Bone health becomes more of an issue as we age; though day to day, it may not be something we generally think about - unless we know we have a problem.
Osteoporosis and osteopenia are silent conditions that are highly common in the ageing population. In the 5 to 7 years post menopause, women may be at risk of loosing up to 20% of their bone density; though we may not be aware of deterioration in our bones until there is a fracture. (To put this in context the average age of menopause is age 51).
Reading research, by Dr. Loren Fishman and colleagues (2016), into the positive impact that yoga could have on bone density provokes me, once again, to re-examine my daily yoga practice. What is interesting about their study is that their intervention for improving bone health required just 12 minutes of daily yoga practice! This 12 minute practice involved extensive activation of groups of muscles, pitting one group against another. Muscle activation exposes bones to greater forces which is believed to stimulate bone growth and contribute to bone health.
Participants in the study had a mean age of 68.2 years on joining. Those who stuck to the programme practised 12 minutes daily for 22 to 24 months! This persistence requires a high level of self-discipline; and by the end of the study 57 participants had shown moderate to full compliancy.
12 different yoga postures were selected for safety and potential impact; and were shared via a dvd with verbal instructions. Here are the 12 poses:
Consisting of 5 standing postures:
Triangle pose (Trikonasana)
Reverse triangle (Parivrtta Trikonasana)
Warrior 2 (Virabhadrasana 2)
Extended side angle (Parsvakonasana)
Tree pose (Vriksasana)
And 7 floor postures:
Locust pose (Salabbasana)
Straight legged twist (Marichyasana 2)
Knee bend twist (Matsyendrasana)
Bridge (Set Bandasana)
Supine hand to foot 1 (with belt) (Supta Padangusthasanaa 1)
Supine hand to foot 2 (Supta Padangusthasana 2)
Corpse pose (Savasana)
12 minutes equates to holding each posture for just 5 full breaths (with approximate breathing rate of 6 seconds for inhale and 6 seconds for exhale); though I can’t tell from the research paper if the poses were performed dynamically or statically.
Outcomes of the study
The effect of the practice was calculated on three main sites in the body commonly associated with fracture: the spine, hip and femur. Higher positive impact was noted for the spine and femur, than the hip on DXA scans (dual-energy x-ray absorptiometric). Dr. Fishman and colleagues concluded: “There is qualitative evidence suggesting improved bone quality as a result of the practice of yoga.”
Aside from measured bone density outcomes, yoga practice may also be preventative of falls associated with fracture due to improved balance! In addition, improved posture reduces stress on the spine, also possibly lessening risk of fracture.
Overall, regular yoga practice has been found to improve posture, balance, range of motion, strength, coordination and gait. All factors that may help to reduce risk of falls and fractures.
Safety of the 12 Yoga Postures / Asanas
Dr. Fishman and colleagues (2016) addressed the safety of yoga for individuals with osteoporosis and osteopenia. They noted that their 741 participants with osteoporosis or osteopenia completed a combined 90 000 hours of practice with no reported or detected fractures or serious injuries. This suggests that the 12 minute yoga practice of 12 asanas is safe.
However, if you have health issues consult your medical doctor before commencing a yoga practice, and if you are new to yoga, perhaps find a class with an experienced yoga teacher or yoga therapist, who will help you find safe alignment and get the most out of your practice. Of course, there may be other evidence based movement practices which have greater benefit for bone health; so please also do your own research!
Reflection - Motivation for Practice?
Although all 12 asanas are well known postures, I find the reverse triangle and the the twisting poses quite challenging to execute since they require crossing the midline, which can be challenging! These postures typically don't make it into my practice, so perhaps it is time for me to lean in and work on integrating them more consistently.
12 minutes is not actually much time, so motivation issues aside, it should be possible to fit into a daily routine. However, I would recommend also including a mobility sequence and warm up routine, for example, rotation through the joints, along with four or five rounds of sun salutation. This could add 15 minutes to the practice.
Plus, of course, you are likely to want to include a 5 minute savasana at the end. So the whole practice could take 32 - 35 minutes daily. That is still realistic and manageable. Hmm... I feel another challenge coming on, though wondering if I have a 22 - 24 month staying power.
Lu, Y.; Rosner, B.; Chang, G.; Fishman, L.M. (2016) Twelve-Minute Daily Yoga Regimen Reverses
Osteoporotic Bone Loss. Topics in Geriatric Rehabilitation • Volume 32, Number 2, 81-87