Disclaimer: This article is for general educational purposes only and does not constitute medical advice. Always consult a qualified health professional for advice specific to your condition. © 2026 Better Physiotherapy Bundoora.
Exercise is the most powerful non-pharmacological intervention for osteoporosis — more effective than calcium supplements alone, and complementary to medication. A physiotherapy-prescribed exercise program builds bone density, reduces fall risk, and improves posture and confidence.
Why Bone Responds to Exercise
Bone is living tissue that responds to mechanical loading by increasing density. When muscle forces and ground reaction forces are transmitted through bone, osteoblasts (bone-building cells) are stimulated to deposit new bone. The type of exercise matters — low-load activities like swimming and cycling do not produce sufficient mechanical stimulus for bone building, whereas weight-bearing and resistance exercises do.
The Two Pillars of Osteoporosis Exercise
1. Progressive resistance training: High-load exercises — weighted squats, hip hinge movements, upper limb pulling exercises — that create compressive forces on the spine and hip (the two most important fracture sites). The LIFTMOR trial demonstrated that an 8-month high-intensity supervised program produced significant improvements in bone density at the spine and hip.
2. Weight-bearing impact exercise: Brisk walking, jogging, stair climbing, dancing, and jumping activities that produce repeated skeletal loading. Impact exercise is most effective for maintaining cortical (outer) bone.
3. Balance training: While not building bone directly, falls are the proximate cause of most osteoporotic fractures. Balance and strength programs reduce fall risk by 30–40% in older adults.
What to Avoid
Not all exercises are appropriate. People with osteoporosis should be cautious about:
- Forward flexion of the trunk under load (increases vertebral compression fracture risk)
- High-impact activities without a progressive build-up
- Activities with high fall risk (step aerobics without progression, slippery surfaces)
- Heavy twisting movements under load
Osteoporosis Physiotherapy at Better Physiotherapy Bundoora
We design safe, evidence-based exercise programs for people with osteoporosis and osteopenia — from gentle weight-bearing beginners to supervised high-load resistance training. We can accept Medicare EPC referrals. Call (03) 9467 6900 or book online.
Frequently Asked Questions
What is osteoporosis?
Osteoporosis is a condition of reduced bone mineral density and structural deterioration of bone tissue that increases fracture risk. Osteopenia is a milder reduction in bone density — a precursor state. Together they affect over 1 million Australians. Post-menopausal women and older men are most commonly affected, though secondary osteoporosis can occur at any age.
What type of exercise is best for osteoporosis?
Two types of exercise are most effective: (1) Progressive resistance training — exercises that load the skeleton through muscle contraction, such as weighted squats, deadlifts, and upper body exercises; (2) Impact exercise — activities like brisk walking, jogging, dancing, and jumping that generate ground reaction forces through the skeleton. Balance training reduces fall risk — a critical element of fracture prevention.
Is it safe to lift weights with osteoporosis?
Yes, when appropriately supervised. The evidence strongly supports high-load resistance training for osteoporosis. A physiotherapist will teach correct technique, select appropriate loads, and monitor for any adverse responses. The LIFTMOR trial showed significant bone density improvements with heavy lifting in women with osteoporosis — with no serious adverse events.
Can physiotherapy help after an osteoporotic fracture?
Absolutely. After a vertebral compression fracture or fragility fracture, physiotherapy provides: pain management, safe movement retraining, postural correction, gentle strengthening, and planning for return to activity. Most fractures occur from falls — fall prevention becomes a priority alongside bone health for future fracture prevention.
Ashley Haleel
Physiotherapist & Owner — Better Physiotherapy Bundoora