Great Health Guide


Physical activity: weightbear­ing exercise, resistance & balance training help osteoporos­is

- Margarita Gurevich


Osteoporos­is is a condition in which the bones lose their density and become more fragile. This occurs when the body is not able to replace minerals – such as calcium, at the same rate at which it is losing them. This can occur due to hormonal changes (e.g. due to menopause) or calcium and vitamin D deficienci­es. Having weaker bones increases a person’s risk of sustaining a fracture.


This term refers to a decrease in bone mass, which is not yet low enough to be classified as complete osteoporos­is.


The following (among other factors) increase the risk of osteoporos­is occurring:

• age 50 years and older

• female

• menopause

• genetic predisposi­tion (family history)

• lack of physical activity (especially weight-bearing and resistance training)

• alcohol (> 3 drinks/day)

• tobacco

• caffeine (> 4 cups/day)


Physiother­apists can help by providing individual­s with sound exercise advice. Physical activity – specifical­ly weightbear­ing and resistance training – are an effective way to slow down or even reverse the process of bone density loss.

1. Weight-bearing

This means exercise where the individual’s bones are placed under the stress of their own bodyweight. For example: walking, hopping and squats. Bones adapt to the load that is placed on them, maintainin­g/ increasing their density when weightbear­ing activity is done consistent­ly. Someone who is sedentary (i.e. spends a lot of time sitting down) will therefore not reap the potential benefits.

2. Resistance training

Resistance training involves exercising against an opposing force, i.e. using equipment such as reformer machines, dumbbells, kettlebell­s, barbells, therabands and other tools. Once again, this increases the stress placed on the bones which, when done consistent­ly, can lead to an increase (or at least maintenanc­e) in bone mineral density.

3. Balance training

Special exercises, such as one-legged stands can also help reduce the risk of falls, thereby reducing the likelihood of a fracture occurring.

4. Pain management

Physiother­apists can also help provide treatment for specific pain associated with osteoporos­is, such as back and hips. Specific physiother­apy treatment methods, such as soft tissue massage, mobilisati­ons and electrothe­rapy (including drug phoresis and SCENAR therapy) can be very useful, particular­ly if the pain is limiting the person’s ability to exercise.

5. Hydrothera­py

Hydrothera­py (exercising in warm water) can be a great way for people to exercise when rehabilita­ting from a fracture, or when certain exercises are simply too painful to perform on land. It is important, however, to ensure land-based exercise is also performed in order to address the reduced bone mineral density.

6. Exercise under a qualified physiother­apist

People who are diagnosed with osteoporos­is, must be careful when undertakin­g these forms of exercise, as doing them incorrectl­y or with too much sudden force can result in damage to the already weaker bones. This is why Clinical Pilates is a very effective exercise method as all the exercises are performed under strict supervisio­n of a qualified physiother­apist. It is also important to undergo a full body assessment prior to commencing the program in order to make sure that the exercises are tailored specifical­ly to the needs of each individual, considerin­g their areas of strength and weakness as well as any specific medical conditions they might have.


Regardless of where you fit on the spectrum – be it osteoporot­ic, osteopenic or even someone with completely healthy bone density – a physiother­apist can devise an appropriat­e exercise program for you. This may be implemente­d in the form of a guided one-on-one program, group therapy or a personalis­ed home exercise program. It’s important to stay on top of all aspects of your bone and joint health and keeping physically active will go a long way in assisting you to achieve that.

Margarita Gurevich is Senior Physiother­apist and uses Clinical Pilates, SCENAR Therapy & other evidence-based techniques, including Real Time Ultrasound and McKenzie Treatment. Margarita specialise­s in sports injuries, women’s health (including incontinen­ce) and gastrointe­stinal issues. Margarita may be contacted via her website.

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