"Yoga enthusiasts link the practice to a long list of health benefits including greater flexibility and range of motion stronger muscles better posture and balance reduced emotional and physical stress and increased selfawareness and selfesteem. But definitively proving these benefits is challenging requiring years of costly research. A pharmaceutical company is unlikely to fund a study that doesnt involve a drug and in any event the research requires a large group of volunteers tracked over a very long time. The subjects must provide health measurements at the outset learn the proper poses continue to do them regularly for years and be regularly evaluated. No one knows these challenges better than Dr. Loren M. Fishman a physiatrist at Columbia University who specializes in rehabilitative medicine. For years he has been gathering evidence on yoga and bone health hoping to determine whether yoga might be an effective therapy for osteoporosis. The idea is not widely accepted in the medical community but then researchers know comparatively little about complementary medicine in general. So in  Dr. Fishman began a small pilot study of yoga moves httpsjournals.lww.comtopicsingeriatricrehabilitationFulltextYoga_for_Osteoporosis__A_Pilot_Study..aspx that turned up some encouraging results. Eleven practitioners had increased bone density in their spine and hips he reported in  compared with seven controls who did not practice yoga. Knowing that more than  spinal fractures and more than  hip fractures occur annually in the United States Dr. Fishman hoped that similar findings from a much larger study might convince doctors that this lowcost and less dangerous alternative to boneloss drugs is worth pursuing. Those medications can produce adverse side effects like gastrointestinal distress and fractures of the femur. Indeed a recent study published in Clinical Interventions in Aging found https that among  women found to have osteoporosis all of whom had Medicare Part D drug coverage only  percent started bone drug therapy within a year of diagnosis. Many of those who avoided drugs were trying to avoid gastrointestinal problems. On the other hand yogas side effects Dr. Fishman and colleagues wrote recently include better posture improved balance enhanced coordination greater range of motion higher strength reduced levels of anxiety and better gait. Weightbearing activity is often recommended to patients with bone loss and Dr. Fishman argues that certain yoga positions fit the bill. Yoga puts more pressure on bone than gravity does he said in an interview. By opposing one group of muscles against another it stimulates osteocytes the bonemaking cells. Most experts argue that its difficult perhaps impossible for adults to gain significant bone mass. Undeterred Dr. Fishman invested a chunk of his own money and with three collaborators  YiHsueh Lu of The Rockefeller University Bernard Rosner of Brigham and Womens Hospital and Dr. Gregory Chang of New York University  solicited volunteers worldwide via the Internet for a followup to his small pilot study. Of the  people who joined his experiment from  to    of them women followed through with doing the  assigned yoga poses daily or at least every other day. The average age of the  participants upon joining the study was  and  percent had osteoporosis or its precursor osteopenia. The  poses by their English names were tree triangle warrior II sideangle twisted triangle locust bridge supine handtofoot I supine handtofoot II straightlegged twist bentknee twist and corpse pose. Each pose was held for  seconds. The daily regimen once learned took  minutes to complete. The researchers collected data at the start of the study on the participants bone density measurements blood and urine chemistry and Xrays of their spines and hips. They were each given a DVD of the  yoga poses used in the pilot study and an online program in which to record what they did and how often. A decade after the start of the study bone density measurements were again taken and emailed to the researchers many participants also had repeat Xrays done. The findings as reported last month in Topics of Geriatric Rehabilitation httpsjournals.lww.comtopicsingeriatricrehabilitationAbstractpublishaheadTwelve_Minute_Daily_Yoga_Regimen_Reverses..aspx showed improved bone density in the spine and femur of the  participants who were moderately or fully compliant with the assigned yoga exercises. Improvements were seen in bone density in the hip as well but they were not statistically significant. Before the study the participants had had  fractures reported by them or found on Xrays. At the time the study was submitted for publication with more than  hours of yoga practiced largely by people with osteoporosis or osteopenia there have been no reported or Xray detected fractures or serious injuries of any kind related to the practice of yoga in any of the  participants Dr. Fishman and his colleagues wrote. Yoga looks like its safe even for people who have suffered significant bone loss Dr. Fishman said in an interview. Furthermore a special study of bone quality done on  of the participants showed that they had better internal support of their bones which is not measured by a bone density scan but is important to resisting fractures Dr. Fishman said. The study has many limitations including the use of selfselected volunteers and the lack of a control group. But all told the team concluded the results may lend support to Dr. Fishmans longheld belief that yoga can help reverse bone loss. Even if bone density did not increase improvements in posture and balance that can accrue from the practice of yoga can be protective Dr. Fishman said. Spinal fractures can result from poor posture and theres no medication for that but yoga is helpful he said. In addition Yoga is good for range of motion strength coordination and reduced anxiety he said all of which contribute to the ability to stay upright and not fall. If you dont fall you greatly reduce your risk of a serious fracture."