Weight lifting and osteoporosis


Living with Osteoporosis: 8 Exercises to Strengthen Your Bones

When you have osteoporosis, exercise can be an important component of strengthening your bones as well as reducing your risks for falls through balance exercise. But before you begin any exercise program, it’s important to get your doctor’s approval first. Your doctor will be able to help point you to what exercises are best for you depending on your condition, your age, and other physical constraints.

Exercises that build healthy bones

While most types of exercise are good for you, not all types are good for healthy bones. For example, weight-bearing exercises can build healthy bone. These exercises involve challenging your muscle strength against gravity and putting pressure on your bones. As a result, your bones will signal your body to produce added tissue to build stronger bones. Exercises such as walking or swimming may be beneficial to your lung and heart health but won’t necessarily help you strengthen your bones.

Anyone with osteoporosis who’s looking to increase their bone strength can benefit from the following eight exercises. These exercises are easy to do at home.

1. Foot stomps

The goal for exercise to reduce osteoporosis is to challenge the key areas of your body that osteoporosis most commonly affects, such as your hips. One way to challenge your hip bones is through foot stomps.

  • While standing, stomp your foot, imagining you are crushing an imaginary can underneath it.
  • Repeat four times on one foot, then repeat the exercise on the other foot.
  • Hold on to a railing or sturdy piece of furniture if you have difficulty maintaining your balance.

2. Bicep curls

You can perform bicep curls with either dumbbells weighing between 1 to 5 pounds or a resistance band. They can be performed seated or standing, depending on what you’re most comfortable with.

  • Take a dumbbell in each hand. Or step on a resistance band while holding an end in each hand.
  • Pull the bands or weights in toward your chest, watching the bicep muscles on the fronts of your upper arms contract.
  • Lower your arms to return to your starting position.
  • Repeat eight to 12 times. Rest and repeat for a second set, if possible.

3. Shoulder lifts

You’ll also need weights or a resistance band to perform shoulder lifts. You can do this exercise from either a standing or seated position.

  • Take a dumbbell in each hand. Or step on a resistance band while holding an end in each hand.
  • Start with your arms down and hands at your sides.
  • Slowly raise your arms out straight in front of you, but don’t lock your elbow.
  • Lift to a comfortable height, but no higher than shoulder level.
  • Repeat eight to 12 times. Rest and repeat for a second set, if possible.

4. Hamstring curls

Hamstring curls strengthen the muscles in the backs of your upper legs. You perform this exercise from a standing position. If necessary, place your hands on a piece of heavy furniture or other sturdy item to improve your balance.

  • Stand with your feet shoulder-width apart. Slightly move back your left foot until only your toes are touching the floor.
  • Contract the muscles in the back of your left leg to lift your left heel toward your buttocks.
  • Slowly control your left foot as you lower it back to its starting position.
  • Repeat the exercise between eight and 12 times. Rest, and repeat the exercise on your right leg.

5. Hip leg lifts

This exercise strengthens the muscles around your hips as well as enhances your balance. Place your hands on a piece of heavy furniture or other sturdy item to improve your balance as needed.

  • Start with your feet hip-width apart. Shift your weight to your left foot.
  • Flex your right foot and keep your right leg straight as you lift it to the side, no more than 6 inches off the ground.
  • Lower your right leg.
  • Repeat the leg lift eight to 12 times. Return to your starting position and do another set using your left leg.

6. Squats

Squats can strengthen the front of your legs as well as your buttocks. You don’t have to squat deeply for this exercise to be effective.

  • Start with your feet hip-width apart. Rest your hands lightly on a sturdy piece of furniture or counter for balance.
  • Bend at your knees to slowly squat down. Keep your back straight and lean slightly forward, feeling your legs working.
  • Squat only until your thighs are parallel to the ground.
  • Tighten your buttocks to return to a standing position.
  • Repeat this exercise eight to 12 times.

7. Ball sit

This exercise can promote balance and strengthen your abdominal muscles. It should be performed with a large exercise ball. You should also have someone with you to act as a “spotter” to help you maintain your balance.

  • Sit on the exercise ball with your feet flat on the floor.
  • Keep your back as straight as possible while you maintain your balance.
  • If you are able, hold your arms out at your sides, palms facing forward.
  • Hold the position as long as one minute, if possible. Stand and rest. Repeat the exercise up to two more times.

8. Standing on one leg

This exercise promotes greater balance.

  • With a sturdy piece of furniture nearby if you need to grab onto something, stand on one foot for one minute, if possible.
  • Repeat the balance exercise on your other leg.

Exercises to avoid

As important as it is to know what exercises can help you, it’s just as important to know which you shouldn’t do. Some activities, like hiking, jumping rope, climbing, and running, simply put too much demand on your bones and increase the risk of fractures. Known as high-impact exercises, they can place too great a strain on your spine and hips as well as increase your risk for falls. They’re best avoided unless you’ve participated in them for some time.

Exercises that involve bending forward or rotating the trunk of your body, such as situps and playing golf, also increase your risk for osteoporosis fractures.

Staying active and exercising helps to stengthen muscles and improve overall bone health.

There are two types of osteoporosis exercises that are important for building and maintaining bone density: weight-bearing and muscle-strengthening exercises.

Weight-bearing Exercises

These exercises include activities that make you move against gravity while staying upright. Weight-bearing exercises can be high-impact or low-impact.

High-impact weight-bearing exercises help build bones and keep them strong. If you have broken a bone due to osteoporosis or are at risk of breaking a bone, you may need to avoid high-impact exercises. If you’re not sure, you should check with your healthcare provider.

