Exercise for Osteoporosis

The Exercise for Osteoporosis prescription:
take one daily for
natural health and strong bones


As a practicing physician interested in the best care for my patients, exercise for osteoporosis treatment is an ideal example of the best of holistic remedies. Knowing now all that we do about the science of exercise, it’s a wonder that a big pharmaceutical company doesn’t try to patent it. If they could, it would be the most effective medicine with the least side effects of any medication that has ever been seen. This is not only true for osteoporosis treatment and prevention, but also for countless other serious medical conditions for which exercise stacks up well against prescriptions. The list includes depression, chronic pain, insomnia, heart disease, diabetes, and cancer prevention. And if exercise works so well, why aren’t more doctors prescribing it, or more patients doing it?

Here are my thoughts on that question, based not only on years of medical practice in which I have frequently discussed exercise habits with my patients, but also on observing myself and my own physical fitness.


Doctors receive little or no training on how to write an exercise prescription, and the benefits of exercise get only a passing mention in medical school. So the fallback position of your doctor when faced with any problem is to reach for a prescription pad for drugs, not to detail an exercise plan. My hope is that will change in the near future, so that exercise for osteoporosis will become as common as bisphosphonates for osteoporosis.

And what about the rest of us? When I am just “me” and not at work in my MD role, what stops me from exercising? You should know honestly that I do make physical fitness a commitment, and I exercise regularly. But it is not easy, and I struggle to make time for it. But even that last sentence is deceptive, because I am not really making time, just deciding what is most important to fit into the 24 hours a day that I have. This could be a very long discussion, but I will simply refer you at this point to a book that changed my life: Seven Habits of Highly Effective People, by Stephen R. Covey is a foundational resource when you are working to live according to your values, putting first things first. Exercise in this model is one of a number of decisions you make when you truly discover that you (not anyone else) have the right to be in charge of what happens in your life.

This area of motivation to exercise can also be addressed through strategies that change the image we have of ourselves in the subconcious mind. When I see myself as a person who exercises regularly instead of “I am such a couch potato”, my behavior will tend to fall in line with my self concept. Hypnotherapy can address this, as can health coaching.

What then do we really know about the benefits of exercise for osteoporosis? For women who already have thinning of the bones, the simple act of walking at least 4 hours per week has been shown in research to increase bone density at the hip. But why wait until the bones are osteopenic or worse? Start young, and use weight bearing exercise as a prevention strategy. The teens and 20’s are the most critical years for building bone mass which must last a lifetime. This is one of the reasons I am so in favor of youth sports for girls. So regular physical activity is most important for young women, and continues to be so throughout the lifespan.

What do we mean by weight bearing exercise? Any form of exercise in which there is resistance against a weight or gravity, so the muscles have to work against it. This includes activities as varied as walking, jogging, heavy gardening, pushing a lawnmower, or using resistance weights at the gym. It does not typically include swimming or cycling, but these are good options for people who cannot for some other physical reason carry out the stronger weight bearing activities. Remember then that weight bearing exercise is the best form of exercise for osteoporosis.

If you already have significant osteoporosis however, I recommend that you see a physical therapist for exercise training first, to reduce the risk that you could actually cause a fracture as you are starting your program.

I am hopeful that this brief introduction has inspired you. If you are young and healthy, invest now in your bones by exercising them daily. If you know you have osteopenia (mild thinning), start now and prove that you can reverse it. And if you have osteoporosis, discuss exercise with your doctor and get a referral to a physical therapist so you can start exercise for osteoporosis safely!

Maybe on a fine day soon, I will see you out walking! Until then…

stay well,



Robert Pendergrast, M.D. 

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