Weight bearing and strengthening exercise can increase bone health at any age.

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Osteopenia and osteoporosis are both diseases of bone loss. Bone is living tissue that is constantly being lost and replaced. After about age 35, more bone is being lost than replaced. That is one of those facts of life we all have to live with. However, exercise can reduce bone loss at any age. [1]

Can Exercise Prevent Osteopenia or Osteoporosis?

Osteopenia is weak bones, osteoporosis is weaker bones. The word “osteoporosis” actually  means porous bone. Although everyone loses some bone density as they age, not everyone gets osteopenia or osteoporosis. Osteopenia affects about 50 percent of people over age 50. [2] Osteoporosis affects over 44 million Americans. [3]

Why some people get osteopenia or osteoporosis and others don’t is not known. You may be at increased risk for both conditions if you don’t get enough weight bearing exercise over your lifetime. Weight bearing exercise is any exercise that you do with your feet touching the ground. Other risk factors are smoking, drinking alcohol, and not getting enough vitamin D or calcium in your diet. [1,3]

Doing about 30 minutes of weight bearing exercise on most days of the week before you reach your peak bone density at around age 35 is the best way to reduce your risk of osteopenia or osteoporosis—it’s like putting more bone in the bank. There is no guarantee that this will prevent either disease, but it may reduce the risk. [1]

Why Exercise for Osteopenia?

Like osteoporosis, osteopenia is diagnosed with a bone density test. Exercise can’t reverse osteopenia bone loss but it may slow it down enough to prevent going on to osteoporosis. Although there are medications you can take for osteopenia, for most people the first treatments are exercise and nutrition, adding vitamin D and calcium to your diet for bone health. [1]

Why Exercise for Osteoporosis?

Exercise won’t reverse osteoporosis but it may slow down bone loss and reduce your risk of a fracture. Fractures are the biggest risk of living with osteoporosis. The most common fractures are in the hip and spine. These fractures can significantly reduce quality of life. [3,4]

Since 50 percent of osteoporosis fractures are caused by a fall, it is important to include bone strengthening exercises along with muscle strengthening exercises and exercise for balance and flexibility. Balance and flexibility do not affect bone health, but they do help prevent falls. [3,4]

Osteopenia and osteoporosis are both diseases of bone loss. Bone is living tissue that is constantly being lost and replaced. After about age 35, more bone is being lost than replaced. That is one of those facts of life we all have to live with. However, exercise can reduce bone loss at any age. [1]

What Exercises Are Best for Osteopenia?

The best exercise program depends on your fitness and health. If you are over 40 or have any health conditions, ask your doctor what exercise level is safe for you and have a physical therapist or exercise specialist design an exercise plan for you. The most important exercises for osteopenia are weight bearing and strengthening. These are the only exercises that actually help build bone and slow bone loss. Strengthening exercises include:

• Lifting weights
• Using elastic exercise bands
• Using weight machines
• Doing push-ups or pull-ups [4-6]

Weight bearing exercises for osteopenia may include low impact or high impact. High impact exercise includes dancing, high-impact aerobics, jogging, stair climbing, and running sports. [4-6]

What Exercises Are Best for Osteoporosis?

There is no one-size-fits-all exercise program for osteoporosis. What is safe and best for you depends on your age, fitness, and the severity of your osteoporosis. Let your doctor and an  exercise therapist design an exercise program to fit your needs. [4-6]

Some exercises may increase you risk for a spine fracture, so you want to avoid any exercise that includes a lot of twisting or bending. High impact exercises that may be OK for osteopenia should be avoided if you have osteoporosis. Balance and flexibility exercises become more important for fall prevention. Your program should probably include:

• Strength training, especially for your upper back
• Low impact weight bearing
• Flexibility exercises
• Stability and balance exercises [4-6]

Any strength training exercises should be tailored to your risk and ability. The best weight bearing exercises include walking and low impact aerobics. An elliptical training machine or a treadmill are indoor low-impact options. [4-6]

Flexibility exercises are stretching and range of motion exercises. These exercises also need to be prescribed by an expert, since you need to avoid stress and bouncing. It is also important to include a proper warm-up period. Stability exercises should be designed for your ability and safety. A tai chi class has been shown to be helpful for some people. [4-6]

The Bottom Line on Exercise for Osteopenia & Osteoporosis

There is no way to reverse bone loss or prevent osteopenia or osteoporosis. Weight bearing and strengthening exercise can increase bone health at any age. There is no best exercise program for everyone with osteopenia or osteoporosis. Avoid picking an exercise program on your own. Talk to your health care provider or work with a physical therapist or trainer.

The best exercise program depends on your fitness and health. If you are over 40 or have any health conditions, ask your doctor what exercise level is safe for you and have a physical therapist or exercise specialist design an exercise plan for you. The most important exercises for osteopenia are weight bearing and strengthening. These are the only exercises that actually help build bone and slow bone loss. Strengthening exercises include:

• Lifting weights
• Using elastic exercise bands
• Using weight machines
• Doing push-ups or pull-ups [4-6]

Weight bearing exercises for osteopenia may include low impact or high impact. High impact exercise includes dancing, high-impact aerobics, jogging, stair climbing, and running sports. [4-6]

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• Bone Density Test: What Your Osteoporosis T-Score Means for Your Bone Health
• Vitamin K Supplement: Which Type is Best for Osteopenia and Osteoporosis Treatment?
• Osteoporosis Guidelines: When Should I Get My First DEXA Scan?

SOURCES

1. AAOS, Osteoporosis Prevention – OrthoInfo – AAOS
2. Harvard Health, Osteopenia: When you have weak bones, but not osteoporosis – Harvard Health
3. AAOS, Osteoporosis – OrthoInfo – AAOS
4. NIH, Exercise for Your Bone Health | NIH Osteoporosis and Related Bone Diseases National Resource Center
5. Mayo Clinic, Exercising with osteoporosis: Stay active the safe way – Mayo Clinic
6. National Osteoporosis foundation, Osteoporosis Exercise for Strong Bones – National Osteoporosis Foundation (nof.org)