An adult has about 206 bones in their body that makes up their skeleton. Bones provide attachment sites for tendons and muscles that allow us to remain upright and move around. Red and white blood cells are made within bone marrow which is in the middle of certain bones. Fat, calcium and other important minerals are also stored in bones which can be deposited and taken out as needed by the rest of your body. Bones are made up of many cells that are constantly laying down new bone and recycling old bone. This balance of breaking down and building bone is called bone remodeling and is vital to bone health. When this process becomes unbalanced, more bone may be broken down than is being built. This decreases bone mineral density (BMD) and increases the risk of fracture; resulting in a condition called osteoporosis.


Bone strength is reduced in osteoporosis, commonly as a result of hormone imbalances and lack of bone loading. Due to the reduced density and strength of bones in this condition, the risk of fractures increases with decreased BMD. Tobacco, excessive alcohol consumption, inadequate nutrition, and physical inactivity can all put you at a higher risk of developing osteoporosis.

Common sites of decreased BMD are hips, spine, shoulders, and wrists.

You should aim to maintain a healthy lifestyle through appropriate exercise and nutrition. This not only decreases your chances of developing osteoporosis but can help you manage the condition.


If your BMD is decreasing it will generally happen slowly over time. Osteopenia is the stage before osteoporosis. This is when BMD is lower than normal but not yet low enough to be classified as osteoporotic. In these mild cases, appropriate management via diet and exercise can increase your BMD.

Testing and Diagnosis

Your BMD needs to be measured in order to be diagnosed with osteoporosis or osteopenia. A dual-energy x-ray absorptiometry (DEXA) scan measures BMD and provides a T-score. Normative BMD values for adults are used to determine your T-score. Upon receiving your diagnosis you should be presented with a management plan which might include exercise prescription, nutritional advice or medication.

Exercise Guidelines

Physical activity is a crucial component of osteoporosis prevention and management. Weight-bearing activities and resistance exercise should form the majority of your program. This is to promote a biological phenomenon called Wolff’s law. The more a bone is loaded, the more bone that will be laid down in order to manage the load. At the very least, this should slow down the progression of osteoporosis. To help maintain, and potentially even increase, bone density, you should follow general exercise guidelines. There are a couple of considerations to be mindful of when exercising with osteoporosis, ask your physiotherapist if any apply to you.


Being physically active has been shown to decrease your risk of developing osteoporosis, but it is also an essential aspect of managing the condition. Both your bones and muscles get stronger with exercise, which slows down the progression of the condition. Balance training is also a crucial part of the rehabilitation process to decrease your risk of falling. Our exercise professionals can help create a plan tailored to you and your lifestyle. Book in for a Rehabilitation Physiotherapy Initial consult to get assessed and started on your management program. You can find more information online on the Osteoporosis Australia website.

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