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Jump Training and Hip Bone Density: What 18 Trials Found

10 min read

The NHS (National Health Service) describes osteoporosis as a condition that weakens bones and makes them more likely to break, and says it is often only found when a fall causes a fracture. The hip is one of the most common places for those breaks. A 2023 review of 18 trials found that adults who did regular jump training had slightly higher bone density at the top of the thigh bone, near the hip joint, than adults who did not jump.

This guide covers what the review found, which parts of the skeleton responded, how many jumps the trials used, what UK experts recommend for people with osteoporosis, and how to start safely. The trials measured bone density, not fractures. The gain was small, and the review does not tell you how much it lowers your risk of a break. The short answer from the review: a median of 50 jumps, four times a week, came with a small to moderate gain in bone density at the femoral neck, the narrow part of the thigh bone directly below the hip joint.

1.5%
Higher femoral neck bone density on average with jump training than with no jumping
Florence et al. 2023, review of 18 trials
50 x 4
Median jump dose in the trials: 50 jumps a session, four times a week
Florence et al. 2023
1.0%
Average gain at the femoral neck in older adults, with a likely range from almost zero to 2%
Florence et al. 2023, older adult subgroup
50
Moderate impacts per session on most days, advised for people with osteoporosis without spinal or several low-trauma fractures
Brooke-Wavell et al. 2022, UK consensus
Sources: Florence et al. 2023, Journal of Sports Sciences. Brooke-Wavell et al. 2022, British Journal of Sports Medicine.

Why bone density at the hip matters

Bone density is a measure of how much mineral is packed into your bone, usually checked with a DEXA (dual-energy X-ray absorptiometry) scan, which the NHS describes as a short, painless procedure. The NHS says women are more at risk of osteoporosis than men, especially if menopause starts early, and that losing bone is a normal part of ageing. It lists the wrist, hip and spine as the most common places for breaks.

The NHS recommends regular exercise to keep bones as strong as possible, and lists not exercising regularly as a risk factor. A 2022 systematic review by Feeba Koshy and colleagues of 13 trials in women after menopause found that most trials reported a positive effect of exercise on bone density, with high-impact exercise appearing to have the largest effect. That review studied women after menopause, not specifically people with osteoporosis. UK advice for people with osteoporosis, covered below, favours moderate impacts.

What the jump training review found

In 2023, Gabriella Florence and colleagues published a meta-analysis in the Journal of Sports Sciences. They included trials in men and women over 18 that compared jump training with no jumping. Fifteen papers covering 19 jump training trials met their criteria, and 18 trials with 666 participants reported bone density. The review abstract does not report the participants' health status, the mix of men and women, how long the trials ran, or the age that split younger from older adults, and the full paper was not available to us.

On average, bone density at the femoral neck was 1.50% higher with jump training than without it. The 95% confidence interval, the range the true effect probably falls in, ran from 0.83% to 2.17%. The authors called this a small to moderate effect. The gain was statistically significant, meaning unlikely to be due to chance, in both younger adults, at 1.81%, and older adults, at 1.03%, though the range for older adults ran from almost zero, at 0.02%, up to 2.03%.

Other sites responded differently. At the total hip, the whole hip region measured on the scan, and at the trochanter, the bony point on the outside of the upper thigh, bone density rose significantly only in younger adults. At the lumbar spine, the lower back, the rise was not significant in either group, though in younger adults it came close. The authors concluded that the response to jump training appears to depend on the site, with the femoral neck the most sensitive.

Bone density change with jump training Percent difference against no jumping, with 95% confidence interval Femoral neck, all +1.50% Femoral neck, younger +1.81% Femoral neck, older +1.03% Total hip, younger +1.26% Total hip, older +0.06% -1% 0 +1% +2% +3% Change in bone density, %
Source: Florence et al. 2023, Journal of Sports Sciences. The review included 18 trials with 666 adults for bone density. The abstract does not say how many trials fed each row. Dots are average differences against no jumping. Lines are 95% confidence intervals, the likely range of the true effect. The dashed row, total hip in older adults, was not significant. Trochanter and lower spine results are described in the text.

How many jumps the trials used

The review did not find a dose-response effect, meaning trials with more jumps did not show clearly larger gains. The authors concluded there is moderate certainty of a gain in femoral neck bone density with the median jump load in the trials, 50 jumps four times a week. Median means half the trials used fewer jumps and half used more. That works out at about 200 jumps a week.

A 2022 UK consensus statement on exercise for osteoporosis, led by Katherine Brooke-Wavell, quotes Australian guidance of about 50 jumps a session on 4 to 7 days a week. That guidance suggests high-intensity jumps, such as drop jumps, for people without osteoporosis, and lower intensity for people at moderate risk. The UK group found no evidence that high intensity works better than moderate intensity, so it chose moderate impacts instead.

