Yoga

Namaste Readers!Yoga and Osteo Cover Photo copy

Yoga has become so popular in our culture that it seems to pop up on the Internet, in alternative medicine and even amongst scientists and doctors. It is typically recognized as an exercise that makes our body more flexible and stronger!

There are many types of yoga that target different parts of our body. Some are meant just for relaxation, while others teach us to strengthen our muscles. So the burning question some of us are asking is, “can yoga help osteoporotic bones?”

Yoga is a great exercise and can strengthen and build balance in almost anyone. Yoga is also now being studied for helping to correct unwanted spine curvature like scoliosis and initial results show promise. Some also say that yoga can help increase our bone mass, although research in this area is not yet conclusive and needs more studies.

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The caveat with yoga is that many of the poses done in a yoga program can harm osteoporotic bones. Yes… harm… so it seems like yoga and osteoporosis may not really go together like a peanut butter and jelly sandwich. Here are some reasons why:

  • Healthy, strong bones can withstand extra stress acting on the skeleton during certain yoga poses. For example, when we bend forward to touch our toes, the spine curves forward and stretches the back leg muscles, such as during the Downward Dog pose. This puts pressure between the bones that make up our spine (called vertebrae). Osteoporosis can seriously weaken our spine bones, which can then fracture even with a little extra pressure, such as during a forward spine bend.
  • Other common yoga poses, such as the Triangle, Half-Twist or Warrior poses require our torso to rotate around the hips. Although they are great ways to relieve muscle tension, the twisting motion, in osteoporotic skeleton, places tension on the spine causing unwanted stress.

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Sometimes osteoporosis can lead to several spine bones being compressed and collapsed due to numerous fractures resulting in a permanent forward hunch (called ‘kyphosis’). This osteoporotic hunch can cause chronic pain, disability and negatively influence health and self-esteem. At this point, even simple things like pulling the knees towards the chest while on the back can add stress to weakened spine.

Yoga and osteo graphic 5copy

Therefore, if you have been diagnosed with osteoporosis and want to exercise safely and effectively, please avoid drastic movements and poses that place stress on your bones, especially your spine, like forward spine bending, spine twisting, lifting arms above shoulder height or high-intensity jumping.

If you have osteoporosis and are still tempted to do yoga, talk to your doctor to see what they recommend, or at least talk to the yoga instructor and ask them to modify spine bends and twists during the class for you. Just remember that you need to be careful to not place too much stress on your bones, like your spine, to cause them to fracture.

Do you have other questions about yoga and osteoporosis?  Comment in the box below.

By Isabel Rodrigues, Kevin Chia, and Dr Luba Slatkovska. Infographics by Kevin Chia.

 

Good Moves

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New Year, new beginnings and resolutions…

Are you looking to move and exercise more this year to help prevent osteoporotic fractures? We applaud you! Physical activity is important for people with osteoporosis or low bone mass. It can help improve strength and balance, and prevent falls and injuries that lead to osteoporotic fractures.

Are you hesitant to get started, because you have osteoporosis, and are worried about fracturing as you move and exercise? It is wise to be cautious. There are certain movements and exercises that are unsafe for people with osteoporosis. But don’t let this caution hinder you completely!

Are you keen to learn which movements and exercises are “bone-unsafe”, and which are “bone-healthy”? You’re in the right place. Consider our Good Moves handouts. Each Good Moves handout aims to describe one bone-unsafe move (and how it increases risk for osteoporotic fracture) or one bone-healthy exercise (and how it can improve muscle strength or balance).

Without further ado, here is our first Good Moves handout. It focuses on a common, bone-unsafe movement: spine rotation or spine twisting. Click on the image below to upload the handout.

Good moves _Spine twisting v5

Stay tuned for more Good Moves handouts in the upcoming months. Also, consider learning more about exercise and osteoporosis from these resources:

  • OsteoConnections pages that describe the link between osteoporosis and exercise
  • Osteoporosis Canada’s exercise recommendations for people with osteoporosis or low bone mass
  • Osteoporosis Canada’s tips for getting started for individuals who are not accustomed to exercise

Osteoporosis Outreach

November is Osteoporosis Month!  Visit us at the annual Osteoporosis Outreach this week. We are helping hospital staff and visitors learn about how to assess risk for osteoporosis and fractures, and  what to do about reducing the risk.   Here is more about us:

Osteoporosis Program, University Health Network and Mount Sinai Hospital:

Osteoconnections.com: The official blog of the Osteoporosis Program that aims to spread awareness about osteoporosis and its connection to overall health. Learn more…

University Health Network: Consist of 4 major centres that care for patients, conduct leading-edge research and train the next generation of health professionals.  Learn more…

Mount Sinai Hospital:  An internationally recognized acute care academic health sciences centre that is dedicated to delivering the best medicine and patient experience.  Learn more…

Osteoporosis Outreach:  9AM-4PM  from November 25 to 27 2014

TUESDAY, NOV 25 2014
Toronto Rehab Institute, University Lobby

WEDNESDAY, NOV 26 2014
Mount Sinai Hospital, Rexall Lobby
Toronto Western Hospital, Shoppers Drug Mart Lobby

