Exercising with osteoporosis can feel intimidating. You may worry about whether certain movements are safe or which activities are right for you. But avoiding movement altogether makes bones and muscles weaker. The key is not to stop moving, but to learn how to move safely. With the right modifications, you can continue to enjoy Essentrics while protecting your bones and supporting your long-term health.
Key Guidelines for Exercising with Osteoporosis
– Avoid loaded spinal flexion, prolonged forward folds or forcing end ranges.
– Progress gradually and stay within your personal comfort zone.
– Focus on elongation, awareness, and multi-directional weight-bearing movements.
– Use techniques like Pulling Up, hip hinging and isometric core work to strengthen and stretch without overloading the spine.
– Replace traditional crunches with isometric ab exercises lying on your back, knees bent and deep core engaged.
– Prioritize safety and alignment: use a mirror when possible, engage the abdominals to support the spine and move slowly with control.
– Remember: not every exercise is right for every body. Adapt movements to your needs and always consult a healthcare professional if you have osteoporosis or related concerns.
Supporting Bone Health Through Movement
With more than 1 in 4 women over age 65 in the U.S. diagnosed with osteoporosis, it’s important to find movement that supports posture, circulation and strength — without overstressing the joints.
Harvard Health explains: “Exercise can help you build bone and muscle strength and improve balance, coordination, and posture — all of which reduce the risk of falls and fractures.” 1 They also note that, when exercising with osteoporosis, certain movements should be adapted to avoid excessive spinal compression, twisting or high impact.
In other words, the goal isn’t to stop moving, but to learn how to move safely. Without regular activity, bones and muscles weaken further. The right kind of exercise helps maintain mobility, confidence and quality of life.
That’s where Essentrics comes in. It’s a gentle, weight-bearing program that engages muscles through full-body, flowing movement. Similar approaches, such as Tai Chi, are considered safe for people with osteoporosis.2 Research shows Tai Chi improves balance and coordination, which can reduce fall risk, an especially important factor for those living with fragile bones.
Everyone’s body and diagnosis are different, so not every movement is right for every person. Always consult your healthcare provider before starting or changing your exercise routine. Below, you’ll find simple modifications to help you keep moving with osteoporosis — supporting your body while reducing strain on areas that need extra care.
Simple Modifications for Moving Safely with Essentrics
Here are the key exercises you’ll modify to keep moving safely and confidently:
– Neutral C
– Spinal Rotations
– Hamstring Stretches – Seated & Chair
– Ab Exercises – Lying on Back
We recommend using a mirror to check your alignment as you practice these modifications, moving slowly and with ease.
Neutral C
Why Modify? Neutral C is one of the fundamental spinal positions in Essentrics, where the spine is rounded, and it’s used in every Essentrics workout. Its primary purpose is to rebalance the spine by stretching the muscles. However, it is important to distinguish Neutral C from the traditional C-Curve spine found in other exercise programs, which can compress the spine and is contraindicated for osteoporosis.
Essentrics Neutral C Position
Image Source: The Miracle of Flexibility: A Head-To-Toe Program to Increase Strength, Improve Mobility, and Become Pain Free by Miranda Esmonde-White
In Essentrics, the key distinction in this position lies in our approach: we emphasize isolating the hips and shoulders from the spine, while “Pulling Up” to create space between the vertebrae — most importantly in the mid-spine, where osteoporosis often increases the risk of fractures. Though this version will be a smaller Neutral C than you may see in some of our videos, this modification will ensure your safety while still allowing you to reap the benefits of our workouts!
How to Modify:
1. Stand with your feet hip-width apart and gently bend your knees.
2. Tuck your tailbone, feeling your hips rotating around your thigh bones.
3. Pull up through your spine, visualizing the little interspinales muscles between each vertebra that help extend and stabilize the spine and maintain posture. Focus on engaging your core, because it supports and balances the strength we need in our lumbar or lower spine.
4. Softly round your shoulders forward. Think of a soft “parenthesis,” rather than a big C shape.
Top Tips: Remember to move with control and avoid a full forward fold. Take a break at any time.
Spinal Rotations
Why Modify? Rotation is essential for life! We twist our spine when looking out the back window of the car or reaching for groceries off the shelf and putting them into the cart. In Essentrics, the key to doing any spinal rotation, such as our Windmill exercise, is deliberate and controlled movement—never working to your maximum.
Tips to Modify:
– Always move slowly and gently with control.
– In any rotation, pull up and allow the hips to move.
– Never hold a position. Once you reach the ideal spot for your body, slowly come out of the exercise.
