Yoga Only Delays Bone Loss in Osteopenic Women

The Effect of Yoga on Markers of Bone Turnover in Osteopenic Women: a Pilot Study. Balk, Judith; Gluck, Melissa; Bernardo, Lisa; Catov, Janet, International Journal of Yoga Therapy;2009, Vol. 19, 63-68

ABSTRACT

Weight-bearing exercise is recommended to improve bone density. Hatha Yoga is a popular form of weight-bearing exercise that includes physical postures, stretching, breathing, and relaxation. We hypothesized that Hatha Yoga would have beneficial effects on bone turnover markers. We conducted a small feasibility pilot study with a prospective, pre-post design comparing markers of bone turnover before and after Yoga training in sedentary osteopenic postmenopausal women. Markers of bone formation were measured with serum bone-specific alkaline phosphatase (BAP). Measures of bone resorption were measured with urinary type I collagen cross-linked N-telopeptide (uNTX). Seven participants completed a 12-week series of one hour per week Yoga classes, in addition to home Yoga practice. We analyzed the correlation between time spent on Yoga and time spent on other weight-bearing exercise and change in bone turnover markers. The amount of Yoga practice was significantly correlated with BAP levels (r = 0.68, p = 0.09). A weaker, non-significant correlation was found between the amount of Yoga practice and uNTX levels (r = -.54, p = .21). Compared to Yoga, other physical activities were less correlated with BAP and uNTX levels. Yoga may have beneficial effects on bone turnover in osteopenic postmenopausal women.

My comments

This is a continuation on my research as to the effectiveness of yoga for osteoporosis after having received that continuing education flyer for yoga based physical therapy treatment that was osteoporosis specific. “Meeks Method” if you want to google it.

As opposed to my last blog which suggested yoga flexion poses could cause vertebral compression fractures, this one looked at the positive aspects of yoga and it’s effects on bones. They reported taking care to avoid end range flexion and extension, which I think is a good idea, and they tried to focus on more weight bearing exercises. The problem was that those weight bearing exercises, as described, were at most balancing on one leg. While I think single leg balance is a good exercise and I have my patients work on it from time to time, I don’t think of it as optimally effective for increasing bone mineral density.

Out of the 13 subjects who entered the study, 5 (38%) dropped out because it was too time consuming (one 60 minute class per week, and 30 minute home exercises on most other days for 12 weeks). Of the remaining 8 subjects they got post test on bone markers showing positive trends but not statistical significance. They did report a trend towards an increase in bone formation, but only 3/7 showed a decrease in bone resorption. Such that they concluded yoga would have a positive benefit those with with osteopenia because it would “slow the expected trajectory” of bone resorption, thus delaying the onset of osteoporosis. I think that is all well and good when compared to nothing, which is what this study did. However, when compared to just doing squats with weights 3 times per week, which has been shown to build back bone in those with osteoporosis, just slowing the inevitable with yoga, seems like an inefficient use of one’s time at best.

As always, if you have any further questions or need for clarifications, please don’t hesitate to ask. Being aware that some of my blog ideas are contentious and occasionally a bit out of the field of my expertise, I encourage my readers to come forth with any questions/comments that are of interest or concern. Your comments are valued and welcomed.

Chad Reilly is a licensed physical therapist, located in North Phoenix, practicing science based medicine with treatment protocols unique and effective enough to proudly serve patients from Phoenix, Scottsdale, Mesa, Chandler, Tempe, Peoria, and Glendale.

2 thoughts on “Yoga Only Delays Bone Loss in Osteopenic Women

  1. Is a study with 13 subjects, 5 of whom dropped out considered useful scientific research? I’ll take increased bone growth over slowing the inevitable onset of osteoporosis. Does it matter how much weight is used for squats to build bone?

    • Hi Marissa,

      A 38% dropout rate makes the findings very questionable, you can read more about attrition bias here. The link says below 5% is good, greater than 20% is awful. I wrote this blog back when I was a yoga hater, but my conclusions remain the same, that typical yoga exercises are of insufficient intensity to combat osteoporosis. Yes most yoga is “weight bearing” but how much weight you are baring matters a lot.

      For the squats nobody know’s how much is necessary but even in the weight training studies for osteoporosis it has been difficult to build bone. In the study I linked about squats they were doing 4 sets of 3-5 reps with 85-90% of their 1 RM max. So really heavy weight, and low reps, however I have seen bone mineral increases in the clinic with my typical “rehab” rep range of 15s, but as you know, I’m working my osteoporotic/osteopenic women up to around 90-100 lb or more for those 15 reps. Lighter weight training studies for osteoporosis were much like this yoga study where at best it seems like they were only delaying bone loss, not building anything.

      For a home program I strongly suspect the jump lunges of Spinal Flow do much the same as heavy squats. In fact the primary reason I changed Level-3 Spinal Flow from regular lunges to jump lunges was I had a gal hit 99 regular lunges in 3 minutes, nearly maxing out the test, and still she had osteopenia. So I thought we definitely need something with more force/impact and maxing out on jump lunges feels 100% as hard as heavy squats to me (at least on the legs, tho probably less so on the spine).

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