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5: Does Yoga Asana Build Bone Density?
461 Plays3 years ago
Welcome to Episode 5 of the Movement Logic podcast! In this solo episode, Laurel addresses the question of whether or not yoga asana builds bone density, where the belief or claim that it does might have come from, and then concrete, evidenced-based ways to improve bone density, as well as how yoga asana fits into these efforts. Here are specific points discussed:
- Where did the idea that yoga builds bone density come from?
- Why is bone density important and why should we want to build it?
- How do you find out if you have osteoporosis or osteopeonia?
- Who is most at risk of developing osteoporosis?
- How does osteoporosis happen?
- How do bones remodel and become denser, stronger, or more resilient?
- What activities build bone?
- When is the best time to work on building bone?
- What are the obstacles to building bone?
- Shoulder older adults lift heavy weights?
- The LIFTMOR study
- What role does yoga play in the conversation around bone density?
Reference links:
Twelve-Minute Daily Yoga Regimen Reverses Osteoporotic Bone Loss
Estrogen Matters
The Physio-Network
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Transcript
Introduction to the Podcast and Mission
00:00:06
Speaker
Welcome to the Movement Logic podcast with yoga teacher and strength coach Laurel Beaverstorff and physical therapist, Dr. Sarah Court. With over 30 years combined experience in the yoga, movement, and physical therapy worlds, we believe in strong opinions loosely held, which means we're not hyping outdated movement concepts. Instead, we're here with up-to-date and cutting-edge tools, evidence, and ideas to help you as a mover and a teacher.
00:00:40
Speaker
Hello and welcome to episode five of the Movement Logic podcast.
Yoga's Impact on Bone Density
00:00:45
Speaker
My name is Laurel Beaversdorf and I'm flying solo as your host today. We're giving Dr. Sarah Court a much deserved day off.
00:00:53
Speaker
Today we're talking about whether or not yoga asana improves bone density. When I started to hear this claim being made, it was probably around 2015 and 2016. I was teaching yoga, teaching yoga teacher trainings, and there was a lot of talk about how the weight-bearing aspect of yoga made it really good for building bone density.
00:01:19
Speaker
And I believe that this belief may have been strengthened or maybe even initiated by a study that was conducted by several PhDs. I'm going to pull that out here now. You might hear my paper rustling. And so, yes, several PhDs, one of which was Lauren, Dr. Lauren Fishman. The title of the study is 12-Minute Daily Yoga Regimen Reverses Osteoporotic Bone Loss.
00:01:49
Speaker
You can Google that study and download it and print it out and read it. Essentially, this study, the title of which is very promising, 12 minute daily yoga regimen reverses osteoporotic bone loss. Wow, that sounds so easy. That sounds so accessible, right?
00:02:10
Speaker
Well, as it turns out, there's lots of problems with this study and the promising title did not yield results, unfortunately, that were quite as promising. Some of the problems with this study that are maybe most glaring is that it's a survey where people who sign up for it have self-selected.
00:02:32
Speaker
And so it says that initially 741 people signed up for the study. But then somewhere along the way, only 57 provided data. And some of that data was really quite incomplete data, like bone scans that were taken pre and post 12 minute daily yoga regimen intervention. So there's a lot of holes in terms of data that you would need to make that very optimistic claim.
00:03:00
Speaker
Now, one of the problems with people self-selecting is that when you don't have a control group, in other words, there aren't two groups of people, one of whom is receiving the treatment that's being tested and the other for which they're receiving like the placebo or they're receiving some other treatment to be kind of compared to like the results of those groups would then be compared to see like how
00:03:24
Speaker
efficacious the tested intervention is. These people all self-selected. They knew what they were getting into. They knew why they were doing it. They may have been people that really liked yoga and just wanted to do yoga. They may have wanted the free DVD that came along with it with the 12 minute.
00:03:41
Speaker
So, there's all kinds of reasons why this was a fairly weak study. But since this time, I think a lot of people have judged the outcome of this study based on its title and less so on the actual results that were reported in it than this really good news about yoga being a great way to improve bone density started to spread pretty rapidly and was used.
