EXERCISE PLAN

FOR BONE HEALTH

(OSTEOPOROSIS)
 Exercise and Bone Health

What is Osteoporosis?
Osteoporosis is a common bone disease which makes your bones
more fragile. This increases the chance of you breaking a bone
(also called a fracture), even with a minor bump or fall.
Osteoporosis may also cause you to lose height, and your posture
to become stooped.

Why exercise?
Regular exercise can help protect you from breaking bones in two
ways: by strengthening your bones (along with the medication
prescribed by your doctor and a calcium-rich diet) and by
reducing your chances of falling. You are at greatest risk of
breaking a bone, for example your hip or wrist, if you fall.
Exercise can improve your balance, co-ordination, strength and
flexibility and therefore make it less likely that you will fall.
Regular exercise can also improve your posture, mood, general
health, and help lessen pain from different causes, including
arthritis. Also, the fitter you are, the easier it is for you to carry
out all your daily activities such as housework and shopping.

What kind of exercise should I do?

Exercise needs to be regular and on-going. Research tells us that
when regular exercise stops, the main benefits are lost.
Your exercise plan should include:

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A warm-up Always start your programme with a gentle warm up
to boost your circulation and prepare your joints and muscles for
exercise.
Flexibility and stretching exercises Flexibility is an important
part of being fit and active. Regular gentle stretches for the
muscles and joints of your shoulders, upper back and neck will
also improve your posture, which is very important if you have
osteoporosis. Always warm-up before doing your stretches. Avoid
‘bouncing’ when you stretch.
Weight-bearing exercises These are exercises in which you
support your own body weight. Research has shown that regular
weight-bearing exercise, such as stair climbing, low impact
aerobics and dancing can slow down bone loss.
Muscle strengthening exercises Stronger muscles will help
reduce pain and give support to your bones and joints. They can
also help you to balance better, making it less likely that you will
fall. When you do the strengthening exercises, you should be
working hard.
Balance exercises Improving your balance makes it less likely that
you will fall. Balance, like everything else, takes practise to improve.
Dancing and exercise to music classes can help improve your
balance. Tai Chi is another good way of improving your balance.
Exercises for general fitness To improve your general fitness, you
need to exercise to the point you are slightly out of breath for about
30 minutes on most days. You don’t have to do this all at once but
can, for example, add up three ten minute activities. Start slowly and
gradually build up. Start by setting aside 5 or 10 minutes, gradually
increasing to 30 minutes of continuous exercise.
This booklet describes an exercise programme that contains all
these types of exercise.

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Swimming and cycling
These exercises are non weight-bearing and therefore do not
improve your bone density. However, they can improve your
fitness and general health, so they are still good to do, but make
sure you are doing some weight-bearing exercise too.

What kind of exercise should I avoid?

Some exercises and activities put you at risk of injuring yourself,
or at worst, breaking a bone. They include:
✗ running, jogging, skipping, jumping and hopping
✗ high impact aerobics
✗ repeated forward bending (eg touching your toes)
✗ fast twisting movements
✗ any exercise that is likely to cause you to fall
If you are exercising for the first time, you should see your GP
first.

Tips for Exercising

✓Always wear well-fitting footwear with cushioned soles or
in-soles, such as trainers, when you are exercising.
✓Make sure the room is at a comfortable temperature.
✓Always start with a gradual warm-up, followed by gentle
stretches.
✓Always start slowly and gently. Build up gradually, working
within your limits. Pace yourself.
✓Keep breathing properly and don’t hold your breath.

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 ✓Although you may already have some discomfort, stop if the
exercise increases or changes your pain in any way. If you
begin to feel unwell during the exercise programme, do not
continue. If this happens again, consult your GP.
✓If you become tired, instead of stopping, try slowing down.
✓Do the exercises in a controlled manner.
✓Find an activity that suits you. There is no point in forcing
yourself to do something that you do not enjoy as it will be
unlikely you will continue with it long term. Try out a few
different ways of exercising to find out what you enjoy the
most.

Where and how can I take part in suitable

exercise?
O Zone Classes within Glasgow These are classes, held in
leisure centres, that are designed especially for people with
osteoporosis. The classes are taken by instructors who have had
extra training on osteoporosis. These classes are the best place for
you to start exercising, and help you to learn what exercises are
most suitable for you. Contact the Active Living Activity
Programme for details (0141 287 0112). There may be similar
classes in other parts of the country.
Other community classes There are a variety of dance, low impact
aerobic, easy exercise, or aqua-aerobics classes held at local leisure
centres that are suitable. However, they are not especially designed
for people with osteoporosis. If you attend one of these classes
always make sure you tell the instructor that you have osteoporosis.

