Latest Info on Muscle and Bone Strength!

by Baxter and Nina

Strong Dream by Paul Klee

Just as the natural aging process affects all organs, structures, and systems of your body, aging also affects the strength of both your muscles and bones. Because both your muscles and bones contribute to your overall strength, loss in one is typically associated with loss in the other, so it’s equally important to actively maintain the strength of both. Fortunately, using yoga to maintain your muscle strength will help with bone strength and vice versa.

For our long-time readers, it’s true we’ve written about how aging affects strength a few times before. But recently, due to Nina’s fortuitous meeting with an expert in sarcopenia and age-related muscle loss, Dr. Christopher Adams (see Age-Related Muscle Loss: An Interview with Dr. Chris Adams), we realized that most of what we’ve written in the past wasn’t quite accurate. So this is our official redo! We hope this information clarifies things for you. What hasn’t changed, however, is our understanding of how effective yoga can be for maintaining both muscle and bone strength as we age. And Chris told Nina he had recently become convinced that he should start practicing himself!

Muscles

We have over 640 muscles in our body, and starting as early as our thirties, these muscles gradually lose strength. This natural aging process, called “skeletal muscle atrophy,” causes your muscle cells and fibers to become smaller and weaker, leading to a loss of muscle mass, quality, and strength. The rate at which we lose muscle strength varies from person to person, and is also influenced by:

• Behavioral factors. Working at a sedentary desk job or not exercising are the most obvious behaviors that contribute to loss of strength over time, although these can be counteracted by becoming more active.
• Genetic factors. Your body type can influence how weak you become with age, due to the natural size of your muscles when you are younger. If you tend to have larger muscles as a young adult, you simply have more muscle mass to lose as you age before you become weak. On the other hand, if you’re someone who tends not to bulk up easily, without intervention, you may become weaker more quickly as you age. Although you cannot change your body type, if you have not already started to do so, you can begin building up your muscles now as a preventative measure. Yoga’s strength building poses and techniques provide an excellent way to do this (see Techniques for Strength Building with Yoga). All things being equal, men and women likely have a similar rate of loss of muscle strength as they age, that is until women reach menopause, at which time the more rapid loss of bone they experience (see below) contributes to greater loss of muscle strength as well. So at that phase of life and even leading up to it, women need to be particularly focused on maintaining muscle strength.
• Environmental factors. Scarcity of healthy food (malnutrition, for example, worsens skeletal muscle atrophy) and environmental toxins are the most obvious environmental factors that can contribute to loss of strength, so if possible, try to keep yourself protected.

Although skeletal muscle atrophy is caused by aging itself, other factors, such as muscle disuse (sedentary lifestyle, joint injuries, arthritis, strokes), certain illnesses that affect nerve and blood supply to muscles or have other negative effects on muscles (diabetes, cancer, and chronic infections like HIV/AIDS, to name just a few), and medications that can weaken or damage muscles (such as prednisone and chemotherapy agents) can accelerate this process. So if you have any of these conditions, using yoga to address them—whether that means by simply start to move again or by actively improving your health, such as improving diabetes control through stress management and exercise—could slow down loss of strength over time. 

Sarcopenia. For some people—whether due to illness, long-time inactivity or just very advanced age—loss of muscle mass can become a serious problem if it falls well below the average muscle mass of the general population. This advanced stage of skeletal muscle atrophy is sarcopenia. Sarcopenia is the disease stage of skeletal muscle atrophy, just as osteopenia and osteoporosis are two disease stages of aging-related bone loss. 

Naturally, this serious loss of muscle mass—which is accompanied by significant muscle weakness—is something we want to avoid if at all possible because serious muscle weakness is of the main factors that can lead to loss of independence, not to mention of enjoyment of activities that you love. Fortunately, gentle forms of yoga can help even very elderly and weak people regain strength.

