Table of Contents

Many of my new clients ask: can osteoporosis be reversed without pharmaceuticals such as Fosamax or Prolia?  Depending on their specific circumstances, osteoporosis can be reversed with a combination of therapeutic exercise and good nutrition. I cover each of these in detail in this blog article. I conclude with a case study of one of my clients and her experience fighting osteoporosis.

Can Osteoporosis be Reversed?

Osteoporosis is a term given to indicate a loss of bone mineral density. It is easier to prevent the condition than it is to treat it. However, if your DEXA results indicate that your bone mineral density scores are in the osteoporosis range, there are a number of important considerations to keep in mind. This article will cover these in detail. Let’s start with a definition of “reverse osteoporosis”.

“Reverse Osteoporosis” Definition

The World Health Organization (WHO) defines the criteria for osteoporosis based on a T-score. A T-score of:

  • -1.0 or higher is normal.
  • Between -1.0 and -2.5 indicates osteopenia.
  • -2.5 or lower indicates osteoporosis.

Your physician will advise you that you have osteoporosis if you have a T-score that indicates your bone density is two and a half standard deviations below the mean of a 30-year-old woman.

If you are sitting on the edge of osteoporosis (-2.5 to -2.9), you could move into osteopenia territory with the right combination of exercise and diet. Technically, if you have increased you bone density to the point where your new score indicates you have osteopenia, you have “reversed osteoporosis”.

But keep in mind if your T-score is lower than -3.0, it might be a considerable challenge to “reverse osteoporosis” and change your diagnosis to osteopenia.

You can, however, stop the decline and build both bone quality and bone density. The ultimate goal is to maintain your independence and stay fracture free. There is more to bone health than a high DEXA score. Your exercise and nutrition program should also address fall prevention strategies, balance, posture and other important areas.

Osteoporosis Diet and Exercise

Clients consult with me because they:

In many cases, their physician advises pharmaceutical intervention. Clients wonder if their physician is prematurely advocating an osteoporosis medication. They want to know if we can work together to reverse osteoporosis naturally without medications like Fosamax, Prolia or Forteo.

I suggest that we help reverse osteoporosis as much as we can with a combination of therapeutic exercise and diet, whether you need pharmaceuticals or not. Studies have shown that people reversed osteoporosis naturally when they:

  • Followed a therapeutic exercise program with adequate levels of weight bearing.
  • Exercised over many years.
  • Were consistent in their exercise routine.

Further, your diet matters. Later in the blog we discuss the right combination of nutrients that appear to stimulate the bone building process. A bone building diet includes key essentials that consolidate the stimuli of exercise and impact loading.

Establish Realistic Expectations

If you are like most people, it probably took a number of years for your bone mineral density to decline to the point where you now have osteoporosis. People exposed to high levels of strong medications or radiation are exceptions to this rule. These individuals have likely experienced an accelerated rate of decline in bone density.

Expect that it will take time (and effort) to reverse your bone loss. Your rate of bone loss is influenced by the following individual factors:

  • Genetic makeup.
  • Hormonal status.
  • Current and historical activity and exercise level.
  • The pharmaceuticals you may currently be on or have taken.
  • Current and past diet over the years.

Your risk of bone loss after menopause may increase compared to your friends because of your genes, even if your physical activity and your diet are the same. Your genetic makeup determines how your bone building cells respond to stimuli. (1) Each individual responds differently to the decline of hormones that come with menopause and andropause.

In the first 7 to 10 years following menopause “maintaining is gaining”. In other words, if you are able to maintain your bone mass, consider that a gain!

Why? Because, without an exercise program and good nutrition, you will likely see an ongoing decline in bone density and a worsening of your osteoporosis. This could lead to an increased risk of fracture.

Reversing Osteoporosis Without Drugs

Most people want to know can osteoporosis be reversed without the use of drugs. I encourage people to pursue that goal when it is realistic. If you are advanced in age and your FRAX score indicates a high fracture risk (as mentioned above), exercise and good nutrition alone might not be adequate. In addition, for many, the amount of impact weight bearing that we do on a daily basis decreases significantly as we age. (2)

An exercise and diet program can take months to affect bone density and the rate of change is slow. In the meantime, pharmaceutical intervention may be a reasonable option to consider. Having said that, pharmaceutical intervention(s) may increase your bone density but do not improve the quality of your bone.

Another important fact is that pharmaceuticals do not reduce your risk of falling or your quality of life. Unlike exercise and improved nutrition, the side effects of pharmaceuticals are mostly negative.

Can Bone Loss be Reversed?

A study by Bassey and Ramsdale (3) found that in women who were more than six years post-menopausal that ground reaction forces from weight bearing exercises had a “maintenance effect”.

The group did not reverse bone loss but they were able to maintain bone density through appropriate weight bearing exercises. Given that the group was destined to lose bone, this should be considered a success. In this case, maintaining is gaining.

If you want to learn more about a targeted weight bearing exercise, I encourage you to read my heel drop exercise post.

