The Impact of Regular Sport Participation on Bone Health and Osteoporosis Prevention: A Narrative Review
DOI:
https://doi.org/10.12775/QS.2026.55.71216Keywords
osteoporosis, bone mineral density, sport, resistance training, prevention, quality of lifeAbstract
Background: Osteoporosis is a global public health challenge linked to population aging and sedentary lifestyles. Non-pharmacological prevention is essential.
Aim: The aim of this study was to review current scientific literature on the impact of regular sport participation on bone health, with emphasis on its role in the prevention and treatment of osteoporosis.
Material and Methods: A review of publications (2021–2026) from PubMed was conducted, including meta-analyses and clinical trials on the relationship between mechanical loading and bone mineral density (BMD).
Results: High-impact and multi-directional sports (volleyball, basketball) provide the most potent osteogenic stimuli. In postmenopausal women, high-intensity resistance training (80-85% 1RM) mitigates bone loss and improves Health-Related Quality of Life (HRQoL). Sport also reduces fall risk in the elderly by enhancing postural stability.
Conclusions: Regular sport participation is the "gold standard" for osteoporosis prevention. Optimizing peak bone mass in youth and maintaining skeletal integrity in old age are vital. Interdisciplinary collaboration is necessary to implement these findings into public health practice.
References
1. Xiao PL, Cui AY, Hsu CJ, et al. Global, regional prevalence, and risk factors of osteoporosis according to the World Health Organization diagnostic criteria: a systematic review and meta-analysis. Osteoporos Int. 2022;33(10):2137-2153. https://doi.org/10.1007/s00198-022-06454-3
2. Wu AM, Bisignano C, James SL, et al. Global, regional, and national burden of bone fractures in 204 countries and territories, 1990-2019: a systematic analysis from the Global Burden of Disease Study 2019. Lancet Healthy Longev. 2021;2(9):e580-e592. https://doi.org/10.1016/S2666-7568(21)00172-0
3. Wrona J, et al. The Effect of Resistance Training on Menopausal Symptoms and Bone Health. Quality in Sport. 2026;49:67834. https://doi.org/10.12775/QS.2026.49.67834
4. Li X, Kordsmeier J, Xiong J. New Advances in Osteocyte Mechanotransduction. Curr Osteoporos Rep. 2021;19(1):101-106. https://doi.org/10.1007/s11914-020-00650-y
5. Proia P, Amato A, Drid P, et al. The impact of diet and physical activity on bone health in children and adolescents. Front Endocrinol (Lausanne). 2021;12:704647. https://doi.org/10.3389/fendo.2021.704647
6. Brooke-Wavell K, Skelton DA, Barker KL, et al. Strong, steady and straight: UK consensus statement on physical activity and exercise for osteoporosis. Br J Sports Med. 2022;56(15):837-846. https://doi.org/10.1136/bjsports-2021-104634
7. Gardinier JD. The diminishing returns of mechanical loading and potential mechanisms that desensitize osteocytes. Curr Osteoporos Rep. 2021;19(4):436-443. https://doi.org/10.1007/s11914-021-00693-9
8. Mancuso ME, Wilzman AR, Murdock KE, Troy KL. Effect of External Mechanical Stimuli on Human Bone: a narrative review. Prog Biomed Eng (Bristol). 2022;4(1):012006. https://doi.org/10.1088/2516-1091/ac41bc
9. Chang X, Xu S, Zhang H. Regulation of bone health through physical exercise: mechanisms and types. Front Endocrinol (Lausanne). 2022;13:1029475. https://doi.org/10.3389/fendo.2022.1029475
