Dem Bones yoga therapy for bone health

Yoga and Osteoporosis: DEM BONES #3


Loren Fishman demonstrates balancing half moon (Circa 1977)

Loren Fishman demonstrates balancing half moon (circa 1977)

In two prior posts I introduced my new series of Yoga Therapy workshops for osteoporosis, osteoarthritis and general bone health. I call it, Dem Bones. The series was created, in part, from research and the knowledge of many yoga therapists, several of whom are MDs. In my third Dem Bones blog, I tap into pointers from Loren Fishman, MD regarding yoga and osteoporosis. Stay tuned for future Dem Bones posts, quoting other prominent yoga therapists and/or physicians.

Iyengar trained Loren Fishman practices reverse triangle during his med school days

Iyengar trained Loren Fishman practices reverse triangle during his med school days

Loren Fishman, MD, says loss in bone density is one of the most widespread chronic health problems found in Western societies. “We worry so much about breast cancer in women, however, in actuality, the risk of a hip fracture is equal to the combined risk of breast, uterine and ovarian cancer,” says Dr. Fishman, an Iyengar-trained yoga teacher and managing partner of Manhattan Physical Medicine and Rehabilitation.

The National Osteoporosis Foundation reports that one in every two women and one in every four men, aged 50 or older, will suffer an osteoporosis-related hip, spine, or wrist fracture. Worldwide, more than 200 million people have osteoporosis or its precursor, osteopenia.

The connection between yoga and osteoporosis is one reason why I’m launching my Dem Bones therapeutic workshops in Texas.* I’m a big believer in yoga for bone health, and now, with Dr. Fishman’s expert input, along with that of other yoga therapists and health professionals I’ve designed my own signature therapeutic sessions that are appropriate for people with osteoporosis, osteopenia, arthritis, or those with most current or old bone injuries.

Long before I’d paid attention to my bone health, my doctor scribbled, “weight bearing exercises” on an Rx.

Loren Fishman's Om pose, omkarasana

Loren Fishman, MD, studied yoga in India with Iyengar, before completing his medical studies

Yoga has always been my modus operandi. So, anytime I was in the gym and working the exercise machines, my brain would ponder how I could best use my own body for weight bearing. Barefoot and on the ground is far more comfortable for me that pushing or pulling on a large steel contraption.

I designed Dem Bones after reading Dr. Fishman’s books, articles, and attending his keynote address and workshop at the International Association of Yoga Therapists annual convention. Of course my learnings are also based on many other books, lectures, studies and my yoga therapy training. But, Dr. Fishman is an expert. He specializes in back pain, bone health and yoga therapy, has authored many books and countless medical reviews and is a med school faculty member. And, yes, a yogi. In fact, all the images in this post are of Fishman when he was in med school.

Loren Fishman, MD, has studied the effects of yoga on osteoporosis for more than ten years

Loren Fishman, has studied the benefits of yoga and osteoporosis for more than 10 years

“Yoga is better than weight lifting, since groups of muscles, each stronger than gravity, oppose one other in asana,” he writes in Yoga for Osteoporosis, (W.W. Norton) which he wrote with Ellen Saltonstall. As little as ten minutes a day can keep the doctor away.  What’s more, yoga improves strength, coordination, range of motion, balance and mental alertness thereby preventing trips or falls, which can be debilitating and even fatal.

that will be published on line ahead of its print date by the peer-reviewed journal Topics in Geriatric Rehabilitation. The researchers tracked 741 participants, over 90,000 hours of yoga. They used DEXA scans to gauge the density in the bones, and evaluate the minerals. Bottom line, yoga raised bone mineral density significantly.

While pharmaceuticals may build bone density, they ignore bone physiology. Fishman says that meds reduce the strength of osteoclasts which dissolve injured bone tissue and initiate bone repair, and, bisphosphonates (e.g., Fosamax and Boniva) can cripple this function, leading to osteonecrosis, spontaneous fractures, retarded healing.

Fishman says bisphosphonates are “associated with gastrointestinal toxicity, jaw and other sites of osteonecrosis, slowed healing, severe and sometimes irreversible leg cramps and bone pain, and many other side-effects.”

Fishman’s research with yoga revealed no serious injuries, and the benefits were chronicled after just ten minutes a day of yoga, over extended periods of time.

Yoga is relatively easy, and accessible to all, even to people who may be wheel chair bound, or amputees.  “Yoga has been shown to reduce back pain, arthritis, and anxiety and to improve gait, neural plasticity associated with motor learning, all capacities that mitigate against the falls that produce osteoporotic fractures.”

Loren Fishman, MD, has studied the effects of yoga on osteoporosis for more than ten years

Loren Fishman, MD, has been an advocate of yoga for 40 years

Osteoporosis and related fractures put a multiple billion dollar toll on our health care. Yoga is free, and an ounce of prevention is incalculable.

Beyond the recent scientific studies, yoga has been tested over the centuries. One of the reasons for its merits is a theory Julius Wolff coined in 1892. Wolff’s Law states, roughly that the more stress a bone sustains, the stronger it becomes. Conversely, a paraplegic will experience significant bone loss along with muscle atrophy.

The explanation is simple.  Muscles are stronger than gravity, explains Fishman, and yoga postures stress bones more than gravity. Most yoga is what I call yang: active poses that work the muscles. Contractions of the muscles increase bone loading,  and isometric contractions, that we often see in Iyengar, Ashtanga, Anusara and other yoga styles, add in more strength building.  The more varied a practice, the more muscles — and bones — you can positively impact.

As with any exercise plan, work with a qualified instructor or therapist. For those that have already been diagnosed with osteopenia or osteoporosis, there are many contraindications within a yoga practice, and a yoga therapist can guide you through modifications to best suit your body.

Dem Bones yoga therapy for bone health*Dem Bones are 90-minute private or semi-private workshops. Sessions can be conducted in my home studio, outdoor deck, or my client’s home or place of business. Book before November 1 and get your sixth session for free. 

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