What exercises increase bone density in the spine?
If you’ve been diagnosed with osteoporosis or osteopenia, you may be concerned about bone density in the spine. The spinal bones (or spinal vertebrae) are among the most vulnerable bones to osteoporotic bone fractures, which can lead to a loss of mobility (Bone Health and Osteoporosis, 2018). Postmenopausal women, in particular, are at a higher risk of developing low spinal bone density due to hormonal changes that lead to a decline in bone mineral density (Endocrine Society, 2022).
However, it is possible to increase or maintain bone density in the spine through physical activity and specific exercises. Weight-bearing activities, such as brisk walking and weight training, are especially beneficial for building bone density in the spine as they place good stress on the vertebral bones, stimulating the production of new bone tissue. Strength training exercises such as resistance band exercises and exercises that use free weights can also improve spinal bone density by strengthening the back muscles and improving posture. Incorporating these types of exercises into a well-rounded exercise program will help you maintain healthy bones and reduce the risk of spinal compression fractures.
Here, we’ll go into each type of exercise that is good for your spine in more detail, then provide specific exercises for spine health to help get you started.
The importance of posture and alignment for spine health
You can do all the exercises you want to strengthen your spine, but none of it matters if you aren't doing your exercises with good posture and alignment. Good alignment refers to how your bones are stacked on top of each other. Every day, the weight of your own body is putting pressure on your bones and joints. The bones in the body are designed to withstand these forces comfortably, but only when the weight is optimally distributed over healthy bones.
In someone with poor alignment or posture, the distribution of these forces can result in too high a force being placed over a more vulnerable section of a bone. This can be the case with the spinal bones. In someone with forward, rounded posture, the force distribution over the bone is uneven, putting more pressure through the front of the vertebrae than the back. In weakened bones, this can lead to a fracture.
Strong back and core muscles, combined with good alignment, can help protect your spine and lower your risk of developing these types of fracture. But it is also important for anyone who plans to do resistance exercises to begin understanding how to engage the core muscles and find good alignment. This combination of knowledge will set you up for success with all other exercises.
Weight-bearing exercises for osteoporosis of the spine
Weight-bearing exercises are any exercises in which you use your own bodyweight to create stress on your bones. This type of stress is necessary for building and maintaining bone density, especially in the spine. Examples of weight-bearing exercises include brisk walking, stair climbing, and lifting weights (Bone Health and Osteoporosis, n.d.). As mentioned earlier, these exercises are effective at increasing bone density of the spine as they create stress that triggers the body to build new bone (Mayo Clinic, 2021).
Strength-training exercises for osteoporosis of the spine
Strength training exercises, such as those performed with weights or resistance bands, can also help improve bone density in the spine. While weight-bearing exercises and activities are beneficial for bone health, adding resistance can increase the load on your bone therefore increasing the demand on the body. Many strength training exercises target the back muscles, which are responsible for supporting the spine and improving posture, which can protect the spine, which in turn helps build and maintain strong bones (Bone Health and Osteoporosis, n.d.). Examples of strength training exercises include push-ups, plank, and lifting weights or working against resistance bands. It's important to start with light resistance and gradually increase that resistance as the muscles become stronger.
Tai chi exercises for osteoporosis of the spine
Tai chi is a low-impact form of exercise that focuses on balance, posture, flexibility and body control. By doing exercises to address balance and body control, you can reduce your risk of falls and therefore reduce your risk of fractures. This exercise is suitable for individuals with osteoporosis or those at risk for fractures and can help build bone density in the spine because it is weight-bearing and focuses on good posture and alignment (Harvard Health, 2020).
Exercises for osteoporosis of the spine
Now that you know how important they are for you, here are a sampling of exercises from the Wellen exercise library that are safe for people with osteoporosis and help protect the bones in the spine.
Standing alignment
Standing with proper posture helps decrease the stress on your spine and joints, improving alignment so that your spinal bones are less vulnerable to compression fractures. Having good standing alignment is an important precursor to many other standing exercises.
How to do it:
- Get into a comfortable standing position with your feet about hip width apart. You can use a mirror for visual feedback if you find it helpful.
- Imagine you have a string pulling you up from the top of your head, lengthening your spine.
- At the same time, push the floor away with your feet as you imagine yourself growing taller.
- Gently squeeze your shoulder blades together, making sure you are not arching your low back as you do so.
- Make sure to keep your lower abdominals engaged.
- Do not arch your low back excessively as you stand tall.
- Breathe normally.
- Hold for 30-60 seconds. Relax.
Gathering chi (tai chi)
Gathering chi is a tai chi exercise that warms up the muscles of your shoulders, arms, mid-back, hips and knees. It is weight-bearing, which is important for spine health, and it encourages improved range of motion, opening up the body for better posture and alignment throughout the day.