10. Oniszczuk A, Kaczmarek A, Kaczmarek M, et al. Sclerostin as a biomarker of physical exercise in osteoporosis: a narrative review. Front Endocrinol (Lausanne). 2022;13:954895. https://doi.org/10.3389/fendo.2022.954895
11. Straburzyńska-Lupa A, Cisoń T, Gomarasca M, et al. Sclerostin and bone remodeling biomarkers responses to whole-body cryotherapy (-110°C) in healthy young men with different physical fitness levels. Sci Rep. 2021;11:16174. https://doi.org/10.1038/s41598-021-95492-8
12. Hughes JM, Guerriere KI, Popp KL, Castellani CM, Pasiakos SM. Exercise for optimizing bone health after hormone-induced increases in bone stiffness. Front Endocrinol (Lausanne). 2023;14:1219454. https://doi.org/10.3389/fendo.2023.1219454
13. Hu X, Wang Z, Wang W, et al. Irisin as an agent for protecting against osteoporosis: a review of the current mechanisms and pathways. J Adv Res. 2024;62:175-186. https://doi.org/10.1016/j.jare.2023.09.001
14. Tsourdi E, Anastasilakis AD, Hofbauer LC, Rauner M, Lademann F. Irisin and bone in sickness and in health: a narrative review of the literature. J Clin Med. 2022;11(22):6863. https://doi.org/10.3390/jcm11226863
15. Shao M, Wang Q, Lv Q, et al. Advances in the research on myokine-driven regulation of bone metabolism. Heliyon. 2024;10(1):e22547. https://doi.org/10.1016/j.heliyon.2023.e22547
16. Ng CA, Gandham A, Mesinovic J, et al. Effects of moderate- to high-impact exercise training on bone structure across the lifespan: a systematic review and meta-analysis. J Bone Miner Res. 2023;38(11):1612-1634. https://doi.org/10.1002/jbmr.4899
17. Otsuka H, Tabata H, Shi H, et al. Playing basketball and volleyball during adolescence is associated with higher bone mineral density in old age: the Bunkyo Health Study. Front Physiol. 2023;14:1227639. https://doi.org/10.3389/fphys.2023.1227639
18. Florence GE, Oosthuyse T, Bosch AN. Skeletal site-specific effects of jump training on bone mineral density in adults: a systematic review and meta-analysis. J Sports Sci. 2023;41(23):2063-2076. https://doi.org/10.1080/02640414.2024.2312052
19. Zouhal H, Berro AJ, Maliha E, et al. Team sports practice and bone health: a systematic review and meta-analysis. J Clin Densitom. 2024;27(4):101508. https://doi.org/10.1016/j.jocd.2024.101508
20. Imeri B, Khaledi A, Mozafaripour E, Gheitasi M. Bone mineral density and content among Iranian elite male athletes in different sports. Arch Bone Jt Surg. 2023;11(3):212-217. https://doi.org/10.22038/ABJS.2022.67195.3196
21. Massini DA, Nedog FH, de Oliveira TP, et al. The effect of resistance training on bone mineral density in older adults: a systematic review and meta-analysis. Healthcare (Basel). 2022;10(6):1129. https://doi.org/10.3390/healthcare10061129
22. Rodrigues IB, Ponzano M, Hosseini Z, et al. The effect of impact exercise on health-related outcomes in individuals at risk of fractures: a systematic review and meta-analysis. Sports Med. 2021;51(6):1273-1292. https://doi.org/10.1007/s40279-021-01432-x
23. Wang Z, Zan X, Li Y, Lu Y, Xia Y, Pan X. Comparative efficacy of different resistance training protocols on bone mineral density in postmenopausal women: a systematic review and network meta-analysis. Front Physiol. 2023;14:1105303. https://doi.org/10.3389/fphys.2023.1105303
24. Hilkens L, Van Schijndel N, Weijer V, et al. Low bone mineral density and associated risk factors in elite cyclists at different stages of a professional cycling career. Med Sci Sports Exerc. 2023;55(5):957-965. https://doi.org/10.1249/MSS.0000000000003113
