Baxter Bell, MD and Nina Zolotow:
Yoga for Health Aging: A Guide to Lifelong Well-Being
makes a great deal of valuable information eminently accessible. Baxter Bell, MD and Nina Zolotow, two well-known major contributors, teachers and therapists in the field, have organized this clear and helpful volume according to the universal needs of older people: there are sections on strength, flexibility, balance and agility, (a combination of coordination and grace), many well-done and revealing photographs, and good references to the poses and vinyasas.
Dr. Bell entered medicine as a family practitioner, and focused on this for more than a decade. He has been teaching, treating with and writing about yoga for more than 20 years ever since. Nina Zolotow is a long time yoga practitioner, yoga instructor, co-author of two other books on yoga with Rodney Yee, and editor-in-chief of the blog “Yoga for Healthy Aging. Between the two of them are more than 35 years of expertise, and an inestimable welling up of caring for us people as we age. The combination of experience, medical knowledge, and imaginative empathy make this book as warm and interesting as it is useful. We are all facing futures in which we become older; armed with this book, it sounds like fun.
Loren Fishman, MD, Erik Groessl, PhD and Paul Bernstein, OMS III:
Objective: Efficacy of 2 yoga poses for degenerative scoliosis (DS) and adolescent idiopathic scoliosis (AIS).
Subjects and Methods: Retrospective study of 49 DS and 25 AIS patients with initial Cobb angles less than 120° (DS) and less than 75° (AIS) performing side plank daily, with lumbar and thoracolumbar curves’ convex side inferior. In complex curves, the half-moon pose was added. Outcome measure included Cobb angles after mean 5.8 and 9.4 months, respectively.
Results: Mean lumbar/thoracolumbar improvement: 23.7% (P < .00) in DS, 34.2% (P = .001) in AIS. Thoracic curves improved 27.6% (P = .001) and 20.3% (P = .004): 2.5% per month and 3.5% per month, respectively.
Conclusions: These yoga poses may reduce scoliosis in DS and AIS.
Judith Lasater, Ph.D., PT.
Restore and Rebalance
This book is valuable for people recovering from serious medical or psychological conditions, and those that would teach them. It stands out by virtue of its creative approach to poses, beautiful photographs and practical advice. The prose seems to have a curative effect all its own.
PROBLEMS WITH THE MAYO CLINIC’S
YOGA FOR OSTEOPOROSIS STUDY
Loren Fishman, M.D. B.Phil.,(oxon.)
February 22, 2019
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
* 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