How Exercise Physiology Helps with Osteoporosis
Osteoporosis is a bone disease that occurs when bone mineral density (BMD) or bone mass decreases. It is often referred to as a “silent disease” as it won’t present with obvious symptoms until a fracture occurs. Another way that Osteoporosis is often detected is by screening and performing bone density scans, also known as a DEXA (dual-energy X-ray absorptiometry) scan which uses low dose X-rays to determine the amount of bone mineral in your bones eg in the hip and spine.
The rate of bone mineral decline accelerates with ageing, typically after peak bone mass is achieved. The age where our bone mass is highest is typically achieved between the ages of 25-30 years. Prevention is always better than cure and this is why physical activity is so highly encouraged early on in life as establishing healthy exercise habits in your youth not only helps to establish a higher bone mineral density baseline but also peak functional capacity.
A great visualisation of this concept of how bone mass decreases with age and the gender differences between this rate loss is demonstrated in the figure below.
The rate of bone mass decline is further accelerated in women during menopause and is therefore why women tend to be at a higher risk of falls.
The facts aren’t grim - The good news is that Exercise Physiology helps with Osteoporosis by strengthening the bones, reducing the risk of fractures and improving your overall wellbeing. Exercise Physiology uses evidence based approaches to provide a safe and effective way to manage your Osteoporosis and prevent it from getting worse. Research has found that the rate of bone mass loss can be slowed down through appropriate bone strengthening exercises and exercise programming to keep you staying active for longer. Osteoporosis doesn’t have to be feared and can be managed through exercise physiology.
What is Osteoporosis
Osteoporosis is a disease where there is a decrease in amount and thickness of bone causing them to become weak and brittle. The hip, spine and wrist are commonly fractured areas in people with osteoporosis who have had a fall.
Osteoporosis affects over 1.2 million Australians and 1 in 3 women and 1 in 5 men over the age of 50 will experience an osteoporotic fracture in their lifetime (Osteoporosis Australia, 2023). Although this statistic may seem grim, a 2022 systematic review in the Journal of Bone and Mineral Research found that resistance training significantly increased BMD in postmenopausal women.
Since exercise Intervention helps with Osteoporosis, Exercise Physiology is therefore a very important treatment tool, particularly for females approaching menopause as the figure above demonstrates, that following menopause, the rate of bone mineral density loss is rapid. Exercise physiology before this stage would be extremely beneficial to slow the progression of this loss.
Risk Factors for Osteoporosis
The likelihood of developing osteoporosis is increased by the presence and number of the following key risk factors, some of which are modifiable, meaning you have control over it.
Non-Modifiable Risk Factors
-
Age: Risk increases with age (especially post-menopause for women).
-
Sex: Women are at higher risk, particularly postmenopausal women due to estrogen decline.
-
Family History: Genetic makeup for low bone density or fractures.
-
Body Frame Size: Small body frames have less bone mass
Modifiable Risk Factors
-
Physical Inactivity: Lack of weight-bearing exercise weakens bones.
-
Poor Nutrition:
-
Low calcium and vitamin D intake
-
Excessive alcohol and caffeine consumption
-
-
Smoking: Decreases bone mass.
-
Low Body Weight: BMI <18.5 increases risk.
-
Medications: Long-term corticosteroids, anticonvulsants, SSRIs, etc.
-
Medical Conditions: Hyperthyroidism, celiac disease, chronic kidney/liver disease.
What is Exercise Physiology for Osteoporosis?
Exercise physiology for osteoporosis focuses on using exercise principles and activity to help strengthen bones and reduce the risk of fractures. It uses scientific knowledge about the body—like how our bones, muscles, and joints work—to design safe, effective exercise programs. These programs are specially tailored for people with low bone density or those at risk of developing osteoporosis, helping to prevent, manage, or slow the condition’s progression.
While general fitness instructors and activity is fantastic for maintaining overall health, clinical exercise prescription for osteoporosis goes much deeper - specific exercises for bone density works.
Exercise physiology for osteoporosis is customised, medically-informed, and carefully designed to meet the specific needs of people with fragile bones—ensuring safety while maximising the benefits of movement.
How Exercise Physiology helps with Osteoporosis.
