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Best Exercises When You Have Osteoporosis

Weight-bearing exercise is one of the best ways to prevent osteoporosis. It can also help you maintain bone density if you’ve been diagnosed with osteoporosis or osteopenia.

Some other forms of exercise, such as resistance training and balance activities — both of which can also be weight bearing — can also be helpful. “One of the biggest concerns for people living with osteoporosis or osteopenia is the risk of falling. Those conditions can increase the chance of falls and fractures,” says Jared Griffin, DPT, who works at Fyzical Hermitage North Therapy & Balance Center in Tennessee. “Exercise keeps the body strong and stable and has been shown to decrease fall risk in older adults.”

But caution is necessary, particularly if you have severe osteoporosis, have already broken a bone, or experience balance issues. High-impact activities, such as jogging or jumping rope, could lead to compression fractures of the spine, not to mention bone fractures in other areas if you fall during the activity. For every 10 percent drop in bone density, the risk of fracture increases two to three times.

A better option for most people with osteoporosis is a combination of the following:

  • Low-impact, moderate-intensity aerobic exercise: This may include walking or using an elliptical machine or stair-stepper.
  • Resistance training: This can involve using your own body weight, elastic exercise bands, or light hand weights.
  • Balance activities: This can include standing on one foot or walking heel to toe. But always have a sturdy object or grab bar within reach for safety.

Weight-bearing exercises are activities in which your bones and muscles work against the force of gravity while in an upright position. Examples include walking, dancing, hiking, jogging, and playing tennis.

These exercises are beneficial because they stimulate bone-forming cells known as osteoblasts. “Osteoblasts are activated when mechanical stress is placed on the skeleton through weight-bearing exercises, and this process can lead to bone remodeling,” says Joseph Hribick, DPT, a clinical assistant professor of physical therapy at Lebanon Valley College in Annville, Pennsylvania. This causes new bone to form, which helps preserve bone mineral density over time. “Another great benefit of weight-bearing exercises is that they also enhance muscle strength, which further supports and stabilizes the bones,” Hribick notes. “This is especially the case in the hips and spine, where fractures are most common.”

If you’ve been diagnosed with osteoporosis or previously broken a bone, check with your doctor before engaging in high-impact weight-bearing activities. More than likely, they’ll encourage you to stick to low-impact weight-bearing options instead, such as:

  • Walking
  • Low-impact aerobics
  • Tai chi
  • Using an elliptical trainer
  • Using a stair-stepper

If you are unable to walk, you can benefit just from standing up periodically.

And if you’re unable to stand, you can still get some of the benefits of weight-bearing exercises by lifting light weights while seated or doing chair calisthenics, such as leg lifts and other exercises that use your own body weight for resistance.

Resistance training, also called strength training, is crucial for challenging muscles and stimulating bone growth. A meta-analysis of studies found that doing resistance training at least three times a week improved health-related quality of life in middle-aged and older people with osteoporosis.

Examples of resistance training include:

  • Standing up and sitting down in a chair
  • Performing leg raises, squats, and toe stands while holding onto a sturdy object
  • Using resistance bands
  • Lifting free weights, such as dumbbells
  • Doing push-ups or pull-ups

Check with your doctor to see which kinds of resistance training they’d recommend for you.

Exercises that strengthen your legs, feet, and ankles and challenge your balance directly are helpful for improving balance. “These exercises enhance stability, coordination, muscle activation, and confidence in movement,” says Hribick.

Tai chi is a series of graceful movements that combines balance and weight-bearing exercise with deep breathing and meditation. While advanced levels of tai chi may include fast movements or deep lunges, beginner-level routines are done slowly. You would bend your limbs and challenge your balance as much or as little as you’d like.

Look for tai chi classes at senior centers, city recreation centers, and the YMCA. Let your instructor know you have osteoporosis before you start a class.

Some other exercises that can help build leg strength include:

  • Side and back leg raises
  • Sit and stand repetitions
  • Side lunges: Step to the side with one foot and bend that knee, then bring your feet back together and do the same move on your other side
  • Heel and toe raises: Rise up on your tiptoes, hold for five seconds, and then lower your heels and shift your weight to them, holding that position for five seconds.
  • Foot exercises: Use your toes to pick up marbles or tissues from the floor. Write the letters of the alphabet with your foot in the air. Repeat with the other foot.
  • Stationary pedaling on an exercise bike

To challenge your balance, try these ideas:

  • Shift your weight from foot to foot. Make the exercise more challenging by turning your head in the direction of the weight shift or in the opposite direction.
  • Stand on one foot, with the other foot just slightly raised off the floor. Stand on a bare floor at first, near a wall or piece of furniture you can hold onto if necessary. For more of a challenge, do the exercise on a carpeted floor.
  • Walk heel to toe along a wall or stationary bar at the gym.

No matter what activity, exercise, or sport you’re doing, certain moves can lead to fractures in weakened bones and should be avoided:

  • Stretches or exercises that involve twisting the spine or rotating the trunk, such as bowling, golf, tennis, and some Pilates and yoga moves
  • Stretches or exercises that involve rounding the spine or bending forward, such as toe touches and sit-ups
  • Exercises that put pressure on the rib cage, such as some yoga poses
  • High-impact movements, such as jumping
  • Contact sports or other activities where falling or colliding with other players is likely

“These movements can place excessive stress on the spine and increase the potential risk of fractures,” says Hribick.

If you’re unsure whether an activity or exercise is safe for your bones, ask your doctor or a physical therapist who’s familiar with osteoporosis and the challenges you face. “Then, start with lower weights and simple exercises. From there, move into heavier weights and compound lifts as comfortable,” says Griffin.

Fracturing a bone can be painful and disabling. Adopting a safety-first attitude is important when staying active with osteoporosis.

  • Exercise offers many benefits for osteoporosis: It can help strengthen bones, improve balance, and reduce the risk of falls.
  • Most people who have osteoporosis benefit from a combination of low-impact, moderate-intensity aerobic activity; resistance training; and balance activities.
  • To reduce the risk of bone fractures, avoid high-impact exercises and bending from the waist.

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