Pilates For Osteoporosis: Exercises To Avoid & Help Osteoporosis
The 20th of October sees the advent of World Osteoporosis day. To coincide with it, Complete Pilates have been publishing a series of posts on the subject, including why women need to strength train and look after your bones: world osteoporosis day 2018.
Exercise can be a confusing area for people with Osteoporosis or Osteopenia. They may be told that they need to be cautious to prevent fractures and told to avoid certain movements or heavy lifting. At the same time, they are also told that keeping fit is essential for staying healthy. Understandably, these mixed messages can put these groups off exercise.
This is bad news. As a health professional, I know how much a sedentary life can negatively impact people with low bone density. At the same time, I also know how much the right sort of exercise can benefit sufferers. It’s why I’m here – to demystify exercise for those suffering with these conditions and get them moving again with these tips on how to exercise safely with Osteoporosis.
How Can Exercise Help Prevent Osteoporosis?
Bones respond to loading. This means that they will adapt to what we are asking them to do. This is vital in people under the age of 30 when our bone density is still increasing.
We tend to get to the peak of our bone density around the age of 30 and it then starts to decline. Before then, the biggest time for change in our bones is during our teenager years when our skeleton is fully developing. This is the time when we can make the most gains in terms of bone density. It is this bone density that we need to build up to prevent fragility and breaks when we are older.
All of this means ‘paying in to the bone bank’ needs to happen from a young age. It’s why the NOS (the National Society of Osteoporosis) are campaigning this year to tell the under 30s about bone health.
For this younger age group, the most important type of exercise is going to be anything that loads your bones. This includes impact exercise such as running, tennis, dancing, football, netball, gymnastics, weights. Basically, anything where you are putting weight bearing load through your bones is a good idea.
These kinds of exercises stimulate the bones to develop and increase in density as they respond to the forces being put through them. They respond best to a variety of loading, so a mixture of sports using upper and lower body is best. Get your teenagers out and exercising as much as possible to look after their bones later in life!
Exercises For Bone Health Later In Life
So, what exercise can we do later in life when we are no longer building up our bone bank?
Weight-bearing and loading is still important. Although it won’t increase our density, it can slow the loss of bone density and maintain it for longer. This is in turn will reduce the risk of breaking a bone. So, all the impact exercises mentioned above are still recommended. The only time we stop recommending higher impact exercise is if someone has a high risk of breaking a bone with significantly reduced bone density. We then need to ensure that they are not going to do more damage than good with weighted or high-impact exercise.
Why Is Exercise Important For Older People With Osteoporosis?
It’s vital to have strength and balance as we age. These factors are even more important if we have low bone density.
Why? Well, it may seem simple, but if we have strong muscles supporting our skeleton and good balance so that we don’t fall over then we will significantly reduce the risk of breaking a bone.
This is where Pilates can be really useful. Obviously, Pilates is not an impact exercise – but it does give you strength and control of your skeleton and improves your balance. Pilates does not have to be performed lying down. There are many movements which are done in standing to challenge our strength and balance improving our function in daily activities.
The other benefit of Pilates is that we can focus on strengthening your ‘anti-gravity’ muscles down the back of your body. These are the muscles that help to keep you upright and balanced.
We can also work on safely maintaining the mobility, flexibility and good alignment of your spine without putting it at risk. Good posture puts less pressure on the skeleton, which is a good thing for Osteoporosis sufferers. And it also has other benefits; according to research, better posture later in life gives us a better quality of life!
Related reading: Pilates for seniors
Which Exercises Should Be Avoided With Osteoporosis?
If you have Osteoporosis there are certain movements which you need to avoid during exercise to reduce the risk to your spine. These are anything that involves forward bending of the spine and particularly forward bending against weight or gravity. Traditional Pilates that has not been adapted for Osteoporosis can include these moves. This means you need to ensure your instructor knows about your diagnosis and is trained in teaching and modifying movements for it.
If you have a diagnosis of Osteoporosis, your main focus should be on working on your strength and balance. You should avoid forwards bending of the spine in exercise (and daily life) to reduce the risk to your vertebrae. It is always advisable to consult with an exercise specialist, like a Physiotherapist or Clinical Pilates Instructor, who specialises in Osteoporosis to get the best individual advice.
What Our Experts Say
Osteoporosis should not be a reason to stop exercising. The greater risk often comes from becoming inactive and losing strength, balance and confidence. Clinical Pilates can be particularly useful because exercises can be easily adapted to the person’s needs and fracture risk.
