Women whose bones are fragile and porous—due to the severe loss of bone density that characterizes osteoporosis-often avoid exercise for fear that jarring or twisting motions could cause fractures.

Done properly, however, exercise is not only safe for people with osteoporosis or its milder form, osteopenia, it actually can reduce or even reverse bone loss. For people whose bones are still healthy, exercise helps ensure that osteoporosis never develops.

Reason: When a muscle exerts tension on a bone, it stimulates specialized cells that increase new bone formation. Also, when muscles that contribute to balance are strengthened, falls (and resulting fractures) are less likely.

Keys: Doing the types of workouts that build bone most effectively...and modifying techniques as necessary to avoid overstressing already weakened bones.

What to do: Start by exercising for 10 to 20 minutes several times a week, gradually building up to 30 minutes a day six days per week. Alternate between a strength-training workout one day and an aerobic activity the next.

Important: Before beginning the exercise program below, ask your doctor which instructions you should follow-the ones labeled "If you have healthy bones" or the ones labeled "If you already have bone loss."

Strength Training For Bones

The only equipment you need are hand weights (dumbbells) and ankle weights (pads that strap around the ankles), $20 and up per pair at sports equipment stores.

For each exercise, begin with one set of eight repetitions (reps). If you cannot do eight reps using the suggested starting weights, use lighter weights. Over several weeks, gradually increase to 10, then 12, then 15 reps. Then try two sets of eight reps, resting for one minute between sets...and again gradually increase the reps. When you can do two sets of 15 reps, increase the weight by one to two pounds and start again with one set of eight reps.

Keep your shoulders back and abdominal muscles pulled in. With each rep, exhale during the initial move...hold the position for two seconds...inhale as you return to the starting position. Move slowly, using muscles rather than momentum. Do not lock elbow or knee joints.

Upper Body

These exercises build bone density in the shoulders, arms and spine.

If you have healthy bones: Stand during the exercises. Start by holding a five-pound weight in each hand...over time, try to work up to eight, then 10, then 12 pounds.

If you already have bone loss: To guard against falls, sit in a straight-backed chair while exercising. At first, use no weights or use one or two-pound weights...gradually work up to three-, then five-, then a maximum of eight-pound weights if you can. Avoid heavier weights --they could increase the risk for vertebral compression fractures.

  • Arms forward.

To start: Bend elbows, arms close to your body, hands at chest-height, palms facing each other.

One rep: Straighten elbows until both arms are extended in front of you, parallel to the floor...hold... return to starting position.

  • Arm overhead.

To start: Raise right arm straight overhead, palm facing forward.

One rep: Bend right elbow, bringing right hand down behind your head...hold...return to starting position. Do a set with the right arm, then with the left.

  • Arms up-and-down.

To start: Have arms down at your sides, palms forward.

One rep: Keeping elbows close to your sides, bend arms to raise hands toward shoulders until palms face you...hold. lower to starting position.


This strengthens and stabilizes "core" muscles (abdomen, back, pelvic area). By improving body alignment, it helps prevent falls and reduces pressure on the vertebrae, protecting against compression fractures of the spine. No weights are used.

If you have healthy bones: Do this exercise while standing...or try while lying on your back, with knees bent and feet flat on the floor.

If you already have bone loss: Done while standing, this is a good option for osteoporosis patients who are uncomfortable exercising on the floor. If you have balance problems, hold onto a counter...or sit in a chair.

  • Tummy tuck/pelvic tilt.

To start: Arms at sides, feet hip-width apart.

One rep: Simultaneously contract abdominal muscles to draw your tummy toward your spine, tighten

buttocks muscles, and tilt the bottom of your pelvis forward to flatten the arch of your back... hold...return to starting position.

Lower Body

These moves increase bone density in the legs and feet. For each rep, raise the leg as high as possible without leaning...hold for two seconds...return to starting position.

Advanced option: Try not to touch your foot to the ground between reps.

If you have healthy bones: Start by wearing a two-pound ankle weight on each leg... gradually increase to 10 pounds per ankle.

If you already have bone loss: Hold onto a counter for balance. To begin, use no weights... build up, one pound at a time, to five pounds per ankle.

  • Leg forward-and-back.

To start: Stand on your right foot.

One rep: Keeping both legs straight, slowly swing left leg forward and up...hold...swing leg down through the starting position and up behind you...hold...return to starting position After one set, repeat with the other leg.

  • Leg out.

To start: Stand on your right foot.

One rep: Keep both legs straight. Slowly lift left leg out to the side...hold...return to starting position. After one set, repeat with the other leg.

Bone-Benefiting Aerobics

  • Biking, stationary cycling, swimming and rowing are good for heart health-but they do not protect against osteoporosis.

Better: Weight-bearing aerobic activities in which you're on your feet, bones working against gravity, build bone mass in the hips and legs.

If you have healthy bones: Good choices include jogging, dancing, stair climbing, step aerobics, jumping rope, racket sports and interactive video games, such as Wii Fit and Dance Dance Revolution. If you enjoy walking, boost intensity by wearing a two-to 20pound weighted vest ($50 and up at sports equipment stores).

Warning: Do not wear ankle weights during aerobic workouts-this could stress your joints.

If you already have bone loss: Refrain from high-impact activities (running, jumping and those that require twisting or bending (racket sports, golf). Do not wear a weighted vest.

Safe low-impact options: Walking, using an elliptical machine (available at most gyms), qigong and tai chi.

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