Osteoporosis affects millions of Canadians, making bones fragile and increasing fracture risk. However, the right exercise program can help maintain bone density, improve balance, and reduce fall risk. At M.O. Therapy in Markham, we help patients with osteoporosis develop safe, effective exercise programs tailored to their needs.
Understanding Osteoporosis
What Is Osteoporosis?
Osteoporosis is a condition where bones become weak and brittle due to loss of bone mass and structural deterioration.
Key Features:
- Reduced bone mineral density
- Deterioration of bone microarchitecture
- Increased fracture risk
- Often called a "silent disease" (no symptoms until fracture)
Risk Factors
Non-Modifiable:
- Age (risk increases with age)
- Female sex
- Family history
- Small body frame
- Ethnicity (Caucasian and Asian higher risk)
Modifiable:
- Low calcium intake
- Vitamin D deficiency
- Sedentary lifestyle
- Smoking
- Excessive alcohol
- Certain medications
Common Fracture Sites
High Risk Areas:
- Spine (vertebral compression fractures)
- Hip
- Wrist
- Ribs
Consequences:
- Pain and disability
- Loss of height (spinal fractures)
- Reduced quality of life
- Increased mortality (hip fractures)
The Importance of Exercise
Why Exercise Matters
Bone Benefits:
- Stimulates bone formation
- Maintains bone density
- Improves bone quality
- Reduces bone loss rate
Other Benefits:
- Improves muscle strength
- Enhances balance
- Reduces fall risk
- Improves posture
- Increases confidence
- Better quality of life
Wolff's Law
Bones adapt to the loads placed upon them:
- Increased stress → bone strengthening
- Decreased stress → bone weakening
- Specific loading builds bone in specific areas
- Regular stimulus needed for maintenance
Bone-Building Exercises
Weight-Bearing Exercises
Activities performed on your feet that work against gravity:
High Impact (for those without fracture history):
- Jogging
- Jumping
- High-impact aerobics
- Stair climbing
- Tennis
Low Impact (safer options):
- Walking (brisk)
- Low-impact aerobics
- Elliptical training
- Stair climbing machines
- Dancing
Resistance Training
Why It Works:
- Muscle contractions pull on bones
- Stimulates bone formation at attachment sites
- Improves muscle strength for fall prevention
- Can be modified for all levels
Key Principles:
- Progressive overload
- Target major muscle groups
- Include spine-loading exercises
- Proper form essential
- Avoid high-risk movements
Recommended Exercises:
- Squats (or chair squats)
- Lunges
- Standing rows
- Chest press
- Shoulder press
- Lat pulldown
- Hip exercises
Balance Training
Critical for Fall Prevention:
- Single-leg standing
- Tandem walking
- Tai Chi
- Yoga (modified)
- Balance board exercises
Progression:
- Start with support available
- Progress to unsupported
- Add movement challenges
- Include dual-task activities
Exercises to Avoid or Modify
High-Risk Movements
Spinal Flexion (Forward Bending):
- Toe touches
- Sit-ups/crunches
- Rowing with excessive forward bend
- Excessive forward bending under load
Why Avoid:
- Increases vertebral fracture risk
- Compresses anterior spine
- Greatest risk with osteoporosis
Twisting Under Load:
- Golf swing with heavy club
- Twisting with weights
- Some yoga poses
High-Impact in Severe Cases:
- Jumping (if fracture risk high)
- Running (if spine involvement)
- High-impact aerobics
Modifications
Instead of Sit-ups:
- Modified planks
- Bird dogs
- Dead bugs (modified)
Instead of Toe Touches:
- Hip hinge movements
- Standing hamstring stretch
- Supine stretches
Safe Exercise Program
Getting Started
Before Beginning:
- Medical clearance recommended
- Know your bone density (DEXA scan)
- Understand your fracture risk
- Work with qualified professional
Start Gradually:
- Begin with low intensity
- Progress slowly
- Listen to body
- Avoid sudden increases
Sample Exercise Program
Warm-Up (5-10 minutes):
- Gentle walking
- Arm circles
- Gentle movements
Strength Training (2-3x/week):
Lower Body:
- Squats or chair squats: 2-3 sets x 10-12
