Preventing Osteoporosis: Build Bone Now to Prevent Fractures as You Age

When it comes to bone health, most of us don’t think much about it — until we’re given a reason to. Maybe it’s a DEXA scan that shows early signs of bone loss. Maybe it’s a fracture that seems to come out of nowhere. Or maybe it’s just a quiet, nagging sense that your body doesn’t feel quite as strong, stable, or resilient as it used to.

In reality, osteoporosis isn’t just a concern for “older women.” It’s a lifelong conversation — one that starts earlier than most people realize. While building strong bones in your 20s and 30s lays the foundation, there’s so much you can do in your 40s, 50s, and beyond to protect and even improve your bone density. 

Keep reading to learn about the different types of treatment, including exercises that help build bone, improve balance, and reduce the risk of fractures. 

Treatment for osteoporosis in women

Effectively managing osteoporosis takes more than just one solution — it takes a well-rounded, proactive approach that mixes lifestyle changes, targeted movement, balanced nutrition, and, when needed, medical support.

These strategies don’t just help preserve bone density — they also support your mobility, confidence, and overall quality of life. With the right plan in place, it’s absolutely possible to stay strong, steady, and resilient as you age.

Medical treatments and hormone therapy for osteoporosis

When it comes to managing osteoporosis, medications and hormone therapy can be powerful tools — especially when used alongside lifestyle changes and exercise strategies. These treatments work behind the scenes to help slow bone loss, support bone rebuilding, and lower your risk of fractures.

Hormone replacement therapy (HRT) 

Estrogen plays a key role in maintaining bone density — which is why the drop in estrogen during the stages of menopause can lead to rapid bone loss. Hormone replacement therapy (HRT) helps replenish those hormone levels, reducing the risk of fractures and potentially lowering all-cause mortality in postmenopausal individuals. 

It’s not the right fit for everyone, but for some, it can be a game-changer. A conversation with your doctor can help you weigh the benefits and risks based on your health history and goals.

Bone-strengthening medications

In some cases, your provider may recommend medications like bisphosphonates or other bone-preserving medications. These help slow bone breakdown and maintain or even improve bone density over time.

If you're feeling unsure about where to start, you're not alone. Talk with your healthcare provider about your bone health concerns — they can help you find the treatment approach that fits your body, your life, and your long-term goals.

Physical therapy treatment for osteoporosis (and prevention)

Movement is medicine — especially when it comes to your bones. Physical therapy is a cornerstone of osteoporosis prevention and management, offering more than just exercises. It’s about learning how to move in ways that build strength, improve posture and balance, and reduce your risk of fractures — all while keeping you active and confident in your body.

But not all movement is created equal. For folks already diagnosed with osteoporosis or osteopenia, certain exercises can actually increase the risk of injury. That’s why working with a physical therapist (PT) trained in bone health is essential. They’ll design a plan that’s not just safe, but also effective — tailored to your unique needs, history, and goals. Here are some of the ways that physical therapy can help.

Weight-bearing exercises

Weight-bearing activities gently stress your bones in healthy ways, triggering your body to maintain or even increase bone density over time. These types of exercises include dynamic, upright movements like:

• Hiking
• Dancing
• Stair climbing

If you’re in the early stages of bone loss, higher-impact options like jogging or jumping might be beneficial — but they’re not for everyone. A PT can help you figure out what your bones can handle safely, especially if you’re new to movement or have a history of fractures.

Resistance training

When it comes to protecting your bones, resistance training is one of the most powerful tools we have. It applies targeted stress to muscles and bones, encouraging them to grow stronger together. Some of the most effective options include:

• Lifting weights or exercising with a weighted vest
• Using resistance bands
• Bodyweight exercises (like squats, lunges, or push-ups)

Focusing on your hips, legs, and core is especially important — these areas provide foundational support and help prevent the types of falls that lead to fractures. Here are some exercises you may see:

Squat with chair for balance

1. Stand behind a sturdy chair, feet hip-width apart, hands resting lightly on the back for support.
2. Engage your core, keep your chest lifted, and shift weight into your heels.
3. Slowly bend your knees and hips, lowering into a squat as if sitting back into a chair.
4. Go as low as comfortable, keeping your back straight and knees aligned with toes.
5. Pause briefly, then press through your heels to return to standing.
6. Repeat for 8–12 reps.

