Exercising with osteoporosis: Stay active the safe way

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.