The 5 Best Pieces of Exercise Equipment for People With Osteoporosis, According to Doctors

Consistent exercise is crucial, especially as you near middle and older age, for increasing bone density (a key marker of bone strength). And for those who are living with osteoporosis, regular movement is all the more vital to maintaining strong and healthy bones.

But knowing which exercise machines are safe is another major factor in staying pain- and injury-free when living with osteoporosis. Learn which cardio and strength machines are the safest and how to use them properly here.

We interviewed a physical therapist and two physicians to learn the most effective exercises and pieces of equipment to offset the effects of osteoporosis and help maintain bone strength.

Using our experts' recommendations, we chose equipment based on criteria including:

• Equipment customization
• Product reviews
• Research-backed literature

"Ellipticals are one of the best cardio machines [for osteoporosis], as they have a lesser impact on your joints," says Andrew Konen, MD, a Texas-based physician who specializes in pain management. "Using an elliptical is a weight-bearing workout that also incorporates upper-body strength training with the machine's arm levers and lower-body strength training as well."

The elliptical is a good choice for people living with osteoporosis or arthritis, according to Theresa Marko, DPT, a New York-based clinical specialist in orthopedics. This machine still puts weight or pressure on your bones to help build strength, but at the same time, you don't get unwanted impact on your joints.

When compared to running or jogging, the elliptical actually has a significantly reduced impact on your joints, according to a January 2014 study in ​Gait Posture​. That's why it's so often recommended in injury rehabilitation.

Start using the elliptical with the lowest resistance you can comfortably handle for about 10 to 20 minutes, five times a week, recommends Pejman Bady, DO, a Las Vegas-based doctor of osteopathic medicine. From there, gradually increase your total time to about 30 minutes, adding small increments of resistance at a time.

1. Holding the machine for stability, step your feet onto the elliptical pedals.
2. Center your feet on each pedal.
3. Grasp each elliptical handle.
4. Set the elliptical to a comfortable resistance.
5. Move your left foot forward as you press the right handle away from you.
6. Using the momentum of your motion, return to the starting position and switch sides.
7. Continue this motion, moving opposite foot and hand at the same time.

While high-impact exercise (like jumping up and hitting the floor in a burpee) can have a damaging effect for folks with osteoporosis, incorporating ​some​ impact can be beneficial, according to Marko. As it offers only minimal joint impact, the treadmill is one of the best machines for runners living with osteoporosis.

Both the elliptical and treadmill are generally safe cardio machines for people living with osteoporosis, but Dr. Bady often prefers the treadmill. "The treadmill is better for building up bone density because of the impact [it has] on the feet," he explains.

And good news for those with knee issues: A treadmill workout ​probably​ won't exacerbate pain. Walking on a treadmill with an incline may actually have positive effects on knee joint health and pain reduction, according to an April 2014 study from ​Gait Posture​.

Begin walking on the treadmill for about 10 to 20 minutes four to five times per week, Dr. Bady recommends. Gradually increase your total walking time to 30 minutes. Once a 30-minute session feels comfortable, you can gradually increase the incline.

1. Step onto the treadmill.
2. Adjust the pace to a slow, comfortable walk.
3. Gradually increase your pace as your body warms up.

When it comes to upper-body strength training, you want a machine that targets the broadest and strongest muscles in your back: your lats. That's why Dr. Bady loves to recommend the lat pulldown machine.

"The lat pulldown machine is an excellent weight-bearing exercise that can help patients with osteoporosis improve their posture and increase their strength," he says.

But it's important to nail down proper form on this one. "I tell patients that the most crucial part of this exercise is to ​not​ to draw the bar behind the neck," he explains, noting that this snafu can have negative repercussions on spinal alignment.

For those living with osteoporosis, Dr. Bady recommends starting with 3 sets of 10 reps at a weight that's manageable to handle (about a 7 or 8 out of 10 on the exertion scale).

