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Exercises for Osteoporosis
It turns out that exercises such as cycling, swimming, and walking aren't that beneficial for osteoporosis. The best exercises create some type of "impact" or flexing of the skeleton. So, opt for sports that involve jumping (basketball, volleyball), or sports that require change-in-direction running (field hockey, lacrosse, soccer, tennis). For people who can't do strenuous exercise, simple jumping jacks are beneficial.


Balance: An Overlooked Element of Fitness?

Author: Stan Reents, PharmD
Original Posting: 05/06/2007 08:10 AM
Last Revision: 12/10/2018 07:35 AM

Most authorities in sports medicine define fitness according to the following 5 elements:

  • aerobic (cardiopulmonary) fitness
  • muscular strength
  • muscular endurance
  • flexibility
  • body composition

However, I propose that "balance" be included in that list. Poor balance, combined with loss of muscular strength in the legs, are reasons why falls in the elderly are so common. While loss of balance has many causes (cerebral insufficiency; ear infections; drugs, such as antibiotics and antihistamines; etc.), balance can be improved with strength training.

According to the American Council on Exercise (ACE), balance training activities (eg., Pilates, Tai Chi, yoga, etc.) and equipment (eg., BOSU® balls, foam rollers, wobble boards, etc.) are among the fastest growing and most popular exercise options for adults. Health clubs and trainers are offering balance training programs for virtually all levels and types of participants. ACE listed "balance training" as one of the top 10 fitness trends for 2006.

Hmmm....if it is a "fitness" trend, then, perhaps it should be included as one of the criteria for defining fitness?....just a thought.


At first, it doesn't seem logical that strength training might improve balance. However, I can verify from personal experience that it is possible. Even if you spend many hours per day on your feet, you won't obtain the same benefit as you get from balance training exercises. Walking or simply standing, surprisingly, doesn't stimulate many of the fine motor skills involved in maintaining balance.

Balance exercises that require no equipment

One-legged stands: One of the easiest exercises you can do to improve your balance is to simply stand on 1 leg. Sure, this seems easy. But, see if you can do it for 30 seconds with your eyes closed. You'll be surprised at how difficult this is. Try it with your arms straight out from your side (form the letter "T" with your arms and body), and then try it with your arms folded across your chest.

If, at first, it is simply too difficult to stand on 1 leg with your eyes closed, then do 1-legged stands with your eyes open. For many people, even this will be challenging. Then, as you get better, close your eyes for several seconds and try to improve on this each time. Stand on 1 leg for 15 seconds with your eyes open, followed by 5 seconds with your eyes closed. Then, do 10 seconds of each, then do only 5 seconds with your eyes open followed by 15 seconds with your eyes closed. Finally, do 20 seconds with your eyes closed and keep increasing that until you can do 30 seconds.

Here are some tips:

• Before you close your eyes, make sure your body weight is centered over your standing leg and you are motionless. Get your balance, then, close your eyes.

• Keep your free leg close to your body center. Or, you can position your free foot against the ankle or lower part of the leg you are standing on.

• Until you get used to these exercises, stand behind a sturdy chair, or do them while facing the kitchen counter. You can keep your eyes closed, but steady yourself intermittently by placing your hands on the back of the chair or the countertop.

In addition to realizing how good (or bad) your balance is, you'll discover how active the small muscles in your foot, ankle, and lower leg are during this drill: they are working hard to maintain your balance. This is good; these are the muscles you want to train.

Next, to improve the strength of the larger leg muscles involved in balance, attempt to touch the ground (with your fingertips) while balancing on 1 leg. This can be done in 2 ways:

Waist bends: First, stand on 1 leg and get balanced. Now, bend forward at the waist and touch your fingers to the ground in front of you while swinging your other leg straight out behind you. (This motion resembles what golfers do when they reach in the cup to retrieve their ball.) Be careful if you have low back problems. You can also reach down to the side while swinging your free leg out to the opposite side. This drill is easy to do once, but try to do 10 in a row without putting your other foot on the ground.

Squats: (NOTE: If you have knee problems, be very careful of this exercise.) Stand on 1 leg and get balanced. Now, instead of bending over, squat down until you can touch your fingers to the ground. Keep your head and eyes forward, and do not swing your free leg out behind you. Simply squat down, then back up.

Here are some tips: Keep your arms and free leg as close to your body center as possible. This drill is a lot easier if you keep your free leg close to the other, as opposed to swinging it out wide. If you swing your free leg out wide in an attempt to maintain your balance, you will overcorrect and start to wobble.

This exercise requires a lot of strength in the quads. If you do it for a few days, you'll be amazed at how fast you will improve not only the strength of your thighs, but, also, how your balance will improve. See if you can do 6-10 reps in a row (ie., do not put your other foot back on the ground until you have touched the floor 6-10 times). If your thighs are screaming after only 4-5 reps, then stop. You can always do more next week.

Exercises with BOSU® balls

If you took a Swiss exercise ball, cut it in half, and put it on a stable base, you'd have a BOSU® ball. (BOSU® stands for "both sides up".) BOSU® balls allow for some creative 2-leg balance drills and make 1-leg balance drills a lot more challenging. So, you may want to start with drills described above where you are standing on the ground.

First, stand on the BOSU® ball with both legs, shoulder-width apart. Keep your arms at your sides. For some people, even this will be challenging. Then, as you get used to it, add the following elements to make it more challenging:

• Move your arms into different positions while attempting to stand motionless: move both arms out front, both arms pointing to one side, etc.

• Begin doing squats

• Have a friend toss you a ball or a pillow; at first, have them toss it towards your mid-section, then, as you get better have them toss it to your sides.

• Move your feet closer and closer together until they are touching and attempt to maintain your balance while standing still

• For maximum difficulty, repeat all of the above while standing on 1 leg


• When doing balance exercises, avoid looking down. Keep your head and eyes level. Try to keep your back relatively straight.

• When training with a BOSU® ball, start with exercises where both feet are on the ball. Then progress to exercises that involve standing on 1 foot.


If you want to purchase a BOSU® ball, check out

Readers may be interested in the following reviews:


Stan Reents, PharmD, is available to speak on this and many other exercise-related topics. (Here is a downloadable recording of one of his Health Talks.) He also provides a one-on-one Health Coaching Service. Contact him through the Contact Us page.


Stan Reents, PharmD, is a former healthcare professional. He is a member of the American College of Lifestyle Medicine (ACLM) and a member of the American College of Sports Medicine (ACSM). In the past, he has been certified as a Health Fitness Specialist by ACSM, as a Certified Health Coach by ACE, as a Personal Trainer by ACE, and as a tennis coach by USTA. He is the author of Sport and Exercise Pharmacology (published by Human Kinetics) and has written for Runner's World magazine, Senior Softball USA, Training and Conditioning and other fitness publications.

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