Exercise and osteoporosis

Exercise and osteoporosis

Exercise and osteoporosis

Osteoporosis is a largely treatable condition and, with a combination of lifestyle changes and appropriate medical treatment, many fractures can be avoided. The right type of exercise plays a major role.

Osteoporosis actually means “porous bones.” When you have osteoporosis, your bones become weak and brittle due to the reduced density and quality of the bone. These porous bones can be so brittle that even a mild bang or stress like bending over can cause a fracture. The loss of bone occurs “silently” and progressively. A major cause of this weakness in the bone structure is a lack of calcium, phosphorus or other minerals in the bones.

We tend to think of osteoporosis as being an affliction of women but a surprising number of men also suffer from it.

The following symptoms become common with osteoporosis:

  • Stooped posture
  • Getting shorter or loosing height
  • Fractures – especially of the wrists, hips, spine and other bones
  • Back pain, which can be especially severe once a vertebra fractures or a collapsed vertebra develops.

The good news is that osteoporosis is now a largely treatable condition and, with a combination of lifestyle changes and appropriate medical treatment, many fractures can be avoided.

Why exercise?

Exercise is an important component in the comprehensive treatment of osteoporosis. Exercise can decrease bone loss, increase bone density and reduce the risk of fractures. It is important to understand the principles of proper exercise for preventing and treating osteoporosis to ensure that an exercise programme is both safe and effective.

Exercises that increase bone density

Both weight-bearing and resistance exercises have been shown to increase bone density.

Weight-bearing exercises refer to activities where the weight of the body is transmitted through the bones, working against gravity. Your bones respond to this force by growing stronger. Weight-bearing exercises can include:

  • Pilates
  • Fast walking (walking with weights around your ankles or in your hands also provide resistance)
  • Jogging (jogging or running on concrete is not recommended)
  • Running
  • Jumping on a trampoline
  • Step aerobics
  • Dancing
  • Weight lifting
  • Hiking
  • Stair climbing.

Bike riding and swimming, although good exercises, are not “weight bearing”. Weight-bearing exercises should be performed at least three to five times per week. The goal is to work up to 45 minutes or more per session. If you already have osteoporosis, you should not perform high impact activities such as jogging or high-impact aerobics. These exercises cause too much jarring of the spine and can increase the risk of vertebral fractures. See a biokineticist for a specialised programme.

Daily activities such as gardening, vacuuming, climbing stairs and mowing the lawn are also weight bearing.

Resistance exercises generate muscle tension on the bones. This strengthens the muscles and stimulates the bones to grow stronger. Exercising with weights or resistance bands are examples of this type of exercise. If you have osteoporosis, make sure to review your strength training programme in advance with your doctor or biokineticist. Resistance exercises should be performed two to three times a week. Pilates is a good form of resistance exercise, using springs, therabands and own body weight.

Postural exercises should be performed throughout the day to reinforce good posture. They help maintain proper body alignment and decrease harmful stress on the back. Stretching the muscles of the chest and strengthening the back muscles help promote good posture. One example is a shoulder stretch. In this exercise, you pull your shoulder blades together while visualising your spine stretching up and lengthening. Again, pilates will improve posture.

Balance exercises help maintain equilibrium and can reduce the risk of falling. These exercises should be performed daily.

Dangerous exercises to avoid

Individuals with osteoporosis should avoid any exercises that increase forward bending or rounding of the spine. These exercises include sit-ups, toe touches, and the use of exercise equipment that applies flexion forces (such as in some abdominal machines). Forward-bending exercises have been found to increase the incidence of spinal fractures in people who have osteoporosis.

Excessive twisting places large compressive forces on the spine. Individuals with osteoporosis should avoid exercises such as windmill toe touches, since there is added stress to the spine when forward bending is combined with rotation.

Custom-designed exercise programmes

A biokineticist can design an exercise programme that is safe and appropriate for both prevention and treatment of osteoporosis. Biokineticists are also trained to teach proper ways to perform daily activities that can help prevent fractures. Many individuals with osteoporosis will have postural changes, and muscle and soft tissue tightness that require the hands-on treatment of a biokineticist. Go to www.biokinetics.org.za to find a qualified biokineticist in your area or contact the EWP for advice.


Exercise. Retrieved from https://www.osteoporosis.org.au
Osteoporosis Exercise for Strong Bones. Retrieved from https://www.nof.org

(Revised by M van Deventer)