My Yoga – Osteoporosis & Osteopenia

From a few conversations I’ve had recently, I thought it might be helpful to share some info on Osteoporosis & Osteopenia, if indeed you have either of the above or perhaps know someone who has.

Before reading on, always ensure you seek guidance from a medical professional to discuss your condition before participating in any form of exercise and that they are happy for you to do so. Your wellbeing and safety is of paramount importance and very much about your own self-care.  

So, lets dive in.  In brief the following conditions are defined below.

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

Osteopenia or “bone poverty”: 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. It precedes but does not always lead to osteoporosis.

While lower bone density means greater risk of fractures (most commonly in the spine, hip, and wrist), more fractures occur in those with osteopenia rather than those with osteoporosis due to the fact that a greater number of people actually have osteopenia.

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. 

Many of the population with low bone density are actually women.  Women are 4 times more likely to develop osteoporosis than men due to the drop in estrogen at the time of menopause leading to a more rapid and significant loss of bone mass. Some medications and other conditions can also contribute to osteoporosis.

Generally speaking, a regular yoga practice can improve overall strength, flexibility, mobility, balance, coordination, endurance, muscle mass, agility, and energy levels for us all. 

When practicing yoga with osteoporosis here’s some top tips to ensure you get the most from your practice.

Top tips to get the most out of your practice

Looking after your Spine – Forward Bends/Folds and Twists

• • Forward Bends/Folds – Limit significantly the range of these postures by placing hands on blocks or resting hands on the knees/thighs, bending the knees, so the spine stays long, limiting any extra pressure on the front of the vertebrae in the spine and any rounding of the back.

    Skip Uttanasana (standing forward fold) in favour of Ardha Uttanasana (half standing forward fold). In this “flat-back pose,” you might bring the hands to blocks, the seat of a chair, or to a wall, in order to maintain your optimal spinal shape. Choose upright seated poses like staff pose over forward folds.

    To stretch the hamstrings, instead of going deeper into a forward fold, practice lying down hand to big toe with a strap around the foot of the lifted leg. In all of these poses, focus both on keeping the spine in its neutral position and on lengthening. 

  • Twists – Avoid any deep twisting. Keep twists to a few degrees with a neutral spine. Avoid rounding of the shoulders.  Lengthening through the spine creates space between the vertebrae.
    
    
  • Mild side bends and twists – When side bending, go only as far as you can without collapsing the waist on the side to which you are bending. When twisting, go only as far as you can while maintaining a gentle inward curve in the lower back.
    
    
  •  Poses that encourage the hands to bear weight – One of the advantages of yoga over other exercises is that bearing weight on the hands allows us to build bone density in the arms as well as the legs.  That said its very important there is no rounding of the upper back.
    
    Examples of poses are: Tabletop, plank, forearm plank, chaturanga, reverse tabletop, and downward facing dog.
    
    
  • Gentle backbends. Because osteoporosis is so often accompanied by thoracic rounding, it’s especially important to work on gentle backbends, which move the thoracic spine in and lift the chest, improving thoracic spine extension.  While some gentle back bending as mentioned above, is fine for students with osteoporosis, big backbends like upward facing dog, wheel, bow, and camel pose with hands on the heels, can be very compressive.

    Examples of Gentle backbends: Bridge, sphinx, baby cobra, camel pose (with hands on your lower back

  • Move from pose to pose slowly – To decrease the risk of falling, it’s important that students with osteoporosis move from pose to pose slowly.
    
    
  • Challenge balance without sacrificing stability – Because a fall could mean a fracture for students with osteoporosis, it’s vital to work on balance in our yoga class. But, to avoid a fall, they should initially challenge their balance while making the most of the support available to them. Use walls, blocks, chairs etc. Having one foot on the ground or lower to the ground to maintain balance.
    
    
  • Crunches or sit-ups – While core strength is important to support the lower back, these poses require loaded lumbar flexion, placing a high demand on the lower back as you work to lift the weight of the upper body

    Instead: Work on core stability in all neutral spine poses by drawing the belly in and up on the exhale. From a lying down position, work the core by lifting and lowering the legs rather than the upper body, keeping the spine in its neutral position.

  • Inversions – Avoid any shoulder stands or intensive poses such as head stand.

Useful Links:

See the link below regarding information on a food rich in Calcium and Vitamin D

https://www.nhs.uk/live-well/healthy-body/food-for-strong-bones/