Osteoporosis Part IV: Lifestyle; The Rhythm Of Life

 

Your seasonal and daily lifestyle is a main element in the prevention and treatment of disease. One can begin with one healthy workout or one healthy meal, but going to the gym one time doesn’t make you healthy, though it’s a step in the right direction. 

Understanding your dosha, your constitutional or genetic type, and it’s qualities, functions and tendencies, provide an understanding of where your tendencies lie, and where you are starting from. Not living according to your dosha can be a recipe for developing an illness. 

Stress is harmful for the body and can cause many different ailments, including compromised bone health. Increased stress also means increased inflammation, and thus an increased osteoclast activity, eroding the bones.

Though osteoporosis is primarily vata disorder, all the doshas benefit from managing their stress levels by living according to circadian rhythms and their dosha, or tendencies.

All the doshic types experience stress in their own unique ways. When the vata dosha is stressed, it increases dryness, weakening the bones and the telomeres on the nerves, that when firing are like dry and frizzy hair, depleting the bone marrow, and thereby why oil applications are helpful remedies for the skeletal and nervous systems. Vata (nervous system) can be vitiated in a vata predominant person as well as in a pitta or kapha predominant person with a vata imbalance, which often occurs when there is any imbalance in the system, and thereby vata becomes involved, and it is often considered in treatments. 

People with predominance of vata are cold, dry, rough and variable and are balanced by warm foods, grounding activities and warm oil applications that nourish and reduce dryness and cold. Those with a predominance of pitta are hot and intense and are restored with cooling foods, moderation in activities and calming oil applications that reduce inflammation. People with a predominance of kapha are cold, damp and heavy, with a slower metabolism and nature, and are balanced by warm, spicey and dry foods, energizing and stimulating activities and warm and detoxifying applications and treatments. Being aware of your type, allows you to determine where you’re starting from, to adapt the treatment and routines according to your constitution, age and condition, in order to achieve better balance, resulting in reduced physical and mental stress, which frees up energy for rejuvenation and better nutrition, and brings the system into coherence for greater clarity, vitality, health and happiness and in this case also better bones. 

Ayurvedic Beneficial Daily routines are also based upon the ebb and flow of the elements which have been studied and are also known as circadian rhythms, and are beneficial in many ways, such as improved digestion, energy and reducing physical and mental stress. Establishing a daily routine such as eating at the same time each day aids in digestion and waking and sleeping at the same time helps support your natural circadian rhythm, which aids in the wonder drug known as sleep! A great baseline to establish is waking with the sun, vata time, beneficial for contemplative practices, making lunch your largest meal at noon which is pitta time, beneficial for digestion, a light supper no later than 7:00pm, and going to bed by 10:00pm during kapha time for better sleep.

As previously mentioned, sleeping is genuinely a way for the body to nourish, rejuvenate and heal itself. During sleep, the body undergoes many essential processes for healthy functioning, including bone remodeling, where the old bone tissue is replaced with new, keeping the bones strong and dense. If sleep patterns are disturbed this process is vitiated, which can lead to a decrease in new bone formation and an increase in bone resorption. In a study done by Swanson et al. (2017) they found that night shift workers and other participants with altered sleep durations and disrupted circadian rhythms had significantly lower bone mineral densities and a nearly 2-fold increase in the percentage of individuals who experienced self-reported fractures in the 8 year follow up. They concluded that these disturbances impaired bone formation, microarchitecture and strength, and are associated with lower bone mineral density observed with increasing the risk of fracture. 

Taking care of yourself by developing the right lifestyle for your constitution, age and condition provides a better chance of preventing osteoporosis and managing symptoms if it’s already present. Managing stress and sleeping well are two very basic tools to keep in mind. 

Ayurveda also has personalized treatment options to maintain and rejuvenate bone health, and are typically discussed with your Ayurvedic Practitioner, along with a comprehensive lifestyle program. 

