Strength Training For Osteoporosis And Sarcopenia: Everything You Need To Know

Osteoporosis and sarcopenia are two medical conditions that can both be debilitating at their worst. Being diagnosed with either one or a combination of the two can seem like it is going to completely derail your life for many people but, in the modern day and age, that doesn’t have to be the case.

While you will certainly need to make some changes to your way of life, which can include tweaking everything from the foods that you eat to the things that you do, there is no reason you can’t enjoy a long and happy life.

However, of all the things you can do to lower the risk of developing these issues or even treating them once they have developed, one of the last things many people would think of is working out. After all, strenuous physical activity will be dangerous for people who are more fragile won’t it?

While that way of thinking is certainly understandable, working out is one of the best things you can do if you are worried about getting, or already dealing with, osteoporosis or sarcopenia.

That is why, in today’s article, we want to show you everything you need to know about strength training for osteoporosis and sarcopenia, to help you live the most normal life possible.

Understanding Osteoporosis And Sarcopenia

Osteoporosis is a condition that affects the health and density of bones directly, whereas Sarcopenia affects the skeletal muscle mass. When a person has either osteoporosis or sarcopenia, they may also experience a reduction in physical strength, due to the loss of muscle mass that they cause. 

Both of these conditions are much more prevalent in the elderly than they are in young people. That being said, some studies show that a reduction in muscle mass can still be seen in patients in their 40s. There is a clear, linear increase in the loss of muscle mass that occurs as an individual gets older.

In some rare instances, people may develop both of these conditions at the same time. In this case, the conditions become known as osteosarcopenia. 

How Do You Get Osteoporosis And Sarcopenia?

There are no specific or fixed known causes of either osteoporosis or sarcopenia, but there are numerous risk factors that have been linked to both of the conditions. 

One of the most common causes of both osteoporosis and sarcopenia is aging, and the prevalence of the conditions is significantly higher in older people than it is in the young. 

Physical inactivity is another of the top causes of both conditions. People who are inactive for a long period can lose up to 5% of their natural skeletal muscle mass after they reach the age of 30. When a person loses muscle mass at a rate faster than this, they are at great risk of developing sarcopenia. 

Osteoporosis is heavily related to bone mass. Some people are at a higher risk of having a reduced bone mineral density, either naturally or because of a poor diet, and this can drastically increase the risk of them developing osteoporosis. 

Are Osteoporosis & Sarcopenia Treatable?

While neither osteoporosis or sarcopenia are considered curable, there are some treatment options for both that can help to reverse the conditions and their symptoms, all of which have a different level of effectiveness.

There is evidence to suggest that it is possible to reverse some of the effects that sarcopenia has on the body. While it won’t always work, this usually involves a person building more lean muscle mass, to make the weakness caused by the condition less of an issue.

Osteoporosis is usually not treatable or reversible but there are a number of management strategies known that may work. Some medications can help to reduce the risk of further bone loss, and there are also techniques that may help improve the strength of bones that have already been weakened. 

Does Muscle Mass Effect Osteoporosis & Sarcopenia

An extreme weakening or loss of muscle mass, particularly as a result of aging, is the definition of sarcopenia so, rather than effecting it, reduced muscle mass is the condition itself.

Osteoporosis is a condition that causes a reduction in a person’s bone density. As muscle mass and bone density are closely tied together, your muscle mass will play a huge role in both the development and progression of osteoporosis.

Does Strength Training Improve These Conditions?

There is some evidence that suggests the use of strength training routines can help people to reduce and improve most of the symptoms associated with both osteoporosis and sarcopenia. 

Strength training also reduces inactivity, which is one of the most significant contributors to reductions in both bone mineral density and muscle mass. 

Exercise on its own does have some limitations, as it has to be combined with an effective nutrition plan and the right diet if it is going to be effective. Research shows that vitamin d and protein play a particularly important role in the process of boosting muscle mass and reducing your symptoms. 

