Exercise and Osteoporosis: Which Exercises are Safe and Which Ones to Avoid

Exercise is an important part of healthy aging. It can improve your strength and balance, slow bone loss, and prevent falls. But if you have osteoporosis, you’ve got to take extra care with your body. Choosing safe exercises can help you get the benefits of exercise while minimizing the risks. It’s especially important to take care to exercise safely if you have severe osteoporosis or have had osteoporosis-related fractures. 

What is osteoporosis?

Osteoporosis is a disease that causes weak bones. It literally means “porous bone.” Normally, our bones are in a constant state of remodeling: Old bone is broken down, and new bone is made in its place. When this process is out of balance and bone is broken down faster than it’s made, the result is osteoporosis.

What is the danger with osteoporosis?

Osteoporosis does not have any symptoms, which means it can progress without anyone knowing about it. This is why it’s often called a “silent” condition. This is an issue because people with osteoporosis have a much higher risk of fractures, or broken bones. With osteoporosis, fractures can happen from a simple fall from standing height — or sometimes from no trauma at all — because the bones are so weak. 

The most common fractures from osteoporosis occur in the hip, spine, and wrist. These fractures are troubling, but not just because they cause pain and loss of mobility. Osteoporosis-related fractures are linked to depression, more fractures, and even a higher risk of death. Almost 30% of people with a hip fracture die within 1 year. 

Because of these risks, preventing falls and preserving bone strength in people with osteoporosis is critical. Exercise and medication can help. 

How does exercise help with osteoporosis?

To put it simply, exercise is good for bone health. But it must be done safely — especially for people with osteoporosis — to avoid injury. 

Exercise is an important element of osteoporosis treatment and prevention because it slows down bone loss. According to the World Health Organization, exercising while young “ helps maximize the mineral density of bones while they are still growing and maturing.” And exercising as you age “minimizes bone loss later in life.”

In addition to its benefits on bone health, exercise can:

• Improve balance

• Prevent falls

• Build strength

• Improve overall health

Is it safe to exercise if you have osteoporosis?

Yes, it is safe to exercise with osteoporosis. But it depends on the type of exercise. Because “exercise” is a broad term describing many types of physical activity, it will be discussed in different categories. The good news is, many different types of exercise are recommended and safe for people with osteoporosis, like:

• Balance training 

• Postural training

• Progressive resistance and strength training 

• Stretching

• Weight-bearing aerobic activities

Remember, it’s always a good idea to consult with a physician before starting a new exercise program.

What’s the best form of exercise if you have osteoporosis?

There isn’t a “best” exercise for osteoporosis. Experts recommend doing a combination of exercises. While aerobic activity is important, it should not be the only form of exercise that people with osteoporosis do.

Weight-bearing and resistance exercises are the most important for bone health. And balance training is recommended for fall prevention. These three categories are discussed below. 

Weight-bearing exercise

Weight-bearing exercise requires you to stand and move against gravity. It relies on you moving your body weight. Weight-bearing exercise helps promote bone cell growth. The weight-bearing exercises that are best for you will depend on your strength, balance, and physical fitness. Some weight-bearing exercise include:

• Walking

• Yoga

• Stair climbing

• Dancing

Strength training

Strength training involves exercising against resistance. Strength training builds muscle, which supports your bones. Strength training can also help you keep the bone mass that you already have. To do strength training, you can use:

• Free weights (dumbbells)

• Weight machines

• Resistance bands

• Exercise machines

Balance exercises

Balance exercises can help prevent fractures by reducing the risk of a fall. There are many forms of balance exercises. Choose the ones that best fit your lifestyle. Some balance exercises to consider are:

• Yoga

• Tai chi

• Bike riding

• Stair climbing

• Pilates

• Stability ball exercises

Experts recommend getting at least 150 minutes of exercise per week. That includes resistance training at least 2 days per week and 15 to 20 minutes per day of balance training.

Posture and stretching exercises can help your mobility and stature. It’s a good idea to get help with these, especially if you’re new to them. Posture and joint flexibility vary from person to person, so go at your own pace.

What exercises should be avoided with osteoporosis?

Due to the risk of fracture, it’s important to avoid certain movements of the spine and hips if you have osteoporosis. This is true not only for exercise but in everyday movements as well. Activities that cause you to bend forward, sideways, or twist your spine should be avoided.

Of course, most exercises involve many different motions and may present several types of risk. For example, yoga involves stretching, reaching, and twisting. And some poses may have a risk of falling. Let’s take a look at what exercises and movements may increase the risk of fractures from osteoporosis and which you should avoid.