00:04:06
Speaker
as a kind of a marketing device, I would say, to promote the practice of yoga specifically among the populations that are often most attracted to yoga, which were older women. This, you know, tendency to want to promote yoga as this
00:04:23
Speaker
efficacious way to solve problems in the body is, you know, it's, it's something we've heard likely before that yoga is all you need, yoga can fix any problem. And this, this belief, I think, kind of underpins this idea that, okay, we're gonna just take this one study and start
00:04:41
Speaker
you know, saying that yoga improves bone density, when it's likely not the case that yoga is a very good way to improve bone density. So we're gonna talk about that today. So spoiler, does yoga, asana improve bone density? Spoiler, probably not, but let's talk about why.
Understanding Osteoporosis and Bone Density
00:04:59
Speaker
So what is bone density? Why should we care about it? Well, we should care about it because osteoporosis, which translates to porous bones,
00:05:11
Speaker
is a degenerative disease that is a major public health concern. When people develop osteoporosis, they lose their bone mineral density, their bones in a sense kind of thin out and become less capable of supporting their weight.
00:05:31
Speaker
as well as less capable of sustaining falls. In other words, bones are more likely to fracture as a result of falling. And this increased risk of fracture is really the problem. So osteoporosis causes an increased risk of fracture, and it's the increased risk of fracture that increases the risk of death.
00:05:55
Speaker
The precursor to osteoporosis is osteopenia, and these two conditions are measured using a DEXA scan, DXA, dual x-ray absorptiometry. Hopefully I said that right. And so the scores that would mean that you have osteoporosis or osteopenia, 2.5 standard deviations below the score of a healthy 30-year-old,
00:06:23
Speaker
A standard deviation is really just deviation from the norm. So they're setting the norm at the bone density of a healthy 30-year-old. If you score 2.5 standard deviations below that, you're considered to have osteoporosis.
00:06:39
Speaker
If you score one to 2.5 standard deviations below, you're considered to have osteopenia. And if you have a score of less than one, you're good to go. Many of you listening have already had your DEXA scan. It's just a part of the process of checking up and making sure everything's healthy and well.
00:06:57
Speaker
So, if you have had a DEXA scan, you likely know what I'm talking about, but just know that this is something that will be a part of a person's healthcare process and protocol as they age. Interestingly, I'm reading a book, Estrogen Matters, which is about the importance of estrogen in an aging woman's body and her health. And a very interesting factoid that I've been thinking about
00:07:24
Speaker
that was shared in that book was that the best predictor of fractures later in life in older adults is actually more strongly correlated to a history of falls than it is to
00:07:41
Speaker
to osteopenia at least, maybe it was also osteoporosis. But so we'll talk more about fall prevention since this is very much relevant to, you know, our goal of staving off osteoporosis or building bone density should also probably include a discussion around
00:07:59
Speaker
fall prevention, because the real root cause here of increased mortality is fracture. So we really want to decrease the risk of fracture. So there are populations of people who are more at risk of developing osteoporosis. So let's talk about who these people are. And this, by the way, is not an exhaustive list. This is not every risk factor. These are just a few.
00:08:25
Speaker
big ones. One is if you're a female, especially a female who entered menopause early. The second risk factor is if you're a woman over 50. Also, older men are at a greater risk of osteoporosis than younger men, but women over 50 have a four times
00:08:45
Speaker
higher rate of osteoporosis than men and fractures as a result of osteoporosis typically occur five to ten years earlier in women than they do for men. Another risk factor is if you're white or Asian and if you are a smaller framed individual
00:09:02
Speaker
Lifestyle and diet matter a lot, so if you smoke, if you drink too much, if you have a vitamin D or calcium deficiency or you have not had a sufficient calcium and vitamin D throughout your life,
00:09:18
Speaker
Now, we talked about how a risk of falls is a better predictor of whether or not someone will sustain a life ending or life altering or life ending fracture. So we can also tack on to the risk factors of osteoporosis, these risk factors that increase your risk of falling.
