Osteoporosis Exercise & Physiotherapy Adelaide – Build Stronger Bones, Strength & Confidence

If you have recently been diagnosed with osteoporosis or osteopenia, you may have been told that exercise is important.

But what type of exercise should you actually be doing?

Is walking enough? Can you lift weights? Should you be jumping? How heavy should you lift? And are there exercises you should avoid?

These are common questions, and the answer isn't simply to "exercise more".

For exercise to effectively support bone health, it needs to provide the right type and level of stimulus while taking into consideration your bone health, fracture risk, strength, balance, previous injuries, medical history and current exercise capacity.

At Body Fit Physiotherapy in North Adelaide, our Osteoporosis Exercise Program is designed to help people with osteoporosis or osteopenia exercise safely and progressively.

Our goal is to help you develop the strength, balance and physical capacity needed to support your bone health and remain active and independent.

What Is Osteoporosis?

Osteoporosis is a condition where bones become less strong and more susceptible to fracture.

Osteopenia describes bone density that is lower than expected but has not reached the diagnostic threshold for osteoporosis.

Osteoporosis itself often doesn't cause symptoms until a fracture occurs. This is why maintaining bone strength and reducing fracture risk are important parts of long-term management.

Common sites for osteoporotic fractures include the:

Hip
Spine
Wrist
Upper arm

Bone density is only one part of fracture risk.

Your muscle strength, balance, falls risk, previous fractures, age, medications, medical history and physical capacity can also influence your overall risk.

This is one reason osteoporosis management should look beyond a bone density number alone.

Why Is Exercise Important for Osteoporosis?

Bone is living tissue that responds to the loads placed upon it.

However, not every form of exercise provides the same stimulus to bone.

Exercise programs designed for people with osteoporosis should generally incorporate several components:

Progressive resistance training
Appropriate weight-bearing and impact exercise
Balance training
General physical activity and conditioning

The type and intensity of these exercises should then be individualised according to the person.

The goal isn't simply to keep moving.

We want to provide an appropriate stimulus to bone, muscle and balance while managing your individual fracture and injury risk.

What Are the Best Exercises for Osteoporosis?

There isn't one single exercise that is best for osteoporosis.

A well-designed osteoporosis exercise program generally combines several different forms of exercise.

1. Progressive Strength Training

Strength training is one of the most important components of exercise for osteoporosis.

Exercises may include movements such as:

Squats
Sit-to-stands
Step-ups
Deadlift variations
Leg press
Rowing exercises
Upper-body pushing and pulling exercises including overhead press
Calf strengthening

The specific exercise is less important than selecting movements that are appropriate for you and then progressively increasing the challenge over time.

This principle is known as progressive overload.

If an exercise program never becomes more challenging, the stimulus provided to your muscles and bones may eventually become insufficient to produce further adaptation.

For this reason, osteoporosis exercise shouldn't necessarily remain at the level of very light weights indefinitely.

Where appropriate, resistance needs to be progressively increased as your strength and confidence improve.

How Heavy Should You Lift With Osteoporosis?

This is one of the most common questions we are asked.

There isn't one weight that is appropriate for everyone with osteoporosis.

Your starting point should depend on factors such as:

Your current strength
Previous exercise experience
Bone density
Previous fractures
Vertebral fracture history
Pain
Other medical conditions
Movement technique
Overall fracture risk

Someone who has trained with weights for many years may have a very different starting point from someone who has never performed resistance training.

Rather than selecting an arbitrary "safe" weight and staying there forever, the aim is to find an appropriate starting point and progressively increase resistance as your capacity improves.

This is one reason assessment and individual exercise prescription can be useful when beginning strength training with osteoporosis.

What Is Impact Exercise and Why Is It Important?

Impact exercise refers to activities where forces are transmitted through your bones when your body contacts the ground.

Depending on the individual, this may progress through activities such as:

Firm heel drops or stomping
Stepping activities
Hopping
Jumping
Landing exercises
Multidirectional impact activities

Impact exercise can provide a different stimulus to bone than traditional strength training.

However, impact exercise is not appropriate at the same level for everyone.

Someone who is relatively young, strong and has osteopenia with no history of fracture may tolerate a very different program from someone with severe osteoporosis, previous vertebral fractures, significant balance problems or multiple medical conditions.

Our approach is therefore to determine whether impact exercise is appropriate and, when it is, establish a suitable starting point and progression.

Is Walking Enough for Osteoporosis?

Walking is excellent exercise.

It supports cardiovascular health, mobility, general fitness and provides some weight-bearing activity.