Weight training is one of the best workout options to help with osteoporosis and sarcopenia, but the workouts can’t be too strenuous.

When a high intensity exercise program is done with low levels of energy, it can lead to a reduction in bone density and muscle mass, rather than the other way around. People already suffering from the conditions will also be at greater risk of injury, so need to be careful they don’t hurt themselves. 

Suggested Exercises & Workout Routines

While we have established that exercising can help to reduce the symptoms of osteoporosis and sarcopenia, not all exercise is created equal. We will now take a look at the types of exercise that can be beneficial for these conditions and determine just why this is and how much it can help.

Lifting Weights

Research shows that weight training is the most effective exercise option to help patients with osteoporosis or sarcopenia to improve their condition. As lifting weights is widely accepted to be the best option for developing lean muscle mass, this shouldn’t really come as a surprise.

When it comes to lifting weights for osteoporosis or sarcopenia, the best options are exercises like deadlifts, bench presses, military presses, squats, and rows.

These are large, compound exercises that can develop maximum strength and size increases in both the muscles and connective tissues, while also featuring little impact, meaning they are not likely to cause any damage.

Those who are less confident with lifting weights can also turn to use resistance machines as well.

While not as effective at building strength and mass as lifting free weights, resistance machines provide comparable results in a safer manner. This makes them a great option for people who are new to working out or have a more progressed version of either of the conditions.

Resistance Band Exercises

Performing resistance band exercises can offer the same sort of benefits to free weights and resistance machines. While they don’t offer anywhere near the same potential for increases in mass or strength, there is also virtually no risk of further injury associated with them.

Resistance bands can be used to do both isolation and compound exercises, while being able to be used from virtually any angle, allowing you to develop muscles and regions as you see fit. They can also be used to directly target the connective tissues and do things not possible with normal weights.

Workouts That Use Gravity As A Resistance

Workouts that use gravity as a resistance can include a great number of different things.

It can mean calisthenic workouts where you literally use the weight of your body as a resistance to train against and build muscle. This is among the best choices, as it provides most of the benefits of lifting weights with very little risk.

It can mean cardio workouts like jogging or running, where your bones and joints have to support the weight of your body as you move. It can even mean daily activities like walking and climbing stairs or playing sports like basketball, football, or tennis.

Any form of physical activity that requires you to move from place to place while supporting the weight of your body can count as workouts that use gravity as a resistance and be beneficial for treating osteoporosis or sarcopenia, although some will obviously be more beneficial than others.

Other Types Of Exercise

Other types of exercise beyond what we have already looked at will mostly be things like stretching routines, such as yoga, tai chi, and pilates, as well as cardio workouts like cycling, rowing, and swimming.

Swimming and cycling won’t do much for bone density on their own but they can cause big increases in muscle mass in both the upper and lower body. They are also particularly good choices for people with conditions like arthritis, where doing weight-bearing activities to build muscle is not an option.

While stretching workouts also won’t do much for the development and growth of muscles, they can lead to great gains in the strength of connective tissues like ligaments and tendons.

This will not only help to make your body stronger, but it will also make it easier to build lean muscle mass in the long run, as you will be able to use larger weights in your resistance training sessions.

Example Exercise Routine For Someone With Osteoporosis Or Sarcopenia

You should now have a good idea of the sort of things you need to be doing to help treat either osteoporosis or sarcopenia. That said, we are now going to show you an example of a perfect workout for people with either condition, which will help them to see maximal benefits.

Warm Up – Rowing Machine

Spend five to ten minutes on a rowing machine, rowing at a low to moderate pace, roughly around 40% of your maximal level.

This will help to work the muscles throughout your body, while gently warming up all of your muscles, tendons, and ligaments, to increase your flexibility and reduce the risk of sustaining an injury later in the workout.

Weight Training

The bulk of the workout will be spent lifting weights. You will be aiming to train all of the muscles in both the upper and lower body, as well as the surrounding connective tissues, by using a range of large compound exercises.

