Strengthen Your Bones: A Guide to Safe Exercise for Osteoporosis

What is osteoporosis?

Osteoporosis is a condition that affects millions of people around the world, especially postmenopausal women. It is a progressive disease characterized by a loss of bone density and mass, which makes the bones more brittle and fragile. As a result, people with osteoporosis are at a higher risk of fractures, particularly in the hip, spine, and wrist.

What exercises should I avoid with osteoporosis?

Fortunately, exercise can help to prevent or slow down the progression of osteoporosis. However, not all exercises are safe for people with this condition. In this blog, we will summarize the precautions and exercises for people with osteoporosis, based on the recommendations of the National Osteoporosis Foundation and the American Council on Exercise.

Firstly, it is essential to understand that exercises that involve high-impact activities or forward flexion of the spine should be avoided. These activities can increase the risk of vertebral fractures in people with osteoporosis. Instead, low-impact exercises like Pilates, yoga, and resistance training are recommended.

What exercises should I do with osteoporosis?

As a physical therapist who has helped many patients with osteoporosis, I have seen the benefits of exercise firsthand. One of my clients, Mary, was diagnosed with osteoporosis in her early 60s. She was initially afraid to do any exercise, fearing that she would break a bone. However, with guidance and a customized exercise program, she was able to gradually increase her bone density and improve her overall strength and mobility.

hip hinge

One of the key exercises that we incorporated into Mary's program was a hip hinge. The hip hinge is a fundamental movement pattern that involves bending forward at the hips while keeping the spine in a neutral position. It is a safe and effective way to strengthen the posterior chain muscles, including the glutes, hamstrings, and lower back. The hip hinge also helps to improve posture and balance, which are important factors in preventing falls and fractures.

To perform a hip hinge, stand with your feet hip-width apart and a slight bend in your knees. Place your hands on your hips or in front of your thighs. Slowly hinge forward at the hips, pushing your glutes back and keeping your spine straight. You should feel a stretch in your hamstrings. Then, engage your glutes and push your hips forward to return to the starting position. Repeat for 10–12 repetitions.

shoulder bridge

Another exercise that is safe and effective for people with osteoporosis is the shoulder bridge. The shoulder bridge strengthens the glutes, hamstrings, and lower back while promoting spinal extension. To perform the shoulder bridge, lie on your back with your knees bent and your feet flat on the floor. Place your hands by your sides. Lift your hips off the ground, squeezing your glutes and hamstrings. Hold for a few seconds, then lower back down. Repeat for 10–12 repetitions.

While the hip hinge and shoulder bridge are safe for people with osteoporosis, there are certain exercises that should be avoided. These exercises include forward flexion of the spine, such as the roll-up and teaser in Pilates. The other Pilates exercises that are contraindicated are the hundred, the roll over, rolling like a ball, single leg stretch, spine stretch, corkscrew, open-leg rocker, saw, swan, neck pull, scissors, bicycle, spine twist, jackknife, seal, and boomerang.

Instead, exercises that promote spinal extension, such as the swan and cobra in Pilates, are recommended. ACE also suggests incorporating resistance training with light weights or resistance bands to help maintain bone density. Other Pilates exercises that are safe to do in a Pilates mat class are the double leg click, side kicks, hip circles, swimming, leg pulls to the front, leg pulls, side kicks kneeling, and the shoulder bridge.

Should I do resistance training with osteoporosis?

Incorporating Resistance Training

Resistance training is another great way to improve bone density, especially for individuals with osteoporosis. Research has shown that resistance training with weights or resistance bands can help to stimulate bone growth and maintain bone density.

When incorporating resistance training, it is important to start with light weights or resistance bands and gradually increase the intensity over time. It is also important to work with a certified personal trainer or physical therapist who can ensure proper form and technique to prevent injury.

Pilates exercises to avoid with osteoporosis.

As mentioned earlier, certain exercises should be avoided, especially those that involve high-impact activities or forward flexion of the spine.

