
Terri Walsh’s Guide to Strength Training for Bone Density
By Terri Walsh, Online Personal Trainer and Creator of Active Resistance Training®
Terri Walsh is an online personal trainer and creator of Active Resistance Training®, helping adults over 40, women in menopause, seniors, and clients with low bone density train safely and intelligently through private Zoom coaching.
Strong bones are not built by wishful thinking. They are built through intelligent loading, consistent movement, adequate nutrition, recovery, and the kind of expert coaching that keeps your body progressing without unnecessary risk. If you have been told you have low bone density, osteopenia, osteoporosis, or simply want to age with more strength and confidence, this guide will help you understand what bone density means and how strength training for bone density can fit into a safe, elevated, and highly personal fitness plan.
For more than four decades, I have helped clients build strength, recover confidence, and train through the realities of aging, injury, travel, menopause, surgery, pain, and life stress. My work through Active Resistance Training® is never a boilerplate PDF. It is a curated, private process designed around your body, your history, your goals, and your ability to progress with precision. If you would like to learn more about my background and method, visit my online personal trainer profile or read my New York Times interview feature.
Important medical note: This guide is educational fitness content. If you have osteoporosis, a history of fracture, spinal compression fractures, balance concerns, pain, or medical restrictions, consult your physician or qualified healthcare provider before beginning or changing an exercise program.
What Is Bone Density, and Why Does It Matter?
Bone density describes how much mineral content is present in your bones. A bone density test, often called a DEXA or DXA scan, uses low-dose x-ray technology to measure minerals such as calcium in the bones and estimate bone strength and fracture risk.[1] Stronger bones are generally more resilient, while lower bone density can indicate osteopenia or osteoporosis, depending on the test result and medical context.[1]
Bone is living tissue. It responds to stress, loading, nutrition, hormones, age, illness, inactivity, and medication. That means your choices matter, but it also means your plan must be intelligent. The goal is not to punish your body into strength. The goal is to give your bones and muscles the right signal, at the right intensity, with the right recovery, in a way your body can actually adapt to.
| Bone Health Term | What It Means | Why It Matters for Training |
|---|---|---|
| Bone density | A measure of mineral content and bone strength. | Helps guide how carefully loading, impact, and progression should be planned. |
| DEXA / DXA scan | A low-dose x-ray test used to assess bone density and fracture risk.[1] | Gives you and your medical team objective information before choosing exercise intensity. |
| T-score | A comparison of your bone density to that of a healthy young adult; MedlinePlus describes -1.0 or higher as normal, between -1.0 and -2.4 as low bone density, and -2.5 or lower as probable osteoporosis.[1] | Helps identify whether your program should emphasize prevention, osteopenia support, or osteoporosis-safe modification. |
| Osteopenia | Low bone density that is not as severe as osteoporosis.[1] | Often a critical window for building strength, coordination, and lifestyle consistency. |
| Osteoporosis | A condition in which bones become weaker and fracture risk rises.[2] | Requires professional medical guidance and careful exercise selection. |
Why Bone Density Becomes a Priority After 40, 50, and 60
If you dieted aggressively in adolescence or young adulthood, avoided strength training, lost muscle, experienced menopause, used certain medications, or lived through long periods of low activity, your 50s and 60s may reveal changes that were building quietly for decades. This is especially relevant for women entering perimenopause and menopause, but it also matters for men over 50 and anyone recovering from illness, injury, or weight loss.
The opportunity is that you are not powerless. While exercise does not guarantee prevention or reversal of osteoporosis, resistance training, weight-bearing activity, posture work, and balance training can help support bone strength, muscle mass, coordination, and fall prevention when they are done consistently and appropriately.[2] [3]
This is why I encourage adults over 50 to know their numbers, understand their DEXA results, and train from reality rather than guesswork. If this stage of life is your focus, you may also find my guides on online personal training for women over 50 and personal training for seniors helpful.
