Which Exercise is Best for Osteoporosis?

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Editor’s Note:  Meet Joan Pagano at the 3T Renewal Summit. She is one of experts.

Over the years, many women have come to me for guidance on the best exercise for their bones.

Their questions vary, asking for help in interpreting the results of their bone density test and what those numbers mean in terms of choosing safe and effective exercises. Each individual is unique but there are general guidelines that apply to all.

One woman saw me working with my regular client in her gym and asked whether I could advise her on her personal situation. She said that in an effort to strengthen her bones she had continually increased her weights, as per the advice of her doctor.  But now she had developed shoulder, lower back and knee issues from lifting too much weight. Although the guidelines for strengthening healthy bones call for high impact, high resistance exercises, it’s counter-productive to overload the joints to the point of injury!

Another woman had been diagnosed with osteoporosis and came to me for a fitness consultation.  She was so stymied by her diagnosis that she had stopped exercising for fear of causing further damage to her fragile bones. There are many safe and effective exercises for osteoporosis, but you need to bone up on the guidelines.

Between these two extremes, there lies a perfect course for your own routine. The National Osteoporosis Foundation classifies exercises in four groups, beginning with those that are most effective for building bone and, in diminishing intensity, those that are safer options if you’ve been diagnosed with low bone mass, osteoporosis or are frail.

Group 1:  Weight-Bearing, High- Impact, Resistance Activities

  • Weight-bearing: standing exercises where you are resisting the force of gravity
  • High-impact: activities where both feet are off the ground
  • Resistance: applying resistance to the muscles using bodyweight, weight lifting tools (like free weights, stretch bands and tubes, weighted balls) and weight machines
  • Examples: jogging or running; jumping rope; basketball; weight lifting

 Group 2:  Weight-Bearing, Low-Impact Activities

  • Weight-bearing: standing exercises where you are resisting the force of gravity
  • Low-Impact: activities where one foot is always on the ground
  • Examples: walking and treadmill walking; cross-country skiing and ski machines; elliptical trainers; stair climbers

Group 3:  Non-Impact, Balance, Functional Exercises

  • Non-impact: activities where both feet are on the ground or you are seated
  • Balance: exercises to reduce your risk of falls and fractures
  • Functional: exercises similar to everyday activities
  • Examples: Pilates and yoga (avoid forward bending postures); Tai Chi; bodyweight exercises like chair squats and heel raises

 Group 4:  Non-Impact Activities, Non-Weight Bearing

  • Non-impact: activities where both feet are on the ground or you are seated
  • Non-weight-bearing: activities where your weight is supported
  • Examples: bicycling and stationary bike; swimming; water aerobics; deep water walking

All of these activities enhance your health and well-being; however, some are less helpful to your bones.  If you love to bike or swim, for example, try to do some cross training by adding in walking or resistance exercises for the lower body, like chair squats.  But always remember,

Safety First!  And be sure to check with your doctor before beginning an exercise program or becoming much more physically active. This information is not intended as medical advice.

For more about healthy exercise for your bones, please see Joan Pagano’s video program “Beat Belly Fat, Bloating, Bone Loss and the Blues:  Simple Steps to a Better You



  • Joan Pagano

    Joan Pagano has specialized in strength training for women since 1988 – training, teaching, and writing books on the subject, including Strength Training Exercises for Women (DK, 2014). When the health benefits of strength training started making headlines in the 1990s, and in particular how weight training could protect the bones and prevent osteoporosis, it was a natural segue for her. At that time, Joan was developing and delivering fitness training guidelines for osteoporosis to national audiences of exercise professionals. Currently Joan is recognized by the industry as a leading authority on exercise program design for osteoporosis. She is certified as an Exercise Physiologist by the American College of Sports Medicine (ACSM) and is on the Ambassadors Leadership Council for the National Osteoporosis Foundation. Visit Joan at: www.joanpaganofitness.com/

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