Instructor helping senior woman for a myofascial release techniq

How Using a Pilates Reformer Can Help Manage Osteoporosis

Osteoporosis is estimated to affect around 200 million women worldwide. And if you have osteoporosis, you know you need a good exercise regime that loads the bone appropriately to maintain bone health.


Your doctor may have even recommended pilates for osteoporosis. You've heard of pilates, but you don't know where to start.


We're breaking down what exercises you need to stay healthy, what pilates reformer is and what exercises to try.

What is Osteoporosis?

First, let's cover a few basics about osteoporosis so that you can better understand why you should do certain exercises and avoid others.

Osteoporosis is a disease that causes the bones to weaken and become brittle. This brittleness can case fractures due to even minor stressors like bending over or coughing.


While anyone can get osteoporosis, older white and Asian women are especially at risk.

Exercises You Need

The primary goal of an exercise program for osteoporosis, including pilates for osteoporosis, is to strengthen the bones.

The best exercises for osteoporosis are weight-bearing exercises like running, walking, dancing, weightlifting, and step aerobics.

This might seem counterintuitive until you realize that weight-bearing exercises aren't just about lifting weights–they're about forcing your muscles and bones to hold you upright against gravity, which ultimately strengthens them.

You'll notice pilates isn't on this list. That's because pilates isn't technically a weight-bearing exercise, though it is a strength-training program that does have benefits for osteoporosis.

But before we talk about pilates for osteoporosis specifically, let's talk about how pilates actually works.

What is Pilates Reformer?

Pilates reformer is a type of pilates class specifically using a machine called the Reformer.

You've most likely encountered mat pilates classes in gyms before because they're cheaper for gyms to do. Whereas mat Pilates teaches you the proper form using bodyweight, machines like the Reformer help you target specific muscle groups with the advantage of being able to modulate the amount of load placed on joint.

What is the Reformer?

The Reformer is the most popular pilates machine designed by the founder of the method, Joseph Pilates, who used such machines to help bedridden patients exercise despite their illnesses to eventually accept load on the joint to prepare for walking.

The Reformer consists of a carriage that moves back and forth across a metal frame. Sounds pretty simple, right? Except that you're the one moving the carriage and providing resistance (with the help of a set of springs attached to the carriage and frame).

Benefits of Pilates

Because of the resistance work involved in Reformer classes, and because pilates places a strong emphasis on correct form, Pilates Reformer has a number of benefits for osteoporosis.

Full Range of Motion

This is where the benefits of a machine shine through.

Using the bars and cables of the Reformer machine guarantees that you'll move your body through your full range of motion, something you may not be able to do on your own.

This is especially beneficial when you're doing pilates for osteoporosis because your posture may weaken as your bones become brittle–especially if you've experienced fractures in the spine.

Body Awareness

Part of the process of moving through your full range of motion is increased body awareness.

After all, pilates has a strong emphasis on proper form. You can't maintain the correct form until you gain enough proprioception (body awareness) to pay attention to the minute details of how your body is moving.

For example, Pilates students are often told to engage their core consistently and maintain an upright spine while doing other exercises. This requires a high degree of awareness that travels with you outside of class.

This is another great benefit of pilates for osteoporosis because it trains you to be conscious of how you're holding your body, which strengthens your spine to maintain proper posture.

Body Control

You might be thinking, wait, don't you already have control of your body if you use it all day to walk around?

That's not exactly the kind of body control pilates for osteoporosis is aiming to teach you. Pilates doesn't just teach you exercises–it teaches you how to move.

Think of it this way–you may think you're too inflexible to lift your arms a certain way when in reality the problem was that you were raising your shoulders and limiting your own range of motion.

Pilates teaches you to spot these issues and move your whole body in synchrony while maintaining proper form, which strengthens your whole body and improves your health in the long run.

Stronger Core

Finally, we couldn't talk about pilates for osteoporosis without discussing the most touted benefit of pilates–a killer core.

It isn't just about a six-pack. In fact, a strong core is essential to good back health.

Pilates benefits your core directly (through regular core work) and benefits your back through exercises targeting back muscles and smaller stabilizing muscles that are often overlooked in core routines. Having the strength to stand upright starts with a good core, which is one of the strong suits of pilates.

Why Pilates for Osteoporosis is Important

Now that you know a bit about osteoporosis and pilates, let's talk about why pilates for osteoporosis is so important.

Pilates has gotten a bad rap in some circles because people think it focuses too much on forward flexion (forward bending) which is dangerous for people with osteoporosis.

This actually isn't true–when done correctly, pilates can offer a great combination of resistance training for strength, balance work, and even some lesser weight-bearing exercises like plank, all of which is crucial to maintaining healthy bone density in osteoporosis.

Pilates shines for two main reasons:

  1. It's great for strengthening muscles
  2. It's low to non-impact training

Low impact training is crucial to osteoporosis because too much stress can cause bone fractures. And if you think osteoporosis exercise is all about bones, think again–strengthening your muscles matters just as much in building and retaining bone density.

