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Guidelines for Yoga Asana Practice When Osteoporosis is Suspected or Diagnosed
Although yoga can build bone density, great caution is recommended once osteoporosis is suspected or diagnosed. Osteoporosis dramatically increases the risk of bone fracture, even from seemingly simple movements. For this reason, individuals with osteoporosis should approach the practice of yoga slowly and mindfully. Ask your physician whether a yoga practice is safe for your specific pattern of bone density. If your physician approves, the following guidelines can help reduce the risk of fracture during a yoga practice. Individuals diagnosed with osteoporosis should consider private instruction with a qualified teacher before attempting to modify the movements in group yoga classes.
1. Avoid flexing the spine (rounding the spine forward) to stretch the back, stretch the legs, or strengthen the abdominal muscles. All of these intentions can be achieved in a lying-down position that involve lifting/moving the legs rather than lifting/moving the head and shoulders.
2. Avoid twisting the spine in any way that uses gravity or leverage to rotate (for example, reclining twists or pulling yourself into a twist using your arms). Rotation should be gradually introduced using simple and slow movement, without force.
3. Backbends and spinal extension (arching the back to open the front of the chest and belly) should also be approached very gently. For example, back muscles can strengthened using arm movements that gently open the chest without overarching the back. Gentle supported backbends (such as placing a rolled towel under the upper back in a reclining position), if comfortable, may also be helpful for restoring posture.
4. Avoid supporting body weight with the hands. Wrist fractures are common in osteoporosis. Wrist/arm muscles can be strengthened through mudras, arm movements, or sustained arm positions (such as keeping the arms raised in tadasana), rather than through positions like plank pose
5. Standing poses and balances are excellent for building leg strength and hip bone density, but the risk of bone fracture from a fall is extremely high. For this reason, challenging standing poses and standing balances should only be practiced with the support of a wall (or chair) and a teacher.
6. Inversions (such as headstand or shoulderstand) are not recommended. However, you can receive many of the benefits of inversions by practicing restorative poses, like legs-up-the-wall pose.
Note that the above guidelines are conservative. Individuals who wish to build bone density but who have not yet developed osteoporosis do not need to follow such a cautious approach. You can begin preventing osteoporosis early in life. In particular, standing balances and arm balances are excellent poses for developing and maintaining bone density. (Examine bone density scans from a yoga student.)
If you teach a population of students who are at high risk for osteoporosis (for example, women over age 60), you should consider incorporating these guidelines into your classes. Many people with osteoporosis are not aware of the condition until they suffer a fracture, and students may not voluntarily modify their practice if they do not recognize their own risk.
For
more information about developing a yoga practice for individuals with
osteoporosis, enjoy this excellent
article by Matthew Taylor. Enjoy these ideas? Sign up to receive monthly ideas for your yoga teaching in the free Open Mind Open Body Newsletter.
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