Essentrics Windmill Exercise
Image Source: Châtelaine
Hamstring Stretches – Seated or at the Barre
Why Modify? In this exercise, people often round their back in an attempt to reach as far as possible. In Essentrics, instead of rounding the spine forward, we hinge forward from the place where our hips and legs meet while Pulling Up to help lengthen the spine and increase space between the vertebra.
Tips to Modify:
– Floor: Sitting on risers will help you maintain a straight back with your legs in front. This reduces the stretch on the hamstrings enough to help you sit up tall and lengthen the spine.
– Barre/Chair: Place one foot on the seat of the chair. Bend your standing leg and keep your hips neutral. Keeping your spine straight (not rounding), Pull Up as you reach to the ceiling or sweep forward.
– If you have trouble getting your leg onto the seat of a chair, you can place it on the floor or a low stool. Be sure to hold the back of a chair so you don’t have to worry about balance!
Modification for Seated Hamstring Stretch: Sitting on Risers
Image Source: The Miracle of Flexibility: A Head-To-Toe Program to Increase Strength, Improve Mobility, and Become Pain Free by Miranda Esmonde-White
Barre/Chair Hamstring Stretch: Pulling Up through the Spine
Image Source: Connective Tissue Workout with Meg Feeney
Ab Exercises – Lying on Back
Why Modify? In a traditional crunch, we round the back as we lift the head. This creates too much force on the delicate vertebra. The safer alternative if you have osteoporosis: isometric abs exercises! This simple yet effective exercise strengthens your core without lifting the body off the floor.
How to Modify:
1. Lie flat on the floor, with your knees bent and feet comfortably apart on the mat. If your chin lifts to the ceiling, place a small cushion under your head.
2. Engage your abs. You can imagine pressing your abs towards the floor or coughing to feel your deep ab muscles engage.
3. Do not lift your head at any point and avoid rocking on your spine.
Top Tip: Use these modifications wherever your workout has a floor abs sequence. In workouts where both legs lift, keep one foot on the ground. You will still build strength in your core, while ensuring you are keeping your bones safe. These modifications are also safe and effective for supporting pelvic floor health.
Example of Isometric Ab Exercises
Contributing writers Dr. Nanette Tummers, Professor Emeritus at Eastern Connecticut State University and Level 4 Essentrics Instructor, and Severina Gates, Level 4 Essentrics Instructor and Educator.
Gentle Workouts to Keep Moving with Osteoporosis
1. Beginner Connective Tissue Workout with Meg Feeney
2. Desk Workout: Hip Pain Release & Prevention with Sahra Esmonde-White
3. Desk Workout: Posture Repair with Gail Garceau
4. Unlock: Feet, Ankles & Calves with Miranda Esmonde-White
FAQ
Q: Can I do Essentrics if I have osteoporosis?
A: Many people with osteoporosis are able to practice Essentrics with modifications, but not every exercise is right for every body. Safety depends on your individual condition, the movement, and how it’s performed. Always consult your healthcare professional before starting or changing your exercise routine.
Q: How can Essentrics support bone health?
A: Essentrics is a weight-bearing program that uses bodyweight and eccentric strengthening movements to engage muscles. This type of gentle loading can encourage bone-strengthening activity, while also supporting posture, circulation, and mobility.
Q: What ab exercises should I avoid with osteoporosis?
A: Avoid crunches or exercises that round the spine. Safer alternatives include isometric ab exercises done lying on your back with knees bent, head down, and deep core engagement to stabilize without lifting or rocking.
Q: How should I modify hamstring stretches?
A: Keep your spine elongated and hinge at the hips instead of rounding forward. Use props like risers, a chair, or a low stool to adjust the stretch so you can move with control and maintain alignment.
Q: What about spinal rotation?
A: Rotation can be safe when performed gently and with control. Focus on lengthening the spine, allow the hips to move, and avoid forcing or holding the position. Move in and out smoothly to reduce strain on the vertebrae.
Q: How do I start Essentrics safely with osteoporosis?
A: Begin with gentle, modified movements and check your alignment in a mirror. Move slowly, focus on techniques like Pulling Up, hip hinging, and isometric strengthening—and always follow the guidance of your healthcare provider.
References:
1. “Effective Exercises for Osteoporosis.” Harvard Health, April 11, 2021. https://www.health.harvard.edu/newsletter_article/effective-exercises-for-osteoporosis
2. Chen, Weidong et al. “Tai Chi for fall prevention and balance improvement in older adults: a systematic review and meta-analysis of randomized controlled trials.” Frontiers in Public Health vol. 11 1236050. 1 Sep. 2023, doi:10.3389/fpubh.2023.1236050