Bones

We have 204 bones in our skeletons and, like our muscles, those bones undergo changes as we age. Bones slowly and gradually become thinner and weaker as we age, though it is only when they reach a certain degree of thinness that a you are at greater risk of a fracture from a fall or prolonged poor postural habits (for example, wedge fractures in the thoracic spine). The rate at which we lose bone strength varies person to person, and is influenced by:

• Behavioral factors. The same behavioral factors that have a negative effect on muscle strength—such as working at a sedentary desk job or not exercising —contribute to bone loss over time, although these too can be counteracted by becoming more active.
• Genetic factors. Your body type can influence how weak your bones become with age. Some people just naturally have thinner bones, so they have less bone mass to lose before bones become weak and brittle. And for women hormonal changes during menopause accelerate the rate of bone loss, which is why more women develop osteoporosis after their fifties. Although you cannot change your body type or gender, if you have not already started to do so, you can begin strengthening your bones now as a preventative measure. Yoga’s strength building poses and techniques provide an excellent way to do this (see Techniques for Strength Building with Yoga).
• Environmental factors. The same environmental factors that have a negative effect on muscle strength—such as scarcity of healthy food and environmental toxins—can contribute to bone loss, so for both muscle and bone strength, try to keep yourself protected.

Osteoporosis. While everyone’s bones thin somewhat as they age, for many people, due to advanced age, illness or medications, or menopause for women, bone thinning can reach a critical point, called osteoporosis. At this stage, the bones are more vulnerable to fractures, which can then be slower to heal due to the bone’s thinness. (Osteopenia is the stage of bone loss just before full osteoporosis, when you are already starting to be at risk for fractures from falls, but not to the same degree as with osteoporosis.)

Because body type and gender influence how weak bones become with age, smaller-boned people and women in general are at greater risk of developing osteoporosis at younger ages than those with thicker, bigger bones or men. However, for people over 65, developing osteoporosis is very common, with up to 50% of women and 25 percent of men developing it. 

For those with osteoporosis, the bones of the thoracic spine (your mid-spine) are at greatest risk for fracture, followed by the wrist bones and the femur bone (thigh bone) in the hip joint. These fractures can lead to ongoing chronic pain, physical disability, and, particularly with hip fractures, premature death. Naturally this is something we’d all like to avoid. Fortunately, yoga strength building poses and techniques can actually reverse bone loss (see Techniques for Strength Building with Yoga) , and practicing yoga balance poses is helpful for preventing falls (see Techniques for Improving Balance).

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Yoga for Strength: An Overview

by Baxter

Downward-Facing Dog Pose for Upper Body Strength

Our long-time readers will already be aware of one of the essential skills we promote here at Yoga for Healthy Aging: strength building. And the two important types of strength yoga can help build are bone strength and muscle strength.

As a family doctor, one of my many roles was that of doctor to my patients who found themselves admitted to a nursing home. For many of these patients, they were admitted for post-operative recovery and physical therapy following a hip fracture and hip replacement related to osteoporosis. So their underlying issue that led to the broken hipbone was the thinning of the bones that affects the vertebrae of the spine, the wrists and the neck of the femur (thigh) bone, this last one usually causing the most problems. If these patients got to work promptly on their physical therapy to improve strength in the legs, they often had short stays in the nursing home and were happily discharged home to complete their recovery there. However, many patients, for a variety of reasons, would not progress in physical therapy and so began to get very weak from inactivity and quickly began to lose muscle mass. For a younger person, rebuilding lost muscle mass doesn’t take that much time, but for older people, that time could double or triple, so preserving muscle strength is a much bigger issue in these individuals.

In addition to my nursing home folks, I also noticed that as my general patient population began to age, somewhere in their 50s many began to notice an overall loss of muscle mass and strength. We’ve written about this idea in previous posts, such as Strength and Aging, a concept known as Sarcopenia, which in some ways is an expected part of the aging process—that is, unless we chose to intervene with specific practices to maintain our muscle mass or increase it. Our now in-house Physical Therapist Shari Ser had this to add about Sarcopenia:

“The composition of our muscle fibers changes from being able to contract quickly and explosively to slower contraction rates. There are also changes in how the information is transmitted through the central nervous system and the “rate of processing information” slows down. There are also changes in our proprioceptive system, that is, in how we sense where our body and its various parts are in space. Our range of motion may change with a decrease in our stamina and our overall flexibility due to system trauma (acute and chronic diseases, decrease in endurance and cardiovascular efficiency). And our genetic predisposition to disease will also affect our overall strength.” 

