Strength Training for Spine Osteopenia
Fortify spine vertebrae with strengthening exercises.
If you’ve been diagnosed with osteopenia of the spine - low bone density not yet osteoporotic – the goal of strength training is to stimulate bone growth in the spine, while also improving posture, core strength, and stability to reduce fracture risk.
Most fractures from bone loss occur in the spine
Forty percent of all osteoporotic fractures occur in the vertebrae of the spine, equal to the combined total for hip (25%) and wrist (15%). They may or may not cause pain or discomfort, but can be life-changing in other ways, affecting your posture, how you sit and stand, how well your skeleton can distribute body weight and absorb the impacts of daily living.
Vertebral fractures can result from a fall, a twisting motion of the torso, or from carrying a load that is too heavy for a fragile spine. They can cause pain as the muscles and other tissues of the back are stretched and strained, or as the nerves may become pinched, however they often occur without any noticeable symptoms.
Osteopenia and osteoporosis are considered silent diseases. A DEXA bone density test can diagnose osteopenia before you fracture a bone. Repeated tests can tell if your bones are losing density or staying the same.
Strengthen the spine with targeted exercise!
The key is to use safe, weight-bearing, and resistance-based exercises that put controlled stress on the spine to encourage bone remodeling, improve your posture and your skeleton’s ability to distribute body weight and absorb the impacts of daily living.
Weight-bearing low-impact exercise
Weight training (resistance) exercises
Weight-bearing low-impact exercise
In weight-bearing exercise your bones maintain you in an upright position against the force of gravity. Weight-bearing low impact cardio exercises are those in which one foot is always on the ground, like brisk walking, elliptical trainers, and stair climbers.
Avoid high impact weight-bearing activities where both feet are off the ground at times, as in running, jumping, basketball, and gymnastics. These may cause jarring of the spine, putting too much force on the fragile vertebrae.
Swimming and cycling are wonderful exercises for overall health benefits, but they are not the most effective for building bone because your weight is supported, either by the buoyancy of the water or the seat of the bicycle. If you enjoy these activities, be sure to include some weight-bearing exercise as well.
Weight training (resistance) exercises
To offset spinal osteopenia and reinforce the vertebrae of the spine, choose a variety of strengthening exercises that target the muscles in your back from all angles. The resistance may be external – like free weights, machines, stretch bands and weighted balls – or it may be your own bodyweight, as in a back extension or an opposite arm & leg lift.
Begin with one set of 10-15 repetitions of each exercise. As you progress, add 2-3 sets, or increase the amount of resistance.
The best exercises for spine osteopenia
One-arm lat row with weight
Horizontal abduction with band
External rotation with band
Bird dog (Opposite arm & leg lift)
Back extension
1.) One-arm lat row The lat (latissimus dorsi) is the largest muscle of the back lending more power to your upper body strength and improving posture.
Stand in a staggered lunge position. Hinge forward from the hip to a 45 degree angle with your back straight.
Hold a free weight in your hand opposite the front leg, arm straight under the shoulder, palm facing in.
Draw your shoulder blade in towards you spine to stabilize it.
Exhale as you bend your elbow to 90 degrees, pulling the weight up to your rib cage.
Inhale as you slowly lower the weight. Do all the reps, then switch arms and repeat.
One-arm lat row: Osteopenia Spine - Video 1
The one-arm row strengthens the largest muscle of the back, the latissimus dorsi, to support the spine and improve posture.
2) Horizontal abduction with band Target the midback muscles (rhomboids and mid-trapezius) to draw the shoulder blades together and in toward the spine.
Hold a band at chest height with your palms down, your arms slightly wider than shoulder width apart.
Your elbows should be rounded, your wrists flat (aligned with your forearms).
Lower the shoulder blades, and put a little tension in the band.
Exhale as you squeeze your shoulder blades together and pull the band into your chest.
Keep your elbows rounded at a constant angle and pull from the back of your shoulders.
Pause briefly and return to the starting position, keeping the band taut.
3) External rotation with band Strengthen the back of the shoulder and the rotator cuff (posterior deltoid and external rotators) to improve posture and bone density.
Hold the band with your palms up, elbows bent at a right angle close to your sides.
Anchor your shoulder blades and put a little tension in the band.
Exhale as you squeeze your shoulder blades together and rotate your forearms outward.
Hold for a second, then inhale as you slowly release back to the starting position, keeping tension in the band.
Horizontal abduction & External rotation with bands: Osteopenia Spine - Video 2 & 3
Two simple stretch band exercises target the midback and to strengthen the spine and correct a forward slouch.
4) Opposite arm & leg lift strengthens the muscles that support the length of your spine, while challenging your balance and core stability.
Kneel on all fours with your hands under your shoulders, knees under your hips, head and neck aligned with your spine.
Contract your abdominals and lift one leg behind you to hip height, knee straight.
When you have your balance, reach the opposite arm forward to shoulder height.
Hold for a second, then slowly lower both your arm and leg to the start position.
Switch sides and repeat, alternating sides for all reps (one rep = both sides).
Opposite arm & leg lift: Osteopenia Spine - Video 4
Bird dog, or opposite arm & leg lift, combines spinal extension with stability and balance work. It works your entire back side!
5) Back extensions trigger the muscles that run the length of your spine (the erector spinae group).
To begin, lie face down on a mat with a folded towel under your forehead to ensure proper alignment of the head and neck with the spine.
Bend your arms, resting your forearms on the floor, palms down.
Engage your core, drawing your naval in towards the spine.
Exhale as you lengthen your spine by reaching forward with the top of your head. Using your back muscles, lift your head and shoulders, still resting your arms on the floor (not pictured).
Pause, then return to start without resting. Repeat for all reps.
When you are ready to progress, lift your arms with your head and shoulders (as pictured), increasing the resistance to your spine.
Back extension: Osteopenia Spine - Graphic 5
Back extensions trigger the erector spinae group, strengthening the muscles that run the length of the spine and improving mobility in the upper and middle back.
Movements to avoid with spine osteopenia
To maintain proper alignment, avoid the following movements or positions:
No slouching (i.e. forward head jutting, upper back rounding)
No bending forward from the waist (as in toe touches in any position)
No twisting at the spine (rotating your shoulders while hips stay fixed)
No leaning and reaching past your safe balanced position
All exercises from Strength Training Exercises for Women by Joan Pagano (DK Publishing, 2014).
Disclaimer: The information presented in this article should not be construed as medical advice. It is not intended to replace consultation with your physician or healthcare provider.