Prevent a Fall, Move Safe and Build Bone

A 2015 Canadian led international consensus process on physical activity and exercise recommendations for adults with osteoporosis with or without vertebral fractures (4) concluded that the therapeutic exercise program goals for people with osteoporosis should be:

  • Fall prevention.
  • Slow the rate of bone loss.
  • Safe movement.


A study published at the end of 2017 highlights the benefits of exercise on fall prevention and reducing the rate of bone loss for individuals with osteoporosis:

“Exercise and physical activity (PA) that additionally result in improvements in muscle strength and increased balance and joint proprioception are likely to reduce the risk of falls and therefore indirectly lower fracture risk. Exercise programs developed for fall prevention have been shown in meta-analysis to reduce falls by up to 39% in community-dwelling older adults.” (5)

Finally, research (5) has shown that increases in bone mineral density from a therapeutic exercise program for osteoporosis “are similar to those seen with antiresorptive drugs (i.e., bisphosphonates, etc) that reduce vertebral and non-vertebral fracture rates.” (5)

A good exercise program delivers additional dividends including improved cardiovascular fitness and better quality of life. Safe movements are key for preventing compression fractures.

Work With a Qualified Health Professional

A diagnosis of osteoporosis often entails lifestyle changes. You will likely have to change your diet, start a therapeutic exercise program, adjust current exercise routines (including Yoga and Pilates), and modify your activities of daily living. Since time is critical, I encourage you to work with a qualified health professional who has experience dealing with people with osteoporosis.

Many people claim to have expertise in osteoporosis treatment. You should be cautious when you hear these claims. Find someone who you want to work with, who has recognized medical credentials (such as a Physical Therapist or Physician), and who has dealt with many people with your medical condition.

Let’s next address the question: can exercise reverse osteoporosis?

Can Exercise Reverse Osteoporosis?

Your diagnosis of osteoporosis is based on your bone mineral density (BMD) scores. However, BMD is only a partial measurement of the health of your bones.

Bone quality, measured with quantitative computer tomography, is critical to successful osteoporosis management. (I discuss bone quality in my article on Bone Quality and Osteoporosis.)

Exercise has been shown to improve bone quality by altering bone geometry and morphology.
While bone density is important and can be easily measured and tracked, it is bone quality that we would like to see improve.

Unfortunately, bone quality tests are not easily accessible. If you work with a qualified health professional, such as a Physical Therapist trained to treat osteoporosis, your exercise program will be designed with bone quality improvement in mind.

Bone Peak Mass

We know that as you hit menopause, the decline of estrogen in the body reduces your bone mineral density scores. By age 30, most individuals have reached their peak bone mass and gradually lose bone mass over time. If you wait until your bone density declines to the point where you have osteoporosis, you’re going to have to maintain or gradually build from that starting point.

Exercise can help you can stave off that decline. This means that if you start the right exercise program, you can maintain (or potentially increase) your bone density.

Many studies show that men and women can increase bone density and reverse osteoporosis. (6)

In one study, the exercise participants increased bone density in the 1% to 2% range. The control group who did not do therapeutic exercise, the bone density decreased in the 4% range. So, technically, the exercise group gained as much as 6%. I discuss this study in detail below.

Start Exercise Early in Life

Exercise is not a strong enough stimulant on its own to bring you back to where you were at your peak bone mass. Your best chance to build and maintain your peak bone mass is if you start vigorous and regular exercise before or when you achieve your peak bone mass.

If you are in your pre-pubertal years, you are the perfect candidate to build bone before your peak bone mass stage. You should exercise hard, play hard, and be sure that you have the nutrition to support the bones. Eventually you will have a wonderful peak bone mass that you would maintain through your adult life.

Share this important information with your children and grandchildren!

Before we discuss the role of nutrition in reversing osteoporosis, let’s look at research that shows how a specific exercise routine can play an important role in building bone.

Exercise Recommendations for Osteoporosis

Exercise is an essential ingredient to bone health. If you have osteoporosis, therapeutic exercise needs to be part of your osteoporosis treatment program.

But what exercises should you do and which ones should you avoid? What exercises build bone and which ones reduce your chance of a fracture? Is Yoga good for your bones? Who should you trust when it comes to exercises for osteoporosis?

A great resource on exercise and osteoporosis is my free, seven day email course called Exercise Recommendations for Osteoporosis. After you provide your email address, you will receive seven consecutive online educational videos on bone health — one lesson each day. You can look at the videos at anytime and as often as you like.

I cover important topics related to osteoporosis exercise including:

  • Can exercise reverse osteoporosis?
  • Stop the stoop — how to avoid kyphosis and rounded shoulders.
  • Key components of an osteoporosis exercise program.
  • Key principles of bone building.
  • Exercises you should avoid if you have osteoporosis.
  • Yoga and osteoporosis — should you practice yoga if you have osteoporosis?
  • Core strength and osteoporosis — why is core strength important if you have osteoporosis?

Enter your email address and I will start you on this free course. I do not SPAM or share your email address (or any information) with third parties. You can unsubscribe from my mail list at any time.