Examples of high-impact weight-bearing exercises are:

  • Dancing
  • Doing high-impact aerobics
  • Hiking
  • Jogging/running
  • Jumping Rope
  • Stair climbing
  • Tennis

Low-impact weight-bearing exercises can also help keep bones strong and are a safe alternative if you cannot do high-impact exercises. Examples of low-impact weight-bearing exercises are:

  • Using elliptical training machines
  • Doing low-impact aerobics
  • Using stair-step machines
  • Fast walking on a treadmill or outside

Muscle-Strengthening Exercises

These exercises include activities where you move your body, a weight or some other resistance against gravity. They are also known as resistance exercises and include:

  • Lifting weights
  • Using elastic exercise bands
  • Using weight machines
  • Lifting your own body weight
  • Functional movements, such as standing and rising up on your toes

Yoga and Pilates can also improve strength, balance and flexibility. However, certain positions may not be safe for people with osteoporosis or those at increased risk of broken bones. For example, exercises that have you bend forward may increase the chance of breaking a bone in the spine. A physical therapist should be able to help you learn which exercises are safe and appropriate for you.

Many of my clients who workout at a gym ask me what I think is the best exercise equipment for osteoporosis. They ask what type of weight lifting they should do for osteoporosis. Further, they wonder if free weight exercises are appropriate and safe for building bone strength, improving balance and strengthening muscle. I will cover each of these questions in this blog post.

A well designed weight training exercise program incorporates weight bearing exercises and strength training for osteoporosis. In other words, weight bearing and strength training is critical to building bone strength. However, certain exercises, when done improperly, can increase your risk of fracture. This advice extends to the gym as well as to home-based exercises.

In the video, I demonstrate eight weight training exercises in a gym. I show how they should be performed to maximize bone building while reducing risk of fracture. You see, technique is very important. The additional load created by these gym machines as well as the way they put you in certain positions, can be problematic. If you use exercise equipment at the gym and you have osteoporosis, I encourage you to follow the instructions I provide in this blog and the video.

In addition, I have section below dedicated to how to be careful with free weight exercises if you have osteoporosis, osteopenia or low bone density. The process of handling free weights before and after your exercises can cause issues. I wrote this section to explain how to properly handle free weights in the gym and at home.

Besides discussing the best exercise equipment for osteoporosis, later in this post I review the Total Gym and suggest alternatives.

This article was last updated on June 5, 2019

Best Exercise Equipment for Osteoporosis

In my opinion, the best exercise equipment you can use at a gym if you have osteoporosis is listed below. Note that several of these require care and modification when you use the equipment.

  • Lat Pulldown
  • Rowing Machine
  • Leg Press
  • Tricep Cable Pulldown
  • Elliptical Trainer
  • Chest Press
  • Free Weights

Weight Training and Osteoporosis Exercise — Upper Body

Here are the upper body weight training and osteoporosis exercises for the gym that I demonstrate in the video:

  1. Lat Pull Down: I demonstrate both the wide grip and reverse narrow grip lat pull down. These are excellent weight training exercises. A couple of points:
    1. First, with the lat pull down you need to pay attention to the bench height. Many times the bench height has been set higher for men and you will need to make the appropriate adjustments.
    2. Second, avoid drawing the bar down behind your neck. This is bad and can cause stress on the neck and the shoulders and can increase the amount of flexion in the back.
  2. Preacher Curl and Standing Biceps Curl: The Preacher Curl puts the spine into a compromised position and can increase flexion. This curl should be avoided. Instead I recommend the Standing Biceps Curl. The biceps curl is an effective and safer weight training exercise. In the blog post I present several variations of the bicep curl that you can make part of your program.
  3. Tricep Cable Pull Down: This is an excellent weight training exercise and a great alternative to tricep extensions on the floor or on the ball. Pay attention to your alignment, isolate the triceps and try to avoid overloading the weight.
  4. Chest Press: The chest press is an alternative to the push up and a weight bearing exercise. However, it can compromise your posture. There are a few modifications you need to be aware of:
    1. Keep your alignment.
    2. Do not let your elbows come back past your shoulders.
    3. Push forward with your arms and chest – not your abdominals.
  5. Free Weights: Free weights are a weight bearing exercise. However, you must handle the free weights with proper body mechanics.

Weight Training and Osteoporosis Exercise — Lower Body

Here are the lower body weight training and osteoporosis exercises for the gym that I demonstrate in the video. Several include upper body movement as well.

  1. Leg Press: A nice alternative to the squat and a great weight training exercise. You need to pay special attention to the seat arrangement to make sure you are not leaning forward and make sure you maintain good alignment and posture throughout the exercise.
  2. Elliptical Trainer: The elliptical trainer provides a great cardiovascular exercise workout and is an excellent weight bearing exercise. Make sure you avoid leaning forward as you hold the upright bars. Keep your posture perfect.
  3. Rowing Machine: The Rowing Machine is a great cardiovascular weight bearing exercise. I demonstrate how to set up and execute the row.

Best Exercise Equipment for a Home Gym

You do not have to go to the gym to do your weight bearing or strength training exercises. A well equipped home gym will be more than adequate. In fact, you do not need a lot of equipment.

The exercise programs in Exercise for Better Bones can be done in the comfort and privacy of your home. The exercise equipment I recommend for the home gym are:

  • Burst resistant stability (Physio) ball.
  • Dumbbells (free weights) between 5 and 20 pounds.
  • Ankle weights.
  • Non slip mat.
  • Loop bands.
  • Foam roller.
  • TheraBands.
  • Strap or rope to use in several stretching exercises.

Exercises to Avoid if You Have Osteoporosis

One further piece of reading for you is my post on osteoporosis exercises to avoid where I talk about osteoporosis exercise contraindications and how to modify unsafe exercises.

