What is Osteoporosis?

I have recently had a member of our online Pilates community and a few people at my studio if they could do Pilates with osteoporosis.

Of course, it is best for anyone who has any medical issue to check with their doctor before beginning any exercise program.  However, it is generally safe to Pilates when you have osteoporosis, AS LONG AS you avoid and/or modify certain exercises.

People who have osteoporosis have weakened bone density.  This means that, in general, these people have more fragile bones and are more susceptible to fractures.

Globally, 1 in 3 women and 1 in 5 men older than 50 will suffer from an osteoporotic fracture!  (Smith & Boser, 2013).  Obviously, this means that osteoporosis is very common.

Several studies, including one published by the Mayo Clinic in 1984, found that people with osteoporosis should avoid exercises that involve spinal flexion.  (Spinal flexion is defined as forward bending.)  It found that flexing the spine can cause micro fractures in the spine.  In turn, these micro fractures can cause kyphosis of the spine (also known as Dowager’s hump or the Quasimodo hump), a decrease in height, and painful fractures in the dorsal and lumbar spines.

 

What Exercises Should I Avoid?

In Pilates, many exercises involve flexing part of the spine. Therefore, people with osteoporosis should avoid them.   Some of these exercises include classic exercises that include scoops, spine stretch, etc.  (There are some instances where studies have shown that mild spinal flexion is not harmful.  To know your specific situation, you should check with your doctor.)

Many Pilates exercises are typically done with a cervical nod, a type of spinal flexion.  However, people with osteoporosis can do these poses without the cervical nod.  That is, people with osteoporosis can simply keep their head down when doing exercises such as the single leg stretch, double leg stretch, etc.

Additionally, Pilates exercises that involve rolling on your spine should also be avoided.   Therefore, anyone with osteoporosis should avoid exercises like rolling like a ball, open leg rocker, etc.

Furthermore, people with osteoporosis should generally avoid deep twisting exercises.   Therefore, people should modify or avoid exercises such as the saw, spine twists, etc.

 

What Exercises Can Someone with Osteoporosis do?

Even though they need to avoid exercises that involve spinal flexion and rolling, most people with osteoporosis can do many Pilates exercises.  (Again, it is always best to check with your doctor regarding your specific condition.)

In my latest video release, I do a 45 minute Pilates class especially made for anyone with osteoporosis.  When I was making it, I wondered if I would run out of exercises to to.   Instead, I couldn’t get enough in.  In fact, I could make several other videos for osteoporosis if there was an interest.

Avoiding excessive flexion at the cervical spine in Pilates is easy. Participants don’t have to keep their head lifted in the exercises.  Instead, they can modify the exercises by keeping their head down.  People can use this option for the single leg stretch, double leg stretch, frog, single leg circles, hundred, double leg drops, single straight leg stretch, etc.

 

The Pilates exercises that involve spinal extension are generally very beneficial for people with osteoporosis for several reasons.   Spinal extension helps strengthen the back muscles and helps promote normal spinal curves and good posture by strengthening the muscles that support the spine (Sinaki et al, 1996). In addition, there is evidence that strengthening the back extensors may decrease the long-term risk of vertebral fractures (Sinaki et al., 2002). Also, since kyphosis may also be linked to weak spinal extensor muscles (Mika , Unnithan, & Mika, 2005).

Some exercises that strengthen the spinal extensors are swimming, single leg kicks, double leg kicks, etc.

Pushups and many of the exercises in the arm series would also be beneficial and safe.

Strengthening the hips is also generally beneficial for people with osteoporosis because strengthening the muscles around the hip can help prevent potential hip fractures.  As a result, someone with osteoporosis can safely do most of the side lying series in Pilates.

 

What are the Benefits of Doing Pilates with Osteoporosis?

If you have osteoporosis, you can benefit from doing Pilates.   Just be sure to avoid the exercises that are not considered safe, or modify appropriately.  If you aren’t sure what to do, you could find a specialized class or purchase a specialized video like the one that I made.

Pilates helps you build strength, and being strong has many benefits.  For instance, as previously mentioned, strengthening your back can help you improve your posture and may help you to avoid or improve kyphosis.   Additionally, strengthening your hips can help you to avoid potential hip fractures.

Pilates also helps you to improve your balance, which can make you less susceptible to falling.

You can also improve your range of motion with Pilates, which can make you less likely to experience pulled muscles and/or muscles spasms.

Last, some research  into Pilates has shown that people who practice Pilates may experience an increase in bone mass density.