The following Pilates mat class exercises are contraindicated and should be avoided by individuals with osteoporosis:

  • Roll-Up
  • Teaser
  • Hundred
  • Roll over
  • Rolling like a ball
  • Single leg stretch
  • Spine stretch
  • Corkscrew
  • Open-leg rocker
  • Saw
  • Swan
  • Neck pull
  • Scissors
  • Bicycle
  • Spine twist
  • Jackknife
  • Seal
  • Boomerang

It is also important to avoid high-impact activities such as jumping and running, as these can increase the risk of falls and fractures in individuals with osteoporosis.

Pilates exercises to do with osteoporosis.

Low-impact exercises such as Pilates, yoga, and resistance training are recommended for individuals with osteoporosis. The following Pilates mat class exercises are safe to do:

  • Double leg click
  • Side kicks
  • Hip circles
  • Swimming
  • Leg pulls to the front
  • Leg pulls
  • Side kicks kneeling
  • Shoulder bridge (mid-height)

These exercises promote spinal extension and help to improve posture and balance, which can reduce the risk of falls and fractures.

Strengthen Your Bones: A Guide to Safe Exercise for Osteoporosis

The Hip Hinge

In addition to the exercises mentioned above, incorporating the hip hinge into your exercise routine can also be beneficial for individuals with osteoporosis. The hip hinge is a movement pattern that involves hinging at the hips while keeping the spine in a neutral position. This movement is commonly used in exercises such as deadlifts, kettlebell swings, and squats.

The hip hinge is important because it strengthens the muscles in the back, hips, and legs, which are important for maintaining posture and balance. Research has also shown that the hip hinge can help to improve bone density in the lumbar spine, which is especially important for individuals with osteoporosis.

Case Study

To illustrate the effectiveness of exercise in improving bone density, let's take a look at the case study of one of my clients. Mary (not her real name) is a 65-year-old woman who was diagnosed with osteoporosis several years ago. She came to me seeking help in improving her bone density and reducing her risk of falls and fractures.

Together, we developed an exercise program that focused on low-impact exercises such as Pilates, yoga, and resistance training. We also incorporated the hip hinge into her daily routine of loading and unloading the dishwasher, doing laundry, and reaching below the sink.

After several years of consistent exercise, Mary's bone density had significantly improved, and she was no longer taking Fosamax. She had progressed from osteoporosis to osteopenia. She also reported feeling stronger, more balanced, and more confident in her daily activities, and she made great improvements that amazed her doctor. Most people digress with osteoporosis, but with the right exercise plan and consistency, Mary found great success.

Strengthen Your Bones: A Guide to Safe Exercise for Osteoporosis
Strengthen Your Bones: A Guide to Safe Exercise for Osteoporosis

Consult with a Healthcare Professional

As always, it is important to consult with a healthcare professional before starting any exercise program, especially if you have osteoporosis. A healthcare professional can help to determine which exercises are safe and appropriate for your individual needs and can also monitor your progress over time.

In conclusion, osteoporosis is a common condition that can be improved through exercise. Low-impact exercises such as Pilates, yoga, and resistance training are recommended while you incorporate hip hinges into your daily life.

Want to learn more about the silent disease known as osteoporosis? Call 512-215-4227 now to speak with our team about getting in for an evaluation with one of our physical therapists.

See what the Mayo Clinic has to say about osteoporosis.

Learn two easy weight-bearing exercises to do daily here... 

Co-Owner / Physical Therapist at CORE Therapy and Pilates
Stephen graduated with a Masters in Physical Therapy in 1998 from LSUMC in New Orleans and is a licensed physical therapist in Texas since 2004. Immediately interested in hands-on therapy, he began to study with Brian Mulligan and became certified in the Maitland Australian Approach in 2003. Stephen has since studied the fascial system through John F Barnes Myofascial Release. Stephen completed a comprehensive Pilates training in 2002 and the GYROTONIC Expansion System® in 2009. The combined treatment of manual therapy with mind-body awareness exercises using Pilates and Gyrotonic concepts was the start of his whole-body treatment approach.
Stephen Dunn