How to do it:
- Stand comfortably with your feet hip width apart.
- Circle your hands up the sides of your body, and then allow your palms to descend slowly. Imagine yourself outside in nature, surrounded by vibrant, healing energy.
- Circle your arms up and overhead, and gather all of that energy.
- As your palms descend downward, imagine you're guiding that energy through every cell of your body.
- Bend your knees gently as you gather the energy.
- Guide the energy through your heart and lungs and all of your organs.
- Breathe normally.
- Repeat for 10 to 20 repetitions.
Abdominal drawing in maneuver
The abdominal drawing in maneuver is a foundational core exercise that helps you recruit and strengthen the lower abdominal muscles, which provide support for your low back.
How to do it:
- Begin lying on a mat with your knees bent and feet flat on the floor.
- You may place your fingers on your lower abdominal muscles just inside your hip bones so you can feel when they are contracting.
- Tighten your lower abdominal muscles by slowly drawing your navel in towards your spine.
- Your muscles should flatten toward the floor as you contract them. They should not bulge.
- Hold the position for 10 seconds, then relax.
- Breathe normally, and do not bear down.
- Repeat 10 times.
Standing isometric thoracic extension against wall
Standing isometric thoracic extension against a wall is designed to help activate and strengthen your thoracic spinal extensor muscles – the muscles that line either side of your spine – to help improve posture and prevent a forward slumped position. This is important for decreasing stress on your spine and preventing compression fractures.
How to do it:
- Begin by standing with your back against a wall.
- Stand with your feet about a foot away from the wall with your knees slightly bent so that your entire back is flat against the wall.
- Gradually press into the wall with your shoulders, as if you are trying to arch your mid-back. You shouldn’t actually move or change the position of your back.
- You should feel the muscles in your mid-back contracting.
- Hold this position for 5 to 10 seconds, then relax.
- Breathe normally.
- Repeat 10 times.
Prone thoracic extension with scapular retraction
Not everyone is comfortable lying on their stomach, if you are ok with getting down on the floor and lying flat on your stomach (or with a pillow underneath your chest and abdomen) then prone thoracic extension with scapular retraction is a great exercise for your spinal muscles. By strengthening the thoracic spine extensor muscles, this exercise will help you prevent forward slumped posture and reduce pressure on the spine.
How to do it:
- Begin by lying on a mat face down. You may place a pillow under your hips if this position is uncomfortable in your lower back region.
- Place your hands next to your sides.
- Lift your chest off the floor and squeeze your shoulder blades together.
- Hold this position for 5 to 10 seconds, then lower back down to the starting position.
- Don't lift so high that you are arching in your low back. This exercise is focusing on range-of-motion in your mid back.
- Breathe normally.
- Repeat for 2 sets of 5 to 10 repetitions.
Standing horizontal shoulder abduction with resistance
Standing horizontal shoulder abduction with resistance targets the muscles of the upper back and shoulder, which are important for preventing forward, rounded shoulders and help promote good posture. It uses a resistance band to add an extra bone-building component to the exercise.
How to do it:
- Stand tall with your feet hip width apart.
- Hold a resistance band with both arms straight out in front of you at about a 90 degree angle to your body. Your palms should be facing up.
- Keeping your arms straight and at chest level, pull the band out to the sides with both arms until your arms are out to your sides and in line with your shoulders, but don’t go beyond that. Then slowly return to your starting position.
- Think about squeezing a pencil between your shoulder blades.
- Breathe normally.
- Repeat for 2 sets of 10 repetitions.
How to incorporate exercise that strengthens your spine into everyday life
Incorporating exercise into daily life can be simpler than you think. Here are a few tips to help you add exercise into your daily routine:
- Practice good standing alignment while brushing teeth and doing dishes
- Use resistance bands or free weights while watching TV
- Try a new bone-health workout such as Wellen that incorporates tai chi, weight-bearing, resistance, posture and balance
How to increase bone density in the spine with exercise
In conclusion, low bone density in the spine is a common concern for individuals with osteoporosis and those at risk for fractures. Weight-bearing exercises, strength training and posture exercises are effective ways to build and maintain bone density in the spine. Remember to start slowly, gradually increasing the intensity and frequency of the exercises, and to listen to your body to avoid overexertion or injury. Knowing what exercises improve bone density in the spine can help improve quality of life and prevent long-term health complications.
As a reminder, it’s always important to consult with a healthcare provider before starting any new and unsupervised exercise program, especially for individuals with osteoporosis or those at risk for fractures. If you are new to exercise, you’ll want a proper assessment and starting point that is safe and appropriate for your age, fitness level and goals. A medical doctor can provide medical advice and a physical therapist can provide you with helpful cues to make sure you are performing your exercises with good posture and alignment.