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Does Weight Bearing Exercise Increase Bone Density

To gain a better understanding whether weight bearing exercise increases bone density, I recently reviewed two studies (6, 7) that looked at exercise and its effect on bone over an extended period of time. I chose these studies because one built on the other and they involved very little equipment that could be accessible to all.


First Study on Weight Bearing and Bone Density

In the first study, the researchers incorporated exercises using the weighted vest. The exercises were:

Later during the study, the researchers incorporated jumps. The exercise group started with jumping on the spot and then gradually built up until they were jumping down from 4, 6, and 8-inch heights.

The first study lasted nine months. The researchers found there was not a lot of change shown in the bones of the women that were in the exercise group versus the control group. Keep this in mind when you go for your DEXA after starting an exercise program. You may not see the results you were anticipating simply because you were not exercising long or hard enough.

weight bearing bone density reverse osteoporosis melioguide

Physical Condition Before Starting the Study

The women (in both the exercise and control groups) were de-conditioned when they entered the study. The conditioning level of the women in the exercise group improved over the nine months of the first study.

The research team started the exercise group with weighted vests that were low in weight and progressed them gradually by one, two or three pounds at each interval. In addition, the number of repetitions and the number of sets was gradually increased over the nine months.

Weighted vests were not used with the jumps. Sessions were conducted three times per week.

The jumping progression was as follows:

  • Four months in, the exercise group was doing one to five jumps per session.
  • Five months into the study, the exercise group was doing six jumps per session.
  • Up to and including month five, all jumps were divided with half being performed on a one inch pad and half from a four inch step.
  • By the seventh month, they had built up to twelve jumps per session and a six inch step.
  • Nine months into the study, they had increases to twenty eight jumps per session and increased the step height to eight inches.

Why wasn’t there an increase in bone density during this nine month study? We know the bone turnover is really slow. Because there was not enough stimulus to the bones throughout the nine month study period, the exercise group did not experience a material change in bone density.

This might sound discouraging but it opened the door to a new opportunity and a significant finding for the research team.

Second Study on Weight Bearing and Bone Density

The research team realized that the first study gave them access to a group of women who, because of the exercises they did, could easily tolerate an increase in weight bearing activities.

They offered all of the members of the exercise group the opportunity to do a second study. During this study phase, the research team increased the weight bearing load on their bones. The second study lasted four and a half years.

Exercise and Control Groups

In the second study, the research team created a control group for comparative purposes. The control group matched with the exercise group on the following characteristics:

  • Age.
  • Height.
  • Weight.
  • Number of years post menopause.
  • Bone mineral density (BMD) score at the hip (in terms of total hip, femoral neck, and trochanteric).

The control group maintained a normal, active life but did not follow an exercise routine.

The average age of participants in the exercise group was 64 years old. The exercise group met to exercise three times a week and continued to do all the weighted vests exercises that they did during the first study.

Osteoporosis Exercise Routines

They did not add any new exercises to their routine. During the first three months, all of the exercises used the weighted vest. The average weight that the weighted vest participants used was eleven pounds — a reasonable weight for most people to carry.

However, the researchers made one change during the second study: The exercise group increased the number of jumps they did per workout session. Over time, they gradually worked their way up to doing fifty jumps per session, spread out throughout the session.

Study #1 Conclusions

At the conclusion of the five-year study time period, the researchers reported the following results:

  • There was no injuries.
  • The women in the control group lost an average 4% bone in the hip.
  • The women in the exercise group gained almost 2% bone in the hip.

One could argue that had the exercise group not followed the prescribed exercise routine, they would have lost 2% bone in much the same way as the control group did. Further, one could conclude that they gained 6% because they had staved off the loss of 2% plus they added 4% onto their existing bone mass.

This is significant because this improvement happened to a group of women in their late sixties — a time usually associated with bone loss.

The two studies demonstrate that if you are consistent in your exercise and you increase and challenge your conditioning, that you can build bone and potentially, reverse osteoporosis.

Is High Impact Exercise Safe on Your Knees?

For overall health and well-being walking should never be discouraged. However, as mentioned in another blog post walking alone is not enough to reverse osteoporosis or even maintain bone density. Introducing more loading to their walking, with a weighted belt or a weighted vest, and adding intervals of brisk walking or running are all effective means to increase the weight bearing forces.

For those of you with mild knee arthritis, a 2017 study (8) looking at high impact training on the strength of the femoral neck showed two exciting findings:

  • High impact loading had a positive effect on the strength of the femoral neck in as short time as 12 months.
  • In addition, high impact training did not have “any harmful effect on knee cartilage composition in post-menopausal women with mild knee osteoarthritis”.

Jumping, however, might not be an appropriate exercise for an individual with more serious joint health problems or a weak pelvic floor. In either case, you should attend to medical issues that prohibit you from jumping.

Squat Jump Exercise

The double squat jump from the Athletic Level in the Exercise for Better Bones program is an excellent example of the kind of exercise that builds bone.

Osteoporosis Diet and Exercise

Nutrition and exercise interact with the bone-building cells.

