Last month, I participated in a CPD (Continuing Professional Development) course focused on bone health and supporting people in yoga classes who were diagnosed with low bone density.
Here are some takeaways from that course, that I believe can be interesting for everyone:
We all agree that bones give us structural support in our body. Less known is that our bones constantly communicate with the rest of our body! They are the storehouse of fat, minerals, and vitamin D that are needed for functioning tissues, neurological impulses in the body, and blood cell production. They also produce a chemical messenger called osteocalcin that acts like a hormone. This osteocalcin is linked to better insulin function and sharper memory.
Throughout our lives, our bones are constantly undergoing a remodeling process. This process, tightly regulated by hormones and other signaling molecules, ensures that our bones stay strong and adapt to changing needs. Special cells called osteoclasts break down old or damaged bone tissue.
We reach peak bone mass in our 30s; after this age, there is typically more breakdown of bone than formation. Therefore as we age, everyone is prone to loss of bone density, but it is more common in the following population: post-menopausal women, and Caucasian and Asian women. Women are twice as likely to have osteopenia (low bone density) as men, and four times as likely to have osteoporosis (as osteopenia progresses bones lose more density and become more porous, resembling a honeycomb with larger holes)!
Several factors can contribute to low bone density, including family history, certain medical conditions like chronic inflammatory conditions and some hormonal issues, as well as lifestyle habits such as smoking, excessive alcohol consumption, certain medications, and poor diet.
Osteopenia and osteoporosis usually go unnoticed - people may have low bone density and show no symptoms. It is "the silent disease", as we can't feel it and are unaware of it until we fracture a bone and have a DEXA scan in the hospital. However, some people may experience back pain, a stooped posture, or a loss of height as the vertebrae in the spine collapse due to weakened vertebrae, before a bone fracture.
The most concerning aspect of osteoporosis is the increased risk of fractures, especially in the hip, spine, and wrist. These fractures can be debilitating and significantly impact a person's mobility and independence, directly affecting longevity and quality of life.
Treatment options focus on preventing further bone loss and reducing fracture risk. Maintaining a healthy weight, eating a calcium-rich diet, and getting regular weight-bearing exercise are crucial. In some cases, your doctor may recommend medication to slow bone loss or stimulate bone formation.
Even with my love and commitment to yoga, I can't promise you that yoga alone guarantees strong, healthy bones. There are too many factors to consider (including lifestyle and diet).
While yoga may not directly increase bone density, the research tells us that physical yoga practice may improve posture, balance, proprioception, and strength, and reduce anxiety.
Better balance and coordination can significantly reduce your risk of falls. Falls are a major concern for people with osteoporosis, as they can lead to fractures. Balance challenges stimulate the vestibular system and improve balance, by this yoga can help you stay safe and independent.
Good posture is also important for bone health. Yoga emphasizes proper alignment and core engagement, which can lead to better posture over time. Back strength is essential in reducing vertebral compression fractures. This improved posture can help distribute weight evenly across all spinal joints.
Yoga practice naturally targets various muscle groups, helping to build strength and improve overall stability through weight-bearing poses and isometric stretching (keeping muscles contracted without movement). Core and leg strength improves balance. Keeping muscles active stimulates the remodelling process in our bones.
Reducing stress and anxiety may help with mobility confidence if one is diagnosed with low bone density. Less stress - reduces bone breakdown (less cortisol in the bloodstream) and supports sleep which is when bone building happens. Yoga also increases body awareness, so we feel more confident in our body and this helps with potential injury warnings.
The most reliable evidence-based studies show that effective building of bone mass density can be achieved by resistance exercise "which needs to be varied, site-specific, and progressive." As such, weightlifting or progressive resistance training can be incorporated to some degree into yoga classes, but it wouldn’t be traditional hatha yoga practice, but rather a more therapeutic or targeted, fun class named "yoga with resistance bands," for example. I would like to offer such a class in the future. Please get in touch if you are interested.
In my group classes, we focus on building back and core strength, dynamic balance, and mindful movement – all elements that can significantly benefit those with osteoporosis. We encourage participants to work within their safe range of motion, without pushing or pulling into a pose, avoiding forceful twists, deep backbends, and excessive flexions, and always offering safe options. This aligns perfectly with the advice for yogis affected by osteoporosis. My recent training has boosted my confidence in guiding people with osteoporosis, which translates into a more supportive and informed teaching style.
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