Turning Wobbles into Wins for Older Adults with Osteoporosis

Discover practical strategies to help older adults with osteoporosis overcome their fear of falling, build balance, and stay motivated to keep coming back to your fitness classes.

Many older adults first discover they have osteoporosis in the most distressing way possible: after a fall that results in a painful fracture. For some, it’s a broken wrist from bracing a fall in the kitchen; for others, it’s a hip or vertebral fracture that leads to a hospital stay and a daunting recovery process. These injuries are not only physically painful but can also be life-altering, often marking the start of a new chapter defined by caution and concern.

Once diagnosed, the reality of osteoporosis sets in - bones are more fragile, and the consequences of another fall are serious. This awareness often leads to a profound fear of falling, which is more than just a fleeting worry for your participants. It can be emotionally debilitating and restrict social engagement and independence - and coming to class. In fact, older adults with osteoporosis are more than twice as likely to experience a significant fear of falling compared to those without the condition, and this fear is closely linked to increased restrictions in daily living.

The statistics are sobering: more than one in four people aged 65 or older fall each year. Studies indicate that after an initial fall, older adults are much more likely to experience subsequent falls, with some research suggesting that up to 50% may fall again within the following year. These repeated falls can lead to a cycle of declining mobility, reduced confidence, and increased dependence on others for daily activities.

For many, the fear of another fall becomes a constant companion, influencing every movement and decision. Yet, it’s important for fitness instructors to recognise that this cycle can be broken. With the right support, education, and targeted exercise - especially balance training - older adults with osteoporosis can regain confidence, improve their stability, and dramatically reduce their risk of falling again.

1. Make balance training a core feature

Balance exercises are proven to help people with osteoporosis reduce their risk of falls and improve overall stability. Whether your class focuses on freestyle aerobics, seated strength, or pilates, find ways to incorporate activities like single-leg stands, heel-to-toe walking, and gentle dynamic moves such as side steps or tai chi. These exercises not only enhance physical balance but also boost participants’ confidence in their own abilities. Remind your class that a little wobble is a sign of progress and that every effort counts toward greater steadiness.

If it’s a dedicated balance or strength class, start each session with simple balance drills using a chair or wall for support, allowing participants to feel secure as they begin. Gradually introduce more challenging moves as participants gain confidence - perhaps moving from static holds to gentle dynamic steps or using props like foam pads for variety. Highlight their progress - no matter how small - so they see tangible results and feel motivated to keep coming back. Celebrate every improvement, reinforcing the message that persistence pays off.

2. Foster a supportive and social environment

A welcoming class atmosphere can make all the difference. When participants feel supported and included, they’re more likely to return and push themselves further. Encourage camaraderie by celebrating achievements, sharing progress, and fostering connections between participants.

Greet everyone by name, encourage group discussions, and allow time for participants to share their experiences. Consider pairing up participants for certain exercises or group challenges to build accountability and friendship. A supportive environment transforms a fitness class into a community, making it a highlight of their week and giving participants something to look forward to beyond the physical benefits.

3. Educate and empower with knowledge

Older adults with osteoporosis often worry about what movements are safe. Take time to explain the benefits of each exercise and how it supports bone health, balance, and independence. Knowledge reduces anxiety and empowers participants to take charge of their health.

Share practical tips, such as, “Standing on one leg while brushing your teeth to help improve your balance.” Explain why you avoid certain movements (like forward bending from the waist) and emphasise the importance of posture and proper body mechanics. When participants understand the why, they’re more likely to stay engaged and motivated. Providing this education builds trust and helps participants feel more in control of their progress.

4. Progress at the right pace, but keep challenging

Safety comes first, but don’t be afraid to challenge your participants as they grow stronger. Start with basic movements and gradually introduce more dynamic balance and strength exercises. Celebrate every improvement, and encourage participants to set personal goals. Always provide options for your participants who aren’t ready for the extra challenges just yet though.

Use gentle progressions, such as moving from seated to standing balance exercises, or adding light resistance, or closing the eyes, as participants become more confident. Remind them that progress is about consistency, not perfection. Encourage them to track their achievements, whether it’s holding a balance pose for a few seconds longer or feeling steadier on their feet. This sense of accomplishment can be a powerful motivator for continued attendance.

