Our bones are adaptable tissue that is constantly being created and reabsorbed. The terms Osteopenia & Osteoporosis are derived from the Greek language.
Osteo = Bone
Porosis= Porous
Penia = Poverty
Osteoblasts=build bone
Osteoclasts =destroy bone
Did you know that 54 million people in the U.S. over the age of 50 have Osteopenia or Osteoporosis? Osteoporosis is a significant loss of bone mineral density. A consequential weakening of bones leaves bones vulnerable and more likely to fracture. Osteopenia is loss of bone mineral density to a lesser degree. Osteopenia is a condition where the bone density is below normal but not low enough to be categorized as Osteoporosis.
Our bone density peaks around the age of 30 then in our mid-thirties our bones begin to decline. There are 300 hundred thousand hip fractures every year in the U.S. (Statistic from American Academy of Orthopedic surgeons) Unfortunately women are four times more likely than males to have these conditions. Skeletal weakness leads to fractures particularly in the thoracic and lumbar spine, wrist, and hip (called fragility fractures). This can begin an arduous cycle that keeps a demoralizing cloud over your golden years.
CONTRIBUTING FACTOR:
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Genetics
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For women decreased estrogen
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For men decreased testosterone (after 70)
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A sedentary lifestyle
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Poor diet malnutrition (such as Celiac disease, absorption issues & eating disorders)
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Low levels of Calcium and/or Vitamin D
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Protein Hyperthyroidism
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Overactive Parathyroid & Adrenal Gland
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Smoking affects the body’s ability to absorb calcium, leading to lower bone density and weaker bones. Nicotine slows the production of the bone-forming cells that are so crucial to healing.
Medications that are prescribed for one condition, unfortunately, can impact bone health:
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SSRI antidepressants (serotonin receptors found in all bone cells)
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Treatments for Breast Cancer block estrogen
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Some treatments for Prostate Cancer block testosterone
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Glucocorticoids (Steroids)
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PPI (Proton Pump Inhibitors)
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Antiepileptic Meds Loop Diuretics (depletes calcium stores)
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Anticoagulants (low vitamin K)
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Chemotherapy drugs for cancer
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Cyclosporine and tacrolimus used for rejection of organ transplants
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Heparin used for preventing blood clots
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Thiazolidinediones such as pioglitazone Rosiglitazone used for diabetes
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Loop diuretics such as furosemide
We are all so busy with our hectic lives that we tend to put off health issues until they disrupt our daily life. Yet, if you add
a few yoga poses daily, it will make a difference in how gracefully you age.
GORAKSHA SATAKAM
Goraksha Satakam is yogic scripture composed in 100 verses by the Rishi (Seer) Goraksha, who lived about fifteen hundred years ago. He taught the ideal of samaradhya, or the “sweetest and most perfect adjustment and harmony in one’s life experience.” Goraksha comes close to the Vedic ideal by emphasizing complete control of the physical body and mental steadiness as the preparation to evolving to nonduality enlightenment on the highest spiritual plane. He is the seer who said there are 8.4 million asanas therefore there are ideal postures for every single type of human in every stage of their unique journey. .It is also said that the architects of yoga noticed how strong and sturdy the ankles were yet they were not very flexible, then they observed wrist mobility, yet they were not designed for weight bearing. Those two observations were their motivation for creating yogic postures that contribute to ankle flexibility and “ wrist work” that solidifies wrist strength.Yoga asana is amazingly adaptable for any age or level of physical ability. Yoga (under proper instruction) improves our posture and body awareness which is a major tool for improving BMD (Bone Mineral Density) and reducing the probability of accidental falls.
THE HEART & BONES OF THE MATTER
I often say yoga is BOGO for your bones. Yoga genuinely offers us thoughtful opportunities for weight-bearing, plus working against gravity stimulates osteoblasts. Keep in mind that Osteopenia-Osteoporosis are spectrums. Many articles on yoga for bone health tend to list out 8-12 poses. Your effort will produce better results if you don’t settle into a redundant routine. Choices of yoga postures should include consideration of your physical ability and history. Repetitive movements (from years of a specific sport or career) does contribute to physical issues, therefore a modification of a traditional yoga posture or a hybrid of 2 posture may be necessary.
