The Importance of Exercise to Help Treat Osteopenia and Osteoporosis

Weight bearing and strengthening exercises are important for people with osteopenia or osteoporosis. Although exercise can’t reverse bone loss, it may slow bone loss and help prevent a bone fracture.

osteopenia osteoporosis exercises

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:

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]

RECOMMENDED FOR YOU

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)

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Chris Iliades, MD

Chris Iliades has an MD degree and 15 years of experience as a freelance writer. Based in Boothbay Harbor, Maine, his byline has appeared regularly on many health and medicine … Read More

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  • QUESTION FROM OSTEOPOROSIS COMMUNITY

    I was told to maintain a good exercise program with osteoporosis. I was told good, strong weight-bearing exercise will actually grow bone. However, many of the exercises I’ve researched require bent toes and subsequent stress on the foot bones. Complicating things: Having diabetic Neuropathy in my feet. That pretty much precludes my being able to run or walk for an extended period of time. Does anyone else in the community have a similar problem? What solutions are you finding efficient? The bottom-line question: How does someone with osteoporosis start and maintain both weight bearing and aerobic conditioning?

  • QUESTION FROM OSTEOPOROSIS COMMUNITY
    I am a 61-year-old woman who has advanced osteoporosis. I have had a femoral neck fracture in 2013, which healed without surgery on its own. I just saw a Naturopathic doctor yesterday. I have been lifting weights for almost two years. I am highly interested in advice on how to build bone through weight lifting. I am also highly interested in the supplement route. The ND just put me on Genistene….I build muscle quickly – one of the only genetic blessings I have! Thank you so much! This is exciting!

  • In addition to the great advisories above, I recently had the following recommended to me via my exercise instructor (who will also order this equipment) for stressless weight lifting to aid in bone growth and density:
    Bodylastics set ($124) from Amazon.com.
    I intend to order this set also; I look forward to keeping myself motivated each day and enjoying the exercising as well.
    Total body exercise has been part of my routine for approximately two years with general exercise in the years prior; I have experienced 2-3 setbacks this year. I can never let anything keep me from developing the strength and health I need to make my life happier and stronger.
    Whatever our age and attitude, we can always be younger, stronger, looking forward to every day. Always check with your health care provider first. Best wishes.

  • I can’t think of a worse exercise for a person with osteoporosis than the straight leg exercises recommended in this article. The forces placed across the vertebral bodies and femoral head and neck are huge with a SLR. These exercises are absolutely contraindicated and have resulted in many fractures.

  • The exercise shown is very hard on the lumbar spine, especially if hands are not placed under the sacral area to even out the spine. Many who have kyphosis, may attempt this exercise and can develop lower back issues. Better moves would be using bands of varying tensions and doing bridges (lifting hips up toward the sky, with band around the quads just above the knee) or clams (lying on side, band around the quads just above the knee, open and close the top knee like a clam- keep hip bones stacked vertically (perpendicular to the floor).

  • I recently discovered after a stress fracture, that running is not recommended for those of us with osteopenia or osteoporosis. Seems that it’s “new” news. The Mayo Clinic advises against running and even hiking – https://www.mayoclinic.org/diseases-conditions/osteoporosis/in-depth/osteoporosis/art-20044989. I also found a conflicting article from Mayo too – https://www.mayoclinic.org/diseases-conditions/osteoporosis/in-depth/osteoporosis/art-20044989?p=1 This is confusing. Another source says avoid running as well – https://ageless-nutrition.com/staying-active-with-osteoporosis/ I’m confused. I’ve been a runner all my lie, I’m only 50 and don’t want to give up running or doing triathlons. Help!!!

  • I have osteopenia. My MD sent me to a university qualified exercise physiologist who coached me on a set of low-impact exercises to improve my bone mass. . Skipping, jump up onto a step and down repeatedly, bounce a 2kg weight ball of a wall and catch it & walking or jogging on sand or grass. Swimming & cycling are good for heart & lungs, but do little for building bone. Hope this helps some.

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