Yoga can be an excellent weight-bearing exercise for those with osteoporosis. Here are some tips for a safe yoga practice…

Many older people today suffer from osteoporosis – in fact, in 2010, an estimated 10.2 million Americans suffered from the disease, while 44% of those over 50 had low bone mass.

Those with osteoporosis face what seems to be a catch-22; the best way to increase bone mass is weight-bearing exercise, but many weight-bearing exercises are inadvisable for those with low bone mass. If you need to avoid high-impact forms of exercise due to osteoporosis or some other reason, yoga can be a great option.

Yoga is a low-impact form of weight-bearing exercise that people of all ages can benefit from. However, if you do have osteoporosis, you will want to check with your doctor before trying yoga.

You will also want to use care when participating in specific yoga exercises. Below are 7 tips from Yoga International for those engaging in yoga with osteoporosis:

1. Do…practice neutral-spine postures.
Students with osteoporosis should make neutral-spine poses like mountain the crux of their practice and should work on aligning the spine optimally in these poses.

“Tip the tailbone back enough that you create a curve in the lower back, and bring your head back over your shoulders. Imagine a plumb line dropping from your ear down through your shoulders, hips, and ankles. Maintain this optimal spinal position during most postures and flows,” physical therapist and author Bill Reif advises.

What about those with rounded upper backs who are unable to create a neutral spine? “Come as near neutral as possible.”

For example: Mountain, reclining hand to big toe pose (using a strap), low lunge, the warrior poses, tabletop, and plank are all neutral-spine poses.

2. Do…focus on lengthening.
Having arranged your spine in its neutral or near-neutral shape, work to elongate it since, according to Reif, “With osteoporosis, the weakened vertebrae sometimes collapse to the point of fracture.” Lengthening the spine creates space between the vertebrae, preventing or correcting that collapse.

For example: “Think often of a marionette string pulling up from your head no matter what position you’re in,” says Reif. Alternatively, imagine lifting up into an object—like a book or jug of water—balanced on the crown of your head.

3. Do…include poses that encourage the hands to bear weight.
Bring your hands to the mat! As noted, one of the advantages of yoga over other exercises is that bearing weight on the hands allows us to build bone density in the arms as well as the legs.

For example: Tabletop, plank, forearm plank, chaturanga, reverse tabletop, and downward facing dog.

(Please note: It is not safe to bear much weight on the hands if the upper back is rounded. In tabletop, work to indent the space between the shoulder blades, and only proceed to poses like chaturanga, plank, and downward facing dog once this is possible. Avoid arm balances like crow that call for a rounding of the back.)

4. Do…include gentle backbends.
Because osteoporosis is so often accompanied by thoracic kyphosis, it’s especially important to work on gentle backbends, which move the thoracic spine in and lift the chest, improving thoracic spine extension, according to Reif.

Even mild forward folds are not recommended for those with osteoporosis (see Don’t #2), but some mild backbending is fine. “The extension movement is much less risky than flexion because of the strength of cortical bone in vertebrae,” Reif explains. (Please note: Big backbends can be compressive, which is contraindicated and will be addressed in the Don’ts section.)

For example: Bridge, sphinx, baby cobra, camel pose (with hands on your lower back), lying down over a foam roller or rolled-up blanket (placed horizontally under the thoracic spine), and restorative backbends…

5. Do…include mild sidebends and twists.
Reif points out that “Varied spinal movement is important for preserving the health and strength of the vertebral bones,” although any pose that rounds the back should be avoided.

These varied movements include mild sidebends and twists, which Reif says “will allow you to maintain the greatest flexibility of your spine without causing the fractures associated with osteoporosis.”

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For example: Bend to the side by just a few degrees while standing or lunging, as well as in reverse warrior, gate pose, or while reclining in bananasana. Enjoy gentle reclining twists like “windshield-wipering” the legs from side to side. And when doing more vigorous twists, keep a neutral spine (i.e., do not round the back), twisting by only a few degrees.

6. Do…move from pose to pose slowly.
To decrease the risk of falling, it’s important that students with osteoporosis move from pose to pose slowly.

For example: Come up slowly from positions like half forward fold (bending the knees and bringing the elbows to the knees for a modified chair pose before rising to mountain pose) to decrease the risk of a head rush and a fall…

7. Do…challenge balance without sacrificing stability.
Because a fall could mean a fracture for students with osteoporosis, it’s vital to work on balance in yoga class. But, to avoid a fall, they should initially challenge their balance while making the most of the support available to them.

For instance, in standing balance poses, bring a hand to the wall to steady yourself, or keep the toes of the foot you’re about to lift on the mat until you feel stable. Reif notes, “You will still improve balance and coordination even if you are not in the ‘full’ pose.”

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For more tips plus yoga “Don’ts”, visit YogaInternational.com…