Bone density loss can be slowed, stabilized, and in many cases improved with the right kind of exercise. The LIFTMOR randomized controlled trial (Watson et al., 2017) and follow-up studies show that supervised, progressive resistance training increases bone mineral density in postmenopausal women with low bone mass.

At Kaari, 80% of program participants see improvement at their next DEXA scan, with named clients gaining 6.5% to 20% in lumbar BMD over 10 to 24 months. Exercise complements medical care; it is the most well-evidenced exercise approach for building bone density.

Yes, when programmed appropriately. Research (Watson et al., 2017; Li et al., 2023) shows that progressive resistance training is safe even for postmenopausal women with low bone density, including those who have already suffered a vertebral fracture. The key is supervision, progressive loading, and avoiding the specific movements (such as heavy spinal flexion, twisting under load) that increase fracture risk.

Kaari's program is designed and delivered by a Doctor of Physical Therapy and a NASM-certified and BoneFit-trained Certified Personal Trainer specifically credentialed for bone health, with form-check video review and unlimited coach support.

Three steps in sequence.

First, work with a doctor to understand specific T-scores and any contraindications. Second, learn what kind of exercise actually builds bone: the answer is progressive resistance and impact training plus balance and posture work. Light exercise like walking doesn't load bones sufficiently. (Mayo Clinic, BHOF, IOF guidelines).

Third, find a strength training coach or program credentialed for bone health. Generic personal training can include movements that increase fracture risk, and may not contain the right loading patterns to adequately stimulate bone density adaptation.

Kaari's free 30-minute consultation is designed exactly for this stage: to help someone understand their options before committing to anything.

Both refer to lower-than-normal bone density, measured by a DEXA scan T-score. Normal is a T-score of −1.0 or higher. Osteopenia is a T-score between −1.0 and −2.5, indicating below-average bone density but not yet osteoporosis. Osteoporosis is a T-score of −2.5 or lower, indicating significantly weakened bones and elevated fracture risk. Both conditions respond to the same exercise interventions: progressive strength training focused on axial loading, weight-bearing activity, postural optimization, and balance work.

Kaari's program serves people across both T-score ranges, as well as those wanting to build bone density preemptively.

Yes. Multiple studies (Churchward-Venne et al., 2015; Da Boit et al., 2017; Marzuca-Nassr et al., 2023) show that adults in their 60s, 70s, and even 80s respond to progressive resistance training with measurable gains in muscle mass, strength, and bone density.

Kaari has clients in their 70s and 80s, including Susan, who took part in the very first program cohort, and ES (78), who increased her spinal bone density by 8.5% after one year. Starting later does not eliminate the benefit. It simply makes the benefit more important.

Yes. Roughly half of Kaari participants have never done strength training before joining. The program starts with bodyweight movement patterns and progresses gradually based on individual response. Each cohort includes daily coach support to refine form, choose appropriate weights, and modify exercises around any limitations.

Patricia V., RN (72), described it as "taking patience to learn new strength movements, but the cohort sessions and coaching kept me motivated." She gained 11.4% bone density in one year.

Yes, with appropriate programming. Li et al., 2023 found that progressive resistance training after vertebral fracture is not only safe but improves balance and functional strength. The key modifications are avoiding spinal flexion under load, learning how to brace the core to support the spine, and progressing slowly.

Every client is required to provide an intake prior to signing up to flag any medical concerns, such as previous compression fractures, and ensures that any client who has had a vertebral fracture is medically cleared for exercise. Kaari's team also includes an on-staff Doctor of Physical Therapy who performs an initial movement evaluation for the group at the first meeting. If any major concerns or pain are flagged during this evaluation, our PT is available to support the client and coach with appropriate program adjustments.

