Fosamax or Exercise?

Hi @tsc. Thanks for the Dr Fishman's 12 poses. I had found them (the YouTube video with Dr Fishman himself and all 3 versions) and tried them but failed miserably at some of the bending levels....even the least drastic osteoporosis ones. And one or two twisting ones made me super nervous because of the combo of the "avoid/don't" twist contradictory advice I've seen/read plus my problems doing some of those...the twist with both hands eventually touching the wall...oh my! I've got longstanding back/neck trouble, which now the OP has piled onto. I'm liking the Osteoporosis-only version....I'll try that next! I can always do another pose during any problematic ones; it's just so disheartening to have to do that. New normals....

I'm also an inveterate researcher and thoroughly appreciate when another shares. I take an algea-sourced calcium, D3, K2, mag, potassium and trace mineral formula. I started this during the 6-year-period during which I lost no more bone density so am possibly a tad superstitious about stopping. (And my diet isn't consistent so hope to fill in any gaps.)

My PCP wanted me to take statins for high cholesterol. (I can't tolerate them, so nope. And make more of the large non-sticky molecules which is luck on my part.) Anyway, I gave a copy of echocardiogram and calcium score results to him. He was impressed but said that they were from years back and I needed something current. I pointed out that they were from 2 weeks earlier. That ended the statin argument and he kept copies for my file, lol.

One weird point about FRAXL ratings. I entered exact data from recent DEXA scan and got those results. Then changed only my age, deducting 10 years and risk numbers fell by 50% while EVERY other variable remained the same. I'm suspecting the algorithm is assuming that age increased odds of falling? I did the same experiment, using correct data, but decided 10 pounds from my weight and all of the risk numbers increased! I'm guessing that result us based on some occult (non-obvious) assumption of inadequate diet or something? I'd be happy to lose those 10 pounds of remaining lockdown weight and doubt they're doing me any health good...

My point is that some of the standardized ratings that we're all measured against include assumptions that don't apply to us. And can be inappropriately discouraging.

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!

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

Teri, I couldn't get that link to open on cellphone. Are these exercises shown on YouTube the same?

Welcome to Connect @rubyrose. You are starting off with a bang. Are you sure this is your first post? We have a lot to look forward to. I am one of those who have had a huge struggle with this facet of my health guidelines. I did not even think of osteoporosis until my new PCP reminded me that at 75 I should be doing something about building and protecting my precious bones. I had not even had a Dexascan. So.....after a very bad start with Boniva, I selected Tymlos. I moved into Osteopenia or held my own in two years. And then what?

After a year on Prolia with side effects, I consulted an endocrinologist at Mayo Clinic. I have left Prolia (gladly I might add) and just completed a month on Alendronate. So far so good......very few side effects. These decisions are quite difficult. I will be thinking about you on Thursday. Would you please let me know how that goes for you?

Sharing is how we gain knowledge on Connect. And as I mentioned, you are starting off with a bang.

May you have happiness and the causes of happiness.
Chris

That's Dr. Fishmanis video. I was doing it for a while, but Algaecal posted onevideo for each variation, which I find easier to follow. And Dr. Fishman has a video on their site talking about yoga practice. I doubt he'd do that if he has problems with twhat they've done.

Here's the link. I hope it works:
https://blog.algaecal.com/yoga-for-osteoporosis/

It worked, thanks.

I do/will not do yoga, though perhaps there are forms I could tolerate safely. I have done tai chi for years. No twisting. All tai chi movements originate from the lower belly area (the dantien). It helps with alignment and balance and the slow movements build muscle. Lots of studies on tai chi for osteoporosis.

Regarding skipping supplements like calcium and S: if you get enough calcium from diet, that's great. Some of us cannot eat dairy. If you live in a climate with lots of strong sun, you may get enough D but noone is the northern areas of the country gets enough D naturally: everyone is deficient without supplements.