Deadlift – 5 x 5 to 10 reps

Start by gripping a barbell in front of you on the floor, with your feet roughly shoulder width apart. Make sure both of your feet remain completely planted on the floor at all times. Slowly lower your butt to the floor by bending your knees, ensuring you keep your back and neck straight at all times.

Keep going till you can’t go any more, at which point your hamstrings will be lower than parallel to the floor. Engage all the muscles in your core, squeeze your glutes, and use all you have to stand yourself back up, making sure you keep your torso and arms fully extended the whole time.

Once you are in a totally vertical position, squeeze your traps and hold there for a second, then repeat the process until you hit the target number of reps.

Squats – 5 x 5 to 10 reps

Stand under a barbell on a rack so it rests across the back of your traps and shoulders and grip it just outside of shoulder width. Keep your feet shoulder width apart, your back straight, and your heels firmly planted flat on the ground at all times.

Unrack the weight and slowly start lowering your buttocks down towards the floor by bending solely at the knees. Carry on going till your thighs go past parallel to the floor.

Squeeze your quads, glutes, hamstrings, and calves, and use them all to push yourself back up into a standing position in one fluid motion, ensuring you keep your back straight the whole time. Pause for a second and then repeat the process till you hit the target number of reps.

Bench Press – 5 x 5 to 10 reps

Lay on a bench and grip the bar just slightly outside of shoulder width, with your palms facing forwards. Make sure to keep the base of your back and shoulders flat on the bench at all times.

You can put a small arch in the base of your back to get better shoulder alignment, although this isn’t always a good move for people suffering with osteoporosis or sarcopenia.

Engage your pecs and slowly lower the bar down to your chest, until it is almost touching and there is a stretch in your chest and shoulders. Pause for a second then squeeze the chest and triceps as hard as you can and use them to press the weight back up in an arcing motion towards the ceiling.

Immediately lower the weight back down and repeat till you have hit the desired number of reps.

Military Press – 5 x 5 to 10 reps

Sit on a bench or stand with your back in a straight, upright position with a barbell in front of you at shoulder height. Grip the barbell with your hands just wider than shoulder width apart with your palms facing forward, lift the weight off the rack, and bring it in to your chest.

Engage your delts and triceps to use them to drive the bar straight up towards the ceiling, until your arms are almost fully extended. Squeeze your delts as hard as you can then immediately begin lowering the weight in a slow and controlled manner.

Go until just short of the starting position and then start pressing it back up straight away and keep going until you hit the desired number of reps.

Bent Over Barbell Row – 5 x 5 to 10 reps

Stand over a barbell and bend forward and grip it just wider than shoulder-width apart with an overhand grip. Engage your core and lats, keep your feet firmly planted, and lift the bar off of the floor with straight arms, until your back is between 45 degrees and parallel to the floor.

Keeping most of your body still, use your lats and biceps to row the weight into the top of your abs, bending only at the elbows. When the bar reaches your body, squeeze your shoulder blades together and contract your lats as hard as you can.

Slowly lower the weight back down, until your arms are almost straight, then immediately row it back in and repeat the process as many times as needed to complete the desired number of reps.


Swimming is a great, full-body workout that will train all your muscles and connective tissues, as well as your cardiovascular system while being totally impact-free and posing almost no risk. It is great to not only combat osteoporosis or sarcopenia but also to improve your cardio, health, and fitness.

The warmth of most gym swimming pools will also be good for soothing sore muscles and joints.

Try to swim for roughly 30 minutes, most of which should be spent at roughly 60 to 70 percent of your maximal level. If you need to take breaks, try to swim at a very slow pace, rather than stopping entirely, as this will ensure you are constantly in motion, burning calories, and building muscles.


We have already mentioned that stretching is a great way to develop the strength of your tendons and ligaments, but it is also a fabulous way to cool down and dispel built-up lactic acid after a workout as well.

Doing your stretching at the end of a workout also means your muscles will already be warm. This means there is much less risk of injury, and you can push yourself harder.

