You have probably read that running is one of the best things you can do for your bones. You may also have read that distance running wears them down. Neither claim holds up well, which leaves a fair question: what does running and bone density after 50 really look like, and what should you add to your week?
The short version is that running is good for your heart, muscles and mood, but easy mileage is not a bone-building programme. The exercise that has raised bone density in trials looks different from a typical running week, and fuelling and training load can push things the wrong way. Here is what the evidence shows, where it is thin, and a cautious template to discuss with your own clinician.
Short Answer: Running Is Good for You, but It Is Not a Bone-Building Programme
Bone health matters because fractures are common. In developed countries, about one in three women over 50 will have an osteoporotic fracture in their remaining lifetime, according to figures cited in a 2025 review in Current Osteoporosis Reports.
So does running build bone density? The data on older runners suggest that endurance running does not stand out from not exercising at all. The trials that did raise bone density used heavy lifting combined with impact. That is a different job from logging easy miles.
What Studies of Older Runners Show
A cross-sectional study in Archives of Osteoporosis (2018) compared three groups: 38 master sprinters (average age 71), 149 master endurance runners (average age 70) and 59 non-athletic controls (average age 74). Sprinters had about 10% higher hip bone mineral density (BMD) than endurance runners and about 9% higher than controls, in the minimally adjusted model. Endurance runners did not differ from controls at the hip or the spine.
This was an observational study, so it cannot prove cause and effect. The authors noted that the sprinters’ advantage was not explained by the loading measures they tracked, including vertical impacts, body composition and muscular output. Why sprinters did better is still an open question.
What about late starters?
A 2019 study in Frontiers in Physiology compared 188 masters athletes, including lifelong runners and those who took up competitive running after 50. Late starters had lower body fat and more leg lean mass than non-athletes, which is a real benefit. Hip BMD did not differ between any of the groups compared.
The takeaway is not that running is pointless. Taking up running later brings clear muscle benefits, but that study does not show bone density benefits from endurance running.
Why Easy Mileage May Not Be Enough
The 2025 review looked at exercise trials in postmenopausal women. It reports that low-impact exercise such as walking, and non-weight-bearing exercise such as cycling and swimming, do not positively affect BMD. High-intensity resistance and impact programmes were the most effective type for lumbar spine BMD.
The review defines “high intensity” fairly strictly: loads above 80% of one-repetition maximum for fewer than 8 repetitions, and impact producing ground reaction forces above four times bodyweight. Moderate-to-low intensity progressive resistance trials did not show spine gains.
These trials mostly involved postmenopausal women, many with low bone mass. Applying them to healthy runners over 50 is an extrapolation, though a reasonable one to discuss with a clinician.
What Does Build Bone: Heavy Resistance Plus Impact
The best-known example is the LIFTMOR trial, published in the Journal of Bone and Mineral Research in 2018. It randomised 101 postmenopausal women with low bone mass (T-score below –1.0) to either supervised high-intensity training or a low-intensity home programme.
- The training group did two 30-minute supervised sessions a week for 8 months.
- Lifting was 5 sets of 5 repetitions at over 85% of one-repetition maximum, combined with impact work.
- Lumbar spine BMD improved by roughly 4% compared with the control group, as summarised in the 2025 review.
- Adherence was high (92% in the training group), and only one minor adverse event was reported, a lower-back spasm. A follow-up safety analysis found no new or worsening vertebral fractures.
The training was supervised and progressive, and about a third of participants had a previous vertebral fracture. It was not a do-it-yourself programme.
Realistic expectations
Meta-analyses cited in the 2025 review suggest lumbar spine gains of about 2–3% with high-intensity protocols, though the evidence is often low-certainty. Hip BMD is “stable at best” even with high-intensity resistance training.
A 12-month multimodal programme (the Osteocise trial) combining fast progressive resistance, moderate-impact weight-bearing and balance work produced net gains of about 1.0–1.1% at the spine and femoral neck, with no change at the total hip. In a 6-month extension, the femoral neck gain persisted even though adherence fell, but the spine gain was lost.
The review also notes that no minimum dose for keeping gains has been established, and small studies suggest BMD can drift back toward baseline after about 12 months of detraining. Hip structure, such as cortical thickness, may improve even when DXA density does not. Think of bone training as something to keep doing.
For how to lift as a runner in general, see our guide to strength training for runners over 50. Here, the point is narrower: heavy loading is the bone-specific tool.
Women, Men and Menopause: Where the Evidence Is Thin
Most of the strongest trial evidence comes from postmenopausal women. For men, it is thinner and more mixed.
A pilot study of impact-loading plus resistance exercise in middle-aged and older men found it was safe but did not significantly improve BMD. The later LIFTMOR-M trial, a semi-randomised (not fully randomised) 8-month study of supervised exercise in men with low bone mass, ended with its authors concluding that twice-weekly high-intensity resistance and impact training is strongly indicated for older men with low bone mass, as reported by Endocrinology Advisor. That is the authors’ interpretation, and the design leaves room for caution.
Evidence is also thin for:
- Fracture outcomes. No exercise trial has been large enough to show that a specific programme reduces fractures.
- Durability. Gains may fade if training stops.
- Recreational runners over 50. Most trials enrolled people with low bone mass, not healthy runners.
Fuel and Load: How Runners Can Harm Their Bones
Running does not protect bone automatically. A 2024 narrative review in PM&R on bone health in masters runners says the research in this group is limited. It also notes that low energy availability (eating too little for the demands of training) can change bone turnover within about 5 days.
