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Yoga and Osteoporosis: Suggestions for Safe and Appropriate Practice – Part 1

One of the most common questions I get from people with a new diagnosis of osteoporosis is can I do yoga? Yoga is defined as “a system of physical postures, breathing techniques, and sometimes meditation derived from yoga but often practised independently especially in Western cultures to promote physical and emotional well-being.” While yoga has many benefits to mind, body and spirit, there are some postures that might not be safe for people with osteoporosis.

Some people may be worried about the yoga practice they have been doing for many years, while others may be wondering about starting yoga to become more active. Below you will find general guidelines for people thinking about starting yoga and those who have some experience, including what to look for in a yoga class and instructor.

THE RISKS AND BENEFITS OF YOGA FOR PEOPLE WITH OSTEOPOROSIS

Like all activities, there are risks and benefits of practising yoga. One risk of yoga can be to experience a fracture.

A fracture could happen when you are doing movements that could pose a risk such as the seated twist and pigeon pose, or if you were to fall. There have been case reports of people with osteoporosis experiencing fractures during yoga. On the other hand, yoga may benefit your quality of life and has been shown to improve balance for people with osteoporosis. However, there is not enough good evidence to say that yoga improves bone mineral density. Based on your own health and abilities, you need to decide if practising yoga is right for you. If you decide yoga is right for you, you also need to be sure to modify riskier positions.

OVERALL PRINCIPLES FOR A SAFE YOGA PRACTICE WITH OSTEOPOROSIS

Tip 1: Consult a physiotherapist if you are new to yoga, have a history of spine fractures, or you are feeling uncertain about what to do. It is especially important to find a physiotherapist who has training for working with people with osteoporosis. Bone Fit™ is a training program for exercise professionals, like physiotherapists, who work with people with osteoporosis. You can find a Bone Fit™ trained physiotherapist using the Bone Fit™ locator by visiting the website.

Tip 2: Seek out a yoga class designed for people with osteoporosis and other health conditions (e.g., osteoarthritis) and ensure your instructor has proper training for working with this population. Yoga instructors can also become Bone Fit™ trained and you can check the locator here. You should also make sure your yoga instructor is certified. Certified instructors are listed on registries such as Yoga Alliance.

Tip 3: Make sure your yoga instructor knows you have osteoporosis so they can give you the appropriate modifications throughout the class. If they don’t know, they won’t be able to help you practise safely.

Tip 4: Focus on controlled movements and less on intensity of the postures. Yoga is not about competition between you and the person on the mat beside you, so work at your own level and pace. Injuries can occur when you try to force yourself into extreme positions.

HERE ARE SOME THINGS YOU CAN THINK ABOUT THROUGHOUT YOUR YOGA PRACTICE TO HELP KEEP YOU SAFE:

Keep your balance steady: Focus on one point with your eyes and maintain firm contact with a support object (wall, ground, steady chair) with your feet and/or hands.

Keep good alignment: Try to keep your spine as tall, lengthened and as straight as possible throughout each posture and transitions between postures.

For more information on exercise for bone health and managing osteoporosis click here.

WRITTEN BY

Dr. Caitlin McArthur
Registered Physiotherapist, PhD
As featured in COPN’s Unbreakable Issue 13

Tribute to Dr. Timothy Murray 1938-2019

Osteoporosis Canada is saddened to announce the passing of Dr. Timothy M. Murray, founding member of Osteoporosis Canada.

Dr. Murray was the Emeritus Professor of Medicine at the University of Toronto, past Director of the Toronto CaMos Centre and past Director of the Metabolic Bone Clinic at St. Michael’s Hospital, Toronto. He played an active role in the American Society of Bone and Mineral Research and the International Society of Clinical Densitometry. He was awarded the Order of Canada in 2007 for his significant contributions to osteoporosis research and education in Canada.

Without Dr. Murray, Osteoporosis Canada would not be the organization it is today.

Through the 1970’s, Dr. Murray was a physician scientist at St. Michael’s Hospital in Toronto researching fundamental bone science. He started the first Metabolic Bone Clinic in Canada at St. Michael’s Hospital in 1981 bringing together people who were already suffering from the acute pain and deformity of osteoporosis, mostly elderly women. During this time the treatment and care for patients was still undeveloped. Dr. Murray’s team worked to develop the medical procedures and facilities together with patients who were also passionately motivated to support the cause.