If you follow these guidelines you will improve your bone health (and overall health) while practicing safe exercise habits. For a more comprehensive osteoporosis exercise program, I encourage you to consult the MelioGuide Exercise for Better Bones program. Good luck with the gym exercises for osteoporosis!

Exercise Recommendations for Osteoporosis

Exercise is vital to bone health and osteoporosis. But what exercises should you do and which ones should you avoid?

A great resource on exercise and osteoporosis is my free, seven day email course called Exercise Recommendations for Osteoporosis. After you provide your email address, you will receive seven consecutive online educational videos on your bone health — one lesson each day. You can look at the videos at anytime.

To register for this free email course, simply click on the image of the couple or click here and provide your email address.

I cover important topics related to osteoporosis exercise including:

  • Can exercise reverse osteoporosis?
  • Stop the stoop — how to avoid kyphosis and rounded shoulders.
  • Key components of an osteoporosis exercise program.
  • Key principles of bone building.
  • Exercises you should avoid if you have osteoporosis.
  • Yoga and osteoporosis — should you practice yoga if you have osteoporosis?
  • Core strength and osteoporosis — why is core strength important if you have osteoporosis?

Free Weight Exercises for Osteoporosis

Free weight exercises can be a very effective part of any osteoporosis exercise program. In the video, I demonstrate how to safely handle free weights if you have osteoporosis. I explain how to make them an effective part of your exercise for osteoporosis program.

Safety with Free Weights

You should be careful handling your free weights. They can place a lot of strain on your spine if you do not lift safely. I find that many of my clients do not handle the free weights properly and need instruction.

One problem I find in many gyms is that quite often the free weights are stacked too low or are on the ground. Unfortunately, many people do not practice proper body mechanics when they lift or return the free weights. Below are tips on how to safely handle free weights.

Tips on How to Use Free Weights if you Have Osteoporosis

Here are a few important tips to follow if you use free weights:

  1. Be careful not to flex your spine when you return the free weights to the bench, when you stand or when you return the free weights to the ground.
  2. Your training does not end until the weights are returned to their resting position. Maintain good form throughout the program. In other words, be mindful of your body mechanics all the time.
  3. If possible, find a gym with raised benches or racks to accommodate the weights.
  4. Avoid extending your reach when you pick up or return the free weights.
  5. Move close to the bench or rack when you are at the end of the free weight training set. This will allow you to return or pick up your weights safely.
  6. Keep the weight close to your body and use your leg muscles to assist you.


I encourage you to incorporate free weights into your weight training osteoporosis program. However, pay attention to the mechanics of handling the free weights and you will enjoy many years of safe bone building.

Total Gym and Osteoporosis Exercise

A reader of this blog recently asked me the following question related to osteoporosis exercise equipment, exercise for osteoporosis at home, and specifically a popular piece of workout gear called the Total Gym:

“I am considering buying the Total Gym for my home. Do you think that it will give me the range of exercises to assist me in battling osteoporosis? Is it the best exercise equipment for osteoporosis?”

Good questions. I like the Total Gym — but I do not love it.

What I Like About the Total Gym

Things that I like about the Total Gym:

  • Easy to set up.
  • Requires limited space usage.
  • Reasonably priced
  • Well constructed (at least the older models I have seen).
  • Good range of exercise choices.

What I Do Not Like About the Total Gym

However, there are things I do not love about it. I especially do not like a number of issues in regards to Exercises for Osteoporosis:

  • For the exercises which are done lying face up on the bench you do not use your erector spinae (deep back muscles) as much as if you did the same exercise without the support or with the support of a burst resistant exercise ball.
  • Not many options for the hip.
  • The pulleys are great but they do not provide your skeleton with as much “loading” (or weight bearing) as you would get by lifting free weights.

The Total Gym YouTube channel has a number of video demonstrating the use of the device. I advise you against doing the following activities if you have osteoporosis, osteopenia or low bone density:

  • High Kneeling Singe Arm Tricep Extension
  • Surfer Lat Pull with Shoulder Extension
  • Abdominal Crunch
  • Isometric Crunch with Bicycle Legs
  • High Kneeling Torso Rotation

Several Alternative Options to the Total Gym

  • Remember, an osteoporosis exercise program that incorporates weight bearing, improves balance, reduces fracture risk and generally is beneficial to your bones does not require that you invest in expensive equipment or go to the gym.
  • The MelioGuide Exercise for Better Bones Program is designed to be self directed (or even better if used with the help of a trained health professional) and does not require much equipment.
  • If you do go to the gym, I recommend that you look at my video on 8 Gym Exercises for Osteoporosis.
  • If you really want a piece of equipment for home use, money is not an obstacle, and you favor a pulley system then I prefer the Inspire Fitness Inspire Functional Trainer FT-1 over the Total Gym because it provides many more options than the Total Gym product.
  • The Inspire Fitness Inspire Functional Trainer FT-1 costs about $2,300 (Canadian) or $2,200 (US). In Canada, you can find it a Fitness Depot. US buyers can find it on Amazon.
  • If you have any other questions related to osteoporosis exercise equipment or exercise for osteoporosis at home, feel free to post a comment below.

Osteoporosis Exercise Plan

Visit my Osteoporosis Exercise Plan page for more information on this topic.

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How to Safely Practice Strength Training With Osteoporosis

You may not think about your bone strength very often, but you should. Bone tissue is constantly being broken down and replaced throughout the first few decades of life, and as we age that process starts to slow down.

This means you lose bone mass faster than it’s created. Osteoporosis occurs when your bones start to become weak, brittle, and subject to fractures, particularly in your hips, wrists, or spine.

