The Do’s and Don’ts of Yoga for Osteoporosis

As we age, it’s normal to lose some bone mass. But losing an excessive amount of bone mass is not. When that happens, the culprit is osteoporosis.

What is Osteoporosis?

Osteoporosis is a disease that weakens the bones and makes them more susceptible to fractures and breaks. Osteoporosis can be prevented and treated with a regimen of weight-bearing exercises, such as yoga for osteoporosis, as well as good diet and lifestyle routines.

Osteoporosis is a “silent disease” that occurs with no warning or symptoms. Loren Fishman, MD and Ellen Saltonstall co-authors of Yoga for Osteoporosis, say osteoporosis is one of the most widespread chronic health problems found in Western societies. Osteoporosis causes a million fractures each year, most of which are vertebral fractures and about 300,000 are hip fractures.

“We worry so much about breast cancer in women, however, in actuality, the risk of a hip fracture is equal to the combined risk of breast, uterine and ovarian cancer,” says Dr. Fishman, a Iyengar-trained yoga teacher and managing partner of Manhattan Physical Medicine and Rehabilitation. Twenty-five percent of those with hip fractures die, and another 25% permanently enter nursing homes, he adds.

Building Bone Strength

Dr. Fishman is currently conducting a major study on the bone-building benefits of yoga and osteoporosis. He says, “When bone cells get stimulated through being compressed or twisted or elongated, they produce more bone mass until that bone gets strong enough, to resist the pressure. In osteoporosis, the bones bend more, so pressure is more effective in stimulating the cells to make bone.”

Bones need both structure and density to remain strong. “Dense bone mass on its own doesn’t necessarily provide protection against fractures; unless the bone fibers are laid down in a way to provide greater strength, the bone mass is not going to be very stable,” says Saltonstall, a yoga therapist and senior certified Anusara yoga teacher.  “It’s like the difference between a pile of steel beams and the George Washington Bridge.”

“Because yoga poses pull and stretch the bones from every conceivable angle, yoga also may stimulate the formation of a bone structure that is able to resist greater amounts of pressure, as well as many different types of challenges,” adds Dr. Fishman.

Safely Practice Yoga for Osteoporosis: The Do's

People with osteoporosis should take great precaution to protect the bones since even simple movements can risk fractures. First, check with your physician to see if yoga practice is safe for your specific bone density and structure. If you get the go-ahead from your doctor, then consider private instructions with a qualified teacher to ensure your movements are correct rather then independently modifying poses in a group yoga class. “The key to getting the benefits of yoga is to ensure that the yoga postures are done with proper alignment,” Saltonstall says.

Start slowly with simple yoga poses, and gradually build up length of practice and level of difficulty. Be careful to not push yourself beyond your limits. To successfully build bone mass, consistently practice yoga and other exercise for osteoporosis for a minimum of 30 minutes a day, five days a week.

Simple back bending poses like the Cobra, Sphinx and Bridge strengthen the spine and prevent what is commonly known as “dowagers hump,” in the elderly.  The Bridge pose and the Full and Half Shoulder Stand also stimulate the thyroid gland, which balances the endocrine system and encourages bone growth. Lunging poses such as Warrior I and II adds needed strength to thighbones and muscles. Poses such as the Dog, the Plank, the Crab and Balancing the Table strengthen the upper body. 

When you’re ready to progress to more advanced yoga poses, there are the Crane, the Half Downward Dog, Dancer, Warrior III, the Bow, the Wheel, Adept’s Pose, and the Supported Bridge Pose.

Postures to Avoid: The Don'ts

Follow these additional yoga for osteoporosis guidelines to keep your bones safe and to build bone density and bone strength.

1. Avoid flexing the spine forward to stretch the back, legs, or abdominal muscles. Several reclining poses can accomplish the same goal.

2. Avoid twisting the spine in a way that uses gravity or leverage for rotation.  Any type of rotation should be introduced slowly using simple movements without force.

3. Approach backbends cautiously and gently, and avoid overarching the back. Gently supported backbends, as with a rolled towel, can help restore posture.

4. Avoid supporting your entire body weight with your hands to avoid wrist fractures, a common problem with osteoporosis. Other poses, such as Mudras, arm movements, or sustained arm positions, can build arm and wrist muscles and bones.

5. Standing poses and balances are excellent for increasing leg strength, but they should be done with the help of a teacher and the support of a wall or chair, as the risk of fracture is increased in these positions.

6. Inversions are never recommended. Rather, try restorative poses such as the Legs-Up-the-Wall pose.

“There are numerous other important ways in which yoga benefits people with osteoporosis, such as improving balance, muscular strength, range of motion, and coordination while lessening anxiety,” says Dr. Fishman. “These are other important benefits of yoga for people with osteoporosis because they each help reduce the risk of falling.”

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