These patients were women who were extremely determined despite their burden of pain. They were convinced that through their efforts and initiative they could affect change. They supported the physicians and researchers by drawing public awareness to the ravages of the disease, by raising money for research and by supporting each other. Ultimately, this group of women formed an army of volunteers across the country – strong and committed. Some of the key people were Eleanor Mills and Lindy Fraser.

Volunteers convinced newspaper columnists to take their osteoporosis story to the general public. Before long, eye catching headlines appeared such as Silent Thief will Rob Our Bones of Calcium, Fighting Back: A walk for all of Canada and Wealthy Women Should do More to Support Research. In the latter article, Dr. Murray was asked why osteoporosis had received so little attention. He responded, “It gets overlooked because of ageism and sexism.”  In response the writer worte, “I was startled. Dr. Murray sounds like a conscious scientific type, not the sort given to the lingo of social change.”

During this time, Dr. Murray together with Dr. Joan Harrison and his clinic staff were thinking about how they could maximize their efforts. One morning Dr. Murray boarded the bus on the way to work and got into a conversation with a new neighbor – a lawyer named Michael Slant. When Dr. Murray told him of his involvement in the field of osteoporosis, Mr. Slant said he immediately knew what Dr. Murray was talking about and he expressed interest. Dr. Murray further shared the difficulties of finding funding for research. Mr. Slant immediately said a society was needed.

As a result of the chance meeting between these two gentleman, the process began to form The Osteoporosis Society of Canada. The work to create the society was done in Dr. Murray’s living room and in October 1982 The Osteoporosis Society of Canada ultimately received its charitable status.

Since 1982, Osteoporosis Canada – the current name of the organization, has grown exponentially and made a significant impact in the areas of bone health and osteoporosis largely due to Dr. Murray. Given the groundbreaking work done in Canada, Dr. Murray who also was asked to consult on the formation of an osteoporosis organization in the United States. And before long, similar organizations started appearing in other countries.

Led by the passion and commitment of Dr. Murray, Dr. Joan Harrison and others, Canadians initiated an international movement in osteoporosis. It was a model of which we can all be proud.

The Osteoporosis Canada family extends it heartfelt condolences to Dr. Murray’s wife Joan, their children Peter and Laura; grandchildren Joe and Clara and their entire family.

You can view the obituary for Timothy MacLeod Murray M.D. here
http://www.blairandson.com/book-of-memories/3962035/Murray-MD-Timothy/obituary.php

TRIBUTES

It is with great sadness but with pride and nostalgic remembrance that I write a few words about Dr Timothy Murray (emeritus professor of medicine) who passed away on August 27. He was my mentor and subsequently my professional colleague and friend for over 30 years. He played a pivotal role in endocrinology and metabolism (E&M) in Toronto and indeed in Canada especially in his chosen area in endocrinology of metabolic bone disease and calcium metabolism.

His research ability and expertise was initially developed at the Massachusetts General Hospital where later he was a visiting scientist both there and at the NIH. He developed an early radioimmunoassay for PTH and his laboratory at the University of Toronto focused on studies on PTH action, on intestinal calcium binding protein, on hormone receptor expression and on osteoblast cell function.

At the clinical level, at St Michael’s Hospital (where he was head of the division of E&M) he was involved in clinical drug trials in osteoporosis. He was one of the founding directors (Toronto site) of the Canadian Multicentre Osteoporosis Study (CaMos). In both areas of research (basic and clinical) he was a pioneer in Canada. He had a very productive, noteworthy and illustrious career.

He was also a very accomplished clinician and teacher and developed the first osteoporosis clinic in Canada. He was the founding director of the Bone and Mineral group at the University of Toronto through which a generation of scientists, clinicians and osteoporosis specialists were trained.
He played a leading role in patient advocacy for osteoporosis and together with Dr. Joan Harrison founded the Osteoporosis Society of Canada (now Osteoporosis Canada) in 1981. He was instrumental in seeing it grow and flourish in leadership positions for many years.

He was an exemplar for the younger generation of physicians and scientists to emulate. He had broad interests outside medicine. He was a talented pianist both jazz and classical. He once told me he helped work his way through medical school playing the piano with Grays anatomy on his lap.

He had many friends in Canada and abroad and will be missed but well remembered as a man of integrity, charm and humor who was so accomplished and such a gentleman.

– Robert G. Josse, MD, FRCP, FRCPC, FACP, FACE University of Toronto

Very saddened to hear about the passing of Tim Murray.

Tim was a research “renaissance” man having made very significant contributions to basic science, particularly in the area of parathyroid hormone, and then, equally significant contributions to clinical research, especially in the area of osteoporosis. He was also a fine clinician, a real gentleman, and a passionate musician.

