Aquatic Exercise For Osteoporosis

Updated: March 3, 2023

water exercise for osteoporosis

As part of the customer care team, I get to speak to you, our customers, every day.

Each conversation gives me more insight into the difficulties of experiencing bone loss, and what it’s like living with the fear of fracture. 

I have spoken to many customers who suffered compression fractures and limited mobility. They remind me that not everyone can walk or do weight-bearing exercises. Or that they are afraid of losing balance, falling, and breaking a hip. And I can see why. In all, 80–90% of hip fractures in older adults are related to falls — and women have a ⅙ risk of having a hip fracture in their life.¹

All studies show that exercise decreases the risk of fracture in adults with osteoporosis. They do this by maintaining or improving bone density and improving balance. This all leads to a decreased risk of falling.²⁻³

I always suggest a few important lifestyle changes to our customers. This includes a daily protein intake of 60 grams and exercising at least 30 minutes a day in addition to our bone supporting supplements. (You can read more about the role of protein for bone health here).

But speaking with you and hearing your concerns pushed me to do some research on alternative exercises that I can recommend to everyone. I know how important exercise is for your bones and health, and I’m passionate about providing everyone with a solution.

Hydrotherapy and Water Exercise for Osteoporosis

Before recommending this to you for bone building, I wanted to investigate if water exercises or hydrotherapy is beneficial for bone health. And also compare the benefits to regular exercises on land.

Usually, weight-bearing exercise is recommended for increasing bone density. In weight-bearing exercises, you are supporting your own body weight through your feet and legs against gravity. So that includes jogging, running, walking, and jumping for example. They increase bone density by having the muscle pull on the bone through impact on the ground and from carrying your body weight. The National Osteoporosis Society mentions that swimming is not weight-bearing. And that it does not affect bone density.³ That’s because there’s less gravity in an aquatic environment.

water exercises for osteoporosis

So What is Aquatic Exercise and Can It Help Your Bones?

Aquatic exercise is “vertical exercise in the water with the participant submerged to chest or shoulder depth”.⁴ I’ve included some examples at the end of this post for you to try. But for now let’s look at the benefits!

The Benefits of Aquatic Exercise:

  • Decreased stress on weight-bearing joints due to the buoyancy of the water
  • Increased mobility due to diminished gravitational pull
  • The ability to use varying levels of resistance for strengthening
  • Increased sensory stimulation in brain

So like I mentioned aquatic exercise is not usually recommended for individuals with osteoporosis because there’s less gravity. But it is recommended for individuals with more severe osteoporosis to improve function and balance. That’s because of the extra benefits from the support and comfort of the water.

Balance is important in reducing the risk of falling and thus the risk of fracture. A 2008 study compared aquatic versus land exercise on balance and quality of life in women with osteoporosis. The study found significant improvements in women’s balance in both land and water exercise. So if you have difficulty exercising on land (or simply don’t enjoy it) aquatic exercise may be a good alternative for you!

Another study from 2008 examined if aquatic exercise can improve bone density. They found that the exercise group was able to maintain and slightly improve their bone density compared to the control group.⁵ They were doing three hours of aquatic exercise for seven months.

So, not only can water exercises increase balance and posture, but they can also increase bone density. Not as much as running or other weight-bearing exercises, but still very significant!

Not a lot of clinical studies have been done to measure the bone-building effect of water exercises, but the ones that have been done show positive results. All of them show increases in balance and muscle development, and in some cases, increases in bone density too. Many people report decreased back pain and improved back strength and posture too.

Unfortunately, water-based exercise classes and hydrotherapy aren’t available everywhere. But don’t let that stop you! You can always try a few exercises at your local pool with an instructor or with friends. If you have hydrotherapy or aquatic classes close to you, I encourage you to take advantage of it. Plus it can be a lot of fun! And when you enjoy exercising, it doesn’t feel like you’re exercising.

Joining an aquatic exercise class for seniors can be terrific fun! Watch this short video from the ABC News channel featuring Dr. Jane Katz:

Do you have difficulty doing regular weight-bearing exercises or just want to try something new? If you do, I have a few great examples of water exercises for you to try.

Water Exercises

Get a feel for the water by slowly moving through it. Feel the warmth, the resistance, and get a sense of your buoyancy. Water spas or jacuzzis provide extra warmth and a soothing massage (but maybe not the super hot ones). Be careful getting into the pool as it may be slippery and don’t be afraid to ask for assistance.

Once you’re in, stand with the water up to your chest. If this makes you feel short of breath, move to shallower water. Remember do not push exercises to the extent that they are painful.

Also, make sure that your movements are comfortable. If a movement is painful, not only could you injure yourself, but you’ll be less likely to want to do it again.

  • Stand with your feet hip-width apart and rest your arms on the surface of the water. Then gently turn your body to the right, swinging your left arm in front of you and your right arm behind you. Keep your elbows straight and in the water throughout. Repeat in the other direction.
  • Stand holding on to the side of the pool. Bend one hip and knee up in front of you, standing tall and keeping your back straight. Then stretch your leg out behind you, keeping your knee straight. Repeat with the other leg.
  • Try taking long strides forwards through the water. Once you’ve got that down, switch it up by walking sideways.
  • Note: If you want to try hydrotherapy, make sure your therapist is an accredited physical therapist in your country.

