Yoga, vertebral fractures, and osteoporosis: research and recommendations

Osteoporosis is characterized by decreased bone density that leaves bones fragile and highly susceptible to fracture. Globally, 1 in 3 women and 1 in 5 men older than 50 will suffer from an osteoporotic fracture, and those individuals will experience a considerably higher risk of postfracture mortality than will the general population. Gentle, weight-bearing exercises such as yoga can help prevent or cease the progression of osteoporosis; however, there is insufficient data regarding which yoga poses present the least risk and are most beneficial to individuals with reduced bone density.

Review the extant literature about the risks and benefits to the spine of particular forms of movement and consider recommendations relative to the practice of yoga.

A review of the PubMed, Medline, and Cochrane databases was conducted that identified manuscripts published between 1966 and 2011 about topics related to osteoporosis and spinal movement.

Movements involving spinal flexion can increase risk for vertebral compression fractures; however, a combination of mild spinal flexion and extension may prove beneficial. Moderate, weight-bearing activities that strengthen the muscles supporting the spinal column, promote balance, improve posture, and enhance quality of life appear to be of greatest benefit. Ample evidence supports the importance of varied spinal movement for preserving the health and strength of the vertebral bodies. Exercise modifications suitable for high-risk individuals may be counterproductive for those at low risk for vertebral fractures. Yoga therapists are cautioned to not apply a one-size-fits-all approach when working with this population. Well-designed empirical studies are needed to further our understanding of which yoga poses present the least risk and are of greatest benefit to individuals with osteoporosis.