You’ve heard the refrain “Use it or lose it.” Your body was built to move, and like your muscles, your bones need this movement to stay strong. But what if you’ve already lost some bone density — will exercise help you? You bet.

“Exercise is probably as important as anything else you do in terms of fracture prevention,” said Robert R. Recker, MD, president of the National Osteoporosis Foundation and director of the Osteoporosis Research Center at Creighton University. “Physical fitness improves your muscle strength, quickens your reflexes and quickens and strengthens your fall-protection reflexes.”

After receiving a diagnosis of osteoporosis or osteopenia, many people shy away from exercise because they worry about falling and breaking a bone. Yet becoming sedentary is the worst thing you can do.

QUIZ: Are You Getting Enough Exercise?

Research suggests that even short periods of inactivity can cause or hasten long-term bone decline. For example, people on bed rest because of pregnancy or an illness can sustain noticeable bone loss in just a few months.

Immobility activates cells called osteoclasts, which break down and remove old bone. Physical activity, on the other hand, spurs the body to make osteoblasts, the cells that make bone. “If you have osteoporosis, then it’s absolutely mandatory to do something,” Dr. Recker says. “Any exercise you can do is helpful. There is no exercise too little not to be of benefit.”

try this

Improve your posture in just minutes a day with simple exercises such as this one: Lie flat on your stomach and let your shoulders touch the floor. Then slowly lift your shoulders off the ground, keeping your back straight, not arched. Hold five seconds and lower your shoulders. Repeat 10 times.

Here’s how you can stay active — and safe.

Why Weight?
Weight training not only strengthens muscles, which can prevent falls — it also has been found to protect bones in postmenopausal women.

In one study, researchers directed postmenopausal women to do a simple back-strengthening exercise using a weighted backpack five days a week for two years. The women were nearly three times less likely to get a fracture over the next decade than women who didn’t do the exercise.

The National Osteoporosis Foundation recommends doing eight to 12 strengthening exercises two to three times a week — one exercise for every major muscle group (thighs, hips, forearms, upper arms, shoulders, back, etc.). If you hate the gym, work out at home with light free weights or resistance bands. If you’re pressed for time, work only one or two muscle groups a day. If you’ve never lifted weights, talk with your doctor before starting a strengthening regimen. 

Hit the Pavement — Gently
Low-impact aerobic exercises have not been shown to slow down bone loss, but they are important for overall fitness and for your confidence in your ability to keep moving. You have lots of choices for activities that get your heart pumping without putting pressure on fragile bones: the treadmill, the elliptical trainer, low-impact aerobics and plain ol’ strolling around the neighborhood.

Chad Deal, MD, head of the Center for Osteoporosis and Metabolic Bone Disease at the Cleveland Clinic, encourages his patients to walk for 30 to 40 minutes three to four times a week. “You don’t have to power walk,’’ he says. “Just get out there and walk.”

If you have very low bone density, avoid jumping and jerky movements, which increase pressure on your bones, and waist-bending exercises, which raise the risk of compression fracture of the vertebrae. 

MORE: Exercise: A Day in the Life

No-Fall Zone
Stretching programs and exercise regimens that emphasize flexibility and balance can lower your risk of falls. The National Osteoporosis Foundation recommends yoga and Pilates, which teaches breath awareness and spinal alignment to strengthen the torso. If you have very low bone density, be sure to avoid forward-bending exercises and spine-twisting movements, which may put too much pressure on your back.

Another good option is tai chi, a Chinese martial art that uses slow, gentle, repetitive movements of the arms and legs to improve coordination and muscle function. Researchers at Emory University School of Medicine found that people who did tai chi for 30 minutes a day fell about half as much as their peers did.

No matter what exercise you choose, take precautions against a tumble that can torpedo your wellness plan. Work out in well-lighted areas, wear properly fitting shoes and keep your laces tied. Watch where you’re going, and get your vision checked regularly.

Sit Up Straight
If your mother nagged you about slouching, she was right. Good posture strengthens the muscles of your upper back, which can keep your shoulders from rounding — a common problem in advanced osteoporosis. Keeping your shoulders straight reduces the strain on your spine and lowers your risk of a backbone fracture.

by Julie Sevrens Lyons