If you’ve been diagnosed with osteoporosis or osteoarthritis of the spine, there’s one popular move you’ll want to consider modifying: the side bend. Whether it is performed as a standing side bend or a seated side bend, this stretch can be unhealthy for your spine and put it at risk of a vertebral compression fracture.
Side bend exercises, performed with or without weights are popular in gym classes, fitness videos and senior exercise classes. This popular exercise could put your spine at risk of a compression fracture or an osteoarthritic flare up. (1, 2, 3)
After I explain how side bends can harm your spine, I will share two great alternatives that will make your spine feel great and allow you to put your mind at ease.
Standing Side Bend and Seated Side Bends
The standing side bend and seated side bend exercises create what’s called “an asymmetrical loaded compression” on your vertebrae and the facet joints.
Here’s what happens to your spine during this movement:
- Uneven weight distribution: Instead of your spine bearing weight evenly and leveraging all of the trabeculae, all the force concentrates into the side you are bending towards. This means fewer trabeculae support the vertebral body.
- Excessive compression: The weight of your head (about 11-12 pounds), shoulders, upper body, and any additional weights you’re holding gets channeled through a smaller surface area in your spine.
- Increased fracture risk: For people with osteoporosis, this concentrated pressure significantly raises the risk of compression fractures.
- Arthritis aggravation: If you have arthritic spinal joints, you have a disproportionately higher load being taken through the facet joints on the side you are bending towards. This loading pattern can trigger painful flare-ups.
The bottom line? If you have osteopenia, osteoporosis, or osteoarthritis of your spine, you are not helping your spine with loaded side bends, rather you may be hurting yourself. (1,2,3)
This is why I want to show you two wonderful alternatives.
Free Osteoporosis Exercise Course
Two Safe Alternative Side Bends
Don’t worry! You don’t have to give up that satisfying side stretch entirely.
Here are two spine-safe alternative side bends that provide the same range of motion without the dangerous loading.
Option 1: Hands and Knees Side Bend
Setup:
- Get on your hands and knees with hands directly under your shoulders
- Keep your elbows slightly bent (bonus: this gives your triceps a gentle workout!)
- Use knee pads if kneeling is uncomfortable
The Movement:
- Bring your right shoulder forward while moving your right pelvis back
- Focus on opening up the entire side body
- Take a breath in, then exhale as you return to center
- Repeat on the other side
- For a deeper stretch: Place your right hand over your left hand for additional side opening
Why it’s safer:
This side bend does not load the weight of your head, shoulders, or upper body onto a small portion of your spine. This allows you to get that satisfying stretch without risk of a vertebral compression fracture.
Option 2: Lying Down or Supine Side Bend
Setup:
- Lie on your back with legs straight
- Raise both arms overhead
- Place a pillow under your head/neck for comfort if needed
- If shoulder compression feels uncomfortable, place a pillow under your arms
The Movement:
- Walk your feet away from your body’s midline
- Simultaneously walk your shoulders in the same direction
- Continue until you feel a “delicious stretch” through your entire side body
- Hold and breathe, then slowly return to center
Side Bend smart exit strategy:
- If you feel pulling in your lower body: Come out with your upper body first
- If you feel more stretch/pulling in your upper body: Lead with your lower body when returning to center.
Why These Side Bend Modifications Matter
These alternatives give you the satisfying range of motion and side body opening that you crave, but with a crucial difference: minimal to zero spinal loading.
You do not have to worry about the uneven loading created by your upper body weight being placed through your vertebrae.
Instead, you can enjoy the feeling of stretching your muscles and fascia knowing your keeping your spine free from harm.
Conclusion
Too many people contact me after injuring themselves while “just trying to help themselves” by following along with exercise classes or workout videos. If you have osteoporosis, osteopenia, or severe osteoarthritis, generic fitness routines aren’t designed with your specific needs in mind.
These simple modifications are not limitations—they empower you by learning intelligent alternatives so you can stay active for years to come.
The goal is to avoid vertebral compression fractures and arthritis flare-ups that could sideline you from the activities you love.
These spine-friendly side bend alternatives will keep you moving while protecting your most important structural support system — your spine.
Margaret Martin
Further Reading
References
- Marras WS, Granata KP. Spine loading during trunk lateral bending motions. J Biomech. 1997 Jul;30(7):697-703. doi: 10.1016/s0021-9290(97)00010-9. PMID: 9239549.
- Wiatt E, Flanagan SP. Lateral Trunk Flexors and Low Back Pain: Endurance and Bilateral Asymmetry. Athletic Therapy Today. 2009 May
- Sungwook Kang, Chan‑Hee Park, Hyunwoo Jung, Subum Lee, Yu‑Sun Min, Chul‑Hyun Kim, Mingoo Choi, Gu‑Hee Jung, Dong‑Hee Kim, Kyoung‑Tae Kim, Jong‑Moon Hwang.
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