, your history, and your confidence determine the starting point.

There is no universal prescription, only progression at a pace that feels right for you.

General rules of thumb on quantity per week

Scientists measure impact using ground reaction force (GRF), the amount of force transmitted through your body into the ground. Research suggests that a GRF of around three times your body weight is needed to stimulate new bone formation (Turner & Robling, 2003). Keep in mind this is relative to the site and current structure of the bone. 

Here’s what different activities look like:

  • Walking: ~1.5 × body weight (Cavanagh & Lafortune, 1980)

  • Running: ~2.5 × (Novacheck, 1998)

  • Skipping (Jump rope): typically between walking and running

  • Drop jumps / vertical rebound jumps: ~4.6–5.5 × (Umberger, 1999; Vainionpää et al., 2006)

*See videos for more context.

It’s also worth remembering that these numbers are averages, GRF varies depending on how experienced the mover is, the surface they’re on, their body type, and the exact way the activity is performed. For one person, brisk walking may generate more force than for another.

There’s nothing magical about a 20 cm drop jump and a rebound, researchers use standardised heights because they’re easy to measure. If structured sets and reps make sense to you, then use them. If not, what matters is gradually adding impact your body can tolerate.

If you can build yourself up so you’re skipping, hopping, or jumping in different ways a few times each week - you’re already giving your bones the kind of stimulus they need.

The exact number or height is less important than making impact a regular part of your movement diet. What matters is the principle: bones respond to impact that is sharp, novel, and progressive.

If you want a heuristic to follow the research points to:

50 - 70 “impacts” a day, 3-5 times a week. Split it up into sets of 10 ish at a time.

But this is all relative - if you’ve not done anything for a while, start with fewer and work up slowly. Ask yourself does this feel uncomfortable or painful? 

Watch the Impact Webinar

References and resources (we’re still building on these but here’s most of them).

Bone quality and bone density

  • Fonseca H., Moreira-Gonçalves D., Appell Coriolano H.-J., Duarte J.A. (2014). Bone quality: the determinants of bone strength and fragility. Sports Medicine, 44(1), 37–53. PMID: 24092631. DOI: 10.1007/s40279-013-0100-7.

Upper-body impact (key study)

  • Lambert C., et al. (2020). Regional changes in indices of bone strength of upper and lower limbs in response to high-intensity impact loading or high-intensity resistance training. Bone, 132:115192.

Seminal and supporting literature

  • Cavanagh P.R., Lafortune M.A. (1980). Ground reaction forces in distance running. Journal of Biomechanics, 13(5), 397–406.

  • Guadalupe-Grau A., Fuentes T., Guerra B., Calbet J.A.L. (2009). Mechanical and metabolic bone loading as determinants of bone mass and strength: a review. Sports Medicine, 39(6), 439–468.

  • Kemmler W., von Stengel S. (2013). Exercise and osteoporosis-related fractures: perspectives and recommendations of the EFOS study group. Osteoporosis International, 24(1): 7–23.

  • LeBlanc A., et al. (2000). Bone mineral and lean tissue loss after long-duration space flight. Journal of Musculoskeletal & Neuronal Interactions, 1(2), 157–160.

  • McArdle W.D., Katch F.I., Katch V.L. (2015). Exercise Physiology: Nutrition, Energy, and Human Performance.8th ed. Wolters Kluwer.

  • Novacheck T.F. (1998). The biomechanics of running. Gait & Posture, 7(1), 77–95.

  • Turner C.H., Robling A.G. (2003). Designing exercise regimens to increase bone strength. Exercise and Sport Sciences Reviews, 31(1), 45–50.

  • Umberger B.R. (1999). Mechanics of vertical jumping. Exercise and Sport Sciences Reviews, 27, 79–84.

  • Vainionpää A., Korpelainen R., Vihriälä E., Rinta-Paavola A., Leppäluoto J., Jämsä T. (2006). Intensity of exercise is associated with bone density change in premenopausal women. Osteoporosis International, 17(3), 455–463.

  • Wang Q., et al. (2013). Trampoline training improves bone strength and body composition in young athletes.European Journal of Applied Physiology, 113(12), 3251–3261.

Further reading

  • NHS Guidance on Osteoporosis

  • Age UK Physical Activity Guidelines

  • UK Government “All Our Health” – Falls and Bone Health

  • Daly R.M. et al. (2019). Exercise for the prevention of osteoporosis in postmenopausal women: an evidence-based review. Journal of Bone and Mineral Research.

  • Giangregorio L.M. et al. (2014). Too Fit To Fracture: exercise recommendations for individuals with osteoporosis.Osteoporosis International.

  • Alison Crouch – Bone-safe movement resources.

Additional references

  • Allison S.J. et al. (2015). High-impact exercise and the proximal femur in older men: a randomized controlled unilateral intervention. Journal of Bone and Mineral Research, 30(9), 1709–1716.

  • Sundh D. et al. (2018). High-impact mechanical loading increases bone material strength in postmenopausal women – a 3-month intervention study. Journal of Bone and Mineral Research, 33(7), 1242–1251.

  • Liu-Ambrose T. et al. (2004). Combined exercise increases cortical bone density in high-risk older women. Journal of Musculoskeletal and Neuronal Interactions, 4(2), 204–205.

  • Pinho R.A. et al. (2020). High-intensity impact training in osteopenic older women. Osteoporosis International, 31(10), 1905–1916.

  • Menkes A., et al. (1993). The effects of strength training on bone mineral density in older adults. (From your list of foundational studies.)

  • Ryan A.S., et al. (1994). (Foundational resistance training + BMD study in postmenopausal women.)

  • Frost H.M. (1987). The mechanostat: a proposed pathogenetic mechanism of osteoporosis. Bone & Mineral, 2(2), 73–85.

Gillian Erskine
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