Osteoporosis and Stress: What is the Link?

The information in this article is taken from Robyn Caruso’s Stress Management courses on the FCEA website.

We are entering a new era with medical fitness in terms of understanding how exercise can help individuals with chronic illness and stress. This is a very exciting time for the fitness industry as baby boomers are becoming our target population. Fitness professionals, through quality education, can be positioned to help these individuals. One of the more common conditions that may be reversed through exercise is Osteoporosis which affects men and women. In this article we will take a look at what Osteoporosis is, how stress affects it, the different risk factors, and how exercise can help.

According to the International Osteoporosis Foundation, there are currently 200 million individuals who are suffering from Osteoporosis worldwide. 1 in 3 women and 1 in 5 men will have osteoporotic fractures in their lifetime. Osteoporosis is referred to as the “silent disease” since most individuals don’t know they have it until they break a bone due to falling. Men are twice as likely than women to have a fracture re-occurrence. It is also known that bone fractures happen about once every three seconds around the world due to Osteoporosis.

Many individuals wonder what Osteoporosis is, how they got it and what treatments are available. Looking for the risk factors and working with medical professionals after diagnosis is important. Osteoporosis is a medical condition where the bones become brittle and fragile from loss of tissue. The commonly known risk factors that are seen in both men and women are: a family history, broken bones after the age of 50, early menopause, calcium and vitamin D deficiency, extended bed rest or long periods of inactivity, smoking, cancer treatment, asthma, or arthritis medication and chronic stress which isn’t often mentioned. When you take a closer look you realize that there are also some different risk factors for men and women that shouldn’t be overlooked.  If a client presents with any of the conditions below keep in mind that Osteoporosis could be a possibility. The table below will demonstrate the differences.

Risk Factors for Osteoporosis In men

Glucocorticoid Medication
Low Testosterone
Excessive Alcohol Consumption
Cystic Fibrosis
Gastrointestinal Disease
Anticonvulsant Medication
Osteogenesis Imperfecta
Neoplastic Disease
Ankylosing Spondylitis
Rheumatoid Arthritis

Risk Factors for Osteoporosis In Women

Exercise Overtraining
Pregnancy and Nursing
Asian American Women
Hispanic Women
Anorexia Nervosa






The link to chronic stress is being studied more frequently and there are definite ties to Osteoporosis. For example, the psychological stress of anxiety has been found to have an effect on lower hip bone density. Even though the stress response and bone regeneration work by two different mechanisms, one interferes with the other. If an individual has been living with chronic stress the hormone cortisol is released as well as epinephrine and norepinephrine which blocks calcium absorption and stops bone regeneration. Over time, the bones will wear down and eventually become Osteoporotic.

When prescribing exercise it is important to review your client’s health history and ask the right questions to fully understand their risk factors. Weight bearing exercises such as walking and weight training are important to help increase bone density. If a client is under a lot of stress, however, easing up on workout intensity is key to helping your client to recover from the flight or fight response. An intense workout can make cortisol levels spike even higher than they already are when under stress and can make the client more susceptible to Osteoporosis.

Fitness professionals may want to think about incorporating mind/body approaches such as Yoga, Tai-Chi and meditation and or Mindfulness into their client’s program. The approaches you choose will depend on the severity of Osteoporosis and what your client is comfortable doing. Some positive aspects of these practices are better balance, coordination, and body awareness for fall prevention. Another benefit of stress reduction is that it lowers cortisol levels that may help with bone regeneration.

Stress Management Institute for Health and Fitness Professionals

Robyn Caruso, B.A., CHES, smes, cpt

Robyn Caruso is the Founder of The Stress Management Institute for Health and Fitness Professionals™. She received her Bachelor’s Degree from Rowan University in Health Promotion and Fitness Management. She is an American Council on Exercise (ACE) personal trainer and group fitness instructor, a Certified Health Education Specialist by (NCHEC), and a Compassion Fatigue Resiliency and Recovery – Educator.
Robyn is an industry expert for the MedFit Network and MedFit Education Foundation Advisory Board Member, adjunct professor for Camden County College and Personal Training Advisory Board Member. Robyn is also a founding member of the Fitness Continuing Education Alliance (FCEA). She has taken the Mindfulness – Based Stress Reduction program (MBSR) through Jefferson University Hospital for Mindfulness. She has been in the fitness industry for 16 years in medical based fitness.
Robyn is the author of Stress Management Exercise Specialist 1st edition, Holistic Stress Management Specialist 1st edition and Holistic Stress Management Consultant 1st edition.

By working in the fitness industry, health and fitness professionals have the privilege of helping clients on a daily basis. When you take one of our specialty courses you are an important part of the healthcare continuum. On average 77% of individuals feel the physical, mental, and emotional symptoms of stress. Corporations spend approximately 3 billion a year on doctor visits and absenteeism.

Share this...
Share on Facebook
Share on LinkedIn