Yoga for Bone Health? An Unexpected Twist
Yoga puts more pressure on bone than gravity does. By opposing one group of muscles against another, it stimulates osteocytes, the bone-making cells. — Dr Loren Fishman
Results of a ten-year investigation suggest that practicing yoga can spark bones to bulk up even better than aerobic and weight-bearing exercises do and for the same reasons – the cells that make bone respond to sustained pressure by making more bone.
The research was conceived in 2005 by Loren Fishman, MD, B.Phil., (oxon.) a Columbia University physiatrist. Dr Fishman reasoned that yoga twisting, squeezing and stretching should stress bone and stimulate bone matrix production.
“Weight lifting, strenuous aerobics, and especially the medications could cause injury among people with osteopenia or osteoporosis, so I identified twelve yoga poses which would put maximal stress on bone and so be most likely to improve bone density.” Other research suggested that that 30 seconds with each pose – a total of twelve minutes once a day – should do the trick. The English language names for the twelve yoga poses are Tree, Triangle, Warrior II, Side-angle, Twisted Triangle, Locust, Bridge, Supine Hand-to-Foot I, Supine Hand-to-Foot II, Straight- legged Twist, Bent-knee Twist and Corpse. Dr Fishman chose these twelve, he says, because they were most likely to stress the spine, the femur, and the hip, the three sites that are most commonly fractured, and not coincidentally, the bones measured by the DEXAs scan.
Colleagues were skeptical but Dr Fishman was not; he invited senior citizen volunteers with compromised bone density to participate in trials. Among 227 participants who were mostly or fully compliant, after two years DEXA scans showed improved bone density in the spine and femur and not one person had been injured. “The injury level was minimal,” Dr Fishman says; “in fact zero, because Mr. Iyengar’s yoga stresses alignment, and with proper alignment, people can try pretty hard and not hurt themselves.” Hundreds of people of average age 65.5 have spent more than 100,000 hours doing these exercises, yet there have been no fractures and no serious injuries of any kind to date.
To many, the bone-health bonus was a surprise finding, as yoga seems to target muscular rather than skeletal strength – but the mechanism, Dr. Fishman explained, is quite specific.
“Julius Wolff, a German anatomist and surgeon had theorized that ‘the architectonic (underlying structure) of bone follows the line of force to which the bone is exposed,’ and his theory has subsequently proved true,” Dr. Fishman says, “down to the molecular level. As it turns out, the physiological mechanism of Julius Wolff’s law has been mapped out over the past few decades. Whether aerobic, lifting or stretching, the path from exercise to bone density is mechanotransduction, a chain-reaction change of mechanical force to electrical eventually chemical energy.
In the course of bone response to any of these forces, the pressure on osteocytes, the cells that make bone, is changed by the cell membrane into an electron volt that powers a chemical reaction inside the cell, creating molecules that enter the nucleus and upregulate DNA that makes RNA and consequentially new proteins that the cell extrudes. These proteins are called osteon, the material that attracts calcium and phosphorus, and then constitutes hydroxyapatite, the material of mature bone.
Loren Fishman is founder and director of Manhattan Physical Medicine and Rehabilitation, and the website sciatica.org The DVD showing the twelve yoga poses can be obtained at the website sciatica.org
Brody, Jane E. 12 Minutes of Yoga for Bone Health The New York Times. December 21, 2015
Fishman, Loren and Saltonstall, Ellen. Yoga for Osteoporosis. W.W. Norton. March 29, 2010
Jaquish, J. Multiple-of-bodyweight axial bone loading using novel exercise intervention with and without bisphosphonate use for osteogenic adaptation, Performance Health Systems, Chicago,
Osteogenic Loading & bioDensity Lecture – Medical Wellness Association 2013
Wolff, Julius. The Law of Bone Remodelling 198 Volume 24 Supplement 4 December (2013)