Strengthening Bones and Bodies: The Remarkable Benefits of Pilates for Osteoporosis


Strengthening Bones and Bodies: The Remarkable Benefits of Pilates for Osteoporosis


Osteoporosis, a condition characterised by fragile and weakened bones, is a growing concern worldwide. It affects millions of people, particularly postmenopausal women and the elderly, making them susceptible to fractures and a diminished quality of life.

In the UK it is estimated that one in two women and one in five men aged over 50 will have an osteoporotic fracture in their lifetime. Whilst having a diagnosis of osteoporosis increases the risk of fracture, there are many other contributing factors including pre-existing health conditions, gender and fracture site.

There are numerous strategies for preventing and managing osteoporosis, one of which is the practice of Pilates. In this article, we will explore the benefits of beginning a Pilates program for osteoporosis and why it’s becoming an increasingly popular choice for improving bone health.

Reference: Royal Osteoporosis Society

Understanding Osteoporosis

Before delving into the advantages of Pilates for osteoporosis, it’s essential to grasp the basics of the condition. Osteoporosis is often referred to as a “silent disease” because it progresses gradually, often without any noticeable symptoms until a fracture occurs. As bones lose density and strength, they become more susceptible to fractures, especially in the spine, hips, femoral neck, and wrists.

Risk factors for osteoporosis include a lack of dietary calcium, vitamin D3, vitamin K2 and protein, as well as hormonal changes, a sedentary lifestyle, smoking and excessive alcohol consumption.

Osteoporosis is a major public health issue, leading to a significant economic and healthcare burden, which is why effective prevention and management strategies are crucial.

According to a 2019 study in Acta Orthopaedica, the one-year mortality after a hip fracture is 21% for those whose fracture is surgically repaired. If the fracture is not repaired, the one-year mortality is about 70%.

Reference: 2019 study in Acta Orthopaedica

A Comprehensive Approach to Osteoporosis Management

Pilates is a low-impact exercise regimen that has gained widespread recognition for its numerous health benefits. It was developed by Joseph Pilates in the early 20th century and focuses on improving strength, flexibility, and overall body awareness. When it comes to osteoporosis, Pilates offers a unique combination of advantages that can significantly impact bone health:

  • Improved Bone Density
    Pilates helps in strengthening bones through weight-bearing exercises that encourage the body to adapt and build denser, stronger bones. Weight-bearing activities put stress on the bones, which stimulates bone-forming cells (osteoblasts) to create new bone tissue, increasing bone density. The controlled movements and resistance exercises in Pilates contribute to this effect.

  • Enhanced Posture and Alignment
    Osteoporosis often leads to poor posture and alignment due to the curvature of the spine. Pilates places a strong emphasis on improving posture, body alignment, and core strength. The exercises encourage the maintenance of a neutral spine position, which can help alleviate and prevent some of the symptoms associated with osteoporosis-related spinal changes.

  • Muscle Strengthening
    Pilates works on strengthening not only the major muscle groups but also the smaller stabilising muscles. This comprehensive approach helps support and protect the skeletal system, reducing the risk of falls and fractures associated with osteoporosis. Strong muscles surrounding the bones can act as a protective layer as well as prepare the body for further or more advanced weight bearing activities such as lifting weights.

  • Enhanced Balance and Coordination
    Osteoporosis is closely linked to an increased risk of falls, which can have severe consequences. Pilates emphasises balance and coordination training, helping individuals improve their stability and minimize the likelihood of falling. This is especially important for older adults with osteoporosis who may be at greater risk for fractures.

  • Joint Mobility
    Osteoporosis can lead to joint stiffness and reduced mobility, making daily activities more challenging. Pilates incorporates a range of movements that promote joint flexibility, which can help alleviate discomfort and improve the overall quality of life for those with osteoporosis.

  • Pain Management
    Injuries resulting from Osteoporosis can cause significant pain, particularly in the spine. Pilates can be customised to address specific areas of pain and discomfort, helping individuals find relief through gentle and controlled movements. This approach is particularly beneficial for those looking to reduce the reliance on pain medications.

  • Mind-Body Connection
    Pilates places a strong emphasis on the mind-body connection. This can be empowering for individuals with osteoporosis, as it fosters a sense of control and self-awareness over their condition. The mental aspect of Pilates can help alleviate stress and anxiety associated with osteoporosis.

Customising Pilates for Osteoporosis

It’s crucial to acknowledge that not all Pilates exercises are suitable for individuals with osteoporosis. To ensure safety and effectiveness, Pilates programs for those with osteoporosis should be customised and supervised by a qualified instructor or physiotherapist. The instructor can modify exercises to accommodate the individual’s specific needs and limitations, ensuring that the risk of fractures is minimised.

Furthermore, individuals with osteoporosis should prioritise exercises that focus on strengthening the spine, hips, and wrists, which are common fracture sites. Here are some key principles to consider when customising Pilates for osteoporosis:

  • Modify exercises

    Exercises that involve forward or side bending waist should be avoided, as these movements can increase the risk of vertebral fractures. Modified versions of these exercises may be suitable depending on the severity of Osteoporosis.

  • Emphasize core strengthening

    Building a strong core is essential for spine stability and posture improvement. Specific exercises, such as bridges, planks, and abdominal exercises, can help strengthen the core muscles without straining the spine.

  • Incorporate balance and coordination exercises

    These exercises can help reduce the risk of falls, which is a significant concern for individuals with osteoporosis. Balance challenges and stability training are beneficial components of a customised Pilates program.

  • Gradually progress

    As individuals with Osteoporosis become more accustomed to Pilates, they can gradually increase the intensity and difficulty of their workouts and may aim to move towards a strength tailored program in addition to Pilates, such as lifting weights. However, any progression should be gradual and under the guidance of a qualified instructor.


Pilates offers a holistic approach to managing and improving bone health for individuals with osteoporosis. Its combination of weight-bearing exercises, muscle strengthening, posture improvement, and mind-body connection makes it an ideal choice for those looking to combat the effects of this debilitating condition.

While Pilates can be a valuable tool in the management of osteoporosis, it should not replace medical advice or other prescribed treatments. It’s essential to consult with a healthcare professional before starting any exercise program, particularly if you have a medical condition like osteoporosis.

With proper guidance and a customised Pilates program, individuals with osteoporosis can experience improved bone density, better posture, enhanced muscle strength, and a greater sense of overall well-being and confidence. Pilates is not just an exercise routine; it’s a journey toward better bone health and a higher quality of life.


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