But walking alone is unlikely to provide all of the stimulus we are looking for in an osteoporosis exercise program.

Walking doesn't usually provide the same progressive muscular loading as resistance training or the same bone-loading stimulus that appropriately prescribed impact exercise can provide.

This doesn't mean you should stop walking.

Instead, walking can form one part of a broader exercise program that also includes appropriate strength, impact and balance training.

Why Does Balance Matter if Osteoporosis Is a Bone Condition?

Improving bone strength is only one part of reducing fracture risk.

We also need to consider why many fractures occur in the first place.

Falls are an important contributor to fractures in older adults.

For this reason, balance training can be an important component of an osteoporosis exercise program, particularly if someone has experienced falls, near falls or increasing unsteadiness.

Balance training may involve progressively challenging:

Your base of support
Visual input
Proprioception
Movement and stepping
Reaction time
Dynamic balance

The goal is to improve your ability to maintain and recover your balance during everyday activities.

Can You Exercise Safely With Osteoporosis?

For most people with osteoporosis, avoiding exercise altogether is not the answer.

Instead, exercise should be appropriately selected and progressed.

The type of exercise that's suitable depends heavily on your individual circumstances.

Additional consideration may be required if you have:

A previous vertebral fracture
Multiple previous fractures
Significant spinal changes
Very low bone density
Significant balance difficulties
A recent fracture
Persistent pain
Other medical conditions affecting exercise

In these situations, your program may need to start differently and progress more gradually.

The objective is not to make exercise unnecessarily restrictive.

It is to find the appropriate balance between providing enough stimulus to create adaptation while managing risk appropriately.

Are There Exercises You Should Avoid With Osteoporosis?

People diagnosed with osteoporosis are sometimes given long lists of activities they should never perform.

We prefer a more individualised approach.

Whether an exercise is appropriate depends on factors such as your fracture history, technique, strength, experience and overall fracture risk.

Particular consideration may be required around loaded, rapid or repeated end-range spinal flexion and rotation, especially in people with vertebral osteoporosis or a history of vertebral fracture.

However, this doesn't mean everyone with osteoporosis needs to become fearful of bending, lifting or movement.

Learning appropriate movement strategies and progressively building physical capacity can be more useful than simply avoiding activity.

What Happens During an Osteoporosis Physiotherapy Assessment?

Our first step is understanding you, rather than simply giving you a generic osteoporosis exercise sheet.

1. Understanding Your Bone Health

We review relevant information including your osteoporosis or osteopenia diagnosis, bone density results where available, fracture history, medical conditions and current management.

We also want to understand your previous exercise experience and what you currently feel confident doing.

2. Understanding Your Goals

Different people come to us for very different reasons.

You may want to:

Start strength training for the first time
Learn how to exercise safely with osteoporosis
Improve your bone health
Reduce your falls risk
Return to the gym
Increase your strength
Improve your balance
Continue running or playing sport
Maintain independence as you get older

Your program should reflect what you're actually trying to achieve.

3. Measuring Your Strength and Physical Capacity

Where appropriate, we establish baseline measures of strength and functional capacity.

This helps us identify areas that may benefit from improvement and gives us objective measures that can be reassessed over time.

4. Assessing Your Balance

If balance or falls risk is relevant, we can assess different components of your balance and determine whether targeted balance training should form part of your program.

5. Developing Your Individualised Exercise Program

We then develop an exercise program based on the findings from your assessment.

Depending on your needs, this may incorporate:

Progressive resistance training
Weight-bearing exercise
Impact exercise
Balance training
Functional strengthening
Cardiovascular exercise
Education around movement and lifting

Most importantly, the program isn't designed to remain static.

As your strength and physical capacity improve, your exercises should be reviewed and progressed.

Why Progression Matters

One of the most important principles in osteoporosis exercise is progression.

Your body adapts to exercise.

An exercise that is challenging when you begin may become relatively easy several weeks or months later.

That's a good thing – it means you've adapted.

But it also means your program may need to progress.

This might involve:

Increasing resistance
Changing the exercise
Increasing movement difficulty
Progressing impact
Increasing balance challenge
Adding speed or power where appropriate

Our goal is to continually find an appropriate level of challenge rather than simply giving you the same exercises indefinitely.

Who Is Our Osteoporosis Exercise Program For?

