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Joints and bones

Osteoporosis: what to load, and what to leave

The guidance for osteoporosis is more specific than avoid bending: back strengthening and spinal extension are recommended, and it is loaded end-range flexion that is held back.

Created by Lee Albert, NMT · 8 August 2026

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This isn’t a workout to push through. It watches how your body responds and adjusts as it goes.

“This is the first practice that seems to understand how carefully my bones need to be treated.” Elena R. · Osteoporosis

What it is

Osteoporosis means bone has become less dense and more porous, so it fractures more easily than it would otherwise. It is silent until something breaks, which is why it is usually found through a scan rather than through symptoms. The spine, hip and wrist are the common fracture sites, and vertebral fractures in particular can happen through ordinary loading rather than through a fall.

How it behaves day to day

On its own it causes nothing you can feel. What people notice, when they notice anything, follows a vertebral fracture: height loss, an increasingly rounded upper back, or back pain that arrives without an obvious event. The practical daily consequence is usually caution, and caution that goes too far has its own cost, because muscle and balance are exactly what protect against falls.

What tends to feed it

• ·Repeated or loaded end-of-range forward bending, particularly with a twist
• ·Long periods of inactivity, which cost both muscle and bone
• ·Falls risk that goes unaddressed, which is the main route to a fracture

What the research recommends

The clearest practical statement is the UK consensus, Strong, Steady and Straight, endorsed by the Royal Osteoporosis Society and published in the British Journal of Sports Medicine in 2022. It is worth being precise about what it says, because it is routinely simplified into avoid all bending. Its pillars are resistance training, impact where appropriate, strength and balance work, and spinal extension, held for three to five seconds, three to five repetitions, at least twice a week. It recommends moderate impact on most days for people without a vertebral fracture, and it stratifies by fracture history and falls risk rather than giving one instruction for everyone. The caution it describes is about sustained, repeated, end-range and loaded flexion, not about every movement in which the spine bends at all. Earlier work by Sinaki is often read as proof that back extensor strengthening alone prevents vertebral fractures; it is more accurately read as limited historical evidence pointing in that direction; a flexion-based programme in the same line of research did not show the same result.

Sources

1. 1
   Strong, Steady and Straight, UK consensus statement on physical activity and exercise for osteoporosis (Brooke-Wavell et al., BJSM 2022)

   Back muscle strengthening and spinal extension exercise are recommended, held 3 to 5 seconds, 3 to 5 repetitions, at least twice weekly, alongside moderate impact for those without vertebral fracture.

Where Vinys is different

• ·The sample covers yoga-based resistance and balance work, standing strength and functional balance in a recognisable, sequenced practice, and support is built into the poses themselves rather than added as a separate warning.
• ·Vinys distinguishes loaded, end-range spinal flexion, the part the guidance actually cautions against, from supported and passive positions, instead of removing every forward-bending movement.
• ·Supported balance work is included by default, because falls are the route to most fractures and balance is trainable, and it stays supported rather than assuming everyone's balance and fracture history are the same.
• ·The bone profile is kept separate from the menopause profile. They are not the same thing, and treating them as one suppresses higher-energy work that a bone profile actually wants.
• ·The sample does not deliver the separate impact recommendation on its own; that applies only when it is appropriate for you, and it is a conversation for your clinician, not something this practice adds by itself.

A short session to try

1. 1

   Interlaced fingers overhead stretch · 3 to 5 slow breaths

   An upright, spine-lengthening start to a standing strength and balance practice.

2. 2

   Warrior I, short stance · 3 to 5 breaths each side

   Standing strength with a shorter stance for stability, one of the consensus statement's resistance pillars.

3. 3

   Warrior II, short stance · 3 to 5 breaths each side

   More standing leg and hip strength, again with a supported, shorter stance.

4. 4

   Chair pose, dynamic sit to stand · 6 to 8 slow reps

   Functional leg strength built as a sit-to-stand pattern, directly useful outside a session.

5. 5

   Warrior III, chair supported · 3 to 4 each side

   Balance training with support built in, rather than balance work withheld until fracture and falls risk are known.

6. 6

   Tree pose, holding a chair · 20 to 30 seconds each side

   More supported balance, trainable at a level that fits today's stability.

7. 7

   Heel raise · 10 to 12 reps

   Loads the legs and trains the ankle strength that balance depends on.

8. 8

   Savasana, short · 2 to 3 minutes

   A settled ending after the standing strength and balance work above.

Movements often used for this

Sessions for this lean on the stability / core and balance families in the library. These are the ones most likely to appear, not a prescription: your own session is built from your answers on the day.

Common questions

Also called low bone density, osteopenia, brittle bones, bone loss. Movements are drawn from the clinically authored Vinys library, and the guidance above is sourced to the publications listed. This page is general movement information, not medical advice, and it is not a diagnosis. How the method works.