Biological Mechanisms of Bone Density Loss and Adaptation
00:09:40
Speaker
which kind of go hand in hand with osteoporosis, right? If you have osteoporosis and a risk of falling, you're more likely to suffer a fracture. And these are bad eyesight and balance, as well as they found that genetics seem to play a role, at least in predicting fracture in that a woman's risk of fractured doubles if her mother had a fracture before age 80.
00:10:05
Speaker
What's up with bone and bone density loss? How does this work? How does it actually happen? We'll talk about how bones are alive. They are not dead things inside of your body, inert, hard, dead minerals, but rather they're very sensitive and extremely communicative. Maybe we get this idea that bones are dead though because we
00:10:32
Speaker
You know, if you eat meat, you're eating the meat off of a dead animal's bone, or if you go for hikes in the woods, I go for lots of hikes, and often we'll see skeleton, animal skeletons lying around. But bones in a living being are as alive as the being itself, and they're communicative. So what that means is
00:10:52
Speaker
that your bones are made up of cells and your cells communicate with other cells. And the word for this in terms of how bones change is that they are mechanosensitive. So mechanosensitive simply means that your bones are sensitive to mechanical input or forces.
00:11:17
Speaker
and these forces can cause bones to change in various ways. We communicate with our bone cells and we can cause them to set off a cascade of cell signaling, so that's that cell communication, which is another way of just saying we can cause them to adapt by loading them, by applying mechanical stress to them.
00:11:40
Speaker
And this can cause our bones to adapt in a way where they actually lay down more cells. They increase in density, for example.
00:11:49
Speaker
The mechanical stress that we apply to bones creates a deformation of the bone. And so this deformation is called strain. In an earlier episode, Sarah and I talked about self-massage, and she defined self-massage as creating a deformation to your fascia or your soft tissues. Same idea.
00:12:14
Speaker
even something like a bone which you might think of as being very hard and like solid and immovable has the ability to deform.
00:12:23
Speaker
And in high enough amounts, this deformation, this strain will lead to the bone signaling to lay down, the bone cells signaling the bone to lay down more cells. That's a really super overly simplified way of explaining it, but just so you can maybe have kind of a rough picture of how this works. So it's really loads applied forces that cause our bones to change.
00:12:49
Speaker
and to increase in density. Now, it can take kind of a long time for bone density to increase. Like four months is the time that it would take for a bone to increase in density. However, it can take as long as six months for that change to be seen in something like a scan. But, you know, six months is not forever. And so what this means is that your bones are not the same today as they were
00:13:16
Speaker
last year or even six months ago. They're in a constant state of change. You can think of it as them being in a constant state of equilibrium. They're in a constant state of balance made up of the cells that are simultaneously building them up and breaking them down.
00:13:35
Speaker
The cells that build your bones up are called osteocytes, osteoblasts specifically, and then the cells that break down your bone are called osteoclasts. Over the course of your life, the balance between bone growth and bone loss starts to change.
00:13:54
Speaker
early in life until about age 25 bone is formed at a greater rate than it is lost until about age 30 and then around age 30 it stays pretty steady for about a decade and then at about age 50 your bone loss begins to outpace your bone formation.
Activities to Combat Bone Density Loss
00:14:21
Speaker
What do we need to do so that the rate of bone formation increases and the rate of bone loss decreases? Here's where I'm going to introduce kind of a maybe a new and somewhat technical sounding and maybe sort of scary sounding word which is
00:14:38
Speaker
that we must partake in osteogenic activity. Okay, so osteo from the root for bone and genesis, which is to create or to form, we need to be doing bone forming activities. Okay, so what activities are osteogenic? There are three characteristics that I'd like to talk about with regards to
00:15:03
Speaker
what it means for an activity to be osteogenic. The first is that the loads of that activity must be high. And so if we think about loads as weight, for example, in weight training, because this is maybe the most accessible way to begin to engage in osteogenic activity for most folks. Loads that are high are those that are
00:15:32
Speaker
85% and up of a one rep max. So a one rep max is a theoretical amount of weight that a person can lift one time and one time only because it's so heavy.
