The Role of Pilates Exercise in Bone Health

One of the most effective ways to combat bone loss is through weight-bearing exercise. Weight-bearing exercises, such as walking, dancing, and resistance training, place mechanical stress on the bones. This stress stimulates bone remodelling by signalling the osteoblasts (bone-forming cells) to build new bone tissue, thereby strengthening the bones.
Pilates, traditionally known for its focus on core strength, flexibility, and posture, can also provide these weight-bearing benefits. This means we need to take our client up out of supine and get them working against gravity to stimulate bone density. With careful modifications, Pilates can be an invaluable tool for clients with osteoporosis and osteopenia, helping to improve bone density, posture, balance, and overall strength, all while reducing the risk of fractures.

How Pilates Supports Bone Health

Pilates exercises can be particularly beneficial for clients with osteoporosis or osteopenia in several ways:

1. Weight-Bearing and Resistance Exercises
Weight-bearing exercises, in which the body works against gravity, are a key component in improving bone density. Pilates offers many standing exercises and those that involve the use of springs and resistance bands, such as the Standing Leg and Arm Springs on the Cadillac, which apply gentle but effective load to the bones. Additionally, using equipment like the Wunda Chair or Reformer allows clients to perform resistance exercises, targeting specific muscles and bones. The resistance provided by springs and body weight challenges the bones to respond by increasing density. Instead of choosing footwork on the Reformer, do this seated on the Wunda Chair. Do lunges on the chair. Do scooter and standing side splits on the Reformer.

2. Improved Balance and Coordination
A major concern for clients with osteoporosis is the increased risk of falls, which can lead to fractures, especially in vulnerable areas like the hips, spine, and wrists. Pilates helps improve balance and coordination, reducing the likelihood of falls. Exercises like Standing Leg Press on the Chair or Standing Side Splits on the Reformer and standing arm springs with the Cadillac engage the stabilizing muscles around the hips, legs, and core, promoting better stability and proprioception.

3. Spinal Alignment and Postural Support
One of the primary dangers of osteoporosis is vertebral fractures, often caused by excessive forward bending or poor posture. Many individuals with osteoporosis may experience a forward curvature of the spine (kyphosis) because of vertebral compression fractures.

Exercises like regressed Swan on the Mat or Reformer, which focus on spinal extension, are beneficial in counteracting kyphosis and promoting a more upright posture. When doing these exercises place a pillow under the abdomen to protect the ribs.

Modifications and Safety Considerations
When working with clients who have osteoporosis or osteopenia, it’s essential to modify exercises to ensure safety. Certain movements, such as high-impact exercises, deep spinal flexion (e.g., rolling like a ball), and extreme spinal rotation, should be avoided, as they can increase the risk of fractures. Instead, Pilates instructors should focus on exercises that emphasize spinal extension, gentle rotation, and weight-bearing movements that are within the client’s capacity.

Educate clients how to move on and off the equipment so as not to flex through the spine. They can then use this information to help them when getting in and out of bed. Also how to sit softly in a chair rather than plonking down. When someone with osteoporosis sits hard down into a chair this is direct spinal loading and can cause spinal fracture if their Osteoporosis is severe. Teach clients sit-to-stand exercises with a focus on sitting slowly, get them to incorporate this into their day, so that whenever they sit it is with a slow and controlled movement, building their bone density at the same time and warding off future fractures.

Pilates can be an effective tool in supporting clients with osteoporosis and osteopenia, offering benefits such as improved bone density, enhanced balance, better posture, and core strength. However, it’s important for Pilates instructors to have a solid understanding of the condition and make appropriate modifications to exercises to ensure safety and efficacy. By integrating weight-bearing and resistance exercises into Pilates sessions and focusing on spinal alignment and balance, Pilates instructors can help their clients maintain and even improve bone health while reducing the risk of fractures.

As awareness of osteoporosis grows, Pilates teachers have a unique opportunity to provide specialised care that promotes long-term health and well-being.

Use promo code BUILDBONE25 for 25% off my Pilates for Osteoporosis and Osteopenia course.
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