Table of Contents
Welcome to my Guide to Yoga for Osteoporosis. I wrote it for people who are concerned about their bone health and wish to practice Yoga safely. The most common questions I get from those individuals are:
- If I have osteoporosis, can I practice Yoga without risking fracture?
- Is Yoga good for my osteoporosis and bone health?
- Are there poses I should avoid or change?
- Should I practice Yoga or Pilates?
The guide addresses each of these questions. It also directs you to resources you can access on this site for more information.
Let’s start with the first question in the list.
Can I Practice Yoga if I Have Osteoporosis?
Many people ask if they can continue practicing Yoga after a diagnosis of osteoporosis or osteopenia.
You can. But you must modify the poses to accommodate your bone health. Where can you learn about safe Yoga poses for people with osteoporosis?
It has been my experience that many Yoga teachers need to become more familiar with osteopenia or osteoporosis. Most Yoga instructors have good intentions, but good intentions will not keep you safe. Most are unaware that they must alter poses for students with osteoporosis or osteopenia. If the poses are not modified, they will do more harm than good.
Yoga for Better Bones
My book, Yoga for Better Bones, teaches you how to practice Yoga if you have osteoporosis or osteopenia.
The early chapters of the book provide information on anatomy and physiology. It explains the movement behind the Yoga poses. These instructions help you better understand the modifications suggested in the book.
This knowledge will help end your fears and make you more confident in your Yoga practice. It is a great place to start your journey.
This guide provides extra material beyond what I offered in my book.
Is Yoga Good for Osteoporosis and Osteopenia?
For many of us, practicing Yoga makes us feel relaxed and invigorated. Many see Yoga as more than an activity. It is an integral part of our self-care. Yoga helps improve balance, increase flexibility, and reduce stress. If you are new to Yoga, the added loading of your hips and spine can help contribute to the health of your bones.
Yoga can be a great adjunct to a bone-building exercise regime. Numerous studies have pointed to weight bearing and strength training exercises as critical components for bone health. Yoga has a little of both of these elements.
If you are a Yoga practitioner, please modify your practice and supplement it with weight bearing and strength training exercises. Keep your Yoga practice bone-friendly to continue practicing into your old age.
My book, Yoga for Better Bones, will teach you how to practice Yoga confidently, despite your diagnosis.
Understanding how your bones respond to stress is very important. It ensures that your practice does not harm you.
12 Poses for Osteoporosis
Do not assume that the 12 yoga poses by osteoporosis Loren Fishman are safe to do. Dr. Fishman himself is extremely flexible, and, like the individuals who were self-selected to be part of his study, they had been long-term Yoga practitioners. Dr. Fishman has specific modifications for his poses for individuals with osteopenia and osteoporosis. However, they are only sometimes adhered to.
One of my clients with a 20% vertebral compression fracture attended a retreat at a reputable Yoga Center in the US. The weekend was focused on Yoga for Osteoporosis. Both the title of the weekend workshop and the reputation of the Center gave her confidence. However, the Yoga instructor/facilitator never asked participants to identify the status of their bone health before leading a group practice.
Take Control of Your Bone Health
On the first evening of the workshop, the primary instructor for the weekend introduced herself and proceeded to lead Yoga participants into poses; some of the poses involved complete end range rotation. My client was concerned and did not want to make a fuss; she modified the poses as we had discussed before she left. Many were not so lucky to have this knowledge.
Take control of your bone health. Remember, you are the only one who will suffer from unsafe poses.
Modifications need to occur during Yoga practice for people with osteoporosis. Adjustments based on your specific needs are especially critical if you have had a vertebral compression fracture, no matter how small. Knowing the modifications you need to make will empower you to take control of your bone health and keep enjoying your Yoga practice for life!
The following two subsections discuss modifications. The main section that follows goes into depth about Yoga and spine health.
Yoga for Bone Density and Bone Health
Yoga involves many movements of the spine. Here are several observations that might help you with your Yoga practice.
The first observation relates to flexibility. Several years ago, I noticed that many Yoga practitioners, like Dr. Fishman, are genetically very flexible, a trait passed down from their parents. They do well with Yoga because many of the poses involve flexibility. I discuss hypermobility in more detail under Yoga Spine Stretch.
The second observation concerns specific Yoga movements. There are five pure movements of the spine:
- Elongation, also referred to as Axial Extension
- Forward Bending or Flexion
- Back Bending or Extension
- Side Bending or Lateral Flexion
- Twisting or Axial Rotation
Yoga for Osteoporosis Tips
When you have osteoporosis, osteopenia or low bone density, you should:
- Stay within your mid-range of rotation, side flexion, and extension.
