Manhattan Physical Medicine and Rehabilitation, LLP
June 5, 2008
Two more reasons not to let medicine do your work for you:
Caveat Consumer
Add atrial fibrillation to the list of complications that occur with the Fosamax. Atrial fibrillation occurs when the entry chambers of the heart beat so quickly that they send blood to the pumping chambers before they have a chance to fill. This renders the heart less effective in sending blood to the lungs, and bringing oxygen to the tissues of your body. Many people live to ripe old ages with atrial fibrillation, but it definitely increases your chances of stroke and other cardiac complications, and reduces your general level of energy.
A recent study reported in the highly respected Archives of Internal Medicine's April 28th issue finds that if a woman uses Alendronate, Fosamax, for only two months, it almost doubles her odds of having atrial fibrillation, regardless of race or unusual body mass index, (BMI). People taking medications to reduce cholesterol, and those with diabetes had the highest risk of developing atrial fibrillation.
Another anti-drug study published at the same time and place cautions people with osteoporosis about thiazolidinediones such as Actos (pioglitazone), Avandia (rosiglitazone), and Avandamet (containing rosiglitazone and another uninvolved medication, metformin). These medications are used to normalize blood glucose in people with Type 2 diabetes. Now as a group, men and women with Type 2 diabetes actually have higher bone density than the average. Yet, in spite of their denser bones, if they have taken these medications for more than 12-18 months, they are two to three times more likely to have fractures than the average person. The fractures were in the hips and arms, not in the vertebral column. The increased risk was not related to BMI, how long they'd had diabetes or other conditions, nor the use of other oral antidiabetic medications.
How Yoga Works
A German engineer who was building a crane in the city of Cologne and wandered into a natural history museum, observed the bones of a vulture's wing and exclaimed "Mein Gott!" The reinforcements in the bird's wing bones were exactly what he had designed for the head of the crane. He published this in a small report, and it was read by Julius Wollf, a surgeon and anatomist. Dr. Wollf found numerous other examples, and published The Law of Bone Transformation in 1892.
Wollf's law, as it has come to be known, states that the architectonic of a bone, its system of structural support, follows the lines of force to which that bone is exposed. The more stress you put on a bone, the denser and stronger it becomes in exactly the way that resists that stress. The formation of bone has been traced at the molecular level from the stretching and compressing of the osteocytes, the cells that make bone, through the actual production of osteoid, the protein framework of bone itself. There are literally hundreds of studies that confirm the actual truth of Wollf's law.
Yoga, by stretching tissues gently but quite vigorously, utilizes Wollf's law's dynamics to strengthen bones safely and surely. Take, for example, a forward bend such as Supta Padangusthasana: It pits knee extensors, forearm, elbow and shoulder flexors, shoulder retractors and paraspinal extensors against hip extensors, with the thigh, shin, ankle and just about every bone below the cervical spine receiving stimulating pressure.
With permission of Ellen Saltonstall, from Yoga for Arthritis Fishman, LM and Saltonstall, E. W..W. Norton and Co, New York, 2008. p.83. Detailed instructions found there.
Does this pose give more or less stimulation to the spine, hip and thigh than these bones undergo in weight-bearing activities such as walking? Muscles are much stronger than the forces of gravity. You need only raise a little finger to convince yourself of that. But with many powerful muscle groups opposing one another, the forces mount up to sizeable multiples of gravitational force.
Where is the bone reinforced? Since yoga has so many unusual positions and stretches, almost every aspect of the bone is strengthened in the variety of safe poses in yoga.
Is this pose dangerous? It is one of the few ways to stretch the hamstrings without curving the spine forward (kyphosis), which is strongly linked to fracture of osteoporotic vertebrae. It safely pits the hamstrings against the quadriceps, muscles af the arms, shoulders and extensors of the spine, giving a self-controlled stretch to the hip capsule at the same time. In this respect it is also beneficial in arthritis. The forces are very great, especially considering that this pose is almost completely fool-proof and safe.
That appears to be why yoga works so well against osteoporosis, and why our study has gone on for nearly 3 years, so far with no reports of fractures.
We are arranging a new series of exercises that we believe will be even safer. It should be available on the website within a month or two.
Comments, Questons, Criticism Suggestions
e-mail: Loren@sciatica.org
or write
Elise Weiss, M.D.
1009 Park Avenue
New York, NY 10028