00:15:48
Speaker
So they wouldn't be able to lift it two times right in a row. They could only lift it one time in a row, and everybody's 1RM is different, right? Everyone has their own level of strength. But 85% of that 1RM is a pretty heavy load. And that's a load that we could lift, I think it's about six times, right? So that's pretty low rep range.
00:16:13
Speaker
Now we can get stronger, meaning we can increase our force output by lifting lower loads or lighter loads. We can get stronger with loads as low as 75%, 70 to 75% of 1RM. Those would be like 10 to 12 rep range sets.
00:16:40
Speaker
But those are not going to be loads that are high enough for building bone. Our bones have a different level of sensitivity and they require a different magnitude of input than our muscles do in order to change.
00:16:55
Speaker
Why does strength training increase bone density? When we think of strength training, we think, oh, making my muscles stronger and in some cases bigger. Well, your muscles attach to bones via tendons and those tendons transmit the force of the muscle, which is contractile to the bone. The tendon itself also is able to store tensile force and so
00:17:23
Speaker
the combined active and passive tension from the muscle and the tendon, added together, act on the bone. And when that tension is high enough, tension, by the way, is just another way to say force. It's a type of force. When that force is high enough, we can potentially create strain on the bone. Remember, strain is that deformation.
00:17:46
Speaker
And that deformation is what causes the bone cells to say, hey, you know what? This is something we're going to have to get ready to handle better. So let's build ourselves up a little bit bigger. So strength training is an osteogenic activity when the loads are high enough. But another characteristic of an osteogenic activity is a high impact activity.
00:18:11
Speaker
And so you can think of, I think great examples of high impact are things like, if you can imagine, basketball, volleyball, stuff done on a court, gymnastics, where the gymnasts are landing from fairly high heights, plyometric type activity,
00:18:33
Speaker
Is potentially osteogenic because of the high impact involved now this is a different mechanism for loading your bones then muscle force and and the tendon it's more about ground reaction force and.
00:18:52
Speaker
When you're just standing on the ground, you're experiencing ground reaction force. You think of your body being pulled downward into the ground and you have a certain weight to your body. That is a force, by the way. Weight is a force.
00:19:06
Speaker
but the ground is also pushing back up against your body. When you land from a height onto the ground, that force of the ground acting back up against your body increases, just as the force of your body landing on the floor increases. And it turns out that 4G, right, so 1G is a measure of ground reaction force when standing, it's just one, you, your body weight.
00:19:33
Speaker
4G is four times your body weight and that is an osteogenic range that you'd want to be hitting. You could figure that out with a force plate, but those tend to only be in labs and maybe are a little too expensive for you to have in your home, but just know that it's quite a bit higher than walking and jogging quite a bit higher. And then the third characteristic of an osteogenic activity is if it's a high speed of loading,
00:20:02
Speaker
I listened to a very interesting course on the physio network, which I think is a great resource that you should check out. And they have a lots of really valuable educational courses. It's geared toward PTs, but movement teachers could totally benefit from watching them as well. And it's very affordable.
00:20:22
Speaker
I was watching a course by Dr. Stuart Worden, who is a professor and studies bone stress fractures, which is relevant to a discussion around osteoporosis because when we're talking about osteoporosis, we're talking about increased risk of fractures that are largely stress fractures that are caused from the thinning of the bone. He's looking at stress fractures that result from
00:20:43
Speaker
sport, typically the type of athlete that would suffer a stress fracture would be like an athlete that runs a lot and maybe someone who has increased their volume, increased their running mileage too quickly.
