When planning out an exercise routine, most people would agree that it’s best to choose moves that give you most bang for your workout buck. It’s all about working better, not harder, right? For some, that might mean working in some burpees or fitting in a quick, 20-minute HIIT sesh. But if you have osteoporosis, a condition where the body loses too much or makes too little bone tissue, your routine may look a little different.
Contrary to what some may believe, exercise is an essential element for treating and preventing osteoporosis. 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.
Not all exercises, however, are safe or recommended for people with osteoporosis. “Some exercises that are not safe for osteoporosis increase the risk of falls and fractures,” says Joan Pagano, exercise physiologist in New York City. “It’s very important that you know how to modify exercises to make them safe for osteoporosis.” Learn more about off-limit exercises for people with osteoporosis.
So if you’re someone with osteoporosis, which moves are recommended?
According to the National Osteoporosis Foundation, there are two types of exercise that build and maintain strength and bone density: weight-bearing exercises—activities where you move against gravity, such as dancing, hiking, or stair climbing—and muscle-strengthening exercises—when you use your body or a weight as resistance against gravity.
Key Bodyweight Exercises for Osteoporosis
According to Pagano, there are four exercises that specifically target—and strengthen—areas that are vulnerable to fractures if you have osteoporosis.
“The ‘4 for life’ exercises together comprise a mini workout that you can do anytime, anyplace—no equipment required,” says Pagano. These are the “4 for life” exercises:
“If I were to give you one exercise for life, it is the squat,” says Pagano. “It is the most functional move, the one that we need to get up from a seated position, and it serves us throughout life.” That’s because the squat works three major muscles of the lower body: the glutes, quadriceps, and hamstrings.
If the classic move is difficult for you, there are many ways to do a squat. Here are three squat modifications that are effective for every body: the wall squat, the sit-to-stand squat, and the stand-to-sit squat.
Push-ups are one of the “4 for life” exercises because they target the three main muscle groups of the upper body: the chest, front of the shoulders, and triceps.
As timeless as the push-up is, let’s face it, performing one is not as easy as it looks. “If you don’t like traditional push-ups there are a [few] modifications you can do that will make them more manageable for you,” says Pagano. Here are three push-up variations that are effective for every body: the wall push-up, the kitchen counter (diagonal) push-up, and the half push-up.
3. Back extensions
The back extension is one of the “4 for life” exercises because it stimulates the muscles that run along the length of the spine. “Where spinal flexion is not advisable [for osteoporosis], a spinal extension, where you’re doing a mild back bend or arching your back, is a very good exercise for osteoporosis,” says Pagano.
There are many ways to do a back extension. If you have osteoporosis, Pagano recommends:
The supported back extension, where you’re standing, bending your back slightly with your hands in a fist at the base of your back.
Theprone back extension, where you’re lying face-down on the floor, arms bent with forearms on the floor, and you lift your head and upper back slightly off the floor.
The prone back extension with arms. This is the same as the prone back extension, except you lift your arms up along with your upper body lift.
Planks are one of the “4 for life” moves because they engage your core. “[Planks] engage the core without rounding the back,” says Pagano. “They’re a great exercise for strengthening the abdominals and the spinal muscles at the same time.”
If the classic plank is too tough for you, here are three ways to modify a plank: the wall forearm plank, the half forearm plank, and the full forearm plank.
“It’s encouraging to have so many variations of exercise available to us,” says Pagano. “So no matter what level of bone density you have, you have choices.”