1. Sit on the lat pulldown seat, adjusting the thigh pad so it sits firmly against the tops of your thighs.
2. Adjust the machine pin to a weight that feels manageable.
3. Reach up and grasp both sides of the machine handle in an overhand grip.
4. Pull your bellybutton into your spine to brace your core and pull your shoulders back and down.
5. On an exhale, pull the handle toward the top of your chest.
6. Pause for a brief moment when the handle hovers right above your chest.
7. Reverse the motion with control and return to the starting position.

The seated leg press is a clear winner for people who have osteoporosis, Dr. Bady, Dr. Konan and Marko agree. The leg press machine keeps your feet fixed to the weight that's moving. And unlike a squat, the weight puts minimal pressure on your knees and ankles.

That being said, all three experts stress the importance of form. "It's important not to lean too far forward and keep a micro-bend in the knees throughout the exercise," Dr. Bady says. (In other words, don't fully extend your legs at the top of the movement — more on that below.)

Start with a light weight (about 40 pounds total) and perform a few reps to see how you feel, Marko suggests. Gradually, you can add more weight if this feels too light or drop some weight if it's too heavy.

"I like people to assess if this is easy, medium or hard," she says. Medium is the ideal level. So, once you find your medium, go for 3 sets of 10 to 12 reps.

1. Add weight plates to the machine, making sure it's even on both sides.
2. Sit onto the leg press seat and place your feet up onto the platform at hip-width distance.
3. Bracing your legs for the weight, unlock the machine to release the platform.
4. On an exhale, press your heels into the platform and push it away from your body, keeping a small bend in your knees even at the farthest point from your body.
5. Reverse the motion to bring the platform back down, bending your knees to 90 degrees.

Although the seated cable row is a great way to strengthen your back, Marko encourages folks with osteoporosis to modify this exercise to a standing position using cable machines. This helps increase the weight your spine has to hold, helping build more strength and stability.

"Plus, most people are slouched throughout the day, so rowing helps strengthen the spine and support the core," she says. "This exercise [also] helps open the chest and take a person out of the concave posture they're often stuck in."

Another major benefit: The standing cable row is a compound exercise, targeting your back, arm and core muscles simultaneously. In other words, you're getting a big bang for your buck!

On the cable machine, aim for 3 sets of 10 to 12 reps using a medium-intensity weight, Marko says.

1. Adjust the cable machine so each handle is at shoulder height.
2. Grasp a handle in each hand in a neutral grip, fingers facing each other.
3. Take a few steps back to add tension to the cables.
4. Pull your shoulders down and back away from your ears and stand with feet at hip-width distance and a tiny bend in your knees.
5. Leading with your elbows, pull the handles toward your ribs, keeping your arms close to your sides.
6. When your fists are just in front of your ribcage, reverse the motion with control, straightening your arms.

All the machines mentioned above are generally safe for those living with osteoporosis (although you should always check with your doctor first). But with that said, buying one of each can burn quite the hole in your wallet. So, if you're considering buying a machine for your home, think about your favorite type of fitness activities.

Not a big fan of walking? Skip the treadmill and go with an elliptical. Do you like mixing up your strength-training routine? There are plenty of cable machine exercises you can try in addition to rowing.

People with osteoporosis should prioritize building stability and strength to prevent falls and reduce the rate of bone loss, according to Dr. Konen. So, if you're only looking to buy one machine, you may want to opt for one of the strength-building picks above.

As mentioned earlier, exercise machines aren't exactly cheap. Your budget determines which specific machines and brands are available to you. So, only invest in a machine you ​know​ you'll use, not a machine you want to try for the first time.

Make sure to read plenty of product reviews, too, especially if you're buying a machine that's on the cheaper end of the spectrum. And consider shopping around holidays when products tend to go on sale.

Workout machines can take up quite a bit of space, unfortunately. And most people don't have a gym-sized amount of free floor in their homes.

So measure precisely how much space you have for workout equipment before you buy. Whip out a measuring tape (don't try to eyeball it) and compare your available space to the machine dimensions in the product info.

Also consider the extra space needed for weights or attachments. For instance, you need extra weight plates if you decide to invest in a leg press, which means you need extra space for storage.