Almost 12% of Canadians aged 40 and older have an increased risk of developing osteoporosis, which is associated with low bone mass and structural bone tissue deterioration. Fragility increases the risk of fractures in areas such as the hips, spine, and wrists, causing significant difficulties with mobility, independence, and activities of daily living. Regular exercise  provides potent benefits for those with osteoporosis, helping to increase bone strength, muscle function, balance, and coordination. All necessary elements for minimizing fracture risk.

Exercising when you have osteoporosis must be done safely and correctly to prevent injury. This article discusses why safe exercises for seniors with osteoporosis is indispensable, explores safe and effective movement alternatives, and offers advice to older adults on integrating osteoporosis-safe exercises into their lives.

Understanding the Role of Exercise in Osteoporosis Prevention and Management

Bone is a living tissue that is  continuously remodeling. Old bone is broken down and replaced with new tissue. Typically, from childhood through early adulthood bone building happens at a faster rate than breakdown, and bone density increases.  In adulthood, these processes happen at about the same rate, which maintains bone density. As women hit menopause, and men move into older adulthood bone break down takes place at a higher rate than bone rebuilding. This leads to a decrease in bone density, which can lead to a higher risk of fractures, but intervention can help mitigate this age related bone loss. 

Weight-bearing and muscle-strengthening exercise help combat age related bone density loss by stimulating bone building cells. 
Exercise helps slows bone loss and it reduces the risk of fractures by improving balance and overall function. 

Exercise enhances joint function, posture, and coordination. Building muscle strength provides essential support and stability. Improved balance further reduces the risk of falls, the leading cause of fractures among older adults. A balanced, appropriately planned exercise regimen is a vital component of osteoporosis management.

Key Principles for Safe Exercising with Osteoporosis in Seniors

There are considerations for exercising with low bone density or osteoporosis. Some movements need to be modified, limited or avoided completely, while other key movements should be prioritized. 

Some guidelines to follow - remember that guidelines are generalizations and for advice more specific to your circumstances you need to consult with your health care providers (Doctor, Physiotherapist) 

• Exercises involving sudden twisting, forward bending (rounding through the spine), or high-impact jumping should be avoided, as they can increase the risk of fractures, particularly vertebral compression fractures.
  
  
  
  
  
• Progress gradually: strengthening exercises should feel challenging but you should be able to do them while breathing and maintaining good technique. If you have to contort yourself, grip through your neck, or hold your breath you might need to decrease the number of reps, or the amount of resistance. 
  • Start small, and build up - in terms of how frequently, how long, reps, and resistance you use. 
  • When the exercises feel easy, it's time to increase the challenge to keep things improving! 

• Keep your posture in mind: proper alignment during your exercises helps make sure that the intended muscles are being targeted.
  
• For bone health prioritize: strengthening exercises, postural exercises, and balance
  
  
• If an exercise doesn’t feel right or causes discomfort, talk to your physiotherapist. They can help ensure you are performing it correctly or suggest alternative exercises better suited to your needs.

• Work with a BoneFit™️ trained clinician: working with ap Physiotherapist or Kinesiologist who understands osteoporosis and exercise will ensure your exercise program is suited to your needs and performed with proper technique. What applies to one individual may be unsafe for another. Your Physiotherapist or Kinesiologist can help create, progress and modify your program to meet your needs. 
  
  

Best Low-Impact Exercises for Seniors with Osteoporosis

Low-impact exercises are safe and help seniors stay active and fit, but are not the primary way to build bone density.

These exercises improve cardiovascular health, balance, coordination, and muscle function —essential for overall well-being and fall prevention.

Low-impact activities like walking remain a safe and effective way for older adults to stay active, improve heart health, build muscle strength, and maintain steady movement.

• Tai Chi: A slow, controlled exercise that enhances balance, body awareness, and coordination, helping reduce fall risk.
• Dancing: Controlled movements that improve coordination and contribute to muscle health.
• Step Exercises: Target key leg muscles with a low step to safely enhance strength.
• Using support aids like trekking poles during walks can add stability and variety to aerobic sessions.

Strengthening and Resistance Training

Weight bearing and resistance training exercises help support bone density. Stronger muscles also enhance general functional capacity.
Resistance training is imperative for bone health. 

Resistance training can include:

• Resistance Bands: These stretchy bands facilitate controlled muscle building.
• Free Weights: Dumbbells or wrist weights build upper and lower body strength.
  
• Body Weight Exercises: Exercises like wall push-ups, chair stands, or leg lifts are a great way to improve strength without equipment.
  
  
  
  

Core strengthening exercises are important and should be included in your program, but many common core exercises involve spinal flexion (rounding forward).

There are many safe and effective ways to strengthen your core or trunk without involving forward bending (spinal flexion). Maintaining a neutral spine during core exercises is important to avoid placing undue stress on vertebrae. Working with a physiotherapist can help create a personalized core strengthening program that is both safe and suited to your osteoporosis needs.

