Osteoporosis: Don’t Lift Heavy Objects, But Do Lift Heavy Weights?

Osteoporosis: Don’t Lift Heavy Objects, But Do Lift Heavy Weights?


“Why are people with osteoporosis advised not to lift heavy objects when it’s helpful to lift weights?” 

Good question! There are many exercises you can do to strengthen your spine, hips, and wrist…the whole skeleton, actually, that don’t involve heavy weight lifting and work as well, without the risk of fracture. Body weight exercises in the right position don’t require large weights to be effective. We’re not going to prevent spine and hip fractures with biceps curls, although they’re good for the wrist and  arms.

Now, there are a few things to consider with that question, such as the beneficial effects of the force of gravity, how much weight is too much for the spine, and the beneficial effects of strengthening muscles to strengthen bones.

How Weight Lifting Helps Our Skeleton

The activities of weight training, weight lifting, and strength training actually fall under the category of resistance (also called resistive) training. The idea is to provide some kind of resistance for your muscles to work against in order to strengthen them so that they produce a harder beneficial tug on the adjacent bones when they contract. That harder tug on the bones stimulates the bone building cells to be active.

Protecting Your Spine When Lifting

Yes, lifting things is helpful to increase the beneficial force of gravity, but with osteoporosis, one needs to protect the spine from too much weight. There isn’t a hard and fast rule for how much is too much. Appropriate body alignment is vital when lifting anything. (See the NOF’s, Proper Body Alignment article.)

SusieVideo-4Even when cooking, a person with fragile bones could lift 10 pounds and fracture if they don’t have good body alignment. Sometimes it can be the awkward position as much as the weight. With Thanksgiving coming up, be careful moving those turkeys, everyone! Get help and/or use good body mechanics by lifting with your legs, not your back. Don’t round your back. Keep any object close to your body so that you’re not stretched out when you’re lifting, which could strain your spine.

Safer Exercises with Osteoporosis or Low Bone Density (Osteopenia)

There are many exercises in the resistance/strength/weight training category that don’t involve putting your spine at risk by lifting heavy weights. Body weight exercises like the squats and lunges are all good examples that benefit the hip bones. Straight-legged leg lifts with ankle weights can also help hip bones while not being risky to the spine or hard on gimpy knees.

SusieVideo-23Back extensions done prone, on all 4s, or even standing are excellent for back extensor muscle strength. At first, just the weight of lifting arms or legs is usually enough resistance. As you get stronger, using even a small dumbbell or ankle cuff in a very low weight will have a good effect without the risk of a heavy weight in say, a dead lift, for example. Any time that you can strengthen back extensors, you’re getting that beneficial pull on the bones of the spine.

SHST-DVD-cover-front-v5Dr. Mehrsheed Sinaki, of the Mayo Clinic, did research with back extensions in which she put weight directly on the participants’ backs. In my classes, members use small dumbbells and ankle weights instead, but only after the weight of their arms and legs isn’t enough resistance. Slow and steady wins this race!

ACE Fitness has a good “Exercise Library” where you can search (upper right box) for examples of these exercises. As always, though, with bone loss you might need to adapt the exercises to keep good body alignment and not use too much weight.

My Safe Strength Training for RBTFOP-DVD2-v2-cover-front-lgOsteoporosis Prevention DVD includes the above exercises with instructions on how to do them safely. My Resistance Band Training for Osteoporosis Prevention DVD only uses body weight and bands for resistance, so there is no worry about lifting too much weight.

Going slowly with your weight lifting will increase intensity so that you don’t need as heavy a weight. Power training is fast weight lifting and the safest way to do it is with weight machines specifically made for fast movement. They are made to slow down as you push harder. Staying safe while using free weights with power training is a little trickier. Get help from a trainer.

The amount of weight a person can lift is all relative. One of my newer class participants is thrilled that she’s up to using 5-6 pounds dumbbells with a couple of the arm exercises. She has beautiful muscle definition, it’s challenging for her and that’s what matters. But again, it’s those body weight exercises like the back extensions and squats that are going to help our spine and hips the most, not how much weight we can lift with a biceps curl.

Cheers! –Susie

Comments (Scroll to the bottom to leave your comment)

  1. Hi Gloria,

    Before you do any exercise with bone loss, please see a physical therapist who is well-versed in exercise with bone loss for at least one appointment to make sure you’re moving safely.
    A plank seems like such a simple exercise, but it can be tricky keeping a neutral spine during the transitions of getting into or out of position and also while holding a plank. A physical therapist could check your positioning, help you make adjustments, and ultimately determine if it’s safe for you to do or not.

    These are things I demonstrate in my Safe Strength Training for Osteoporosis Prevention DVD:
    • It’s important to stay safe while transitioning to the floor. Use support if you need it in order to keep a neutral spine. There is a demonstration in this video, from Too Fit to Fracture, on how to safely get down on the floor to exercise. https://www.osteoporosis.ca/osteoporosis-and-you/too-fit-to-fracture/video-series-on-exercise-and-osteoporosis/
    • There are different methods for getting into the plank. I prefer to walk out from an “All 4s” position and, hinging at the hips, lower my hips from above, instead of starting with my hips low—on the floor—and bringing them up. The latter can strain one’s lower back.
    • While holding the plank, I stay straight—like a plank—and keep my head in line with my spine; not letting it droop or tilt back.
    • I keep my shoulders back and shoulder blades down to avoid “hunching” of my upper back.

