It is essential for yoga students with osteoporosis to avoid extremes in range of movement. The poses and practices below should be avoided.
1.Crunches or sit-ups.
While core strength is important to support the lower back, these poses require loaded lumbar flexion, placing a high demand on the lower back as you work to lift the weight of the upper body, leading to fractures in the thoracic or lumbar vertebrae.
Instead: Work on core stability in all neutral-spine poses by drawing the belly in and up on the exhale. From a lying down position, work the core by lifting and lowering the legs rather than the upper body, keeping the spine in its neutral position.
2. All poses that require spinal flexion (rounded-back poses).
Osteoporosis patients should avoid not only sit-ups and crunches, but all poses that require spinal flexion (rounded-back poses) because of the stress that puts on the lower back. This means steering clear of forward folds, even mild ones, and also avoiding hugging the knees in as you lie on your back—as you would for wind relieving pose or happy baby.
Rolling up to stand, a challenging movement should always avoid.
Skip uttanasana (standing forward fold) in favor of ardha uttanasana (half standing forward fold). In this “flat-back pose,” you might bring the hands to blocks, the seat of a chair, or to a wall, in order to maintain your optimal spinal shape. Choose upright seated poses like staff over forward folds like stretch of the west (leaning back if necessary to curve the lower back in toward the belly and lift the chest).
To stretch the hamstrings, instead of going deeper into a forward fold, practice lying down hand to big toe with a strap around the foot of the lifted leg. In all of these poses, focus both on keeping the spine in its neutral position and on lengthening.
3. Don’t Practice big backbends.
While some gentle backbending, with osteoporosis, big backbends like upward facing dog, wheel, bow, and camel pose with hands on the heels, can be dangerously compressive. The thoracic spine is the area of the spine at greatest risk for those with advanced osteoporosis.
4. Avoid Extreme twists and sidebends.
Trunk rotations cause torsional stress on the spine. The discs and vertebral bones are stressed most when in a rounded position combined with a big twist. For e.g. moving into a deep chair pose twist or a Marichi’s pose with your elbow to the outside of your thigh is off limits. Big sidebends often have an element of twisting to them and can be compressive too.
Instead: Stick with the milder twists and sidebends listed in the Do’s.
5. Do an inversion practice.
Those diagnosed with low bone density who have practiced inversions regularly throughout their lives and are able to keep their neutral-spinal alignment in these poses may be able to safely practice inversions such as headstand, shoulderstand, and handstand, but consult your doctor first.
If you do practice inversions, practice them at the wall in order to minimize the risk of falling.
For those who haven’t already been practicing poses like these regularly, this is not the time to start. The weakened, low-density vertebrae will not tolerate the compression [of these inversions].
Instead: For many of the circulatory and energetic benefits of inversions, practice milder inversions like downward facing dog, bridge, and legs up the wall.
6. Join fast-paced, competitive classes.
Stability is of the essence for osteoporosis women. Steer clear of the classes and the teachers that encourage you to move so fast you risk your balance.
Instead: Take hatha, Iyengar, gentle, restorative, yin yoga, or any alignment-focused practice.
Through asanas that are modified for greatest benefit, one can retain—and even regain—not only strength of muscle but strength of bone.