- Lunges (or step-ups): 2 sets x 10 each leg
- Calf raises: 2 sets x 15
Upper Body:
- Wall push-ups or chest press: 2-3 sets x 10-12
- Rows: 2-3 sets x 10-12
- Shoulder press: 2 sets x 10-12
Core (Modified):
- Modified plank: Hold 15-30 seconds
- Bird dogs: 2 sets x 10 each side
- Bridges: 2 sets x 12
Balance Training (Daily):
- Single-leg stance: 30 seconds each leg
- Tandem standing: 30 seconds
- Heel-toe walking: 10 steps
Weight-Bearing Aerobic (Most Days):
- Walking: 30 minutes
- Or other weight-bearing activity
- Moderate intensity
Progression Guidelines
When to Progress:
- Exercise feels easy
- No adverse effects
- Proper form maintained
How to Progress:
- Increase resistance/weight
- Add repetitions
- Increase duration
- Reduce support (balance)
Specific Considerations
After Vertebral Fracture
Increased Caution Needed:
- Avoid forward flexion
- Minimal twisting
- Focus on extension exercises
- Strengthen back extensors
- Work with physiotherapist
After Hip Fracture
Rehabilitation Focus:
- Progressive strengthening
- Weight-bearing as allowed
- Balance training
- Fall prevention
- Gait training
Severe Osteoporosis
Modified Approach:
- Lower impact activities
- Pool exercises may be appropriate
- Focus on safety
- Emphasis on balance
- Professional supervision recommended
Fall Prevention
Environmental Modifications
Home Safety:
- Remove tripping hazards
- Good lighting
- Handrails on stairs
- Non-slip bath mats
- Secure rugs
Personal:
- Appropriate footwear
- Vision correction
- Medication review
- Hearing aids if needed
Physical Strategies
Improve:
- Balance through exercise
- Strength to recover from trips
- Reaction time
- Confidence in movement
Regular Assessment
- Annual fall risk assessment
- Vision and hearing checks
- Medication review
- Home safety evaluation
Nutrition and Exercise
Supporting Bone Health
Calcium:
- 1000-1200 mg daily
- Food sources preferred
- Supplements if needed
Vitamin D:
- 800-2000 IU daily
- Important for calcium absorption
- Many Canadians deficient
Protein:
- Adequate intake important
- Supports muscle and bone
- 1.0-1.2 g/kg body weight
Timing
Around Exercise:
- Stay hydrated
- Protein after exercise
- Balanced nutrition overall
Treatment at M.O. Therapy
Physiotherapy
Our physiotherapists provide:
Assessment:
- Functional evaluation
- Balance assessment
- Strength testing
- Fall risk screening
Treatment:
- Safe exercise prescription
- Balance training
- Posture improvement
- Home program development
Massage Therapy
Our RMTs help with:
- Pain relief
- Muscle tension
- Relaxation
- Mobility improvement
Chiropractic Care
Chiropractic treatment may include:
- Gentle mobilization
- Posture assessment
- Movement optimization
- Exercise recommendations
Frequently Asked Questions
Can exercise really build bone? Yes, weight-bearing and resistance exercises stimulate bone formation and can help maintain or even increase bone density. The effect is site-specific—you build bone where stress is applied.
Is it safe to exercise with osteoporosis? Yes, when done correctly. In fact, exercise is one of the most important things you can do to manage osteoporosis. The key is choosing appropriate exercises and avoiding high-risk movements.
What exercises should I avoid with osteoporosis? Avoid or modify exercises involving forward bending of the spine under load (sit-ups, toe touches), high-impact activities if you have vertebral fractures, and twisting movements under load.
How often should I exercise? Aim for strength training 2-3 times per week, balance exercises daily, and weight-bearing aerobic activity most days. Total exercise should be at least 150 minutes per week of moderate activity.
Book Your Assessment
If you have osteoporosis and want to develop a safe, effective exercise program, M.O. Therapy in Markham can help. Our team will assess your needs and create a personalized plan.
Call (905) 201-5827 or book online for your assessment. We offer direct billing and same-day appointments.