Two key cells play a major role in building bone. First are the osteoblasts. They are responsible for producing osteocytes — cells found in the bone.

Then we have osteoclasts. Those are the cleaners and cutters of bone.

Can Diet and Exercise Reverse Osteoporosis

Researchers have studied (1) if exercise and nutrition can stimulate osteoblasts to increase their production of osteocytes. Further, they have examined if there are there things that we can do with diet and exercise to optimize the production of osteocytes.

In a recent article (1) entitled Diet and Exercise: a Match Made in Bone, the authors discuss the important role that both exercise and nutrition play in the health and strength of your bones.

We know from long term studies that high intensity, high frequency exercise will play a significant role in bone preservation and formation. Intense weight bearing over time can reverse osteoporosis.

Diet Recommendations

The following nutrients appear to have a positive affect on the production of osteocytes. Some nutrients have been studied more than others but the paper encourages further research in the area.

We have listed off, where appropriate, foods that are rich in these nutrients.

  • Arganine: A semi-essential amino acid. It is essential (your body cannot make it) when your young and nonessential (your body can make it) as you grow older. Amino acids are the building blocks of proteins which is why foods that you associate as protein rich are also rich in arganine. Turkey, pork loin, chicken, pumpkin seeds, peanuts, spirulina, soybeans, chickpeas, lentils and dairy are all good sources of the amino acid, arganine.
  • Calcitriol: The man-made version of Vitamin D or cholecalciferol.
  • Lactoferrin: A protein found in body secretions. A popular supplement for boosting the immune system.
  • Daidzen and Genistein: Isoflavanoids naturally found in foods such as soybeans and soy products as well as a number of plants and herbs.
  • Fluoride: An element derived from fluroine.
  • Strontium: A mineral found in sea water and soil. Seafoods are rich in strontium. Whole milk, meat, poultry, wheat bran, and root vegetables contain smaller amounts.
  • Oleuropein: A compound found in olive oil and olive leaves.
  • Retinoic Acid: A compound derived from Vitamin A. All dark green, yellow and red vegetables as well as red or yellow non-citrus fruits are rich in Vitamin A. It is also in sardines, cod, liver and fish oils.
  • Vitamin D: The natural form of Vitamin D made in our liver as a product of sunshine (UVB light) on our skin.
  • Vitamin K2: Bovine liver, chicken liver, butter, curd cheese, edam cheese, egg yolk, and Natto (a Japanese fermented dish). I have written an article that discusses Vitamin K2 and bone health.

Osteoporosis and Genetics

Finally, your genetics plays a key role in bone health.  Your genetics influence the stimulation of osteocytes and how they respond ultimately to exercise and nutrition. However, you cannot control your genetics but you can control your choice of exercise and nutrition.

Exercise Recommendations for Osteoporosis

Exercise is an essential ingredient to bone health. If you have osteoporosis, therapeutic exercise needs to be part of your osteoporosis treatment program.

But what exercises should you do and which ones should you avoid? What exercises build bone and which ones reduce your chance of a fracture? Is Yoga good for your bones? Who should you trust when it comes to exercises for osteoporosis?

A great resource on exercise and osteoporosis is my free, seven day email course called Exercise Recommendations for Osteoporosis. After you provide your email address, you will receive seven consecutive online educational videos on bone health — one lesson each day. You can look at the videos at anytime and as often as you like.

I cover important topics related to osteoporosis exercise including:

  • Can exercise reverse osteoporosis?
  • Stop the stoop — how to avoid kyphosis and rounded shoulders.
  • Key components of an osteoporosis exercise program.
  • Key principles of bone building.
  • Exercises you should avoid if you have osteoporosis.
  • Yoga and osteoporosis — should you practice yoga if you have osteoporosis?
  • Core strength and osteoporosis — why is core strength important if you have osteoporosis?

Enter your email address and I will start you on this free course. I do not SPAM or share your email address (or any information) with third parties. You can unsubscribe from my mail list at any time.

  • This field is for validation purposes and should be left unchanged.

Reverse Osteoporosis Naturally: A Case Study

Here is a case study of a real patient — someone who I believe is representative of many of the people who get osteoporosis.

For the several years I have been seeing a patient who is concerned about her bone health. Recently, she completed her third bone mineral density (BMD) DEXA test and her results were disappointing. Her T-score in her hips was 2.5 standard deviations below that of a healthy 25 to 30 year old and the diagnosis was osteoporosis.

She is one of a number clients who have asked me: can osteoporosis be reversed? Until they modify their current exercise program to incorporate exercises and movements that benefit their bones they will not reverse osteoporosis.

Here is the history of her T-scores in tabular format:

Here is the same data in chart format:

t-score dexa bmd results

The Decline in Bone Density: 2015 to 2018

She originally contacted me in 2015 about her bone health and asked me to advise her what she could do at that time to avoid osteoporosis. I gave her my recommendations. Unfortunately, she did not follow them.

She has a busy life and liked her routines. She enjoyed her exercise classes but did not take the time or make the effort to integrate the changes we discussed into her routine. I believe if she had followed the recommended modifications, she could certainly have held her BMD scores in the -2.0 range at her spine and -1.7 range in her hips and avoided osteoporosis.

