How to Do Pilates While Safely Managing Osteoporosis

by Steven Fetherhuff
Pilates Cropped

With its rise in popularity, it’s never been easier to find Pilates classes. Pilates is a gentle yet effective form of exercise that can be done on a mat or with the support of specially designed machines. Pilates focuses on building core strength, increasing flexibility, improving coordination and balance, and enhancing alignment, posture and body awareness. If you have osteoporosis, Pilates can be an effective part of your regular exercise program. However, not all exercises are appropriate for those with low bone density. A traditional program will have to be modified to keep your bones safe from the risk of fracture. Those with osteoporosis might want to look for classes that are specifically geared to their condition. And of course, you should check with your healthcare provider before beginning any new exercise program.

Here’s what you need to know before you hit the mat or machines:

• Go Pro: First, find a certified Pilates instructor experienced in working with those with osteoporosis. A knowledgeable instructor will choose the most appropriate exercises for your condition and help you learn the correct exercise form.

• Don’t Get the Bends: There are hundreds of different Pilates exercises. It is important to AVOID those that involve spinal flexion (forward bending) and twisting motions as these movements compress your spine, overloading your vertebrae and putting weaker bones more at risk of fracture. Avoiding this can be a challenge, as three quarters of traditional Pilates mat exercises are flexion based! So what can you do? Many of the Pilates forward bending exercises can be performed safely by simply maintaining a neutral spine.
And don’t feel like you’re slacking—keeping your spine neutral can make an exercise even more challenging because it engages the stabilizing muscles of the lower back and pelvis, including the deepest layer of the abdominals. Also, when lying on your back, be sure to keep your head on the floor (perhaps with a towel underneath).

• Decompress: Posture is a choice – it takes a concerted effort not to slouch.
So embrace extension (backward bending). These types of exercises not only relieve pressure on the vertebral bodies of the spine, but also strengthen the upper back muscles and decrease the forward tilt of the head and rounded shoulders, improving your posture.

• Line it Up: Alignment refers to the relationship of the head, shoulders, spine and hips to each other. Proper alignment of the body puts less stress on the spine and ensures good posture, thereby decreasing risk of fractures. The support of the Pilates machines can help guide your body toward the optimal alignment for you.

• Find Your Sides: Include exercises that encourage use of the muscles around the hip, which when strengthened can decrease the risk of falling. Pilates exercises lying on your side are a great way to enhance lateral hip muscle usage, as well as challenge balance and core strength. When performing side-lying practices, be sure to keep your hips stacked on top of one another as these exercises are particularly difficult to do without flexing or rotating the spine.

• Keep an Even Keel: Exercises that address balance can help decrease the risk of falls. There are many Pilates protocols that challenge proprioception and balance, so make sure that kneeling and standing exercises are included in your Pilates repertoire.

• Be Mindful: Pilates also focuses on proper body mechanics. Form is everything! Developing mind-body awareness during your workout keeps you thinking about how you’re moving when outside of the Pilates studio too. Performing exercises that are similar to functional movements (climbing stairs, stepping down from a curb, getting out of a chair or bed) will keep you strong and conscious of your form in these everyday activities.

If you make the proper movement choices necessary to maintain healthy bones and avoid fracture, you can safely enjoy the plentiful benefits of Pilates.

Steven Fetherhuff, PMA-Certified Pilates Teacher™, is a Pilates instructor with the Rehabilitation Department at Hospital for Special Surgery’s Integrative Care Center. In addition to working individually with clients, he has designed and currently teaches the Pilates for Better Bones community equipment classes.

Topics: Featured, Orthopedics, Rehabilitation and Fitness
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The information provided in this blog by HSS and our affiliated physicians is for general informational and educational purposes, and should not be considered medical advice for any individual problem you may have. This information is not a substitute for the professional judgment of a qualified health care provider who is familiar with the unique facts about your condition and medical history. You should always consult your health care provider prior to starting any new treatment, or terminating or changing any ongoing treatment. Every post on this blog is the opinion of the author and may not reflect the official position of HSS. Please contact us if we can be helpful in answering any questions or to arrange for a visit or consult.

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