First Meeting with an Instructor

When you first meet with one of our instructors, there are a few things you need to make sure you cover in your pilates class.

Let Them Know You're Doing Pilates for Osteoporosis

First and foremost, you need to let the instructor know that you're doing pilates for osteoporosis management.

There are a few reasons for this. First, you may need a release form from your doctor before you begin taking classes.

Second, this will let the instructor know that you shouldn't be doing certain exercises that will put you at risk of fractures. This includes bending, exercises that combine flexion and rotation of the spine, or exercises that load the spine in flexion.

If you're not sure what should be omitted or modified, ask your doctor.

Movement Principles

At Pilatique, we offer Reformer and STOTT PILATES. Part of STOTT PILATES (and any successful pilates regimen) is incorporating basic movement principles that ensure safe movement, which is especially important in pilates for osteoporosis.

There are two key factors your teacher should focus on if you're new to Reformer Pilates: breath and neutral pelvic placement.

In Pilates, you do what's called lateral costal breathing. Instead of breathing

by expanding your lower belly the way you would normally, you're breathing by expanding your ribs. This is what allows you to maintain good core engagement while breathing properly.

A neutral pelvic placement is essential to doing functional activities without rounding your spine.

Set Appropriate Goals

Once you've learned the basics, it's time to work with your teacher to set appropriate goals for your pilates for osteoporosis regimen.

There are a few reasons for this. First, appropriate goals will give you something to work towards and a way to track progress.

Second, this will help you make sure that you have a program that's intelligently designed to meet your needs so that you can make appropriate progress in managing your osteoporosis over time.

Pilates for Osteoporosis Exercises

Now that you know what to look for in pilates for osteoporosis training, here are a few great pilates exercises to help keep your bones strong and healthy.


If you've taken part in yoga before, you've seen a pose called cobra that's pretty similar to swan. And if you're incorporating yoga into your osteoporosis management, watch out for these poses.

Swan is an extension exercise that does wonders to strengthen the back, shoulders, glutes, and hamstrings.

To start, make sure the standing platform is securely latched and lie on the long box with your feet on the bar. Your knees will be bent, legs turned out, and the balls of your feet on the inside edge of the Reformer.

From here, slowly extend the legs and lift the upper body to form a straight line. Then, inhale to reach the arms overhead and extend the spine. With control, return to the starting position.

Side Splits

Side splits are great for strengthening the hips while taking you through your full range of motion and creating greater hip flexibility.

Start by placing one foot on the standing platform with the other foot as far onto the carriage as feels comfortable. Maintain a strong core and an upright spine. You should feel comfortably balanced in this position.

From here, inhale and slowly press the carriage out using your inner thigh muscles. Your weight should be evenly distributed on both feet and your posture should remain fully upright. Pause at your widest point.

Exhale and slowly, with control, return the carriage to starting position.

Leg Circles

If you want to increase hip and hamstring flexibility while also strengthening your hip flexors and hamstrings and creating stability in the lower spine, it's time to start doing leg circles.

Start by lying on the carriage with your spine in neutral position. Put your feet in the straps and straighten your legs as close to a 90-degree angle as

possible while maintaining a neutral spine.

Then, lower your legs as far down the center as you can while maintaining a neutral spine. Slowly circle both legs out to the sides and back up to center, returning to starting position. You should have a neutral spine and active core throughout.


Here, we're using toes footwork as our example, but there are several other forms of footwork that can be beneficial to you.

To start, lay flat on the carriage with a neutral spine and your head resting on the headrest. Your toes will rest on the bar two to four inches apart with your heels raised (think wearing high heels and you've got the right idea).

Slowly and with control, straighten the legs completely, maintaining an active core and neutral spine.

Then, slowly return to starting position.

Seated Arm Series

This one works a lot like leg circles, but this time, it's strengthening the upper back instead.

Start by lying with a neutral spine on the carriage. Your knees and feet should be raised at a 90-degree angle and your hands will be gripping the straps while your arms stretch out to the side in a T position.

From here, exhale and move the arms toward your torso, keeping them on a flat plane of motion as you do so. Inhale and slowly raise your arms to the ceiling at a 90-degree angle from your torso (like a zombie reaching out to grab someone, except stronger).

Finally, exhale and return the arms to their original T position.

Pulling Straps

Finally, you're returning to your long box with pulling straps.

Start out lying supine on the long box. This time, your legs will be straight and lifted to form a straight line with your back. Reach out and grab hold of the straps with your hands. Your chest should be just past the edge of the long box as you do this.

From this position, lift your head and your chest as you slowly pull the straps towards your hips, pulling the long box forward as you do this. Exhale slowly to return to starting position.

Finding the Right Pilates Class for You

Think you're ready to start doing Pilates Reformer classes as part of your osteoporosis management? We're ready to help.

Click here to check out our Reformer class schedule. We limit classes to five people, so you can be sure to get individualized instruction. Or, if you still have questions, feel free to get in touch with us.