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Tai-Chi This is a Chinese form of meditation in movement and is
usually performed as if in slow motion. Studies have shown that
Tai-Chi is successful in improving balance and can therefore help
prevent falling. You should always start by attending a beginners
class.
GP Referral Scheme This scheme allows your GP or
Physiotherapist to refer you directly to your local Leisure Centre
where a qualified instructor will set up an exercise programme
that suits your needs. The referral letter will contain any relevant
medical information that the instructor needs to know in order to
set up the appropriate exercise programme. If you are interested
in getting on an exercise programme, ask your GP, Practice Nurse
or Physiotherapist to refer you.
Gymnasiums or Fitness Suites Entering a gym for the first time
can be a bit daunting, but a good gym will give you a free
introductory session. During this session a qualified instructor
will assess your fitness level. Don’t be put off by younger or fitter
people, they are just like you, trying to do something good for
themselves. If you are joining a club, or gym, choose one that is
close to your home or your workplace. In the winter you will be
glad that you did.
Walking and climbing stairs Walking and stair-climbing are
great exercises, weight-bearing, and free! Become more active in
daily life. Walk to the shops, or get off the bus one stop early and
walk the rest of the way. Take the stairs instead of the lift. These
changes will make a difference and you will be surprised how
quickly your body will respond.
A Home Exercise Programme If you are unable to go to class,
or choose not to, you can do the exercise programme described in
this booklet. As with all exercise, you will need to do the
exercises regularly (several times a week).

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Home Exercise Programme
The exercises that follow are designed for you to do at home any
time of the day that suits you. Although some of the exercises
may appear to be easy for you, it is important that you do them
regularly to maintain your flexibility, strength and balance. You
don’t have to do all the exercises at once or all in the same day.
For example you could do half of them one day and the other half
the next day. Or you could do some in the morning and some in
the afternoon. If you enjoy music then try doing the exercises
with some of your favourite music playing.
The following exercises are divided into a warm up and three
sections:
mobilising, strengthening and balance.

Warm-up
Before you begin exercising, it is important to do a few
movements to warm up. This will boost your circulation, prepare
your muscles and joints for the exercises and prevent injury. You
should always warm up by being active for about 5–10 minutes
before moving on to the mobilisers.
The following can provide your warm up. You can do these
sitting down or standing.
• Lifting your feet one at a time off the floor – as if you were
marching on the spot. Swing your arms gently at the same
time.
• Circling your ankles.
• Tapping your toes.

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 Mobilisers

1 Stand with your

hands clasped in
front of you. Keeping
your arms straight, lift
them forward and above
your head. Separate your
hands and bring them
sideways to the starting
position.
Repeat 5 times, slowly.

2 Sit with your back

straight and feet flat on
the floor. Pull your shoulder
blades together while
turning your thumbs and
hands outwards keeping
your body straight.
Hold for 12 seconds.
Repeat 3 times.
Do not hold your breath.

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3 Sitting straight backed.
Pull your chin in, keeping
your neck and back straight
(not tipping your head
forward), like making a
double chin. Hold the end
position and feel the
stretching in the top part of
your neck.
Hold for 12 seconds. Repeat 3
times.
Do not hold your breath.

4 Sit or stand. Circle your

shoulders backwards.
Repeat 5 times, slowly.

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5 Standing in a walking
position with the leg to be
stretched straight behind you
and the other leg bent in front
of you. (Take support from a
wall or chair). Point both your
feet forward and keep your
heels on the floor. You should
feel the stretch in the calf of
the back leg.
Hold for 12 seconds then
relax.
Repeat for other leg.

6 Sitting towards the

front of the chair,
straighten your right knee.
Rest your right heel on the
ground. Left foot flat on
the floor. Straighten your
spine. Keeping a straight
spine, lean forwards until
you feel a stretch at the
back of the right thigh.
Hold for 12 seconds.
Repeat with other leg.

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 7 Stand holding on to a
support with your right
hand. Hold your left ankle
with your left hand. If you
cannot comfortably reach
your ankle, hold the bottom
of your trouser leg. Try to
keep your knees close
together.
Hold for 12 seconds, release.
Repeat for the other leg.

Repeat each of the following exercises 12 times. Increase to

doing an extra 12 times once you have mastered the exercise.
Rest between the sets of 12.
Where (Easier) and (Harder) exercises are shown, start with the
easier. Move on to the Harder version when you feel ready.
Remember: the exercise should not be painful.