Treatment, and often prevention, typically involves healthy eating and regular strength training.

Aaptiv can help with that. We’ve got classes as short as 10 minutes that are easy to fit into a busy schedule.

Here’s how you can safely practice strength training with osteoporosis, and why it’s so important.

Strength training is safe for those with osteoporosis.

“Osteoporosis, a disease that results in weak, brittle bones, is a major health threat that affects 44 million Americans each year,” explains Suzanne Andrews, president of Healthwise Exercise and founder of Functional Fitness on PBS TV.

“It is referred to as the ‘silent disease’, because one out of two women over age 50, and one out of eight men, develop osteoporosis.”

Many people with osteoporosis worry that strength training is unsafe, but Andrews says this is a myth. She views strength training exercises as a “must” as long as you follow certain precautions and work with an expert who knows what they’re doing.

Strength training can be used as a way to keep bones strong, build muscle mass, and reduce the risk of injury, overall.

Research shows that strength training increases bone density and the strength and flexibility of the muscles that support your bones. It helps with better mobility and functionality in your lifestyle.

It helps improve and increase bone density.

There’s a direct and positive relationship between the effects of strength training and bone density. “Your bones react to stress you place on them, and that reaction is increased strength and cellular density,” says Andrews.

“Simply put—weights are a good stress to make your bones stronger. If you live a sedentary lifestyle, your bones get weaker, as they’re not being challenged with weight. If you exercise with weights (resistance training), your bones get stronger.”

According to Aaptiv trainer Jennifer Giamo, weight training can also reduce your risk of breaking a bone, due to an accidental fall.

Strengthen your bones with Aaptiv’s strength classes. With classes across several categories, we’ve got something for everyone.

Another thing that will help? A diet high in calcium and vitamin D—two elements important for healthy bones.

Be sure to get a bone density test.

If you’re not sure how strong your bones are, then talk to your doctor about a bone density test.

“Half of people don’t even know they have it, so if you’re 50 with back pain and/or rounded posture, you should request a bone density scan from your doctor,” advises Andrews.

“Most of my patients who I see in therapy from fractures, tell me they never had a bone density test until after they fell—only to find out they had osteoporosis.”

Stick to light weights and low-impact exercises.

Giamo says to focus on low-impact, weight-bearing exercise. This includes walking, or light aerobic training on the elliptical, treadmill, or stair climber.

Lunges and squats, in her opinion, can also improve hip and lower body bone density, and maintain the integrity of your muscles and joints.

“Dеаd lіftѕ, squats, and lungеѕ wіth dumbbеllѕ аrе аll extremely effective in toning and firming weakened leg and buttocks muscles,” says Andrews.

Aaptiv has visual guides that show you exactly how to perform each of these moves with proper form and muscle engagement.

“Nоt оnlу аrе thеу mоrе comfortable to do than dеаd lіftѕ with a bar, ѕquаtѕ аnd lunges with hand weights offer lеѕѕ ѕріnаl compression and pressure on your lower bасk. When beginning any workout routine, start оut wіth light wеіghtѕ. Allow your muscles time to stabilize under the additional stress safely. As you become stronger, slowly build up thе аmоunt of wеіght you lіft, and over time, watch your ability to do activities of daily living become easier.”

Similarly, Lauren Lobert, DPT, and lead physical therapist at APEX Physical Therapy, recommends whole body exercises in a standing position.

Add free weights or resistance bands to increase stabilization demands on your body.

This allows you to increase the level of difficulty without increasing the weight or injury risk.

Skip anything that causes pain.

Andrews warns against any rounded back movements, such as a traditional sit-up, bending sideways, or twisting. This will help minimize the risk of a fracture.

It’s also smart to focus on day-to-day functionality as a target goal, along with mindful movement, depending on your situation. Avoid targeting the areas you experience the most pain or that feel weak.

These areas usually include the hip, knees, or lower back. Instead, focus on bodyweight and functionality. After all, you carry your body with you daily so bodyweight exercises alone can improve day-to-day movement.

Train with a professional before going it alone.

As with any workout, it’s best to get an approval from your doctor before jumping right in. Then, it’s probably smart to meet with a professional trainer who can work with you one-on-one to make sure you’re using correct form.

You’ll move better and more efficiently, which will help you feel stronger faster.

Now that you know all the benefits of strength training, get started on a consistent routine today with Aaptiv.

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Here’s what you should—and shouldn’t—do to keep bones strong and avoid fractures.

If you have osteoporosis, you may worry that being active means you’re more likely to fall and break a bone. But the opposite is true. Regular exercise with a properly designed program can help prevent falls and fractures. That’s because exercise strengthens bones and muscles, and improves balance, coordination, and flexibility—all key for people with osteoporosis.

The problem is that guidelines for exercising with osteoporosis are not crystal clear. In general, “you want to do exercises that improve or maintain bone density in the way of strength or resistance training and also include impact-style aerobic exercise,” says Karen Kemmis, D.P.T., an expert for the National Osteoporosis Foundation.

But how much impact is safe? And should certain exercises always be avoided?

The answers to these common questions depend on your history of fractures and the severity of your osteoporosis, Kemmis says. “If somebody has had a fracture with no trauma or low trauma, meaning there wasn’t an obvious incident to cause it, then we have to be careful and stick with low- to no-impact exercise,” she says. (See the eight best low-impact workouts for older adults.)

On the other hand, someone who does not have severe osteoporosis and has no history of fractures or other injuries can do higher-intensity exercise. “But that doesn’t mean power lifting,” Kemmis says. It means things like brisk walking or dancing.

