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If running or jumping hurts, you can still build a bone-supportive exercise routine. Walking and stair climbing are low-impact, weight-bearing options identified by the Royal Osteoporosis Society. Add progressive resistance, balance, and functional movements—such as sit-to-stands, heel raises, hip hinges, bridges, rows, and standing on one foot—as tolerated. The safest choice depends on your pain, fracture history, fall risk, fitness, and other medical conditions, so increase difficulty gradually and obtain individual advice when those factors are significant.
What to do when impact exercise is painful
“Low impact” does not mean “no load.” Walking and stair climbing keep you upright and place manageable forces through the legs and hips without the repeated, higher forces of running or jumping. Resistance exercises add a different kind of stimulus by making muscles work against body weight, elastic bands, or weights. Balance and functional exercises help you control everyday movements and may reduce falls, which is important because a fall can cause a fracture even when bone strength is reduced.
Osteoporosis Canada’s 2023 guideline recommends balance and functional training at least twice weekly and suggests progressive resistance training at least twice weekly. Its recommendations are for postmenopausal females and males aged 50 years and older. The Royal Osteoporosis Society gives walking and stair climbing as examples of low-impact weight-bearing activity and advises starting at a level that suits you, then building gradually.
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A free scan shows the junk files, broken settings and background clutter dragging Windows down - then fixes them in one click.Free scan · Windows 10 & 11These activities support bone and fracture-risk management; they do not guarantee stronger bones, prevent every fracture, or replace osteoporosis medicine when medicine is indicated.
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How the main options differ
| Activity type | Examples | What it contributes | Important cautions |
|---|---|---|---|
| Low-impact weight bearing | Walking, stair climbing | Upright loading and aerobic activity with less impact than running or jumping | Use a pace, surface, rail, and distance that feel manageable; stairs may be unsafe with poor balance or acute pain |
| Progressive resistance | Sit-to-stands, squats, lunges, hip hinges, bridges, rows, presses, abdominal and back-extensor work | Muscle strengthening and graduated loading through the skeleton | Increase resistance or repetitions slowly; modify bending or twisting when fracture risk is high |
| Balance training | Tai chi, standing on one foot, heel raises, changing direction | Better control during movement and fewer fall opportunities | Practise near a stable support and progress only when the current level is steady |
| Functional training | Chair stands, stair-climbing practice, turning, carrying out daily movement patterns | Transfers exercise gains to tasks such as rising, stepping, and changing direction | Use a chair, banister, or supervision if a loss of balance is possible |
| Optional flexibility or mind-body work | Yoga or Pilates modified for your situation | Mobility, body awareness, and general activity alongside the core program | Avoid rapid, repeated, sustained, loaded, or end-range spinal flexion or twisting when advised to do so |
No source establishes a universal ranking of these activities. Compare an option by its impact and weight-bearing level, whether resistance can progress, the balance demand, spinal bending or twisting, your comfort and access, and your fracture history and other health conditions.
Low-impact weight-bearing choices
Walking
Walking is the simplest starting point for many people. Begin with a duration and speed that do not increase pain during the session or leave you markedly worse afterward. A level indoor route, a smooth outdoor path, or a treadmill can make the load predictable. Supportive footwear and a walking aid may be appropriate for some people, but an aid should be fitted and used correctly.
Progress one variable at a time: add a few minutes, a short extra walk, a modest incline, or a slightly faster pace. If symptoms flare, return to the last comfortable level rather than pushing through. Walking can supply general aerobic activity, but it should sit alongside resistance, balance, and functional work rather than replace them.
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Stair climbing
Stairs provide upright loading and a practical way to strengthen stepping muscles. Start with a small number of steps, hold a banister, and use a step-to pattern if alternating feet is painful or unsteady. A low step or a single flight can be enough at first. Increase repetitions only after you can complete the current amount with controlled foot placement and no alarming symptoms.
Stairs are not automatically suitable: dizziness, severe knee or hip pain, or a high likelihood of falling changes the risk. Practise with a clinician or exercise professional if you are unsure.
Progressive resistance without jumping
Resistance training is not limited to a gym. Body weight, elastic bands, and free weights are all valid resistance sources. The key word is progressive: over time, the exercise becomes a little more challenging while technique remains controlled.
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Lower-body and hip exercises
- Sit-to-stands: Rise from a firm chair and sit back down slowly. Use your hands or a higher seat initially; lower the seat or add repetitions later.
- Squats: Lower only as far as you can keep your feet stable and your back comfortable. A chair behind you provides a depth target.
- Lunges: Use a short split stance or hold a support. A reverse step is often easier to control than stepping forward.
- Hip hinges: Push the hips back while keeping the spine relatively straight, then stand by driving through the feet. This trains the hips without repeatedly rounding the back.
- Bridges: From a comfortable lying position, lift the pelvis using the hips and buttocks. Reduce the range or choose another exercise if lying down is painful.
Upper-body, trunk, and back-extensor work
- Rows: Pull an elastic band or cable toward the body while keeping the shoulders controlled.
- Press movements: A wall push-up, band press, or light weight press can be adjusted by changing the angle or resistance.
- Back-extensor exercises: Choose a clinician-approved movement that strengthens the muscles along the back without forcing a painful end range.