00:20:58
Speaker
and have not allowed their bones to adapt to those increased loads. He found that there was a study done on a pitcher's arm. So this is about speed of loading. We're talking about speed of loading being a characteristic of an osteogenic activity. He found that
00:21:16
Speaker
A pitcher, pitchers can pitch balls like 90 to 100 miles an hour. And this major league baseball pitcher might have even been a collegiate pitcher, I'm not sure. His pitching arm, the bone of his pitching arm was so much larger.
00:21:33
Speaker
than the bone of his non-pitching arm. This tells us a little bit something about how that high speed of loading from pitching a ball, you know, 90 to 100 miles an hour was osteogenic. Okay. The other characteristic of an osteogenic activity, and this one's really important
00:21:54
Speaker
is that it be variable. In other words, our bones get bored with a lack of variety.
00:22:04
Speaker
And this is why running is, even though running is impact, running is not the best for bone growth because it's cyclical and it's too repetitive.
Role of Movement Teachers and Yoga in Bone Health
00:22:16
Speaker
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00:22:27
Speaker
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Speaker
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00:23:11
Speaker
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00:23:35
Speaker
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00:24:01
Speaker
The technical word for bone cells getting bored is not the technical term. The technical term is cellular accommodation. The cells become accommodated or accustomed to a certain type of loading and then they stop responding. It's almost like they become insensitive to it.
00:24:19
Speaker
So when you think about a sport like volleyball or basketball or gymnastics, there is repeated impact, but it's varied impact because if a player jumps up to rebound a ball, they land maybe more on their left foot or maybe next time on their right foot or maybe next time on both feet, or they land at various angles. Same thing with gymnastics. You're landing at various angles time and time
Promoting Osteogenic Activities in Children
00:24:42
Speaker
again. There's much less repetition in terms of the angle of forces that the body is experiencing.
00:24:49
Speaker
and then there's just lower reps because it's not a cyclical activity. This is an important characteristic as well. Additionally, in this course by Dr. Stewart, I wanted to share this with you because it's a question that I have and it's not necessarily something that I've heard lots of people talking about, but it's something that I've been thinking about. He shared something about a study that was done on rats where their bone was loaded in a longitudinal way with some kind of machine that was pressing on the bone.
00:25:17
Speaker
It was progressively increased over time and the bone growth increased over time, but then there was a plateau where the bones stopped increasing in strength, in maybe it was density, right? And then they
00:25:35
Speaker
took some time off, like they took five weeks off, and then they resumed again after a five-week break to load the bone in the same way and found that the rate of bone growth at the initiation of that new period of loading was much more rapid than it was toward the end of the last period of bone loading. In other words, it wasn't just that the bone cells, it's maybe the case that bone cells don't just get
00:26:05
Speaker
bored in the moment after like 100 reps, but they might also get kind of bored over a longer period of time. And so it may be the case and doctors to award made this case that that periodization is also important for bone growth. And so periodization
00:26:24
Speaker
is an important and somewhat controversial topic in strength training. The definition of it is the planned manipulation of training variables. So it's just manipulating how you're training basically.
00:26:38
Speaker
You can manipulate how many sets and reps you're doing, but also the exercises you're doing over the course of weeks. So from two to six weeks is a typical training block. And then you would, after those two, three, four, five, six weeks are done, you would change things up. You would change the protocol. And this is to prevent, for strength training, the onset of over-training, over-training syndrome,
00:27:06
Speaker
It also is very important for staving off boredom. People get bored of doing the same exercises over and over and over again. They just want to change.
00:27:14
Speaker
it increases adherence to strength training. The study that Dr. Stuart Warren was talking about showed how periodization was also important for bone building in these rats and that if they would load the bone for six weeks and then take like six weeks off and then load the bone again after six weeks off, that the rate of growth was increased after that break. So I thought that was very interesting.
00:27:42
Speaker
And so I'm listening for maybe more about that if there are in future more studies coming out looking at the role that periodized loading plays in the rate of bone growth. The last characteristic important for bone development, bone mineral density building is that the loading be specific. So in other words, if we are potentially dealing with an osteoporotic bone,
00:28:10
Speaker
It's usually in a particular area of the body. And the most common sites for bone mineral density loss are the hip, but also the spine. So that's a second site.