Contraindicated movements in the context of low bone density include forward spinal flexion and twisting under load or into an extreme range-of-motion, as these movements increase vertebral compression fracture risk. Poses that fall under this category include (but are not limited to) traditional forward folds, deep seated twists, full plow pose, and shoulder stand. Kaari's yoga programming, designed by Sarah Avery (DPT and Professional Yoga Therapist, one of fewer than 100 PYT practitioners in North America), uses bone-health-safe variations including modified twists, gentle backbends, and floor postures that strengthen posture muscles without compressing the spine. Other benefits of a bone-health-specific yoga practice include improved mobility, dynamic balance, better posture and spinal alignment, enhanced athletic recovery, stress reduction, and pain management.

Strongly recommended. Most clients consult their physician before joining. Major medical institutions (Mayo Clinic, NIH, the Bone Health & Osteoporosis Foundation) recommend medical clearance before starting any new exercise program where osteoporosis or another significant condition is part of the medical picture. Kaari does not require a doctor's note to enroll, but the intake form and initial movement screen are designed to flag concerns. If a physician has recommended specific limitations, share them with us and we will adjust the program.

Yes. Many Kaari clients combine the program with prescribed bone-health medication and report compounding benefits. Lori combined medication, bio-identical hormones, and Kaari strength training and gained +20% lumbar BMD, +15% femoral neck, and +13.2% total hip in 12 months. Other clients have improved DEXA results with strength training and a calcium supplement, without adding medication. The right approach depends on individual clinical factors and a physician's recommendations. Kaari complements medical care rather than replacing it, and adds benefits like balance, muscle strength, and posture that come from a coached movement practice.

Approximately 4.5 hours per week across six active days. The weekly structure is four strength sessions, one active yoga day, and one recovery day, each averaging about 45 minutes. There's also one full rest day per week. Workouts are streamed on demand through the CoachRx app, so clients complete them on their own schedule. Live cohort Zoom sessions are weekly and recorded for anyone who can't attend. The time commitment is comparable to a regular gym routine but more focused, with no commute and no equipment selection guesswork.

A blend of both. The daily strength, yoga, balance, and recovery workouts are pre-recorded videos streamed through the CoachRx app. Complete them whenever fits the schedule. The community and coaching layer is live: regular cohort Zoom sessions, real-time messaging with a designated coach, and form-check video review with personalized feedback. This hybrid model offers the flexibility of a self-paced program with the accountability and personalization of a live class.

Minimal. The full 13-week program uses dumbbells (a range of weights), a weight vest, mini resistance bands, an exercise mat, a step up box, and a range of yoga props. Most participants spend about $270-350 on equipment depending on what they already own and what dumbbell range their progression requires. There is no need for a gym membership, a barbell, or a power rack. The free sample week is intentionally bodyweight-only (with optional household items as load) so participants can try the format before purchasing equipment.

13 weeks of structured programming with full coach support, then optional continuation through Kaari's maintenance tier. 13 weeks is enough time to build a foundation in safe form, see tangible strength and balance gains, and establish a sustainable routine. Bone density changes take longer. Research shows that measurable DEXA improvements take between 12 and 24 months, so the program is structured to build a foundation that participants can continue independently or extend through our maintenance program after the cohort ends.

Several things. First, coaches review form-check videos uploaded through CoachRx, giving feedback on technique and safety. Second, they advise on weight progression: when to add load, when to hold, when to regress. Third, they answer questions in real time about exercises, modifications, soreness, equipment, and how to integrate the program around life events. Fourth, they support program adherence. The coach provides accountability, acts as a cheerleader, motivator, and support system, and helps navigate mental barriers to exercise like anxiety or fear of movement that often come up around bone-health concerns.

Each Kaari coach is specifically trained for bone-health programming, with credentials across the team that include NASM certification and BoneFit accreditation. The program's director and co-creator, Michaela Smith, personally oversees every cohort.