THURSDAY, NOV 27 2014
Princess Margaret Cancer Centre, Murray Street Lobby
Toronto General Hospital, Eaton Lobby

Precautions for osteoporosis exercises

It is important that osteoporosis patients exercise, but even more critical that they exercise in the right way. Exercising in the wrong way can be more harmful than not exercising at all! Below are a few important points to keep in mind:

1. Avoid forward bending and twisting the spine.

Twisting/rotating the spine
Twisting/rotating the spine

People with osteoporosis often have an abnormal curvature of the spine known as kyphosis. This occurs when vertebrae (bones that make up the spine) weaken and press upon each other. Exercises or activities that require forward bending can worsen this hump-backed posture and increase the risk of severe injuries. For this reason, exercises such as sit-ups, curl-ups, and toe touches, all of which involve forward bending, should be completely eliminated from any osteoporosis exercise program.

Twisting (rotating) the spine also puts great pressure on the vertebrae (see image). When forward bending and twisting is done at the same time, the stress on the spine is greatly increased. Also, be careful to avoid forward bending and twisting not only during exercise but also during day to day activities such as lifting, vacuuming, sitting, and sneezing.

2. Do not lift a load forward and away from the body.

Lifting forward and away from the body
Lifting forward and away from the body

Avoid lifting a weight forward and away from the body when you are exercising (see image). This can put a lot of stress on the back and cause forward bending of the spine.

3. Do not lift a weight above shoulder height.

Do not perform exercises that require lifting a weight above the shoulders as this causes a tendency towards forward bending. This increases stress on the spine and may lead to injuries.

4. Avoid jogging, jumping, and skipping.

Jarring of the spine during jogging, jumping, and skipping can cause spinal injuries. Try speed walking instead.

 


The above information was taken from the Osteoporosis Exercise Guide

 

Upper body exercises

In follow up to our previous post from yesterday, certified exercise specialist Dr. Marta Erlandson begins our series of exercise videos by demonstrating upper body exercises that are good for developing bone and muscle strength.

Exercise for bone health

As we have highlighted previously, exercise is important in both preventing and treating osteoporosis. But physical activity can be a confusing issue for osteoporosis patients and individuals with low bone mass as some types of exercises can harm weakened bones.

The Osteoporosis Exercise Guide gives detailed descriptions of bone-friendly exercises and also describes what types of exercises and activities can be harmful to bone health. We have also recently created a few videos with Dr. Marta Erlandson PhD, an exercise expert, and former post doctoral fellow with the Osteoporosis Program. Marta is a Certified Exercise Physiologist and recently appointed Assistant Professor at University of Saskatchewan, College of Kinesiology.

In her first video, Marta talks about exercise and bone health and what kind of movements to avoid if you have osteoporosis.

Exercise on trial (part 2)

dumbbellsIn our last post, we reviewed the existing evidence on whether exercise can prevent fractures by looking at the results of a recently published meta-analysis (a type of study where results are combined from different trials). We concluded that at this time we do not have definite proof to say that exercise reduces fracture risk.

Why then do health professionals stress that exercise is good for osteoporosis patients? The answer lies in our understanding of how bones function. Bones are similar to muscles in that we need to work them in order to keep them healthy and fit. So when we use our body weight or lift weights for example, not only do our muscles have to work to hold up that weight, but our bones also work and become strong. And just like muscles, bones can become weak and deteriorate if they are not used. People who are wheelchair-bound, for example, have very low bone density in their legs.

So although we currently do not have proof to say that exercise will definitely protect us from osteoporosis-related fractures, the effects of exercise on bone still warrant physicians to highly recommend it. Also keep in mind that the benefits of exercise are numerous and extend to all parts of your body! (Read more on the benefits of exercise here and here.)

But before you tie up your laces and head out for a jog, a word of caution: safety is an important factor to consider when exercising, especially if you have low bone mass, are frail, or have a tendency to lose your balance or fall easily.* Exercising incorrectly in these cases can actually be more harmful than not exercising at all! Avoid high-impact exercises (such as running, jumping rope, and skipping) and avoid activities which flex, bend, or twist your spine.

Osteoporosis Canada has some excellent information on general exercise guidelines for people with low bone mass and what types of exercise are best for building bone strength. In addition, you might want to consult with a certified exercise specialist that is familiar with the special needs of people with osteoporosis. In Canada, you can find such an exercise specialist by visiting the Bone Fit website.

Osteoporosis Exercise GuideOur research group has also produced a booklet called the ‘Osteoporosis Exercise Guide’ which is based on over 15 years of experience working with osteoporosis patients. It provides detailed instructions on exercises that are most beneficial in building bone strength and also provides important guidelines for daily activities to avoid fractures. For more information, or to purchase a copy, please email osteoporosis@uhn.ca.

*If you have heart problems, high blood pressure, diabetes, or are overweight, you should first check with your physician before starting an exercise program.