Interview with Dr Loren Fishman on Yoga for Osteoporosis and Other Topics

by Baxter

For those of you not familiar with the work of Dr. Fishman, he is a long-time yoga practitioner, a physician specializing in rehabilitative medicine, and someone who is endlessly curious about the power of yoga to address health issues, such as osteoporosis, osteopenia, arthritis, and scoliosis. We are fortunate he agreed to this interview today so we can learn more about his recent research on bone health.  

Baxter: Can we begin with a little background on what got you interested in osteoporosis and yoga in the first place?  

Loren: When I was in India (1972-75) I got the first part of the idea, seeing these people from a truly ancient culture who still walked hundreds, even thousands of miles. These people seemed to me to have such strong, almost metallic bones. Mr. Iyengar gave me the same impression, only more so. 

Afterwards, in medical school, when I learned about Wolff’s law, that the strength of a bone depended on the forces to which it was subjected, I put the puzzle together: Yoga, generating forces many times greater than gravity, built bones up and made them stronger. But it has to be yoga graced by great attention to alignment. Otherwise, those great forces would cause injury.  

Baxter: We have written about your early work on osteoporosis in a pilot study done in 2009, but I know you have done a more recent study with exciting results. Can you tell us about that research and how our audience of yoga practitioners and yoga teachers might use what you have discovered?

Loren: After the pilot study was successful, I made a DVD and gave it away to 1000 people from every part of the world to use for our next study. It took eight years to get all the data we needed to complete this second study. We published this 1000 patient study (241 actually compliant) as Twelve-Minute Daily Yoga Regimen Reverses Osteoporotic Bone Loss, Lu, Yi-Hsueh; Rosner, Bernard; Chang, Gregory; Fishman, Loren M. Topics in Geriatric Rehabilitation April/June 2016 - Volume 32 - Issue 2 - p 81–87.  

Baxter: Can you tell us about the safety and accessibility of your bone strength protocols?

Loren: Safety? We asked everybody in the 1000-patient study to get X-rays before and after the two years they practiced using the DVD. About one quarter of them actually did. Results: No fractures, no significant advance of arthritis. No yoga-related fractures reported by anyone in the study. In fact no serious injuries of any kind were seen or reported in over 100,000 hours of people doing this yoga daily. Over 80% of them had osteoporosis or osteopenia when we started. In the final analysis, the spine and hip improved significantly, (p =.02 and.01), and the femur improved more than it does in people using the most popular medicines (p = .0002). 

When we saw that the yoga in the DVD actually worked, we put it up here on YouTube and sell the DVD through PayPal on the website sciatica.org. 

Baxter: Are there any unanswered questions you still have regarding the use of yoga for osteoporosis? 

Loren: Yes. How do you convince the doctors? The study got written up in the New York Times, and the one on scoliosis in the Wall Street Journal, but the medical community remained largely unpersuaded. We are now working on another study that we call a dose-response study, in which we have participants see a yoga teacher who is trained in our yoga every two weeks to see what “dose” of yoga the participants are giving themselves. Then we’ll see what happens to their DEXA scans in two years. I suspect not only does it work, but is synergic with the various medicines, yielding an effect that is greater than just adding the two effects together. But that’s just a suspicion. In a few years or so we’ll see if there’s a relation between how much you put into your yoga and how much stronger your bones become. 

Baxter: What is next for you? Any upcoming or ongoing studies? And can our readers participate in some way?

Loren: Yes, we’re now doing another certification training in osteoporosis, and certified teachers can give classes, report data, and participate in our newest dose-response study. We also have one coming up on lower back pain. After all, back pain is the biggest medical reason people seek out yoga. Here yoga appears synergic with medicine. These courses are analogous to “post graduate work” after becoming a yoga therapist. They have online and workshop components.

We’ve just gotten another study accepted by “Muscle and Nerve” on botulinum toxin for piriformis syndrome. And we just submitted a study in which yoga is more effective for scoliosis than any conservative method ever published, and unlike surgery, innocuous and just about free. We have patients from age 8 to the late 80’s. Then we’re working with Carnegie Mellon’s computer people on a new, objective way to analyze the facial expression of pain, to give a more objective way to understand pain. Do people realize that probably one third of medicine is based on pain, and yet all we have to rate it is the puerile one-dimension 1-to-10 scale?  

Baxter: I understand you have started offering trainings in your way of addressing osteoporosis. What are these trainings like and where can our readers learn more about them?

Loren: The up-and-coming trainings are in North Carolina, at an Appalachian mountain retreat called Art of Living near Boone, starting May 31, and another in San Francisco in mid-July. That San Francisco training is almost full, but the one in Boone is pretty open. They are 40-hour teachings, 20 hours online at artoflivingretreatcenter.org.

We have also developed alternative sets of poses for osteoporosis to ward off the inevitable ennui of doing the same poses day in day out, and also to strengthen the bones of the wrist, the fourth most probably fracture site (as I said earlier, we have put the first group—the group we’ve already proven to work—online for free at YouTube and offer DVDs on the website sciatica.org). And we give workshops, such as the one at Art of Living in North Carolina and online training to teach yoga teachers to train people to do these poses at their proper level. We feel this is an effective, innocuous, and quite valuable skill for yoga teachers to acquire.

Baxter: Is there anything else you’d like to say to our readers?  

Loren: Yes, there’s a recent controversy about how long should a yoga class be, based on an article in the Atlantic Monthly. In this era of Dog Yoga and Pizza Yoga I think people can get on the wrong track. Like anything else, the length of a class depends on whom you’re teaching and what you’re teaching them. The length isn’t important in itself. How long does a word have to be to keep its meaning? One should measure progress not by distance traveled, but by proximity to goal.  

Baxter: Sage advice, and thank you for all of this important and relevant information. We look forward to hearing more of the results of your studies in the future!  

Loren Fishman, MD is Medical Director of Manhattan Physical Medicine and Rehabilitation in New York City, author of eight books and author or editor of more than 70 academic articles. He is a world-recognized pioneer in the treatment of piriformis syndrome and rotator cuff tear and an expert in curing back pain. "A Thomas Edison of yoga therapy,” according to Pulitzer-Prize winning author William Broad, Dr. Fishman has done peer-reviewed clinical research on yoga and osteoporosis, scoliosis, and rotator cuff tear. He has integrated yoga into his medical practice for decades. Dr. Fishman received a degree in philosophy from Oxford University. Then he studied yoga in India with BKS Iyengar.

Dr. Fishman is Associate Research Editor of Topics in Geriatric Rehabilitation, on the staff at Columbia College of Physicians and Surgeons, and a past president of the New York Society of Physical Medicine and Rehabilitation. 

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