What type of exercises should be avoided in osteoporosis?

• A. Trunk flexion and rotation, particularly in combination.
• B. Walking.
• C. Gentle standing balance.
• D. Upper body resistance only.

Answer: (A)

Movements that bend the spine forward and twist it should be avoided in osteoporosis because the spine is more prone to fracture when loaded in flexion and torsion. Flexion (bending forward) increases compressive forces on the front of the vertebral bodies and can lead to compression fractures, while adding rotation (twisting) raises shear and twisting forces on the vertebrae, further increasing fracture risk. So trunk flexion and rotation, especially together, are best avoided. Safer options include walking and gentle standing balance, which provide weight-bearing benefits with lower spinal risk, and upper-body resistance work only if performed with a neutral spine and controlled technique to protect the vertebrae.