Posted on by Active EP

Osteoporosis & Exercise Physiology

Building Stronger Bones with Targeted Loading

Osteoporosis often goes unnoticed until something breaks — a wrist after a simple fall, a vertebrae after bending forwards, or a hip fracture that changes someone’s independence overnight. It’s not just about “thin bones”; it’s about reduced confidence, fear of falling, and uncertainty about what movement is actually safe.

At Active EP, we see this every week — and the good news is, there’s strong evidence that targeted, progressive exercise can help build stronger bones, improve balance and strength, and reduce fracture risk, even after an osteoporosis diagnosis.

💡 What Osteoporosis Is & Why Exercise Matters

Osteoporosis is a condition where bones lose density and internal structure, becoming more fragile and more likely to break. It’s especially common in the spine, hip and wrist.

Osteoporosis = reduced bone strength and a higher risk of fractures.
It is usually silent – many people don’t feel pain until a fracture occurs.
Bone is living tissue – with the right loading, it can adapt and become stronger at any age.

As we age (and especially after menopause), bone breakdown can start to outpace bone building. Exercise is the key signal that tells your body to keep investing in bone and muscle strength.

Strength + impact training can increase or maintain bone mineral density (BMD).
Balance and muscle strength reduce the risk of falls — a major cause of fractures.
A well-designed program builds confidence so you feel safer doing daily activities.

This is why modern osteoporosis guidelines place structured exercise alongside medication and nutrition as essential treatment — not an optional extra.

📚 The Evidence in Plain Language

High-quality trials and guidelines consistently show that progressive resistance and impact-style exercise are some of the most effective non-pharmacological ways to improve bone density and reduce fracture risk.

The LIFTMOR Trial demonstrated that heavy, supervised lifting increased hip and spine BMD in women with low bone mass.
Systematic reviews show resistance + impact exercise outperforms walking alone for bone health.
Major global guidelines now recommend supervised strength and balance training for those with osteoporosis.

Medications and supplements matter too — especially for people at higher risk — but without progressive loading, bones don’t get the mechanical stimulus they need to adapt.

⚖️ Where Exercise Fits with Other Osteoporosis Treatments

Exercise works best when paired with other evidence-based treatment options. Here’s how they compare:

TreatmentWhat It DoesLimitationsEvidence Summary
Resistance & HiRIT TrainingBuilds BMD, muscle strength, and improves function.Requires supervision and graded progression.Strong evidence from LIFTMOR and multiple RCTs.
Impact / Power ExercisesApplies high-magnitude loads to stimulate bone.Needs careful prescription depending on fracture risk.Improves bone geometry and structural strength.
PharmacotherapySlows bone breakdown; reduces fracture risk.Side effects possible; requires medical monitoring.Strong evidence, especially with combined lifestyle strategies.
Calcium & Vitamin DSupport bone mineralisation.Insufficient alone to improve BMD.Useful as part of a complete plan.
WalkingGreat for general health and activity.Load often too low to increase BMD.Should be combined with targeted loading.

In short: Exercise = foundation. Medication = support. Nutrition & lifestyle = essential add-ons.

🏥 How Osteoporosis Exercise Works at Active EP

Every program is tailored, but most clients progress through three key phases:

Assessment & education: DEXA review, falls risk, posture, co-existing conditions.
Supervised strength training: squats, deadlifts, presses, step-ups — scaled to your ability.
Balance, impact & posture training: carefully layered as confidence and tolerance improve.

Clients often begin cautiously — worried about lifting or bending — but gradually discover they’re capable of far more than they imagined.

🎯 Common Presentations We Help With
Post-menopausal women with osteopenia or osteoporosis on DEXA.
Adults recovering from spine, wrist or hip fractures.
People on long-term steroids or with medical conditions affecting bone health.
🚫 Myths to Bust
“I have osteoporosis, so lifting weights is dangerous.”
With proper supervision, strength training is not only safe — it’s one of the most effective treatments.
“Walking is enough to improve my bone density.”
Walking helps heart health but doesn’t provide enough load to build bone strength.
“I’m too old for my bones to change.”
Bone responds to load at any age — improvements in strength, balance and function are always possible.
💪 Summary: Science Meets Strength
Exercise is the foundation for building stronger bones and reducing fracture risk.
Medication and nutrition support the program when appropriate.
Confidence and independence improve as strength and balance return.
📅 Ready to Build Stronger Bones?

If you’ve been told you have low bone density or osteoporosis, you don’t need to guess which exercises are safe.

Our Accredited Exercise Physiologists at Active EP design programs tailored to your scan results, confidence and goals — whether that’s returning to gardening, lifting grandkids, or simply feeling steadier on your feet.

Want to know if this approach is right for you?
Reach out to our Active EP team and start building your bone strength with confidence.

References

Watson S. L. et al. (2018). Heavy resistance training is safe and improves bone density in postmenopausal women with low bone mass (LIFTMOR). Osteoporosis International.

Giangregorio L. M. et al. (2014). Osteoporosis exercise guidelines for people with low bone density and fractures. Osteoporosis Canada.

Nikander R. et al. (2010). Targeted exercise and bone structural strength in postmenopausal women. Medicine & Science in Sports & Exercise.

Howe T. E. et al. (2011). Exercise for preventing and treating osteoporosis in postmenopausal women. Cochrane Database of Systematic Reviews.

Beck B. R. et al. (2017). Osteogenic loading programs and bone strength in older adults. Journal of Bone and Mineral Research.