In general weight-bearing for healthy bones requires (holding/weight-bearing) yogic posture for 20 seconds. When starting or changing anything with the body, I do insist on a gradual progression. It is the most intelligent approach, respects the body, and is always the best choice. When working with a new patient at Re3 wellness (especially if they had led a sedentary lifestyle.)
I set the room up for maximum safety, teach via yogic formulas, taking learning style into consideration, and then we are all set to apply weight-bearing. At first, we weight bear for a brief amount then gradually build up to a full 20 seconds if that becomes light and easy then weight bear for 30 seconds.
OSTEO TO DO’s:
DO have a good idea of appropriate modifications for posture that are not healthy for your condition. (There are safe modifications for every single yoga posture to include modified down dogs.)
DO start modifying postures to keep the spine neutral, avoiding extension, flexion, and compression.
DO avoid deep forward bends and deep backbends.
DO keep feet hip-distance apart, not the traditional feet together at the front of the mat.
DO avoid tricks from Vinyasa-style practices such as jumps, hops, and skips.
DO omit all quick directional changes or transitions.
DO avoid “ coiling up or abdominal style crunching like positions” there are so many more constructive options.
DO avoid “roll-ups.” It’s common in some yoga classes to “roll-up” to stand. Again there are many other options.
IF DIAGNOSED WITH OSTEOPOROSIS:
DO set yourself up for successful balancing on one leg by avoiding thick, fluffy, suede, cork, or spongy yoga mats. (8mm or 6 mm can be difficult for some to balance on, test mats out but keep in mind that the 4mm mat thickness is the most versatile) I have also had students set up two yoga mat stations (two yoga mats side by side). One mat is a thick mat for seated postures than a thinner mat for safety, grip, and balance.
DO avoid Sirsasana and Sarvangasana- modify by opting for supported legs up supported on a wall (Virparita Karani)
DO try very mild side bends. It is possible to do it safely but should be approached gently.
DO try Supine twists which are safe for most but it really depends on the specific patient’s state with their condition.
DO believe that it’s never too late to add a new approach to your life.
DO all things with love including taking care of your beautiful bones & body that have always been doing their very best on your behalf.
ABSOLUTELY DO Find a teacher familiar with the condition who offers a variety of modified yoga postures, multiple ways to enter and exit each postures,and avoids too much redundancy by teaching a healthy variety of variations. Even backward chaining familiar postures will contribute not only to bone health but add amazing, shimmering shine for developing neuroplasticity in your golden years.
RESEARCH LINK AND ADDITIONAL RESOURCES
Studies focuses on yoga for healthy aging
National survey of yoga practitioners: mental and physical health benefits.
Ross A, Friedmann E, Bevans M, Thomas S.
Complement Ther Med. 2013 Aug;21(4):313-23.
Effects of yoga on mental and physical health: a short summary of reviews.
Büssing A, Michalsen A, Khalsa SB, Telles S, Sherman KJ.
Evid Based Complement Alternat Med. 2012;2012:165410.
Frequency of yoga practice predicts health: results of a national survey of yoga practitioners.
Ross A, Friedmann E, Bevans M, Thomas S.
Evid Based Complement Alternat Med. 2012;2012:983258.
Resources:
National Institutes of Health Osteoporosis and Related Bone Diseases National Resource Center 800-624-2663 (toll-free) 202-466-4315 (TTY) NIHBoneInfo@mail.nih.gov www.bones.nih.gov National Osteoporosis Foundation 800-231-4222 (toll-free)
Additional reading and references
References:
Healthwise Staff. (2019). Low Bone Density. Michigan Medicine, University of Michigan. https://www.uofmhealth.org/health-library/tp23004spec#:~:text=All%20people%20begin%20losing%20bone,low%20bone%20density%20or%20osteoporosis.
Lu, Y. H., Rosner, B., Chang, G., & Fishman, L. M. (2016). Twelve-minute daily yoga regimen reverses osteoporotic bone loss. Topics in geriatric rehabilitation, 32(2), 81.
Harvard Health. (2020). Yoga: Another way to prevent osteoporosis?. Harvard Health Publishing, Harvard Medical School. https://www.health.harvard.edu/womens-health/yoga-another-way-to-prevent-osteoporosis]
Yoga International (2020). New Research on Yoga and Bone Health. Yoga International. https://yogainternational.com/article/view/new-research-on-yoga-and-bone-health