There is a lot of confusion about yoga and bone health, especially with claims like "12 minutes a day of yoga is enough" to maintain strong bones. While yoga offers a fantastic baseline for mental health, physical health and spiritual connection & community; relying solely on it is not sufficient for promoting bone health, particularly during perimenopause & beyond.

Especially during and after this transitional period, taking care of our bones becomes increasingly important. It’s easy to overlook the silent changes happening within our skeleton as we focus on visible signs of aging. Yet, menopause brings significant changes to our bone health due to the decrease in estrogen levels, making it crucial to choose the right types of exercise.

Menopause and Bone Health: Understanding the Impact

During menopause, the decline in estrogen levels accelerates bone loss, resulting in decreased bone density and an increased risk of osteoporosis and fractures. Estrogen has a protective effect on bones—it helps maintain bone density by slowing down bone resorption (the breakdown of bone tissue through the action of osteoclasts) and encouraging osteogenesis (the formation of new bone tissue by osteoblasts).

Once estrogen levels fall, this balance shifts, and bone resorption starts to outpace bone formation, leading to a net loss of bone mass.

Given these changes, it becomes essential to incorporate physical activity that promotes osteogenesis to maintain or improve bone density. However, not all types of exercises are effective in stimulating bone growth, and some may even fall short despite being beneficial for other aspects of health.

Osteogenesis and Exercise: What’s the Connection?

Osteogenesis is the process by which new bone is formed. It is driven by osteoblasts—bone-forming cells that respond to mechanical stress by increasing bone formation. For osteogenesis to occur effectively, physical activities need to apply enough mechanical stress on the bones- ie enough activity to "tell the bones" to strengthen. This stress signals the body to build stronger and denser bone tissue. The most effective exercises for promoting osteogenesis are those that are weight-bearing and involve impact forces.

Why Repetitive, Low-Impact Exercises Aren’t Enough for Bone Health

In the context of osteogenesis, repetitive movement is often categorized as "low-impact" or "non-weight-bearing", meaning it does not create sufficient mechanical stress on the bones to trigger significant bone growth. Here's why these types of movements may be less effective:

1. Insufficient Mechanical Loading: Activities such as cycling or swimming do not apply enough force to the bones to stimulate bone formation. For bones to respond and strengthen, exercises need to involve loading that stresses the bones in multiple directions at higher intensities. Without this varied loading, the signal for osteoblasts to increase bone formation is weak. 
2. Lack of High-Impact Forces: Repetitive, low-impact activities do not generate the kind of high-impact forces required to trigger significant bone remodelling. Jumping or weightlifting, for example, creates much higher forces on the skeletal system than walking or other low-impact movements. This difference in force generation makes high-impact exercises much more effective in stimulating osteogenesis.
3. Monotonic Loading: When loading is repetitive and uniform, such as during jogging on a flat surface, it does not vary the strain on the bones sufficiently to stimulate bone growth. For optimal bone health, the skeleton needs exposure to different directions and intensities of strain to keep bones challenged.
4. Low Osteogenic Potential: Some exercises are considered to have low osteogenic potential because they do not create the diverse mechanical strain patterns necessary for promoting bone growth. While they may improve cardiovascular health or muscle endurance, they lack the stimulus needed to significantly increase bone density.
5. Reduced Adaptive Response: When exercises are repetitive and do not vary in intensity or direction, the bones can develop a reduced adaptive response, meaning they stop responding as strongly to the mechanical stress. To continuously promote bone growth, exercises should be varied and progressive, with ongoing increases in challenge.

Can yoga improve bone strength?

Yoga is generally considered a "relatively low loading" activity. While poses involve weight-bearing on the hands, feet, or other parts of the body, the forces generated, often do not reach the levels required for significant osteogenesis. 

That said, yoga plays an important supportive role in maintaining bone health and is the perfect way into low load exercise for anyone who has NOT been exercising much at all. It can enhance balance and coordination, reducing the risk of falls, which is crucial for preventing fractures. But for stimulating bone growth directly, more dynamic and high-impact exercises are needed.

Research also shows that at their full length, muscles reach the maximum ability to strengthen/ grow/ hypertrophy, because when stretched they are working hardest. Also of course because if you hold anything at full stretch- eg your baby or a shopping bag at arms length its a lot harder work than tucked in close!

So we do have ways to adapt yoga for more strength work IF that feels appropriate - we might lose some of the deep relaxation effect we are looking for. OR we can get our strength work elsewhere. 

