When I mention to my yoga students that a pose is good against osteoporosis, I often get a blank stare. We are usually not aware of this “silent disease” that can put us at a high risk of breaking bones and becoming incapacitated. However, this progressive loss of mineral density in bones is very real. Almost 1/3 of women have a hip fracture before they are 80 years old. 25% of hip fractures after 50 lead to death within the year because of the resulting immobility, painful nights, increased risk for infection, change of lifestyle, depression etc. Although osteoporosis is less prevalent in men, they are by no means excluded and often less timely diagnosed. Once diagnosed with osteoporosis, it is possible to counteract further bone weakening, but preventing this difficult condition is much easier and more effective than treating it. The good news is that practising yoga is one of the best ways to prevent and manage osteoporosis!
Osteoporosis and its contributing factors
When you are diagnosed with osteoporosis, literally “porous bone,” your bones have lost mineral density to such an extent that you are at a great risk of fractures, especially of the hip, spine and wrist. This progressive bone weakness excludes no ethnic group or gender, and its prevalence is increasing as life expectancy improves.
Some causes of osteoporosis we can’t control, such as genetics, hormonal changes and premature menopause. When you are older than 30, it also doesn’t help to know that it is extremely important to build bones in childhood, teens and twenties through a good diet and exercise. We have built maximum bone density by age 30. Still, after 30 you can avoid a rapid worsening of bone weakness by cultivating good habits with exercise, lifestyle and diet. In terms of diet, it is important to have an adequate mineral intake, such as calcium, magnesium, zinc and potassium. Also vitamin D (through sunshine and/or supplements) is essential to aid the absorption of calcium.
Factors contributing to osteoporosis are smoking and an excessive intake of alcohol, red meat, salt, sugar and caffeine. Depression and anxiety can also be worsening factors. It may not come as a surprise that stress plays a negative role in the development of osteoporosis. This is because stress, especially when chronic, disturbs the balance of our hormones and (cortisol, the stress hormone) inhibits the production of oestrogen and progesterone, hormones that are essential for bone production.
Many forms of exercise help to build bone, if they combine the effects of gravity and muscle activity. So also walking is good. Exercise in general supports coordination, stability, balance and muscle tone. Many older people fall because they lose confidence in their ability to move and they may suffer from weakened muscles. Yoga helps improve coordination and confidence. It strengthens muscles, improves balance and increases flexibility, gives a sense of relaxation and well being, so let’s look at this in more depth.
How yoga can help
- Weight-bearing exercise
It is not only “working with weights” that helps to build bone. Yoga does include many weight-bearing poses, such as standing poses, inversions and arm balances, but bone growth is also stimulated through dynamic tension between muscles, which is the case in most yoga poses. This means that one muscle group opposes the action of another and the bones feel double pressure. Holding the yoga poses for at least 8 seconds is considered a good duration for bone building.
- Promoting calm
Yoga’s combination of poses, breathing techniques and relaxation promotes the relaxation response in our body and hence has a positive impact on the nervous system and the regulation of the adrenal glands.
- Exercise without drawbacks
As opposed to impact sports such as running, yoga is beneficial for the joints. When osteoporosis starts to manifest, the picture is often complicated by osteoarthritis. This wear and tear of the joints can be aggravated by sports that put pressure on the joints. Yoga movements are not only low impact but can be good for arthritis as well, as they lubricate the joints by encouraging their whole range of movement.
Weight lifting is sometimes advocated to prevent and manage osteoporosis but weight lifting does not improve flexibility or balance and can lead to disc-related injuries and lower back pain.
When you suffer from osteoporosis, spinal fractures can occur quite commonly during normal activities. The fractures decrease the spine’s height and if your posture is bad, with a rounded upper back and forward neck, the fractures will exacerbate the spinal curve and lead to severe rounding of the upper back. Yoga can help improve posture, preferably before any fractures occur.
Principles of yoga for osteoporosis
Once you have osteoporosis, avoid inversions that put pressure on neck and upper back. Also avoid sudden movements, forward bends and balancing poses without the support of a wall or chair. Forward bends increase the risk of vertebral fractures, while backbends are better.
Suitable Exercises when you have osteoporosis:
Up and down on the toes near a wall.
Stand near a wall or chair. Inhale and lift the feet slowly so you balance on the toes. Exhale and lower the feet. Do this a few times and then add the arm movement, bringing the arms up and to the side with the inhalation, down with the exhalation. Repeat several times, coordinating breath and movement. This movement strengthens the feet, ankles and legs and is calming.
Tree pose against or near the wall
(Stand near a wall or chair).
This balance on one leg is traditionally done with the foot against the inner thigh. However, the foot can be under the knee, or one toe can even touch the floor: choose the position that feels right but avoid placing the foot directly against your knee.
-When balancing on the right foot, keep lifting through the right hip so that you do not bend the right hip.
Keep paying attention to the breath in this balance and work up to staying in the position for at least a minute on each side. Try imagining roots underneath your standing foot, and the exhalation going down the leg and into those roots. When you breathe in, feel tall, lifting from the waist up.
Forward bend with the wall
Forward bends are too risky when you have osteoporosis so instead use a wall to rest your hands. Keep the hands quite high and walk back slightly until you feel a nice lengthening along the spine.
To lengthen the spine and counteract kyphosis, it is good to practice this gentle back bend. It is an excellent position whether you have osteoporosis or not.
-Before raising the shoulders and head, tilt the pelvis by tucking the tailbone under. This is important to avoid compressing or straining the lower back.
-Do not put weight on the hands but lift the shoulders and the head by contracting the upper back muscles. It is not a big movement.
-Keep looking down to keep the neck long and in line with the upper back.
Child with support
Child’s pose is soothing and relaxing for the back, but because forward bends are counter-indicated, practice child’s pose on a chair or sofa. Use a rolled towel under the ankles if the feet are tight.
Finish with a few minutes Relaxation on the back.
If you have been diagnosed with osteoporosis a general yoga class is not advised and might put you at a greater risk for fractures. If you would like to learn how to adapt your yoga practice or indeed start yoga, try to find a yoga therapist with knowledge of osteoporosis. You could also contact me to discuss a yoga programme that could help you reverse bone loss, gain confidence and balance, increase strength and flexibility and deal with stress.
Prevention of Osteoporosis
The following are examples of poses that can prevent osteoporosis. They include weight bearing, balance and relaxation.
Good for arm strength, elongation of the spine and to quiet the adrenal glands.
-Start in child and place your feet hip-width and your hands shoulder-width apart.
-Keep the back long while you unfold the legs.
-Allow the head to hang down so the neck can relax.
-feel the tailbone reach away, in the opposite direction to the head.
-Keep the shoulders broad and definitely do not push the chest down to the floor.
-Stay for a few breaths and rest back down in child.
Dog pose can be tricky when your hamstrings are tight. Feel free to bend your legs as that encourages the spine to release.
Strengthening for the whole body, one side at a time. Practise near or even against a wall to start with. Place the lower knee down if this is easier.
This is my favourite pose, as it feels expansive and exuberant. It is strengthening as well as good for hip flexibility. It is best to try this pose against a wall to start with because the balance is not easy.
-Place one foot alongside the wall.
-Slowly start balancing on that foot, keeping the back long.
-Rotate the body to the side so it is facing forward.
-The length of the spine and feeling of ease in the back is more important than the final pose. Whether you reach the final pose or not, keep the head, spine and leg in line.
-Feel the length of your body, as if the head is attracted one way and the foot the other way.
-Try the other side and alternate a few times.