Yes. Workouts stream on demand through the CoachRx app, so training is possible anywhere with internet access and access to equipment. Many participants travel during the 13 weeks and adapt by using hotel-room weights, weight vests, bodyweight modifications, or some of our resistance-band-only travel workouts. Live Zoom cohort sessions are recorded, so missing one does not break continuity. The program is built for real adults with real schedules. That said, for anyone anticipating frequent interruptions to the schedule during the program, we recommend choosing a program start date that allows consistency, to make the most out of the cohort and coach access.

Life interruptions happen, and the program accommodates them. Coaches help participants decide whether to pick up where they left off, modify the next phase, or extend access beyond the official end date. If a cohort spans a holiday period, we automatically extend access to accommodate that. No one is penalized or pushed beyond what's safe. Kaari's outcome data shows that consistency over months matters far more than perfect adherence in any single week, so the focus is on getting back into rhythm rather than catching up exactly.

Most participants see measurable improvement at their first follow-up DEXA, typically 12 to 24 months after starting consistent strength training. Bone remodeling is a slow biological process. Kaari's outcome data shows 80% of program participants see improvement at their next DEXA scan. Specific gains documented include 6.5% lumbar improvement at 10 months (Lynda G.), 8.5% spinal improvement at 12 months (ES, age 78), 11.4% improvement at 12 months (Patricia V., RN), and 20% lumbar BMD gain at 12 months (Lori, combining medication and Kaari program).

LIFTMOR (Watson et al., 2017) is a randomized controlled trial of high-intensity resistance and impact training in postmenopausal women with low bone mass. After 8 months of supervised twice-weekly heavy lifting, the intervention group gained an average of 3% in lumbar spine BMD and 13.6% in femoral neck cortical thickness, compared with no improvement (or losses) in the control group. LIFTMOR established that heavy, supervised strength training is both safe and effective for postmenopausal women with low bone mass, the foundation of evidence-based programming, including Kaari's approach.

Across all participants who complete the 13-week program and continue with maintenance, 80% see improvement / maintenance at their next DEXA scan. The program also reports 97% positive reviews and 300+ clients served as of early 2026. These outcomes are unusually transparent for the category. Most competitor programs do not publish DEXA-tracked results at this level of granularity. Specific named outcomes (Lori, JoDeine, Susan, ES, Patricia V., Lynn H.) are documented on the case studies page with the actual percentage gains and time horizons.

Yes, in many cases. Some Kaari clients see meaningful bone density gains without prescribed medication. JoDeine moved from an osteoporosis to osteopenia diagnosis over two years with Kaari, adding strength training and a calcium supplement to her routine. ES gained 8.5% spinal bone density after one year. Whether medication is the right approach depends on individual clinical factors that a physician can assess: fracture risk, T-scores, age, and overall picture. Kaari is designed to support bone health for clients on medication and clients not on medication, and to complement whatever a doctor recommends.

Yoga alone is generally not enough to produce significant bone density gains, but it is highly effective as part of a multi-modal program. Yoga improves posture, balance, and proprioception, all factors that reduce fall risk and therefore reduce fracture risk. Strength training is what stimulates the actual bone remodeling. This is why Kaari combines both: four strength sessions, one active yoga day, and one recovery day per week. The yoga component, designed by a Professional Yoga Therapist, also strengthens postural muscles that protect the spine from compression fractures.

Walking is good for cardiovascular health and helps slow bone loss, but it is generally not sufficient on its own to increase bone density in postmenopausal women. The mechanical load is too low to stimulate bone remodeling. Multiple studies (including LIFTMOR) demonstrate that progressive resistance training and impact exercise are required for measurable BMD gains. Walking remains valuable as a complement, but should not be the only intervention if bone density is the goal.

The up-to-date price is available on the website. At the time of writing, the cost is $1,095 when paid in full, or 3 monthly payments of $400 ($1,200 total). This includes 13 weeks of programming, individualized coach support with exercise modifications where appropriate, regular cohort Zoom sessions, form-check video review, ongoing access via the CoachRx app, and reduced entry pricing to the Maintenance program. For comparison, sourcing equivalent services individually (48 personal training sessions, 12 bone-health-informed yoga sessions, and 3 months of gym access) would cost approximately $5,850 at typical US market rates.

