How to Safely Exercise with Osteoporosis: A PhD-Backed Blueprint

How to Safely Exercise with Osteoporosis: A PhD-Backed Blueprint

Last Updated: July 27, 2025

Introduction: Moving Past the Fear of Exercising

For those newly diagnosed with osteoporosis, the advice to “start exercising” can be as terrifying as it is helpful. Questions immediately flood the mind: How do I start? What if I push too hard? How do I know when to stop? General advice often lacks the specific, structured guidance needed to build confidence. A 2019 PhD thesis from Ziauddin University provides a solution by detailing the exact safety framework used in its clinical trial. This isn’t just a list of exercises; it’s a complete blueprint for a safe exercise for osteoporosis program, covering the critical components of warming up, monitoring intensity, cooling down, and knowing the absolute signs to stop.

The Foundation: A Plan Built on Professional Guidelines

The safety and effectiveness of the study’s entire exercise program were built on a trusted foundation. The research states that all training protocols were “based on the guidelines provided by ACSM using the FITT protocol.” ACSM (American College of Sports Medicine) provides the gold standard for creating exercise prescriptions, ensuring the plan is grounded in established scientific principles for safety and efficacy. The total exercise session was 45-65 minutes, broken down into three essential phases.

Phase 1: The Essential Warm-Up (5-10 Minutes)

Jumping straight into a workout with “cold” muscles and joints is a recipe for injury, especially with osteoporosis. The study mandated a specific warm-up protocol to prepare the body safely.

• Activity: Participants used a cycle ergometer (stationary bike).
• Duration: 5 to 10 minutes.
• Intensity: A gentle pace, less than 55% of Maximum Heart Rate (MHR).
• The Goal: The purpose was twofold: to increase overall body temperature and to raise the heart rate by about 10 beats per minute from its resting state. This process, as the thesis notes, “increase[s] the body temperature” and prepares the cardiovascular and musculoskeletal systems for the main workout.

Phase 2: The Workout & How to Monitor It Safely

During the main conditioning phase, monitoring intensity is the most critical component of a safe exercise for osteoporosis plan. The study used a two-pronged approach to ensure participants were working hard enough to stimulate bone but never pushing into a danger zone.

1. Objective Monitoring: The Karvonen Method

The researchers used a precise formula to determine each participant’s target heart rate (THR) zone.

• Calculation: This involved calculating the Heart Rate Reserve (HRR), which is MHR minus Resting Heart Rate (RHR). The training zone was then set to 55-75% of this reserve, plus the RHR.
• Example for a 65-year-old with a resting heart rate of 70:
  • MHR = 220 – 65 = 155 bpm
  • HRR = 155 – 70 = 85 bpm
  • Lower Limit (55%) = (85 x 0.55) + 70 = 117 bpm
  • Upper Limit (75%) = (85 x 0.75) + 70 = 134 bpm
• In Practice: The participant would use a heart rate monitor and adjust their treadmill speed or resistance level to keep their heart rate within this 117-134 bpm zone.

2. Subjective Monitoring: The Borg RPE Scale

Not everyone has a heart rate monitor. The study also used the Borg Rating of Perceived Exertion (RPE) scale, a simple 0-10 scale where participants rate how hard they feel they are working. This subjective measurement is a “well-known indicator for heart rate check-up and work up efforts.” Participants were clearly instructed on how to use the scale (where 0 is “nothing at all” and 10 is “very, very heavy/almost maximum”) and told to report their exertion level throughout the session.

Phase 3: The Protective Cool-Down (5-10 Minutes)

Stopping a workout abruptly can cause dizziness and increase muscle soreness. The study included a mandatory cool-down phase to allow the body to return to its resting state gradually.

• Activity: Participants performed deep breathing exercises while seated in a comfortable chair.
• Monitoring: Oxygen saturation and pulse rate were continuously monitored until the pulse returned to its normal resting rate.
• The Goal: As the thesis states, “The purpose of cool down is to remove the lactate accumulation from the body and prevent from muscle soreness.”

The Ultimate Safety Net: When to Stop Exercising Immediately

Perhaps the most valuable part of this blueprint is the list of non-negotiable “Exercise Termination Criteria.” If any of the following events occurred during a session, the exercise was stopped immediately. This is a critical safety list for anyone engaging in safe exercise for osteoporosis.

• Decrease in Oxygen Saturation: If oxygen saturation, measured by a pulse oximeter, fell below 90% during training.
• High Perceived Exertion: If a participant reported their exertion level had reached an 8 out of 10 on the Borg RPE scale.
• Upon the Request of the Patient: Participants were empowered to stop at any time they felt uncomfortable, for any reason, without needing to justify it.

Conclusion: A Blueprint for Confidence

This PhD study does more than just recommend exercise; it provides a detailed, structured, and replicable blueprint for how to do it safely. By adopting a formal structure of a warm-up, a carefully monitored workout, a protective cool-down, and a clear understanding of when to stop, you can remove the fear and uncertainty from your fitness journey. This framework empowers you to take control of your health, building stronger bones and renewed confidence with every safe and effective session.

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Author Bio

Dr. Amna Aamir Khan holds a Doctor of Philosophy (PhD) in Physical Therapy from the College of Rehabilitation Sciences at Ziauddin University. Her research focuses on the effects of targeted exercise interventions on functional parameters in clinical populations.

Source & Citations

Thesis Title: EFFECTS OF OSTEOANABOLIC EXERCISES ON GAIT, BALANCE AND FEAR OF FALL AMONG OSTEOPOROTIC FEMALES
Researcher: Amna Aamir Khan (DPT, MSc)
Guide (Supervisor): Prof. Dr. Pirzada Qasim Raza Siddiqui
University: Ziauddin University, Karachi, Pakistan
Year of Compilation: 2019
Excerpt Page Numbers: 56, 57, 61-65, 68

Disclaimer

“Some sentences have been lightly edited for SEO and readability. For the full, original research, please refer to the complete thesis PDF linked in the section above.”

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