Hey there, Chrissie here to break down what osteoporosis is and what you can do to alleviate the pain!
It’s very normal that at a particular stage of life, accelerated bone loss occurs in both women and men. There’s actually a surprising amount of osteopenia in younger people, hypothesized by decreasing cow's milk during the bone development stages of life in addition to hormone disruptive additives and chemicals. Other reasons could include inadequate physical activity and weight-bearing exercises, stress, sedentary lifestyles, thyroid problems, systemic gut diseases, inflammatory diseases, lack of sun exposure, and vitamin D. Fluctuations or severe overages and depletions could lead someone down the path to osteopenia quickly!
44 million Americans have been diagnosed with osteoporosis and because of this, it’s one of the most widespread chronic health problems in Western societies. This osteoporosis often leads to fractured vertebrae and hip - of the million fractures per year attributed to osteoporosis, roughly 700,000 are vertebral and 300,000 are in the hip. Here’s another staggering statistic, of those hip fractures, 25 % die from complications and another 25% end up in nursing homes and never leave to return to their homes. Yikes.
So, what can we do about this? Well, early identification is very necessary. Currently, the standard in medicine is usually to medicate, supplement with calcium and vitamin D, and add some exercise. Here’s the problem: it’s too much too late. The bone density that grows from the supplementation isn’t significant enough to prevent a fracture from a traumatic fall.
So, now what’s the answer? Well, we need to look at how our bodies are made, and how bone grows to begin with. Ready for your anatomy lesson? Here we go.
Embryologically, bones are made through osteogenesis. Three types of bone cells are called osteocytes, osteoblasts, and osteoclasts and in short, harden cartilage and ossify it into bone. When the fetus travels through the birth canal, the bones are very pliable. It’s not until the age of crawling and walking to the bones start to harden at a more rapid pace. When a child breaks a bone we call it a greenstick fracture because the bones are still pliable and bendier rather than brittle. As the growing process continues, more and more osteoblasts come to make new bones matrices and this is how we not only grow taller, but our bones increase in density. So, the answer is, that we need more osteoblastic activity!
Well, how do we do that? Let’s move on to Biomechanics now. Wolff’s Law states that bone density will change in response to changes in the function forces that are applied to a bone. Osteoblasts increase their workload when then the mechanical demand is high and osteoclasts will increase their workload when mechanical demands are low. In palatable terms, the bone will create more bone when more force is placed on it. Bones will adapt to the stressors placed on them, so, weight-bearing activity properly stresses bones to create new bone growth. This is the key to preventing osteoporosis!
Weight-bearing activity is any activity that applies the necessary forces to the long bones and joints. Think of walking, running, tennis, boxing, and yoga. Swimming and the elliptical are not going to be good examples of weight-bearing exercises. The compressive forces of weight-bearing activity have proven to slow and even reverse osteopenia and osteoporosis.
The force-generating positions and movements in yoga stimulate bones to be stronger both in mass and density and also provide strengthening and stabilizing which is great for fall prevention. Balance is key to any preventative treatment and yoga has plenty of that in it already. Think about how complete a yoga practice is with the stretch, strengthen, weight bearing, coordination, focal points, postural alignment, confidence in graceful movements, and the breath body connection.
As with any physical activity and physical pain complaint, make sure you have clearance from your treating MD before participating in a new form of exercise. If you already have osteopenia or osteoporosis, there are some poses that might be too taxing for the bones that are weak. Here are some things to consider.
Listen to your body and always make sure you are operating within comfortable limits.
Don’t be afraid to use blocks, straps, and other props to make poses more attainable and enjoyable.
It appears that 30 minutes per day for 5 days a week is all it takes to stimulate bone growth
Two-legged standing poses, such as Warrior 1 and 2, Lunges, Chair pose, and standing balancing (one-legged) poses improve strength, particularly of the spine, core, hips, and legs. Weight-bearing poses on your arms, such as Downward-Facing Dog pose, Down Puppy pose, and Plank poses, stimulate strength of the core, arms, and upper body. You may have to limit the amount of weight that goes on your hands and wrists if these are areas of concern with bone or joints. Modify the poses to decrease the amount of weight-bearing (for example, a Plank pose could be done standing with the hands on the wall and a Downward-Facing Dog pose could be done as a Puppy Dog pose.) Eventually, once you build enough muscular and bone strength in these areas it is usually possible to progress to support more or full body weight.
Sometimes fractures can happen without the typical feedback like pain and discomfort. Fractures can be especially sneaky in the spine so avoid excessive twisting back bending and forward folds.
6. Stay away from handstands and headstands because these are advanced poses and in the beginning, typically there can be a lot of unevenly distributed weight in the head or shoulders. A less risky alternative is a down dog or dolphin for an inversion practice. There are many tools and props to use to achieve a head below heart inversion like the one I have that I bought from Amazon.
7. Limit the range of motion - more doesn’t mean better. A staff sensation is all it takes to ignite a muscle and keep the bone weight-bearing.
8. Don’t push it. The human body doesn’t subscribe to the “No pain, no gain” fallacy. Honor your edges and practice pain-free movements.
9. In most yoga poses, an elongated spine is encouraged, especially for those with any vertebral osteopenia/osteoporosis. Don’t cave, round or curl as this isn’t bone stacking and therefore not weight-bearing.
10. Correct alignment for proper muscle recruitment is crucial. However, the body is very smart and will often take the path of least resistance. Inventory and observe where your body is “bailing out” or giving up and then slowly, back out of the intensity.
As a rule of thumb, finding the right range of motion in combination with the right muscle engagement is the best prevention of critical injury. This is why is so important to move slowly and bring ultra awareness of keeping proper alignment. It could be suggested that private yoga instruction with a certified instructor would give you the individual attention you need. If this isn’t an option, a smaller group class can be taken but be sure to tell your instructor ahead of time so they can offer up alternatives to poses. As you become more aware and in tune, you will know how to modify your own yoga practice.
If you have osteopenia or osteoporosis it’s important that your condition doesn’t create fear and it shouldn’t prevent you from moving and living with ease. Everyone who steps onto a mat needs to take into account their physical, mental, and spiritual states and practice in a way that promotes overall health and wellness. Approach the body with our "Body Curiosity", educate yourself on your condition, and get guidance if needed. Embrace the new body that is your home and treat it well with courage, curiosity, and grace!
My heart hugs your hearts, Chrissie
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