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Research-Based Yoga for Seniors

Add benefit to your program design with a practice that ages well.

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Yoga for seniors

Yoga is an ancient form of movement that has helped millions of people thrive in body, mind and spirit. It is well documented that a regular yoga practice promotes calmness, strength, endurance and well-being (Woodyard 2011). These benefits, and countless others, extend to many special populations, including older adults. In fact, if you’d like to elevate the service you offer your senior clientele, adding yoga for seniors will set you apart and allow you to help your older clients even more. You don’t have to specialize in teaching yoga to insert its many benefits into your program design, and it may be the perfect boost your aging clients need to address specific issues.

As we age, breakdown outweighs buildup, and this affects us from top to bottom, inside and out. Natural changes in hormone levels affect muscle mass (sarcopenia) and can lead to decreases in bone mineral density, which can then lead to osteopenia and, eventually, osteoporosis (Padilla Colon et al. 2018). Unfortunately, it is common for these conditions to accelerate when osteoarthritis, heart disease, chronic pain, poor sleep, depression, anxiety, cognitive impairment or other health issues spur a decrease in activity. Before long, balance is compromised, frailty is exacerbated, and the stage is set for a devastating fall that can severely curtail quality of life or life expectancy. Every year, 1 in 3 people over the age of 65 suffers a fall, and that number increases with age (NIA 2017; Rao 2018).

It’s likely that your clients chose to train with you so that they could combat these problems. Did you know that yoga for seniors addresses many of these issues?  Let’s explore the research into yoga and aging and learn how to apply the findings to your program design.

Osteoarthritis

Aching and inflamed arthritic joints can seriously hinder a progressive training program. Yoga practice offers many paths for a wide range of practitioners. In one study that looked at the effects of yoga on people with knee osteoarthritis (OA), researchers found that participants who took 90-minute, modified Iyengar yoga classes once a week for 8 weeks reported a reduction in pain and improvements in joint stiffness and physical function (Kolasinski et al. 2005).

Another study looked at 36 women, average age 72, who all had knee OA and participated in a 20-week study. The yoga group showed significantly greater improvement on the WOMAC pain scale, which measures knee OA pain, when compared with the control group (Cheung et al. 2014). Another study found that an 8-week yoga practice improved hand pain, tenderness and range of motion (Bernstein 2021).

It is tempting to avoid and “work around” arthritic joints, but yoga poses provide a new option. Yoga’s slow, controlled movements emphasize body awareness and allow inflamed ligaments and tendons to warm up in a gentle, multidirectional way that can increase ROM and decrease joint pain.

Training tip: Incorporate yoga for seniors in slow, deliberate motions that connect to the breath as a warmup before attempting other movements that involve tender joints.

See also: Yoga for Optimal Performance

Balance

Regarding balance, if you don’t use it, you lose it. The data confirms this and, in particular, shows that yoga is a proven way to regain lost balance. In a systemic review of 15 yoga studies, Jeter et al. (2014) found 11 that listed improved balance as a positive outcome of participating in a regular yoga program.

An Australian study published in The Journals of Gerontology found that people who attended 12 weeks of a twice-weekly yoga class in a residential care facility could balance on one leg longer, stand and sit faster without the aid of their arms, and walk at a brisker pace than a control group by the end of the study. Participants also noted that they felt safe and had fun in the yoga classes (Tiedemann 2013; Rao 2018).

By incorporating yoga poses that combine balance, movement and breath into a session, trainers can help clients strengthen the musculature (core, back and hips) that helps prevent falls. These moves can be intimidating and humbling for clients. They may feel frustrated at their bodies for wobbling and struggling with what were previously simple movements. However, it’s important to remind people that each wobble not only trains muscles surrounding joints to be stronger but also strengthens the feedback of proprioceptors in muscles and joints. Those proprioceptors in turn send signals to the brain. Rehearsing these neurophysiological and neurocognitive reactions trains neuroplasticity, the brain’s ability to organize and form connections, and mitigates declines in brain matter volume (Bullock 2021). Fostering this challenging mind-body connection is like handing a dumbbell to the brain, allowing it to “bulk up.”

Balance exercises fire many small, supporting muscles and require core control. It’s preferable not to save this work until the end of the workout when large muscles are already fatigued, energy is low and the likelihood of injury is higher. A better choice is to make balance a main feature of the session.

Training tip: Set your yoga-focused balance movements apart from other balance work by connecting the breath with movements. Cue your clients to bring their awareness inward and observe as they hold and correct. Coaching a mind-body connection at this level will help them when faced with real-life balance challenges.

