If you have osteoporosis, the exercises most important to avoid are those that load the front of your spine (sit-ups, toe touches, crunches), high-impact activities like jumping and running, and forceful twisting motions. These movements can create enough compression or shear force on weakened bone to cause fractures, particularly in the vertebrae. The good news is that most of these have safer alternatives that still keep you strong and active.
Forward Bending and Core Exercises
The single most important category to avoid is spinal flexion, meaning any exercise that rounds your back forward. This includes sit-ups, crunches, toe touches, and picking things up with straight legs. The reason is straightforward: in everyone’s spine, the front portion of each vertebra has thinner bone than the back. When you round forward, compression force concentrates on that thinner front edge. In healthy bone, this is no problem. In osteoporotic bone, it can cause a wedge fracture, where the front of the vertebra collapses while the back stays intact.
This matters beyond the gym. Every time you bend to tie your shoes, reach for something on a low shelf, or slouch in a chair, you’re flexing your spine. The goal isn’t to never bend forward in daily life, but to avoid doing it repeatedly under load or as a structured exercise.
For core work, the fix is choosing exercises that keep your spine in its natural arch. Leg lifts while lying on your back, planks (if you can hold good form), and gentle bracing exercises all strengthen your abdominal muscles without compressing the front of your vertebrae.
High-Impact Activities
Jumping, running, jogging, and any exercise with sudden jarring landings can fracture weakened bones. The forces involved aren’t necessarily enormous, but they’re fast and repetitive, and osteoporotic bone doesn’t absorb shock the way healthy bone does.
This recommendation isn’t universal, though. A UK consensus statement published in the British Journal of Sports Medicine draws an important distinction. If you have osteoporosis but no history of vertebral fractures or multiple low-trauma fractures, moderate-impact exercise like stamping, light jogging, and low-level hopping is actually recommended, with at least 50 impacts per session. These controlled impacts help stimulate bone to maintain or build density.
If you do have vertebral fractures or a history of multiple fractures, the recommendation drops to brisk walking as your upper limit for impact, aiming for about 20 minutes a day. This is a precautionary guideline rather than one backed by proof that moderate impact causes further fractures in this group, but the theoretical risk is real enough that experts err on the side of caution.
Twisting and Rotational Movements
Forceful spinal rotation puts significant shear stress on the vertebrae and the small facet joints that connect them. Those facet joints resist more than 50% of the front-to-back shear load on your spine, and when bone is weakened, the combination of compression and rotation can be enough to cause a fracture.
Golf is one of the clearest real-world examples. The golf swing generates high rotational force through the lumbar spine, and case reports in the medical literature document vertebral compression fractures occurring during a round of golf in people with osteoporosis. Tennis involves similar rotational demands. Both sports can potentially be modified with a rigid back support or by reducing swing intensity, but they carry genuine risk.
In the gym, avoid Russian twists, seated rotational machines, and any movement where you’re twisting forcefully through your midsection under load. Gentler rotation, like a controlled twist while lying on your back with your knees supported on a wall or blanket, is a safer way to maintain spinal mobility.
Weightlifting Limits for Spinal Osteoporosis
Resistance training is one of the best things you can do for bone health, but the rules change depending on where your bone loss is. If your osteoporosis is in your spine, keep the weight you lift with your arms or against your trunk to 20 to 25 pounds or less. Avoid movements that have you bending forward or twisting your trunk while holding weight. Bending backward (extension) is generally fine.
If your osteoporosis is in the hips, there’s no specific weight restriction. The hip joint handles compressive loads well, and strengthening the muscles around it actually helps protect against the fractures that matter most.
Regardless of location, use slow, controlled form. A good tempo is four counts to lift and four counts to lower. Tighten your abdominal muscles before each rep to brace your spine, and move only the muscles the exercise is designed to target. Jerky, rapid movements are a consistent risk factor across all exercises because they produce unpredictable peak forces that controlled movement doesn’t.
Yoga and Pilates Modifications
Both yoga and Pilates are popular for flexibility and strength, but both involve poses and movements that are problematic for osteoporosis. Many Pilates exercises use a “C-curve” position that rounds the spine forward, bringing the head and shoulders toward the abdomen. This is exactly the flexion pattern that risks vertebral compression fractures.
In yoga, forward folds are the main concern. A key principle from Osteoporosis Canada: you can use a sturdy chair to modify a downward-facing dog (keeping your spine long and straight), but you should not use a yoga strap to pull yourself deeper into a forward bend. The strap increases the flexion force on your vertebrae, which is the opposite of what you want.
Several common poses can be done safely with modifications:
- Twists: Do them lying down instead of seated, and rest your knees against a wall or folded blanket so you don’t rotate too far.
- Child’s pose: Place a yoga block under your forehead or rest it on stacked fists to prevent your back from rounding.
- Thread the needle: Do it lying on your back with your head resting on the ground, avoiding a rounded spine.
If you’re doing chair yoga, be especially careful with any bending or twisting of the spine. Focus on postures that lengthen and straighten rather than curl.
Balance Training to Prevent Falls
Avoiding dangerous exercises is only half the equation. Most osteoporotic fractures don’t happen during exercise. They happen during falls. That makes balance training one of the highest-value activities you can do, and it’s worth treating as a daily habit rather than an afterthought.
Effective balance exercises don’t require equipment. Standing on one foot near a kitchen counter (so you can catch yourself), heel-to-toe walking along a hallway, and sit-to-stand repetitions from a chair all build the leg strength and proprioception that keep you upright. The sit-to-stand exercise is particularly useful because it trains the exact movement pattern involved in getting out of chairs and off toilets, two common fall scenarios.
Once basic balance feels stable, closing your eyes during standing exercises dramatically increases the challenge. Start with 10-second holds and work toward 30 seconds. Have someone nearby or stand in a corner when you first try this, since removing visual input reveals how much your balance actually depends on your eyes.