- Modify all poses that involve flexion of your spine.
- Practice elongation or axial extension throughout your Yoga practice and daily activities.
Your poses may look different if you are less flexible than other students or instructors. That’s fine. Your body is unique to you, and you are only responsible for keeping your body safe. Try not to be tempted to push yourself to your limit.
Yoga Poses to Avoid With Osteoporosis
Repeated forward flexion or end-range motions of the spine increase your risk of spinal or vertebral compression fractures. If you have osteoporosis or osteopenia, modify the poses that involve these movements.
Research shows that the following movements create large compression forces on the spine, which in turn compress the vertebrae:
- Repeated flexion movements in the spine.
- Extremes of compression.
- Side bending or rotation.
In my book Yoga for Better Bones, I cover the poses to avoid and how you can modify them to keep you safe.
These products are designed with your bone health in mind.
Yoga for Better Bones
Yoga for Better Bones is my book dedicated to safe Yoga. It is available on Amazon in print and Kindle formats.
Hatha Yoga for Osteoporosis Video Series
This Hatha Yoga series is designed for individuals with osteoporosis, osteopenia or low bone density who want to follow a Hatha routine.
Yin Yoga for Osteoporosis Video Routines
Practice these Yin Yoga routines knowing that the movements are safe for your bones.
Yoga for Spine Health
Most people learn they have osteoporosis from their DEXA or bone mineral density (BMD) report. If it shows that they have lost bone mass in their spine, they must be very mindful of the following:
- Their spinal alignment.
- Which poses are safe to do.
- What poses to change.
- How to decompress their spine.
Yoga for Spinal Alignment
I encourage participants to maintain their best spinal alignment whenever I teach a yoga class. Have you ever noticed how much easier it is to take a full breath and how good you feel after a Yoga class? The good feelings from Yoga practice are mainly due to the encouragement to keep a tall posture and focus on your breath. You can feel and breathe this way all day.
Invite a healthy standing pose to whatever standing activity you do. If you have been sitting for a while, take a break. Stand and follow along:
- Begin by standing with your feet hip-width apart.
- Bring attention to how you distribute your weight through your feet.
- Ask yourself, Is it even on both sides?
- Where is the weight distributed? Under your heels? The base of your toes? Outside of your feet? Through the arches?
Soften Your Knees
- Next, soften your knees. Not everyone “locks their knees,” but most do. Locking our knees is a very passive way to stand. It allows us to hang on to our ligaments rather than use our muscles.
- How does the weight distribution change after softening your knees?
Please take a moment to go back and forth between locking and softening your knees to compare how it feels.
You likely do not need to soften your knees if you already have an even weight distribution through these points:
- The base of your big toes.
- The base of your little toes.
- The center of your heels.
Bend your knees if it gives you better weight distribution. For many, it is a crucial step to improving standing posture.
- Next, press your feet into the floor.
- Invite equal and opposite energy to rise through your soft knees, thighs, and pelvis.
- Bring awareness to the space between your pelvis and your rib cage.
- Elongate this space through your body’s front, back, and sides.
- Continue to invite a lengthening of your torso.
- Allow the energy to rise through your spine.
- Draw the crown of your head toward the sky.
This movement may feel challenging. But, with time and practice, it will be much easier than keeping a slouched posture.
Yoga Spine Stretch
As I mentioned earlier, my experience as a Yoga instructor has made me aware that most Yoga participants are hypermobile.
Hypermobility means that your joints are more flexible than the average person’s. Hypermobile individuals love to stretch but do not need to be more flexible.
I encourage you to review this video demonstrating the Beighton hypermobility test. You can follow along with me to test whether you are hypermobile.
Determine if you are anywhere on the hypermobility scale. If so, please watch my videos on Yoga and hypermobility.
Also, I recommend you choose a Yoga practice focused more on strength and balance. I have several for you to choose from in my Hatha Yoga Series.
Many individuals with hypermobile feet and ankles experience several undesirable outcomes. They often have frequent ankle strains, sprains, near falls, or actual falls because they do not receive feedback fast enough from their joints to react.
Building solid foot and ankle strength and maintaining balance are essential for hypermobile people. Practice your balance in a safe place and, over time, challenge yourself beyond the tree pose. You will learn these alternative balance positions in my Hatha Yoga series.
