Pilates may help improve strength, balance, function, and mobility in people with osteoporosis. However, you may have to modify certain movements to prevent injury.

Osteoporosis is a condition that weakens the bones, making them brittle and susceptible to fractures. It mostly affects people ages 50 years and older, and is more common in people assigned female at birth.

Treatment for osteoporosis will usually involve medications to help strengthen your bones.

Some research suggests that Pilates may also be beneficial for osteoporosis. Pilates is a type of low impact physical exercise that focuses on posture, balance, flexibility, and core strength.

Rebekah Rotstein, a Pilates instructor, ambassador for American Bone Health, and creator of Buff Bones®, said that “Pilates can be beneficial [for those with osteoporosis], but needs to be modified appropriately.”

Keep reading to learn more about the possible benefits, risks, and types of Pilates for osteoporosis.

Research on the possible benefits of Pilates for osteoporosis is limited and mixed.

However, researchers have identified several possible physiological and psychological benefits of incorporating Pilates into a treatment plan for osteoporosis. These may include:

  • improving physical strength, posture, balance, mobility, and function
  • preventing bone mineral density loss
  • preventing falls and bone fractures
  • reducing physical pain
  • boosting mood and sleep quality
  • managing stress, depression, and fatigue

Some foundational principles of Pilates include breathing, concentration, precision, and flow, also making it a true mind-body modality.

Although Pilates may offer possible benefits for people with osteoporosis, it’s more effective when combined with medical treatments and weight-bearing exercises.

To increase bone density, the bones must adapt to heavier loads put on the body.

Before starting Pilates, consider speaking with a healthcare professional or certified instructor who understands osteoporosis. They could help customize a program specifically for you.

Experts recommend muscle-building and impact exercises for osteoporosis to improve strength, balance, mobility, and bone density.

In particular, exercises that target the hip, spine, and wrist may be invaluable for osteoporosis. According to the International Osteoporosis Foundation, these are the joints most susceptible to bone fractures.

Several types of signature Pilates exercises may be beneficial if you have osteoporosis. For instance:

  • Side Leg Series and Bridge variations emphasize core strength, alignment, and balance while strengthening the muscles around the hip.
  • Exercises on all fours and plank variations are great for full-body conditioning as well as wrist strengthening.
  • Standing Pilates, foot strengthening, and balance-enhancing exercises help with the prevention of falls.
  • Back extension and strengthening exercises may help with posture and mobility, but they’re not recommended for stenosis or spondylosis.

Adding resistance to bodyweight exercises could help increase the load and improve bone quality. This may include using resistance bands, the reformer, chair, or tower.

Some traditional Pilates exercises may not be suitable for someone living with severe osteoporosis or bone loss.

According to the Royal Osteoporosis Society, excessive flexion (rounding your back) and twisting may increase your risk of a spinal fracture.

Sudden movements, lateral flexion (side bending), and exercises that involve rolling in a curved position on your back are also a concern. These may include Pilates exercises like:

  • Rolling Like a Ball
  • Roll Down
  • Roll Up
  • Hip Roll
  • The Cat
  • Curl Up
  • Roll Over

It should be noted that even though excessive flexion, twisting, and lateral flexion may be contraindicated for osteoporosis, we are not robots that walk, move, and perform in a linear fashion.

There are many different types of movements you can still do if you have osteoporosis, but these may require modifications and differ from someone else with the same diagnosis.

According to Rotstein, “Certainly avoiding loaded thoracic flexion is key, but you can still find ways to mobilize through rotation that is isolated and safe.”

A qualified Pilates instructor can help develop exercises that still prepare, strengthen, mobilize, and stretch your body safely.

Many of the Pilates exercises can be bone-friendly and safe for osteoporosis with a few modifications.

The Royal Osteoporosis Society recommends moving smoothly and with control. It’s also important to stay within your comfort range. If an exercise causes pain, stop immediately.

Modifications involve finding ways to support your back while minimizing the curve, strain, and flexion of the spine.

For example, during abdominal strengthening exercises that traditionally involve curving forward, omit lifting the head and shoulders.

Incorporating a hip hinge with a neutral spine instead of rounding the body forward keeps the spine straight and sets the body up for optimal load transmission through the joints.

Using wedges, towels, walls, and chairs to provide additional support can help you perform certain movements while minimizing any risks.

Working with a qualified and knowledgeable instructor or a specialized bone-safe Pilates class is recommended.

Exercises that involve curving, flexing, or load-bearing the spine should be limited or avoided if you have osteoporosis.

Pilates may help improve balance, mobility, strength, and function in people with osteoporosis. However, more research is needed to fully understand its role in osteoporosis management.

Pilates may be a tool to include in your lifestyle to help manage osteoporosis.

It’s important to speak with a healthcare professional before starting a new exercise regime and to work with a knowledgeable Pilates instructor or participate in a specialized bone health class.

Better coordination, core and hip strength, optimal posture, and balance are key to preventing falls and preparing the body for activities with higher loads.

Modified Pilates includes many movement options for anyone with osteoporosis to remain healthy, strong, and fracture-free.