Our program may be appropriate if you:

Have recently been diagnosed with osteoporosis
Have been diagnosed with osteopenia
Have been told to begin strength training
Are unsure which exercises are safe
Want to start lifting weights
Want to introduce impact exercise
Have experienced a previous fragility fracture
Have become concerned about your balance
Want to reduce your risk of falls
Want a structured exercise program rather than generic advice
Already exercise but want to ensure your program appropriately targets bone health

You don't need to wait until osteoporosis becomes severe before starting appropriate exercise.

People with osteopenia or other risk factors for declining bone health may also benefit from establishing an appropriate strength and exercise program earlier.

What Does the Research Say About Exercise for Osteoporosis?

Current Australian osteoporosis guidance recommends a combination of progressive resistance training, weight-bearing impact exercise and challenging balance training as part of exercise aimed at reducing fracture risk.

Resistance training should provide enough challenge to stimulate adaptation and should be progressively increased as capacity improves.

Impact exercise can provide an important stimulus to bone but needs to be appropriate for the individual's fracture risk and physical capacity.

Balance training is also important because reducing falls risk is an important component of reducing fracture risk.

For people who are frail, have significant osteoporosis or have a high risk of vertebral fracture, exercise may need to be modified and supervised.

This is why the most appropriate osteoporosis program isn't necessarily the same for everyone.

Frequently Asked Questions About Osteoporosis Exercise

Can strength training help osteoporosis?

Progressive resistance training is an important component of current exercise recommendations for osteoporosis. It helps improve muscle strength and, when appropriately prescribed, can contribute to the mechanical loading required to support bone health.

Can I lift weights if I have osteoporosis?

Many people with osteoporosis can perform resistance training. The appropriate exercises, starting resistance and progression depend on your fracture risk, previous fractures, exercise experience, technique and general health.

Is walking enough for osteoporosis?

Walking has many health benefits and provides weight-bearing activity, but it generally shouldn't replace progressive resistance, appropriate impact and balance training in a comprehensive osteoporosis exercise program.

Should I do impact exercise if I have osteoporosis?

Impact exercise may be beneficial for bone health, but the appropriate level varies considerably between individuals. Previous fractures, bone health, strength, balance and general physical capacity should be considered before deciding where to start.

Can exercise increase bone density?

Certain types of appropriately prescribed resistance and impact exercise can provide an osteogenic stimulus and may help maintain or improve bone mineral density. Results vary between individuals, and exercise also provides important benefits beyond bone density, including improved strength, balance and physical function.

What if I have had a vertebral fracture?

A history of vertebral fracture changes how some exercises may need to be prescribed. Exercise can still be important, but assessment and an individualised program are particularly valuable in this situation.

Is osteoporosis exercise only for older women?

No. Although osteoporosis becomes increasingly common after menopause, osteoporosis also affects men and can occur at younger ages depending on individual risk factors and medical history.

How often should I strength train with osteoporosis?

Current Australian guidance recommends progressive resistance training at least twice per week. Your individual program may differ depending on your capacity, goals and other exercise.

Do I need to stop bending or lifting if I have osteoporosis?

Not necessarily. Generic restrictions aren't appropriate for everyone. Your fracture history, spinal health, technique, load and individual risk should be considered. Learning appropriate movement strategies and developing strength can be an important part of maintaining independence.

Osteoporosis Exercise & Physiotherapy in Adelaide

Body Fit Physiotherapy provides individualised osteoporosis and osteopenia exercise programs from our clinic in North Adelaide.

Our approach is based around understanding your current physical capacity and developing a program that provides an appropriate level of challenge.

Depending on your needs, your program may include progressive strength training, impact exercise, balance training and general conditioning.

We can then reassess and progress your program as your strength, confidence and physical capacity improve.

Our aim isn't simply to give you a list of osteoporosis exercises.

We want to help you understand what you're doing, why you're doing it and how your program needs to progress over time.

Learn More About Osteoporosis & Exercise

We've developed a growing library of physiotherapy resources answering common questions about osteoporosis, bone health and exercise.

Osteoporosis and Exercise: Why Strength Training Is One of the Most Powerful Medicines for Your Bones

Over 50 - what you need to do to thrive as you age

Take the Next Step

If you've been diagnosed with osteoporosis or osteopenia and aren't sure how to exercise appropriately, an individual assessment can help establish where to start.

At Body Fit Physiotherapy, we can assess your current strength, balance, exercise experience and physical capacity and develop a program around your individual needs.

Osteoporosis Exercise & Physiotherapy Adelaide
Body Fit Physiotherapy – North Adelaide, South Australia

If you'd like to find out whether our Osteoporosis Exercise Program is appropriate for you, contact our team or book an initial assessment.

Book to Improve Your Bone Health