Osteoporosis Canada

Yoga and Osteoporosis: Suggestions for Safe and Appropriate Practice – Part 2

Yoga has many benefits to mind, body and spirit. But for someone with osteoporosis or at risk of a broken bone, there are some movements that should be modified or avoided.

You should modify any postures or movements that:

  • make you bend your spine forward, backward or twist as far as you can (example: rag doll)
  • are done in sitting (example: seated twists)
  • force your hip into full rotation (example: pigeon)
  • are repetitive (doing a movement over and over – example: rolling like a ball)
  • rapid (moving quickly – example: jumping your feet to your hands from downward facing dog)
  • weighted (holding a weight or something heavy while you do the movement – example: Russian twist with a dumbbell)
  • any of the above in combination (e.g., repetitively bending forward as far as you can)

Sometimes it is not the end position that is the problem, it is how you get in and out of the position. For example, downward facing dog encourages a straight back and is a safe posture to do with osteoporosis – but, it is dangerous for your spine to get out of the posture by jumping your feet to your hands and rolling up through your spine.

A better way to transition out of downward facing dog is to drop to your knees. Come into standing by bringing one foot forward into a kneeling position and push up into standing, keeping your back tall and straight. If that is difficult or your balance is wobbly, then do it next to a wall or very sturdy chair. Downward facing dog is best done with a qualified yoga instructor to make sure it is done correctly.

You need to modify these movements because they put a lot of pressure on your spine and hip bones in ways that increase your risk of breaking a bone. Since osteoporosis already makes your bones more likely to break, you should try to decrease any other factors that could cause them to break. Modifying the movements listed above may help decrease your risk for a broken bone when practising yoga.

Here are some suggestions for yoga postures to continue to do, to avoid and to modify. This is not an exhaustive list but will help give you an idea of what you might need to start or stop doing. If you are uncertain, contact a physiotherapist for advice.

Wide angle shot of young mixed race female doing home workout or yoga from home, following an online workout on computer or online.

Yoga postures you can continue to do with proper instruction and guidance

  • Corpse
  • Bridge
  • Warrior
  • Mountain
  • Chair
  • Crocodile
  • Sphinx
  • Locust

Yoga postures you should avoid:

  • Spinal rocking
  • Rag doll
  • Saw
  • Plow
  • Pigeon

Yoga postures you should continue to do with proper guidance, instruction AND modifications:

  • Twists – don’t go as far as you can, do them lying down instead of sitting: in a knees-down twist lying on your back, rest your knees on a nearby wall or folded blanket so you don’t go too far
  • Child’s Pose – put a yoga block under your head or place your forehead on stacked fists to avoid a rounded back
  • Thread the needle – do it lying on your back, keep your head down on the ground to avoid a rounded back

What about props? Props should only be used when they help you make the posture safer or more aligned but shouldn’t be used to help push you further or deeper into a position. For example, you could use a sturdy chair to help you do a modified downward facing dog, but you shouldn’t use a yoga strap to help pull you further into a forward bend.

Chair yoga may be appropriate in some situations but could increase the risk for spine fracture if not done carefully. If you are very unsteady on your feet or are unable to get down to the ground, then chair yoga could be an option. However, you must be very cautious about alignment since all the yoga postures in chair yoga will be done in a seated position. Sitting puts a lot of pressure through the bones in the back, increasing the risk for a broken bone. Sitting and bending or twisting increases the risk even more. If you are doing chair yoga, you should be especially careful to modify bending or twisting the spine and focus more on postures that encourage a straight or lengthened spine. Standing or lying down are better positions to be in if they are safe for you. Hot yoga can cause people to overstretch into unsafe positions and should be avoided for people with osteoporosis.

With the guidance of an exercise professional who is trained to work with people with osteoporosis, yoga can be safe, beneficial and enjoyable. Remember to seek out a yoga instructor that has training to help you make modifications and a class that is appropriate for you, and to practise at your own level.

For more information on exercise for strong and healthy bones click here.

Dr. Caitlin McArthur
Written By

By Dr. Caitlin McArthur

Registered Physiotherapist, PhD

As featured in COPN’s Unbreakable Issue 14

Tai Chi: Fall Prevention and Bone Health

Shayla Mueller and Veronique Murphy

What is Tai Chi?

Tai Chi is a type of exercise that originally began as a martial art in China hundreds of years ago. It is sometimes described as “meditation in motion” as it engages both the mind and the body. Practising Tai Chi involves using slow, controlled body movements while focusing on breathing. These slow movements increase self-awareness, allowing you to be in complete control of your body. Each movement is held in a specific position for a brief moment before changing to a new position. The transitions involve different movements such as shifting weight from one leg to another, rotating the neck, torso, arms and legs, and stepping in different directions.

Tai Chi focuses on coordination and flexibility, helping to improve your ability to move and complete life’s daily activities. There are many different types of Tai Chi, each with a different pace and style of movement.

Why Should I Consider Tai Chi?

Tai Chi has many positive health benefits including improvements in muscle strength, flexibility and balance. It is a full body exercise that is considered to be equivalent to low or moderate intensity aerobic exercise. This means that you may be able to talk while doing it but not sing a song.

Tai Chi is a popular form of exercise, particularly among older people. It has many advantages, including being an easily accessible, affordable activity available in many communities. No special clothing or equipment is required. It is often practised in groups, providing an opportunity to socialize and meet new people.

Most importantly, research has found Tai Chi to be a safe form of exercise for people with low bone density.

Tai Chi and Fall Prevention

Reducing fall risk is an important way to reduce your risk of fractures. A recent review of studies found Tai Chi to be effective for fall prevention short-term in older adults. In fact, it can reduce the rate of falls by almost 50% during the first year that people are practising Tai Chi. Research has also shown that Tai Chi may improve balance, which is an important part of reducing the risk of falling. People who practise Tai Chi regularly do better on balance tests and their bodies sway less when they are standing. The slow, shifting movements of Tai Chi activate the leg muscles, improving a person’s strength and ability to respond if they become off balance. Many of these studies show benefits after 12 weeks of training. Tai Chi can also help people improve their mobility. Many of the Tai Chi movements copy the movements used in walking, such as shifting weight from one leg to the other and stepping in different directions. Performing these movements slowly and repeatedly allows the brain to adapt and create new connections that can lead to improved walking. This allows people to build confidence in their walking and be less afraid of falling.     

Effect of Tai Chi on Bone Density

The effects of Tai Chi on bone density have also been studied. A recent review found that regular participation in Tai Chi (45-90 minute sessions between 2 and 7 times a week) for at least 24 weeks may be an effective way to slow the reduction in bone density that is seen in perimenopausal and postmenopausal women, as well as in individuals with osteoporosis. However, more research is required to confirm the results and to determine the amount of exercise and frequency of training necessary to provide benefit.

If you are practising Tai Chi or thinking about taking it up, we know that it:

  • Is safe for people with low bone density,

  • Reduces the rate of falls,

  • Is a whole body and mind exercise that challenges balance,

  • Focuses on coordination and flexibility, helping you perform activities of daily living,

  • Is a group activity, and

  • Is easily available and affordable.

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