00:28:22
Speaker
that is a common site of bone mineral density lost, and then the wrists.
Challenges and Insights in Bone Building
00:28:27
Speaker
So when we say specific, loads must be specific, loading your wrists sufficiently with high enough magnitude or maybe its rate or impact is not going to change the bone mineral density of your hip.
00:28:41
Speaker
Okay, so really kind of rudimentary putting it that way. But also, you know, when we're looking at increasing bone mineral density, we have to think about the region of the body we're targeting, but also the vector, the direction in which we're applying for. So it's actually quite, quite complex. That might lead us to ask like, as movement teachers, if you're a movement teacher, is it our is it our role to be
00:29:05
Speaker
treating? Never, actually, right? The answer is no, we don't treat conditions. Are we equipped to be able to help people overcome specific osteoporotic conditions within their body? Not if we're not working in conjunction, my opinion is not if we're not working in conjunction with a clinician, okay?
00:29:28
Speaker
So, because you can see that there are just so many individual considerations that we would need to take into account to know exactly how to work on reversing bone mineral density loss in someone's body. That being said, as movement teachers, we do potentially have the tools and the training, specifically if we have the tools and training to work with people on adding things like
00:29:56
Speaker
load and impact to their practice, we do have the tools to provide a generalized protection to the body through these forms of conditioning. And that is within scope of practice. If it is within your micro scope of practice, go back and listen to our episode on scope of practice, which
00:30:18
Speaker
which means that you are trained and qualified to help your students work on those capacities. Okay, is yoga, so here's the central question, is yoga osteogenic? Okay, the big question. We know that loads need to be high magnitude, 85% of a 1RM. We know that loads can also be high impact and high speed. And I think based on that, we can maybe hopefully understand
00:30:49
Speaker
relatively well now. Yoga is not an osteogenic activity because the loads are generally not high enough, the loads are low impact, and we move relatively slowly traditionally in a yoga class. Okay.
00:31:05
Speaker
So there it is. But that's not the end. I'm going to leave you with that. What can we do to build bones? Let's end on a hopeful note. Okay. So first and foremost, and this has to be, you know, said, the most important time to be working on building bones is pre puberty, is
00:31:29
Speaker
the time of our life in which our bone formation is rapidly outpacing bone loss. Now, most of you, if not every single one of you listening to this podcast in any particular time are post puberty, unless your kids are listening. And if you do have kids, you're going to want to hear this. So you want to have
00:31:54
Speaker
you want to provide your children with opportunities for osteogenic activity. This, for me, looks like putting Ellie on in gymnastics, for example, but when she started wanting to jump off of high structures, at first I was freaked out about it, and now I have a much more positive attitude toward this tendency of hers to want to climb up on furniture and
00:32:17
Speaker
take a huge leap off of it. The mama inside of me is like, oh, you're going to hurt yourself. But the bone mineral density enthusiast is going, yes, bone loading, osteogenic activity, high impact, go for it. But I have her in gymnastics. She's three and a half, but hopefully we can kindle the flame of interest for these osteogenic type activities like gymnastics, potentially some forms of dance, maybe sports.
00:32:44
Speaker
So just know that, you know, that's the time where the time is ripe. The time is ripe for creating lifelong, strong, resilient bones. However, if you're post puberty, if you're even an older adult, some osteogenic activities include heavy strength training as we discussed, plyometrics, and maybe speed and agility training as well.
00:33:08
Speaker
Um, if you're already, uh, you know, engaged in some sports, maybe you play some intramural sports, things like court sports, like basketball, uh, volleyball, I imagine tennis is probably not bad. Um,
00:33:24
Speaker
Think about activities where the impact is high. Those are probably going to be pretty good for your bones. If you do anything involving speed and agility where you're sprinting and moving very quickly, these would potentially involve higher impact or higher speed of loading. This could potentially be osteogenic.
