Osteoporosis and Exercise: Why Gentle Resistance Training Strengthens Your Bones and Eases Back Pain
Osteoporosis: A Silent Threat to Bone Health
Osteoporosis is a common condition in older adults where bones become thin, fragile, and more likely to break—even from small bumps or minor falls. It is especially prevalent in postmenopausal women, although men are also at risk. The disease often develops silently, with the first noticeable sign being a fracture, most commonly in the hip, wrist, or spine.
Causes and Risk Factors
Several factors contribute to the development of osteoporosis:
Ageing and Menopause: Bone loss accelerates with age, particularly after menopause due to a drop in oestrogen.
Genetics: A family history of osteoporosis increases personal risk.
Lifestyle Choices: Poor diet (low calcium and vitamin D), lack of exercise, smoking, and heavy alcohol use all negatively affect bone health.
Medical Factors: Certain medications (like corticosteroids) and chronic conditions such as rheumatoid arthritis contribute to bone weakening.
The most serious complications of osteoporosis are fragility fractures, especially of the spine and hip. These can lead to long-term disability, pain, and loss of independence. Fortunately, gentle resistance exercise is a powerful tool for prevention and management.
The Role of Exercise in Osteoporosis Management
Exercise is one of the best ways to slow bone loss, reduce fracture risk, and improve strength and balance in people with osteoporosis. Contrary to outdated beliefs, movement is not only safe—it is essential.
Why Resistance Exercise Matters
Bones are living tissues that respond to stress. When muscles contract during resistance exercise, they stimulate bone-building activity. Over time, this helps to preserve or even increase bone density, particularly in key areas like the spine and hips.
Key research findings:
LIFTMOR Trial (Australia): Postmenopausal women doing supervised resistance and impact training increased spinal bone density by 3%, with no injuries reported (Watson et al., 2015).
Mayo Clinic Study: Women who did back-strengthening (extension) exercises had significantly fewer spinal fractures than those who did no exercise or flexion-based movements (Sinaki et al., 1984).
Even if high-intensity training is not suitable, gentle resistance training using bands, body weight, or light dumbbells has proven benefits. These include maintained bone density, improved posture, and greater functional strength.
Back Pain, Exercise, and Osteoporosis: Understanding the Link
Many people with spinal osteoporosis report back pain. This pain is often caused not by fractures, but by deconditioned muscles and stiff ligaments that have not been used in some time. When gentle exercises are introduced, it is normal to feel some discomfort as the body adjusts.
Important distinctions:
Muscle soreness after exercise is normal, especially when starting out.
Sharp or severe pain is not normal and should be assessed by a health professional.
Avoidance of exercise due to fear of pain can lead to worsening weakness and instability.
Gentle strengthening of the back and core muscles helps stabilise the spine, improve posture, and reduce discomfort over time. Safe extension exercises (like prone back lifts or supported standing extensions) are especially effective for reducing chronic back pain related to osteoporosis.
Exercise Benefits Beyond Bones
Exercise for osteoporosis is not just about bones—it supports the whole person.
Strength and Mobility
Improves daily function (e.g., standing up, walking, lifting objects).
Increases independence and reduces fall risk.
Enhances balance, flexibility, and energy levels.
Psychological and Emotional Well-being
Builds confidence and reduces fear of movement.
Improves mood and decreases anxiety through endorphin release.
Creates a sense of empowerment in managing health.
Safety First: Tips for Getting Started
For those new to exercise or returning after a long break, these safety tips are essential:
Start slowly with low resistance and few repetitions.
Avoid spinal flexion (e.g., sit-ups, toe-touches) which can increase fracture risk.
Use support (walls, chairs) for balance training.
Warm up and cool down with each session.
Listen to your body – mild soreness is okay, sharp pain is not.
Always consult with your osteopath, physiotherapist, or GP before starting a new exercise program, especially if you have a history of fractures or severe osteoporosis.
Final Thoughts: Keep Moving—Gently but Consistently
Gentle resistance exercise is one of the most effective, research-backed strategies for improving bone health and managing osteoporosis. It strengthens not only bones but also muscles, joints, posture, and confidence. Most importantly, movement brings freedom—freedom from fear, pain, and the physical limitations of fragility.
If you or a loved one has osteoporosis, remember: it is never too late to start. Start slow, stay consistent, and enjoy the benefits of a stronger, more resilient body.
References
Sinaki, M. and Mikkelsen, B.A., 1984. Postmenopausal spinal osteoporosis: flexion versus extension exercises. Archives of Physical Medicine and Rehabilitation, 65(7), pp.593–596. Link to study
Watson, S.L. et al., 2015. Heavy resistance training is safe and improves bone, function, and stature in postmenopausal women with low to very low bone mass: novel early findings from the LIFTMOR trial. Journal of Bone and Mineral Research, 30(4), pp.749–757. Link to study
Giangregorio, L.M. et al., 2014. Too Fit To Fracture: exercise recommendations for individuals with osteoporosis or osteoporotic vertebral fracture. Osteoporosis International, 25(3), pp.821–835. Link to study
Royal Osteoporosis Society (UK). (2020). Exercise and osteoporosis. Access full guide
International Osteoporosis Foundation (IOF). (2022). Living with osteoporosis: Exercise. Website