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Falls

Half your protection is balance

Strong bones still break if you fall the wrong way.

3 min read · Medically reviewed by Dr. Emily Warren, DPT · Updated July 2026

Doctor of Physical Therapy (DPT) · BoneFit®-certified (Osteoporosis Canada) · LIFTMOR protocol–trained · Credentialed McKenzie (MDT) therapist · Mindful Movement Physical Therapies

It’s easy to focus only on bone density, but most fractures happen when someone falls. People who fall sideways onto the hip are far more likely to fracture than other fallers. So fall prevention is not optional — it’s half of your fracture protection.

What works

The evidence (Sherrington et al.) is clear that effective balance training is genuinely challenging — it safely reduces your base of support and shifts your center of gravity, progressing toward standing without holding on. Aim for about 3 hours of balance work spread across the week.

  • Single-leg stands, progressing from fingertip support to hands-free
  • Tandem (heel-to-toe) and sideways walking
  • Multi-direction reaches and weight shifts
  • Strengthening the outer-hip muscles that resist a sideways fall
Brisk walking is great for health, but it isn’t enough on its own to prevent falls — and high-risk individuals shouldn’t rely on it. Dedicated balance training is what moves the needle.

Frequently asked questions

What are the best balance exercises for osteoporosis?

The most effective balance training is challenging enough to reduce your base of support and shift your center of gravity: single-leg stands progressing from fingertip support to hands-free, tandem (heel-to-toe) and sideways walking, and multi-direction reaches. Pair these with outer-hip strengthening to resist a sideways fall. Aim for roughly three hours of balance work per week.

Is walking enough to prevent falls with osteoporosis?

No. Walking is good for general health, but it doesn’t sufficiently challenge balance to prevent falls on its own, and high-risk individuals shouldn’t rely on it. Dedicated, progressive balance training is what reduces fall risk.

Why does balance matter as much as bone density?

Because most osteoporotic fractures happen during a fall, not spontaneously. Falling sideways onto the hip carries especially high fracture risk. Improving balance reduces how often and how hard you fall — which is why it’s roughly half of your fracture protection.

Sources

  • Sherrington C et al. Exercise for preventing falls in older people. Cochrane Database Syst Rev, 2019.
  • Bone Fit™ — Osteoporosis Canada (evidence-informed exercise training for health professionals)

Keep reading

Basics

Osteoporosis, explained simply

The Science

Why we lift heavy (safely)

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