Evaluating Her Exercise Routine: 2015 to 2018

After her recent diagnosis of osteoporosis in 2018, we sat down to reevaluate what she had been doing over the past three years. She liked her group exercise classes that she attended three times a week for about ten months of the year. Her exercise classes included a step class and a flow class.

She also walked when she was in Europe two months of the year but admitted that, although her walks were occasionally as long as ten kilometres, she only walked two to three times per week.

She was not doing any upper body strength training. The weights she used in her exercise classes helped her maintain some tone in her arms but did not challenge her bones enough to make a difference. I told her that she could easily do twenty or more repetitions with the five pound dumbbells.

How to Reverse Osteoporosis: 2019

What does her BMD scores tell us about her exercise choice? Walking and exercise classes had a positive impact on her hip BMD but were not intense or frequent enough for her spine. She was not losing bone density in her hips as fast as her spine — but she was still losing bone. Her spine BMD showed that she definitely needs to up her game in this area.

  • Hip Bones: For her hip bones, we discussed the option of doing two step classes versus a step and a flow class. As well, I recommended that she could progressively build up to doing fifty jumps (sets of ten jumps, five times a day spread out throughout the day) on the days that she did not attend a class. Her pelvic floor is strong and she does not experience leaking with jumps, and she does not have prolapse or incontinence.
  • Spine: She committed to doing strength training for her back and upper body.

If she is consistent, I believe she will be able to reverse her osteoporosis and stop the gradual decline of her bone mass. I encourage you to look at your past score and assess your exercise choices based on what your scores are telling you. It can make all the difference in the world.

Can Osteoporosis be Reversed Conclusion

Can osteoporosis be reversed? Yes, it can. This article identifies what you can achieve given the health of your bones. The nutrition and exercise choices you make dictate whether osteoporosis can be reversed.


  1. Willems H, et al, Diet and Exercise: a Match Made in Bone, Curr Osteoporosis Rep, 2017; 15(6): 555-563
  2. Hannan K, et al. A novel accelerometer-based method to describe day-to-day exposure to potentially osteogenic vertical impacts in older adults: findings from a multi-cohort study, Osteoporosis Int. 2017; 28(3): 1001–1011
  3. Bassey J, Ramsdale S. Weight-bearing exercise and ground reaction forces: a 12-month randomized controlled trial of effects on bone mineral density in healthy postmenopausal women. Bone, 1995 Apr;16(4):469-76
  4. Giangregorio, L.M., et al, Too Fit To Fracture: outcomes of a Delphi consensus process on physical activity and exercise recommendations for adults with osteoporosis with or without vertebral fractures, Osteoporosis International, 2015 Mar; 26(3): 891-910
  5. Review Prescribing Physical Activity for the Prevention and Treatment of Osteoporosis in Older Adults Lachlan B. McMillan 1,* ID , Ayse Zengin 1 , Peter R. Ebeling 1 and David Scott, November 2017
  6. Shaw, J., Snow, C., Weighted Vest Exercise Improves Indices of Fall Risk in Older Women, Journal of Gerontology, 1998, Vol 53, No. 1, M53-M58
  7. Shaw, J., Snow, C., et al, Long-term Exercise Using Weighted vests Prevents Hip Bone Loss in Postmenopausal Women, Journal of Gerontology, 2000, Vol 55A, No. 9, M4893-M491
  8. Multanen J., Rantalainen T., Kautiainen H., Ahola R., Jämsä T., Nieminen M.T., Lammentausta E., Häkkinen A., Kiviranta I., Heinonen A. Effect of progressive high-impact exercise on femoral neck structural strength in postmenopausal women with mild knee osteoarthritis: A 12-month RCT. Osteoporos. Int. 2017;28:1323–1333. doi: 10.1007/s00198-016-3875-1.

Osteoporosis Guidelines

For more information, check out my Osteoporosis Guidelines.


September 7, 2018 at 8:04pm

Debbie Kimble

Thanks for great article and information. Having recently suffered a tibial plateau fracture and grade 4 stress fracture in 2nd metatarsal, and another stress fracture in same foot, all from a little fun jumping in a bouncy house, I am wondering if jumping or other high impact activities as suggested could cause additional fractures. I normally walk 4 miles daily, and in the Spring experienced my first stress fracture, 3rd metatarsal. I am so discouraged, as I enjoy riding my horse, walking my Shelties, and staying active. My Tscores are bad, -3.9 lumbar spine, -3.0 left femoral neck, -3.1 right femoral neck, worse than when first checked 4 years ago. I have family history. The meds didn't help my Mom, and I am highly skeptical given extreme side effects possible, and fact that Forteo only works as long as taken, and apparently discontinuing the drug will cause rapid decline. How can I find a practitioner who will help me implement the strategies you have outlined? Very discouraged. Thx for any advice you can offer.

