Move Smart: Exercising for Bone Strength and Fall Prevention

Exercise is one of the most powerful tools we have – not just for managing diabetes but also for strengthening bones, improving balance, and preventing debilitating falls. For individuals with osteoporosis, regular physical activity isn’t just recommended – it’s essential. Here’s why and how you should move smartly and safely.

Why Exercise Matters for Osteoporosis

Osteoporosis weakens bones by reducing bone density and quality, making them more fragile and susceptible to fractures. While medications can slow bone loss, exercise plays a unique role in stimulating bone formation and maintaining muscle strength, balance, and coordination – all critical for staying independent and avoiding injuries.

Engaging in the right types of movement:

• Stimulates bone remodeling – the natural process of replacing old bone tissue with new.
• Enhances muscle mass, which in turn helps support bones and joints.
• Improves coordination and reflexes, reducing the likelihood of falls.
• Boosts insulin sensitivity, which is particularly beneficial for individuals managing diabetes.

The American Diabetes Association’s 2025 Standards of Care also emphasize the role of exercise in improving insulin action, glycemic management, cardiovascular health, and reducing the risk of falls – a vital concern for people with both diabetes and osteoporosis.

Recommended Exercises for Bone Health

Not all exercises provide the same benefits. Here’s what the Bone Health & Osteoporosis Foundation (BHOF) and experts recommend:

Weight-Bearing Aerobic Exercises: Build Bone Through Gravity

These activities force your bones and muscles to work against gravity while you stay upright, triggering bone-forming cells (osteoblasts) to strengthen your skeleton.

Examples include:

• Walking
• Hiking on uneven terrain
• Dancing
• Low-impact aerobics
• Stair climbing
• Light jogging (with your doctor’s approval)

Why it works: These movements place gentle stress on the bones, which helps stimulate bone growth in the legs, hips, and spine.

How much: Aim for 30–45 minutes most days of the week. Beginners can start with 10-minute sessions, building up gradually.

Strength/Resistance Training: Strong Muscles, Stronger Bones

Resistance exercises apply targeted pressure to bones via muscle contraction, helping preserve or increase bone mass.

Options include:

• Free weights or machines
• Resistance bands
• Bodyweight exercises like squats or wall push-ups

Why it matters: Resistance training improves both bone density and muscle strength, helping maintain posture and stability – crucial for reducing fall risk.

How often: Do strength exercises 2–3 times per week, targeting major muscle groups.

Balance and Coordination: Stay Steady, Prevent Falls

Falls are the leading cause of fractures in older adults with osteoporosis. Improving balance helps prevent these potentially serious injuries.

Try:

• Tai Chi
• Yoga (osteoporosis-safe poses only)
• Balance drills, like standing on one leg for 30 seconds at a time

Why it works: Balance exercises enhance neuromuscular control, reducing your risk of stumbling or falling.

How often: Add balance and coordination exercises to your workout routine 2–3 times per week. 

Safety First: Tips for Exercising with Osteoporosis and Diabetes

Before starting or changing your exercise regimen:

• Consult your healthcare provider, especially if you have diabetic complications like neuropathy or retinopathy.
• Avoid high-risk movements like bending forward from the waist or twisting the spine under load.
• Use supportive footwear and clear exercise areas of tripping hazards.
• Monitor your blood glucose before and after exercise, especially during prolonged aerobic sessions.

Exercise is a powerful tool for managing osteoporosis and diabetes. The right kind of movement helps protect your bones, boosts your confidence, and preserves your independence. With consistency and care, you can strengthen your body and reduce your risk of falls and fractures.

Remember: No falls, no fractures.

This article is a colloboration between DiabetesSisters, Barbara Hannah Grufferman, and the Bone Health & Osteoporosis Foundation (BHOF).

References:

1. Bone Health & Osteoporosis Foundation (BHOF) https://www.bonehealthandosteoporosis.org/patients/exercise
2. National Institute on Aging (NIA) https://www.nia.nih.gov/health/exercise-physical-activity
3. Mayo Clinic https://www.mayoclinic.org/diseases-conditions/osteoporosis/in-depth/osteoporosis-exercise/art-20044743
4. Bone Health & Osteoporosis Foundation (BHOF) https://www.bonehealthandosteoporosis.org/patients/fracture-prevention/exercise
5. American College of Sports Medicine (ACSM) https://journals.lww.com/acsm-msse/Fulltext/2004/11000/Physical_Activity_and_Bone_Health.23.aspx
6. Centers for Disease Control and Prevention (CDC) https://www.cdc.gov/falls/prevention/index.html
7. Johns Hopkins Medicine https://www.hopkinsmedicine.org/health/conditions-and-diseases/osteoporosis/best-exercises-for-osteoporosis
8. Harvard Health Publishing https://www.health.harvard.edu/staying-healthy/why-strength-training-is-important-for-older-adults
9. American Diabetes Association (ADA). (2025). Facilitating Positive Health Behaviors and Well-being to Improve Health Outcomes: Standards of Care in Diabetes—2025. Diabetes Care, 48(Supplement_1), S86–S101. https://diabetesjournals.org/care/article/48/Supplement_1/S86/157563

Barbara Hannah Grufferman, a nationally recognized advocate for healthy aging, is the author of several books on positive aging, and is the host of AGE BETTER, a weekly podcast. She also serves as Special Advisor to BHOF.