Many people think osteoporosis is just a normal part of ageing. While our bones do change over time, osteoporosis isn’t something we simply have to accept. Staying active and exercising regularly is one of the most effective ways to support bone strength and reduce fracture risk.
Osteoporosis is a condition where bones gradually lose density and strength, making them more fragile and more likely to fracture from everyday falls or even minor bumps.
A key reason exercise works so well comes down to Wolff’s Law—the idea that bone is living tissue that adapts to the loads placed on it. When we regularly challenge our bones through weight-bearing, impact, and resistance exercise, they respond by remodelling and becoming stronger, helping maintain or improve bone mineral density.
Just as importantly, exercise improves muscle strength, balance, and mobility, which helps reduce falls—the main cause of osteoporotic fractures.
Below is a summary of the 2017 Exercise and Sports Science Australia (ESSA) Position Statement recommendations for exercise in the prevention and management of osteoporosis.
1. Impact Loading
Impact-based activities provide an important stimulus for bone growth by exposing the skeleton to higher forces.
Examples include:
- Jumping
- Hopping
- Skipping rope
- Bounding
- Drop jumps
Recommendations:
- Progress gradually from bodyweight activities before increasing jump height or adding external load.
- Aim for high-impact activities where appropriate (greater than four times body weight).
- Perform around 50 impacts per session, 4–7 days per week.
Who should be cautious?
Individuals with established osteoporosis, a history of fragility fractures, or a high risk of falls may not be suitable for high-impact exercise. For these individuals, moderate-impact activities and progressive resistance training are often safer and more appropriate.
2. Progressive Resistance Training
Strength training is another cornerstone of osteoporosis management. Loading the muscles also loads the bones they attach to, stimulating bone adaptation while improving strength, function and confidence.
Recommended exercises include:
- Squats
- Deadlifts
- Split squats
- Hip abduction and adduction
- Back extensions
- Rows
- Calf raises
- Dorsiflexion exercises
These exercises target the major muscle groups around the hips and spine, which are common sites for osteoporotic fractures.
Training recommendations:
- Perform 8 exercises per session.
- Train at a high to very high intensity (approximately 80–85% of one-repetition maximum, or around 2 repetitions in reserve).
- Complete 3 sets of 8 repetitions.
- Train at least twice per week.
Is Heavy Strength Training Safe?
Many people worry that lifting heavy weights is unsafe if they have osteoporosis. However, research suggests that even frail individuals can safely perform high-intensity resistance training when supervised by an appropriately qualified health professional, such as a physiotherapist or exercise physiologist. Programs should always be individualised based on a person's health status, fracture risk and exercise experience.
The Takeaway
Exercise is a powerful tool for maintaining bone health. An effective osteoporosis program should include:
- Regular impact-loading activities (where appropriate)
- Progressive resistance training
- Balance and mobility exercises to reduce fall risk
If you have osteoporosis or are at an increased risk of fractures, the team at Wild Physio + Fitness can work with you to develop a safe, individualised exercise program that supports your bone health and helps you stay active.
References:
1. Beck et al. (2017) PMID: 27840033
