Osteopenia, Osteoporosis and Yoga September 23, 2016 by Jennilee Toner https://www.ekhartyoga.com/articles/osteopenia-osteoporosis-and-yoga

What happens if you’ve been diagnosed with a bone density loss condition? How can you continue to enjoy the benefits of yoga while taking extra care of your bones?

Hatha yoga – the physical branch of yoga – strengthens, stretches and supports all the systems of the physical body, it calms and clears the mind of unnecessary chatter, and can remove blockages from energetic pathways so that life force can flow with ease.

You’re probably familiar with at least some of these benefits of yoga but what if you have been diagnosed with a bone density loss condition like osteopenia or osteoporosis? Is yoga still beneficial for YOU and your bones? If so, which postures and practices will be beneficial, and which should you approach with more awareness and caution than before? And are there ways that Hatha yoga can help us to prevent or live with the condition?

Osteoporosis: A bone density condition that occurs when bones become weak, brittle and porous.

Osteopenia: A bone density condition that occurs when the body doesn’t make new bone as quickly as it reabsorbs old bone. In Osteopenia, bone density is lower than normal peak density but not low enough to be considered Osteoporosis.

Bone growth, modelling and remodeling
There are 206 bones in the human body (not including the minute bones of the ear). The shapes of our bones are long, short, irregular and flat. Bones grow, model and remodel throughout our lifetimes.
*Growth occurs during childhood and adolescence. In long, short and irregular bones the cartilage is replaced by bone tissue. In flat bones, thin “sheet-like” connective tissues are replaced with bone tissue.
*Modelling is when bones change shape (mostly during adolescence) due to mechanical stressors placed upon them.
*Remodeling is the process of bone breakdown, reabsorption and renewal.

In people diagnosed with osteopenia and osteoporosis there is increased activity of the breakdown cells (osteoclasts) but decreased activity of the bone rebuilding cells (osteoblasts). This low bone turnover (more breakdown then rebuild) leads to low bone density and bone strength, increasing the risk of micro-fractures and fractures.
Osteoblasts: Type of bone that mineralizes and forms bone tissue. Osteoclasts: Type of bone cell that breaks down bone tissue.
Osteocytes: Type of bone cell that regulates the jobs of the osteoblasts and the osteoclasts.

Strengthening your bones with yoga
There are no symptoms for bone density loss conditions such as osteoporosis and osteopenia. Most people only discover they have the condition after their first fracture and have a bone density test. Losing bone is a normal part of ageing so therefore we need to take care of our bones from an early age through exercise and a healthy diet with plenty of calcium and Vitamin D from the sun. Certain groups are more at risk of developing osteoporosis. Always speak to your doctor if you have any concerns about your health.

Bones are living tissue and they respond to mechanical stressors. Weight bearing exercises, including yoga, help tremendously in the remodeling process of our bones. They encourage more bone growth increasing the rate of HEALTHY bone turnover and so are vitally important to practice especially when we are younger.

Holding up one’s body weight in standing postures such as Warrior 1 or 2, balancing postures such as Tree and Dancer, and in horizontal postures such as Plank helps maintain the balance between bones breaking down and bones rebuilding.

Looking after your spine – forward bends and twists
Many spinal fractures are due to poor alignment (poor posture). Because our thoracic spine is already in a convex (kyphotic) curve, we instinctively tend to hunch over a bit. With the over-conditioning of sitting many people have tight, locked-short chest muscles (pectoralis major and minor) and tight, locked-long upper back muscles (rhomboids, mid and lower trapezius) which can take the already kyphotic curve of the thoracic spine and make it dramatically more pronounced, potentially resulting in the syndrome of Kyphosis – a hunchbacked condition also known as Dowager’s Hump. Yoga can help to maintain the spine’s natural curves, read Fountain of youth found in yogi’s spine.

hatha-for-beginners---square

If you are diagnosed with osteopenia or osteoporosis the likelihood of spinal bone fractures is increased. One family of postures contraindicated for those with osteopenia and osteoporosis are forward bends – for fear of fractures on the anterior (front) portion of the vertebral bodies (irregular bones of the spine).

In order to continue to practice many of the forward bend postures such as Uttanasana (standing forward bend) and Prasarita Padottanasana (standing wide legged forward fold) it is important to bend the knees and tilt from the pelvis – rather than bending at the thoracic spine. It can help to place the hands on blocks so that the spine stays long and there is no extra pressure on the front of the vertebrae.

Other contradictions for those diagnosed with osteopenia or osteoporosis are some spinal twisting poses…especially ones where there is a possibility of a rounded spine occurring in order to get into the twist. It is always wise to remember that Parivrtta (the Sanskrit word that precedes most twisting poses) means REVOLVE and not twist.

Always inhale and lengthen your spine before allowing the hips, ribs, shoulders and skull to revolve slightly around it. When bone density has lessened and the possibility of fractures has increased, it is wise to not do any twisting postures that may require you to round forward to perform the twist. Again, use blocks to prop yourself in such a way to keep the spine lengthened. For example sitting up on a block to raise the hips in seated twists.

Looking after your hips – strong and steady
Many hip fractures that happen in the aging population occur during falls – often due to an inability to balance and/or vision impairment. Those who are diagnosed with osteopenia or osteoporosis have weaker, less dense and porous bones. Falling on these weakened bones increases the risk of bone fractures especially in the hips, ankles and wrists.

improve-your-balance-yoga

In order to help prevent falls from occurring it is important to strengthen our ability to balance. I tell all my students when they are wobbling while in balancing postures such as Tree or Extended Hand to Big Toe: “Your bones, your bone-connecting tissues (ligaments) and the muscles that surround them are getting stronger…Right Now.”

Practice these poses regularly to build stronger bones and also to prevent the risk of fractures due to falls as you get older.

If you already have been diagnosed with bone density loss it is good to be by a wall or use a chair for many of these balancing poses.

The takeaway message:
To build strong bones and promote healthy bone turnover, practice weight-bearing yoga poses like the Warriors and Plank pose. To minimize the risk of falls (and fractures) as you get older, work on your balance with Tree pose, Dancer’s pose and any other one-legged balances.

If you have already been diagnosed with osteoporosis or osteopenia take extra care of your spine by using props to keep your spine long in forward bends (bending from the pelvis, not thoracic spine) and gentle twists.

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