5. Address the fear openly and compassionately

Fear of falling is common, but it doesn’t have to be a barrier. Acknowledge these concerns and share evidence that regular balance and strength training can significantly reduce both the risk and the fear of falling. Open conversations help participants feel seen and supported.

Invite participants to share their worries and offer reassurance based on research: exercise not only reduces fall risk but also builds the confidence needed to stay active and independent. Remind them that every step they take in class is a step away from fear and toward freedom. By creating space for honest discussions, you help participants feel less alone in their concerns and more empowered to overcome them.

6. Do further training and stay informed

To best support your participants, commit to ongoing professional development. Completing courses like Balance Training for Older Adults by Third Age Fitness will equip you with the exercises, techniques and safety guidelines for working with this population. You can also consult with specialist healthcare providers in the fields of balance and osteoporosis to deepen your understanding and refine your approach.

Continuing education ensures you’re delivering safe, effective, and up-to-date programming. It also demonstrates your commitment to your participants’ well-being, building trust and credibility. Encourage your colleagues to pursue further training as well, so your entire team can better serve this community and stay at the forefront of best practices.

7. Keep classes fun, varied, and engaging

Variety and enjoyment are key to long-term participation. Mix up your routines, use music they can sing along to, and inject humour to keep classes lively and engaging. The more enjoyable the experience, the more likely participants are to make it a regular habit, and the more they will be able to push through those fears that might otherwise hold them back.

Rotate through different balance, strength, and flexibility exercises. Incorporate games or friendly competitions to add excitement and challenge. Remember, laughter and enjoyment are powerful motivators - when participants have fun, they’ll keep coming back for more. A positive, energetic atmosphere can transform exercise from a chore into a highlight of the week.

A special focus on osteoporosis this month

May is Osteoporosis Awareness and Prevention Month, making it the perfect time to open up conversations with your class about bone health. Use this opportunity to share practical tips and empowering facts on how participants can prevent or slow the progression of osteoporosis. By raising awareness now, you’re helping everyone take proactive steps toward stronger bones and better balance - both in and out of class.

Remember, you’re not just teaching a class - you’re transforming lives. Every time an older adult with osteoporosis chooses to show up and move, they’re taking a step toward greater independence and vitality, and trusting you to guide them. Your encouragement, expertise, and empathy can make all the difference.

Keep investing in your own learning, create a supportive environment, and celebrate every win, big or small. Together, you and your participants can conquer fear, build strength, and enjoy the journey to better health.

Ready to deepen your expertise? Explore our Balance Training for Older Adults online course, or connect with local specialists in balance and osteoporosis for more insights. Share your own tips and success stories in the comments-let’s keep inspiring each other to make a difference!

Trudi Edmeades is the co-founder and Managing Director of Third Age Fitness, where she inspires fitness instructors to create fun, creative, and community-driven classes for older adults. With over a decade of experience teaching and developing accredited courses, Trudi is passionate about helping instructors engage and empower older participants to build strength, confidence, and vitality through movement.

Sources

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Vaishya, R., & Vaish, A. (2020). Falls in Older Adults are Serious. Indian journal of orthopaedics, 54(1), 69–74. https://doi.org/10.1007/s43465-019-00037-x

International Osteoporosis Foundation. “Falls prevention (patients).” https://www.osteoporosis.foundation/patients/prevention/falls-prevention

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Montero-Odasso, M., van der Velde, N., Martin, F. C., Petrovic, M., Tan, M. P., Ryg, J., Aguilar-Navarro, S., Alexander, N. B., Becker, C., Blain, H., Bourke, R., Cameron, I. D., Camicioli, R., Clemson, L., Close, J., Delbaere, K., Duan, L., Duque, G., Dyer, S. M., Freiberger, E., … Task Force on Global Guidelines for Falls in Older Adults (2022). World guidelines for falls prevention and management for older adults: a global initiative. Age and ageing, 51(9), afac205. https://doi.org/10.1093/ageing/afac205

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