Pilates for Osteoporosis: Benefits, Safety, and Risks

Osteoporosis is a disease that weakens bones, making them brittle and prone to breakage.

It mainly affects women over the age of 50 and more and more men and young women. The current course predicts an epidemic by 2050 with enormous economic and personal costs (1, 2).

Focusing on bone health early is ideal in terms of prevention. However, it is never too late to start making positive changes.

One of those positive changes could be starting a Pilates practice.

Rebekah Rotstein, a Pilates instructor and American Bone Health ambassador, created Buff Bones®, a medically recognized movement system that uses Pilates, among other modalities. Rotstein emphasizes that “Pilates can be beneficial [for those with osteoporosis]but must be modified accordingly”.

A bone-friendly Pilates class has numerous benefits for overall bone health and is safe for people with low bone density, osteopenia, or osteoporosis.

Pilates can improve your quality of life with osteoporosis, but it’s important to note that a traditional Pilates class isn’t appropriate for someone with low bone density. The best way is to work in person with a certified trainer who understands osteoporosis and can customize a program just for you.

Prevents bone loss

Research on Pilates and bone density is inconclusive. Some studies report increases in bone density, while others found none at all.

While most studies on Pilates and osteoporosis find very small increases in bone density after practicing Pilates, they positively note that Pilates can prevent further bone loss and that it is a safe workout with many other benefits (3, 4, 5, 67).

While bone density is an important component of bone health, it’s not the only factor that makes or breaks your bones (literally).

Redstone reminds us that bones must be both resilient and dense to handle all kinds of powers. Although Rotstein is a Pilates advocate, she strongly recommends adding strength training to your physical activity. In order to increase bone density, the bones have to adapt to heavier loads on the body.

Relieves pain and improves quality of life

Some of the core principles of Pilates are breathing, focus, precision, and flow, making it a true mind-body modality that improves self-awareness (8).

Breathing can be a means of relaxing and calming the nervous system. Improved self-awareness makes the individual accountable and accountable and more likely to make adjustments needed for their own well-being.

Studies have shown that Pilates reduces pain, improves quality of life, elevates mood, reduces stress, and is a safe and beneficial form of exercise (5, 910, 11, 12).

Improves balance and prevents falls

Falls are harmful to people with osteoporosis and are the leading cause of fractures.

Not only is Pilates excellent for the physiology of improving balance and gait, but for the result of the confidence it instills in maintaining one’s independence (1213, 14, fifteen).

Improves posture and alignment

Optimal posture and alignment allows the body to move and function more easily.

Misalignments and poor posture contribute to compression of joints and organs along with tight and imbalanced muscles.

Combining the strength, mobility, and flexibility of Pilates with a focus on optimal alignment may result in reduced pain (13, 16, 17, 18, 19).

Improves mobility

Mobility is achieved through a balance of strength and flexibility.

Mobility is essential for a controlled and optimal range of motion in the joint. It fits with overall health and is an essential component of alignment, strength and balance for ease in everyday and extracurricular activities.

Pilates exercise is a slow, controlled combination of strengthening and stretching that improves flexibility (13, 2021).

When it comes to Pilates Matwork, there are many signature Pilates exercises that are not only safe but also have great benefits for people with osteoporosis.

Muscle building exercises are often prescribed to help people with osteoporosis (22). Exercises that stabilize and strengthen the hip, spine, and wrist are invaluable considering these are the major joints prone to fracture (23).

All side leg series and bridge variations emphasize core strength, alignment, and balance while strengthening the muscles around the hips.

Back extension and strengthening exercises are particularly important and should be emphasized (unless there is stenosis or spondylosis). Quadruped (on all fours) and plank variations are great for full-body conditioning and wrist strengthening.

Standing Pilates, foot strengthening, and balance exercises are also great as they support the weight and help with fall prevention. Adding resistance like resistance bands or weights is even better, since weight bearing with added stress helps improve bone quality.

If you are able to use Pilates equipment like the reformer, chair, or tower, you will build more strength due to the resistance created by the springs.

Many of the more traditional Pilates exercises are not suitable for people with osteoporosis.

Excessive bending (rounding of the back) and twisting are unsuitable for damaged bone tissue.

Loaded bending or exercises where you roll on your back in a hunched position are also a problem. These include Pilates exercises such as Rolling Like a Ball, Open Leg Rocker, Control Balance, Jackknife, and Roll Over.

Exercises that combine lateral flexion (side bending), flexion, and rotation are best avoided.

It should be noted that while excessive flexion, twisting, and lateral flexion are contraindicated in osteoporosis, we are not linear walking, moving, and performing robots.

Rotstein says, “People should be aware that there are so many ways to move when diagnosed with osteoporosis! Certainly it’s important to avoid loaded chest flexion, but you can still find ways to mobilize through rotation that is isolated and safe.”

A good Pilates teacher will prepare and strengthen your body in a safe way, while still mobilizing and stretching. If you are living with osteoporosis and want to try Pilates, first find a qualified trainer to guide you safely.

Many of the Pilates exercises, with some modifications, can be bone-sparing and safe for osteoporosis.

Take all those ab exercises that traditionally have you bending forward, for example. Just skip the head and shoulders raises to modify the movement accordingly (which makes these ab exercises more difficult, by the way!).

Integrating a hip hinge with a neutral spine, rather than rounding the body forward, keeps the spine straight and aligns the body for optimal load transfer through the joints.

It is recommended to work with a qualified and knowledgeable trainer or specialized bone safe Pilates class.

Pilates for osteoporosis is an invaluable tool to incorporate into your lifestyle for optimal bone health.

It’s important to consult your doctor before beginning any new exercise program and work with a knowledgeable Pilates instructor or take a specialized bone health class.

The benefits of better coordination, core and hip strength, optimal posture and better balance are key to preventing falls as well as preparing the body for higher impact activities (e.g. weight training).

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

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