If you’re not sure about the severity of your osteoporosis, talk to your doctor about a bone mineral density scan or revisit the results if you’ve already had one. This test scans the most common sites of bone loss, most notably hips and spine. “We look at four segments of the lumbar spine,” Kemmis says, referring to the lower back. “It’s the only part of the spine we can assess because the ribs get in the way of the test, but we assume what’s going on with this part of the spine is also going on with the rest of the spine.”

The type of bone in the spine also tends to change more quickly with age, so osteoporosis may show up there first. “Interestingly, arthritis of the spine can give a false reading on a scan, since a bone spur from arthritis may appear as a denser part of the bone but doesn’t mean the bone is actually stronger,” Kemmis says. So be sure to notify your doctor if you have arthritis to confirm an accurate reading.

How to Choose the Right Form of Exercise

Exercising with osteoporosis means finding the safest, most enjoyable activities for you given your overall health and amount of bone loss. There’s no one-size-fits-all prescription, which is why it’s important to check with your doctor or physical therapist before you start a new workout program. That said, here are some general guidelines to follow when exercising with osteoporosis.

And if you haven’t yet, be sure to check your eligibility for free access to gyms and exercise classes nationwide through SilverSneakers. Check your eligibility and find locations here.

1. Strengthen Your Muscles

Strengthening your muscles can slow the bone loss that happens with osteoporosis and may help prevent fall-related fractures. Your workouts should revolve around functional movements, like squats, lunges, and pushups, and may incorporate free weights, exercise bands, machines, or just your own body’s weight as resistance.

Kemmis recommends lifting in a range of eight to 12 reps and making proper form your top priority. “Using even light weights with poor posture can be dangerous for someone with osteoporosis,” she says. If the back is curved in a flexed posture while a weight is lifted, it can put strain in the vertebrae, which could result in a compression fracture. If you have perfect posture, you can tolerate much more.

“The challenge is you often don’t know you’re injured until it’s too late,” Kemmis says. “Good posture, proper body mechanics, and keeping a neutral spine and not bending forward are most important.” If you’re not sure you should do a certain exercise, don’t. “You’re better to be safe than sorry.”

If you’re new to strength training, for everything you need to know to get—and stay—strong through the years.

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2. Use as Much Impact as You Can Tolerate

This rule applies to weight-bearing aerobic activities, which involve doing aerobic exercise on your feet, with your bones supporting your weight. These types of exercise work directly on the bones in your legs, hips, and lower spine to slow mineral loss. They also provide cardiovascular benefits, which boost heart and circulatory system health.

Weight-bearing aerobic exercise is an important element of your overall routine, but it’s up to you to select the appropriate amount of impact based on your health care team’s recommendations and your comfort level.

Depending on the degree of osteoporosis and baseline activity level, you might start out with low-impact exercise, like using an elliptical, says David Geier, M.D., a sports medicine physician and orthopedic surgeon in Charleston, South Carolina. “Then you can advance to higher levels of impact, like jogging, hiking, stair climbing, or aerobics classes.”

While swimming and cycling have many benefits, they don’t provide the weight-bearing load your bones need to slow mineral loss. However, if you enjoy these activities, do them. Just be sure to also add weight-bearing activity as you’re able.

Another tip: To spread the stress and impact to different parts of the body, Dr. Geier recommends cross training, or doing different types of exercises in any given week. For example, you could do the elliptical on Monday, resistance exercises on Tuesday, swimming on Wednesday, and so on.

“And always stop if pain develops and get checked out by a doctor,” Dr. Geier adds.

3. Allow Your Body Enough Time to Heal

Jogging or doing any high-impact exercise daily or nearly every day may not allow your body enough time to heal, Dr. Geier says. “You already have decreased bone density, so the repetitive stress without enough time to heal the microscopic bone damage could build up and lead to a stress fracture,” he says.

Allow at least one full day between high-impact exercise, and gradually increase the number of workouts you do each week. Again, cross training by mixing in different types of workouts helps reduce the risk of fracture.

4. Avoid Forward Bends and Twists

Yoga and Pilates are helpful for stretching and lengthening, but they also include forward-bending and twisting movements that can strain the spine. Any movement involving extreme spinal flexion, or forward bend, creates compression between the vertebrae and can trigger a “cascade of fractures,” Kemmis says. “Hinging forward at the hips is different than rounding your back and compressing the spine, which is more dangerous.”

You’ll want to avoid yoga or Pilates movements that involve bending forward or rotating the trunk:

  • Rollup, rollover, or rolling like a ball
  • Teaser or open leg rocker
  • Corkscrew or bicycle
  • Spine twist or any deep twists
  • Pigeon pose or deep hip stretches
  • Assisted stretching from teachers to increase range of motion

This doesn’t mean you can’t enjoy your favorite classes. Exercises like planks, spinal extensions (cobra pose), and balance moves (tree pose) can be safe and help improve strength. Be sure to arrive a few minutes early to talk to your instructor about your limitations. He or she will be able to provide recommendations or modifications to keep you safe—while still getting a great workout.

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Getting Started on Weight Training for Osteoporosis

How should you start weight training for osteoporosis? Focus on the back and the hip, says Don Lein, MS, PT, a physical therapist at the University of Alabama-Birmingham’s Spain Rehabilitation Center and its Osteoporosis Prevention and Treatment Clinic. Those are the areas most damaged by bone loss, and the areas most at risk from osteoporosis-related fractures.

“Good exercises include hip extension, hip abduction and adduction, and hip flexion — anything that works around the hip,” he says. “Backward bending is also good.”

Here’s one particularly good exercise:

  • Sit on a bench or chair with 5-pound weights strapped to each ankle.
  • Then “march” in place, lifting the knees alternately.

“You’re working the hip flexor muscles, which are attached to both the back and hip, which leads to improved bone and muscle mass in both areas,” explains Lein.

