Exercising with Osteoporosis: Be Safe, Be Effective

Patient Expert

Once you have osteoporosis, exercise can be tricky. Are "active" exercises dangerous? Is swimming effective? Let's find out what types of exercise are both safe and effective when osteoporosis has already weakened your bones.

When you were young, you thought nothing of climbing trees, jumping off the swing at the height of its arc, and joining a girlfriend for some double-Dutch jump rope, did you? All of those activities were excellent for your bones - while they were young, supple, and growing.

But now, declining bone mass over 10, 20, 30 or more years has put you into osteoporosis. Your doctor has read you the riot act, which boils down to this: you need to exercise, but you need to BE CAREFUL.

Be careful about what?

One of my fellow experts on this site, Lila de Tantillo, writes in Exercise for Bone Health, "DON'T try anything that could be dangerous for your level of bone health. For example, sit-ups or crunches can cause compression fractures in the spine for those with low bone mass, and an abdominal machine may be safer for some. Wall squats may be a good alternative to the leg press for those concerned about their hips. Avoid moves that are jarring, require twisting your back or involve the risk of a bad fall."

That last sentence is critical, and draws a line in the sand between those who are in full-blown osteoporosis, and those trying to prevent it.

If you don't have osteoporosis, it's good to put a certain amount of pressure on your bones in the form of impact exercises: active team sports, jogging, jumping rope, step aerobics, and the like.

But if you have osteoporosis, the last thing you want to do is stress your bones so much that they break. And the high-impact exercises cited above probably wouldn't be appropriate for you. Nor would any exercise that challenges balance, or requires you to twist your back - e.g., some forms of yoga, tai chi, Pilates, and the like.

So, what about non-impact exercises? Say, swimming, or a gentle yoga class?

Unfortunately, while these exercises definitely build muscle strength, which can help you maintain balance and prevent falls; they don't do a whole lot for your bones. Your bones require weight-bearing exercise to gain strength; and any exercise that doesn't force you to bear the full weight of your body as you perform it isn't providing much bone benefit.

So, what to do?

Low-impact weight-bearing exercises.

This type of exercise should put just enough pressure on your bones to build them up without stressing them to the point of fracture. Examples of low-impact weight-bearing exercise include the following:

-An elliptical training machine or stair-stepper: Your local gym will have both of these machines. Both qualify as weight-bearing, and both include optional handles, which you'll want to hold onto to prevent a fall.

Don't want to join a gym? Find a set of stairs, and climb it - several times a day. Remember to hold onto the banister

-Fast walking, either on a treadmill, or outdoors: While a leisurely stroll may build muscle, it doesn't help your bones. In order to make it a truly effective weight-bearing exercise, you need to put some energy into walking.

This doesn't mean you have to break into a jog; but setting the treadmill between, say, 3.0 and 3.5mph is probably a good challenge for you, and stresses your bones in a positive, low-impact way.

-Low-impact aerobics: Again, your local gym probably offers classes termed "low impact." These might include vigorous yet smooth exercise moves, ones that don't involve twisting or jumping, done in series; and fast dancing, again without any twists or jumps.

-Gardening: Yes, gardening - pulling weeds, planting bulbs and seeds, hoeing, raking, pruning, and mowing the grass all provide your bones with a certain amount of resistance, which translates to weight-bearing exercise.

-Bicycling. There's some disagreement among experts as to whether or not bicycling is a weight-bearing exercise. My opinion is, it qualifies if you do it vigorously enough.

While riding outdoors is fun, it's probably not the best idea for someone with osteoporosis, due to balance issues and the possibility of a fall. Indoor stationary bikes do the job, exercise-wise, but they're kind of boring.

Good compromise: an adult trike. Don't laugh! They're lots of fun, you get to enjoy fresh air and scenery, and a trike is virtually impossible to tip over. My 91-year-old mother-in-law rides her trike up and down the street most warm days, and it does her a world of good.

So, maybe your days of jitterbugging and competitive tennis are over. But that doesn't mean you have to become a couch potato. Get up and get going (carefully). You'll not only be helping your bones, you'll be lightening your mood as well - I guarantee it!

Note: For safety's sake, anyone with osteoporosis embarking on an exercise program or any new physical activity should consult her doctor first.