Exercise Recommendations for Osteogenesis

For optimal osteogenesis and bone health, research indicates that engaging in high-impact exercises like jumping and weight-bearing activities is essential. Specifically, studies suggest that performing 10-20 jumps daily can significantly improve bone mineral density.

In addition to jumping, it's beneficial to incorporate weight-bearing exercises for 20-30 minutes three times a week. This can include activities such as brisk walking, jogging, or dancing. Moreover, aim for at least 150 minutes of moderate-intensity cardiovascular exercise each week to support overall heart health and maintain a balanced fitness routine. Finally, consider adding two to three sessions of resistance training per week targeting all major muscle groups to enhance bone strength further. Combining these exercises—high-impact, weight-bearing, and resistance training—will provide the necessary mechanical stress on bones, stimulating osteogenesis effectively and promoting overall bone health.

What Types of Exercise Are Best for Osteogenesis?

1. High-Impact Exercises:
• Jumping and Hopping: Studies published in the Journal of Bone and Mineral Research show that high-impact activities such as jumping 10-20 times a day can increase bone mineral density at the hip and spine. These exercises create significant stress on the bones, prompting the body to build stronger bone tissue.
• Plyometric Exercises: Involving explosive movements like jumping, plyometric training can significantly improve bone strength. Research has shown that postmenopausal women who engage in plyometric exercises see improvements in bone density, particularly in areas prone to fractures, such as the femur (thigh bone).
2. Dynamic Weight-Bearing Activities:
• Running and Stair Climbing: These high-impact activities generate forces that stimulate osteogenesis by exerting pressure on the bones. Engaging in these activities regularly can help maintain bone density and slow down bone loss.
3. Resistance Training:
• Strength Training: Lifting weights or using resistance bands increases mechanical loading on the bones, stimulating osteoblast activity. According to studies published in Osteoporosis International, resistance training is particularly effective at increasing bone density in the spine and hip areas.
• Progressive Overload: It’s important to gradually increase the resistance over time, ensuring that the bones continue to be challenged and do not adapt to a lower level of stress.
4. Weight-Bearing Aerobics:
• Walking, Dancing, and Hiking: While these activities are not as impactful as jumping, they still provide a weight-bearing stimulus to help maintain bone health, especially when performed regularly.
5. Combination Exercise Programs:
• Research suggests that combining different types of exercises—high-impact, resistance training, and balance exercises—yields the best results. This approach not only promotes osteogenesis but also enhances muscle strength and balance, helping to prevent falls and fractures. 

Ways to Incorporate More Weight-Bearing Activity into Your Asana Practice 

1.  Progress Inversions (e.g., Wall Handstand Support):
   Practicing inversions like handstands against a wall helps build strength in the arms, shoulders, and core while stimulating the bones in the upper body. Holding these poses for longer durations encourages gradual bone loading, which is essential for increasing bone density over time.

2. Jumping Handstands / Single Arm Handstands:
   Incorporating dynamic movements like jumping into handstands or practicing single-arm handstands builds explosive strength and challenges balance. This dynamic weight-bearing on the wrists and arms promotes both muscle and bone strength.

3. Single Arm Planks – Lower and Lift to Full Range of Motion on One Arm or Leg:
   Performing planks with one arm or leg off the ground requires significant stabilisation and shifts weight into the active arm or leg. Adding lowering and lifting movements increases joint and bone loading, which is essential for maintaining bone density and strength, especially in the upper body.
4. Add Jumps into Poses (10–20 Jumps Repeated Throughout the Practice):
   Introducing jumps—whether it’s into or out of poses—encourages rapid, weight-bearing movements that engage different muscle groups. Jumping is a form of plyometric exercise, which is beneficial for stimulating bone growth due to its higher-impact nature.
5. Incorporate More Explosive Movements (e.g., Jumping Back/Forward on Hands or Practice Crocodile):
   Fast, explosive movements like jumping back and forth in arm balances or practicing the crocodile pose (an advanced plank) challenge your upper body, core, and bones by adding dynamic resistance. This type of explosive power helps strengthen muscles and stimulate bones.
6. Hops in a Press-Up (Push-Up) Position:
   Hopping in a press-up position (also known as plyometric push-ups) challenges your body to bear weight quickly and explosively on the arms. The shock impact from hopping can stimulate bone growth and increase muscle strength in the chest, arms, and shoulders.
7. Include More Bodyweight Work, Like Press-Ups (Push-Ups):
   Press-ups are an effective way to load the bones in the arms, shoulders, and chest while improving muscle strength. Regularly incorporating bodyweight exercises like push-ups into yoga practice adds weight-bearing resistance, which helps maintain bone density, especially in the upper body.
8. Progressively Load the Body with More Challenging Arm Balances:
   Gradually working towards more advanced arm balances like crow, forearm stands, or L-sits (inspired by calisthenics) can effectively load the bones in the upper body. These positions require strength and balance, challenging the bones and joints in new ways, which is vital for bone health during menopause.

