Strong Bones, Osteoporosis & Pilates


Osteoporosis is a condition where bones lose important minerals such as calcium quicker than they can be replaced by the body, resulting in a decrease in the thickness or density of bones. This can lead to them becoming fragile and brittle, and at a higher risk of fractures than normal bone. Often called the “silent disease”, osteoporosis can occur without any signs or symptoms until a bone fracture or break can be caused by even a minor bump or accident. Over time, these fractures can lead to changes in posture (e.g. developing a stoop in your back), loss of height and muscle weakness.


Osteoporosis is diagnosed by measuring the mineral density of your bones (usually at the hip and spine) through a dual energy X-ray absorptiometry (DXA) scan, and this will enable doctors to determine the extent of bone loss and if any action is needed to improve your bone health. The DXA scan will give you a “T-Score”, and the result will indicate if your bones are in the range of either:

  • Normal (T-Score 1 to -1)
  • Low bone density, also called osteopenia, which if not addressed can lead to osteoporosis (T-Score -1 to -2.5) or
  • Osteoporosis (T-Score -2.5 or lower) 

Finding out your bone density as early as possible is important so that you can take action to keep your bones strong, slow bone loss and decrease the risk of breaks. It is recommended that anyone over the age of 50 with risk factors should have a bone density scan, however some risk factors may also require people under 50 to have one.


Risk factors for developing osteoporosis include: a family history, medical history, genetics, gender (females are at a higher risk), age of over 60 years, hormones, certain medications, smoking, low levels of exercise, high alcohol intake, being underweight, low calcium and low vitamin D levels. Addressing any of these risk factors can help to reduce the risk of developing osteopenia or osteoporosis.


Certain types of activities are highly recommended to help improve and maintain bone density, including weight bearing activities and strength training.

Weight bearing activities are ‘anti-gravity’ (against the resistance of gravity) exercises on land, and include jogging, running, skipping, stair climbing, dancing and any land-based sport. Higher impact activities such as tennis and basketball have a greater effect on bone strength than low impact activities such as walking. However, lower intensity exercise may be a more appropriate starting point for some people, with the aim being to progress to more moderate or high impact exercise over time.

Strength training includes any form of resistance or weighted training, as well as functional exercises that lift your own body weight. This type of activity provides the stimulus of both ‘compression’ on the bone from gravity and ‘traction’ on the bone from the attached muscles to promote stronger and healthier bones. Examples of such exercises include weighted squats and the bench press.


Pilates is a form of resistance based exercise, particularly when done with specialized equipment. Exercises such as jumping on the Reformer can provide a safe and controlled method of introducing impact to the bones without loading the joints as much as when performing the same activities on land. The improvement in muscle strength that comes with Pilates can also help to reduce the risk of falls and sustaining a fracture. This is further enhanced with the improvement of balance, coordination and reaction speed that can come with certain Pilates exercises. Pilates works on improving posture, which can help to decrease the compressive loads on the spine, and lessen the chance of wedge fractures. It is also one of the few activities that includes controlled spine and hip “extensor” exercises, which is important to undertake regularly for improved posture & for osteoporosis management.

For anyone with osteoporosis, osteopenia, or at risk of developing either, it is important that Pilates is done with a physiotherapist or qualified instructor who knows which exercises are appropriate, as some exercises can be potentially dangerous for anyone with osteoporosis.

At Fix and Flex we can develop you a personalised program that addresses your bone strength and health, whether in a preventative or management manner, so book in with one of our qualified physiotherapists today!



Bone Density


Osteoporotic Fractures