    Best wishes,

  2. Thanks, Susie. I had the same question and just followed the easier version of the plank that is in your strength training DVD.

    However, I am looking for a physical therapist who is really knowledgeable about osteoporosis. I have found that not all of them are. If you have any ideas for how to find such a person, please let us know!


  3. Barbara, try a university hospital and ask for their PT who specializes in osteoporosis.

  4. Hi:

    I did finally find one, but felt uncomfortable in the hospital environment (and it’s a bit far away). However, I will go if you think that specific training in relation to osteoporosis is necessary, as opposed to a general Physical Therapy education.

    Awaiting your response soon I hope,

    Barbara in Baltimore

    The very best to you and your family

  5. Barbara, general physical therapy is a hit and miss proposition. Some PTs have osteoporosis training, many don’t. If you can get a specialist, it’s worth the extra time to pursue.
    Best wishes,

  6. Is it advisable to use ankle weights if one has a problem with varicose veins in the legs?

  7. Dear Susan,
    Increasing blood flow in the legs is often encouraged for those with varicose veins. I would think that an ankle weight could impede blood flow, like crossing the legs would, so it probably wouldn’t be a good idea. You could discuss it with your doctor and see if placing the ankle weight anywhere else, like above the knee for lying down leg lifts, would work for you. If your doctor recommends not using ankle weights, you could do more squats and lunges instead of leg lifts to target the leg muscles and hip bones.
    Kind regards,

  8. Hi Susie – I am 62 years old and found out last year that I have osteoporosis. I have been lifting moderate to heavy weights 3 times a week for 9 years, in addition to HIIT training on a treadmill 3 days a week. I have continued with most of my weight training with the exception of heavy deadlifts and back extensions with weights. I still do farmers carry with two 45 pound weights. Are these activities harmful if I’m doing them correctly? I have worked with 3 trainers in the past and am certain my form is good. Do you have any suggestions for me?

  9. Kathryn, it sounds like you have a wonderful workout routine, but with an osteoporosis diagnosis, a prudent course of action would be to have a trainer show you more muscle strengthening exercises that work your muscles but don’t put so much weight on your skeleton. It’s a conundrum, getting the right amount of weight-bearing exercise, but not too much. What helps bones can also hurt them if it’s too much with bone loss and in the later part of your life.

    Even if you’re keeping perfect form, it’s hard to know if your spine has and will continue to have the strength to support the load. So far it has. Your risk of fracture will be much higher at 80 than at 62, but who is going to fracture next, we don’t know. A first fracture greatly increases the chance of a second, so the goal is to avoid that first one.
    Usually, it’s the forward bending that causes wedge compression fractures, but there’s always the outlier whose entire vertebra collapses, not just the weaker front side. It’s rarer, but there’s no way to know who it will happen to, unless one has already had a vertebral fracture, in which case, another is more likely.

    I wish you well and encourage you to challenge your trainer to come up with a safer strength training workout that has less pressure on your spine.

    Kind regards,

  10. Carol, not yet, but I’ll send out a notice in my newsletter when I do, so be sure to sign up! Thanks for your interest!

  11. Susie,
    I love your videos. I recently have been diagnosed with osteoporosis and I have walking workouts on DVDs but,want to make sure they are safe.
    I’m hoping you make a cardio dvd for osteoporsis.

  12. How nice to hear from you, Dolores! The walking videos you’re doing should not have any of the risky moves for those who already have bone loss. All the movements should be done with a neutral spine. There should be no forward bending, no deep side bending, no twisting to the point of strain, no very high impact, or no quick, uncontrolled moves, all of which are contraindicated for those with bone loss. So, keep a neutral spine and don’t do movements such as bending forward to touch your toes or big, jerky twisting motions. Stand tall and stay safe!

  13. Hi I have had osteoporosis for 23 years iam classes at high risk have had one fracture through a fall 5 years ago . I babysit my grandchildren and I lifetime the little 2 year old can I do myself harm lifting her . As I have the osteoporosis in my hips and spine. I do 5 pound weights and walking too . I should mention I am on Actonel once a month have been for some time. . Is there anything else I should be doing to help my bones . Thank u .

  14. Gerry, a strength training program could help strengthen your muscles so you’d have more strength for your daily activities. Being stronger will also help you keep good body alignment to avoid falls and fractures. With your history of osteoporosis and fractures, the best way to do this is to request a referral from your healthcare provider to a physical therapist (PT) who could get you started on a safe strengthening program.
    A one-on-one appointment or series of appointments with a good PT can give you the basics on how to move safely. Getting that personal feedback will ensure that you’re moving correctly. In my DVDs, I also give detailed instructions on safe movement with bone loss, but there’s nothing like personal feedback from a physical therapist to get you off to a good start.
    Best wishes,