September 10, 2018 at 10:24pm

Margaret Martin replies

Hi Debbie, Like you, I am concerned about your low BMD scores. The 'healing time' off your feet only contributes to lower BMD scores since you have not been able to weight-bear as much.

If you had a stress fracture walking I suggest that when you start up again that you break up your walking to two 2 mile walks am/pm or even three 1.3 mile walks a day. This will be more beneficial on your bones while reducing the potential of another stress fracture. With animal studies bone responds better if the same number of impacts is spread out over the course of the day rather than all at once.You may even consider

Nordic walking poles to reduce the ground reaction forces and reduce your fall risk.

I highly recommend that you work with a very knowledgeable endocrinologist and a nutritionist. You will need their support and skill in protecting your bones. Exercise is crucial but your bones have demonstrated that they cannot handle the impact of jumping.

I encourage you to explore the Beginner Level strength exercises, some modification may be needed while you are healing. If you have not been strength training build your repetitions gradually so that your bones gradually adapt. Be sure to study the safe moves listed within my ebook (you will find the link inside Exercise for Better Bones). How you move is critical in keeping your spine safe. Once your fractures are healed you will also want to do daily balance exercises to reduce your risk of falling.

If you had a stress fracture walking I suggest you break up your walking to two 2 mile walks am/pm or even 3 1.3 mile walks a day. This will be more beneficial on your bones while reducing the potential of another stress fracture.
With animal studies bone responds better if the same number of impacts is spread out over the course of the day rather than all at once.

Better the devil you know than the devil you do not know.

December 15, 2018 at 5:43am


Hi, I am 50yrs old and have been diagnosed with Osteoporosis. My previous scan aged 40yrs old was normal. How can you help me with improving my BDM without medication?

December 15, 2018 at 7:32am

Richard Martin replies

Hi Amelina

Margaret is unable to provide advice specific to your situation without an assessment. She is available for consultations at:

December 15, 2018 at 8:58pm


I have my drs appointment this Tuesday 18/12. I wait till I hear her advice Thanks

January 8, 2019 at 1:32pm


Thanks for all the great info - I will revisit this later when I have time to do it justice. One major question I have - I understand that the jumping seems to be very effective, and also the weighted vest. Are these two still safe if I've already had a compression fracture? I also recently broke my sternum as a result of a pretty mild car accident (from the seatbelt), which makes me wonder if my osteoporosis could have contributed to that. With both of these, I'm a little nervous about the jumping and the vest, but would love to use them if it won't make things worse in my situation!

January 9, 2019 at 10:20pm

Margaret Martin replies

Hi Carol, I am glad you are asking such important questions.
If your posture is good and you gradually increase the weight in the vest, allowing your spine time to strengthen then you should be fine to wear a weighted vest when doing your exercises such as those outlined in the study: squats, forward lunges, lateral lunges and step ups.Assuming you are able to do these types of exercises without a weighted vest.
If however, as you increase the weight you experience discomfort I would encourage you to consider a weighted belt.
I do not think that jumping is a good option for you at this time.
Wishing you all the best,

January 8, 2019 at 2:04pm


Thank you for this great article and your great book, Exercise for Better Bones. You have written that bicycling is not weight-bearing, and therefore not a good exercise for treating osteoporosis. This makes sense, when one is seated and bicycling at an easy, low resistance. But what about spinning? I find it takes great thigh effort to bike when the bicycle is at a high resistance, especially when one bikes in a standing position, out of the saddle. Is the upright position on a bike, at a high resistance, not weight-bearing to some degree?

January 10, 2019 at 5:49pm

Margaret Martin replies

Hi Jane,
The effort you feel spinning when you feel you are using great thigh effort to bike when the bicycle is at a high resistance, especially when in a standing position (out of the saddle) is still not equivalent to a hard squat set. If you were to compare the two: say you are averaging 80 RPM. You stand for 30 seconds during that time you complete 40 revolutions. This is equivalent to doing 40 squats with a high load. This is still considered an "endurance" set. To build bone the load should be high enough that you cannot complete more than 8 - 12 reps.
The following article is a good review:
If you love cycling (like I do) and spinning do not stop. However, be sure to supplement your spinning with more bone building sports/exercises. We exercise for our heart and soul as well as our bones and muscles!
Hope to see you on the trail one day!

January 9, 2019 at 5:54pm


Thank you for this wonderful article. It was so helpful to actually see a chart comparing bone density scores rather than reading about percentages of bone loss from test to test! I have learned so much from you! I have your Better Bones book and do the excercises and recently bought and read your Yoga bone book. Thank you for showing an example of the jumping you were referring to. Most of all, thank you for giving easy to understand ideas that anyone can use and follow through with as far as exercises and nutrition. This article gave me a lot of hope that I can do something for my bones myself!

January 10, 2019 at 5:19pm

Margaret Martin replies

Hi Colleen, I appreciate you taking the time to write such a supportive, positive comment. Richard is the one who puts everything together. He is glad to know that the charts were helpful in comparing bone density change over time.
I am especially grateful that you received a sense of hope from the article. Start gradually and keep building.
All the best,

January 10, 2019 at 1:22am


Thanks so much for your detailed reply....I really appreciate it.