How Strength Training Supports Bone Density
Strength training matters because muscles attach to bones through tendons. When you lift, push, pull, squat, hinge, carry, or resist force, your muscles create mechanical tension. That tension gives bone tissue a reason to maintain or improve its structure. Federal health guidance from NIAMS identifies strength or resistance training as one of the best physical activities for bone health, alongside weight-bearing and balance-focused exercise.[2] [3]
The most effective bone-density program is rarely one single exercise. It is a thoughtful system that combines resistance, weight-bearing movement, balance, posture, flexibility, recovery, and nutrition. For many clients, this is where private coaching is invaluable: the exercise must be challenging enough to create adaptation, but controlled enough to respect joint health, spinal safety, and fracture risk.
| Training Element | Examples | Bone-Density Value | Coaching Consideration |
|---|---|---|---|
| Progressive resistance training | Dumbbells, machines, resistance bands, bodyweight strength work | Supports muscle and bone loading.[2] [4] | Progress gradually; prioritize technique before heavier loads. |
| Weight-bearing exercise | Walking, stair climbing, hiking, dancing, low-impact aerobics | Helps bones respond to bodyweight loading.[3] [5] | Choose low-, moderate-, or higher-impact options based on bone status and medical guidance. |
| Balance training | Step-ups, controlled lunges, weight shifts, tai chi-inspired drills | Supports coordination and may help reduce fall risk.[3] | Essential for clients with osteoporosis, seniors, or prior falls. |
| Posture and upper-back strength | Rows, wall slides, scapular control, spinal-extension work | Supports alignment, shoulder mechanics, and safer daily movement.[4] | Especially important for people with rounded posture or spinal concerns. |
| Mobility and flexibility | Hip mobility, ankle mobility, gentle chest opening | Supports better mechanics and confidence in movement. | Avoid aggressive spinal flexion or twisting if osteoporosis risk is present.[4] |
Weight-Bearing Exercise vs. Strength Training: You Need Both
Many people hear “weight-bearing exercise” and think walking is enough. Walking is valuable, especially for consistency, cardiovascular health, and daily movement. However, walking alone may not provide enough progressive loading for the upper body, hips, spine, or major muscle groups. Bone-health organizations consistently distinguish between weight-bearing exercise and muscle-strengthening exercise, because each contributes something different.[3] [5]
Weight-bearing exercise means your body works against gravity while you are on your feet. Strength training means your muscles work against resistance. For bone density, the sophisticated approach is not to choose one. It is to combine both, then personalize the plan based on DEXA results, balance, joints, pain history, age, training experience, and confidence.
| If Your Goal Is… | Prioritize This | Why |
|---|---|---|
| Building foundational strength | Resistance training two or more days weekly, as appropriate | Muscle-strengthening exercise is included in federal activity guidance and bone-health recommendations.[3] |
| Supporting hip and leg bone loading | Squats, sit-to-stand, step-ups, lunges, stair work, walking progressions | Lower-body loading supports practical strength for daily life. |
| Improving posture and spinal support | Upper-back strength, rows, controlled extension, core stabilization | Mayo Clinic highlights strength training as useful for posture and support, while warning against unsafe bending and twisting in osteoporosis.[4] |
| Reducing fall risk | Balance drills, gait control, single-leg progressions, controlled transitions | NIAMS identifies balance and coordination as part of fracture-prevention support.[3] |
| Returning after low activity or injury | Low-impact weight-bearing work and conservative resistance | Safety and consistency come before intensity. |
What Exercises Help Increase Bone Density Safely?
There is no universal “best exercise” for every person with low bone density. The right exercise depends on your DEXA results, fracture history, posture, pain, balance, movement skill, medical advice, and training background. That said, the following categories commonly appear in bone-health guidance and can be adapted for many clients when properly coached.[2] [3] [4] [5]
| Exercise Category | Examples | Best For | Safety Notes |
|---|---|---|---|
| Lower-body strength | Squats, sit-to-stand, step-ups, split squats, hip hinges | Hips, legs, glutes, balance, functional independence | Hinging and depth should be coached carefully if there is spine or hip concern. |
| Upper-body strength | Rows, wall pushups, elevated pushups, presses, band pulls | Posture, shoulders, upper back, daily strength | Start with controlled ranges and excellent alignment. |
| Core stabilization | Dead bug variations, bird dog, anti-rotation presses, breath-led bracing | Spinal support and movement control | Prioritize stabilization over sit-ups or aggressive spinal flexion. |
| Low-impact weight bearing | Brisk walking, stair climbing, low-impact dance, hiking on level terrain | Consistency, cardiovascular health, leg loading | Increase duration and terrain gradually. |
| Balance and coordination | Weight shifts, tandem stance, supported single-leg work, controlled carries | Fall prevention and confidence | Use support when needed; safety is the first priority. |
| Power and impact progressions | Heel drops, light hops, quick step-ups, higher-impact work | Selected clients with adequate readiness and medical clearance | Not appropriate for everyone; high fracture risk requires professional guidance. |
Classic exercises such as kettlebell swings, pushups, squats, deadlifts, and shoulder presses can be useful for some clients, but they are not automatically appropriate for everyone. The exercise is only as good as the form, progression, context, and body performing it. In a premium private program, I choose and modify exercises based on you, not on a generic list.
