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Osteopenia and running : Impact of resistance training

by P. Debraux | 5 June 2018

osteopenia, osteoporosis, sport, running, distance, recreational, bone mineral density, physical activity, weight-bearing, science, performance, health, resistance training

Osteopenia is a decrease in bone mineral density, an intermediate physiological state between normal bone health and osteoporosis. Osteopenia happens when the value of the bone mineral density is between -1 and -2.5 standard deviations compared to the average taken for reference (subjects in good health, of the same sex and of the same age). Beyond that, it is about osteoporosis. It is generally believed that from the age of 40-50, human beings begin to lose their bone capital until their death, with aggravating factors, such as sedentarity and menopause in women, for example. This osteopenia is called physiological, that is, normal... However, this is not an inevitable phenomenon. Like muscle mass, bone mass can be stimulated by mechanical loading induced by physical activity.

However, not all physical activities have the same impact on the bone mass. Indeed, only the weight-bearing physical activities can generate a stimulation such that the bone tissue growth will be greater than its destruction. Running is one of those activities where the body is subjected to mechanical loading at each foot strike. But surprisingly, many studies have reported low bone mineral densities in female and male runners...

First encountered in the female athlete, this problem was named the female athlete triad, an old concept associating eating and hormonal disorders with osteoporosis. However, several studies have shown that male athletes also have similar problems and that this problem is the consequence of a more general phenomenon resulting from an energy deficit compared to the daily needs of athletes, which in turn affects a very large number of physiological processes. That's why this syndrome has been renamed Relative Deficiency Energy in Sport (RED-S). Many athletes sometimes think that, being leaner, they will have a competitive advantage, especially in weight-class sports, or in sports where body mass must be moved over long distances. This imbalance between intake and caloric expenditure is the main problem underlying this syndrome, and it affects women AND men. What is the impact of osteopenia in recreational runners, what impact would the addition of resistance training sessions have in the training program on bone mineral density, knowing that resistance training is known for its positive effects on bone mineral density ?

The Study

To answer this question, a team of American researchers investigated the relationship between resistance training, testosterone concentration, biological markers of bone metabolism, and bone mineral density of young male runners. For this purpose, the authors of the study recruited 25 young Caucasian men (23-32 years old) and divided them into 3 groups :

  • Control Group (n = 8) : All persons in this group had less than 1 hour of exercise per week.
  • Running Group (n = 8) : People running at least 32 km per week, and not practicing resistance training.
  • Running + Resistance Training Group (n = 9) : People running at least 32km per week and practicing at least 1 weekly weight training session.

For all participants in the study, a bone densitometry was performed for the whole body and for specific regions : the proximal femur, the femoral neck, the trochanteric region and the lumbar spine (L1-L4). In addition, a blood test was conducted to measure testosterone levels (total and free), vitamin D and biological markers that promote bone formation or prevent its degradation and those that promote bone degradation or suppress its formation.

Results & Analyzes

The main results of this study show that in recreational runners, the bone mineral density does not differ from that of people not practicing any regular physical activity. While for runners doing at least one weekly weight training session, the bone mineral density is significantly higher (Fig. 1). The Running group was running significantly more (69.1 ± 24.3 km / week) than the Running + Resistance Training group (44.8 ± 13.8). However, a statistical analysis showed that the weekly running volume did not contribute to the observed differences. These results suggest that running alone is not a sufficient stimulus to induce stimulation of bone mass.

Measurement of bone mineral density in the 3 groups

Figure 1. Measurement of bone mineral density in the 3 groups.

Concerning the testosterone blood test, no difference was observed between the 3 groups, whose concentrations were within the normal range (Fig. 2 and 3). Finally, concerning the biological marker concentrations influencing bone metabolism, only a significant difference in vitamin D was observed for the Running (22.9 ± 2.4 μg / L) and Running + Resistance Training (26.0 ± 3.0 μg / L) compared to the Control group (13.7 ± 1.2 μg / L). In all cases, these rates are considered insufficient.

Measurement of the total testosterone

Figure 2. Measurement of the total testosterone... (Cliquez sur l'image pour l'agrandir)

Measurement of the free testosterone

Figure 3. Measurement of the free testosterone... (Cliquez sur l'image pour l'agrandir)

Overall, these results suggest that resistance training alone influences bone mineral density. In addition, the lack of difference between the Control group and the Running group shows that there is no sign of osteopenia in these recreational runners. Scientific studies on the subject suggest that a low to moderate volume of running can lead to a light increase in bone mineral density (compared to sedentary people) while a high volume of running could erase these benefits. Obviously, intensity also plays a big role, as sprinters and jumpers usually have very high bone mineral density.

Practical Applications

The results of this study show that recreational running is not enough to allow effective stimulation of bone mineral density, but adding at least one weekly weight training session is enough to increase it significantly. Thus, even if running at moderate volume can slightly stimulate bone mineral density, the higher the volume, the less the impact will be large. Incorporating resistance training (or intense activities, such as sprints) with at least one session per week would not only counteract these negative effects, but also strengthen the bone capital.


  1. Duplanty AA, Levitt DE, Hill DW, McFarlin BK, DiMarco NM, and Vingren JL. Resistance training is associated with higher bone mineral density among young adult male distance runners independent of physiological factors. J Strength Cond Res 32 (6) : 1594-1600, 2018.

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