How you move your body is just as important as what you put in your body. To help your new water-based exercise regime be even more effective, I recommend partnering your aquatic workouts with our clinically supported bone builders, AlgaeCal Plus and Strontium Boost. And if you haven’t tried it already, I recommend Triple Power Fish Oil. It will help reduce inflammation that is causing bone loss, plus it aids with swelling and pain in your joints.

Please let me know if you have any questions in the comment section below and definitely let me know how these exercises work for you!

PS: Our blog posts now have a print-friendly function that allows you to print our blog posts without images. You can remove any sections you like before printing. Click the green printer icon on the left of your screen.


  1. Arnold, C. M., Busch, A. J., Schachter, C. L., Harrison, E. L., & Olszynski, W. P. (2008). A Randomized Clinical Trial of Aquatic versus Land Exercise to Improve Balance, Function, and Quality of Life in Older Women with Osteoporosis. Physiotherapy Canada, 60(4), 296–306.
  2. Brown, J. P., Josse, R. G., & The Scientific Advisory Council of the Osteoporosis Society of Canada. (2002). 2002 clinical practice guidelines for the diagnosis and management of osteoporosis in Canada. CMAJ: Canadian Medical Association Journal, 167(10), s1–s34.
  3. [NOF] National Osteoporosis Foundation 2008. Clinicians guide to prevention and treatment of osteoporosis [online].
  4. Sova R. Aquatics: the complete reference guide for aquatic fitness professionals. Boston: Jones & Bartlett; 1992
  5. Rostein A, Harush M, Vaisman N. (2008) The effect of a water exercise program on bone density of postmenopausal women. Journal of Sports Medicine and Physical Fitness. 48(3):352-9.

Article Comments

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  1. Maggie

    October 1, 2016 , 9:43 am

    The 2008 study…. 3 hours of aquatic exercise for 7 months? Please clarify…is that per day? per week?

  2. Monica

    October 3, 2016 , 4:55 am

    Hi Maggie,

    To clarify, the study says that, “[these] women trained for seven months for three one-hour sessions per week.”

    – Monica @ AlgaeCal

  3. Evi Hofmann

    October 1, 2016 , 2:00 pm

    I wonder if the breaststroke helps to increase bone density in the spine. My bone density has improved 10 percent in the spine in one year. I love swimming and swam nearly every other day feeling a little guilty not doing anything for my bone density wth swimming.

  4. Jennifer fazio

    September 14, 2018 , 6:04 am

    I keep on hearing calcium is bad…And doesn’t help.

  5. Jenna AlgaeCal

    September 20, 2018 , 10:45 am

    Hi Jennifer,

    Did you know that calcium is just one piece of the puzzle? There are 13 essential bone supporting minerals, so it’s important to replenish our bones with all of these nutrients! AlgaeCal is plant-based and naturally contains these minerals, including calcium, magnesium, zinc, boron & vanadium.

    The safety of AlgaeCal is confirmed in all 3 of our human clinical studies. The latest, a 7-year long trial showing complete safety along with consistent and linear increases in bone density year after year! To see those studies go here.

    Feel free to email [email protected] or call us at 1-800-820-0184 if you have any questions or concerns 🙂

    – Jenna @ AlgaeCal

  6. Margaret

    July 8, 2020 , 5:28 am

    Does wearing ankle weights while walking in pool help weight bearing exercises?

  7. Megan AlgaeCal

    July 9, 2020 , 11:50 am

    Hi Margaret!

    Adding ankle weights is a great way to create a weight-bearing exercise. Keep up the great work! 🙂

    -Megan @ AlgaeCal

  8. Wanda Turner

    November 10, 2021 , 9:54 am

    I had had osteoporosis for several years but didn’t pay much attention to exercise instruction until recently after a spinal compression fracture. I walk at least 180 minutes per week on land but I also love to do water aerobics. Now that I am learning that land exercising that involves curving the spine, twisting, or bending at the waist, I’m rather stymied as to if I am helping or harming my spine. There is little information posted about what water aerobics are good or bad. There is even less info about the additional complication of doing water aerobics once a fracture has happened. Any direction you can give me or point me to would be greatly appreciated.

  9. Ishneet AlgaeCal

    November 24, 2021 , 2:18 pm

    Hi Wanda!

