You’ve been told all your life to stand tall, but osteoporosis symptoms can make that a challenge. The lost height from bone loss and curved spine of dowager’s hump (called kyphosis) can make it hard to feel your best. But good posture is possible — and if you’re facing bone loss, practicing good posture can reduce the risk of fracture.
How Not to Move
If you have been diagnosed with osteoporosis, there are certain movements you should avoid to protect your spine.

Curling forward. Any time you arch your back, whether you are slouching as you read a book, attempting a deep forward bend to stretch, or bending down to water a plant, you put your spine at risk. Think of the vertebrae of a healthy spine as a stack of slightly flexible bricks that can adjust to the pressure of forward movement, and visualize the osteoporosis spine as a stack of shredded wheat. This can help you will understand how the same movement puts the spine of someone with osteoporosis at risk. Try to keep your back as flat and straight as possible, relying more on hips, knees, and legs to get you up and down.
Twisting your spine. It’s so easy — and probably habitual — to twist your spine at the waist or shoulders as you get out of bed or move an object from one spot to another. “I always tell patients to keep their nose, knees, and toes pointing in the same direction,” says Carleen Lindsey, PT, a physical therapist based in Bristol, Conn., and a spokesperson for the American Physical Therapy Association. This may feel a bit awkward as you start to practice it.
What You Can Do
Try picking up these habits as you move through your day:
  • Use your legs. “One thing people can easily do is a true hip-knee-ankle bend while pinching together their shoulder blades,” says Lindsey. This will help you keep your spine straight as you get down (instead of curl down) to lift something, talk to a toddler, or pet a dog.
  • Use support when lying down. When relaxing in bed or on the couch in a reclined position, use rolled towels or pillows to keep your spine as straight as possible. Build a base of pillows behind your head, back, and under your knees, and then add a roll of towels to support your neck and another roll to support your lower back.
  • Use support when sitting. You may need to use a lumbar pillow to support your lower back when you are sitting. Pillows behind your upper back can also help support a curved back. And remember: no slouching over a keyboard or book! If you are reading, consider using a pillow or lap desk to raise your book so you can see it easily.
  • Walk. Women who walk briskly and with long strides actually reduce their risk of hip fracture. Of course, you need to keep in mind the basics of posture as you walk: Keep your spine straight, face forward, and tighten your abdominal muscles.
  • Practice. Every new motion requires some practice in order to make it automatic. For example, says Lindsey, “Everyone knows you should lift with your legs, not with your back. But you need to practice doing it the right way three times a day for your body to unlearn the old way.” Studies show that learning and continuing these new habits helps protect your bones and may even reduce kyphosis.
Exercise to Improve Posture
Being physically active is an important part of improving your posture. And doing the right exercises can actually decrease some of the visible symptoms of osteoporosis, improve your balance, and reduce your risk of falling. In a recent study, women with a dowager’s hump who practiced a series of specific spinal exercises strengthened their spines, became more flexible, and reduced their humps over the course of a year.
While the right exercises help keep your bones healthy, the reverse is also true: The wrong exercises can be harmful for people with bone loss. Here are some exercises that Lindsey recommends:
  • Strengthen the upper back. While sitting, place hands behind your head, elbows out. Use shoulders to pull elbows back slightly. Return to sitting position.
  • Strengthen the shoulders. Stand facing a corner, about one step away. Put your forearms up against each wall, elbows even with your shoulders. Keep your neck relaxed and chin slightly tucked. Tighten your stomach. Pinch your shoulder blades together across your back. Hold, then relax. Repeat. You can also strengthen shoulders by standing facing one wall and placing both hands flat against it above your head. Alternating arms, slide one hand down the wall to shoulder height and then up again.
  • Use a wall for support during weight training. Standing against a wall can help keep your body aligned correctly as you lift weights (for example, bicep curls or raising arms above your head). Face forward (chin and head high), bend your knees slightly, and keep your stomach tight as you do standing exercises.
  • Floor exercises. When you do floor exercises to strengthen your core, keep your belly button pulled in and avoid arching your lower back or lifting your head. Skip exercises like twists and crunches. Instead, learn how to use your abdominal muscles to lift and move your legs.
This is just a glimpse of the ways in which you can have healthy, strong posture despite osteoporosis. You might want to work with a physical therapist, who can teach you movements and exercises to help you accomplish your goals.