If there is one exercise that almost everyone can do, it’s walking. It requires no gym membership, no special equipment, and can be done almost anywhere. A good pair of supportive shoes and a safe place to walk are often all you need.
Many people are disappointed to learn that walking alone usually does not increase bone mineral density enough to produce measurable changes on a DXA scan. They wonder, “If my bone density isn’t improving, is walking really helping?”
The answer is a resounding yes.
Bone Density Is Only Part of the Story
A DXA scan measures one important component of bone strength – bone mineral density. But bone strength also depends on factors that a DXA scan cannot directly measure, including bone geometry (its size and shape), the internal architecture of the bone, and the quality of the bone tissue itself. Researchers now recognize that these characteristics all contribute to skeletal strength and help bones resist breaking (1).
It is important to recognize that although bone density and bone strength are closely related, they are not the same thing. Two people can have exactly the same bone density but different bone strength because the internal structure of their bones is different. As a result, their bones may not have the same ability to resist fractures.
Walking places repeated weight-bearing forces through the legs and hips with every step you take. Although these forces are usually not large enough to produce significant increases in bone density, they help maintain the integrity of the skeleton and may promote favorable adaptations in bone structure over time. The takeaway is simple: walking benefits your skeleton in important ways that go beyond what a DXA scan can measure.
The Outcome That Really Matters
Ultimately, our goal isn’t simply to improve a number on a bone density scan. It’s to prevent fractures. This is where walking plays a particularly important role (2).
One of the landmark studies on walking followed more than 61,000 postmenopausal women for 12 years (3). Women who walked at least four hours per week had approximately a 41% lower risk of hip fracture than women who walked less than one hour per week. Even better, the researchers found that each additional hour of walking per week lowered hip fracture risk by about 6%. More recently, long-term follow-up studies have continued to show that walking for exercise is associated with a meaningful reduction in hip fracture risk in older women (4).
Walking helps reduce fracture risk in several different ways:
- It strengthens the muscles that support your hips, knees, and ankles.
- It improves balance and coordination, reducing your chance of falling.
- It helps maintain joint mobility, making everyday movement easier and more confident.
- It provides regular weight-bearing stimulation, encouraging your skeleton to remain as healthy and resilient as possible.
The Bottom Line
Walking is one of the simplest, safest, and most accessible ways to improve your bone health. It costs nothing, requires no special skills, and can be adapted to almost any fitness level.
If you’re living with osteoporosis or osteopenia, don’t judge the benefits of walking by your next DXA scan alone. Although walking may not dramatically increase your bone density, it improves many of the other factors that help you stay active, independent, and fracture-free.
So lace up your shoes and start walking. Your skeleton benefits with every step.
References
- Kaptoge S, Beck TJ, Reeve J, Stone KL, Hillier TA, Cauley JA, Cummings SR. Prediction of Incident Hip Fracture Risk by Femur Geometry Variables Measured by Hip Structural Analysis in the Study of Osteoporotic Fractures. Journal of Bone and Mineral Research 2008 Dec;23(12):1892-904.
- Bruyère O, Scott D, Papaioannou A, Buehring B, Camargos BM, Chapurlat R, Chevalley T, Dennison EM, Kaux JF, Lane NE, Messina OD, Rizzoli R, Torres JM, Paccou J, Reginster JY, Tuzun S, Blank RD, Silverman S, Pinto D; Rehabilitation Working Group of IOF Committee of Scientific Advisors. The Impact of Sedentary Behavior and Physical Activity on Bone Health: A Narrative Review from the Rehabilitation Working Group of the International Osteoporosis Foundation. Calcified Tissue International 2025 Aug 15;116(1):109.
- Feskanich D, Willett W, Colditz G. Walking and Leisure-time Activity and Risk of Hip Fracture in Postmenopausal Women. JAMA 2002 Nov 13;288(18):2300-6.
- Liu E, Liu RY, Moraros J, McCloskey EV, Harvey NC, Lorentzon M, Johansson H, Kanis JA. Association Between Walking and Hip Fracture in Women Aged 65 and Older: 20-year Follow-up from the Study of Osteoporotic Fractures. Osteoporosis International 2025 Jul;36(7):1155-1164.