    Thanks for reaching out with your concern! When it comes to twists and forward bending movements, it’s all about technique. When twisting – make sure you twist with a neutral spine (don’t round your upper back) and power the twist with your core, rather than pulling yourself into it with your limbs. For forward bending, hinge from the hips (not the waist) and come forward only so far as you can maintain a neutral spine. Wanda, many people who have suffered compression fractures and limited mobility are afraid of losing balance, falling, and breaking a hip so water is a great place to exercise because it provides resistance with every movement. Muscles become strengthened with consistent water exercise. When you move your body in the pool, the low-impact resistance activates your muscles to help make them more flexible and mobile. Balance is important in reducing the risk of falling and thus the risk of fracture. A 2008 study compared aquatic versus land exercise on balance and quality of life in women with osteoporosis. The study found significant improvements in women’s balance in both land and water exercise. So if you have difficulty exercising on land (or simply don’t enjoy it) aquatic exercise may be a good alternative for you! HERE is a link to that study if you are interested to give it a read. Our blog post also covers a few good examples of aquatic exercises that you can do to strengthen your bones. If you are ever in doubt about the safety of an exercise, please first consult an exercise specialist who can assess your needs and capabilities! Hope this information helps.

    -Ishneet @ AlgaeCal

  10. Julie

    September 22, 2022 , 5:41 am

    What exercise using hand weights is best for osteoporasis in the spine? Are planks recommended? I worry that I won’t do planks correctly…….from what I read it doesn’t suggest that water aerobics are helpful……….any information or recommendations with hand weights would be greatly appreciated………….

  11. Chelsea Dugas

    September 23, 2022 , 12:17 pm

    Hi there, Julie!

    We have a wonderful group of hand weight exercises for osteoporosis of the spine HERE that can help! Let us know if you have any other questions! 🙂

    – Chelsea @ AlgaeCal

  12. Naomi

    February 6, 2023 , 1:13 am

    I have a broken pelvis and have developed osteoporosis post lung transplant. Impact of steroids apparently. So I have had the infusion to try and reverse or slow down damage to my bones. I want to exercise so am going to the local pool daily and get in the deep end. What exercises are good for me to help offset weight gain while I have restricted movement as well as build strength?

  13. Yoori AlgaeCal

    February 7, 2023 , 9:22 pm

    Hi, Naomi!

    We are so sorry to hear that you’ve developed bone loss, but we are glad you found AlgaeCal! While we do not have any recommendations for exercises to help offset weight gain, I’ve listed a few links to our bone-health exercises below that may help you! Of course, please do consult your physician before adding in new exercise regimes to ensure safety :).

    Exercises You Can Do At Your Desk
    Seated Exercises For People With Limited Mobility
    5 Bone-Strenthening Exercises in the Morning

    I hope this helps, Naomi! Please never hesitate to reach out if you have additional questions!

    – Yoori @ AlgaeCal

  14. Joy Reese

    April 13, 2023 , 11:12 am

    I am wondering if walking in pool will help with weight bearing?

  15. Shelby AlgaeCal

    April 13, 2023 , 12:36 pm

    Hi Joy! Great question – it’s my understanding that walking in a pool isn’t quite as weight-bearing as walking on dry land, because water’s buoyancy counteracts gravity! That said, walking water absolutely has benefits in general, and can help improve strength and balance. 🙂

    – Shelby @ AlgaeCal

  16. Chris Marshall

    May 9, 2023 , 4:59 am

    What about polystyrene resistance equipment for hands and feet?
    Ski-walking using these in deep water must be good?

  17. Manja

    May 10, 2023 , 12:02 pm

    Hi Chris! This is a great advanced variation if you wish to add more resistance into your exercise for muscle strengthening. The strongest mechanical forces on your bones are those created by muscle contractions. And these muscle contractions condition your bone density, strength, and microarchitecture. Of course, we still recommend the basic variation for those new to exercising, until they build up the strength.

    – Manja @ AlgaeCal

  18. Jeanne Strauchon

    February 29, 2024 , 6:31 am

    This was a very interesting and helpful article. Our local Y has a Vortex pool where you walk with or against a current. I’m assuming it helps with balance, but i wonder if moving/pushing against a current helps more if one has some osteoporosis (in my femoral neck)

  19. Yoori AlgaeCal

    February 29, 2024 , 3:13 pm

    The Vortex pool at your local Y sounds like a fantastic resource, Jeanne! Aquatic therapy is often recommended for individuals with bone loss due to its low-impact nature and ability to provide resistance without putting excessive stress on the joints.

    While we aren’t sure if moving against a current helps MORE for those with bone loss, walking against a current, as you described, can indeed help improve balance and strength. The resistance provided by the water can help build muscle strength, which is particularly important for individuals with bone loss! 🙂

    – Yoori

This article features advice from our industry experts to give you the best possible info through cutting-edge research.

Lara Pizzorno
MDiv, MA, LMT - Best-selling author of Healthy Bones Healthy You! and Your Bones; Editor of Longevity Medicine Review, and Senior Medical Editor for Integrative Medicine Advisors.,
Dr. Liz Lipski
PhD, CNS, FACN, IFMP, BCHN, LDN - Professor and Director of Academic Development, Nutrition programs in Clinical Nutrition at Maryland University of Integrative Health.,
Dr. Loren Fishman
MD, B.Phil.,(oxon.) - Medical Director of Manhattan Physical Medicine & Rehabilitation and Founder of the Yoga Injury Prevention Website.,
Prof. Didier Hans
PHD, MBA - Head of Research & Development Center of Bone Diseases, Lausanne University Hospital CHUV, Switzerland,