Osteoporosis & Bone Density Physiotherapy in Perth

Yes. Progressive resistance training and impact-loading exercise are the most effective non-pharmacological interventions for maintaining and improving bone mineral density. The evidence is particularly strong for progressive resistance training targeting the spine and hip -- the most common fracture sites. Studies consistently show that supervised exercise programs can arrest bone density decline and in some cases produce modest improvements in BMD. Exercise also improves muscle strength, balance, and reaction time, which reduces falls risk -- the most important proximal cause of fracture. The key is appropriate loading: too little is ineffective, too much risks fracture. Physiotherapy-supervised programs calibrate this precisely.

Yes, when appropriately designed and supervised. The risk of not exercising -- progressive deconditioning, falls, and continued bone loss -- substantially outweighs the risk of supervised exercise in the vast majority of osteoporosis patients. Exercises to avoid with significant vertebral osteoporosis include high-impact spinal flexion under load (e.g., full sit-ups, deadlifts with heavy spinal flexion), high-velocity rotational movements, and any activity with a high fall risk without adequate supervision. Your physiotherapist will design your program with these considerations built in, progressing you safely from your current level.

The two most effective modalities are progressive resistance training and impact loading exercise. Progressive resistance training -- using weights, resistance machines, or body weight -- applied to the major muscle groups of the spine and hip produces the greatest bone-loading stimulus. Exercises include squats, hip extensions, rows, and overhead press when appropriate for your fracture risk. Impact loading -- activities such as jumping, hopping, and jumping jacks -- provides a different loading stimulus to bone and is particularly beneficial for hip bone density. Walking, while beneficial for general health, produces insufficient bone-loading stimulus to meaningfully improve bone density in osteoporosis. A well-designed program combines both modalities.

This is a medical decision best made with your GP or endocrinologist, based on your DEXA scan results, FRAX fracture risk score, and individual circumstances. Generally, exercise and medication are complementary rather than alternatives: exercise addresses the functional deficits (strength, balance, falls risk) that medication does not, while antiresorptive medications (bisphosphonates, denosumab) or anabolic medications slow bone loss or stimulate bone formation in ways that exercise alone cannot fully replicate in severe osteoporosis. For osteopenia (T-score between -1 and -2.5), exercise alone may be sufficient depending on fracture risk. For osteoporosis (T-score below -2.5), particularly with prior fractures, medication alongside exercise is typically recommended.