The way in which Exercise Physiology helps with Osteoporosis has a lot to do with the way Accredited Exercise Physiologists (AEP) will design personalised exercise programs that take into consideration your condition, exercise history, current capacity, goals and other factors to ensure safe, effective and evidence based exercises are prescribed for your maximum benefit.
An Exercise physiology program for osteoporosis designed by an AEP will include weight-bearing, resistance training for osteoporosis and fall prevention exercises. Evidence highlights that high impact and progressive resistance training can significantly improve BMD in the spine and hips as these exercises stimulate bone forming cells, known as Osteoblasts and improving BMD can reduce the risk of Osteoporotic Fractures. A study from 2021 known as ‘The LIFTMOR study demonstrated that supervised, high-intensity resistance training is safe and effective for improving bone health in older adults with low BMD.
Resistance training is a key element in every osteoporosis management plan developed by an AEP. Exercise physiology for osteoporosis is guided by Wolff’s Law, which states that bone adapts to the stress placed upon it. By applying targeted load through resistance exercises, the program stimulates bone growth and strengthens both bone and muscle—providing essential support to protect and stabilise the skeletal system.
AEPs will also incorporate balance, posture and functional movement training to target proprioception and help reduce falls risk as well as improve confidence in day to day activities like climbing the stairs. Research by Exercise & Sports Science Australia showed how AEP-guided programs reduced falls by 23% and improved quality of life outcomes in older adults with osteoporosis.
Although Osteoporosis is asymptomatic and does not cause pain, the benefits of Exercise Physiology is numerous, helping mobility, reducing joint stiffness and promoting stronger bodies to navigate life.
Exercise Physiology helps Osteoporosis by:
✅ Building Bone Strength
✅ Improving Balance and Coordination
✅ Reducing Pain and Stiffness
✅ Enhancing Muscle Strength
Our Osteoporosis Program at
Stay Active Longer
Optimal Bone Health Through Movement
-
Initial Assessment: Review bone health history, DEXA scan results (if applicable), posture, mobility, risk factors, current functional capacity
-
Individualised Program: Tailored exercise prescription with progression tracking
-
Supervised Sessions within a fully equipped Gym setting with an Accredited Exercise Physiologist.
-
Safe access to high end Gym Equipment.
-
Education & Lifestyle Advice: Nutrition, fall prevention, daily movement strategies
EPC/Chronic Disease Management Plans are accepted and can be obtained by your GP for Medicare rebate.*
Effective Bone Strengthening Exercises.
1. Weight-Bearing Exercises:
-
Walking, stair climbing, light jogging, dancing, Zumba
-
Moderate to high impact is more effective (if safe)
-
Improves bone stimulation in hips and legs
2. Resistance Training:
-
Free weights, resistance bands, machines
-
2-3x a week, focusing on major muscle groups
-
Increases bone density and muscular strength
3. Balance and Posture Training:
-
Tai chi, functional movement drills, proprioception exercises
-
Reduces fall risk
-
Postural Strengthening to reduce kyphosis and risk of vertebral fractures.
4. Flexibility Work:
-
Gentle stretching to maintain joint mobility and prevent stiffness
Key Considerations for Osteoporosis Exercise Programming:
-
Overload: Progressive increase in mechanical load helps improve bone density.
-
Site-Specificity: Exercises target areas most at risk (e.g., hips, spine, wrists).
-
SAID Principle: Specific Adaptation to Imposed Demands — bone will strengthen in response to specific types of stress.
FAQS about Osteoporosis and exercise
Can exercise reverse osteoporosis?
Exercise is one of the most powerful non-drug treatments for managing osteoporosis. While it won’t fully reverse osteoporosis, it plays a crucial role in preserving independence, preventing further bone loss, and improving quality of life.
Is it safe to lift weights if I have low bone density?
Yes - lifting weights is actually encouraged if you have low bone density as it is one of the best ways to build stronger bones - however there are a few safety tips when lifting weights with osteoporosis.
What are the safety tips when lifting weights with osteoporosis?
-
Focus on slow, controlled movements
-
Prioritize proper form and technique over heavy weights.
-
Start with low to moderate resistance and progress gradually.
-
Target key areas prone to fractures: hips, spine, wrists.
What are some bone strengthening exercises for osteoporosis?
Wall squats or sit-to-stand
Step-ups
Resistance band rows
Dumbbell Shoulder presses
Heel raises (calf raises)