Considering Yoga for Osteoporosis Lori Taft Sours, PhD, CTY August 2014
Many people who are middle-aged and beyond, especially women, have decreased bone density, which leads to osteopenia or further into osteoporosis. This condition may have many causes, including genetic propensity, hormonal factors, poor nutrition for bone health, and lack of exercise. Regardless of the cause, the result is the same: an increased risk of bone fracture due to the weakened state of the bones. The typical spots for diagnosing osteopenia and osteoporosis include the forearm, hips, and lumbar spine. Once osteoporosis is present, medication is often recommended. However, it might be possible to both prevent the onset of osteopenia and reduce the progression of osteopenia into osteoporosis by regular exercise.
It is often assumed that the only or best exercises to prevent osteoporosis are weight-bearing exercises such as walking and weight training. However, in Yoga for Osteoporosis, Loren Fishman and Ellen Saltonstall make the case that yoga is also effective in strengthening bones. They cite a physiological principle known as Wolff’s Law, which states that “the architectural strength of a bone develops along the lines of force to which the bone is subjected.”[1] They note that one of the forces that affect bone strength is dynamic tension, “which occurs when one muscle or muscle group opposes the action of another.”[2] The forces created through this muscular activity are greater than gravity, and stimulate greater bone strengthening than weight-bearing exercise alone. The muscle movements which produce dynamic tension are exactly the muscle activities present in most yoga postures. Fishman and Saltonstall also note that the duration of the pressure is important, and that if the pressure lasts at least eight seconds, the physiological bone-strengthening processes begin. Since most yoga postures should or could be held longer than eight seconds, (unlike the constant movement found in most other sports), “through yoga practice, the bone has the stimulus duration required to promote the processes of strengthening.” [3] Thus it appears that an asana practice in which one holds asanas for more than eight seconds might be an ideal practice for strengthening bones, or at least slowing their process of thinning.
Fishman and Saltonstall describe a study they conducted in which three groups of subjects (one with osteoporosis, one with osteopenia, and one control group) were taught ten yoga poses that strengthen the parts of the body most vulnerable to fracture when the bone density is low: lumbar spine, thoracic spine, hip, and thigh. At the time of writing their book, the study was still in progress, but the results were already showing that the subjects who had been doing these yoga poses for two years had shown statistically significant rise in their bone density for the spine and the hip.[4] In addition, yoga can help in osteoporosis by developing the ability to balance with strength (thus preventing falls) and to catch oneself when one starts to fall. Dr. Andrew Weil notes that we can protect ourselves from falls by “attending to [y]our body’s capacity to compensate quickly for sudden twists, bumps, and skids.”[5] Several studies have looked at the effectiveness of a yoga practice (including both postures and breathing) in increasing balance and/or reducing fear of falling in older adults. Schmid et al[6] note that fear of falling (FoF) is common among frail older people, and that in fact, it is one of the greatest fears experienced by the elderly. There is a vicious cycle in which fear of falling leads to decreased activity, which leads to decreases in strength and balance, which places a person at greater risk of falling. They conducted a pilot study to explore whether balance and fear of falling could be improved with a 12-week yoga “intervention.” They concluded that “yoga may be a promising intervention to manage FoF and improve balance, thereby reducing fall risk for older adults.” [7]
So both physiologically for osteoporosis prevention and treatment, and in terms of quality of life for osteoporosis patients, yoga can be an invaluable (as well as safe) tool. Tüzün, Ş et al, in their study looking at yoga as an alternative training for quality of life and balance in women with osteoporosis, note, “The efficacy of yoga in the rehabilitation of post-menopausal osteoporosis has been shown in several studies…..the maintaining of emotional stability, improvement in posture, balance, and coordination and increasing in body flexibility are major effects of yoga in postmenopausal osteoporosis.”[8]
Fishman and Saltonstall sum up these considerations as follows: “Yoga builds muscle strength and joint flexibility and improves balance and posture, all while promoting calm, considered response to life’s challenges.”[9]
Notes:
[1] Fishman, M.D., Loren, and Ellen Saltonstall. Yoga for Osteoporosis. New York: W.W. Norton & Co., 2010. Print, p. 56.
[5] Weil, M.D., Andrew. Healthy Aging. New York: Alfred A. Knopf, 2005. Print. P.189.
[6] Schmid, A A., M Van Puymbroeck, and D M. Koceja. "Effect of a 12-week yoga intervention on fear of falling and balance in older adults: a pilot study." Arch Phys Med Rehabil 1.4 (2010): 576-83. Ebscohost. Web. 25 Mar. 2014.
[8] Tuzun, S, I Aktas, U Akarirmak, S Sipahi, and F Tuzun. "Yoga might be an alternative training for the quality of life and balance in postmenopausal osteoporosis." Eur J Phys Rehabil Med 46.1 (2010): 69-72. Ebscohost. Web. 25 Mar. 2014. P. 71.