New Study Beginning
In spite of positive comments about the study in the New York Times, the Harvard Women’s Health Letter and NPR, the almost free and effective treatment has not gained much application in the medical community. Dr. Ethel Siris, a prominent authority in the field of osteoporosis studied more than 100,000 osteoporotic women who had health insurance covering the cost of osteoporosis medications. She found that less than 30% actually took these medicines, at least partially because of their common and severe side-effects. But the side-effects of yoga are better posture, improved balance, greater strength, range of motion and coordination, and lower anxiety, all factors that mitigate against the fractures just about as strongly as the rise in bone mineral density. Therefore we are beginning a new study, seeking a dose-response relationship between yoga and bone mineral density and bone quality, a more compendious measure of a bone’s resistance to fracture.
For those interested in the new study, beginning summer-fall 2016, the following is relevant.
This study attempts to prove that properly chosen yoga poses can reverse osteoporosis without having negative effects on the joints. In addition, we hope to establish a dose-response relationship between the quantity and quality of yoga, and rise in bone mineral density, and possibly bone quality.
Conventional medical wisdom puts people in an impossible position: exercise with impact, jogging, for example, is needed to stimulate the cells that build bone, but unfortunately, such exercise fairly reliably brings about arthritic joint destruction. No-impact exercise is harmless to the joints, but unfortunately, leaves the bones to slowly weaken even to the breaking point.
Therefore when it comes to bones, it is literally both ends against the middle. At the same time, it is universally acknowledged that not exercising at all tightens joints and ligaments, weakens muscles and bones alike, and is the worst of both worlds.
As the population of the world grows older, these questions are critical for the continued activity and health of an increasing number of people. Present estimates are that 200,000,000 people suffer from osteoporosis or osteopenia.
Evidence in the animal literature confirms that unconventional tugs of the sinews and ligaments can arrest, and often reverse osteoporosis. The pilot study detailed below corroborates these findings. The transcriptional coactivator PGC-1alpha is liberated from muscles in exercises such as yoga, and suppresses a broad array of inflammatory responses, likely including arthritis.1 There are also physiological reasons to believe that yoga improves the circulation of synovial fluid, within joints, slowing the “wear and tear” that may stand at the origins of osteoarthritis.
The proposed study measures osteoporosis through the accepted means, radiographic bone density measurement, dual energy X-ray absorptiometry otherwise known as DEXA scans. We measure progression in osteoarthritis with standard hip and lumbar spine X-rays. Each subject has thyroid functions, standard electrolyte, mineral and liver/kidney function tests, two assays for vitamin D, and a urine test measuring the rate of bone resorption before learning the 12 yoga poses that comprise the program. Bone scans and X-rays, performed at study onset and at the end of year 2, are read by radiologists that have no idea which patients are receiving yoga, and which are not. The study participants will receive a newsletter about developments and research in osteoporosis. A DVD of the poses is for sale to all participants at the home page of this site, and it is streamed at without cost at:
There is an on-line message board for communication between the participants and also with the physicians and yoga teachers involved in the study. People may post messages in English and Spanish. Every two years a statistical analysis will be done, and a scientific paper will be written after results are judged significant.
In order to do a meaningful analysis of the “dose” of yoga, it will be necessary for participants to visit a yoga teacher certified in our method every two weeks. Your arrangement with the teachers is up to you and the teacher. It may be a group class or an individual session or a short review. There are currently only 18 certified teachers, mostly in New York and New Jersey, although there are also teachers in Pennsylvania, Texas, Illinois, and California. If you are not located near enough to one of these teachers, then unfortunately you will not be eligible for the study. We will be conducting more certification sessions in the winter in New York and Chicago, and in San Francisco in the summer of 2017. The current list of certified teachers is given on this website under the tab “Osteoporosis” and also under the tab “Certification for Teachers,” and the study itself, with induction forms can be found at:
Recently we have added a state-of-the-art measure of bone quality, that may also be offered to study participants without cost. After receiving the DVD, study participants and qualified others may be able to have every-two-years bone quality studies as well.
We have already completed a ten-year, with a paper published by the peer-reviewed journalTopics in Geriatric Rehabilitation. In it we analyze the outcome of 741 people who completed at least two years of yoga (the intervention group) these same people’s change in bone mineral density during the two year period before they began using the DVD. These people had an average age of over 68 years, and all had normal laboratory values. Over 80% had osteoporosis or osteopenia at the study’s onset.
As you can see, the patients that did yoga for two years now have stronger bones than they did when they started. Statistically, this result was significant.
Sometimes we have had to adapt the yoga poses for people that are unable to use the classical position. The DVD has three versions of each pose, and your teacher will very likely be able to help you with that.The idea is to progress from the simplest level to the more advanced levels in any pose for which it is safe to do so. Trying hard, putting some effort into the 12 minutes of yoga, is also important. The Iyengar yoga method that stands behind each of the poses pays great attention to alignment, enabling people to try hard without injury.
There were no injuries in the ten years of the study. So far, with 741 people in the study, (227 fully documented) and well beyond 100,000 hours of people doing these poses, many of them having before-and-after X-rays of spine and hips, we have no reported fractures related to yoga. Interestingly, we have over 20 fractures reported from falls on the street, traffic accidents, and the like.
The results of the study are now in, and the statistician has found that yoga does significantly improve bone mineral density for the spine, (P <.05) the femur (P < .002) and, slightly less convincingly, for the hip (P < .05 on 2 of 3 measures; not significant for the third). This work appeared in the peer-review journal “Topics in Geriatric Rehabilitation,” and is available on line ahead of printing at the URL above.
The DVD may be purchased by anyone for $25 on the home page of this website.
Reference (Click on name to go to reference)
1. Handschin C, Spiegelman BM. “The role of exercise and PGC1alpha in inflammation and chronic disease.”Nature. 2008 Jul 24;454(7203):463-9.
We recently completed an eight year study, following a successful pilot study in which patients doing yoga imoroved their DEXA scans in two years of doing yoga, versus controls who did not do yoga. The surprising success of this small study impressed us enough to make a 12-pose 12 minute DVD and disseminate it to 741 people who were willing to complete an induction form, get some blood tests and a urine test, and a send us a DEXA scan from no more than six months ago,and another older one from at least one year ago. Then, after they’d done the yoga on the DVD daily for two years, we repeated the DEXA scan. There is more on each of these below.
What are the major causes of yoga injuries, in which poses, and what are the major injuries?
A 33,000 yoga teacher and student study.
We have recently completed a double blinded randomized controlled study comparing botulinum injection to placebo in people for whom the electromyographic evidence favored piriformis syndrome.
The entire study is being reviewed now for publication (August 27, 2016), but the graphic representations of the results are so good that I cannot resist putting them here.
Rotator Cuff Syndrome
We stumbled upon a series of maneuvers which activates muscles that perform the actions of the torn supraspinatus muscle. Then a process akin to operant conditioning prompts the same muscles to be active whenever the torn muscle would be brought into play, perpetuating the substitution so that people may painlessly and powerfully lift the arm in ways that previously were prevented by the torn muscle.
We have found a simple yoga pose which, done one time daily, reverses nearly every case of scoliosis we have encountered. We published a small series of adolescent idiopathic scoliosis patients’ and degenerative scoliosis patients’ successes with this simple method, and are currently studying more advanced methods with more complex curves.