Resistance training should be done two to three times a week, working all major muscle groups with rest days in between. The exercises should feel challenging, but you should still be able to complete them with good technique. A good general guideline is that if you are doing a set of 10 reps, the last 3 reps should feel tiring but possible. 

Our team of Physiotherapists and Kinesiologists can help you develop a program and progress it as you get stronger. 

Balance and Stability Exercises

Balance exercises decrease falls and prevent fractures. The latest World Guidelines for Falls Prevention and Manangement suggest accumulating 150 minutes of exercises that challenge your balance every week. 

Some ways to work on your balance:

• Single-leg Stands: Hold on to a stable surface and practice standing on one leg.
• Heel-to-Toe Walks: Walking with the heel directly in front of the toe tests balance.
• Tai Chi and Yoga: Both enhance strength, balance, and movement awareness, promoting better posture and stability. However, yoga for individuals with osteoporosis certain poses involving deep spinal flexion (rounding the back) and/or twisting may need to be avoided or modified. It is essential to seek guidance from a qualified instructor familiar with osteoporosis to ensure safe practice.
  
  

If you're feeling unsteady, and trying balance exercises on your own doesn't feel safe, working with a Physiotherapist or Kinesiologist is a great way to be safe and challenge your balance. 

Incorporating balance exercises into daily activities is a great way to make sure they get done! For examples: stand on one foot while brushing your teeth, or walk heel-to-toe in a straight line to build balance.

Regular daily practice of balance exercises can significantly reduce the risk of falls.

For safety and to ensure the exercises are appropriate for your ability, it is best to have these exercises prescribed or supervised by a Physiotherapist familiar with osteoporosis

Mobility Matters: Support Your Bones and Joints

Balance and strengthening exercises aren't the only important elements to preventing falls and managing osteoporosis. Staying mobile is important too! 

• Spinal Extension Stretches: These encourage upright posture and support spinal alignment. 
• Chest Opening Stretches: Reverse the tendency of forward hunching and help relieve stress on spinal discs. 
• Hamstring and Calf Stretches: Boost lower limb mobility and support balance.
• Neck and Shoulder Rolls: Ease tension and relieve strain in the upper body.

Suggestions for Integrating Safe Exercises into Everyday Routine

• Begin Slowly: if you're not already exercising, adding 5–10 minutes of regular exercise is beneficial and easily incrementable.
• Establish a routine that works for you: schedule specific times for exercise or weave short bouts of activity throughout your day to make it easier to stay consistent and enjoy variety.
• Use Support:Using chairs, walls, or rails when learning new movements, particularly ones that challenge your balance, can be helpful. 
• Stay Hydrated and Warm Up: Preparation is the key to preventing injury.
• Consult Healthcare Professionals: Talk to your Doctor and Physiotherapist about your specific needs 
• Combining daily activity with targeted exercise can significantly improve quality of life and bone strength.

Common Myths Surrounding Exercise and Osteoporosis

Myth: Exercise will lead to fractures in individuals with osteoporosis.

Fact: Exercise, when properly designed and monitored, can strengthen muscles and bones and lower the risk of fractures.

Myth: Bone building occurs only with high-impact exercise.

Fact: While high-impact exercises may stimulate bone density more directly, low-impact resistance training is effective for building muscle strength, which helps reduce the risk of falls, the leading cause of fractures in older adults. Improving strength and stability is a crucial goal in preventing fractures associated with osteoporosis.

Myth: You're too old to exercise if you have osteoporosis.

Fact: It's never too late; even modest exercise can enhance bone health and outcomes. No matter how old you are, exercise is crucial for health and function! 

How Physiotherapy Assists Safe Osteoporosis Exercises

Physiotherapists offer professional expertise in evaluating individual needs, creating safe exercise programs, teaching proper technique, and tracking progress. They will also take into consideration other health conditions, diagnosis, injury or pain point you may be dealing with. 

At Fit For Life Physiotherapy in Burlington, ON, our therapists customize osteoporosis-friendly programs including strength, balance, mobility and flexibility training. We instruct body mechanics and safe movement techniques necessary for injury prevention and self-care mastery.

Conclusion

Exercise, when undertaken with caution and expert advice, is an effective tool to control osteoporosis in older people. Commit to the inclusion of safe osteoporosis exercises in your life. Consult with healthcare providers, especially physiotherapists, to guarantee proper and practical exercises. With regular, properly designed movement, osteoporosis does not need to be a limiting factor to living well in your golden years.

If you're looking for individualized guidance, book in with one of our BoneFit ™️ trained clinicians. 

Resources:

Hadjidakis, D. J., & Androulakis, I. I. (2006). Bone remodeling. Annals of the New York Academy of Sciences, 1092(1), 385-396. https://doi.org/10.1196/annals.1365.035

Public Health Agency of Canada. (2020). Osteoporosis-related fractures in Canada: Surveillance report. Government of Canada.https://www.canada.ca/en/public-health/services/publications/diseases-conditions/osteoporosis-related-fractures-2020.html