High impact

Any movements that cause high impact to weak bones can result in fractures. Jumping, lunging, and punching are motions that generate a high level of impact. Exercises that result in high impacts include:

• Jumping rope and jumping jacks

• Aerobics

• Speed walking, running, and jogging

• Calisthenics

• Karate, boxing, and punching bag

Risk of fall

Movements that are likely to result in falls should be avoided. Activities with a risk of falls include:

• Biking

• Horseback riding

• Treadmill use

• Any activity that requires shifting of weight (yoga, dance, and aerobics)

But keep in mind that almost any activity — including walking — could result in a fall. This is especially the case if you have or are taking:

• Dizziness

• Vision or balance problems

• Certain medications, like those that cause sleepiness or confusion 

You should talk to your medical provider about your fall risk and degree of osteoporosis. Together, you can decide what activities you should avoid and which ones would be safe. 

Reaching/twisting motions

Movements that involve reaching/twisting should be avoided if you have osteoporosis. They can result in vertebral (spine) fractures. Spinal fractures are the most common type of fracture linked to osteoporosis. Some activities and exercises that require reaching and twisting movements include:

• Power yoga

• Aerobics

• Golf

• Tennis

Activities that involve a wide range of motion are great exercise. But they can put too much stress on weakened vertebral bones and you should avoid them. Everyday motions such as sneezing, coughing, or reaching to a high shelf can result in similar fractures. Exercises that involve reaching or twisting motions can also increase the risk of a fall.

What are the risks of exercising if you have osteoporosis?

It is possible to injure yourself with exercise if you have osteoporosis — especially if you overdo it or perform exercises incorrectly. If you are new to balance training or strengthening exercises, consider working with a physical therapist to learn how to exercise and stretch safely.

If you’ve had an osteoporosis-related fracture, or you’re at high risk for one, experts recommend you consult with a physical therapist before starting exercise. They can show you which exercises are safe to do, as well as how to do them. You can ask your primary care provider for a referral, or you can find physical therapy near you.

Other choices

While exercise is important for people with osteoporosis, it’s only one part of staying healthy. Diet and lifestyle changes and medications can also help you keep your bones as healthy as possible. Learning how to prevent falls is important too. 

Diet and lifestyle

Getting plenty of calcium, vitamin D, and other bone-healthy nutrients in your diet will help keep your bones strong. Keep in mind that supplements are also an option if you need them. Your medical provider can help you determine whether or not you need calcium or vitamin D supplements. 

It’s also helpful for your bones if you cut back on cigarette smoking and avoid drinking excessive amounts of alcohol. Both have been linked to an increased risk of fractures — including in men. 

Medications 

There are several osteoporosis medications available to help improve bone health. They either slow bone loss or build new bone. Medication can help with osteoporosis for postmenopausal women and men over the age of 50 who have any of the following:

• Fracture of the hip or spine

• T-score, which scores bone density, less than -2.5

• T-score between -1.0 and -2.5 and high 10-year probability of osteoporosis-related fracture, measured by FRAX (a tool that determines your fracture risk)

You can work with your medical provider to help figure out which osteoporosis medication is best for you. 

Fall prevention

Falls are the leading cause of fractures in people with osteoporosis. You can improve your balance with certain exercises, like those mentioned above. But it’s also important to know what steps you can take to prevent falls, like:

• Have your hearing and vision tested

• Remove rugs and other trip hazards from your home

• Use an assistive device like a cane or walker as needed

• Wearing non-slip, low-heel shoes

• Use shoulder bags or fanny packs to leave your hands free when walking

• Avoid standing up too quickly

More information and resources

• American Physical Therapy Association

• National Osteoporosis Foundation

• Osteoporosis Canada

Why trust our experts?

Written by:

Mandy Armitage, MD

Mandy Armitage, MD, has combined clinical medicine with her passion for education and content development for many years. She served as medical director for the health technology companies HealthLoop (now Get Well) and Doximity.

Edited by:

Karla Robinson, MD

Karla Robinson, MD, is a medical editor for GoodRx. She is a licensed, board-certified family physician with almost 20 years of experience in health through varied clinical, administrative, and educational roles.

Reviewed by:

Frank Schwalbe, MD

Frank Schwalbe, MD, is an assistant professor of anesthesiology at the Yale School of Medicine. He has practiced anesthesiology for 30 years.

Our editorial standards

Meet our experts