How does yoga affect our skeletal system?
How does yoga affect balance and bone health?
Methods
The researchers searched databases to identify randomized control trials that evaluated yoga’s effects on balance, falls, fear of falling, bone mineral density, bone turnover markers, and fall prevention.
Results
Among 18 individual studies included in the review study, 12 reported that yoga or yoga plus another treatment improved balance compared to a control. One study reported a decrease in frequency of falling, and a separate study reported a decrease in the fear of falling after a yoga treatment. Three studies reported that markers of bone health were either maintained or increased after a yoga treatment.
Conclusion
Yoga helps maintain balance, may reduce falls, and may support long-term bone health.
Background
Our skeletal system gives our body part of its structure. It forms the compression members in the biotensegrity system of our body, and provides multiple essential functions. Additionally, our bones produce red blood cells, store minerals, and provide protection. For example, our ribcage helps protect many of our vulnerable organs.
One of our skeletal system’s most important functions is its role in enabling movement. Like all of our body systems, our bone health can start to show signs of deterioration as we age. Maintaining healthy bones as we age is one key to reducing fractures and other consequences of falling. Our balance can likewise decline as we age, increasing our fear of falling. Maintaining a good sense of balance as we age can reduce both actual falls and the fear of falling.
One activity that shows potential to help with all of these aspects of skeletal health is yoga. Preliminary research has shown that yoga positively affects balance. Likewise, because yoga potentially includes many types of weight-bearing poses, it seems to support maintaining bone density as well. The research team on the study we summarized here chose to explore previous research evaluating yoga’s effects on multiple aspects of skeletal health in order to report a more comprehensive picture of how yoga affects our bone health.
Research question
How does yoga affect balance and bone health?
Research methods
The researchers searched several databases to identify studies that evaluated yoga’s effects on balance, falls, fear of falling, bone mineral density, bone turnover markers, and fall prevention. They used Medline, Embase, Cochrane Central, Register of Controlled Trials, and the CINAHL databases to identify studies. They specifically searched for the keywords yoga, balance, fall risk, fear of falling, bone mineral density, and bone turnover markers. The studies were included if they were randomized controlled trials evaluating healthy participants and compared yoga interventions to either an active control or no intervention.
During the review process, the research team wanted to address several specific questions:
How does yoga affect balance?
How does yoga affect fall risk and fear of falling?
How does yoga affect bone mineral density?
Is yoga associated with any adverse skeletal issues like fractures?
Results
The research team included 18 randomized control trials in the review study. Fifteen studies evaluated the effects of yoga on balance, falls, fall risk, and fear of falling. Ten of those compared yoga with an active control, and five compared yoga with no intervention. Three studies examined the effects of yoga on bone mineral density. The types of yoga styles used in each individual study varied.
Effects of yoga on balance:
Six studies found that balance improved in the yoga treatment group compared to no intervention
Three other studies reported that yoga was as effective as stretching plus strengthening exercises, Taiji, or Tai Chi exercises in improving balance
Two studies found that yoga plus other exercises improved balance more than either treatment alone
In one study, a yoga treatment and a Tai Chi intervention each improved balance more than an exercise control treatment
In one study with an active control, it was unclear whether yoga and the control resulted in different effects on balance
There was no improvement in balance in either the yoga treatment group or the active control group in one study
There was a greater improvement in balance in one study when participants did a combination of vocal training, dancing, and breath work, compared to yoga
Falls and fear of falling
Frequency of falls decreased after a yoga intervention in one study
Fear of falling decreased after a yoga treatment when compared to before the yoga treatment and to a control group in one study
In one study, there was no difference between yoga and the control group regarding the effects on falling frequency
Bone health – bone mineral density
In one study, bone formation markers and bone alkaline phosphate (a measure of bone turnover) decreased in the control group, but were maintained in the yoga treatment group
There was no effect of yoga on bone mineral density in one study
In a different study, the effects of yoga on bone mineral density were specific to particular areas of the body. In the exercise group, but not the yoga group, bone mineral density decreased in the hip area. However, bone mineral density decreased in both the exercise and yoga groups in the lumbar spine
In a separate study, osteocalcin levels (a biochemical marker of bone formation) increased in the yoga group, but decreased in the exercise control group
Why is this relevant to yoga practitioners?
Although bone health is important at any age, we especially need to pay attention to it as we progress into our later years. This is because bone health is one essential part of keeping us active as we age. A regular movement routine supports healthy immune function, cardiovascular function, and better sleep, among many other benefits, and bone health is an important component of being able to move. The older we get, the harder it often is to maintain our movement routine as our body slows down. Our proprioception and balance can decrease as we age, increasing our fear of falling because we’re less confident of our ability to move easily. Additionally, as we get older, the pace at which we create new bone cells slows, so maintaining our bone density becomes even more important.
The review study that we summarized here suggests that yoga may have some contribution to maintaining bone mineral density, a marker of bone health. However, which yoga interventions specifically support bone health was unclear from the research that’s been conducted so far. Many smaller studies evaluated in the larger review study supported yoga’s positive impact on developing and maintaining balance, and therefore reducing falls and the fear of falling. So, yoga may indirectly support bone health by helping us feel more confident in our movements and encouraging us to keep going.
Conclusion
Bone health is an important part of aging well. A healthy skeletal system can help us confidently maintain a movement habit. Yoga can be a part of maintaining bone health, reducing falls, and the fear of falling, and therefore keep us moving as we age.