Monday, October 18, 2021

Exercises to Tackle Osteoporosis

With age, bone weakness is something most of us worry about. Dr. Varun Shanbhag lists some exercises that can help

Osteoporosis, which literally means ‘porous bone’, is a condition characterized by brittle or weak bone structure. The body constantly absorbs and replaces bone tissue in normal individuals. However, in osteoporotic individuals, this process is slowed down leading to more bone absorption and less bone creation, which leads to brittle or delicate bones.

Certain factors predispose the occurrence of osteoporosis like steroid medication, autoimmune disorders, etc. It occurs most commonly in postmenopausal women (low oestrogen levels) and males having low androgen levels. Thus, people who are more than 60 years of age are at high risk of suffering from this disorder.

Clinically they show symptoms like back pain, hip pain, generalized body pain caused due to fracture/compression of the bone/spine because of brittle bone structure. Along with medications and nutrient supplementation, the proper type of exercise is recommended to tackle osteoporosis effectively.

The typical approach to the patient with osteoporosis depends on T-score on the Bone Mineral Density chart (determines the severity and extent of osteoporosis).

Weight-Bearing Exercises

Common types of exercise recommended for osteoporotic patients are weight-bearing exercises. In weight-bearing exercises, a person utilizes his own body weight and performs the exercises. As mentioned earlier, bone formation-destruction is a continuous process and when an individual performs bodyweight exercises, there is a stimulation to bone creation process by way of stimulation of osteocytes (bone-forming cells).

Weight-bearing exercises are divided into two types: Low Impact and High Impact

Low Impact Exercises: They have proven to be the safest form of exercise for osteoporosis patients which involves the highest frequency and lower intensity of exercises.

Eg – Elliptical training machines, brisk walks, step up machines, low-intensity aerobics.

High Impact Exercises: They are to be preferably performed under the guidance of an expert and after due discussion with the doctor/physiotherapist. If there has been a history of bone break/fracture, one needs to avoid these forms of exercise.

Eg – Dancing, hiking, jogging, jumping rope, stair climbing, sports activity.

Resistance Training

Training with weights is recommended to increase the muscle and, consequently, bone strength. It can be done as a progression to weight-bearing exercises. An individual moves his body weight or other heavy objects against gravity.

Eg – Weight-lifting, elastic band exercises, body weight lifting (squats, push-ups) functional movements (marching movements).


Posture Guidance

An individual should be careful about the posture while performing exercises in standing or any alternate postures as the wrong posture increase the load incidence on bone and may lead to fracture.

Eg – A very wide stance while performing squats can lead to pressure on femur bone leading to its fracture.


Balance training exercises, when incorporated with other exercise programs, can help improve postural control and balance which would prevent falls and bone damage.

Eg – Tai Chi, parallel bar gait training, balance board exercises (supported by the therapist).

Non-Weight Bearing Exercises

Non-weight bearing exercises like swimming are allowed but not highly recommended, as lack of body weight pressure leads to less bone stimulation/bone formation.

Overall, exercises, when done properly and under the guidance of an experienced physiotherapist, can help the patient to recover faster from osteoporosis and its associated ailments, along with proper diet, medication, and supplementation.

Dr Varun Shanbhag
Dr Varun Shanbhag is a consultant rehabilitation physiotherapist and director of Exercise Klinic in Mumbai.

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