Here are seven other important weight training tips:

  1. Work under the supervision of a qualified, certified personal trainer, especially at first and particularly if you have any medical issues.
  2. Do strength training two to three times a week, with at least one day of rest between each session (especially if you’re working the same muscles at each session).
  3. Do one exercise for each major muscle group, for a total of eight to 12 different exercises. Do one or two sets of eight to 10 repetitions for each exercise.
  4. Lift the weight slowly; lift to a count of four and lower to a count of four, says Lein. “This decreases the likelihood of injury while helping to recruit the muscle better.”
  5. Don’t use other muscles to compensate. You should only be moving the muscle you’re supposed to be moving!
  6. Tighten abdominal muscles to help protect your spine.
  7. Periodically consult with a trainer about increasing the amount of weight you lift as you become stronger.

Strength training builds more than muscles

Most of us know that strength training (with free weights, weight machines, or resistance bands) can help build and maintain muscle mass and strength. What many of us don’t know is that strong muscles lead to strong bones. And strong bones can help minimize the risk of fracture due to osteoporosis.

A combination of age-related changes, inactivity, and inadequate nutrition conspire to gradually steal bone mass, at the rate of 1% per year after age 40. As bones grow more fragile and susceptible to fracture, they are more likely to break after even a minor fall or a far less obvious stress, such as bending over to tie a shoelace.

Osteoporosis should be a concern for all of us. An estimated eight million women and two million men in the United States have osteoporosis. It is now responsible for more than two million fractures each year, and experts expect that number will rise. Hip fractures are usually the most serious. Six out of 10 people who break a hip never fully regain their former level of independence. Even walking across a room without help may become impossible.

Numerous studies have shown that strength training can play a role in slowing bone loss, and several show it can even build bone. This is tremendously useful to help offset age-related declines in bone mass. Activities that put stress on bones can nudge bone-forming cells into action. That stress comes from the tugging and pushing on bone that occur during strength training (as well as weight-bearing aerobic exercises like walking or running). The result is stronger, denser bones.

And strength training, in particular, has bone benefits beyond those offered by aerobic weight-bearing exercise. It targets bones of the hips, spine, and wrists, which are the sites most likely to fracture. What’s more, resistance workouts — particularly those that include moves emphasizing power and balance — enhance strength and stability. That can boost confidence, encourage you to stay active, and reduce fractures another way — by cutting down on falls.

For more information on the benefits of strength training, purchaseStrength and Power Training by Harvard Medical School.

Image: iStock

As a service to our readers, Harvard Health Publishing provides access to our library of archived content. Please note the date of last review on all articles. No content on this site, regardless of date, should ever be used as a substitute for direct medical advice from your doctor or other qualified clinician.


Welcome to our continuing blog series all about the impact that Muscle Quality has on many areas of your overall health. One area which is of special concern to many of us is Osteoporosis. This article, along with our last post, Muscle Quality and Osteoporosis, aim to explain how improving Muscle Quality through strength training can improve your bone density and decrease your risk for developing Osteoporosis.

While the previous post explored what causes diminished bone mineral density and what exactly osteoporosis is, now we want to discuss solutions and things we can do to protect ourselves from the risks of losing bone mass.

Osteopenia: less bone mass

Osteoporosis: less bone mass that results in an increased risk for fracture

Fluctuations in bone mineral density can be normal to some degree. The decreased production of sex hormones, age, genetics can all be responsible for a low bone density score. Furthermore, people with lower muscular strength, lean mass and sarcopenia (age-related loss of muscle mass), are associated with and are indicators of osteoporosis. The concern, however, is not necessarily a lower bone mineral density but the increased risk for a fracture. The lifetime risk of any osteoporotic fracture is high and lies within the range of 40-50% in women and 13-22% for men. So what are we going to do about it? Might I suggest improving your muscle quality?


There are two ways in which improving muscle quality directly improves the health of the skeletal system and more importantly protects us from greater risk of fractures from osteoporosis.

  1. Increased bone mineral density
  2. Stronger muscles yield greater structural support to the skeletal system as well as greater force absorption.

First, we have the direct, measurable effect that strength training has in improving bone mineral density. We are talking specifically about improving your ‘score’ or the density of the bone on a bone mineral density test. There are various schools of thought on how activity and exercise can improve bone mineral density. Many health care professionals will have you believe walking is a great way to strengthen bones however this is NOT the case.

I think we can all agree that exercise improves bone mineral density. However, it goes back to what is our definition of exercise (see our definition of exercise in this article). All exercise is NOT created equal. Exercise has to force the body to make a positive adaptation. We at The Exercise Coach® define a positive adaptation to include increased bone mineral density which isn’t always understood by some health care professionals and personal trainers. I feel like the bad guy here but walking and other weight bearing activity like jogging does NOT stimulate bone density improvements. Dr. Nelson discusses this in her book Strong Women, Strong Bones, and the research says the same thing.

What’s more is that moderate intensity strength training where no meaningful demands are put on the musculature does NOT induce bone mineral density improvements either.

So what does work? Right Intensity Training™ of course!* The reason is because there is meaningful demand being put on the muscles. We know that as muscles become stronger and capable of generating more force the surrounding structures: tendons, ligaments, bone must also become stronger.


Exercise not only needs to induce positive adaptations but also ensure that the body is not being put at risk for injury. We are looking for the sweet spot of exercise intensity that forces positive adaptations while protecting the body from any potential injury. This is where our trademarked Right Intensity Training™ is the ideal.

