YOGA FOR OSTEOPOROSIS

THE DO’S AND DON’TS

Life expectancy in the UK is around 79yo for men and 83yo for women.
The Uk’s population is aging and by 2050 1 in 4 people in the UK will be over 65yo. People are definitely living longer.
We all want to live happy healthy lives, but getting older comes with its own challenges.

The Office of National Statistics (ONS) reports that half the people over 65 will spend their lives living well and healthy the other half will spend their older age in poor health.
One of the most common health conditions the older adults are faced with beyond dementia is osteoporosis. 

WHAT IS OSTEOPOROSIS and WHY IS IT A PROBLEM?

Osteoporosis is the thinning of the bones. 
The body has a way to strictly regulating calcium in the blood and this is important for :

• intracellular cell signalling (as described in the Introduction to Endocrinology)
• muscle cell contraction
• nerve cell activity

This regulation is done through a range of systems in the body and hormone signalling.
It is very much related to Vitamin D, which acts as a hormone in the body – In simpleton terms if your diet does not contain enough calcium, or the signalling mechanism is affected by vitamin D deficiency, calcium leaks out of your bones.
This in time results into the thinning of the bones, hence osteoporosis.

Many other mechanisms exist on the metabolism of calcium – from thyroid issues, to renal failure and CVD medication which affects calcium absorption from the diet. Osteoporosis can be a result of those functions being affected.

Osteoporosis is a problem because it leads to bone fractures.
Often those that experience bone fracture because of osteoporosis do not even know they were affected by osteoporosis, because its diagnosis is not widely available.

Checking bone density is the only way currently to diagnose.
The way to check bone density is with a DEX scan, but this diagnostic tool is not widely available.
The majority of people that are at risk from osteoporosis are therefore not diagnosed until they experience a fracture, especially women who are at greater risk after menopause.

Fractures from FALLS is in fact are the single largest cause of hospital admissions in older adults (age UK).
Hip fractures are very common amongst people over 65 and they have a sizeable and potent impact on the NHS.
1 in 4 falls are hip fractures. 

YOGA FOR OSTEOPOROSIS

A little google search on yoga and osteoporosis returns many results that highlight the benefits of practising yoga to not only prevent osteoporosis but reverse the effect of osteoporosis on the bones.
2 factors in fact contribute to this:
– Posture
– Balance.
Both be the results of a regular yoga practice.
Yoga will also improve balance and reduce the risk of falls. 

Practising yoga with osteoporosis students.

1. Check that students have been given the all clear from the doctor.
2. Move slowly and mindfully:
   Repetitive tracking movement is favoured, while long holds, or fast paced asana centred practices are not.
   Pawamuktasana- joint freeing series- that can be used to warm up the body, rather than mat based sun salutations that would put a big load on the wrists and require large ROM to achieve.
3. Strength not stretch. Strength with standing asana but avoid loading the wrists. Again dynamic tracking movement will help keep the body warm and mobile and avoid the likelihood of overstretch or going beyond the full ROM and causing an injury.
4. Balance poses, static and dynamic must always be included in your practice.
   Also work with cross lateral body movement, similar to that of walking, in order to increase proprioception – the awareness of the way we place our body at a given place and time.
   ALWAYS offer support during balancing poses (chair / wall).
5. Keep the integrity of the spine:
   Teach your students to forward bend with integrity – long back, bending knees etc, or turn pose on its head and practice without the load in a supine position. 
   Teach twists with integrity again, encouraging long spine.
   Avoid twists with forward bending.
   Include gentle backbends – with an abdominal strengthening focus – ensuring good posture & better breath, but pay close attention to Kyphotic students during your practice.
6. Support:
   Encourage chair based yoga or a practice by the wall to avoid the likelihood of falling. 
   Teach your students how to use other props during the practice to maintain integrity of the spine and avoid stressing joints by going into a full range of motion in their practices.
   Encourage your students to try restorative practices also for overall wellbeing.
7. Consistency:
   Encourage your students to do little and often – pawamuktasana, balancing, etc
   Big results can be achieved BY ANYONE with consistent practice.
8. Finally no inversions – this loads wrists, and spine unnecessarily increase the likelihood of fractures.

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In summary:
Osteoporosis is the thinning of the bones.
The problem with osteoporosis is the lack of diagnosis AND bone fractures.
Yoga is fantastic for osteoporosis, so much so that it can even reverse the effect it has on the body
Proper alignment should be the focus of your practice encouraging repetitive tracking movement and practising using support (wall, chair, blankets, etc)
Avoid inversions, loading the wrists, practising in full ROM and long holds.

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The Chair Based Yoga Manual