What Exercises Should You Avoid With Osteoporosis?
If you have osteoporosis, a history of spinal compression fracture, or high fracture risk, the question is not simply “what should I do?” It is also “what should I not do yet?” Mayo Clinic cautions that people with weakened bones may need to avoid high-impact exercise, jerky rapid movement, and bending or twisting at the waist, including movements such as toe touches and sit-ups.[4]
This does not mean you should become afraid of movement. It means your program should be curated. A safe osteoporosis exercise plan often emphasizes controlled strength, upright posture, hip-dominant movement, supported balance work, and careful spinal alignment. You can still become stronger, more capable, and more confident, but the route should respect your medical reality.
| Movement Pattern | Why It May Need Modification | Safer Training Direction |
|---|---|---|
| Repeated loaded spinal flexion | May be inappropriate for some people with osteoporosis or spinal fracture risk.[4] | Core stabilization, hip hinging, supported posture work. |
| Fast twisting under load | Can create forces the spine may not tolerate well in high-risk clients.[4] | Slow anti-rotation strength and controlled mobility. |
| High-impact jumping or running | May be inappropriate for weakened bones or fracture risk.[4] | Low-impact walking, stair work, or carefully progressed impact only with clearance. |
| Heavy lifting without coaching | Poor form may increase risk and reduce benefit. | Technique-first progressive resistance training. |
| Balance drills without support | Fall risk may outweigh benefit if poorly set up. | Use a wall, chair, rail, or trainer-guided setup. |
How Much Weight Should You Lift for Bone Density?
The right weight should feel challenging, controlled, and repeatable without pain, panic, or form breakdown. For many clients, I begin with a load that allows excellent technique and then progress gradually. If a weight feels effortless, it may not provide enough stimulus. If it forces you to compensate, twist, hold your breath aggressively, or lose alignment, it is not the right weight today.
A smart progression often looks like this: first improve movement quality, then increase repetitions, then increase resistance, then refine tempo, range, or complexity. For bone density, consistency and progression matter more than ego. The goal is not to prove how heavy you can lift once. The goal is to train in a way that your bones, muscles, joints, and nervous system can adapt to over time.
Nutrition for Bone Density: Calcium, Vitamin D, Protein, and Recovery
Strength training is powerful, but it does not work in isolation. Your body needs the raw materials to build and maintain tissue. MedlinePlus notes that low bone density recommendations may include exercise as well as calcium and vitamin D.[1] Protein also matters because muscle is the active tissue that helps you lift, stabilize, balance, and move through the world with confidence.
For many adults, especially women over 50 and clients rebuilding after illness, under-eating can be a hidden barrier. If you are not eating enough calories, protein, and micronutrients, your body may struggle to build muscle or recover from training. A common baseline protein reference is approximately 0.8 grams per kilogram of body weight per day for generally healthy adults, although individual needs may vary based on age, training, medical status, and physician or dietitian guidance.
| Nutrition Priority | Why It Matters | Practical Direction |
|---|---|---|
| Calcium | Key mineral in bone structure.[1] | Discuss intake and supplementation with your healthcare provider. |
| Vitamin D | Helps support calcium-related bone health.[1] | Ask your medical provider whether blood testing or supplementation is appropriate. |
| Protein | Supports muscle repair and strength development. | Include protein across meals, especially if training regularly. |
| Adequate calories | Training adaptation requires energy. | Avoid chronic under-fueling, especially during menopause, recovery, or weight loss. |
| Rest and recovery | Bone and muscle adaptation happen between sessions. | Sleep, hydration, and planned recovery are part of the program. |
If you want more structured meal support, my private online personal training clients receive monthly recipe packs and meal-planning resources through the A.R.T. Virtual Studio Membership. You can also explore the A.R.T. online fitness program and class library or visit the Active Resistance Training® shop.
How Often Should You Test Bone Density?
