As our clients age, the risk of Osteoporosis increases. Clients with Osteoporosis should take care to protect their bones. As Pilates instructors we need to know what Osteoporosis is and how to help our clients deal with it.

What is Osteoporosis?

Osteoporosis means porous bones. It is a disease that causes bone tissue to deteriorate so that the density is compromised and it looks like there are holes in the bone tissue. Such deterioration increases the risk of fracture. Osteopenia, which means thin bones, is the precursor to osteoporosis.

The Osteoporosis Canada website warns that “fractures from osteoporosis are more common than heart attack, stroke and breast cancer combined.” Even more alarming is the statement that “at least one in three women and one in five men will suffer from an osteoporotic fracture during their lifetime.”

Sobering statistics. And serious business for those affected. In extreme cases, a simple sneeze can cause a fracture. Unfortunately osteoporosis is a silent disease: often there are no symptoms until fracture occurs.

What causes osteoporosis?

Some factors are uncontrollable, like age and gender. As we age our bones naturally lose vitality. Women are at greater risk of bone loss than men, particularly because of hormonal changes after menopause; however, men can develop osteoporosis too.

Race/ethnicity also makes a difference; for example, Asians and fair-skinned Causasians tend to develop osteoporosis more than other groups. Thin and small-boned people have a higher incidence of osteoporosis because their peak bone mass is lower to start with and there is less stress on their bones due to their lower body weight. A family history of osteoporosis and previous fracture because of osteoporosis are additional risk factors.

There are several controllable factors too—nutrition and lifestyle in particular. What we eat (or don’t), stress, and habits—like smoking, drinking alcohol, caffeinated and/or carbonated drinks and spending a lot of time sitting—all affect bone integrity. Poor posture, balance and muscle strength can also compromise bone health.

How is osteoporosis diagnosed?

The best way to determine if you have osteoporosis is through a bone scan, which tests bone mineral density (BMD). Testing is a good idea after age 50. Results are given as a T-score. The T-score compares your BMD to that of an average young adult at peak bone mass of the same gender and race/ethnicity (typically in the mid-twenties). A Z-score compares BMD to others of similar age, gender and race/ethnicity.

T-scores are more common. A T-score of -1 is normal and indicates a low risk of fracture. A score between -1 and -2.5 suggests Osteopenia and a BMD loss of approximately 10-15%. Above that level the diagnosis is Osteoporosis. BMD loss is 25% or greater and the risk of fracture is high.

The most common sites for osteoporosis are the thoracic and lumbar spines, hip joint and wrist.

What can we do?

We are indeed what we eat! For specific diet recommendations consult a professional nutritionist. But at the very least eat lots of good quality protein, fruits and veggies and make sure you’re getting enough calcium, magnesium and vitamin D. All are important for bone health.

When it comes to physical activity, research shows that exercise is beneficial for osteoporosis and can slow bone loss or even reverse it to some extent. Indeed, one of our clients recently told us she regained some lost height—all because of the Pilates classes she attends at Body Harmonics!

How does exercise help?*

The best exercise programs are those that reduce the risk of falls and prevent further bone loss. Weight bearing and strength training exercises are good candidates. Exercises that increase balance and flexibility also help.

Weight-bearing means that the entire weight of the body is supported by the legs. Try walking, jogging, climbing, line dancing, low-impact aerobics or racquet sports. Weight bearing exercise helps because bones respond to mechanical stress, such as gravity and the pull of muscles on the bones. This stress helps build more bone.

Avoid high impact activities, forward bending (flexion), excessive side bending and rotation. These activities put undue stress on bones and can lead to fractures.

Another way to increase bone density is through the use of whole body vibrational training (WBVT). In one six-month study, WBVT produced a significant increase in hip bone density in postmenopausal women, while conventional training only slowed the rate of deterioration.

*If you have osteoporosis you may be at risk for fracture. So consult your doctor first and exercise with caution.

What about Pilates?

In Pilates, positions like all-fours, plank or downward dog offer weight bearing for the upper body and may help with bone density in the wrist and arm. The reformer and springboard offer weight bearing and resistance training for the whole body. Standing work is also very beneficial. At Body Harmonics we offer group classes and private sessions that are specifically geared to people with Osteoporosis and Osteopenia. *If you have osteoporosis you may be at risk for fracture. So consult your doctor first and exercise with caution.

Find out more…

There are lots of resources with information about Osteoporosis. The Osteoporisis Canada site ( and Mayo Clinic ( good place to start. At the Body Harmonics Studios we also offer Osteoporosis and Balance workshops for teachers and the general public. Look under the Public Workshops and Teacher Training tabs online at

Over to you…

Do you work with clients who have Osteoporosis? Tell us some of the  exercises and modifications you use for your clients who have Osteoporosis. Let us know! We want to hear from you.

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Jane Aronovitch

Jane Aronovitch

Jane Aronovitch is a Pilates & Movement teacher. She is also a writer and author. Her book, Get on it: BOSU Balance Trainer, is available at Body Harmonics, Amazon and Chapters Indigo.

“I love making ideas clear so teachers can directly apply what they learn in concrete and practical ways – and people can make connections, feel better, move with ease, and have fun.”

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