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Fosamax or Exercise?

Osteoporosis & Bone Health | Last Active: May 2 7:43am | Replies (73)

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@tsc

Hi @catluvr999, I found a video or something Dr. Fishman had written that he does not think the twisting is dangerous or comparable to the forward bending. He's a doctor of rehabilitation medicine so I elect to trust him. At first I found the poses excruciatingly difficult, but after doing them for a month, they've become easier and I notice I'm stronger. I started with the osteoporosis version, then moved on and am now doing the Prevention (in the algaecal video) with some modifications. My suggestion - just do what you can comfortably, don't force it, and stay with that level as long as you feel you need to. All the best!

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Replies to "Hi @catluvr999, I found a video or something Dr. Fishman had written that he does not..."

By the way, I found this at http://www.sciataca.org under Recent Publications,

PROBLEMS WITH THE MAYO CLINIC’S

YOGA FOR OSTEOPOROSIS STUDY

Loren Fishman, M.D. B.Phil.,(oxon.)

February 22, 2019

Less there than meets the eye
Dueling Osteoporosis Research

Wonderful news – the Mayo Clinic has begun studying yoga for osteoporosis, another indication that mainstream medicine is recognizing the importance of yoga in medicine.

“Tissue and Bony Injuries Attributed to the Practice of Yoga: A Biomechanical Analysis and Implications for Management,”* published in the Mayo Clinic Proceedings on February 20, 2019, cites twelve yoga poses it finds dangerous for those who have osteoporosis. I’m writing to assure you that what they’ve found is not dangerous for people doing the yoga in the DVDs I’ve created — “12 Poses vs. Osteoporosis,” Series I and Series II.

The paper gets some things right

The 12 poses I have chosen for you have been shown to arrest and reverse osteopenia and osteoporosis All of the poses that the Mayo authors found cause bony injury involve flexion – bending forward or forward folding. I believe this contraindication is correct. The Fishman Method DVDs “Twelve Poses vs. Osteoporosis, Series I and Series II” uses yoga to arrest bone loss and increase bone mass. The DVDs contain no forward flexion poses. My peer- reviewed and published yoga program** has been shown to have beneficial results, and has produced no fractures — none.

The paper gets some things wrong

1. The Mayo authors advise patients who have arthritis as well as osteoporosis not to do the Bridge pose (Setubandhasana) or the seated twist (Marichyasana) because they may cause injury. The original Fishman Method DVD*, “Twelve Poses vs Osteoporosis, Series I” contains these very two poses. In over 100,000 hours of practice by more than 1000 practitioners there have been no reports of fracture or serious injury of any kind. Not one. I believe twists are actually a n excellent and safe way to strengthen vertebral bodies – the most frequently fractured of all bones.

That is because forward bending can produce the very fractures we’re trying to prevent! In our 741 patient-study,** the circular movements of twists appear to significantly improve vertebral bone mineral density. The Mayo Clinic study includes patients who also have arthritis. Facet arthritis can indeed cause pain with backbends. But conflating arthritis with osteoporosis is confusing: the pain does not come from the osteoporosis.

2. Unfortunately, both the Mayo Clinic and I coincidentally chose 12 poses, which is confusing. But the similarity ends there. The Mayo Clinic article does not distinguish between different styles of yoga or even name the styles in the study. My Twelve Poses DVDs are based on Iyengar yoga, in which past medical history and alignment are paramount.

3. Sometimes people have long-standing conditions they’re unaware of until they do yoga. These injuries are not caused by yoga, but they are recognized while doing yoga. Fifteen of the ‘injuries’ the Mayo Clinic’s researchers identify are kyphoscoliosis. This is a chronically developing condition, and cannot realistically be believed to occur while doing yoga, as any doctor knows.

Along with the Mayo Clinic authors, I lament that yoga is often done without training or education about which poses might be dangerous. That is one of the reasons I created YIP.guru, (Yoga Injury Prevention.) This searchable compendium lists contraindications for osteoporosis (including flexion).

In general, it is true that yoga can cause injuries, and one must be knowledgeable and careful. It may be said that medications and surgery may have even worse side-effects. I think the yoga therapy community would appreciate medical studies that test to substantiate the positive effects of yoga

References

* Soft Tissue and Bony Injuries Attributed to the Practice of Yoga: A Biomechanical Analysisand Implications for Management Melody Lee, MD; Elizabeth A. Huntoon, MD, MS; and Mehrsheed Sinaki, MD, MS Journal of the Mayo Clinic.

* Lu YH, Rosner B, Chang G, Fishman LM. Twelve-minute daily yoga regimen reverses osteoporotic bone loss. Top Geriatr Rehabil. 2016;32(2):81-87