4 Rules for Exercising Safely with Osteoporosis

Don’t let fear of fractures keep you from having a healthy fitness routine.

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If you have osteoporosis—a condition where the body loses too much or makes too little bone tissue—the thought of getting regular exercise may seem out of reach, frightening, or counterintuitive. Lift weights? No way, I’ll break a bone!

In fact, one of the biggest myths about osteoporosis is that skipping out on exercise will help keep your bones healthy and intact. Having a regular fitness routine is actually one of the most important things you can do to prevent and treat osteoporosis. (Learn more about how exercise is essential for osteoporosis here.)

Even though exercise with osteoporosis only modestly affects your bone mineral density, it has a huge effect on strength, flexibility, and balance—all of which keep you upright and sturdy. This can help prevent falls and potentially life-threatening fractures.

While not all exercises are safe for people with osteoporosis, there are a lot of moves that are. “There are many safe exercises that you can do with osteoporosis ... that will keep your bones strong, and [help you] keep your balance and posture strong as well” says Joan Pagano, an exercise physiologist in New York City.

So what does a safe fitness routine for osteoporosis look like? Here are four essential rules to live by when exercising for osteoporosis:

RULE #1. Keep your health care provider in the loop.

To ensure you’re working your body safely and effectively, it’s important to know what areas of your body have been affected by osteoporosis by getting a bone density test. “Is it in your spine? Is it in your hip? Is it in your wrist? That will inform an exercise program,” says Pagano.

For example, if you have osteoporosis in your spine, you’ll want to find a modification for any exercises that require a rounding of the spine, such as toe touches. (Here are more off-limit exercises for people with osteoporosis—and what to do instead.)

You may also consider consulting with an exercise specialist to learn how to progress in your exercise program safely (i.e., when and how much to increase weights), stretch and strengthen your muscles, and correct poor posture. They can also help you find the best workouts for you based on your bone mineral density results.

RULE #2. Warm up and cool down before and after every workout.

“It’s important when you’re exercising to [start] every workout with a little warm-up,” says Pagano. A warm-up is any light activity—such as walking or stretching—that gets your blood pumping and prepares your muscles and joints for more intense activity, she says. “If you don’t [warm up], you could injure yourself.”

When your workout is coming to an end, it’s also important to cool down. “Cooling down is important so that you ease yourself out of an exercise session,” says Pagano. This can help you avoid any dizziness from stopping too quickly.

RULE #3. Start slowly and work your way up.

If you’re exercising at a higher intensity than your body is ready for, it can create a jarring effect to the skeleton, which may actually injure your bones, says Pagano.

When beginning a new exercise routine with osteoporosis, start with light weights and a few repetitions, and build up from there. “You need to have a gradual progression as you increase your weights and only go to a level that is comfortable for your joints,” says Pagano. “We need to protect the joints as much as we need to protect the bones.”

RULE #4. Listen to your body.

Listening to your body means tuning in so you get to know your body and the signals it’s sending, says Pagano.

When starting an exercise routine, you may have some muscle soreness and discomfort, but it shouldn’t be seriously painful or last more than 48 hours. “If you start experiencing pain in any part of your body, you may be doing an exercise that’s not good for you,” says Pagano.

If you have any pain or discomfort, see your doctor or exercise physiologist before your next exercise session.

“If you get a diagnosis of osteoporosis, it can be quite daunting and even scary, but please know that there are many exercises that you can benefit from that will improve your health,” says Pagano.