Osteoporosis, a chronic condition characterised by decreased bone density and increased fragility, affects millions worldwide, particularly older adults and postmenopausal women. As the population ages, the need for effective strategies to prevent and manage osteoporosis becomes increasingly important.
We all know that exercise plays a crucial role – but when it comes to high-impact exercise which places significant stress on bones and joints, such as running, jumping, and plyometrics – the question arises as to whether this type of exercise is beneficial or detrimental for individuals who already have or who are at risk of osteoporosis. While the term ‘high-impact’ may seem intimidating, especially for those with fragile bones, emerging research suggests that it can in fact, be a powerful ally when approached correctly.
Understanding osteoporosis
Osteoporosis is marked by the loss of bone mass and structural deterioration of bone tissue. This makes bones porous, weak, and more susceptible to fractures, especially in the hips, spine, and wrists. The condition is often silent until a fracture occurs, which can significantly impair mobility and quality of life.
Bone is a living tissue that constantly remodels itself. One of the most effective natural stimuli for bone formation is the strain placed on bones during weight-bearing activities. This is the reason that exercise is most recommended for bone health. But what kind of exercise?
High-impact exercise – friend or foe?
The case for the “Friend”
High-impact exercise includes movements that involve both feet leaving the ground simultaneously—examples include jumping, hopping, skipping, running, and certain forms of strength training. These activities deliver higher forces to the skeletal system, which in turn can trigger adaptive responses that increase or maintain bone density.
Multiple studies have shown that high-impact activities can lead to an increase in bone mineral density, particularly in premenopausal and early postmenopausal women – and particularly in the hip, a critical area for fracture prevention. Exercises such as squats, deadlifts, and weighted lunges stimulate bone growth through the stress they place on the musculoskeletal system.
The caution for the “Foe”
Despite its potential benefits, high-impact exercise is not universally suitable for everyone with osteoporosis. For individuals with advanced bone loss or a history of fractures, high-impact movements can pose a significant risk. The force generated during jumping or sudden movements could lead to stress fractures or falls, particularly if the individual has poor balance or muscular weakness.
Spinal flexion as in certain abdominal crunches or improperly performed squats, is particularly dangerous, as it can contribute to vertebral fractures. Furthermore, individuals with kyphosis (curved upper spine), common in osteoporosis, are at greater risk of falling or overloading fragile spinal bones.
A key point to note is that it is not the high-impact exercise in itself that is inherently dangerous, but rather that the exercise must be carefully tailored to the individual’s bone health, fitness level, and medical history.
Guidelines for safe high-impact exercise
Medical clearance: Before starting any high-impact programme, individuals with osteoporosis should consult a healthcare provider for an assessment of fracture risk and overall fitness.
Gradual progression: Beginners or those with low bone density, should start with low-impact, weight-bearing exercises such as brisk walking, progressing gradually to light jumps or resistance training under supervision.
Focus on form: Proper technique is critical. Poor posture or uncontrolled movements can increase the risk of injury, especially to the spine. Therefore it is vital to work with a physical therapist or exercise specialist trained in osteoporosis-safe fitness who can ensure that exercises are appropriate and effective.
Combine with balance and flexibility work: To reduce the risk of falling, high-impact activities should be complemented with exercises that enhance balance, co-ordination, and flexibility, such as Tai Chi or yoga, but avoiding poses that may stress the spine.
Older adults: Light jumping, step-ups, and low-intensity strength training, adapted for safety, can still provide enough stimulus to prevent further bone loss while enhancing muscle strength and stability.
So, is high-impact exercise a friend or foe when it comes to osteoporosis?
- The answer lies in the context. For those with low fracture risk and sufficient baseline fitness, high-impact exercise can be a powerful tool to build and maintain bone strength. When implemented thoughtfully, it becomes an ally in the fight against bone loss.
- However, for individuals with advanced osteoporosis, poor balance, or a history of fractures, high-impact movements must be approached with caution—or possibly avoided altogether in favour of safer alternatives. In such cases, the focus should shift to resistance training, balance work, and low-impact activities that still contribute to bone health and functional ability.
- Ultimately, high-impact exercise is neither inherently friend nor foe—it is a tool. Like any tool, its effectiveness and safety depend on how, when, and by whom it is used. With medical guidance, individualised planning, and careful execution, high-impact exercise can indeed be a formidable friend in the management and prevention of osteoporosis.
NOFSA (National Osteoporosis Foundation South Africa)
NOFSA is the only non-profit, voluntary health organisation dedicated to promoting lifelong bone health. We focus on reducing the widespread prevalence of osteoporosis while working to find a cure for the disease, and by supporting research and developing programmes of education and advocacy.
Find out more about our work at: www.osteoporosis.org.za
