Osteoporosis Awareness Month: Preventing Fractures

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“Not only is health a normal condition, but it is our duty to not only to attain it but to maintain it.”

– Joseph Pilates 

There is some natural bone loss as women and men age.  As we grow older, bones can break or weaken if we don’t take steps to keep them strong.  The most common breaks in weak bones are in the wrist, spine and hips.  In order to prevent future fractures follow these key movement guidelines in your daily activities:

  • Sit up tall  when coughing and sneezing – do not bend forward.
  • Stand to the side of the oven and bend at the hip without twisting to reach into the oven.
  • Keep your spine straight when putting on your shoes or socks.
  • Bend at the hips when you lean over the sink to brush your teeth or wash your face.  
  • Do not try to open heavy or stuck windows. 
  • Be careful and keep your spine straight when lifting heavy objects especially from the floor.
  • Sit up tall and straight when having a bowel movement to minimize risk of vertebral fractures.  


Everyday Activities 

  • General lifting 
  • Brushing teeth
  • Driving 
  • Exercising 
  • Loading the dishwasher 
  • Loading the oven
  • Making your bed

Access and download the DO-IT-RIGHT_ONE-PAGE-POSTER from the American Bone Health Organization.


Foundational Movement Principles 

  • Find a neutral spine (upright, sidelying, prone or supine) 
  • Transition from the floor to standing using a neutral spine using quadruped position 
  • Hip hinge vs. rounding / flexing the spine 
  • Always avoid movements that load the spine in a flexed, sidebending or rotational position 
  • Improve core strength
  • Postural strengthening 
  • Spine stretching and strengthening 

Access and download the ABH-DO-IT-RIGHT-AND-PREVENT-FRACTURES from the American Bone Health Organization.

General Contraindications

If something is questionable in your mind best to ask a qualified and educated healthcare movement practitioner who specializes in Osteoporosis / Osteopenia before doing any movement and risking a possible fracture.  

  • All rollups, rollerovers, short spine, plough 
  • All forms of crunches 
  • Abdominal work with oblique rotation 
  • Increased pressure on the ribcage
  • Forced external rotation of the hip n standing or in floor exercises 



1. Once bone mineral density is restored, can patients return to flexion, rotation, sidebending? 

Answer: Yes, if no previous fracture history.  A patient had -1.8 T-score in spine and in 2 years has returned to -0.7 T-score.  She has a history of 4 vertebral compression fractures.  So I will still not allow flexion, rotation or sidebending in her program.  If she had never had a fracture I would allow these movements (sample case from TheraPilates).  

2. What should be the T-score in order to return to flexion, sidebending and rotational movements?

Answer:  T-score that is WNL or anything above -0.9 can resume flexion, sidebending and rotation.  As long as there is no previous fracture history (sample case from TheraPilates).  

3. For patients with hip osteoporosis is “Z” sitting in mermaid ok?

 Answer: Yes, if it is easily achieved and not forced.

4. Is external rotation (ER) sitting with 90 degrees hip flexion ok to do?  Can this stretch increase risk of fracture? 

Answer: Yes, this stretch can increase risk of fracture.  It places increased pressure directly through the neck of the femur.  

5. Is biking riding considered a weight bearing exercise to build bone density?  

Answer: I would suggest biking riding as a means of cardiovascular conditioning in patients with any knee issues or limited ROM vs. no cardiovascular movement.  I would prefer having a patient physically pound the pavement to get the vibration “piezoelectric” effect through the bones.  

These are just a few moves to keep you moving.  We believe in treating the whole person with a holistic approach and blend our knowledge and training of movement, nutrition, massage therapy and traditional chinese medicine. 

We love teaching mindful movement and even during this time, we are here to support you in your journey to wellness by offering online remote training from anywhere in the world. Contact us today to get started and learn to move with less pain and greater ease. We look forward to answering your movement questions and/or concerns.

Feel free to check out our blog posts specific to pilates, pre/post natal, bone building for osteoporosis/osteopenia, mindful meditation, restorative yoga therapy, partner and endurance training.

Assumption of the Risk: By attempting any of the exercises, you do so at your own risk.  We make no representations, guarantees or warranties that the information or exercises on this blog are appropriate for you or will result in improvements of your medical condition or function.  

Not medical advice or physical therapy.  This content is intended to provide information and instructions on general exercises that may help increase strength, mobility, and function for specific areas of the body.  It is not intended to be a substitute for obtaining a medical diagnosis or medical or physical therapy advice from a qualified licensed provider.  You should seek medical advice from a qualified physician or physical therapist before trying any of the exercises or self-treatment suggestions on this blog, particularly if your pain is from a traumatic injury or event. 


  1. AMERICAN BONE HEALTH ORGANIZATION, Do-It-Right-And-Prevent-Fractures. 
  2. BETZ, S., 2010. TheraPilates for Osteoporosis.