January 12, 2019 at 6:07pm


Hi Margaret
thank you very much for the precious informations you 're providing us.
i noticed in the diet section there is no mention about the plums - they should be beneficial right?
if somebody does not have the weihgtes vest could he/she wear a dumbell of 5 punds in each hand doing the
squat lunges exercies?

January 15, 2019 at 9:22pm

Margaret Martin replies

Hi Albert,
The dried plums are great:
As far as you second question. Yes. You will see in Exercise for Better Bones the exercises performed with dumbbells. As you get stronger the weighted vest is a good complement when you are challenged holding more weight you can wear it instead!
Keep well,

February 22, 2019 at 1:56pm

Rhea Van Breda

Thank you for this site that I stumbled on. I have osteoporosis, and I have to take Prednisone for another condition. Currently I am on 3.5 mg. I'm not happy aabout it, but it does control the pain. You mentioned jumping. I have pelvic floor issues (though they are improving), and I have been jumping on a rebounder. Would that be as helpful? Thank you!

February 26, 2019 at 10:19am

Richard Martin replies

Hi Rhea, Your welcome! I am glad you found us. Life is always a balancing act. Pain control is important. Here is an article we wrote on rebounders:
All the best.

March 13, 2019 at 11:37am


After rather bad news today re bone density, I came across your website / book. Thank you! You have given me some hope again. I'm an active 56 yr old (same height and weight as I was at 20) but due to sustaining a wrist fracture (running backwards in a training exercise class) was given a routine DEXA scan. The results surprised me as I've never suffered from fractures or pain before - LS -2.8, L3 -3.1 & L4 -3.4
The route offered is to take alendronate (fosamax) but I'm nervous of starting at such a young age. Seeing your blog and book has inspired me to try and manage it myself for a few years. I understand bone growth is slow and I'm not sure I can reverse these scores (can I??) but I'm planning to live to at least 100 so I have time to try! Thank you for such a supportive and reasonable article.

March 13, 2019 at 1:50pm

Richard Martin replies

Hi Sue,
You are welcome! I am glad it has brought you hope. I do have clients with scores like yours who have gradually built up by 0.2 points or so per year, despite being postmenopausal. Needless to say, you'll want to be sure to focus on exercises that target the spine. Because your T-scores are in the low range, and you are only 56 yr old you are at a good age to consider hormone replacement (HRT). This along with exercise will have a bigger impact. I cannot say if this is a safe option for you. This will have to be a discussion between you and your physician/Gynecologist. Our HRT blog might help:
A recent study showed that women who were on HRT had better bone quality, which was sustained even two years after stopping HRT. Hormones, exercise and good nutrition our the building blocks we have some control over.
It sounds like you have the determination and many years ahead to make a change.
All the best to you!
Margaret (typed from Richard's lap top since we are on Holidays :) )

March 13, 2019 at 2:14pm


This is Carol from the question above re weighted vests. I have just had an updated bone density done, and am alarmed at the results. The hip was just in the level of osteopenia, but the spine average T-score was -3.7, with one of the vertebrae being -4.1. And they didn't go up to the thoracic vertebrae, which is where my earlier mild compression fracture was. I did see an endocrinologist as part of this program, and she is recommending some kind of medication, leaving it up to me to decide which one. I have always resisted this route (I'm 69) but think maybe I should consider it at this point. My real question is "Just how bad is this? Am I actually crumbling? Should I be alarmed if I need to cough or sneeze? Can I still read in bed, slouching against the pile of pillows, or is that making things worse? I don't know how to understand what that T-score means in day to day life." It's hard to figure out how to proceed, though I intend to make myself an exercise program with your materials (very carefully!) Any advice you can give will be gratefully received....

October 21, 2019 at 2:10pm


I found your site and am so thankful. I've been diagnosed in the early stage of osteoporosis (just on the edge between osteopenia). I've tried resisting medicine because my mother has had bad side effects, but feel I must do something. How do you decide what to take? And, recently, a new franchise OsteoStrong moved into our area. Do you have any advice on whether that works?

October 21, 2019 at 5:41pm

Richard Martin replies

Hi Susan. If you have been diagnosed in the early stage of osteoporosis, we recommend that you consult with a licensed and qualified health care professional. You can check with Physical Therapists in your area for someone. Quite a large number of Physical Therapists in the US have taken Margaret's 15 hour course on MedBridge. Thanks.

October 21, 2019 at 5:52pm

Richard Martin replies

Hi Susan. You should discuss a pharmaceutical intervention strategy with your physician. Margaret wrote this article on Prolia so that her clients could have an informed discussion with their physician. I encourage you to read it.

January 28, 2020 at 2:37pm


Hi Margaret, I enjoyed reading your article and subscribed to your exercise program. I have been very active throughout my life and was very surprised to find out that I have osteopenia. I am 54 years old and recently had a DXA test. My bone density shows osteopenia on my spine. My T-score is -1.9. Both of my hips are fine -0.1 (left hip) and 0.2 on right hip. I will be seeking out Physical Therapy and meet with my doctor to see what she has to say. My mom and her sister have osteoporosis. I am have been taking Tamoxifen for the last 2 years and am wondering if this is related. I'm looking forward to starting your program and feel blessed to have found your website. Thank you!!

