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4 Rules for Safe Exercising with Osteoporosis

By Linda Melone April 08, 2020 Health and Fitness

On the list of “fun things to do,” medical tests of any kind don’t usually make the top 10. Some, however, are notoriously worse than others.

For example, I’d rather have my body cryogenically frozen until we have an alternative to colonoscopies than to go through the prep for another one. 

Bone mineral scans (a DXA test), on the other hand, are painless, require no nasty tasting gallon of prep to choke down – and don’t require prancing around in a fashionable backless paper gown.

So, when I went into my first DXA scan 10 years ago at age 50, I was in a better mood than usual for a medical appointment. 

Unexpected Diagnosis

I joked and chatted with the technician as she set me up on the scanner. “After all these years of weight training my bones must be stronger than giant redwoods,” I said, positive I’d be one of their shining examples of good health and strong bones. 

She laughingly agreed.

Her chuckles came to an abrupt halt as my test results popped up across her screen.

Her sudden silence was in such contrast to our initial festive mood, I asked the obvious question, “Well… what do you see?”

Normally, technicians tell you to wait for the doctor to explain test results, but she broke protocol and told me outright, “You have osteoporosis.” Not only that, but it was severe. 

To give you an idea of how severe… a DXA scan gives a T-score, which measures the normal bone mineral density against that of a healthy young adult and is measured in standard deviations. 

A score of 0 is the norm and scores below 0 indicate progressively lower and lower bone mass. A T-score of -2.5 or lower indicates osteoporosis.

My T-score was -3.6.

Wait, what??? How can that be? 

I’ve been lifting weights since the dawn of time, take vitamin D, and eat tons of yogurt shouldn’t that be enough to keep my bones healthy as the proverbial oxen?

My Youth Years Came Haunting

The short answer: Nope.

The long answer: Not if you had an eating disorder in your teens when your bones were still developing.


I was anorexic in my late teens, starving myself of the necessary nutrition required to build healthy bones.

By the time I came out of that self-destructive haze (which took many years), the damage was done. 

In short, my hips and spine are as fragile as a house of cards in an F5 tornado. 

Since my diagnosis, I’ve spoken to many bone experts, have been on several regimens, and I go to a specialist every two years to check my progress. 

“You will never not have osteoporosis,” my doctor tells me. “The best we can do is stop it from getting worse.” 

The bad news: No amount of weight-lifting can reverse osteoporosis. 

The good news: Some exercises can improve or maintain bone density. Others may put someone with osteoporosis at a higher risk of fractures.

Problem is, guidelines for exercising when you have osteoporosis are not crystal clear. 

However, several general rules can help you stay safe as you get fit.

Learn Perfect Form and Use Good Posture When Working Out

Lifting even light weights with poor posture can be dangerous for someone with osteoporosis. Your back can tolerate more when you work out with perfect posture than if you lift with a rounded back something you should never do.

Start Easy

Depending on the degree of osteoporosis and baseline activity level, start out with low-impact exercise, like using an elliptical. Then, if your physician approves, you can advance to higher levels of impact, such as jogging or aerobics classes.

Know the Safe Pilates and Yoga Exercises

Exercises that require you to use a rounded back increase the risk of fractures along the spine and should be avoided. This includes certain yoga and Pilates poses that create compression between the vertebrae. Tell your instructor your limitations, and they’ll provide recommendations to keep you safe. 

Examples of Pilates exercises to avoid include (see a complete list on the website):

Hundred, Rollup, Rolling, Crisscross, Teaser, Single/Double Leg Stretch, Neck Pull, Open Leg Rocker, Rollover, Corkscrew, Bicycle, Boomerang, Seal, Crab, Control Balance, Spine Twist, and others. 

Safe Pilates moves: Core control, dynamic alignment such as planks and side planks, leg strength and spinal extensions, such as cobra.

Yoga exercises to avoid: Rounding poses, deep twists, deep hip stretch such as Pigeon Pose and warrior – as well as assisted stretching from teachers to increase range of motion. 

Safe yoga poses: Balance exercises such as tree pose, dynamic alignment, leg strength, and spinal extension poses.

Include Resistance Exercises

Strengthening your muscles helps reduce fracture risk and includes lifting weights, using elastic bands, weight machines, lifting your own body weight with exercises such as push-ups.

Be sure to focus on functional movements, according to recommendations by the National Osteoporosis Foundation.

These include exercises that mimic movements you use in everyday activities, such as squats and combination exercises that involve more than one joint – squats with biceps curls, for example.

What’s the health status of your bones? Do you have osteopenia or osteoporosis? What exercises work best for you? Which of these rules were most helpful? Let’s chat below!

Disclaimer: This article is not intended to provide medical advice. Please consult with your doctor to get specific medical advice for your situation.

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The Author

Linda Melone is a Certified Strength and Conditioning Specialist, certified trainer and award-winning health and fitness writer. She recently switched careers, again, currently helping businesses with their marketing messages.

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