Robin’s synopsis of BEST EXERCISES for OSTEOPOROSIS with Joan Pogano

Joan Pogano is an exercise physiologist specializing in women’s health & active aging and the author of Strength Training for Women

According to Joan Pogano, there are two types of resistance training:

  1. Weight-bearing exercise in which you use your body weight to resist the force of gravity.  You cannot get this with swimming or cycling.
  2. Strength training in which you apply resistance to muscles to make them grow stronger. This resistance will translate to the bone that the muscles are pulling on.

Strength training should be done every other day to allow muscles to recover or you can do a “split-program” where you alternate days for the upper body, lower body, or core activities.  This allows recovery time as you are not using the same muscle groups every day.


High-impact versus low impact exercise

High-impact activity is when both feet come off the ground, like jumping.  This has an impact on bone.

With osteopenia or osteoporosis use low-impact activities where one foot is always on the ground.


Avoid rounding of the spine if you have low bone density to avoid force on fragile vertebrae.  No toe touches, plow in yoga, or rotation with flexion as in an overhead serve in tennis or releasing a bowling ball.

Hip hinge, bending from the hips and knees, instead of bending at the waist to avoid fracture risk.

Also, avoid lifting a weight overhead like putting a suitcase in an overhead bin or a large object in a high cabinet.

Working with a physical therapist or exercise specialist is important so they can look at your movements to make sure you are doing them safely.


Joan believes that the bottom line of exercise for osteoporosis is the prevention of falls and fractures.  Balance and core stability will keep you on your feet and no equipment is needed.

Stork Stance

Start safely by holding on to something for support if you need it and then gradually remove the support.  Start by aligning your feet, hip-width apart, and stack your head, shoulders, hips, and ankles.  Engage your core by pulling your belly to your spine. Think of your abdomen coming in and up and “make your pants lose”.  Then pick up one leg and hold for at least 30 seconds.  Progress to having one eye or both eyes closed.  Repeat on the opposite side.

Tandem Stance

Place your feet in line with each other, heel to toe, as if you were walking on a tightrope.  Use the same progression as with the Stork Stance.

Tandem Dynamic Balance

Actually walk the tightrope.


Practice balance while reaching.

Balance activities can be done several times a day as muscles are not being stressed as in lifting weights.


The one exercise that Joan believes everyone should be able to do for life is a sit-to-stand squat.  This keeps your legs and glutes strong so you can stand up from sitting without using your hands.  Practice with your arms crossed and squeeze your gluteal muscles as you come to stand.

Lastly, Joan recommends calf and toe raises in standing. Toe raises keep your shin muscles strong as these muscles are the first to lose strength as we age.


A comprehensive strength training program incorporates posture, alignment, and core stability.  Most people understand how to implement a walking or stretching program but find strength training more confusing.  Find a practitioner with certification in working with older adults, start small, and take steps to stay active as you age.

Many people become motivated when they see their life getting smaller: not being able to get up from the couch or get to the floor to play with grandkids or become breathless on a walk.  Know that you can start a program at any stage and at any age.

My solution for creating new habits:

Start small, do it in community, and have an accountability partner!

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