Physical exercise is known to stimulate bone osteogenesis in patients with osteoporosis. However, all types of exercise do not have the same beneficial effect on bone mineral density (BMD).

Two types of exercises have emerged as being appropriate for patients with osteoporosis. These include weight-bearing aerobic exercises, including impact activities or any other exercise in which arms, feet, and legs bear the weight, such as walking, climbing stairs, jogging, volleyball, tennis, Tai Chi, and dancing; and strength and/or resistance exercises, wherein joints are moved against some kind of resistance. These exercises are site-specific and seem to increase muscle mass and BMD only in the stimulated body regions.

Other exercise protocols include multicomponent exercises and whole-body vibration. Multicomponent exercises encompass different exercises such as aerobics, strengthening, progressive resistance, balancing, and dancing, and aim to increase or preserve bone mass. These exercises seem to be indicated particularly in deteriorating elderly patients. Whole body vibration (WBV) exercises are performed with dedicated devices. These exercises yield favorable results, particularly in improving balance and reducing the risk of falling.

Evidence indicates that there is a statistically significant effect of exercise on bone density in postmenopausal women in comparison with control groups. Exercises with the most prominent effect on BMD for the neck of femur seem to be the progressive resistance strength training for the lower limbs. Intervention that is most effective for BMD at the spine is the multicomponent training exercise program. Weight-bearing aerobic exercise and training with vibrating platforms also improve BMD.

These exercises tend to increase BMD in postmenopausal women, and seem to prevent further bone loss in osteoporotic patients.