25. Freitas L, Bezerra A, Boppre G, et al. Does swimming exercise impair bone health? A systematic review and meta-analysis comparing the evidence in humans and rodent models. Sports Med. 2024;54:2373-2394. https://doi.org/10.1007/s40279-024-02052-x
26. Hutson MJ, O'Donnell E, Brooke-Wavell K, Sale C, Blagrove RC. Effects of low energy availability on bone health in endurance athletes and high-impact exercise as a potential countermeasure: a narrative review. Sports Med. 2021;51(3):391-403. https://doi.org/10.1007/s40279-020-01396-4
27. Florvåg AG, Berg ØA, Røksund OD, Jorem GT, Bogen BE. Exercise interventions to improve bone mineral density in athletes participating in low-impact sports: a scoping review. BMC Musculoskelet Disord. 2025;26(1):73. https://doi.org/10.1186/s12891-025-08316-5
28. Faienza MF, Lassandro G, Chiarito M, et al. How Physical Activity Shakes the Bone. Front Pediatr. 2023;11:1226524. https://doi.org/10.3389/fped.2023.1226524
29. Zhang W, Zhao J, Pan L, et al. Impact of physical activity on bone health in youth: a systematic review and meta-analysis. Front Physiol. 2024;15:1512822. https://doi.org/10.3389/fphys.2024.1512822
30. Hu K, Cassimatis M, Girgis C. Exercise and Musculoskeletal Health in Men With Low Bone Mineral Density: A Systematic Review. Arch Rehabil Res Clin Transl. 2023;6(1):100313. Published 2023 Dec 6. https://doi.org/10.1016/j.arrct.2023.100313
31. Bae S, Lee S, Park H, et al. Position Statement: Exercise Guidelines for Osteoporosis Management and Fall Prevention in Osteoporosis Patients. J Bone Metab. 2023;30(2):149-165. https://doi.org/10.11005/jbm.2023.30.2.149
32. Mohebbi R, Shojaa M, Kohl M, et al. Exercise training and bone mineral density in postmenopausal women: an updated systematic review and meta-analysis of intervention studies with emphasis on potential moderators. Osteoporos Int. 2023;34(7):1145-1178. https://doi.org/10.1007/s00198-023-06682-1
33. Sadaqa M, Németh Z, Makai A, Prémusz V, Hock M. Effectiveness of exercise interventions on fall prevention in ambulatory community-dwelling older adults: a systematic review with narrative synthesis. Front Public Health. 2023;11:1209319. https://doi.org/10.3389/fpubh.2023.1209319
34. Dyer SM, Suen J, Kwok WS, et al. Exercise for falls prevention in aged care: systematic review and trial endpoint meta-analyses. Age Ageing. 2023;52(12):afad217. https://doi.org/10.1093/ageing/afad217
35. Kenzhegazova G, Baspakova A, Suleimenova R, et al. Effects of exercise interventions on health-related quality of life in older adults with osteoporosis: a systematic review and meta-analysis. PeerJ. 2026;14:e21023. https://doi.org/10.7717/peerj.21023
36. Aleixo P, Abrantes J. Proprioceptive and Strength Exercise Guidelines to Prevent Falls in the Elderly Related to Biomechanical Movement Characteristics. Healthcare (Basel). 2024;12(2):186. https://doi.org/10.3390/healthcare12020186
37. Hejazi K, Askari R, Hofmeister M. Effects of physical exercise on bone mineral density in older postmenopausal women: a systematic review and meta-analysis of randomized controlled trials. Arch Osteoporos. 2022;17(1):102. https://doi.org/10.1007/s11657-022-01140-7
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2026 Martyna Kudła, Julia Kociuba, Zuzanna Kruczek, Julia Kurcińska , Szymon Kurciński, Paulina Łobaza, Gabriela Zając , Agata Krawczyk , Paweł Czechowicz, Justyna Czechowicz, Mikołaj Antkiewicz, Aleksandra Arczyńska-Antkiewicz, Maria Drozd, Natalia Pawełczak, Dorota Kołkowicz
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.
Stats
Number of views and downloads: 17
Number of citations: 0
