Osteoporosis Exercise: How to Move Safely and Effectively

Q: Is it safe to exercise with osteoporosis?

For most people with osteoporosis, exercise is safe and actively encouraged. What matters is choosing the right type and level of activity for you. Before you start a new routine, speak to your GP or a health specialist to check what suits you.

Q: What exercises are best for bone density with osteoporosis?

Weight-bearing exercise and resistance training both matter. Weight-bearing activities like walking, jogging, dancing, or marching on the spot load your bones against gravity and prompt them to stay strong. Resistance training, with weights, resistance bands, or your own body weight, builds your muscle strength and adds load to the bone through the pull of your tendons. You get the most benefit by combining the two.

Q: What movements should be avoided or modified with osteoporosis?

Exercises that bend your spine far forward, like sit-ups or touching your toes, are best skipped or changed quite a bit. It is also worth being careful with repeated or forceful twisting of your spine. In yoga or Pilates, any pose that rounds your spine forward needs adjusting. A physiotherapist can help you work out which movements to modify based on your history.

Q: How often should resistance training be done for bone health?

Two to three days a week is the suggested rhythm for muscle-strengthening work, covering your legs, arms, and spine. The aim is progressive loading. You choose a weight you can manage for around 8 to 12 repetitions with good form, then build the load up gradually as you get stronger.

Q: Does swimming count as weight-bearing exercise for osteoporosis?

Swimming and cycling are good for your heart health and worth keeping up if you enjoy them. Because they do not load your bones against gravity though, they do not give much bone-strengthening effect on their own. They work best as part of a routine that also includes weight-bearing and resistance activity.

An older woman stretching her arm outside.

The information in this article is for general informational purposes only and does not substitute for professional medical or dietary advice, particularly during pregnancy. If you are outside the UK, please consult your local doctor, midwife, or healthcare provider for guidance that reflects your country's recommendations.

After a diagnosis of osteoporosis, you can feel pulled in two directions. You hear that exercise matters, and at the same time you carry a quiet worry that moving might cause harm. That tension, wanting to stay active while fearing you could do damage, is something you may feel often. Staying still carries its own risks though, and with the right kind of movement, exercise can support your bone density, your strength, and your steadiness.²

Through and after menopause, your oestrogen levels fall, and that drop raises your risk of osteoporosis. Staying physically active is one of the main ways you can support your bones, alongside any treatment your doctor has suggested. Exercise works with that treatment, and over time it stays an important part of looking after your bone health.³

Weight-bearing exercise and why it matters for bone density

Weight-bearing exercise is any activity where your feet and legs carry your body weight against gravity. As you move, the impact travels through your bones, and that force is what prompts them to stay strong. This loading is what makes weight-bearing activity so useful for your bone density, and it is something non-weight-bearing exercise cannot match.⁴

If you have osteoporosis but no spinal fractures, aiming for around 50 moderate impacts on most days is a good target. You can get there with activities like jogging, low-level jumps, and skipping. If you have spinal fractures, or find higher-impact movement difficult, 20 minutes of low-impact weight-bearing exercise on most days works better, such as brisk walking or marching on the spot.⁵

Moderate-impact options include jogging, running, dancing, and racket sports. Lower-impact options include walking, marching, and using an elliptical trainer. Swimming and cycling are good for your heart and worth keeping in your routine. Because they do not load your bones against gravity though, they do not give the same bone-strengthening effect, and they work best alongside weight-bearing activity.⁶

Woman wearing a cap, swimming in an indoor pool.

Resistance training and progressive loading

Resistance exercise means working your muscles against a force, whether that is your own body weight, free weights, or a resistance band. As your muscles contract, your tendons pull on the bone, and that pull is what stimulates the bone tissue and builds its strength.⁷

Muscle-strengthening work two to three days a week, covering your legs, arms, and spine, is the suggested rhythm. Moves like squats, wall press-ups, and resistance band work reach the main muscle groups. The aim is to build the load up gradually over time, rather than staying at the same weight.⁸

The approach that works best is progressive resistance training. You pick a weight you can lift for around 8 to 12 repetitions, stopping at the point where one more rep with good form is no longer possible. Once that starts to feel manageable, you nudge the weight up a little. Starting at a comfortable level and building slowly matters, and learning the technique with a professional helps you avoid injury.⁹

Balance work and reducing the risk of falls

As you build muscle strength, you also become steadier on your feet, and that steadiness lowers your chance of falling. Falls are a major cause of fractures when you have osteoporosis, so balance training earns a real place in your routine. Tai Chi comes up often as a way to improve your balance and help you move with more confidence.¹⁰