Abhyanga is a full body massage using specific medicated/herbalized oils tailored to one's constitution and condition. Regularly scheduled Abhyanga Massage helps improve blood circulation and reduce pain, with the oil providing nourishment to the bones and muscles. 

Basti is an enema therapy that helps remove toxins from the body, balance vata dosha, and improve nutrient absorption. 

Basti Therapeutic Oil Applications are also utilized, where a donut is created around areas that need nourishing, like the low back or knees and is filled with warm, medicated/herbalized oil for bone and muscle nourishment and rejuvenation.

Swedana is an herbal steam bath: that induces sweating, brings heat, warmth and moisture to the tissues and eliminates toxins. It's particularly helpful for reducing stiffness and pain in the joints and muscles to help alleviate symptoms of osteoporosis.

Shirodhara is a treatment where oil is gently streamed back and forth across the forehead that is used to restore the nervous system. It integrates the hemispheres of the brain and nervous system, dropping one into the alpha state, providing a coherence of the brain and heart that offers a very deep relaxation with a profound reset to the entire system, and clarity and insight attained in this state of veda, beyond ordinary perception. 

Schedule an Ayurvedic Discovery Consultation or Ayurvedic Massage and Body Treatment 

Resources: 

Chaya’s Ayurvedic Guide Book 

Swanson CM, Kohrt WM, Buxton OM, Everson CA, Wright KP Jr, Orwoll ES, Shea SA. The importance of the circadian system & sleep for bone health. Metabolism. 2018 Jul;84:28-43. doi: 10.1016/j.metabol.2017.12.002. Epub 2017 Dec 9. PMID: 29229227; PMCID: PMC5994176.

 

Osteoporosis Part III: Exercise For Bone Health

 

Exercise is a crucial part of any healthy and balanced lifestyle. While the idea of putting stress on the body may seem counterintuitive when the bones are weak, in the case of osteoporosis, weight bearing exercise is necessary in its treatment and prevention. 

In general, prevention is the best medicine. We accrue most of our bone mineral density in adolescence, with bone mass peaking in our 20-30s. After 30, bone rebuilding slows down and its loss begins, thereby, exercise in young adulthood is beneficial for countless numbers of reasons and should be a part of any lifestyle. 

Any sort of exercise has great benefits for osteoporosis, including reduction of inflammation and stress, which both contribute to bone loss, as well as improving overall balance and fitness. However, in the case of bone health, the specific bone increasing benefits or weight bearing exercises are important and most beneficial for bone health. Especially in young, healthy populations, the running, dancing and jumping type exercises put stress on the bones and stimulate the growth and strengthening, allowing old bone to be replaced with new bone. Resistance style training can be tailored to any age or fitness level by sticking to body weight or bands and working up to adding weights. This type of exercise improves muscle strength and builds up muscle around the bones that help protect them from fractures. Balancing type of exercise is also helpful and adaptable and accessible to all ages and fitness levels. Things such as tai chi, yoga or even standing on one leg can improve proprioception, balance and reduce the risk of falling. 

If osteoporosis is already present, the recommendations are similar in order to prevent further bone loss, with a few tweaks or adjustments. Strength training, especially for the upper back, flexibility, stability, and balance are all still encouraged. However, weight bearing aerobic activities would need to not be high impact. For example, walking should replace running or using the elliptical machine instead of climbing stairs. Anything imposing sudden or forceful movement, or that increases the risk of falling should be avoided. Other techniques to some consider questionable are excessive or unsupported bending and twisting motions, as well as forward flexion of the spine, such as sit ups and toe touches without modifications. A certified Yoga Therapist or Physical Therapist can provide safe and effective and personalized routines.

 Ayurveda and Yoga are synergistic. Together they balance one’s mind, body, and energy or spirit, for deeper awareness and optimal health. While being remarkable for overall health, yoga as a form of exercise, has been shown to improve bone mineral density. In a study done by Lu et al. in 2016, researchers recruited 741 volunteers and followed them for 10 years comparing pre yoga bone mineral density (BMD) with post yoga BMD changes. The yoga practice was a 12-minute DVD of 12 yoga poses that they believed would stimulate the bones and increase BMD in the lumbar vertebrae, hip, and femoral neck. The 12 poses are included below and each of these were held for a minute every single day.