4 Pilates Exercises To Boost Bone Health
Below are 4 exercises that are ideal for you to do if you have low bone density or Osteoporosis. They will challenge your strength and balance. These exercises are safe, provided you are pain-free and mobile.
You should aim to do these at least three times a week to feel the difference. For balance, it is best to challenge it as much as possible every day. This can be included in your daily routine, for instance, can you stand on one leg whilst you brush your teeth or walk down the corridor as if you were on a balance beam? Every little challenge makes a difference to your body, your balance and your bones!
1. Standing Footwork
This challenges your balance, coordination and strength in your anti-gravity muscles
Start by standing tall. Then, push the hips back into a small squat. From here, lift onto the heels pressing the ball of the foot into the floor. Finally, straighten the knees and then lower the heels. Repeat x 15
2. Scooter
This exercise challenges your balance and strength through the spine and hips.
3. Press Ups
This gives you weight bearing through your arms and wrists and strengthens the triceps, this can help to reduce the risk of wrist fractures.
Come into all fours with your hands under the shoulders and the knees under the hips. Lean forward as you bend the elbows along the line of your body so that you feel your upper arms working as your chest lowers and then lifts again. Aim to maintain your spine in the same posture throughout. Repeat x 15
4. Dart
Like this spine extension exercise, this move works the strength down the back of your body to keep your spine upright, protect the spinal bones and help with balance.
Start by lying on your front. If it’s comfortable, rest your forehead on a small folded towel. Arms are by your side.
Now, imagine that your body is being stretched as tall as possible from the crown of your head down to your tailbone. Roll the shoulders back to open up the collar bones and hover the hands. Next, allow the head and chest up to come off the floor – this will work the upper back. Remember: you shouldn’t feel any pain or strain in the lower back. Slowly lower back down and repeat x 10
Key Takeaways
- Weight-bearing, resistance and impact exercise are important for building bone density when young and helping slow bone loss later in life.
- For people with osteoporosis, improving strength and balance can reduce falls and lower the risk of fractures.
- Pilates can support bone health by strengthening postural muscles, improving balance and maintaining safe spinal alignment.
- Exercises should be adapted to the individual’s bone density, fracture risk, mobility and medical history.
- People with osteoporosis should generally avoid repeated or loaded forward bending of the spine unless specifically advised by a qualified healthcare professional.
Conclusion
Exercise remains essential for people with osteoporosis or osteopenia, but it needs to be appropriate for the individual. Weight-bearing and resistance exercise help maintain bone strength, while Pilates can improve posture, balance, muscle strength and confidence in everyday movement. With suitable modifications and professional guidance, staying active can help reduce falls, protect the spine and support long-term independence.
Feeling Inspired
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Education is key
These blogs are designed to give information to everyone, however, it is important to remember that everyone is different! If you have not seen one of our therapists and have any questions about injuries, what you have read or whether this may be useful to you, please just ask. We are more than happy to help anyone and point you in the right direction. Our biggest belief is that education is key. The more you understand about your injury, illness and movement, the more you are likely to improve.
If you are not sure whether this is for you, simply get in touch. We are here to help!
FAQs
Is Pilates safe for osteoporosis?
Yes, Pilates can be safe and beneficial for people with osteoporosis. It can improve posture, strength, balance and movement control, but the instructor should understand the condition and modify exercises appropriately. There is a risk and reward weighted to every exercise you do, so it is important to choose those that will give you the biggest reward, not just today, but also in the long run.
Which Pilates exercises should be avoided with osteoporosis?
Exercises involving repeated, forceful or loaded spinal flexion should generally be avoided. This may include traditional roll-ups, rolling exercises, deep forward bends and movements combining spinal flexion with rotation. Doing very large end of range motion exercises also needs to be moderated.
Can Pilates increase bone density?
Pilates alone is unlikely to produce large increases in bone density because it is usually low impact. However, it can support bone health by improving strength, balance and posture, particularly when combined with resistance and weight-bearing exercise. It can also help reduce your risk of falls, which in turn will help prevent fractures.
What is the best exercise for osteoporosis?
The most effective programmes usually combine resistance training, weight-bearing activity, balance exercises and posture work. The appropriate intensity depends on bone density, previous fractures, fitness and individual risk factors.
How often should someone with osteoporosis exercise?
Strength and weight-bearing exercises are generally recommended several times per week, while balance activities can be practised daily. A healthcare professional or osteoporosis-trained exercise specialist can provide personalised guidance.
Published 18 Oct 2018 · Updated 22 Jul 2026