Earlier in the week you did the wall test. Head to the wall, chin level, and either the back of your head touched or it didn’t. You also checked your height against your peak.
If you haven’t done it yet, do it now, because your result decides which track you start on. Everything below is built around those two numbers.
Here’s the promise, kept deliberately narrow. This protocol will not un-collapse a fractured vertebra. Nothing can. What it will do is start to strengthen the spinal extensors that hold you upright, address the postural share of that forward curve, and, over time, lower your risk of the fractures that cause the fixed kind. That last point isn’t a nice-to-have. It’s the whole reason this work matters more than posture ever did.
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Read this part properly. It’s the difference between a protocol that helps and one that hurts.
A failed wall test or lost height can mean a silent vertebral fracture you don’t yet know about. Most of the exercises here are safe regardless. The heavier ones, the loaded carries and the hinge, are not automatically safe if your spine is already compromised. So before you add external load:
If you lost more than 4cm, failed the wall test, or have diagnosed osteopenia or osteoporosis: Discuss with your GP before you touch the loaded carries or the hinge. The extensor and wall-angel work below is almost always fine to begin in the meantime. The barbell and heavy dumbbell work waits for the green light.
Sudden or recent back pain, pain that wakes you at night, or unexplained weight loss: stop and see your GP first. These are not “train through it” symptoms.
No red flags and you passed the test: you’re clear to run the full protocol. Start on the maintenance track.
A rushed hinge under load on an undiagnosed fracture is exactly how a manageable situation becomes a serious one.
This is the part I need you to take seriously, because getting it wrong doesn’t just waste time. It causes the exact injury we’re working to prevent.
Do not load spinal flexion. Flexion is bending or curling the spine forward. Loaded or repeated flexion is the single most dangerous thing you can do to a spine that’s already lost bone.
We’ve known this since 1984. In a Mayo Clinic study, Sinaki and Mikkelsen followed 59 postmenopausal women with spinal osteoporosis and split them by the exercises they were given. The women doing extension work, the kind in this protocol, had a new-fracture rate of 16%. The women doing forward-bending flexion exercises fractured at 89%. Not a rounding error. More than five times the risk, from the movement that looks harmless in every gym class going.
The physics is simple. Bending or rounding forward under load concentrates force on the front edge of the vertebral body, which is exactly where an osteoporotic spine is weakest and where wedge fractures form. Later work has only reinforced it, including case reports of fractures from strenuous forward-folding yoga in people who had nothing worse than mild bone loss.
So, off the menu if you’ve lost height or failed the test:
Sit-ups and crunches
Weighted twists and Russian twists
Toe-touches and standing forward folds under load
Roll-ups and deep spinal-flexion Pilates or yoga positions
Any loaded movement where your spine rounds forward to move the weight
This is not a case of “be a bit careful.” It’s a clean line. Train the spine into extension, never load it into flexion.
Most posture “fixes” are a random pick-and-mix of stretches. This isn’t. Four movements, each doing a specific job, and they cover the whole chain from the small postural muscles to heavy full-body loading.
1. Prone extensions. This is the engine of the whole plan. Lying face down and lifting the chest against gravity trains the thoracic extensors directly, in the exact pattern they’ve stopped doing. This is the single most studied, most protective movement for a rounding spine.
Prone press up on elbows - Fit Family Physical Therapy
Bodyweight Prone Back Extensions
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