00:33:41
Speaker
heavy strength training. So this is likely the most common sense place to begin because strength is the baseline capacity for the previous two types of osteogenic activity I just named. Strength is a baseline capacity you want to have in order to engage in speed and agility training plyometric training.
00:34:07
Speaker
because it supports those activities. There's a reason why athletic training almost always includes strength training and basic strength training, by the way, as well as sports-specific strength training. It's such a huge part of the off-season and the pre-season and even the in-season training of athletes.
00:34:30
Speaker
So what are the obstacles then to building bone? Why might we not be doing it or why might we not be able to do it? Well, I think the first and maybe biggest obstacle to building bone is the belief that you are already doing a bone building activity when in fact you are not.
00:34:50
Speaker
So that's kind of the reason that this episode exists, which is that if you are doing yoga asana and you've been told it's bone building because it's weight bearing, one, let's talk about this word weight bearing. Everything on planet Earth and the Moon and Mars is weight bearing.
00:35:10
Speaker
It's more weight-bearing on Earth than the moon, but weight is a force. It's mass times gravity. Everything has weight on planet Earth because gravity is ubiquitous, and so it's not enough for something to be weight-bearing to be osteogenic. It has to be pretty high magnitude, as we discuss 85% 1RM and or high impact, 4G, right? 1G is not weight-bearing enough. It's weight-bearing, but it's not weight-bearing enough.
00:35:38
Speaker
And then secondly, the reason I think it's potentially the biggest obstacle of all that people believe that they're doing something that is bone density building when it's not, when it comes to yoga.
00:35:51
Speaker
You know, yoga practitioners tend to be that population most at risk of suffering from osteoporosis. These are older women. So it's especially important, I think, that we dispel the myth that yoga asana is bone density building because in doing so, we may be actually preventing the population most in need of osteogenic activity from seeking it out because they already think they're doing it.
00:36:16
Speaker
All right, and then what are some other obstacles to building bone? Well, I think that a baseline of strength might be missing for most of us to feel confident, to engage in some of these osteogenic activities, like a baseline of strength may be important to train heavy. In other words, we often don't start strength training by training heavy. It's not that we
00:36:44
Speaker
that all people can't or shouldn't start by training heavy. But it's often the case that we need to first learn the exercises with lower than 85% of 1RM loads. Get comfortable with the coordination of those exercises, which by the way, when it comes to strength training, coordination is strength. Strength is one of the outcomes of improved coordination, I should say.
00:37:06
Speaker
But we also need to become confident with our ability to strength train. And you can actually build strength with lower than 85% 1RM. And so we would make sense to start with like 75%, right? Maybe 80%. And then as we establish that baseline of strength, we start to be able to load up more with more confidence, with better technique, and then increase the load on our tissues.
00:37:33
Speaker
that much more to potentially positively affect the bone. So another obstacle is equipment for heavy strength training. So say you've already started a basic strength training program, you've built that baseline of strength, you're working in that like maybe 70 to 80% 1RM and now you're like, okay, I want to start lifting heavy, but you still only have that 20 pound kettlebell and that's probably not going to cut it for your deadlift, right? So one of the bigger
00:38:03
Speaker
limitations to people being able to train heavier is equipment. You may need to have barbells for something like a 85% 1RM deadlift, especially if you do already have that baseline of strength where you're able to, you know, your 85% 1RM is your body weight and you're probably not going to want to invest in a kettlebell that weighs as much as your body because they're expensive.
00:38:26
Speaker
So, things like a gym membership, you know, space in your house, to have a barbell and maybe a rack, like these are definitely potential limitations. However, there are ways to manipulate exercises and to, you know, configure the equipment that you do have to increase the load.
00:38:48
Speaker
So the last limitation might be education, right? Seeking out help from qualified individuals who can help you work toward being able to lift heavier in order to increase your bone density. All right.
