Osteoporosis occurs when bones lose minerals (such as calcium) more quickly than the body can replace them, leading to a loss of bone thickness (bone mass or density). As a result, bones become thinner and less dense so that even a minor bump or accident can cause serious fractures. These are known as fragility or minimal trauma fractures.

If you have been diagnosed with osteoporosis, it is important to plan an exercise program that will help maintain or improve your bone health. Exercise can help strengthen bones, improve balance and coordination, and reduce the risk of falls. However, it’s important to work with your healthcare provider and a qualified exercise professional to develop a safe and effective program.

The benefits of exercise

Exercise plays a vital role in maintaining bone health because progressive weight-bearing, resistance exercise helps to stimulate new bone growth. Exercise can also maintain muscle strength, mobility, flexibility, and balance.

Improving balance and strength reduces the risk of falls and fractures, resulting in a substantially improved quality of life.

Osteoporosis requires particular kinds of exercise. These include weight-bearing and resistance exercises such as walking and lifting weights.

Be aware that any positive gains in bone strength are lost when you stop exercising, so your exercise must be regular and ongoing.

Weight-bearing exercise

Weight-bearing exercise means any exercise that is done while you are on your feet so that gravity is exerting a force.

Your bones become stronger when they bear weight during exercise and when some amount of ‘impact’ or extra strain is placed on those bones.

If the ‘strain’ level is too low, the bone will not become more robust and may still lose mass. Too much ‘strain’ could result in injury. The best ‘strain’ is from activities that may be new to your body, which means your bones are getting a variety of forces and loads on them.

Examples of weight-bearing activities are jogging, walking, tennis, dancing, golf, and netball. Swimming and cycling are not considered weight-bearing exercises (but are good for muscle strength).

Resistance exercises (lifting weights with your arms or legs)

Resistance exercises, also called strength training, can have a good effect on the health of your bones and have been shown to reduce the number of falls in older people.

The strong muscle contractions required to move a heavy weight place stress or ‘strain’ on the bone to which the muscles are attached. When bone feels a ‘strain’ repeatedly (as in regular exercise training), it increases bone mass to become stronger.

Targeting specific muscle groups around the hip, spine and arms with weight-lifting is also a good idea.

Everyday activities do not produce enough ‘strain’ to change bone mass, so resistance exercises must be increased as the body adapts to each new level.

Recommended exercises for different stages of life

Group	Type of exercise
Healthy Adults	A variety of weight-bearing activities and progressive resistance training for at least 30 minutes, 3-5 times per week. AVOID prolonged periods of inactivity.
Post-menopausal women and middle-aged men	Varied exercise regime – include moderate to high impact weight-bearing exercise and high intensity progressive resistance training, at least 3 times per week. Tip: specific ‘spinal extension’ resistance training during middle-age has been shown to reduce spinal fractures.
Older adults and people at risk of osteoporosis	Participation in varied and supervised exercise programs is encouraged. These include weight-bearing activities, progressive resistance training and challenging balance and functional activities, at least 3 times per week.
Frail and elderly	A combination of progressive resistance training and balance exercises is recommended to reduce falls and risk factors for frailty (which may include muscle wasting, poor balance, fear of falling).
Osteoporosis*	A combination of weight-bearing exercise with supervised progressive resistance training and challenging balance and mobility exercises, at least 3 times per week.
Osteoporosis – after a fracture has occurred	Exercise is an important part of rehabilitation, and a program will normally be planned and supervised by a physiotherapist. Exercises will be determined by the type of fracture and the patient’s age and level of physical function. Resistance training has been shown to be effective following hip fracture.

*Moderate to high-impact activities are only recommended for people with osteoporosis who do not have a previous fracture (s) or lower limb arthritis. Consult your doctor and physiotherapist for advice.

Arthritis & Osteoporosis WA runs exercise classes specifically designed for people with osteoporosis.

A physiotherapist leads the program, specifically for people diagnosed with osteoporosis or who have experienced a “first low trauma” fracture. The classes cater for people with all levels of mobility, including those with more complex medical conditions who may not be able to exercise in a regular gym.

To view our Osteoporosis Exercise classes, visit our website for more details: https://www.arthritiswa.org.au/services/exercise/