What UK experts recommend for people with osteoporosis

The UK consensus statement recommends resistance and impact exercise to maximise bone strength, strength and balance activities to reduce falls, and exercise that strengthens the back muscles to improve posture. It says heavy resistance exercise, or weight-bearing exercise with impact, appears the most effective for bone strength. For people with osteoporosis who do not have spinal fractures or several low-trauma fractures, it recommends moderate impact exercise on most days, such as stamping, jogging, low-level jumping or hopping, with at least 50 impacts per session. It also suggests brief bursts of about 50 impacts, for example 5 sets of 10, with lower impact such as walking in between. It does not recommend the highest-impact exercise, such as landing from a height.

For people who have spinal fractures or several low-trauma fractures, the statement recommends impact exercise on most days, usually only up to the level of brisk walking, aiming for 150 minutes a week. It calls this a precaution because of theoretical, unproved risks of further spinal fractures. It also recommends balance and muscle strength exercise at least twice a week to reduce the risk of falls, and advises avoiding postures with a lot of forward bending of the spine. Most of its impact recommendations rest on expert agreement, because trial evidence in people with osteoporosis is limited. It reports little evidence that physical activity is linked to significant harm, and says the benefits generally outweigh the risks.

Who should take care

The UK consensus statement advises people with spinal fractures or several low-trauma fractures to keep impact up to the level of brisk walking, and recommends individual advice from a physiotherapist at the start of a new programme. People at risk of falls should start with targeted strength and balance training. The statement also notes that bladder leakage might be a barrier to impact exercise, and that this might need to be addressed first.

The NHS says that in osteoporosis a cough or sneeze sometimes breaks a rib or partly collapses a bone of the spine, and that some older people develop a stooped posture when bones in the spine have broken. By a low-trauma fracture we mean a break from a minor fall or knock.

In our view, speak to your GP (general practitioner) or a physiotherapist before you start jumping if you have osteoporosis, have had a break from a minor fall, have developed a stoop, have had a hip or knee replacement, have knee, hip or ankle arthritis or ongoing joint pain, leak urine when you jump, or have problems with balance. Stop if a session causes sharp pain or swelling.

How to start jumping

These steps are ours, built from the review and the UK consensus statement. Read the section above first if you have osteoporosis or have had a fracture.

1
Check your starting point
If you have had a spinal fracture or more than one break from a minor fall, skip steps 2 and 3. Keep impact to brisk walking and ask a physiotherapist for a plan, as the UK statement advises. If you are unsteady on your feet or have fallen, start with balance and strength work before any jumping.
2
Start with low impacts
Begin with heel drops, stamping and small hops in place, landing softly with your knees bent. The UK statement advises building up gradually with good technique.
3
Build up the dose
Over several weeks, work up to about 50 moderate impacts a session, such as 5 sets of 10 with walking in between, on four or more days a week.
4
Add strength and balance
The UK statement says heavy resistance exercise, or weight-bearing exercise with impact, appears the most effective for bone strength. It also recommends balance and strength work at least twice a week.

Frequently asked questions

How much did jumping raise hip bone density?
In the 2023 review, femoral neck bone density was 1.50% higher on average with jump training than without it. In older adults the gain was smaller, at 1.03%, with a likely range from almost zero to about 2%.
Does jumping help the spine?
The review found no clear benefit at the lower spine. The result in younger adults came close to significance, so the evidence is uncertain.
Is jumping safe if I have osteoporosis?
The UK consensus statement recommends moderate impact exercise for people with osteoporosis who have not had spinal fractures or several low-trauma fractures. For people who have, it recommends impact up to brisk walking and advice from a physiotherapist at the start. In our view, anyone with osteoporosis should get individual advice first.
Do more jumps give bigger gains?
The 2023 review did not find a dose-response effect. The median dose in the trials was 50 jumps, four times a week.
Does jumping replace strength training?
No. The UK statement recommends resistance and impact exercise together for bone strength, balance and strength exercise at least twice a week to reduce falls, and daily physical activity with less time spent sitting.

The bottom line

In a review of 18 trials in 666 adults, femoral neck bone density was 1.5% higher on average with jump training than without it, with a smaller and less certain gain in older adults. Total hip and trochanter density rose only in younger adults, and the lower spine did not change significantly. The trials measured bone density, not fractures, so the review does not tell you how much jumping lowers your fracture risk. The median dose was 50 jumps, four times a week. UK experts recommend moderate impacts with strength and balance work for people with osteoporosis, and impact up to brisk walking for people with spinal fractures or several low-trauma fractures. In our view, build up gradually and get advice first if you have osteoporosis or a past fracture.

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Related reading

Sources

  • 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. Journal of Sports Sciences 2023. pubmed.ncbi.nlm.nih.gov/38305252
  • Brooke-Wavell K, Skelton DA, Barker KL, et al. Strong, steady and straight: UK consensus statement on physical activity and exercise for osteoporosis. British Journal of Sports Medicine 2022. pubmed.ncbi.nlm.nih.gov/35577538
  • Koshy FS, George K, Poudel P, et al. Exercise Prescription and the Minimum Dose for Bone Remodeling Needed to Prevent Osteoporosis in Postmenopausal Women: A Systematic Review. Cureus 2022. pubmed.ncbi.nlm.nih.gov/35859964
  • NHS. Osteoporosis. nhs.uk/conditions/osteoporosis
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