This leads right into the fact that stronger muscles result in stronger structural support for our bones. Remember, osteoporosis means that the loss of bone mineral density has resulted in an increased risk of fracture. Furthermore, some may even argue that decreased bone mineral density is a natural part of aging that coincides with hormonal changes and it’s inevitable. Do we just accept our fate and go quietly into the night if thisis true? Of course not!!! So to combat that we must find ways to lower your risk for fracture.


As muscle quality improves, several factors can lead to a decreased risk for fracture. First, think of the stronger the supporting musculature the more force absorption your body can tolerate. We see this with the eccentric aspects of our training. Not only are we able to absorb more force but the increased muscle quality also works as a force-dissipating agent to protect our bones.**

Another interesting way to look at reducing your risk of fracture is to understand the structural support of the spine itself. Arthur Jones, an exercise pioneer, said if you stripped away the surrounding muscular support around the spine it would collapse beneath the weight of a can of soda. The reason it doesn’t is because of the muscle mass supporting it.** Stands to reason that it’s as pretty good idea to maximize the muscle we have if we want to prevent and reduce our risk of bone fractures.

To recap, walking, low to moderate intensity activity, and weight-bearing recreation do not and will not stimulate improvements in bone mineral density nor does it reduce your risk for osteoporotic fracture. Right Intensity Training™ and improved muscle quality is the only and best way to have a positive impact through exercise! Good thing you know where to go for that!

* See articles Effects of High-Intensity Strength Training on Multiple Risk Factors for Osteoporotic Fractures; The effects of progressive resistance training on bone density: a review.

** Dr. Doug McGuff, Body By Science, pg 107

Read the rest of this series:

Muscle Quality: Improving It Will Change Your Life

Muscle Quality and the Neurological System: Part 1

Muscle Quality and the Neurological System: Part 2

Muscle Quality and Fat Loss

Muscle Quality and “Cardio”

Muscle Quality and Cardiovascular Health

The Downside to prolonged “Cardio”

Muscle Quality and Osteoporosis

How to Combat Osteoporosis through Strength Training

Muscle Quality and Gastrointestinal Health

Muscle Quality and Inflammation

Muscle Quality and Brain Health

Muscle Quality and The Endocrine System: Part 1

Muscle Quality and The Endocrine System: Part 2

Exercise for Your Bone Health

A complete osteoporosis program

Remember, exercise is only one part of an osteoporosis prevention or treatment program. Like a diet rich in calcium and vitamin D, exercise helps strengthen bones at any age. But proper exercise and diet may not be enough to stop bone loss caused by medical conditions, menopause, or lifestyle choices such as tobacco use and excessive alcohol consumption. It is important to speak with your doctor about your bone health. Discuss whether you might be a candidate for a bone mineral density test. If you are diagnosed with low bone mass, ask what medications might help keep your bones strong.

The National Institutes of Health Osteoporosis and Related Bone Diseases ~ National Resource Center acknowledges the assistance of the National Osteoporosis Foundation in the preparation of this publication.

For your information

For updates and for any questions about any medications you are taking, please contact:

U.S. Food and Drug Administration
Toll Free: 888-INFO-FDA (888-463-6332)
Website: https://www.fda.gov

For additional information on specific medications, visit [email protected] at https://ww.accessdata.fda.gov/scripts/cder/daf. [email protected] is a searchable catalog of FDA-approved drug products.

NIH Pub. No. 18-7879-E

5 Ways to Boost the Bone-Building Power of Your Workout


Author: Katy Santiago Bowman

In an age of advanced drugs and treatments for bone loss, simple exercise programs that can prevent and restore bone density are often overlooked. The nutritional aspects of fostering bone health, like getting enough calcium, are also important. But certain ways to work out and move your body can create the weight-bearing load your bones need to get stronger.

Exercise can help even if you already have bone loss

Ten million Americans suffer from osteoporosis, and another 34 million have low bone mass and high risk for osteoporosis. If you’ve been diagnosed with osteoporosis or osteopenia (low bone density for your age, but not low enough be a risk factor for fracture), it’s important to know that it most likely hasn’t affected your bones’ ability to develop. You’ve just stopped “loading” them.

It’s also unlikely that your bone density is low in all the bones throughout your body — it’s likely centered in a few spots that you’ve neglected moving. You can begin simple weight-bearing exercises at any time, sending the message to the bone that you’d like it to start growing now!

Certain areas are more prone to bone density loss

The ribs, wrists, hips and spine are the most common places to lose bone. Let’s take the hips as an example of how these areas can become trouble zones: Your hips are designed to rotate and have a large range of motion. If you sit a lot, then they aren’t moving as much. Even if you’re walking, cycling, or even swimming, chances are you’re still only moving your hips in the same direction most of the time — in a linear pattern, straight ahead and straight behind. If you don’t move your hips in the patterns in which they were designed to move, the bone is sent the message that it doesn’t have to maintain as much density as it would need if it had to move more.

5 ways to boost your workout’s bone-building power

If you’ve been exercising regularly yet developed low bone density anyway, your movement habits need to change — but you can do it fairly easily.

1. Move your body in new ways

Choose exercises that work your body in different directions than you’re used to. If most of your workouts consist of walking, try yoga poses, dance workouts or t’ai chi once a week to add lateral movement.

2. Do weight-bearing exercise (but know what that means)

Weight-bearing is not the same as using weights! There is a lot of confusion on this point. Weight-bearing actually refers to how much of your body weight you are holding up while exercising. For example, walking would be more weight-bearing than riding a bike. And swimming is the least weight-bearing exercise, as the buoyancy of the water is doing most of the work to hold up your body.

The term “using weights” can mean any type of resistance exercise – whether it be elastic tubing, body resistance (like push-ups or yoga’s arm-balance poses), weight machines, circuit equipment, or hand-held weights. While using weights can be a great way to exercise, it is weight-bearing exercise that is critical to a bone-density-building program.