Poses of the DVD from top left: (1) Vriksasana—tree, (2) Trikonasana—triangle, (3) Virabhadrasana II—warrior II, (4) Parsvakonasana—side-angle pose, (5) Parivrtta Trikonasana—twisted triangle, (6) Salabhasana—Locust, (7) Setu Bandhasana—bridge, (8) Supta Padangusthasana I—supine hand-to-foot I, (9) Supta Padangusthasana II—supine hand-to-foot II, (10) Marichyasana II—straight-legged twist, (11) Matsyendrasana—bent-knee twist, (12) Savasana—corpse pose. 

Using dual-energy x-ray absorptiometric scans radiographs of hips and spine, a bone quality study was taken, resulting in overall bone mineral density improvement of the spines, hips, and femurs of the 227 moderately and fully compliant patients, and a monthly gain in bone mass density, BMD, was significant in the spine (0.0029 g/cm2, P = .005) and femur (0.00022 g/cm2, P = .053). Researchers could then conclude that yoga appears to raise BMD in the spine and the femur safely, but insignificant increase in the hips.

An important point to note, is that while these yoga poses were proven to be effective, the quality of the movement, and not just the movement itself, is important and relevant to the outcome. Proper alignment is necessary in any sort of yoga practice, but the addition of Bandhas may be the missing component to many practitioners’ results. Bandhas literally translates to “lock” or “tighten” and they are intentional muscle contractions with the aim of redirecting energy flow within the body. The purpose is to purify the nadis and chakras which balances the flow of prana. This is done by blocking the descending movement of consciousness and redirect it upwards through the moola bandha. Then keep it centered in the heart through the Jalandara bandha. Lastly, using the uddiyana bandha to help with stability by building and harnessing the energy. The technique behind this is to use the muscles of the legs, pelvic floor and torso to all work together to stabilize, support, and align the bones of the pelvis, sacrum, and spine. To engage the core, one would start at the foundation of the pose, then exhale, and engage mula bandha (root), udiyana bandha (below the navel), and jalandhara bandha (chin/throat). Next, one would inhale and fill the lungs from the top down. After an even ratio or 4-4-4-4, you would then choose a breath ratio to align with your own needs and goals. Lastly, coordinate the movement with bandha and breathing, with focus to the ajna chakra, between the eyebrows at the pineal gland. If done correctly the outcome of the yoga flow will be the optimal use of muscles, alignment, support and stability. Doing this can also literally act as a shock absorber to provide protection from stress and strain to the joints and ligaments. Therefore, proper form and the use of Bandhas and breathing, not only enhances the effects of the treatment and prevention of osteoporotic symptoms by increasing muscle strength and bone density, it also ensures that the yoga poses being performed are done in a safe manner that will not damage already weak bones. 

In summary, the outlined forms of exercise as well as Ayurvedic Yoga Therapy that includes a comprehensive assessment and properly executed movement with bhandas and breathing have been scientifically proven for the prevention and treatment of osteoporosis.

Schedule an Ayurvedic Yoga TherapySession 

 Works cited:

https://www.mayoclinic.org/diseases-conditions/osteoporosis/in-depth/osteoporosis/art-20044989

https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/osteoporosis-and-exercise

https://www.niams.nih.gov/health-topics/exercise-your-bone-health#:~:text=Resistance%20training%20 exercises%20

Lu YH, Rosner B, Chang G, Fishman LM. Twelve-Minute Daily Yoga Regimen Reverses Osteoporotic Bone Loss. Top Geriatr Rehabil. 2016 Apr;32(2):81-87. doi: 10.1097/TGR.0000000000000085. Epub 2015 Nov 5. PMID: 27226695; PMCID: PMC4851231.