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Falls

Half your protection is balance

Strong bones still break if you fall the wrong way.

3 min read · Published by Mindful Movement Physical Therapies · Updated July 2026

Awaiting clinical review — written from published sources and not yet checked by a clinician. Talk to your provider before acting on it.

Key takeaways

  • Balance training is part of a multicomponent exercise plan aimed at reducing falls. It does not provide a fixed percentage of fracture protection.
  • Falling sideways onto the hip carries a far higher fracture risk than other falls.
  • Balance work only counts if it is genuinely challenging: narrow your base of support rather than repeating easy drills.
  • Train near a counter or wall so you can push the difficulty safely.

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 belongs alongside strength training and individual fracture-risk management.

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 — making balance work an important part of a broader prevention plan.

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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