How Resistance Training Supports Cartilage, Tendon and Bone Health
Build strength. Keep moving. Give the body a reason to stay strong.
Cartilage, tendon and bone are living tissues. Resistance training helps regulate their maintenance. Cardio builds the fitness to keep moving.
We talk a lot about muscle. Build it. Make it stronger. Have enough in reserve to do the things you love.
But muscle does not work alone.
Cartilage distributes pressure across our joints. Tendons carry the pull of muscle into bone. Ligaments help guide and hold joints together. Bone provides the framework that carries us.
These are living tissues. Their cells produce, maintain and break down the materials they are made from. That ongoing work is their metabolism. The forces applied during resistance training help regulate this activity, supporting maintenance and, where the demand is appropriate, adaptation. 1, 2, 3
This is why I advocate resistance training alongside cardiovascular exercise as a way of life. Develop the strength to carry the demand. Build the fitness to keep going. Give the tissues appropriate work, and time to respond.
Dance. Ride. Lift. Carry. Have enough left in you to enjoy it.
Resistance training deserves a place in your life
Being active matters. Deliberately developing strength matters too.
Resistance training asks your muscles to work against a challenge. That might be your body weight, tubing, a machine or a weight in your hand. Muscular effort applies force through tendons, across joints and into bone.
We can organize that demand. Choose the movement. Adjust the resistance. Practise it with control. Gradually ask more.
This gives us a practical way to develop capacity rather than leaving everything to whatever daily life happens to require.
The World Health Organization recommends both aerobic activity and muscle-strengthening work, with strengthening for all major muscle groups on at least two days each week. They contribute different benefits. Both deserve a place in the plan. 4
Whatever your starting point, make resistance training deliberate. Find an appropriate challenge. Have something to develop.
Cartilage health requires load
Articular cartilage covers the ends of bones inside our freely moving joints. It provides a smooth surface for movement and helps spread pressure across the joint.
Cartilage contains a strong network of collagen fibres that helps hold it together as it is stretched and pulled. Within that network, molecules called proteoglycans attract and retain water, helping cartilage resist being squeezed. When we put weight through a joint, pressure in that water helps support the load. Cells called chondrocytes maintain the cartilage by producing and managing the material around them. 1
Think about rising from a chair. Your muscles pull, the joints move and pressure passes across their surfaces. Cartilage helps carry and distribute that pressure.
Add resistance and the muscular demand changes. So does the loading through the joint. The position, effort and resistance all influence the forces involved.
This is why exercise selection matters. We want a challenge that serves the body doing it.
Movement contributes to cartilage maintenance
Healthy adult articular cartilage has no blood vessels running through it. Its cells still need nutrients, and waste still needs to leave.
Those substances must travel through the cartilage, largely from the fluid surrounding the joint. Some of this exchange happens as dissolved substances gradually spread through the tissue. Loading and unloading also move fluid and can help transport substances within its structure. 5
Movement also gives the cells information.
Repeated movement changes the pressure within cartilage. The tissue deforms, fluid redistributes and its cells receive signals that help regulate its metabolism: producing and maintaining the material that supports the joint, while managing its breakdown.
Appropriate loading helps maintain cartilage homeostasis—the healthy balance between these processes. Laboratory and animal research shows that suitable repeated loading can support this balance by encouraging tissue maintenance and reducing some signals that promote breakdown. Excessive or injurious loading can disrupt it. 6
The technical term for cells responding to mechanical forces is mechanotransduction. The useful idea is simple: the cells notice the work, and that influences how they care for the tissue.
Resistance training gives us an adjustable way to provide that work. A controlled chair rise, squat or leg press can apply repeated loading while developing the muscles that move the joint. We can change the resistance, range and number of repetitions to suit the person.
The purpose is regular, useful demand. Enough to matter. Appropriate for the tissue receiving it.
What does the research show in people?
Human studies suggest that cartilage can respond to changes in exercise.
In a small four-month study following partial meniscus removal, supervised exercise improved a scan measurement associated with the cartilage’s water-attracting molecules. The programme included several kinds of exercise, so we cannot assign the result to resistance training alone. 7
A study of resistance exercise in water also found changes in cartilage composition, although the measurements did not all point toward the same benefit. These findings show that cartilage can respond; they do not establish that exercise reliably rebuilds a damaged joint surface. 8
The practical evidence gives us a clear reason to train. Resistance exercise can increase muscular strength, reduce pain and improve function in people with osteoarthritis. Reviews of exercise trials have generally not found harmful effects on knee cartilage from the programmes studied. 9, 10
Exercise can help you move with less pain and do more of what you enjoy, even when it has not repaired damaged cartilage.
Build the strength to move. Give the joints manageable work. Develop the capacity to keep participating.
Tendons need the pull
Every muscular effort pulls through a tendon. Tendons transfer that force to bone, turning effort into movement. Some also stretch and recoil, contributing to the spring in your step.
Tendons have a metabolism too. Their cells produce and maintain collagen, while processes within the tissue break it down. Repeated loading helps regulate this activity. Lasting development takes repeated demand over time. One demanding workout does not immediately create a stronger tendon. 3
A review of 61 studies found that loading made lower-limb tendons more resistant to stretching under force and changed the properties of their material, with smaller increases in size. Much of this evidence came from resistance training. 11
A tendon can therefore change how it works without becoming dramatically bigger.
This is another reason to make training consistent. Apply a useful challenge. Repeat it. Build it gradually. Allow time for the response.