If you are over 50, in menopause, have fracture risk factors, have a family history of osteoporosis, or have been told you have low bone density, it is worth discussing bone-density testing with your healthcare provider. MedlinePlus explains that DEXA scans can help diagnose osteopenia or osteoporosis, predict future fracture risk, and monitor whether treatment is working.[1]
Testing frequency is a medical decision. Your physician may recommend a schedule based on your age, T-score, fracture history, medications, family history, and whether you are already being treated. The important point is that your training should be informed by facts. If you know your bone-density status, your program can be more precise.
Enter Online Personal Training With Terri Walsh via Zoom
Private online personal training is ideal for clients who want expertise, privacy, convenience, and personalization without being processed through a generic fitness system. My Zoom sessions are face-to-face, hour-long, and fully customized. I do not send you a boilerplate PDF. I build a program on you, about you, and for you.
We typically meet a minimum of twice weekly, with additional workouts chosen around your schedule, preferences, and needs. You also gain access to online fitness content, livestream classes, monthly recipe releases, and accountability support. The point is custom means exactly that: custom.

Strength Training for Bone Density Osteopenia Osteoporosis
Fitness Assessment
We begin with a thorough fitness assessment to understand where you are, how you got there, what your body is telling us, and where you want to go. If bone density is part of your concern, we discuss your DEXA results, medical guidance, fracture history, pain, balance, training experience, and confidence with movement.
Training Modalities
Your plan may include carefully selected combinations of endurance, flexibility, strength training, barre, Pilates-inspired work, mobility, body-weight training, yoga-informed movement, posture work, balance drills, and Active Resistance Training®. The blend changes as your body changes.
Nutrition, Tracking, and Accountability
We can work closely on nutrition, meal planning, and accountability. Some clients want detailed tracking. Others prefer a more intuitive process. I know how to track progress manually, with fitness technology, or with a hybrid approach. The goal is to help you understand your body’s cues and build sustainable competence.
If you are ready to begin, complete the consultation request form. I will be excited to learn more about you and help you train with intelligence, strength, and confidence.
Also Included: A.R.T. Virtual Studio Membership
Online personal training also includes access to online fitness content, including livestream classes, OnRamp, Newbie Series, Fundamentals, Beginner Series, A.R.T. Mat 1.1–28.4, Holis Series, Stretch & Mobility, Components, MasterClasses, Prescriptives, and other releases. You can practice on your schedule, stream classes to your devices, and choose from beginner, intermediate, and advanced options.
You also receive monthly EAT WELL Recipes by Terri Walsh, a practical collection of easy-to-make meals with accessible ingredients. The recipe packs include printable PDFs, step-by-step recipes, breakfasts, lunches, dinners, desserts, shopping lists, snack smoothies, protein fruit bowls, and a meal-planner calendar. For updates and new resources, you can subscribe to the newsletter.
Client Experience: Rebuilding Strength After Bone Density Loss
The following testimonial from Dianne speaks directly to the level of customization required when strength, injury, fracture history, and confidence all intersect:
“I lost too much weight in the hospital. I weighed in at 103, with accelerated bone density loss due to mitigating circumstances. Terri’s mission then was to build me back up — damn near from scratch. Terri’s carefully planned and measured workouts rebuilt my musculature completely. I had five compression fractures in my back — and Terri worked a program to help me heal it all. It took a year, but we got me literally put back together again.”
— Dianne Houston, Writer/Director
This is the difference between a generic workout and a coached method. When the body has been through injury, illness, weight loss, or bone-density changes, training must be careful, progressive, and deeply personal.
Frequently Asked Questions About Strength Training for Bone Density
What is the best exercise to increase bone density?
The best approach is usually a combination of progressive resistance training, weight-bearing exercise, balance work, and posture training. NIAMS identifies weight-bearing exercise, resistance training, and balance training as important categories for bone health.[3] The best plan for you depends on your DEXA results, medical history, fracture risk, and movement ability.
Is strength training safe if I have osteoporosis?
Strength training can be part of an osteoporosis-safe exercise plan, but it must be individualized. Mayo Clinic recommends guidance from a physical therapist or personal trainer experienced with osteoporosis and warns that some people should avoid high-impact movement, rapid jerky motion, and bending or twisting at the waist.[4]
What is a bone density test?