In a small study of male runners (9 below the median energy availability, 10 at or above it, 19 controls), those with lower energy availability had lower lumbar spine BMD Z-scores than non-athletes and weaker tibial bone microstructure. Runners with higher energy availability had higher hip BMD Z-scores than controls. The study is very small and not specific to over-50s, but it shows that fuelling matters. For protein targets, see protein for runners over 50.
Practical points from the masters review
- Raise training volume before intensity, and never both at once. Our piece on the 10% rule covers progression more broadly.
- Optimal energy availability for masters runners has not been described, so there is no magic calorie number.
- Calcium and vitamin D needs rise at older ages.
- If you have a bone stress injury or other running injury, have your nutrition assessed.
- Hormone testing can help separate low energy availability from perimenopause or menopause where relevant.
Falls Matter as Much as Density
More than 90% of hip fractures follow a fall, according to the 2025 review. A Cochrane review of 116 randomised trials in adults aged 60 and over (25,160 people, 74% women) found that exercise cut the rate of falls by 23% (rate ratio 0.77). Balance-challenging and multi-component programmes worked best.
Meta-analyses in community-dwelling older adults suggest roughly 20–30% fewer fall-related and major osteoporotic fractures, mostly from balance and functional training. The review suggests an effect needs about 1.5–3 hours a week of multimodal exercise for at least 3–6 months. The best prescription has not been established, and these were healthy older adults, not specifically runners.
A Cautious Weekly Template for Runners Over 50
This is a practical suggestion built from the research above, not a prescription. The trials used supervised, progressive programmes, so ask a clinician or qualified trainer to help you start, especially with heavy loading.
| Day | Session | Purpose |
|---|---|---|
| Mon | Easy run | Aerobic fitness, muscle |
| Tue | Heavy lifting and impact work, built up gradually under supervision | Bone loading (the trial-tested element) |
| Wed | Easy run plus balance work | Falls prevention |
| Thu | Rest or walk | Recovery |
| Fri | Heavy lifting and impact work | Bone loading (second weekly session, as in LIFTMOR) |
| Sat | Longer easy run | Endurance |
| Sun | Rest, or balance and mobility | Recovery, falls prevention |
- Do not add mileage and intensity in the same week. Our guides to speedwork and long runs can help you plan.
- Eat enough to support your training, and ask about calcium and vitamin D.
- Keep the bone work going, because gains may fade if you stop.
If you are worried about your knees under heavier loading, read our look at running and knees.
Frequently Asked Questions
Does running build bone density or just maintain it after 50?
The evidence does not show that endurance running builds bone. In masters athletes, endurance runners’ hip and spine density did not differ from non-athletic controls, while sprinters had higher hip density. That is observational data, so it cannot prove cause, but it suggests running alone is not a reliable bone builder.
Can long-distance running lower my bone density?
It can if fuelling falls short. A small study of male runners found lower spine bone density and weaker tibial structure in those with low energy availability. Low energy availability can change bone turnover within about 5 days. Research in masters runners is limited, so the safest approach is to eat enough and build training load gradually.
What exercise is best for bone density if I am already a runner?
In postmenopausal women, high-intensity resistance combined with impact had the strongest results for lumbar spine density, with gains of around 2–4%. Walking, cycling and swimming showed no bone benefit. Trials were supervised and progressive, so get guidance before starting heavy lifting, particularly if you have low bone mass.
Is it safe to run with osteopenia?
This depends on your individual situation, and the research does not answer it for running specifically. Trials of supervised heavy training in women with low bone mass reported few adverse events, but they were tailored programmes. Ask your doctor or physical therapist what is appropriate for you before changing your training.
Should runners over 50 get a DEXA scan?
A review of older athletes warns that many are unaware their bone density is declining because they assume activity is enough. It recommends DEXA scans and regular bone density testing for ageing athletes. Whether and when you should be scanned is a decision for you and your clinician.
When to Check With Your Doctor
Talk to your doctor before starting heavy lifting or impact training if you have been told you have osteopenia or osteoporosis, have had a fracture, or are unsure about your bone health. Ask about a DEXA scan, especially if you are postmenopausal, have had a bone stress injury, or have been under-eating or losing weight while training.
See a clinician promptly for sudden severe pain, especially in the back, hip or a bone that hurts with every step. Seek urgent care for chest pain, fainting or unusual breathlessness.
References
- Hip and spine bone mineral density are greater in master sprinters, but not endurance runners compared with non-athletic controls. Archives of Osteoporosis (Nottingham Trent University repository), 2018.
- Exercise for Postmenopausal Bone Health – Can We Raise the Bar?. Current Osteoporosis Reports, 2025.
- High-Intensity Resistance and Impact Training Improves Bone Mineral Density and Physical Function in Postmenopausal Women With Osteopenia and Osteoporosis: The LIFTMOR Randomized Controlled Trial. Journal of Bone and Mineral Research, 2018.
- Bone health and the masters runner. PM&R, 2024.
- Male Runners With Lower Energy Availability Have Impaired Skeletal Integrity Compared to Nonathletes. Journal of Clinical Endocrinology & Metabolism, 2023.
- Bone-Targeted Exercise Strategies to Reduce Fracture Risk in Men (coverage of the LIFTMOR-M trial). Endocrinology Advisor, 2020.
- Review on bone mineral density and osteoporosis in older athletes. PubMed Central, 2025.
- Comparison of Muscle Function, Bone Mineral Density and Body Composition of Early Starting and Later Starting Older Masters Athletes. Frontiers in Physiology, 2019.