00:39:07
Speaker
My last couple of questions are, you know, before we end, are should older adults lift heavy? Specifically, should older adults who have been diagnosed with osteoporosis and osteopenia lift heavy? I think the answer to this question is, well,
00:39:27
Speaker
more studies are needed but check out this is my second study i want to share with you today check out the lift more study so i want to share with you a little bit about the lift more study because it has some super duper positive results and it was a fairly from my understanding well conducted
00:39:47
Speaker
study. So the LIFTMORE study. The LIFTMORE randomized controlled trial, the whole title of this is high intensity resistance and impact training improves bone mineral density and physical function in post-menopausal women with osteopenia and osteoporosis. In this study, there was a total of 406 post-menopausal women
00:40:13
Speaker
who consented to participate, 101 met the inclusion criteria, and 27 of them, that's 28% reported in osteoporotic fracture within the past 10 years. So these are people with osteoporosis, many of them, and not only that, but osteoporotic fractures. These individuals engaged in a, I believe, eight month, twice a week, supervised
00:40:41
Speaker
heavy strength training protocol. They were compared with the control group which did a low to moderate intensity, I believe unsupervised protocol and the results were pretty positive. I'll just read straight from the article.
00:41:01
Speaker
Our observed improvements in bone mineral density surpassed previous reports from reputable exercise interventions, an observation that could be considered intuitive in light of the well-known positive relationship between load magnitude and bone adaptation. The limiting feature of high-intensity resistance training in this demographic has traditionally been the perceived increased risk of fracturing fragile bone with heavy loading. We believe this overly conservative approach has contributed to an unnecessary stagnation in the field
00:41:31
Speaker
The evidence from the LIFTMORE trial that high intensity loading can indeed be tolerated by post-menopausal women with low to very low bone mass justifies a quantum change in attitude in this regard. So I encourage you to Google the LIFTMORE L-I-F-T-M-O-R study. It's open source. Download it, print it out, read it. It's pretty exciting findings.
00:41:56
Speaker
Now, what is yoga's role in this conversation about bone density? Does it not help us out at all? Not at all. Yoga plays a very important role in this conversation around bone density because we're talking about bone density because we don't want to sustain life altering slash ending fractures.
00:42:21
Speaker
That is at the root of our aim to increase bone-mural densities, to decrease fracture. And yoga plays a very important role potentially in decreasing risk of fracture because it can improve balance. It can reduce risk of falling. Yoga is excellent balance training. There are many, many opportunities in a traditional yoga class to work on balance.
00:42:45
Speaker
Additionally, yoga is wonderful for helping to establish someone's body awareness or their proprioception, which can carry over to being able to learn other types of movements more readily, more easily. And additionally, yoga can contribute to a lower, but it can be a starting point for us to start to build a baseline of strength as well, especially in certain types of asanas.
00:43:14
Speaker
I'll also say that heavy strength training is also an evidence-based way to improve balance. So combined yoga and heavy strength training may be a wonderful pairing of modalities for both reducing risk of falling, improving balance, and then the heavy strength training
00:43:32
Speaker
for causing that increase in bone mineral density. Okay. Well, that was a lot for one solo talk, but we'll probably be continuing this conversation in the future because it is a very relevant and hot topic today in at least my community of movers.
00:43:57
Speaker
A note to you listeners that you can check out our show notes for links to references that we mention in the podcast. And you can also visit the Movement Logic website where you can get on our mailing list to be in the know about sales on our tutorials and potentially future bone building offerings. Thanks so much for joining us on the Movement Logic podcast. Join us again next week for more Movement Logic and more strong opinions loosely held.
00:44:27
Speaker
Thank you so much for listening. If you enjoyed today's episode and you want to support us, please subscribe, rate, and review on Apple, Spotify, Stitcher, or wherever you listen to podcasts. If you'd like to watch, head on over to our website at movementmagictutorials.com forward slash podcast, where you can watch the video version. We'll be back in your ears next week to nerd out about movement without taking ourselves too seriously in the process.