Is running good for bone health?

Running is a widely practiced and accessible form of physical activity with well-established health benefits; however, its effects on bone health remain unclear. This narrative review examines key mechanical, systemic, and individual factors influencing bone adaptation in runners. Current evidence suggests that running may provide some skeletal benefit compared with inactivity, particularly at directly loaded sites such as the lower limb. However, bone responds most effectively to dynamic, high-magnitude, high-rate, and multidirectional loading, whereas the repetitive and high-volume nature of distance running may provide a less potent osteogenic stimulus. Mechanosensory saturation may further limit the effectiveness of prolonged repetitive loading. Beyond mechanical factors, bone health in runners is influenced by systemic factors such as energy availability, hormonal status and sleep, as well as individual factors including training history, early sport specialization, and prior bone stress injuries. Collectively, these findings suggest that running alone may not be sufficient to optimize bone health. Incorporating varied, higher-impact loading alongside running, while addressing systemic and individual determinants, may provide a more effective strategy for maintaining and improving skeletal health. In this review. The aim of this narrative review is to examine some key factors that influence bone adaptation in runners and to discuss their role in long-term bone health.