A bone density test, also called a DEXA or DXA scan, is a low-dose x-ray test that measures minerals in the bone. It can help diagnose osteopenia or osteoporosis, predict fracture risk, and monitor whether treatment is working.[1]
How do I read bone density results?
Bone-density results often include a T-score and may include a Z-score. MedlinePlus explains that a T-score of -1.0 or higher is considered normal, between -1.0 and -2.4 indicates low bone density, and -2.5 or lower indicates probable osteoporosis.[1] Your physician should interpret your results in the context of your full health profile.
How long does it take to build bone density?
Bone adaptation is gradual. Most people should think in months and years, not days and weeks. Training consistency, nutrition, recovery, medical status, hormones, medications, and baseline bone density all influence progress. The goal is to build a sustainable program that can support bone and muscle health long term.
Can walking alone improve bone density?
Walking is valuable weight-bearing activity, but it may not be enough by itself for a complete bone-density program. A stronger plan often includes resistance training for the upper and lower body, posture work, and balance training.[3] [5]
What exercises should people with osteoporosis avoid?
Some people with osteoporosis may need to avoid high-impact exercise, fast jerky movement, and repeated bending or twisting at the waist, such as toe touches or sit-ups.[4] The safest approach is to ask your healthcare provider for restrictions and work with an experienced trainer who can modify movements.
How can women over 50 increase bone density naturally?
Women over 50 can support bone health with strength training, weight-bearing activity, balance training, adequate protein, calcium, vitamin D, sleep, and medical guidance when needed. Exercise and nutrition support bone health, but they do not replace medical evaluation or treatment for osteoporosis.[1] [2]
Are weight machines useful for bone density?
Weight machines can be useful because they provide measurable resistance and may help some clients train with more control. Free weights, bands, bodyweight movements, and machines can all have a place in a well-designed resistance-training program.[3] [5]
How do I start if I am afraid of getting hurt?
Start with assessment, medical clearance when appropriate, and expert coaching. A safe beginning may include supported sit-to-stands, wall pushups, light rows, balance drills near a stable surface, walking, and gentle mobility. The goal is to build confidence through precision, not overwhelm your body with intensity.
Personal Invitation: Train for the Body You Want to Live In
Bone density is not just a scan result. It is part of how you stand, walk, lift, recover, travel, work, age, and participate in your life. If you want a strong body, you need a plan that respects the whole body: bones, muscles, joints, balance, nutrition, recovery, confidence, and personal history.
If you are ready for private, high-level support, I invite you to complete the consultation request. We will build a program that is intelligent, personal, and designed to help you move forward with strength.
ALSO INCLUDED: A.R.T. Virtual Studio Membership
Online personal training also includes all the online fitness content: LiveStream Classes, OnRamp, Newbie Series, Fundamentals, Beginner Series, ART Mat 1.1-28.4, Holis Series, Covid Series LIVE, Stretch & Mobility, Components, MasterClasses, Prescriptives, New Series, and 2021 Releases,
- Practice on your schedule.
- Classes stream to all devices.
- Over 450+ classes, workouts & series.
- Beginner. Intermediate. Advanced.

Monthly Recipe Packs & Meal Plans
EAT WELL Recipes by Terri Walsh, a monthly compilation of delicious, easy-to-make recipes with easy-to-find ingredients. You’ll save time with meal prep, and all your macros are available with a scan code for myfitnesspal – so you can track to your heart’s content or not. And…again…they’re EASY AND DELICIOUS. They include:
- New recipe pack every month
- Printable PDF’s
- Simple recipes, step by step
- Breakfasts, lunches, dinner and deserts!
- Accommodates gluten-free, dairy-free, meat-free
- Shopping lists
- Snack smoothies and protein fruit bowls
- Meal planner calendar




Client Testimonials & Reviews
Terri Walsh has spent four decades transforming bodies and changing lives, and her clients say it best. From Oscar winners and CEOs to everyday people navigating menopause, injury, and midlife reinvention, these testimonials reflect the real results of Terri’s Active Resistance Training® method: stronger bodies, renewed confidence, and a smarter approach to fitness that lasts.
Join Our Newsletter
Inside offers, Recipes & Fitness tips every month
For a limited time, join our newsletter to receive our Healthy. Easy. Delicious. Christmas Recipe Pack. FREE! 10 healthy and delicious recipe pdf download.





































