The Best Exercise Equipment for People With Osteoporosis, According to Doctors

But it can be tricky to determine which machines are least likely to cause pain and injury. Before you begin any exercise program, be sure to consult with your primary care physician to ensure your chosen equipment and exercises are safe for your body.

To get you started on your search, we interviewed a physical therapist and two physicians about the most effective exercises and equipment for offsetting the effects of osteoporosis and maintaining bone strength.

Here are the best cardio and strength machines for people with osteoporosis, according to these experts, as well as tips for their safe and effective use.

1. Elliptical

“Ellipticals are one of the best cardio machines [for osteoporosis], as they have a lesser impact on your joints,” says Andrew Konen, MD, a Texas-based physician who specializes in pain management. “Using an elliptical is a weight-bearing workout that also incorporates upper-body strength training with the machine’s arm levers and lower-body strength training as well.”

The elliptical is a good choice for people living with osteoporosis or arthritis, agrees Theresa Marko, DPT, a New York–based clinical specialist in orthopedics. This machine still puts weight or pressure on your bones to help build strength, but at the same time, you don’t get any unwanted impact on your joints.

How to Use It

Start using the elliptical at a low resistance you can comfortably handle for about 10 to 20 minutes, recommends Pejman Bady, DO, a Las Vegas–based doctor of osteopathic medicine. Start with two to three times a week, gradually increasing to four or five. Gradually increase your total time to about 30 minutes, adding small increments of resistance as you’re able.

1. Hold the machine for stability and step your feet onto the elliptical pedals.
2. Center your feet on each pedal.
3. Grasp each elliptical handle.
4. Set the elliptical machine to a comfortable resistance.
5. Move your left foot forward as you press the right handle away from you.
6. Using the momentum of your motion, switch sides.
7. Continue this motion by moving the opposite foot and hand at the same time.

2. Treadmill

While high-impact exercise (like jumping up and dropping to the floor in a burpee) can have a damaging effect for folks with osteoporosis, incorporating some impact can be beneficial, according to Dr. Marko. Because it offers only minimal joint impact, the treadmill is one of the best machines for walkers and runners living with osteoporosis.

Both the elliptical and the treadmill are generally safe cardio machines for people with osteoporosis, but Dr. Bady often prefers the treadmill.

“The treadmill is better for building up bone density because of the impact [it has] on the feet,” he explains.

How to Use It

Begin walking on the treadmill for about 10 to 20 minutes two to three times a week, gradually increasing to five times per week. Gradually build up your total walking time to 30 minutes. Once a 30-minute session feels comfortable, you can start to incrementally increase the incline.

1. Step onto the treadmill.
2. Adjust the pace to a slow, comfortable walk.
3. Gradually increase your pace as your body warms up.

3. Lat Pulldown Machine

When it comes to upper-body strength training, you want a machine that targets the broadest and strongest muscles in your back: your lats. That’s why Bady loves to recommend the lat pulldown machine.

“The lat pulldown machine is an excellent weight-bearing exercise that can help patients with osteoporosis improve their posture and increase their strength,” he says.

But it’s important to focus on form during this exercise.

“I tell patients that the most crucial part of this exercise is to not draw the bar behind the neck,” he explains, noting that this movement can have negative repercussions on spinal alignment.

How to Use It

For those living with osteoporosis, Bady recommends starting with two to three sets of 8 to 12 reps at a weight that allows you to maintain perfect form. If your form is not perfect, use a lighter weight to avoid injury.

1. Sit on the lat pulldown seat, adjusting the thigh pad so it sits firmly against the tops of your thighs.
2. Adjust the weight-selector pin to a weight that feels manageable.
3. Reach up and grasp both sides of the machine handle in a wide, overhand grip.
4. Pull your belly button into your spine to brace your core and pull your shoulders back and down.
5. On an exhale, pull the handle toward the top of your chest.
6. Pause for a brief moment when the handle hovers right above your chest.
7. Reverse the motion with control and slowly return to the starting position as you inhale.

4. Seated Leg Press

The seated leg press is a clear winner for people who have osteoporosis, Bady, Konen, and Marko agree. The leg press machine keeps your feet fixed to the weight that’s moving. Unlike a squat, the weight puts minimal pressure on your knees and ankles.

That being said, all three experts stress the importance of form.

“It’s important not to lean too far forward and to keep a very slight bend in the knees throughout the exercise,” Bady says. (In other words, don’t fully extend your legs at the top of the movement; more on that below.)

How to Use It

Start with a light weight and perform a few reps to see how you feel, Marko suggests. You can gradually add or drop weight if it feels too light or too heavy.

“I like people to assess if this is easy, medium, or hard,” she says. Medium is the ideal level. So once you find your medium, go for two to three sets of 8 to 12 reps.

1. Add weight plates to the machine, making sure both sides are even.
2. Sit on the leg press seat and place your feet up onto the platform at hip-width distance.
3. Bracing your legs for the weight, unlock the machine to release the platform.
4. On an exhale, press your heels into the platform and push it away from your body, keeping a small bend in your knees so they’re never fully locked.
5. Reverse the motion as you exhale to slowly bring the platform back toward you, bending your knees to 90 degrees.

Marko loves single-leg presses for her patients with osteoporosis. One-legged exercises can help even out muscle imbalances, preventing pain and injury. If you decide to try this variation, though, opt for a little less than half the weight you did with two legs, she says.

5. Cable Machine

Although the seated cable row is a great way to strengthen your back, Marko encourages folks with osteoporosis to modify this exercise to a standing position. This helps increase the weight your spine has to hold, helping build more strength and stability.

“Plus, most people are slouched throughout the day, so rowing helps strengthen the spine and support the core,” she says. “This exercise [also] helps open the chest and take a person out of the concave posture they’re often stuck in.”

Another major benefit: The standing cable row is a compound exercise, targeting your back, arm, and core muscles simultaneously. In other words, you’re getting a big bang for your buck!

How to Use It

On the cable machine, aim for two to three sets of 8 to 12 reps using a medium-intensity weight, Marko says.

1. Adjust the cable machine so each handle is at shoulder height.
2. Grasp a handle in each hand in a neutral grip, fingers facing each other.
3. Take a few steps back to add tension to the cables.
4. Pull your shoulders down and back away from your ears. Stand with feet at hip-width distance and a slight bend in your knees.
5. Leading with your elbows, pull the handles toward your ribs, keeping your arms close to your sides.
6. When your fists are just in front of your ribcage, reverse the motion with control, slowly straightening your arms.

The Takeaway

• Ellipticals, treadmills, lat pulldown machines, seated leg presses, and cable machines are recommended by doctors for safely building bone density and strength for people with osteoporosis.
• Always prioritize proper form and gradually increase weight and intensity to prevent injury and maximize benefits.
• Before starting any new exercise routine, get your doctor’s approval to ensure it’s safe and right for you.