Spinal Decompression Exercise: Yoga for Thoracic Spine
The spinal decompression exercise removes the effects of gravity on the spine. This exercise helps relieve the pain and pressure that many individuals with thoracic or lumbar vertebral compression fractures feel.
Decompression, or taking weight off your spine, involves lying on your back. It would be best if you were as flat as you comfortably could. You are probably already familiar with decompression. It is called the Corpse Pose of Shavasana in Yoga.
The need for pillows and towels depends on how hunched forward your posture is. The more hunched forward you are, the more support you will need.
Pillows and Your Posture
First, you may need a pillow under your head. You may also require smaller pillows or folded towels under your arms as they rest away from your side with palms up.
With the passing days and weeks, you can reduce the size of your head pillow and eliminate arm support.
Permit yourself to take 10-minute spine decompression breaks throughout the day. You will find this helpful if you get an achy or painful back when doing your daily chores. Many clients will sit on a soft chair with a heating pad instead of lying down. It might feel better, but it is only causing more compression in your spine.
You will have more energy and better posture after lying on your back than sitting in a chair. Spinal decompression will help you resume your day’s activities with better posture.
Which is Better for Osteoporosis, Yoga or Pilates?
I am unaware of any study comparing the benefits of Pilates to Yoga for bone health.
In 2021, a study compared High-Intensity Resistance Training (HiRIT) to a Pilates exercise program. (1) The Pilates program was called Buff Bones. The study concluded that:
“Both programs improved functional performance, but the effects of High-Intensity Resistance Training were more significant for improving leg and back muscle strength.”
The study showed a positive relationship between the amount of weight lifted and the lumbar spine’s muscle strength and bone mineral density.
A 2022 systematic review (2) concluded:
- There is low-certainty evidence that Pilates improves physical functioning and quality of life.
- The effect of Pilates on falls and bone mineral density is uncertain.
- No evidence of the impact of Pilates on mortality, fractures, or adverse events. (2)
Modifying Pilates for Clients with Osteoporosis
Physical Therapist, Sheri Betz, is the owner of TheraPilates. Ms. Betz published an article called Modifying Pilates for Clients with Osteoporosis. In this article, she stated that half of the Pilates moves are unsafe for people with low bone density or osteoporosis. (3)
If you have osteopenia or osteoporosis, the following moves are unsafe:
- Roll-Over – both ways
- Rolling Back / Rolling Like a Ball
- Spine Stretch
- Rocker with Open Legs
- Neck Pull
- Spine Twist
- Control Balance
Yin Yoga with You in Mind
I love teaching Yin Yoga and providing the support and guidance to keep my class members safe.
Do not assume that a Yin class’s slow, gentle nature can cause no harm. Many of the Yin poses can place your spine in harm’s way.
Please watch my video on my concerns about Yin practice.
Consider my Yin Yoga routine if you are looking for a safe Yin practice. I cover the Floor and Wall sequences for you to relax into a deep safe stretch.
I encourage you to supplement that video with my book, Yoga for Better Bones. Three things you will learn in Yoga for Better Bones:
- The five elements you should look for in an exercise regime to stimulate bone building.
How to customize your Yoga practice.
- The poses to avoid, the poses to change and the poses you might consider dedicating more time to.
- You will gain the knowledge you need to continue your Yoga practice for many years.
Yoga for Osteoporosis Recommended Posts
Yoga for Osteoporosis Guide: References
- Melanie Kistler-Fischbacher, Jedidah S Yong, Benjamin K Weeks, Belinda R Beck. A Comparison of Bone-Targeted Exercise With and Without Antiresorptive Bone Medication to Reduce Indices of Fracture Risk in Postmenopausal Women With Low Bone Mass: The MEDEX-OP Randomized Controlled Trial. Journal of Bone and Mineral ResearchVolume 36, Issue 9 p. 1680-1693 2021
- Emily Claire McLaughlin, Joan Bartley, Maureen C Ashe, Debra A Butt, Philip D Chilibeck, John D Wark, Lehana Thabane,Jackie Stapleton, Lora M Giangregorio. The effects of Pilates on health-related outcomes in individuals with increased risk of fracture: a systematic review. Appl Physiol Nutr Metab . 2022 Apr;47(4):369-378.
- Loren Fishman, Twelve-Minute Daily Yoga Regimen Reverses Osteoporotic Bone Loss (12 poses). Top Geriatric Rehab. 2016 Apr; 32(2): 81–87
- Sherri Betz. Modifying Pilates for Clients with Osteoporosis. IDEA Fitness Journal. April 2005.