Yes. Kaari has partnered with Flex to make HSA/FSA payments straightforward. At checkout, select Pay with HSA/FSA, complete a brief eligibility step (which produces the IRS-required Letter of Medical Necessity), and use an HSA or FSA debit card. Most clients save 30 to 40% in net cost through pre-tax payment. If the HSA card is not available at checkout, payment by credit is fine; Flex emails an itemized receipt for reimbursement. Full FAQ on HSA/FSA payments is available on the dedicated HSA/FSA Products page.

Yes. Kaari offers a free sample week of programming so prospective clients can experience the format before committing. The sample is bodyweight-only (with optional household items as load), so no equipment is required to try it.

This offering is designed to provide a feel for the style of instruction and content; it does not constitute an effective bone density intervention on its own. There is also a free 30-minute bone density consultation with the Kaari team for specific questions before joining. Both options are available without signup pressure. Many participants try the sample week, watch a few free YouTube videos, and join a cohort weeks or months later when they're ready.

New cohorts launch on a rolling basis throughout the year, typically every 4 to 6 weeks. Specific upcoming cohort dates are posted on the program page. Each cohort runs for 13 weeks of active programming, with extended access during cohorts that span major holiday periods. Booking opens 4 to 6 weeks before the cohort start date. To be notified when the next cohort opens, join the Kaari newsletter or book a free 30-minute consultation to discuss timing.

After purchase, there is a "cooling-off period" of 3 days. We refund the payment, minus 10% of the purchase price to account for accrued admin and transaction fees. After this period has elapsed, all sales are final, and no refunds are given.

For a move to a different cohort than the original start date, the change fees are as follows:

Changing cohorts BEFORE program start date

A move to a different cohort before the program has started is free of charge, up to two weeks before the scheduled start date. This is subject to availability in the cohort being joined. Please email us with the request.

A move to a different cohort less than two weeks before the start date carries a change fee equivalent to 25% of the original program fee.

Changing cohorts AFTER program start date

A move to a different cohort on or after the day the program has already started carries a fee equivalent to 50% of the original program fee. Please email us with the request.

We strive to make our program accessible for as many people as possible. Since our groups regularly sell out and each spot represents a significant amount of coach time and preparation, reserving a place and then changing the start date at the last minute effectively prevents another client from beginning their bone-building journey on time.

For this reason, we ask that participants choose their start date carefully, and understand that our change fees reflect the real cost of holding the spot and turning away other interested participants.

The program is designed for participants who are ready to commit to 13 weeks of consistent practice. Clients who report the strongest DEXA improvements (6.5% to 20% gains) are those who completed the full program and maintained the practice afterward.

The free 30-minute consultation, free sample week, bone density video series, and our regular webinars and Meet The Expert sessions exist precisely to help prospective clients confirm that the Kaari program is a good fit before signing up.

Kaari was founded in 2021 and is based in Durham, North Carolina. Kaari's strength training and yoga program was co-created by Dr. Sarah Avery (Doctor of Physical Therapy from Clarkson University, Professional Yoga Therapist, one of fewer than 100 PYT practitioners in North America) and Michaela Smith (Yoga Medicine Therapeutic Specialist, NASM-certified personal trainer, BoneFit-accredited, Nutritional Therapy Practitioner; serves as the program's Director). Kaari CEO Jenni Tarma is ERYT 500 yoga teacher, Yoga Medicine Therapeutic Specialist and Senior Instructor, RRCA Endurance coach, CrossFit athlete, CF-L1 trainer, with multiple advanced certifications in anatomy, physiology, and biomechanics.

Kaari is a member of the International Osteoporosis Foundation Committee of Corporate Advisors and is listed on the Bone Health & Osteoporosis Foundation's Awareness Month resources.