Health
Pilates for osteoporosis and menopause: is it good for your bones?
In short: Meta-analyses do not show that pilates alone clearly increases bone density, but it may help slow bone loss and support balance and posture. The UK consensus statement recommends three things for osteoporosis: resistance and impact exercise for bone, strength and balance to prevent falls, and spinal extension for posture. For safety, it advises avoiding positions with a high degree of forward bending.
Bone loss speeds up after menopause, and many women ask: "Which exercise should I do for my bones?" Pilates is often suggested. But is it really good for bones, and what should people with osteoporosis watch for?
Please note: if you have osteoporosis, a previous fracture or a history of spinal fracture, discuss your exercise programme with your doctor and always tell your instructor. This article is for information only.
Osteoporosis and menopause
Osteoporosis means bone density falls and bones break more easily. After menopause, bone loss accelerates as oestrogen drops. That makes menopause an important time to invest in bone and muscle health.
What does the UK consensus statement recommend?
The 2022 "Strong, steady and straight" consensus statement makes these recommendations for people with osteoporosis:
- Strong: resistance and impact exercise to maximise bone strength.
- Steady: strength and balance training to reduce falls.
- Straight: spinal extension exercise to improve posture and potentially reduce the risk of spinal fractures.
For safety, it recommends avoiding postures involving a high degree of spinal flexion during exercise and daily life. The statement stresses that, in general, the benefits of physical activity outweigh the risks.
Does pilates increase bone density?
Postmenopausal women
A 2022 meta-analysis of 3 randomised trials found pilates did not significantly increase bone density at the lumbar spine, hip or femoral neck. Only one study was of satisfactory quality.
Pilates and yoga together
A 2021 meta-analysis of 11 studies and 591 women found no significant difference compared with control groups, but reported a small effect suggesting bone density was maintained before versus after the programmes.
Pilates alone is not enough for bone, but it is a strong complement for balance, posture and muscle strength.
How do we adapt pilates for osteoporosis?
- We limit forward bending: we remove or adapt roll-ups, crunch-type movements and stretches that bend the spine deeply.
- We include back extension: back extension on the box and chest opening match the statement's "straight" recommendation.
- We add resistance: reformer springs and standing strength work load the muscles.
- We train balance: the Chair and standing movements build balance and control against falls.
- Combine with other exercise: brisk walking or impact exercise approved by your doctor adds extra benefit for bone.
Menopause and osteoporosis at Studio 4 Pilates
With students who have osteoporosis or are going through menopause, we build the programme taking your bone density results and your doctor's advice into account. We recommend starting with private classes. For posture, see our kyphosis article; for questions about age, see this article.
Frequently asked
Can people with osteoporosis do pilates?
Most can, with an adapted programme that avoids deep forward bending. Talk to your doctor and inform your instructor.
Does pilates stop bone loss?
Research does not show that pilates alone clearly increases bone density. It is a useful complement for strength, balance and posture; your doctor decides on treatment.
How many days a week should I exercise during menopause?
The World Health Organization recommends 150–300 minutes of moderate activity and at least two days of muscle strengthening a week for adults, adding balance training at older ages.
Sources
- Brooke-Wavell K et al. Strong, steady and straight: UK consensus statement on physical activity and exercise for osteoporosis. BJSM, 2022
- de Oliveira RG et al. Effects of Pilates Exercise on Bone Mineral Density in Postmenopausal Women: A Systematic Review and Meta-analysis. J Geriatr Phys Ther, 2022
- Fernández-Rodríguez R et al. Effectiveness of Pilates and Yoga to improve bone density in adult women: A systematic review and meta-analysis. PLoS One, 2021
- Bull FC et al. WHO 2020 guidelines on physical activity and sedentary behaviour. BJSM, 2020