Important Considerations for Menopause
 

1. Gradual Progression: For those new to high-impact exercises, start slowly to avoid injury. Begin with lower-impact weight-bearing exercises and gradually progress to higher-impact activities.
2. Consistency is Key: Regular, long-term exercise is essential to maintaining bone health. Research shows that bone density gains can be lost if exercise routines are stopped, so consistency is crucial.
3. Safety First: Always listen to your body and consult with a healthcare professional if you have any existing conditions that may affect your exercise choices.

The decline in estrogen levels during menopause makes it harder to maintain bone density, but exercise can play a significant role in combating bone loss. While yoga offers many benefits, it should be supplemented with exercises that provide dynamic, multi-directional loading and high-impact forces to effectively stimulate osteogenesis. Incorporating a combination of high-impact exercises, resistance training, and weight-bearing activities can help keep your bones strong and healthy through menopause and beyond.

Remember, bone health is a lifelong journey. Embrace a diverse exercise routine, challenge your bones, and take steps today to support your skeleton for the years ahead.

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References

1. Menopause and Bone Health

   • Cummings, S. R., & Melton, L. J. (2002). Epidemiology and outcomes of osteoporotic fractures. The Lancet, 359(9319), 1761-1767. DOI: 10.1016/S0140-6736(02)08657-9
   • Riggs, B. L., & Melton, L. J. (1986). Involutional osteoporosis. New England Journal of Medicine, 314(26), 1676-1686. DOI: 10.1056/NEJM198606263142606

2. Osteogenesis and Exercise

   • Turner, C. H. (2001). Bone strength: Current concepts. The Journal of Musculoskeletal & Neuronal Interactions, 1(3), 231-234.
   • Kaji, H., & Chihara, K. (2006). The role of mechanical loading on bone metabolism and its clinical significance. Clinical Calcium, 16(5), 883-890.

3. Jumping and High-Impact Exercise

   • Kohrt, W. M., Ehsani, A. A., & Barlow, C. E. (2001). Impact exercise and bone mineral density in postmenopausal women. The Journal of Clinical Endocrinology & Metabolism, 86(9), 4268-4271. DOI: 10.1210/jc.86.9.4268
   • Sievanen, H., & Uusi-Rasi, K. (2003). Effects of jumping on bone mineral density in postmenopausal women: A randomized controlled trial. Bone, 32(5), 599-607. DOI: 10.1016/j.bone.2003.01.003

4. Weight-Bearing and Resistance Training

   • Pruimboom-Brees, I. M., & Goudsmit, E. M. (2009). The effects of resistance training on bone mineral density in postmenopausal women: A meta-analysis. Osteoporosis International, 20(4), 547-561. DOI: 10.1007/s00198-008-0683-1
   • Shahar, D. R., & Shahar, M. (2005). Exercise and bone density: A meta-analysis. Bone, 37(6), 945-952. DOI: 10.1016/j.bone.2005.07.010

5. Combination Exercise Programs

   • Hannon, J. C., & McCulloch, L. A. (2010). Effects of a combined exercise program on bone mineral density and strength in postmenopausal women: A randomized controlled trial. Osteoporosis International, 21(3), 409-415. DOI: 10.1007/s00198-009-0896-3
   • Wang, Y., & Jiang, S. (2018). A meta-analysis of the effects of combined exercise on bone density in postmenopausal women. European Journal of Clinical Nutrition, 72(7), 949-958. DOI: 10.1038/s41430-018-0175-4

6. Safety and Gradual Progression

   • Gusi, N., et al. (2006). Exercise and falls prevention in older people: A systematic review of the literature. Aging Clinical and Experimental Research, 18(1), 22-30. DOI: 10.1007/BF03327292
   • Campbell, J. L., et al. (2005). Recommendations for increasing physical activity: A systematic review of the evidence for the effectiveness of exercise for improving physical function in older adults. Journal of Geriatric Physical Therapy, 28(3), 82-88. DOI: 10.1519/00139143-200504000-00007