- Abdominal exercises: Use a version that maintains comfortable spinal alignment; avoid fast, repeated curl-ups when they are contraindicated for your fracture risk.
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Balance and functional training to reduce falls
Osteoporosis Canada’s guideline recommends balance and functional training at least twice each week. Examples include Tai chi, heel raises, standing on one foot, changing direction, chair stands, and stair-climbing practice. The guideline’s evidence summary reports a rate ratio of 0.44 (95% confidence interval 0.25–0.76) for fall-related fractures with functional and balance training across seven studies involving 2,139 participants. The estimate is low certainty, so it should not be interpreted as a guaranteed reduction for every person.
A safe progression
- Establish support. Stand beside a counter, rail, or heavy chair. Keep the support close enough to touch without reaching.
- Begin with two-foot tasks. Practise heel raises, weight shifts, and controlled chair stands.
- Add movement. Try slow turns, side steps, or changing direction while keeping your eyes on the path.
- Reduce assistance gradually. Move from two hands to one hand, then to a fingertip, only when the previous level is reliable.
- Increase duration or complexity—not both at once. A longer single-leg hold, a narrower stance, or a gentle head turn can each raise the challenge.
Never practise a difficult balance drill near stairs, clutter, wet floors, or an unlocked chair. Someone who has fallen repeatedly may need supervised instruction rather than independent experimentation.
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How much activity is a reasonable target?
NIAMS reports the general U.S. adult activity guidance as 150 minutes (2.5 hours) of moderate-intensity exercise per week or 75 minutes of vigorous-intensity exercise, plus muscle-strengthening activity at least twice weekly. That is population guidance, not an individualized osteoporosis prescription. Pain, disability, recent fracture, and conditioning may require a lower starting point and a slower build.
The osteoporosis-specific recommendations are frequency targets rather than a demand to complete a particular routine: balance and functional training at least twice weekly, and progressive resistance training at least twice weekly. Short sessions can be distributed across the week. For example, a person who has been cleared for exercise might walk on several days, perform resistance work on two nonconsecutive days, and add brief balance practice on those or other days. This is an illustrative structure, not a prescription.
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- Screen the situation. Note recent fractures, painful spinal fractures, repeated falls, dizziness, severe joint pain, and conditions that affect breathing, heart function, or movement.
- Choose a tolerable baseline. Select a short walk, a few chair stands, or a supported balance drill that you can perform with steady technique.
- Record response. Write down pain during the activity and how you feel later that day and the next morning. A lasting flare means the dose was too high.
- Repeat before progressing. Practise the same amount on multiple occasions until it feels controlled.
- Change one factor. Add a small amount of time, one or two repetitions, a little resistance, or a modestly harder balance position—not all at once.
- Keep variety. Combine weight-bearing activity with resistance, balance, and functional practice so that one painful movement does not determine the whole program.
Spinal safety and movement modifications
For people at high fracture risk, guidance advises caution with rapid or repeated spinal bending and twisting, deep end-range positions, and bending or twisting while carrying a load. A hip hinge—bending at the hips while keeping the back straight—is one modification described by the Royal Osteoporosis Society. This does not mean every person must avoid all spinal movement; the appropriate range depends on diagnosis, fracture history, symptoms, and professional assessment.
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Yoga and Pilates can be supplemental activities when they are safe or modified. Tell the instructor about osteoporosis or previous fractures, skip forceful end-range positions, and avoid being pushed into a painful stretch. These activities do not replace the balance, functional, and resistance components emphasized in the Canadian guideline.
When to get individual advice
Ask a doctor or physiotherapist for an individualized plan if you have a recent fracture, painful spinal fractures, multiple broken bones, many falls, substantial pain, or another medical problem that interferes with exercise. An osteoporosis-informed exercise professional can help select movements, set an initial intensity, and decide how to progress. This is particularly important before stair practice, unsupported balance work, or loaded resistance training when your fracture risk is high.
Stop exercising and seek appropriate medical care for concerning symptoms. The Royal Osteoporosis Society lists pain, dizziness, severe shortness of breath, chest tightness, nausea, and clamminess as reasons to stop. New severe pain after a movement, inability to bear weight, or symptoms suggesting a fracture warrant prompt assessment rather than a return to training.
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Medication and the wider bone-health plan
Exercise is one part of fracture-risk management. The Royal Osteoporosis Society explicitly states that exercise is not a replacement for osteoporosis medicine. If a clinician has prescribed medication, do not stop or delay it because you have started walking, resistance training, or balance work. Discuss nutrition, vitamin D or calcium advice, vision, home hazards, and other fall risks with your healthcare team as appropriate.
Quick Recap
Key decisions when choosing an exercise
- Can you perform it without escalating pain? Comfort and the response later that day matter more than completing a fashionable exercise.
- Can the load progress? Walking distance, step repetitions, band tension, body position, or weight can be adjusted in small increments.
- Does it challenge balance safely? Use support and supervision when a fall is plausible.
- Does it involve spinal flexion or twisting? Modify loaded, rapid, repeated, or end-range movements when advised.
- Does it fit your circumstances? The best routine is accessible, repeatable, and compatible with your fracture history, fitness, and other conditions.
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