Practicing yoga is known to improve balance, flexibility, and strength. But people who have osteopenia (low bone mass) or the more severe osteoporosis (fragile, brittle bones) must be careful to not harm themselves with poses that significantly flex or extend the spine, according to a small study published in Mayo Clinic Proceedings.
The researchers studied 89 mostly female participants (average age 58) who hurt themselves while practicing yoga. About one in four of the participants had a prior diagnosis of osteoporosis. Some were new to yoga, but many had been practicing for years.
Most reported pain in the back, but pain in the neck, shoulder, hip, or knee was also common. Injuries affected the soft tissues (such as muscles, ligaments, and tendons), joints, and bones and ranged from strains and sprains to rotator-cuff injuries, slipped disks, and compression fractures.
The researchers identified 12 poses that put people with osteoporosis or osteopenia at increased risk for injury, including the seated forward fold, downward facing dog (pictured in the lead photo), warrior 1, side plank, bridge, boat, lotus and half lotus (seated cross-legged position), and headstand. The most severe injuries occurred during extreme spinal flexion and extension.
What you should do
If you’ve been diagnosed with low bone density, ask your doctor whether it’s safe to begin or continue practicing yoga. If you’re cleared, choose a form of yoga that’s not too intense, and look for smaller classes where you can benefit from individual attention. Inform your yoga instructor—who should be certified with at least 200 hours of training—before class that you have osteoporosis or osteopenia.
Ask for pose modifications that won’t put too much load on your back or other areas where you may be injury-prone. If you prefer practicing at home unsupervised, take care to avoid the poses listed above.
You might consider taking a few classes before you practice on your own so that your instructor can give you feedback on your form. A session with a physical therapist, especially one who holds a yoga certification, can also help you with technique.
This article first appeared in the July 2019 issue of UC Berkeley Health After 50.
Also see Yoga for Arthritis.