Osteoporosis: 5 Back Strengthening Exercises

Osteoporosis refers to a reduction in bone mass resulting in an increased susceptibility to fracture.  It is the most common bone disease in women over 50.  Osteoporosis affects more than 40 million women in the United States.  This represents approximately half of the population 50 and older.  More than one million fractures related to osteoporosis occur each year.   The majority of these fractures occur in the hips, pelvis, or spine.  Hip and pelvic fractures commonly occur as a result of falls.  However, spine fractures related to osteoporosis often occur without any form of trauma.

Osteoporosis

Spine fractures are a common result of poorly managed osteoporosis.  These fractures lead to ongoing pain, breathing difficulties, poor posture, muscle loss, and deterioration in quality of life.  Medical management with medications is controversial.  These drugs may address the specific bone deficits.  However, the majority do not directly affect the pain, muscle weakness, and loss of function that accompany spine fractures.

Exercise for Osteoporosis

Back strengthening exercises decrease the risk of fractures due to osteoporosis.  Exercise has also been shown to improve pain and physical function following fractures.  A 2010 study from Canada found decreased pain, improved function, and improved standing ability in women who performed 10 weeks of back strengthening exercises after a spine fracture.  These back exercises can be learned through a few visits of physical therapy and then be performed regularly as part of a home program several times per week.  The following 5 exercises are a few examples but any program should be tailored to meet the individual’s own needs.

Supine Bridge

The bridge is a great exercise to strengthen the hips, hamstrings, and low back.  Begin by lying on your back with the hips flexed and the feet lined up with the shoulders.  Perform the bridge by lifting both hips from the floor.  A common mistake is to excessively arch the low back.  Hold the bridge position for 2 seconds then return to the starting position.  Lower the body back down in a slow and controlled manner.

Be sure to achieve the bridge position by extending through the hips.  If you lack mobility in your hip joints or hip flexor muscles this may lead to compensation through the low back.  This can be corrected with manual therapy and mobility exercises.  You can also try bringing your fleet slightly closer together and the knees slightly wider apart.  This will allow you to achieve greater hip extension range of motion.

Bird Dog

This exercise targets the hips and low back muscles.  Begin on the hands and knees with the back flat.   The shoulders are directly over the hands and hips directly over the knees.  Slowly raise the left arm and right leg until horizontal with the trunk.  Maintain a straight line with the trunk, upper extremity, and lower extremity.  It is important to avoid trunk rotation and not allow the back to sag or arch.  Hold this position for 2 to 3 seconds.  Then repeat with the right arm & left leg, alternating sides with each repetition.  To increase the challenges of the exercise increase the hold time to 10 seconds. Perform 10 to 12 repetitions on each side for multiple sets.

Prone Back Extension

This exercise targets the erector spinae muscles of the middle and upper back.   Begin lying face down with 1 or 2 pillows placed under the abdomen.  Place the arms, with the palms down, along the sides of the body not touching the floor.  Lift the shoulders and chest away from the floor while keeping the chin tucked.   Maintain normal breathing while you hold this position for 5 to 10 seconds.  Perform 5 repetitions.

Prone Arm Lift

Begin lying face down with both arms elevated to shoulder level and the elbows bent.   Lift the arms away from the floor and pull the shoulder blades down and back.   It is important to keep the chin in a tucked position to avoid overstressing the neck.   Maintain normal breathing while you hold this position for 5 to 10 seconds.  Perform 5 repetitions.   This exercise targets the erector spinae muscles of the upper back along with the trapezius and rotator cuff muscles.

Wall Slide Exercise

This exercise targets the muscles of the upper back and shoulder blade.  Stand facing a wall with one foot slightly ahead of the other.  Place both forearms against the wall starting just below shoulder level.   Initiate the movement by sliding the forearms up the wall.  Once the elbows are fully extended overhead, slightly lift the hands and arms away from the wall.  Be sure to avoid arching the low back as you lift away.  Instead, think about tilting the shoulder blades backward as you lift.   Pause at the top of the movement before returning to the start position in a controlled manner.

Closing Thoughts

These are only 5 of many possible back strengthening exercises for people with osteoporosis.  They target the upper and lower back, hips, and shoulder blade muscles.  These are the muscles which are important for maintaining an erect upright standing posture.  We recommend women over the age of 50 perform these or other similar exercises as part of an individualized regular preventative program.  Your physical therapist can help you determine which exercises are best for you.

References

  1. Bennell KL, Matthews B, Greig A, et al. Effects of an exercise and manual therapy program on physical impairments, function and quality-of-life in people with osteoporotic vertebral fracture: A randomised, single-blind controlled pilot trial. BMC Musculoskelet Disord. 2010;11(36):1-11.