January 28, 2020 at 6:59pm

Margaret Martin replies

Hi Adelia,
Your hip BMD scores are very good - equal to that of a 25 year old! When you meet with your Physical Therapist have her focus exercises for your spine. The one study I found on Tamoxifen concluded: "In postmenopausal women, treatment with tamoxifen is associated with preservation of the bone mineral density of the lumbar spine. Whether this favorable effect on bone mineral density is accompanied by a decrease in the risk of fractures remains to be determined. (N Engl J Med 1992;326:852–6.)"
My guess is you were either a runner or did some sport such as soccer or basketball but did not do much upper body strength training. Hence you built strong bones in your legs and not so much in your spine.
Exercise for Better Bones outlines which exercises you should focus on for your spine.
All the best,

July 9, 2020 at 10:24pm


Hello, thank you for posting an article of hope and outlining how one can build bone and overcome osteoporosis. Your pragmatic and optimistic advice gives hope. I am a man in my late 50s who has never had problems with my bones until recently. 4 years ago after a knew problem caused me to discontinue my 30 year jogging routines.. I shortly began to have problems in my lower back. I had a dexa scan in January of 2020 and was diagnosed with osteoporosis. My lumbar spine reading was -2.8, left femoral neck -2.6 total hip -1.7. I wasn't surprised and told my doctor my mother had osteoporosis and I shared a lot of hereditary traits from my mother. Dr. said that it is nonetheless caused by hormone issues in women and may have same cause for me. We did a variety of tests and then multiple checks and found out that my testosterone levels were low but more importantly my prolactin levels were at 90, 5 times higher than a lactating woman. We never found a prolactinoma but the doctor proceeded with treatment for a microprolactinoma and 6 months later my hormone levels are now balanced and I'll be on cabergoline for the (apparently, very small tumor of the pituitary gland. All other tests including bone marker tests look good at this time.. I intend to follow your regimen and get my bones strengthened but as I understand it.. if my issue was hormones, which have now been corrected, would it be normal for me to expect a reversal of my issues anyway with treatment. I have refused to take bisphosphonates because I have dental implants planned over the next year, and they just won't work for me, but hoping to reverse it so my doctor does not push the bisphosphonates at me next year.

July 10, 2020 at 9:55am

Richard Martin replies

Thank you for sharing your story. Keep us posted on your progress.

August 26, 2020 at 11:24pm


I am finding great value in your .site. I would like to . bring a find. To know how fragile bones are dexa is incomplete. new machines add a tbs score. This indicates bone quality. This can pretty much alter your decision to take medicine.

August 27, 2020 at 10:22am

Richard Martin replies

Hi Anna. Thanks for your comment. You should probably read this article on DEXA.

December 27, 2020 at 4:24pm

Brenda J Taylor

Hi, I just stumbled across your article while looking for answers to my declining bone density. I was diagnosed with seronegative Rheumatoid Arthritis last year and started on Methotrexate. I had a DEXA last year and another one this year. The one this year shows declining bone density despite taking a bone builder supplements containing Vitamin D3, Vitamin K2, Calcium, Magnesium, and biotin. I also take a multivitamin with B vitamins and Vitamin D. Because I take the Methotrexate, I also take 1000 mg of Folate (I prefer it in its natural form to taking folic acid). Last year, my dr said she would give me one year of supplementation to show some improvement and if that didn't happen she wanted me on Fosamax or Boniva. I do not want to take either of these medications as I know that they ten to caus fractures. My scores have decreased slightly from -1.1 to -0.8 for my spine and -2.9 to -2.8 for the femoral neck. My femoral mean has stayed the same. I just subscribed to your exercise program so I am hoping that helps. Do you have any other suggestions for me?

December 27, 2020 at 8:01pm

Richard Martin replies

Hi Brenda. Thank you for your comments. Margaret is unable to provide feedback or consultation without an assessment. The decision to take or not take a medication is a serious one. If you need to speak to her, you can check out her coaching service:

March 28, 2021 at 8:01pm

Mary Kris Lynch

I am convinced that weight workouts strengthen bones I get mine with a wt vest like the one at ********** just put it on go out and walk or shop whatever each day bone will grow stronger no boring repetitious workouts just a nice fun walk in the fresh air

July 4, 2021 at 10:48am

Walt Brown

What is best calcium supplement?

July 4, 2021 at 3:51pm

Richard Martin replies

Hi Walt: You should read this blog post on calcium supplements.

January 25, 2023 at 7:56pm

Erin Ries

Loved your case study about the woman who revisited her exercise program with you in 2018. I'm curious to know if she followed your suggestions and if yes, has her bone health has improved. The reason I ask is that I am 66 and have osteoporosis. I was doing burpees and jumping jacks, but only once a week (which sounds like from your case study to be clearly not enough).