Lower trapezius pulldowns with resistance band

1. Anchor a resistance band at waist height (e.g., in a door or around a sturdy object).
2. Stand tall, feet hip-width apart, knees slightly bent, and hold one end of the band in each hand, arms straight in front of you at shoulder height.
3. Engage your core and pull both arms straight back, keeping elbows straight and close to your sides.
4. Squeeze your shoulder blades together at the end of the movement.
5. Slowly return to the starting position with control.
6. Repeat for 8–12 reps.

Posture and spinal alignment

A strong, aligned spine is key to preventing vertebral compression fractures — a common complication of osteoporosis. Posture-focused exercises work to:

• Improve spinal extension and flexibility
• Strengthen the upper back and shoulders
• Build core stability and reduce unnecessary strain on the spine

The goal isn’t just to “sit up straight,” but to support your body in a way that feels strong, comfortable, and sustainable. Here are some exercises you may see:

Standing wall angels:

1. Stand with your back against a wall, feet a few inches away, knees slightly bent.
2. Press your lower back, upper back, and head gently into the wall.
3. Raise your arms to form a “goal post” shape — elbows bent at 90°, wrists and elbows touching the wall if possible.
4. Slowly slide your arms up the wall, keeping contact with elbows and wrists.
5. Pause briefly at the top, then lower back to the starting position.
6. Repeat for 8–10 reps, maintaining steady breathing and wall contact.

‍Planks:

1. Start on hands and knees (quadruped), wrists under shoulders, knees under hips.
2. Step one foot back at a time to extend legs straight behind you.
3. Keep your body in a straight line from head to heels by engaging your upper back, deep core, glutes, and quads.
4. Keep your shoulders stacked over your wrists, and hips in line with shoulders.
5. Hold for 20–30 seconds or as tolerated, maintaining steady breathing.

Balance and coordination

Many osteoporosis-related fractures don’t happen because bones are weak — they happen because of a fall. That’s where balance and coordination training comes in. These exercises help improve proprioception (your sense of where your body is in space) and strengthen your reflexes, so you can move with more stability and less fear:

• Single-leg balance work
• Tai Chi or gentle yoga
• Stability drills

Working with a physical therapist ensures these exercises are not only safe, but appropriately challenging — helping you progress without putting yourself at risk. Here are some exercises you may see:

Single leg squat with foam roller:

1. Stand sideways next to a wall, place a foam roller at hip height between your outer thigh and the wall.
2. Press the roller into the wall with your thigh for light support.
3. Lift the inside leg slightly off the floor, balancing on the leg closest to the wall.
4. Slowly bend the standing knee, lowering into a shallow squat while keeping your knee aligned over your toes.
5. Push through your heel to return to standing, maintaining pressure on the roller.
6. Repeat for 8–10 reps, then switch sides.

Reverse lunge:

1. Stand tall with feet hip-width apart, hands on hips or at your sides.
2. Step one foot back, landing on the ball of your foot.
3. Lower your back knee toward the floor, keeping your front knee aligned over your ankle.
4. Keep your torso upright and core engaged for balance.
5. Press through your front heel to return to standing.
6. Repeat 8–10 reps per side, moving slowly and with control

NOTE: Not all exercises are appropriate for folks who have already been diagnosed with osteoporosis. Certain movements may increase your risk of fractures, making it essential to work with a specialist trained in osteoporosis management.

Don’t wait to protect your bone health

Osteoporosis may be common — especially as we age — but it doesn’t have to hold you back. With the right combination of movement, support, and medical care, you can protect your bones and feel strong, steady, and confident in your body — not just today, but for years to come. It’s never too early (or too late) to start.

At Origin Physical Therapy, we’re not just here to treat symptoms — we’re here to help you reclaim your strength. Our pelvic health specialists understand the challenges that come with bone loss and aging, and they’re experts in creating evidence-based plans that fit your needs. Whether you're working to prevent osteoporosis or navigating it now, we’ll help you move safely, build strength, and reduce your risk of fractures — all with compassion, intention, and care.

If you’re ready to take the next step, we’re ready to walk with you. Book an appointment today. Your future self will thank you — and so will your bones, your balance, and your confidence.