The stretching routine you decide to perform is entirely up to you. Everything from yoga to a routine of basic stretches can be extremely beneficial here, so just select the routine you personally find helps you the most and that you enjoy.

How To Start Working Out Safely With Osteoporosis & Sarcopenia

When your first start working out with osteoporosis or sarcopenia it is important to begin slowly, so that you minimise the risk of injuring yourself. This can include using light weights, performing less reps and sets of each exercise, and not doing each movement through your full range of motion.

You also want to thoroughly warm up before a session, to get your muscles and joints ready for what is to come and further reduce the risk of injury. Accessories like a compression sleeve can also be a useful tool, as they protect the joint from damage, particularly when it is under great pressure.

How Does Age Effect Bone Health & Fitness?

Age is the number one thing that affects bone density and health. Osteoporosis and sarcopenia will not be an issue that everyone has to face in their life, but everyone needs to be aware of what plays a role in the health of their bones and how they can improve it at every stage of their life.

Adolescents & Young Adults

Your bones will be continually growing during your childhood and, provided you have been receiving sufficient nutrients, they will be incredibly strong during this period unless you suffer from a health condition or illness.

This means it is in adolescence or the early stages of adulthood that you may first start to see some mild deterioration. However, if you take the necessary steps, this is also when they can reach their absolute peak as well.

By consuming a diet rich in vitamins c and d, as well as minerals like calcium and iron, you can work to build the strength and density of your bones from the inside.

Then, once you hit the age of about 16, when most of your bone growth will have occurred, you can begin following a strength training program without any risk. This will build them from the outside, pairing perfectly with your diet to help you attain an optimal level of bone health and density.

Adults & The Elderly

As you begin to get older, beginning around your early 30s, you will start to see your first decreases in bone density. While strength training can still be useful to keep your density up, this is the first time where your level of physical activity won’t be enough to manage the situation on its own.

Foods or supplements rich in the vitamins and minerals we mentioned above will become vital, and those who start to see the first signs of problems may need to be prescribed hormonal supplements as well. This is something that is often seen with women, especially those who have had children.

Trips and falls will become more frequent if bones and joints start to weaken, and the frequency of injuries that result from them will also increase.

These problems will become particularly problematic once you hit your 50s. 15% of people over 50 who sustain a fracture will never fully recover, while 25% will develop further issues that negatively impact their health. This is why it is vital you get on top of the problem before it is too late.

How Does Body Weight Affect Bone Health & Fitness?

Your overall body weight doesn’t technically affect your bone density and health. However, if you are very heavy and have a high body fat percentage it absolutely will.

The weight that is not bone or muscle puts a great deal of pressure on your skeleton. Bones, joints, and connective tissues will all suffer as a result of this strain, so keeping your weight and body fat percentage in check as you age is imperative for the long-term health and density of your bones.

Is There Anything Else That Effects Bone Density & Health?

Bone density and health are primarily determined by your age, diet, and the physical activities you engage in. That said, they aren’t the only things that can affect it, as there are various health conditions that will have an impact as well.

Anorexia, cancer, celiac disease, hormonal imbalances, inflammatory bowel disease (IBS), kidney and liver diseases, multiple myeloma, rheumatoid arthritis, smoking, alcohol consumption, and various other medications and lifestyle choices can all have an effect on your bones.

Final Thoughts

Bone density and health is an issue many people will overlook but is one that you need to be aware of if you are going to live a long, fit, healthy, and happy life. This article will hopefully give you a good idea of what to do to make your bones strong and dense as you age and what to avoid.

For those who still want to do even more to keep their bones healthy, you can even consider trying things like sauna blankets as well. This won’t increase bone density, but the warmth can be very beneficial for aching joints, helping to keep you pain-free after your workouts.

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Steve is a retired professional wrestler with over 10 years of experience in the personal fitness industry. He is a certified personal trainer working with a wide variety of athletes as well as a fitness writer.

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