What are Osteopenia and Osteoporosis? Fitness Pilates Newsletter

As we are just days away from Christmas, I wanted to close this year’s newsletter by returning to a topic we began earlier in the year — osteoporosis.

Bone health is something many people don’t think about until forced to — often after a fracture, a scan, or a conversation with a healthcare professional. As around 1 in 2 women have osteoporosis or osteopenia there will be a percentage of women in your Fitness Pilates class that may or may not know they have it.

What are Osteopenia and Osteoporosis?

• Osteopenia means bone density is lower than average, but not yet at the level of osteoporosis.
• Osteoporosis means bones have become weaker and more fragile, increasing fracture risk.

Osteopenia does not mean you will definitely develop osteoporosis — it’s often an early warning sign and an opportunity to act.

How common is it?

Low bone density is very common.

• Around 1 in 2 women and 1 in 5 men over the age of 50 will experience a fragility fracture in their lifetime
• Bone loss accelerates after menopause due to changes in oestrogen
• Many people are unaware they have osteoporosis until a fracture occurs

This is why education, screening, and appropriate movement matter so much.

Where does Osteoporosis affect the body?

Although bone loss is systemic (it affects the whole skeleton), fractures tend to occur in specific high-risk areas:

• Spine (vertebrae) – compression fractures, loss of height, rounded posture
• Hips – often following a fall and associated with longer recovery
• Wrists – commonly fractured when catching a fall
• Ribs – in more advanced cases

You may have osteoporosis in the spine but not yet in the hips, or vice versa — which is why individual assessment matters.

How do you know if you have osteoporosis?

The most accurate way to assess bone density is through a DEXA scan, which usually measures the hips and spine.

Results are given as a T-score:

• Normal: above -1
• Osteopenia: -1 to -2.5
• Osteoporosis: below -2.5

Many people feel perfectly well, which is why osteoporosis is often referred to as a “silent condition.”

Signs and symptoms to be aware of

Often there are no obvious symptoms, but possible signs include:

• Loss of height over time
• Rounded upper back or stooped posture
• Unexplained back pain
• Fractures from minor falls or low-impact incidents

The DO’s for Osteoporosis & Osteopenia

Bone health is not about stopping movement — it’s about choosing the right kind of movement.

Focus on:

• Regular, consistent exercise
• Weight-bearing movement
• Strength training to support bones
• Balance and posture work
• Controlled, mindful movement rather than force

In Fitness Pilates, we prioritise alignment, stability, strength, and confidence — all key elements for long-term bone health.

The DON’Ts to be mindful of

Certain movements increase fracture risk, particularly for the spine.

Avoid or modify:

• Repeated or forceful spinal flexion
• Deep forward bending under load
• Twisting combined with flexion
• Fast, jerky or high-impact movements
• Aggressive stretching at end range

Movement should feel supportive, not stressful.

Fitness Pilates: Exercises that SUPPORT Bone Health

Fitness Pilates can be incredibly beneficial when programmed appropriately.

Helpful movement patterns include:

Standing work

• Squats and sit-to-stand
• Standing leg strength
• Balance exercises
• Upright functional movement

Supine and side-lying

• Neutral spine core work
• Bridges (small to moderate range)
• Side-lying leg strength
• Light resistance arm work

Prone (where appropriate)

• Back body strengthening
• Postural and upper back support
• Gentle spinal extension

The focus is on hip strength, posture, balance, and confidence.

Exercises to avoid or modify in Fitness Pilates

• Roll-ups and roll-downs
• Crunches and sit-ups
• Deep spinal flexion stretches
• Bicycle-style abdominal work
• Russian twists or loaded rotation

Some gentle flexion may be appropriate for individuals with osteopenia, but this should always be individualised and progressed carefully.

The most important message

Bone health is not about fear or restriction.

With the right approach:

• Movement becomes protective
• Strength builds confidence
• Posture improves function
• Balance reduces fall risk

Consistency matters far more than intensity.

Final thought

With intelligent, well-structured Fitness Pilates, we can support bone strength, posture, balance, and confidence at every stage of life.

I hope you find this article useful and are able to share it with your clients.

If you’re interested in Reformer Teacher Training, either Fitness Pilates Reformer or the Level 3 Reformer Pilates (Group & One-to-One) qualification, we’re running face-to-face courses at the C2GO Studio on 2nd and 3rd January. Full details are below.

If you’re considering adding Reformer to your teaching or studio offering, I also have a great contact for sourcing reformers — so please feel free to get in touch for a chat on 07976 268672.

Wishing you a wonderful Christmas 

Love always 

Rachel x

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