Exercising with osteoporosis: Stay active the safe way
If you have osteoporosis, you might mistakenly think exercise will lead to fracture. In fact, though, using your muscles helps protect your bones.
Osteoporosis is a major cause of disability in older women. Osteoporosis is a bone-weakening disorder that can result in broken bones, such as in the hip and spine. When this happens, it be hard to move freely and live independently.
How can you lower your risk of these injuries? Exercise can help.
Certain types of exercise strengthen muscles and bones. Other types can improve balance, which can help prevent falls.
Benefits of exercise
It's never too late to start exercising. Regular physical activity can:
- Increase muscle strength.
- Improve balance.
- Decrease the risk of broken bones.
- Improve posture.
- Lessen pain.
Exercising if you have osteoporosis means finding the safest, most enjoyable activities for you based on your overall health and amount of bone loss. There's no one-size-fits-all prescription.
Before you start
Consult your health care provider before starting any exercise program for osteoporosis. You might need some tests first, including:
- Bone density measurement.
- Fitness assessment.
In the meantime, think about what kind of activities you enjoy most. If you choose an exercise you enjoy, you're more likely to stick with it over time.
Choosing the right form of exercise
These types of activities are often recommended for people with osteoporosis:
- Strength training exercises, especially those for the upper back.
- Weight-bearing aerobic activities, like walking.
- Flexibility exercises.
- Stability and balance exercises.
People with more advanced osteoporosis may have a high risk of a broken bone. They might be discouraged from doing certain exercises. Ask your primary care provider or physical therapist whether you're at risk of osteoporosis-related problems. Find out what exercises are safe for you.
Strength training
Strength training includes the use of free weights, resistance bands or your own body weight to strengthen muscles, tendons and bones. Strength training is especially helpful to build back muscles that are important for posture. It also can help support bone density.
You should tailor your strength training to your ability and level of comfort, especially if you have pain. It is worthwhile to talk to a physical therapist or personal trainer who has experience working with people with osteoporosis. They can help you develop a strength-training routine. They also can help you learn to use proper form and technique to prevent injury and get the most from each workout.
Weight-bearing aerobic activities
Weight-bearing aerobic activities involve doing aerobic exercise on your feet, with your bones supporting your weight. Examples include walking, dancing, low-impact aerobics, elliptical training machines, stair climbing and gardening.
These types of exercise work directly on bones in the legs, hips and lower spine to slow bone loss. They also improve blood flow and are good for the heart.
Even though aerobic exercise is good for overall health, it's not all you should do for exercise. It's also important to work on strength, flexibility and balance.
Swimming and cycling have many benefits, but they don't provide the weight-bearing load that bones need to slow bone loss. However, if you enjoy these activities, do them. Just be sure also to add weight-bearing activity as you're able.
Flexibility exercises
Moving joints through their full range of motion helps keep muscles working well. Stretches are best performed after muscles are warmed up. For example, it's good to stretch at the end of an exercise session or after a 10-minute warm-up. Stretches should be done gently and slowly, without bouncing.
Avoid stretches that flex the spine or require bending at the waist. Ask your health care provider which stretching exercises are best for you.
Stability and balance exercises
Efforts to prevent falls are especially important for people with osteoporosis. Stability and balance exercises help muscles work together in a way that makes falls less likely. Simple exercises that improve stability and balance include standing on one leg and movement-based exercises such as tai chi.
Movements to avoid
If you have osteoporosis, don't do the following types of exercises:
- High-impact exercises. Activities such as jumping, running or jogging can lead to fractures in weakened bones. Avoid jerky, rapid movements in general. Choose exercises with slow, controlled movements. If you're generally fit and strong despite having osteoporosis, however, you might be able to do somewhat higher-impact exercise than someone who is frail.
- Bending and twisting. In people who have osteoporosis, bending forward at the waist and twisting at the waist can increase the risk for broken bones in the spine. Exercises to avoid include touching your toes or doing sit-ups. Other activities that may require you to bend or twist forcefully at the waist are golf, tennis, bowling and some yoga poses.
If you're not sure how healthy your bones are, talk to your care provider. Don't let fear of bone fractures keep you from having fun and being active.
Video: Bent-over row with resistance tubing
Edward R. Laskowski, M.D.: The bent-over row is an exercise you can do with resistance tubing to work the muscles in the back of the shoulder. Specifically, the bent-over row targets the posterior part of the deltoid in the shoulder. That's important, because many people focus on the muscles at the front of the shoulder. For strength in the shoulder, what you really want is balance between the front and back muscles in the shoulder.
Nicole L. Campbell: To do the bent-over row with resistance tubing, start by standing with your feet shoulder-width apart on the center of the tubing.
Grasp both tubing handles with your palms facing in, and bend your knees comfortably and keep your back in a neutral position. Slowly bring your elbows back. Keep your elbows close to your body. Then slowly return to the starting position. You'll feel as if your shoulder blades are coming together. You might imagine that you're squeezing a pencil with your shoulder blades.
When you're doing the bent-over row, remember to keep your back in a neutral position. Do not flatten the curve of your low back, and don't arch your back in the other direction. Keep your movements smooth and controlled.
To make this exercise more challenging, move your foot closer to the tubing handle, then bring your elbow back just as you did before.
For most people, one set of 12 to 15 repetitions is adequate.
Remember, for best results, keep your back in a neutral position and your elbows close to your body. Keep your movements smooth and controlled.
Video: Bent-over row with dumbbell
Edward R. Laskowski, M.D.: The bent-over row is an exercise you can do with dumbbells to work the muscles in the back of the shoulder. The bent-over row targets the posterior part of the deltoid in the shoulder. That's important, because many people focus on the muscles at the front of the shoulder. What you really want is balance in the shoulder muscles.
Nicole L. Campbell: To do the bent-over row with a dumbbell, hold a dumbbell in your hand and stand with your feet comfortably apart. For most people, this is about shoulder-width apart. Tighten your abdominal muscles. Bend your knees and lean forward at the hips, keeping your spine nice and straight. Let your arms hang straight below your shoulders and slowly raise the weight until your elbow lines up just below your shoulder and parallel with your spine. Then slowly lower the weight to the starting position. You'll feel tension in the back of your shoulder and the muscles across your upper back.
When doing the bent-over row, do not allow your shoulder to roll forward.
For most people, one set of 12 to 15 repetitions is adequate.
Remember, for best results, don't allow your shoulder to roll forward during the exercise. Hold your shoulder as stationary as possible, keeping your spine neutral, your abdominal muscles tight, and your movements smooth and controlled.
Video: Seated row with weight machine
Dr. Laskowski: The seated row is an exercise you can do with a weight machine to work the muscles in your upper back. Specifically, the seated row targets the muscles in your upper back and also the latissimus dorsi — a muscle on the outer side of the chest wall. This exercise will help improve your posture and help protect your shoulders.
Nicole Campbell: To do the seated row with a weight machine, start by sitting on the weight bench with your knees bent and by grasping the cable attachment. Your arms should be extended and your shoulders stretched slightly forward. Slowly pull the cable to your waist, until your elbows are bent and your shoulders are back. Then slowly return to the starting position. You'll feel tension in your back and arms.
When you're doing the seated row, make sure you feel only a mild stretch in the starting position.
For most people, one set of 12 to 15 repetitions is adequate.
Remember, for best results, do not lean too far forward in the starting position. Also, keep your movements smooth and controlled.
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June 22, 2023
- Bone health: Exercise is a key component. The North American Menopause Society. http://www.menopause.org/for-women/menopauseflashes/bone-health-and-heart-health/bone-health-exercise-is-a-key-component. Accessed April 2, 2023.
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