Ligaments also respond to tension, although direct evidence about training changes in human ligaments is more limited. Build strength in the muscles that support the joint, and practise moving with control. Avoid forcing the joint beyond its comfortable range. After injury, the loading plan must fit the tissue and its stage of healing. 12
Bone needs a reason to remain strong
Bone looks solid and permanent. Yet its cells are continually maintaining it.
Some cells build bone. Others remove it. Cells living within the hard structure sense mechanical forces and help coordinate this work.
This formation and removal is part of bone metabolism. Loading influences the balance. Appropriate demand can encourage bone-building activity, while prolonged disuse can shift the balance toward bone loss. Age, hormones and nutrition also influence the response. 2
Resistance training gives bone a substantial reason to respond. Muscles pull on it. External resistance adds demand. Suitable impact activities provide another stimulus through contact and landing. These forces act locally, so the exercises we choose matter. 13
A review of 80 studies found favourable exercise effects on spine and hip bone density in postmenopausal women. Results varied between programmes, but the opportunity for benefit remained. 14
In the LIFTMOR trial, eight months of supervised resistance and impact training increased spinal bone density and better preserved density at part of the hip than a low-intensity comparison programme. The women were screened and closely supervised. Preparation and appropriate instruction belonged in the result. 15
Older bone can respond. Give it an appropriate opportunity.
Cardio belongs beside the strength
Cardiovascular exercise develops the fitness to sustain activity. It also gives us repeated opportunities to move.
Walk. Ride. Swim. Choose something you want to return to.
Resistance training and cardio serve the same life from different directions. One deliberately develops force-producing capacity. The other develops the fitness to keep working. Both contribute to health. 4
They do not provide identical demands to every tissue. Cycling and swimming can be valuable cardio without providing the same bone-loading stimulus as resistance training and suitable weight-bearing impact. 13
That is why the combination matters.
Have the strength for the task and the fitness to enjoy where it takes you.
Make it a practice you keep
A programme gives the work a place in your week. It gives progression a purpose and recovery a place in the plan.
Start with the body you have. Learn the movement. Find an appropriate challenge. Repeat it long enough to develop, then review what comes next.
The tissues are living and their maintenance is ongoing. The pattern matters: useful demand, repeated consistently, with time and nourishment to support the response.
Progression keeps the work relevant as your capacity changes. Recovery helps you return ready to do useful work again.
Joint disease, tendon pain, ligament injury and osteoporosis require adjustments suited to the condition. Persistent swelling or worsening function is a reason to review the demand.
What do you want your body to keep carrying you through? Who do you want beside you?
That is the purpose behind Soma-X training programmes and membership: making resistance training and cardio a continuing part of the life you want to live.
Join us. Give the work a place in your week. Have something to develop and something to look forward to.
Build strength. Keep moving. Keep the adventure.
References
- Zhao Z et al. (2020). Mechanotransduction pathways in the regulation of cartilage chondrocyte homoeostasis. Journal of Cellular and Molecular Medicine, 24:5408–5419.
- Osteocyte-mediated mechanical response controls osteoblast differentiation and function (2024). Frontiers in Cell and Developmental Biology.
- Magnusson SP, Kjaer M (2019). The impact of loading, unloading, ageing and injury on the human tendon. The Journal of Physiology, 597:1283–1298.
- World Health Organization. Physical activity: recommendations for adults.
- Jackson AR, Gu WY (2009). Transport properties of cartilaginous tissues. Current Rheumatology Reviews, 5:40–50.
- Mechanotransduction and cartilage integrity (2011). Annals of the New York Academy of Sciences.
- Roos EM, Dahlberg L (2005). Positive effects of moderate exercise on glycosaminoglycan content in knee cartilage: a four-month, randomized, controlled trial in patients at risk of osteoarthritis. Arthritis & Rheumatism, 52:3507–3514.
- Efficacy of progressive aquatic resistance training for tibiofemoral cartilage in postmenopausal women with mild knee osteoarthritis: a randomised controlled trial (2016). Osteoarthritis and Cartilage, 24:1708–1717.
- The Effects of Resistance Training on Pain, Strength, and Function in Osteoarthritis: Systematic Review and Meta-Analysis (2024).
- Bricca A et al. (2019). Impact of exercise on articular cartilage in people at risk of, or with established, knee osteoarthritis: a systematic review of randomised controlled trials. British Journal of Sports Medicine, 53:940–947.
- Lazarczuk SL et al. (2022). Mechanical, Material and Morphological Adaptations of Healthy Lower Limb Tendons to Mechanical Loading: A Systematic Review and Meta-Analysis. Sports Medicine, 52:2405–2429.
- Bleakley C, Netterström-Wedin F (2023). Does mechanical loading restore ligament biomechanics after injury? A systematic review of studies using animal models. BMC Musculoskeletal Disorders, 24:511.
- Strong, steady and straight: UK consensus statement on physical activity and exercise for osteoporosis (2022). British Journal of Sports Medicine.
- Exercise training and bone mineral density in postmenopausal women: an updated systematic review and meta-analysis of intervention studies with emphasis on potential moderators (2023). Osteoporosis International, 34:1145–1178.
- Watson SL et al. (2018). High-Intensity Resistance and Impact Training Improves Bone Mineral Density and Physical Function in Postmenopausal Women With Osteopenia and Osteoporosis: The LIFTMOR Randomized Controlled Trial. Journal of Bone and Mineral Research, 33:211–220.