Can Pilates Help with Bone Density?
I hear a version of this question all the time, usually from women in their 40s and 50s: "My doctor mentioned osteopenia at my last scan; can Pilates help to increase bone density?" It is a good question, and the honest answer is not a simple "yes." Osteopenia is not osteoporosis; it is a warning, and the exact point where the next steps really start to matter.
What Osteopenia Means
Osteopenia means your bone density has dropped below normal peak levels but has not fallen far enough to be classified as osteoporosis. Bone density naturally declines with age, and that decline speeds up around perimenopause and menopause as estrogen, which helps protect bone, drops off. Catching it at the osteopenia stage means there is a real opportunity to influence what happens next.
Pilates and Bone Density
There is a connection between Pilates and bone density, though not in the way most people assume. Pilates is not a high-impact, bone-loading exercise the way running or jumping is, and that is worth noting if bone density alone is your goal. A 2021 review pulled together data from 11 studies and nearly 600 women, and the short version is that Pilates on its own does not meaningfully increase bone density, at least not by the numbers (Read the study here). What it does help with is maintaining existing bone density.
In my experience, that is only part of the picture. Pilates also builds the muscle, balance and stability that protect you from the falls and fractures that make low bone density dangerous in the first place, and that matters just as much for bone health as density itself. Working your muscles puts stress on the bone, and that stress is one of the things that tells bone to hold onto its density.
The Full Picture for Stronger Bones
If your main goal is building max bone mass, weight-bearing, high-impact movement, think jumping, running or heavier resistance training, will do more for you than Pilates alone.
However, in my practice, once a client has built enough strength, stability and coordination, I like to add load into traditional Pilates exercises — for example, kettlebells added to single-leg squats and side-split squats on the reformer. This is where a session starts to double as the resistance training that builds bone density, not just protects it.
What This Looks Like in Practice
Osteopenia is a call to action, not a diagnosis to fear. The earlier you start paying attention, the more power you have in what happens next.
Pilates supports bone health best alongside weight-bearing exercise, not instead of it. Pair the two and you get both sides covered: the density-building and the everyday resilience that comes with it.
Tell your Pilates instructor if your doctor has flagged low bone density. It changes how we build your sessions, with more emphasis on load-bearing work and balance training from the start.
Where This Goes Next
This article is part of a broader look at healthy aging and bone health. Read more from this series:
Pilates At 40, 50 and 60: What Changes and Why It Matters →
Pilates for Balance and Fall Prevention — Why It's Important to Start Young →
The Nervous System Benefits of Pilates: What It Does for Your Body →
If you want a Pilates practice built around your body is right now, that is exactly what I do one-on-one. Contact me here.
A quick note: This article is educational, not medical advice. If you have been diagnosed with osteopenia or osteoporosis, please talk with your doctor about the exercise approach that is right for you.