You may have personally noticed this sort of challenge in the spring that first time you worked in the garden, or when you decided to store all that Christmas stuff up in the attic one afternoon, and the next day you were surprisingly sore, weak and tired in the muscles you had used the day before. This could be early evidence that you are having a bit of Sarcopenia setting in!

The main culprit on planet Earth that necessitates that we have adequate strength is, of course, gravity. We have to have enough strength, along with that other essential skill, balance, to get up each day and move around to do the things we have to do and want to do! And we have to have enough strength to simply get out of bed, stand well and move about the home, community or work space in easy fashion. This would lead us to want to keep the muscles of walking and standing very strong, and add in decent strength for the arms depending on other activities we engage in. In an early interview for YFHA, Shari Ser noted that, “Strength … has to be reproduce-able and renewable.” So, you have to be able to get up and down many times a day easily, and have ways to maintain, restore and improve your strength from day to day.

A lot of people turn to the gym and circuit training to do isolated muscle strengthening on machines that, for example, strengthen muscles that flex the elbow (biceps and a few assistants!). This is great for building strength in that isolated muscle group, but unless you are doing curls with the milk cartoon as an everyday activity, it may not translate into smooth, strong, balanced movements in your daily routines. For that, yoga asana practice is a great combination of both isolated muscle strengthening and coordinated, graceful strong movement. And because a balanced asana practice includes standing poses, backbends, forward bends, twists and inverted poses, a regular practice that includes a wide range of poses will build strength in the muscles and bones throughout your entire body. 

Isolated strengthening is accomplished via the process of holding poses statically for a certain amount of time. Research has noted that bone strengthening starts around 10 seconds into a held pose and continues for up to 70 seconds or so, and muscle building starts around the 90-second mark. This has led me to recommend working up to a 90 second hold in many of your poses to achieve both goals. Now, if you are starting out on the weak side, you may find that after a short while you lose the ability to hold the pose safely. So, that is your starting point, that amount of time you could go before feeling like you had to come out, and you’d add a few seconds to your hold every few days or once a week and gradually work your way up to the 90 second goal. (See Strength Building: How Long to Hold Poses for revised recommendations.)

Shari also noted, “Repetition of effort with your current range of motion builds strength.” That means you can also get the benefit of the repetitions you see folks doing on those machines at the gym by entering and exiting the poses dynamically with your breath for a given number of times. I often use the timing I learned from TKV Desikachar of coming in and of a pose six times with the breath. For certain poses, this can mimic real life activities, such as Powerful Pose (Utkatasana), which would help with transitions in and out of a chair. When you extend your practice to include the dynamic complex sequences like Sun or Moon salutations, you will add in more practice balancing and improving your agility, so you get even more bang for your buck. Taken all together, these ways of utilizing the asana to build strength will give you quite a complete system for bond and muscle strength as you age.

And you could also extend the benefits of a complete practice that includes pranayama in order to improve the muscular strength of the breathing muscles, whose primary muscle, the diaphragm, needs the assistance of many other muscles when strong breathing takes place, like anytime you exert yourself. So improving the subtle assistant muscles of breathing, such as, the intercostals, and the larger more powerful muscles of breathing, such as, the abdominals, will give your overall respiratory system a work out, too. Of course, your asanas will also strengthen many of the accessory muscles of breathing, so there is a nice synergistic result from including more than just one yoga tool!

And for those of you out their that want to get even more detailed about how yoga improves strength, check out this juicy post by our scientist extraordinaire, Ram, called Yoga Asanas: Endurance Training or Resistance Training?

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