Movements to modify or avoid

Not every movement carries the same risk, and some positions put extra load on your spine. Postures that bend your spine far forward, like sit-ups or toe touches, are best skipped or changed quite a bit. It is also worth being careful with repeated or forceful twisting through your spine.¹¹

If you enjoy yoga or Pilates, you can often carry on with a few adjustments. Poses that round your spine forward need changing or skipping. It helps to tell your instructor about your diagnosis so they can offer you suitable variations. There is also a Pilates-inspired workout video made specifically for people with osteoporosis, which gives you a practical starting point.¹²

Getting professional guidance for your osteoporosis exercise routine

A physiotherapist can look at your situation, build a programme that suits your bone density and any fracture history, and teach you the right technique. You can ask your GP for a referral. Once you have a safe foundation in place, a qualified exercise professional with osteoporosis experience can support you too, though a physiotherapist is the main clinical route.¹⁴

There is also a specialist nurse helpline run by the Royal Osteoporosis Society if you have questions about your condition or want guidance on staying active. If you are not sure where to start, talking to your GP or calling that helpline is a practical first step.¹

Frequently Asked Questions

Is it safe to exercise with osteoporosis?

What exercises are best for bone density with osteoporosis?

What movements should be avoided or modified with osteoporosis?

How often should resistance training be done for bone health?

Does swimming count as weight-bearing exercise for osteoporosis?

Sources

[1] Osteoporosis Helpline

The Royal Osteoporosis Society provides a specialist nurse helpline for anyone who has questions about their condition or wants guidance on physical activity.
[2] Strong, steady and straight: exercise recommendations for osteoporosis

The evidence is clear that with the right kind of movement, osteoporosis exercise can support bone density, strength, and steadiness. People with osteoporosis should be encouraged to do more, not less.
[3] Exercise and the menopause

During and after menopause, declining oestrogen levels increase the risk of osteoporosis. Regular physical activity is a key lifestyle measure to help manage this.
[4] NHS: Osteoporosis – Prevention

Weight-bearing exercise is any activity where your feet and legs support your body weight against gravity. The impact — the force travelling through your bones — stimulates them to stay strong.
[5] Royal Osteoporosis Society: Exercise and Osteoporosis

Around 50 moderate impacts on most days is the target for people with osteoporosis but no spinal fractures. Activities include jogging, low-level jumps, and skipping. For those with spinal fractures or who find higher-impact activity difficult, 20 minutes of low-impact weight-bearing exercise such as brisk walking or marching on the spot is advised.
[6] NHS: Osteoporosis – Prevention

Moderate-impact options include jogging, running, dancing, and racket sports. Lower-impact options include walking, marching, and using an elliptical trainer. Swimming and cycling do not provide the same bone-strengthening stimulus and work best when combined with weight-bearing activity.
[7] NHS: Osteoporosis – Prevention

Resistance exercise involves moving your muscles against a force. The pull of tendons on bone as muscles contract stimulates bone tissue and contributes to bone strength.
[8] Bone and muscle strengthening

Muscle-strengthening exercise two to three days a week, targeting the legs, arms, and spine, is the recommended frequency. Examples include squats, wall press-ups, and resistance band exercises. The goal is to gradually increase the load over time.
[9] Bone and muscle strengthening

Progressive resistance training means choosing a weight you can manage for around 8 to 12 repetitions before your muscles reach the point where another repetition with good form is no longer possible, then increasing the weight gradually as you get stronger.
[10] UK physical activity guidelines: evidence summary

Building muscle strength supports steadiness and reduces the risk of falling. Falls are a significant cause of fractures in people with osteoporosis. Tai Chi is specifically recommended as a form of exercise that improves balance.
[11] UK physical activity guidelines: evidence summary

Postures involving a high degree of forward spinal bending — such as sit-ups or toe touches — should be avoided or significantly modified. Repetitive or forceful twisting of the spine should also be approached with caution.
[12] Exercise for Your Bone Health

In yoga or Pilates, poses that involve rounding the spine forward need to be avoided or modified. An instructor should be made aware of the diagnosis. The NHS has a Pilates-inspired workout video produced specifically for people with osteoporosis.
[13] NHS: Osteoporosis – Prevention

If you have been diagnosed with osteoporosis, the NHS advises talking to a GP or health specialist before starting a new exercise programme.
[14] Bone and muscle strengthening

You can ask your GP for a referral to a physiotherapist, who can design a safe, personalised programme and teach correct technique. A qualified exercise professional with experience in osteoporosis can also support you once a safe foundation has been established.