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.

By Mayo Clinic Staff

Osteoporosis is a major cause of disability in older women. A bone-weakening disorder, osteoporosis often results in fractures in the hip and spine — which can severely impair your mobility and independence.

How can you reduce your risk of these life-altering injuries? Exercise can help.

Certain types of exercise strengthen muscles and bones, while other types are designed to improve your balance — which can help prevent falls.

Benefits of exercise

It’s never too late to start exercising. For postmenopausal women, regular physical activity can:

  • Increase your muscle strength
  • Improve your balance
  • Decrease your risk of bone fracture
  • Maintain or improve your posture
  • Relieve or decrease pain

Exercising if you have 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.

Before you start

Consult your doctor 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
  • Flexibility exercises
  • Stability and balance exercises

Because of the varying degrees of osteoporosis and the risk of fracture, you might be discouraged from doing certain exercises. Ask your doctor or physical therapist whether you’re at risk of osteoporosis-related problems, and find out what exercises are appropriate for you.

Strength training

Strength training includes the use of free weights, resistance bands or your own body weight to strengthen all major muscle groups, especially spinal muscles important for posture. Resistance training can also help maintain bone density.

If you use weight machines, take care not to twist your spine while performing exercises or adjusting the machines.

Resistance training should be tailored to your ability and tolerance, especially if you have pain. A physical therapist or personal trainer with experience working with people with osteoporosis can help you develop strength-training routines. Proper form and technique are crucial to prevent injury and get the most from your 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 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.

It’s important that aerobic activities, as beneficial as they are for your overall health, are not the whole of your exercise program. 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 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.

Flexibility exercises

Moving your joints through their full range of motion helps you keep your muscles working well. Stretches are best performed after your muscles are warmed up — at the end of your exercise session, for example, or after a 10-minute warm-up. They should be done gently and slowly, without bouncing.

Avoid stretches that flex your spine or cause you to bend at the waist. Ask your doctor which stretching exercises are best for you.

Stability and balance exercises

Fall prevention is especially important for people with osteoporosis. Stability and balance exercises help your muscles work together in a way that keeps you more stable and less likely to fall. Simple exercises such as standing on one leg or movement-based exercises such as tai chi can improve your stability and balance.

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 engage in somewhat higher-impact exercise than can someone who is frail.
  • Bending and twisting. Exercises in which you bend forward at the waist and twist your waist, such as touching your toes or doing sit-ups, can increase your risk of compression fractures in your spine if you have osteoporosis. 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 doctor. Don’t let fear of 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.