Be cautious with certain Yoga postures if you have Osteoporosis or Osteopenia

As physical therapists who own a Yoga studio and recommend this ancient practice to the general population, it is important for us to be aware of any risks associated with Yoga. The benefits of this exercise program certainly outweigh not doing anything at all!

But, we want to be able to inform participants and potential referral sources to our studio on Yoga injuries and any medical conditions that may put you at risk.

There have been multiple reports of injuries from Yoga ranging from mild muscle strains. These are usually in the shoulders, knees, hips, backs and wrists. Mild muscle strains from myofascial overuse , or from “pushing” it too far, can certainly heal if managed correctly. These risks are usually benign but there could be more serious risks depending on your medical history.

A more severe injury that is noted in the literature is a bony fracture. We are more concerned of those who are at risk of bony fractures. The biggest risk for this type of injury is if you have Osteoporosis and/or Osteopenia.

Women are also more affected by osteoporosis and osteopenia than men because of the changes associated with hormonal differences

Exercise can be great intervention for bone health for individuals who have Osteoporosis and Osteopenia, but we recommend avoiding extreme flexion and extension exercises of the spine. We call this “hyperflexion” and “hyperextension”.

In fact, a recent study by Lee et al 2019 from the Mayo Clinic found the following Yoga poses caused injuries when individuals were referred to a musculoskeletal specialist from his/her family doctor.

Most of the injuries came from the spinal flexion maneuvers. Spinal flexion exercises in yoga encourage spine flexibility through muscles and ligaments in the back column. Although a healthy spine can tolerate such postures with ease, an osteoporotic or osteopenic spine may have difficulty translating the forces.

From the study above, 29 of the 89 patients had bony injuries, not just muscles! We can deal with muscles but definitely do not want bony injuries! This was the largest description of yoga-induced vertebral injuries to date.

Several key aspects we recommend if you want to try Yoga:

1. Be sure to let the instructor help you improve your form to decrease injury risk.

   • At PhysioFit of North Carolina, our studio is limited to 14 participants so you can feel personal attention, even in a group class! We also offer personal, 1:1 Yoga sessions.

2. If your joints/muscles do not feel “right”, as if you are pushing it too much, please ask for modifications of the poses.

   • Guided support will be given to each and every student, all levels are welcome.

3. Consult your physician if you are concerned over Osteoporosis or Osteopenia to get a Bone Mineral Density Test through a Dexa-Scan (dual-energy X-ray absorptiometry or DXA).

4. Once you are cleared to perform Yoga from your physician if you have Osteoporosis or Osteopenia, you could also consult one of our Physical Therapists to help guide you to a proper Yoga routine with recommendations on poses to avoid or modify.

   • At PhysioFit of North Carolina, we specialize in our “Feel it to Heal it Physio” Approach so you know what muscles you are supposed to be exercises during Yoga and even more importantly, what muscles you are not supposed to be working!

Our goal is to help keep you moving and living an active lifestyle!

Be sure to read our other blog posts on what Yoga poses to avoid if concerned of extreme spinal flexion and extension moments!

If you are looking for Yoga in Wake Forest, NC; I hope we can have you join us at our studio!