A few sets of squats here and there does not count as strength training, and it certainly won’t be stimulating any bone density changes.
If you’re already active multiple days a week whether that’s running, tennis or anything else that isn’t strength training. This is the program for you. 2 sessions which you can do on days off or spread out appropriately from an already planned session.
These plans are not to be completed immediately before or after your run or tennis match. They should be separated by at least 4 hours and a good meal, this is crucial to get the best out of your training (without losing any of the joy of what you’re already doing).
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I’m a UK physiotherapist, writing honest bone health education. I cite every claim so you can check it yourself.
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Three reasons the usual advice fails
One. It’s the wrong loading. In Monday’s piece we found that master sprinters had hip bone density 10% higher than master endurance runners, who were statistically indistinguishable from people who did no training at all (Piasecki et al., 2018). We know that bone is a stubborn body tissue, it has to have a high strain magnitude and rate, which unfortunately endurance running or cycling do not have.
Two. It’s badly timed. We know from animal studies that bone responds to shorter loading intervals spread out with recovery time in between, in comparison to one prolonged session. This is due to the bone cells desensitising after too many signals and then needing 4-8 hours to fully recover. So always make sure when using the plan that you have had a minimum of 4 hours rest before.
Three. It’s too little of the right thing. A 2025 meta-analysis of 40 studies in 2,230 postmenopausal women aged 50 to 60 found combined training significantly improved bone density at the femoral neck and the lumbar spine. Resistance training alone produced only non-significant positive effects at those sites.
Combined, both resistance and impact in addition to cardiovascular or games.
Before you start
This is not for you right now if:
You have a current or suspected bone stress injury. Bone pain that’s worse with impact and localised to one spot needs imaging, not a program.
You have osteoporosis with a prior vertebral fracture. There’s a modified version of this and it isn’t this one. Skip to the tier section.
You have unresolved balance problems or you’ve fallen in the last six months.
You’re in the acute phase of any injury, or you have pain that changes with position.
Self-screen. Answer these honestly before session one:
Can you stand on one leg, eyes open, for 20 seconds without holding on?
Can you get down to the floor and back up without using your hands or furniture?
Have you had a fracture from a fall from standing height or less?
Do you know your T-score?
No to 1 or 2, or yes to 3, means get seen by a physiotherapist before starting the impact session. The resistance session is still available to you.
Tiers. This runs through the whole program, so find yours now.
Tier 1 — osteopenia, no fracture history. Full program as written.
Tier 2 — osteoporosis, no fracture history. Full resistance work. Impact introduced only from week 3, and only once the resistance session is comfortable. No single-leg hopping.
Tier 3 — prior fragility fracture. Clinician clearance first, in person. Resistance work only. No impact, no jumping, no loaded spinal flexion, until you’ve been reviewed.
I have not examined you. This is education, not a prescription.
Nutrition
The failure for this population is not the training. It’s the deficit.
The issue I see many active people struggle with isn’t the motivation for training, but the calorie or material deficit they put themselves into.
Bone density cannot be improved by signalling alone, the body must have the right materials to then build density with. This means getting the appropriate amount of calories, protein and minerals into your system through diet (as much as possible) and supplements if needed.
If a person is exercising heavily and trying to maintain a low weight they can often restrict themselves into what we call relative energy deficiency, this can lead to the body trying to find minerals from somewhere. Often, that somewhere is their bones.
Protein. Aim for roughly 1.2 - 1.6 grams per kilogram of body weight daily, spread across four meals rather than loaded into dinner. For a 65kg woman that’s about 105g a day, or 25 to 30g per meal.
Total energy. During these eight weeks, don’t diet. If fat loss is a goal, do it in a separate block. You will really struggle to make any meaningful progress if you restrict yourself here.
Calcium and vitamin D. Try to get as much calcium through your diet and supplement the final amount if needed, to get adequate vitamin D in the UK a supplement is needed through the British winter. These are the bricks, the training is the instruction.
Free posts tell you what the evidence says. Paid posts tell you what to do on Monday morning.
This week, paid members get the 2 session program to add into your week. If you want your next DEXA to move, this moves it (eventually).