Tim touched many people who are better for having known him and experienced his friendship. His passing has increased the void in the type of clinician scientist he represented.

He will certainly be missed.

– David Goltzman, MD, FRCPC McGill University

Like all of us, I’m very sad to hear the news of Tim’s passing. As Dr. Goltzman points out, Tim excelled as a dedicated scientist, teacher, and clinician, and was an even finer person.

I first met Tim when I was an MRC research fellow working on parathyroid hormone in Chicago, and he has been a mentor and friend ever since I returned to Canada. As the first Chair of the Medical Advisory Board of the Osteoporosis Society of Canada, he invited me to join in 1983. He organized and chaired the Osteoporosis Society of Canada’s first national consensus conference on osteoporosis, and these conferences evolved into the Osteoporosis Canada Guidelines, the 4th iteration of which are now being prepared.

His musical skills were amazing, and one of my great regrets was never getting to hear the Tim Murray Jazz Quintet in concert. At the meeting to initiate the Canadian Multicentre Osteoporosis Study (CaMOS) held at the Banff Centre in the late 1990’s, we did have the opportunity to observe his virtuosity, albeit on an old, slightly out-of-tune piano.

My condolences to his family.

– David A. Hanley, MD, FRCPC University of Calgary

About Tim Murray.

I have been thinking about Tim recently and wanting to share with him my recent review of progesterone and bone (Climacteric 2018). And now it is too late.

I was a new comer to British Columbia and UBC in the late 1970s, worked with some renal experts here (Drs. Bert Cameron and the Roger Sutton) on bone health issues and became an advisor to O-STOP, the home-grown osteoporosis self-help group. I therefore knew about the first osteoporosis guidelines project in Canada in the 1980s. And I wished I’d been invited.

I later ran into Tim at the American Society for Bone and Mineral Research meeting—I can’t remember where we were, but we chatting in the sun, there was a sudden downpour and we hid under the same tree! I started cautiously telling him about my idea that progesterone was important for women’s bone formation. He was quite clear in rejecting that notion. I felt hurt.

However, after my 1-year observational study was published in the New England Journal of Medicine in 1990 he sought me out. That study, in 66 normally ovulatory, healthy young women observed over one year had cycles that remained regular but for many, ovulation became disturbed. We found that 20% of cancellous spinal BMD change was related to mean luteal phase length.

He contacted me, asking me more about my research. He invited me to the next OC guidelines conference.

I later worked with him in the early years of the Canadian Multicentre Osteoporosis Study (CaMos)—his and my centres had the slowest and most difficult time in recruitment. One year, when we had our annual CaMos Meeting in Banff, on a night after dinner with deep mountain darkness outside we stood around a piano in a lovely light wood hall listening to his amazing keyboards and singing Jerusalem.

Miss you Tim!

– Jerilynn C. Prior, MD, FRCPC University of British Columbia

Very sad news.

Tim was not only a talented scientist and musician but he was an outstanding mentor and gentleman. I remember my first SAC meeting in 1984 when he gave me the opportunity to join the OC circle and his continuous support during my closer involvement with OC.

There are only few people like Tim, that you have the chance to meet and interact with in a lifetime.

– Jacques Brown, MD, FRCPC Université Laval

Highlighted

2019 Spring Donor Newsletter

A UNIQUE WAY TO CREATE AWARENESS ABOUT BONE HEALTH

Attendees of Toronto Fashion Week saw something unusual on the catwalk this year: a line of innovative fashions incorporating bubble wrap! Acclaimed fashion designer David Dixon partnered with Osteoporosis Canada to create the Bübl collection – a play on the idea of bubble wrap as a universal symbol for protection.

Unfortunately, those living with osteoporosis don’t have the kind of protection that bubble wrap offers. For 2 million Canadians, the risk of fractures is an unrelenting anxiety.

“Everyone knows someone affected by this disease – I was excited by the creative challenge it presented and by the chance to use fashion to help those affected by it.”
— David Dixon

Presented on the opening night of Toronto Fashion Week, the Bübl collection was a unique chance to increase public consciousness around risks and issues surrounding osteoporosis, and to encourage Canadians to make bone health a priority. Visitors to the Bübl website were presented with the opportunity to take an osteoporosis Know Your Risk quiz – joining the more than 35,000 others who learned their own risk through the quiz in 2018.

The collection featured shimmering pieces in white, blue, and black, each incorporating bubble wrap or back braces. Throughout the show, these elements served as a constant reminder of the “silent thief” that weakens the bones of millions of Canadians each day.

