Photo by @towfiqu999999 Unsplash
When we think about staying strong as we get older, we usually think about our muscles. We want strong arms, strong legs, a strong core, but underneath all of those muscles is something just as important that doesn't always get the same attention: our bones. Bone health is one of those things that's easy to take for granted when we're younger. Then somewhere along the way, words like bone density, osteopenia, and osteoporosis start becoming part of the conversation. And suddenly, keeping our bones strong feels a lot more important.
The good news is that movement plays an important role in supporting bone health. Pilates can absolutely be part of that picture, especially when it's combined with weight-bearing activity and appropriate strength training.
Our Bones Are Living Tissue
I think it's easy to picture bones as the permanent framework underneath everything else, but bone is living tissue that is constantly being broken down and rebuilt. When we're younger, the body generally builds bone faster than it loses it. As we age, that balance begins to change. Bone loss can become especially important for women during and after menopause because declining estrogen can accelerate the process. Men experience bone loss with age too, so this isn't only a women's health issue. That's why taking care of our bones isn't something we should wait to think about until there's already a problem.
Why Exercise Matters for Bone Health
Bones respond to the demands we place on them. Weight-bearing activity and resistance exercise create mechanical stress that signals the body to maintain and strengthen bone tissue. Walking, hiking, resistance training, and other appropriately loaded activities can all be valuable. Where does Pilates fit into that?
Pilates can provide resistance, particularly when we're working with springs, body weight, and equipment. It also improves strength, posture, coordination, and balance, all of which become increasingly important as we age, but I also don't like pretending Pilates is the answer to absolutely everything. For optimal bone health, Pilates works beautifully as part of a well-rounded movement routine rather than necessarily being the only exercise you do.
Pilates Builds Strength Around Your Bones
Strong muscles help support and protect your skeleton. Pilates strengthens the muscles around the hips, spine, shoulders, and pelvis while teaching those muscles to work together. That matters because we don't move through life one muscle at a time. We bend down. We carry groceries. We climb stairs. We reach overhead. We get up from the floor. The stronger and more coordinated the muscles surrounding our joints are, the better prepared our bodies are for those everyday demands.
Balance Might Be One of the Most Important Pieces
When we talk about osteoporosis, we understandably focus on bone density. But there's another side of the conversation that matters just as much: preventing falls. A stronger bone is important, but avoiding the fall that could cause a fracture is pretty important too.
Pilates gives us so many opportunities to practice balance in controlled ways. Depending on the person, that might begin with supported standing exercises and eventually progress to more challenging single-leg work. We also work on core stability, hip strength, foot and ankle control, and coordination, all things that contribute to better balance. Balance isn't something you either have or you don't. It's a skill, which means we can practice it.
Posture and Spinal Strength Matter
One of the reasons I love Pilates is how much attention we give the spine. We strengthen the muscles that support it. We work on alignment. We build awareness of how we're sitting and standing. For someone with healthy bones, Pilates includes movement in many directions: flexion, extension, rotation, and lateral flexion.
However, someone who has osteoporosis or significant osteopenia may need to modify certain spinal movements. Exercises involving loaded spinal flexion, deep twisting, or certain other positions may not be appropriate depending on someone's fracture risk and medical history. That's why an individualized program matters.
Pilates Equipment Gives Us Options
The Reformer, Cadillac, Chair, and other Pilates apparatus give instructors a huge range of ways to adjust an exercise. Springs can provide resistance. They can also provide assistance. We can change body position, range of motion, stability demands, and load depending on what someone needs. That flexibility is one of the reasons Pilates can work so well as people age. The goal isn't to make the workout easier. It's to make the workout appropriate.
Don't Forget Traditional Strength Training
If you've read some of my other posts, you already know I'm a fan of combining Pilates with strength training. This becomes especially important when we're talking about healthy aging and bone health. Progressive resistance training allows us to gradually increase the load placed on muscles and bones. Pilates contributes strength, stability, mobility, posture, and body awareness. Walking and other weight-bearing activities add another piece.
Put those things together, and you have a much more complete approach than trying to make one type of exercise do everything. You don't have to choose between Pilates and weights. They can be really good friends.
Nutrition Matters Too
Exercise is only one part of maintaining healthy bones. Our bodies also need the nutritional building blocks to maintain bone tissue. Calcium, vitamin D, protein, and overall adequate nutrition all play important roles. That doesn't mean everyone needs to run out and start taking supplements. Your individual needs depend on your diet, health history, medications, age, and other factors. If you're concerned about bone health, your healthcare provider can help determine whether you're getting what you need and whether bone-density screening is appropriate.
What If You Already Have Osteopenia or Osteoporosis?
A diagnosis doesn't mean you need to stop exercising. In fact, staying active is generally an important part of managing bone health. It does mean your exercise program may need to change. Some traditional Pilates exercises, especially certain loaded flexion or twisting movement, may need to be modified or avoided for someone at increased risk of spinal fracture.
This is not the time to follow a random workout online and assume every exercise is appropriate for you. Talk with your healthcare provider or physical therapist and work with an instructor who understands osteoporosis-safe exercise. There are still so many things you can do. We just choose them thoughtfully.
Start Before You Think You Need To
I think this might be one of the biggest takeaways. We shouldn't wait until we're older to start caring about our bones. Building and maintaining strength throughout adulthood gives us a better foundation for the future. The Pilates you do today isn't only about how your body feels after class. You're investing in the version of yourself who wants to be active ten, twenty, or thirty years from now.
A Final Thought
Bone health isn't particularly glamorous. You're probably not going to finish a Pilates class, look in the mirror, and say, “Wow, my bone density looks amazing today,” but some of the most important benefits of exercise are the ones we can't see. Every time we strengthen our muscles, challenge our balance, practice good alignment, or appropriately load our bodies, we're doing something that can support us far beyond today's workout. Pilates can be an incredibly valuable part of that. It helps us build something I think becomes more valuable with every passing year: A body that is strong, supported, confident, and capable of continuing to move.
-Natalie
