Introduction by Joan to Part 3 of her new series, The Best Exercises for Osteoporosis Prevention.

What exercises should you not do if you have osteoporosis?

While there are certain osteoporosis exercises to avoid if you’ve been diagnosed with osteoporosis, exercise is extremely beneficial. Your program should follow these safety guidelines that pertain to specific positions and movements, as well as to impact-loading or jarring of the spine or hips, which we’ll get into.

The cardinal rule is to talk with your doctor about any exercise program before beginning a routine or intensifying your exercise program.

Osteoporosis exercises to avoid

If you have osteoporosis, you should avoid any of these activities or exercises:

1. Jar the spine
2. Lifting loads overhead
3. Lifting heavy objects some distance away from your body
4. Bending forward from the waist with the back rounded
5. Quick twisting movements from the waist or twisting with impact
6. Moving your leg sideways or across your body against resistance
7. Anything that makes falls more likely

1. Jar the spine   

Jarring the spine, or impact loading as in high impact cardio exercise, increases the risk of spinal fracture because the weakened vertebrae cannot tolerate this force.  This means no jumping, no jogging or running, or any activity where both feet are off the ground at the same time.  (Impact loading exercises are advisable for osteoporosis prevention, but not if you’ve been diagnosed).

Osteoporosis exercises to avoid #1: Jumping, jogging, and running or any activity where both feet are off the ground at the same time.

2. Lifting loads overhead     

Lifting a load overhead may cause compression to the spinal vertebrae, increasing the risk of fracture. Avoid exercises like a military press or shoulder press in which you raise the weights above your shoulders.. This also applies to lifting heavy household items onto a shelf above your shoulders or hoisting your carry-on into the overhead bin. A shoulder stand in yoga has the same effect, when your shoulders and upper back are bearing your bodyweight.

3. Lifting heavy objects some distance away from your body  

Lifting heavy objects at a distance away from your body, as in lifting a heavy roasting pan from the oven, requires you to lean into them, increasing your risk of falling while putting stress on your spine in the forward-bending position. Move objects closer to you so that you are not leaning and reaching beyond your safe balanced position.

4. Bending forward from the waist with the back rounded

Bending forward from the waist with the back rounded (spinal flexion) dramatically increases the forces on your spine, increasing the danger of a collapsed vertebra.  This means no crunches or sit ups, no toe touches in any position (standing or seated), or rowing machines that may require this position. Certain positions in yoga and Pilates need to be modified for safety guidelines.

Osteoporosis exercises to avoid #4: Bending forward from the waist with the back rounded (spinal flexion).

However, spine extension exercises which are performed by arching the back are safe. These exercises strengthen the back extensor muscles, the large muscles that hold the spine erect, reducing the development of a dowager’s hump, reducing back fatigue, and strengthening the spine itself.

5. Quick twisting movements from the waist or twisting with impact

When you twist at the waist your shoulders rotate but your hips don’t, increasing the risk of damaging fragile vertebrae of the spine. Make it a habit to rotate your whole body with the torso aligned shoulders over hips, rather than turning from the shoulders or twisting your back.

Sports like tennis, golf and bowling are also risky as they combine twisting movements with the impact of hitting a ball.  Seek professional guidance as to how to modify these activities for safely.

Osteoporosis exercises to avoid #5: Twisting from the waist when the shoulders rotate but your hips do not.

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6. Resistance exercise machine

Use caution in moving your leg across the midline of your body with resistance, as in exercises you might perform in the gym with certain types of resistance-exercise machines, including cables.  Also, avoid extreme external hip rotation with bodyweight, as in the pigeon pose in yoga. A weakened hip may be more susceptible to breaking when stressed in this manner.

In addition to avoiding these activities and using proper body mechanics, the most important strategy to protect your bones is to prevent falls and fractures. Falls are the leading cause of injury in people over age 65. Each year about a third of all persons over 65 will fall.  Many of these falls result in a broken bone, often at the hip or wrist (the result of an outstretched hand to break a fall).  Many factors can lead to a fall:

• Poor balance
• Weak muscles
• Vision problems
• Certain diseases
• Alcohol use
• Some medications
• Hazards in the home

Many of these factors can be corrected with appropriate exercise, medical consultation, and fall-proofing the home.

For more information on creating a well-rounded strategy to prevent falls, please see Exercises for Fall Prevention.

Disclaimer: The information presented in this article should not be construed as medical advice. It is not intended to replace consultation with your physician or healthcare provider.