Physical therapy can help prevent and manage osteoporosis and rehabilitate related injuries. A program that targets bone and muscle strength can improve balance and reduce a person’s fall risk.

Osteoporosis affects more than 54 million people in the United States, according to a 2014 study. The disease, which causes bones to become weak and porous, increases a person’s risk of bone fractures.

Physical therapy may help improve stability, range of motion, and mobility. It may also focus on strengthening and include a review of body mechanics. This can all help manage symptoms of osteoporosis and decrease the risk of fractures due to falls.

This article looks at physical therapy for osteoporosis, the types of exercises physical therapy may involve, and the benefits of physical therapy for osteoporosis.

It also covers the treatments and outlook for osteoporosis, as well as how to find a physical therapist.

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Physical therapy involves a variety of stretches and exercises. It may include techniques such as soft tissue mobilization, electrical stimulation, and thermal modalities (cold or heat therapy).

Physical therapy for osteoporosis aims to reduce a person’s risk of injury, strengthen bones, and help the body recover from injuries. Physical therapy may also help manage pain and prevent or slow the onset of osteoporosis.

A person may need physical therapy if they:

  • are at risk of osteoporosis due to age or a family history of the condition
  • have a diagnosis of osteoporosis
  • have another health condition that affects their bones
  • have experienced a fracture because of osteoporosis

Research shows that physical therapy is effective in managing osteoporosis. One 2017 review of studies suggests that when combined with increased vitamin D and calcium intake, physical therapy may help prevent fractures due to osteoporosis by improving movement, stability, and mobility.

Another review from 2019 notes that physical therapy can help reduce the risk of fractures, strengthen the bones, manage pain, and aid in recovery.

The types of exercise a physical therapist recommends may differ from person to person. They will adjust the program depending on the person’s age, fitness level, and physical capabilities.

According to a 2018 review of studies, resistance training and weight-bearing aerobic exercises are the two types of exercise most beneficial to people with osteoporosis.

Resistance training exercises

These exercises can help build bone and muscle strength, improve balance and posture, and reduce the risk of falls.

Examples of exercises that a physical therapist may suggest for a person with osteoporosis include:

  • Balance exercises: Balance exercises, such as standing on one leg or getting up from a chair without the use of the arms, can help improve balance and prevent falls.
  • Weightlifting: Lifting weights can help strengthen muscles and joints, improve balance, and reduce a person’s risk of falls.
  • Gravity resistance: Gravity resistance exercises, such as squats, may help improve bone health and balance.
  • Exercise bands: A person can use an exercise band to help them use their own body as a resistant force.

Weight-bearing aerobic exercises

These exercises can help improve balance and posture and increase strength and mobility.

Examples of weight-bearing aerobic exercises a physical therapist might suggest for a person with osteoporosis include:

  • Stomping and heel drops: Stomping one foot at a time or transferring weight to one heel at a time can help challenge areas of the body that osteoporosis typically affects, such as the hips.
  • Jogging: Jogging puts stress on the bones and causes them to become stronger over time.
  • Racquet sports: Using racquets helps target areas like the arms and shoulders, as well as keeping a person on their feet, which challenges bones to become stronger.

Physical therapists may not recommend all of these exercises for everyone. For example, they may not advise people with a risk of falling to do these particular exercises. Also, a person who has recently had a knee replacement may find walking easier on their knees than running.

Individuals should discuss weight-bearing exercises with their physical therapist.

Physical therapy has several potential benefits for osteoporosis. These include:

  • reducing pain
  • improving balance
  • reducing the risk of falls
  • preventing bone loss
  • strengthening muscles
  • adjusting stooped posture
  • improving quality of life

Evidence shows that physical therapy may have an effect on the early stages of osteoporosis and may also help prevent further bone weakening.

Physical therapy may improve a person’s outlook by helping to prevent further bone weakening and reducing the risk of falls.

If a person does not receive treatment in the early stages of osteoporosis, they may experience injuries that can cause fractures and chronic pain. Without timely treatment, osteoporosis can lead to disability and a loss of independence.

A person can speak with a doctor about getting a referral for a physical therapist. Some insurance providers may require a person to have a doctor’s referral before they will cover physical therapy.

A person can also contact their insurance provider or browse their website to find physical therapists within the network.

The American Physical Therapy Association (APTA) provides a free online directory where people can search for registered physical therapists in their area.

Other treatments for osteoporosis include lifestyle changes, such as eating a diet rich in vitamin D, calcium, and other nutrients, and stopping smoking. Some people may also benefit from taking vitamin D and calcium supplements.

A doctor may prescribe medication to treat osteoporosis, which may include:

Below are answers to some frequently asked questions about physical therapy for osteoporosis.

What exercises should you avoid with osteoporosis?

A person with osteoporosis should avoid exercises that twist or overexert the spine, such as sit-ups or golf, and activities with a high risk of falling and injury, such as horseback riding, contact sports, and snowboarding.

Does Medicare cover physical therapy for osteoporosis?

Medicare covers physical therapy for osteoporosis as long as the physical therapist accepts Medicare and the treatment is medically necessary.

A person should check with their healthcare professional and Medicare to determine how many physical therapy sessions Medicare will cover annually.

Physical therapy may help reduce the risk of falling and injury in people with osteoporosis. It can help improve balance, strengthen bones and muscles, reduce pain, and increase mobility.

The most beneficial exercises a person can do to manage and prevent osteoporosis are weight-bearing aerobic exercises and resistance training exercises.

People should follow their physical therapy program closely and avoid overexerting themselves or performing exercises that may put them at risk of injury.

Benedetti MG, et al. (2018). The effectiveness of physical exercise on bone density in osteoporotic patients.

Bone health and osteoporosis. (2023).