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 Strength

1 (Easier) Stand holding on

to a support. Lift your leg
slowly out to the side
(be careful not to twist).
Repeat 12 times, then repeat
with the other leg.

(Harder) Lie on your side. Keep the bottom leg bent and the
upper leg straight. Keep hips rolled forward. Lift the upper leg
straight up with the heel leading the movement (be careful not to
twist). Repeat 12 times, then repeat with the other leg.

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 2
Stand in front of a small step
holding onto something secure.
Step up 12 times with each leg.

3 (Easier) Sit on the edge of

a chair with your hands
either behind your head or on
your hips. Arch your back,
then let it go (be careful not to
lean back or forward).
Repeat 12 times.

(Harder) Lie face down with

your arms behind your back.
Keep your chin down close to
your chest and keep looking at
the floor. Slowly lift your chest
off the floor as high as you
can, then come back down.
Repeat 12 times. Do not hold
your breath-breathe out as you
lift your chest off the floor.

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 4 Stand facing a wall with your
feet well back from the wall,
and your hands flat on the wall.
Bend your elbows and lean your
body towards the wall. Push your
body away from the wall by
straightening your arms.
Repeat 12 times.

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Stand up and sit down for 2 minutes. If possible, try not to
use your hands.

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 6 Hold onto a
support. Rise up
onto your toes, and
then lower.
Repeat 12 times,
rest, then repeat.

7 (Easier) Hang your

hands over the edge of a
chair back. Bend and flex
your hands up and down
from the wrists.
Repeat 12 times, then turn
your hands over and do 12
more on the other side.

(Harder) Do the same exercise as above but hold a weight in

your hands. You can use a bag of sugar, a tin of beans or
something else.

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 Balance

1 Stand holding on to
something, with one foot
off the floor. Try to let go and
keep your balance as long as
you can. Practice both sides as
often as you can.

2 Stand with your finger tips

on the back of a chair and
with one foot in front of the
other. Try to let go of the chair
for as long as you can.
If you find this exercise easy,
try closing your eyes –
but BE CAREFUL!

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 Taking Care Of Your Back
The spine is one of the most common areas of the body to be
affected by osteoporosis. It is therefore very important that people
suffering from osteoporosis protect their back. These are some
ways that you can protect your back.

Lifting
Know your own strength and only lift what you can handle.
Always lift and carry close to the body.
Bend your knees and let your legs do all the work.
Don’t twist your back, turn with your feet.

Sitting
Avoid low soft chairs that have poor back support. Use an upright
firm chair that does not allow your lower back to slouch. Get up
and straighten your back out at least every thirty minutes.

Standing
Avoid bending forwards for long periods of time.
Have your working surface at a comfortable height.

Driving
Have frequent breaks during long journeys to stand up and walk
around a little.
Sit in an upright position that does not allow your lower back to
slouch.

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Sleeping
Using a firm mattress will give your back more support.
Getting in and out of bed:
• Sit at the side of the bed.
• Lower yourself onto your elbow.
• Lower further onto your shoulder bending your knees at the
same time.
• Draw your knees up until your legs are on the bed.
• Roll body and knees together to face the ceiling.
The reverse sequence should be used when getting out of bed.

How to keep going

✓Plan your activity and slot it into your daily/weekly
schedule – if it becomes part of your routine you will be
more likely to do it.
✓Exercise with friends.
✓Keep a diary of your activity.
✓Mix and match your programme.
✓Exercise to music you enjoy.
✓Enjoy your exercise.

Notes

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The information contained in this booklet is of a general nature.
For more specific advice, you will need to see a physiotherapist.

Active Living Activity Programme for Glasgow

(Including details of O-Zone Classes) 0141 287 0112

VERSION 3 April 2004-10-22

Produced by

GLASGOW ROYAL INFIRMARY PHYSIOTHERAPHY

DEPARTMENT

THE NATIONAL OSTEOPOROSIS SOCIETY

This society offers support to people with osteoporosis through a

range of detailed information booklets, a national telephone help
line and a network of regional support groups.
For more information contact

NATIONAL OSTEOPOROSIS SOCIETY

PO Box 10, Radstock, Bath BA3 3YB

Tel: 01761 471771
Fax: 01761 471104
Helpline: 0845 450 230
Website: www.nos.org.uk
e-mail: [email protected]

Medical Illustration Services x24692 . GRI Job No. 111114

April 2004 – review date April 2006

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