Exercise and sports for people with osteoporosis

Activities that repeatedly strain the bones by using your own body weight are especially good for strengthening your bones. These include climbing stairs, jogging and hiking, but not swimming or cycling. Swimming and cycling can have other advantages, and improve stamina and muscle strength, though.

As well as keeping active in daily life, special exercises are also a good idea. They are chosen to strengthen your bones and muscles, and to improve balance. The exercises are not just a good idea for preventing and treating osteoporosis. They can also lower the risk of falls (the main cause of fractures in older age).

The exercises that are suitable for people with osteoporosis depend on various individual factors, including

• your physical condition (strength, agility, balance and coordination),
• any other medical conditions, or medications you are using,
• your risk of falls,
• your risk of bone fractures, and
• previous age-related falls or bone fractures.

It is best to talk to a doctor, physical therapist or sports scientist to work out which exercises are suitable for you personally. This is especially important if you have already had osteoporosis-related fractures or have other medical conditions. A medical professional can also test your strength, agility and balance. That can help to get a better overall impression of your physical condition.

Personal preferences are also important when choosing the types of exercises. Exercise should be a regular part of your everyday life, so it’s easier if you enjoy it.

Yes, specific exercises can still help. Strong back muscles are needed for lots of everyday activities, and they can protect the spine.

Isometric exercises are well suited for strengthening the back muscles if you have osteoporosis. Isometric back exercises tense the muscles without the back being bent. That puts less strain on the spine. You can do these exercises lying down on your front or back, or standing or sitting with your back against a wall.

It is best to avoid exercises where you have to curve your back a lot or bend your upper body a long way forward. They increase the risk of vertebral fractures. Those kinds of exercises include common stomach muscle exercises like “sit-ups,” “crunches” and “jackknives.”

Sports where you have to rotate a lot or very quickly (like golf and tennis) are not suitable either. Some yoga and pilates exercises also involve similar sequences of movements. People who do yoga or pilates should let their instructor know about their osteoporosis to find suitable exercises.

Professional advice and instruction is important when finding suitable exercises and learning how to do them correctly.

There are various prevention and treatment options for osteoporosis. The statutory insurer coverage mentioned here refers to the situation in Germany. Other countries may have similar offers:

• Prevention courses offered by statutory health insurers (prevention)
• Physical therapy instruction (treatment)
• Functional training courses in groups (treatment)

Prevention and health care courses offered by statutory health insurers include courses to strengthen muscles, bones and joints, as well as to improve balance and coordination, such as tai chi. Some of these courses are also offered online. Statutory health insurers regularly publish information about their courses.

Physical therapy is an option if you have already been diagnosed with osteoporosis. The goal is to learn exercises that you can then do on your own. They might include exercises using your own body weight or using exercise equipment.

Physical therapy is offered individually or in groups. In Germany, doctors can prescribe up to three lots of six 20-minute sessions of physical therapy for people with osteoporosis, or more if there are medical reasons for it. A new prescription for physical therapy can be issued after six months. It is a good idea to learn exercises that you can do on your own over the long term, whether at home or in a gym. You can also learn how to protect your spine in everyday life – for instance, by learning how to lift heavy objects correctly.

Functional training is another option. This is a special kind of exercise class or water aerobics class for people with conditions like osteoporosis. The courses are led by qualified instructors and take place once or twice a week in groups. They include exercises to strengthen the bones and muscles, as well as exercises to prevent falls.

If the course provider has been approved by statutory health insurers, the costs of functional training courses are covered for up to two years. Doctors can prescribe functional training using a special form without it affecting their budget. Regional osteoporosis support groups also organize and offer functional training courses.

The following table shows an example of an osteoporosis training course. It is based on recommendations for the prevention of bone fractures in people with osteoporosis.

It might be necessary to make adjustments to the training plan if you have other conditions such as arthritis, rheumatism or a heart or nerve disease.

These exercises are not suitable or possible for everyone, either. But even if you can’t do all of them, it is important to keep active and move about as much as possible in everyday life.