Osteoporosis is often an intimidating diagnosis, but no matter the state of your bones, you can take action. Because osteoporosis usually develops without symptoms, it is frequently called a “silent disease.” Let’s take a closer look at what this condition means, why it matters, and how you can safely build strength and protect your independence.
What Is Osteoporosis? (Osteo-What?)
Bones are made of cells and minerals, most notably calcium and phosphate. Think “osteo” = bone, and “porosis” = the porosity or number of tiny holes, referring to a lack of calcium and a decrease in bone mineral density.
Simply put, osteoporosis is a more advanced form of osteopenia. Both describe below-average bone mineral density, which changes the structure of the bone and increases your risk for fractures — even from a minor fall or everyday activities.
Understanding your bone density: the DEXA scan
Bone density is measured using a DEXA scan (a type of X-ray). It provides two critical scores measured in standard deviations:
Z-score: Compares your bone density to people the same age as you.
T-score: Compares your bone density to a healthy young adult of the same sex. This helps determine your fracture risk and treatment needs:
Normal: A T-score of -1.0 or higher.
Osteopenia: A T-score of -1.0 to -2.5 (10% to 25% less bone density than a healthy young adult).
Osteoporosis: A T-score of -2.5 or less (at least 25% less bone density than a healthy young adult).
Why does osteoporosis matter?
Low bone mineral density significantly increases a person’s risk of breaking a bone — most commonly in the hips, spine, and wrists.
Sometimes these breaks happen due to a fall. Other times, spinal compression fractures occur over time due to lifting heavier items or increased upper back rounding (kyphosis). Beyond the physical break, fractures can lead to:
- Severe or chronic pain
- Loss of independence
- Hospitalization and delayed healing
- Reduced quality of life and an increased risk of future fractures
Because our bodies build strong bones easily in youth but slow down with age, it is vital to start treatment early to prevent further bone loss.
Am I at risk for osteoporosis?
It is normal for bone density to decrease slightly each year after age 50. However, when that process accelerates, it is often driven by a combination of factors. Review the categories below to see what pertains to you:
Genetics: Assigned female at birth, post-menopausal, White or Asian descent, or a family history of osteoporosis (especially a parent with a hip fracture).
Lifestyle Factors: Sedentary lifestyle, tobacco use, or heavy alcohol consumption (more than 2 drinks per day).
Medication Use: Long-term use of oral or injected corticosteroids (such as prednisone or cortisone).
Diet: Low calcium intake, history of an eating disorder, or gastrointestinal surgery limiting nutrient absorption.
Medical Conditions: Celiac disease, irritable bowel syndrome, kidney or liver disease, cancer, or rheumatoid arthritis.
Exercise and bone health
Exercise is one of the most effective non-medication treatments for maintaining bone health and reducing fracture risk. Bones respond dynamically to the stress placed upon them — either through impact or muscle pull. Research shows that exercise programs lasting six months or longer can help slow bone loss, particularly in the hips and spine.
The strongest evidence supports programs combining three elements:
High-Force Resistance Training: Using weight machines, free weights, resistance bands, or functional strength exercises to place healthy stress on bones and muscles.
Weight-Bearing Activity: Walking on different surfaces, hiking, climbing stairs, or jumping to stimulate bone remodeling.
Balance Training: Static and dynamic balance activities, weight-shifting, and reaching drills to prevent falls before they happen.
Exercise safety matters: the goal is safe movement
While higher-force exercises are more effective for maintaining bone density than low-intensity movement alone, they are not appropriate for everyone.
High-Impact Caution: Activities like running or jumping can provide great benefits for bone health in some individuals, but they can also increase fracture risk if introduced too quickly or performed without proper technique.
Individualization: People with osteoporosis may be at greater risk if they have poor landing mechanics, insufficient strength, balance impairments, or a history of spinal fractures.
The goal is not simply to exercise harder, but to exercise safely. Proper form, appropriate loading, and gradual progression are essential for maximizing benefits while minimizing risk.
How physical therapy can help individuals with osteoporosis
Physical therapists are movement specialists who can develop individualized exercise programs based on your DEXA scan results, medical and fracture history, strength, balance, and personal goals.
A physical therapist can help you:
Determine whether higher-force strengthening or impact exercises are safe for you.
Teach safe movement, lifting, and bending strategies.
Improve balance, posture, and core stability to reduce fall risk.
Progress your routine safely over time so you can stay active and build confidence.
Boost your bone health with these 5 exercises!
Try performing these exercises for 2-3 sets of 8-12 repetitions each, approximately 3 times per week. Rest days are important to allow your muscles and bones time to recover before loading them again.
Squats
Keep your chest up, and, if using a weight, hold it close to your body. You can use a chair or a weight bench to guide your position at the bottom of your squat.
Wall pushups
Stand an arm's length away from a wall and place your hands in a pushup position. Lean in with a straight back, bending arms to a 90-degree angle, then push back to starting position.
Planks
Hold your body straight and parallel to the floor while resting on your toes and elbows/forearms. Don't let your butt raise up in the air or your hips sag to the floor. Maintain a straight line from head to toe.
Hip hinges
Stand with feet hip width apart and bend forward from the hips keeping a flat back or neutral spine. It should feel like you’re pushing your bottom out and backward as your chest comes forward, and your knees stay slightly bent. Use a long dowel or pole to aid in keeping your spine straight.
Side stepping with resistance
Place a looped resistance band around your legs just below the knees. From a hip-width stance with our knees bent, step laterally with one foot, maintaining tension in the band, then bring the other foot in. Alternate directions. Keep your toes pointed forward throughout the exercise.
Boost your balance with these 3 moves!
Try these three exercises to help improve your balance and practice them every day. Sometimes these are easiest to perform while brushing your teeth or waiting for something to heat up in the microwave. Always have a chair, counter, table, or wall nearby to grab if needed.
Single-leg balance
Try to increase the amount of time you can balance on each side to 30 seconds. Make sure you have something secure to hold on to for support if needed, such as a countertop or a wall.
Single-leg deadlift
Lift one leg in front of you for a moment before slowly lifting it behind you as you tip forward. Return to starting position and alternate sides. Try to keep a neutral spine throughout the exercise.
Tandem stance balance
Stand with the wall close enough to assist with balance. Position the right foot directly in front of the left, as if on a balance beam, with the right heel touching the toes of the left foot. Maintain this balanced stance for 30-45 seconds, keeping the head up, core tight, and shoulders back; slight separation is acceptable if bringing the feet close together is challenging. Alternate lead foot.
Learn more about physical therapy for osteoporosis.
For additional information about osteoporosis or to get a strength and balance training program that is specific to you, reach out! Our experts can teach you further strategies on how to strengthen areas that are most affected by osteoporosis, make sure form is appropriate during exercises, educate on safe lifting techniques, and discuss other strategies to help prevent falls.
