Bone Health Part 2: What is Osteopenia?

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Sometimes called “pre-osteoporosis,” osteopenia is bone density lower than normal, but not osteoporotic.  It is a risk factor for developing osteoporosis but does not always lead to it.

If you’ve been diagnosed with osteopenia on a bone density test, your readings may show that you have low bone density in your hip, spine, or wrist. There are plenty of exercises you can do to maintain bone strength in these areas and offset more bone loss. In this article, you’ll learn safe exercises to preserve bone density, as well as what exercises to avoid.

Exercises for Osteopenia

If you’ve been diagnosed with osteopenia, you can work to maintain bone density and may even be able to reverse loss of bone density through exercise. But first…

What is osteopenia?

Osteopenia is low bone density as measured in a bone density test, sometimes referred to as “pre-osteoporosis”. While lower than normal density, osteopenia is not low enough bone loss to be osteoporosis. It is considered a risk factor for osteoporosis but does not always lead to it.

There are many safe exercises for osteopenia, including modifications of the best exercises for osteoporosis prevention. The emphasis shifts from high impact exercise to low impact, applying more moderate stress to the bones to protect vulnerable joints.

Exercises for osteopenia

Resistance is the key factor in both types of exercise for osteopenia

  • Weight bearing, low impact cardio exercise

  • Weight training with caution to protect the joints

What is included in weight bearing exercises?

Weight bearing refers to standing exercises where you are resisting the force of gravity.  To avoid jarring the spine or other vulnerable joints, switch to low impact cardio activities, those where one foot is always on the ground (as opposed to high impact where both feet are off the ground).

Weight bearing, low impact cardio exercises for osteopenia

  • Walking and treadmill walking

  • Cross-country skiing and ski machines

  • Elliptical trainers

  • Stair climbers

Weight training for osteopenia

Weight training can help preserve bone density and offset bone loss by applying resistance to the muscles which also stimulates the bones.  The resistance may be bodyweight or external resistance like free weights, stretch bands and tubes, weighted balls and weight machines.

However, it’s important to use less resistance when working joints that are at risk for fracture, like the spine, hips, and wrists.  Lift lighter weights for 10-12 exercises that target the major muscle groups (legs, back, chest, shoulders, arms and core) with 10-15 repetitions per exercise. One set is enough to develop and maintain strength, but 2-3 sets will deliver more benefit.

Examples of safe exercises for working the spine, hip, and wrist:

  • Chair Squat

  • Push up

One-arm row

It’s important to work all the muscles of the back In order to target the spine from different angles. The one-arm row works the largest back muscle, the latissimus dorsi, to strengthen the spine, improve posture, and create shape and definition in the torso.

  • Stand in a staggered lunge position.

  • Bend forward from the hip to 45 degrees with the spine straight.

  • Hold a weight directly under the shoulder in the hand opposite the front leg.

  • Draw shoulder blade in towards the spine and exhale as you pull the weight up to the rib cage.

  • Inhale, lower the weight back to starting position and repeat.

  • Do 10-15 reps each side.

One-arm row: Weight training exercise for osteopenia – Video 1


The squat is the #1 exercise for life, the most functional movement that we need to get up from a seated position, from the toilet, from the bath tub. It engages the large muscles of the lower body – the glutes, quadriceps, and hamstrings – and strengthens the hip bone (femur). The first variation of the squat is the Chair squat. Master it before moving on to more advanced versions.

  • Sit on the edge of a sturdy chair, legs parallel, slightly wider than hip width apart, knees bent at 90 degrees.

  • Move feet back several inches behind knees, cross arms over chest, and lean forward with the spine straight.

  • Exhale and squeeze the glutes in the buttocks as you press through your feet to stand up.

  • Straighten knees (without locking them) at the end of the movement to come to a fully upright position.

  • Pause, then slowly sit back down.

  • Begin by doing one set of 10-15 reps, and progress to doing 3 sets.

Squat: Weight training exercise for osteopenia – Video 2

Push up

The push up is a very efficient movement that engages three major muscles of the upper body -the chest, shoulder and triceps (in the back of the upper arm)- and is weight-bearing through the wrist. The position of your arms determines which muscle you target. You can do a pushup standing parallel to a wall, on a diagonal at the kitchen sink, or on the floor from your knees or your toes.

  • For a kneeling pushup, kneel on the floor, wrists slightly forward of the shoulders, and 3-4” wider than shoulder width apart. (An exercise mat will help if the floor surface is not cushioned.)

  • Cross ankles and lift lower legs.

  • Drop the hips and shift weight forward onto your arms so there is no direct pressure on your kneecaps.

  • Keep spine straight from shoulder to hip to knee.

  • Inhale and bend elbows out to the side to form a box as you slowly lower your chest to the floor.

  • Exhale as you straighten arms and push up to the start position.

  • Begin with one set of 10-15 reps and build up to two sets.

Push up: Weight training exercise for osteopenia – Video 3

What activities should you avoid if you have osteopenia?

Some exercises and activities overload fragile bones, especially the vertebrae of the spine. As you round the back forward or twist at the waist, you may fracture these bones. Therefore, use caution when:

  • reaching down

  • bending forward

  • twisting rapidly at the waist

  • lifting heavy objects

  • jarring your spine with impact

  • doing anything that increases your chances of a fall

Osteopenia is diagnosed with a bone density test , which measures the amount of mineral in your bone to determine how strong it is. It is covered by Medicare after age 65.

For younger women, a bone density test may be appropriate depending on their risk factors for osteoporosis.

Disclaimer: The information presented in this article should not be construed as medical advice. It is not intended to replace consultation with your physician or healthcare provider.


  • 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:

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