The Know Your Risk quiz promoted alongside the Bübl collection is a simple way for people of all ages to find out their personal risk factors for developing osteoporosis. The goal is ultimately to empower quiz respondents to become aware of their bone health and if appropriate seek medical care sooner – before a break.

To see the Bübl collection visit bublfashion.ca

Click here to donate online

AN EXTRAORDINARY VISION

I had the incredible opportunity to serve as Osteoporosis Canada’s patient ambassador for the Bübl fashion campaign. Although I didn’t know what to expect when I agreed to get involved, it came together in a truly spectacular and moving way.

I was just 40 years old and a new mother when I suffered spine fractures due to osteoporosis, so I found myself in tears as I watched models walking the runway with back braces – the same kind of brace I myself had to wear when my back broke. Those memories are hard for me to relive, yet they are such an important part of my personal journey through living with osteoporosis.

Although I have been a volunteer with Osteoporosis Canada for nearly two decades now, I can say this is the most amazing visibility I’ve seen the disease receive. To have osteoporosis brought literally centre stage in such an artistic and moving way was truly special to witness.

Bübl Fashion, presented by Osteoporosis Canada, is another important step forward in making Canadians unbreakable.

Christine Thomas,
Osteoporosis patient and advocate

Left to right: Dr. Famida Jiwa, Dr. Sandra Kim,
Dr. Heather Frame, Christine Thomas

Click here to donate online

THE MOST EFFECTIVE POST-FRACTURE OSTEOPOROSIS CARE

Fracture Liaison Service (FLS) is the most effective program to prevent repeat fractures due to osteoporosis. In an FLS, a coordinator screens fracture patients for osteoporosis and follows-up with them to make sure they receive the care they need to prevent the next fracture. This care may include a bone mineral density test and/or osteoporosis medication.

FLS coordinators form relationships with patients’ family doctors to ensure a seamless transition of care and the continued use of interventions necessary to prevent further fractures. The FLS model has been proven to be by far the most efficient and effective when it comes to making sure the first break is the last.

With so many Canadians in need of fracture-related care, Osteoporosis Canada is committed to making FLS available coast to coast. Most recently, we hosted a British Columbia FLS forum in Burnaby to explore the possibility of expanding FLS throughout the province. Although it was designed mostly for a BC audience, it was also attended by healthcare professionals from Alberta, New Brunswick and Prince Edward Island. We hope this Forum will help stimulate the implementation of new FLSs in BC and other provinces!

Osteoporosis Canada offers a consultation service and on-going support to healthcare professionals and healthcare administrators who want to implement an FLS. Many tools and resources are available on Osteoporosis Canada’s online FLS Hub. Your support for Osteoporosis Canada will help us to expand awareness of the need for FLS for the many Canadians who suffer a fragility fracture each year. 

Click here to donate online

LIVING LIFE TO THE FULLEST & GIVING BACK

The choice to leave a gift in my Will to Osteoporosis Canada was easy. After all, I was one of the lucky ones… But I know so many of my fellow Canadians aren’t so fortunate.

I received my osteoporosis diagnosis before I ever suffered a fracture. After three decades as a medical radiation technologist, I’ve seen the devastating effects of this disease – and I’m so thankful my family doctor followed Osteoporosis Canada’s clinical practice guidelines and tested my bone density.

I want every Canadian to have the chance I did. I want more of us to receive our diagnosis early, when there’s still time to modify our lifestyles and choose the best treatment for us. I want the public to be educated about reducing their disease risk. I want everyone to be able to live life to the absolute fullest: and I know Osteoporosis Canada’s work is a vital part of making that possible.

I’m so grateful for the care I received. And I’m honoured to do my part to give back by leaving a gift to Osteoporosis Canada in my Will. This is a special chance for me to be part of changing the lives of millions of Canadians living with or at risk of developing osteoporosis… I can’t imagine a better way to leave my footprint on the world!

Nancy Macklin,
Osteoporosis patient and bequest donor

Osteoporosis Canada extends our sincerest gratitude to Nancy Macklin and other legacy donors who have made the generous decision to leave a gift to the organization in their Will. Your support ensures the sustainability of the work we are doing to bring awareness to the importance of bone health in our country. Thank you for your gift in making Canadians unbreakable for generations to come.

For information on making a gift in your Will, call 1-800-463-6842 or email donate@osteoporosis.ca

Click here to donate online

© Osteoporosis Canada, 2024
Charitable Registration No. 89551 0931 RR 0001