Vertebral compression fractures associated with yoga: a case series
Jad G Sfeir1, Matthew T Drake1, Vikram J Sonawane1
1Division of Endocrinology, Diabetes, Metabolism and Nutrition, Department of Internal Medicine, Mayo Clinic, Rochester, MN, USA.
European Journal of Physical and Rehabilitation Medicine
|April 25, 2018
Summary
Certain yoga poses may increase fracture risk in individuals with osteoporosis. Spinal flexion exercises in yoga can lead to vertebral compression fractures, especially in older adults with bone density loss.
Area of Science:
- Gerontology
- Orthopedics
- Sports Medicine
Background:
- Exercise is crucial for skeletal health, but safety in at-risk populations is under-reported.
- Yoga's popularity stems from physical and psychological benefits.
- Some yoga poses may elevate fracture risk, particularly spinal fractures, contrary to popular belief.
Purpose of the Study:
- To investigate the association between yoga and vertebral compression fractures (VCF) in at-risk individuals.
- To highlight potential risks of specific yoga practices in populations with decreased bone mineral density.
Main Methods:
- Case report analysis of nine subjects (8 women, median age 66) who experienced VCF after initiating yoga.
- Review of medical history, bone mineral density (BMD) scans, and fracture details.
Main Results:
- All nine subjects developed VCF (thoracic, lumbar, or cervical spine) after engaging in yoga spinal flexion exercises (SFE).
- Four patients had osteoporosis and two had osteopenia; lowest T-scores were consistently in the spine.
- Most patients had no other identified risk factors for bone loss, suggesting yoga SFE as a potential cause.
Conclusions:
- Yoga SFE can precipitate de novo VCF due to increased mechanical loading in susceptible individuals.
- Yoga is not universally bone-protective and requires careful pose selection for fracture-risk populations.
- Individualized assessment is crucial for fracture prevention when recommending yoga.
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