2 out of 3 people over 50 experience osteopaenia or osteoporosis. Osteoporosis is the loss of bone density (a deterioration of the microarchitecture of bones) and quantity. Both loss of quantity and quality of bone increase the risk of fracture.
Do you want to stay physically active into old age? Changes start around 30-40 and accelerate after 50 years old. Start your prevention regime now and slow down bone loss.
How does exercise increase bone strength?
The structural support of bone follows the lines of force to which that bone is exposed. When bone cells get stimulated by being compressed, twisted, or elongated, they produce more bone mass until that bone gets strong enough to resist the pressure. At that point, the pressure no longer distorts the bone, and the bone-making cells stop making more. What a wonderful feedback system.
In osteoporosis, the bones bend more, so the pressure is more effective in stimulating the cells to make more bone.
Like weight training, yoga works by stressing the bone. Yoga stimulates the bone with contraction at almost every conceivable angle for long periods of time.
What is often overlooked in modern weight-training exercises, and when evaluating the effects of osteoporosis drugs, is there is a difference between structure and density. Dexa scans will get a measurement of density, but they tell us nothing about the structure of the bone.
Dense bone mass on its own doesn’t necessarily provide protection against fractures; unless the bone fibres are laid down in an alignment to provide greater strength, the bone mass will not be very stable. Bone, when put together, creates a well-organised, completely integrated structure that can sustain huge amounts of weight—because of the strength created by the structural interconnections.
Density and structure both matter for bone health.
We don’t have convenient ways to measure the structure of bones as of yet. We do have ways to measure the density. Osteoporosis drugs reduce the risk of fractures considerably, but the functional limitations of simply building bone mass without proper structure and strength are not addressed.
Yoga helps build bone mass because yoga poses pull and stretch the bones from every conceivable angle.
It may also stimulate the formation of a bone structure that can withstand greater pressure and various types of challenges.
Many people think twists are contraindicated for people with osteoporosis:
Researchers have found that twists are very beneficial and carry little if any risk. Twists give such a symmetrical pressure to the vertebral body that it’s not a fracture risk. And even though doctors caution their patients with osteoporosis never to do any twisting, there seems to be no actual evidence that twists are bad in and of themselves.
Of course, if you’re twisting and lifting something at the same time, it’s a different story. However, yoga twists provide symmetrical pressure. “Gentle, supported twists are safe to do as part of one’s yoga practice”. Twists are very important exercises for osteoporosis because they give a complete stimulus to the vertebral body.
If you have certain other spine conditions, like a herniated disk, twists can be a problem. If all you have is osteoporosis, there’s almost no way of developing strength and stimulating bone growth than exposing that vertebra to pressure. We do have to avoid forward bends in people with osteoporosis, and the side bends they can do are limited. So twisting the vertebra is one of the few ways to get all of the vertebrae under some compression and stimulate bone growth in the vertebrae. This is extremely important because so many osteoporosis fractures happen in the vertebrae.
The key to reaping the benefits of yoga for osteoporosis is to ensure the postures are performed with proper alignment.
Every joint in the body and every part of the body has an optimal alignment. There are several yoga styles that emphasise precise alignment. If the joints are aligned properly, not only do you get the best stimulus of the bones, but you have much better balance, too.
Interview with Dr. Fishman M.D. and an Iyengar-trained yoga teacher, and the managing partner of Manhattan Physical Medicine and Rehabilitation state; “Over the last 10 years, we have given yoga practices, including twists, to many people, generally over the age of 65, almost all of whom have had significant osteoporosis. This has been well over 30,000 hours of yoga. There hasn’t been a single incidence of fracture. In fact, nothing bad has happened. We haven’t had one thing go wrong. This is something that both yoga teachers and yoga practitioners should know”.
What are the risk factors for osteoporosis?
- Family history
- Low intake of Calcium or Vitamin D deficiency
- Broken a bone? If from a minor bump or fall it should be investigated if you are 50 years +
- Low hormone levels – early menopause in women or low testosterone in men
- Coeliac disease or inflammatory bowel disease and other malabsorption disorders
- Diabetes
- Certain breast cancer or prostrate cancer treatments
- Corticosteroids – commonly used for asthma, rheumatoid arthritis or other inflammatory conditions
- Thyroid conditions – overactive thyroid or parathyroid
- Rheumatoid arthritis
- Chronic liver or kidney disease
- Certain epilepsy, antidepressant or HIV treatment
Lifestyle factors
- Low levels of physical activity
- Smoking
- Excessive alcohol intake
Body build and weight
- A thin body build can increase your risk
- Obesity studies suggest hormone changes associated with obesity can impact bones
(from Healthy Bones Australia)
Ayurveda (lifestyle sister science of yoga) and Osteoporosis:
- Exercise
- Calcium intake – whole foods eg dairy, leafy greens, nuts, beans, fish (salmon and sardines)
- Vit D – 800iud/day
- Stress impacts bone density. Pacify the nervous system.
Osteoporosis is an excess of the element of “air” in the bones, this is a Vata quality (dosha). To counteract the airy quality of this aspect, warming, cooked, nourishing foods that comfort the nervous system are recommended.
Olation – oil on the skin is absorbed, and can be warming and nourishing, and calm the nervous system. Creating a peaceful, serene, grounded quality in the body and mind counteracts stress and benefits bone health.
This links in with Western medicine’s increasing understanding of the HPA axis (hypothalamus, pituitary, adrenal) – more to come on this topic in later blogs.
Nothing in this article should be construed as medical advice. Osteoporosis is a serious condition; always consult a doctor about any medical concerns before starting any exercise regimen.