Because the skeleton’s job is to hold the entire weight of the body, lifting three, five, or even 20 pound weights is not as important to bone health as is being strong enough to carry your own body mass.

3. Favor activities that get you up on your feet to load your bones with your own body weight

Do the treadmill instead of an exercise bike for part or all of your workout. Walk the golf course instead of getting a cart. Stand up and do some stretches or knee lifts while you watch TV, rather than sitting on the couch the whole time. Stand at the sink to do your make-up rather than sitting at a make-up table.

4. Critique your gait and what’s affecting it

Often when I am developing an exercise program for someone with low bone density in the spine, I can identify habits in their gait patterns that are decreasing the loading signals to the bone. Tight calf muscles, for example, can really affect how the heel strikes the ground while you’re walking, decreasing the vibrations that move up the leg to keep the hips strong. Learn some good stretches in my Gaiam Restorative Exercise for Foot Pain DVD.

High heels (even one inch!) and excessively cushioned shoes also quiet the signal that would help build bone density in the hips and back.

5. Add balance exercises to help prevent fractures

The most significant health risk for anyone with low bone density is the risk of a fracture. Falling can definitely lead to fractures or bone breaks, so balance exercises to help prevent falls should be at the top of your exercise list! Try using a “wobble board” or inflated half-ball, or include moves that strengthen one side of your body at a time, such as one-legged squats or yoga’s Tree Pose and Warrior III.

When you start a new balance program, it may take awhile for your body to gain the muscle control and strength to keep you steady. Be safe! Start by standing on one leg while leaning against a wall or holding onto a chair, in time increments your body can handle. If you don’t have the strength or stability to stand on one leg, work on developing your muscle strength before you try to balance on one leg.

Links to Evaluations:

The Strong Bones Program includes progressive weight training, flexibility and balance activities. These exercises are safe and effective for women and men of all ages, including those who are not in perfect health.

The national web site can be found at: STRONG WOMEN STRONG BONES

People with health concerns such as arthritis, heart disease, osteoporosis, diabetes, obesity and back pain often benefit the most from an exercise program that includes lifting weights a few times each week. Currently your certified instructors are Linda Olson, Kara Skarlupka, Charlotte Schwartz, Winnie Preston, Sue True, Carol Stern, Jeanne Kaczorowski, Chris Verbeten, Sharon Buss, Sandy Schinke, Debra Bahr-Kimball, Cindy VanLannen and Debra Brandt.

Strong Bones classes meet for 1 hour twice a week all year round.

Class fees are $35.00 per quarter


  • Improves Bone Density
  • Reduces Falls
  • Improves Flexibility
  • Increases Strength

Physician Waiver Form

First Timers: https://uwex.co1.qualtrics.com/SE/?SID=SV_cYZ58uUCnZoF9RP

Repeaters of the class: https://uwex.co1.qualtrics.com/SE/?SID=SV_eM5M5OTm0M6xewR


Monday’s and Friday’s at 4:30 pm Regular Session
St. Anthony’s Church
430 Swanke Street
Tigerton, WI

Debra Brandt – Instructor

Monday’s and Friday’s at 4:30 pm Regular Session
Holy Family Church
202 N Ellms Street
Wittenberg, WI

Sally Korbisch – Instructors

None at this time – Please call the office if you would like to see a class in this area.

4:30 – 5:30 pm Tuesday and Thursday – Regular Session
Hillcrest Primary School
1410 S Waukechon St.
Shawano, WI 54166

Sharon Buss – Instructor

8:30—9:30 am Monday and Wednesday – Regular and Advanced Sessions
Zion Lutheran Church
Fellowship Hall – Lower Level
1254 S Union St, Shawano, WI 54166

Carol Stern, Sue True and Linda Olson – Instructors

For the Advanced Strong Bones Class you need to have completed the first session and be able to use 8 pounds weights

7:30—8:30 am Tuesday and Thursday – Regular and Advanced Sessions
Zion Lutheran Church
Fellowship Hall – Lower Level
1254 S Union St, Shawano, WI 54166

Kara Skarlupka – Instructor

For the Advanced Strong Bones Class you need to have completed the first session and be able to use 8 pounds weights.

7:30—8:30 am Monday and Friday
St. Paul Lutheran Church
Fellowship Hall
240 E Green Bay St, Bonduel, WI 54107

Kara Skarlupka – Instructor

4:05 pm – 5:05 Monday and Thursday
St. Francis Solanus Catholic Church
724 Mader Street, Gresham, WI 54128

Sandy Schinke – Instructor

5:15 pm – 6:15 Monday and Thursday
Peace Lutheran Church
N6315 Cty. Road D, Tilleda WI

Charlotte Schwartz – Instructor

12:00 – 1:00 pm Monday and Wednesday
Total Fitness
212 E Green Bay Street, Suite C, Shawano, WI 54166

Sue True – Instructor

3:45 pm – 4:45 pm Tuesday and Thursday
Sacred Heart Cafeteria
321 S Sawyer Street, Shawano, WI 54166

Jeanne Kaczorowski – Instructor

5:00 pm – 6:00 pm Monday and Wednesday
N8605 Oak Street, Bowler

Peggy Lempke – Instructor

At the present time you can attend the Family Center class free of charge.

4:30 pm – 5:30 pm Monday and Thursday
500 Church Lane, Hatley

Josie Pingel – Instructor
Please contact Josie at 715-446-3085 for availability. Class fee is $1.00 per session.


Clintonville Community Center
30 S Main Street, Clintonville
1:00 pm – 2:00 pm Monday and Thursday

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