Bone Density

People practicing yoga for seniors

If a client is concerned about bone loss, incorporate challenging yoga poses that use large muscle groups.

Rowe, Koller & Sharma (2021) report that age-related bone loss can only be decelerated or reversed by applying stress to the bone. As we age, the activity of our osteoblasts (cells that break down bone) outpaces bone formation by osteoclasts. Wolff’s law states that bones will adapt in response to the stress or demands placed on them (Rowe, Koller & Sharma 2021). So, to stimulate osteoclasts to lay down new bone, stress must be applied to the existing bone. The multidirectional pull of muscle on bone via strength training has long been proven the most effective stress for overall bone health.

Fortunately for many frail clients, yoga for seniors can be a gentle way to reap the same benefits. In a 10-year study published in Topics in Geriatric Rehabilitation, researchers compared changes in bone mineral density in 741 volunteers before and after a consistent yoga program. Lu et al. found improvements in BMD in the spine, hips and femur of the volunteers who were moderately or fully compliant with participation. This demonstrates that the stress stimulus provided by the pull of muscles during yoga poses can be effective in mitigating bone loss. Yoga has also been found to safely raise BMD in the spine and femur (Lu et al. 2016).

Training tip: If a client is concerned about bone loss, incorporate challenging yoga poses that use large muscle groups. Many of the balance and core exercises will do double duty in this category and allow a focus on the hips and spine. Gradually introduce harder poses, giving clients opportunities to increase ROM and improve their ability to hold poses for more breaths.

See also: The ABCs of Teaching Yoga

Cardiovascular Health

Cardiovascular disease is still the leading cause of death for men and women in the United States in 2021 (CDC 2021). The interplay between heart, lungs and blood vessels should be at the forefront of any physical activity program for the aging population. Yoga for seniors offers many benefits for both the lungs and the heart.

But how does yoga stack up against other forms of exercise? A 2015 study published in Complimentary Therapies in Medicine pitted daily brisk walking against daily yoga practice to determine the effect each would have on blood pressure in elderly subjects. Yoga was the clear victor. The yoga group showed improvements in vascular function and blood pressure and a reduction in sympathetic activity (Patil, Aithala & Das 2015).

Deep, deliberate breathing is a keystone of yoga, and in a 2014 study, yoga was found to improve pulmonary health. Heart rate and respiratory rate dropped significantly with 12 weeks of regular practice (Bezerra et al. 2014). The decrease in respiratory rate was due to an increase of tidal volume (the amount of air that moves in or out of the lungs with each respiratory cycle), allowing the heart rate to slow and overall cardiovascular markers to improve.

Training tip: Encourage clients to fill their lungs all the way to the bottom, expand their ribs and exhale fully—a common oversight that keeps breathing shallow. Lead a few practice breaths before adding movement to ensure that clients can connect to their breath and make the most of each inhalation and exhalation.

Stress

When we are stressed, we sleep poorly, our hormones react, total-body inflammation rises, and our telomeres (protective caps—at the end of chromosomes—that shorten with age) grow shorter even more rapidly (Tolahunase, Sagar & Dada 2017). In brief, all of our bodily systems suffer. Although older adults may be retired and no longer subject to career stress, they are not immune to this stress response and yoga for seniors can help.

In a cross-sectional study, 65 men and women ages 60 and older were evaluated for sleep quality and quality of life (QOL) before and after participation in a yoga program. Members of the yoga cohort reported improvements in both sleep quality and QOL over the control group (Bankar, Chaudhari & Chaudhari 2013).

Another study, published in Oxidative Medicine and Cellular Longevity, measured biomarkers of cellular aging and found that a focus on physical postures, breathing and meditation promoted cellular longevity. Specifically, cortisol levels decreased and telomerase—the enzyme responsible for maintaining telomere length—increased significantly (Tolahunase, Sagar & Dada 2017).

Training tip: Emphasize deep breathing and slow movements to help clients’ bodies switch out of sympathetic drive and turn on the parasympathetic nervous system. Being able to make this transition drives down cortisol, decreases blood pressure and reduces anxiety.

See also: The Benefits of Yoga Nidra: The Yoga of Sleep

Yoga for Seniors: Integrate and Educate

When you are planning programs for older clients, yoga can easily be among the top five options. Not only can you easily integrate yoga for seniors into almost any aspect of your program design, but it’s a good opportunity to educate clients about health and wellness. Your aging clients rely on your expertise to improve their lives. They want to become healthier, live well and feel better. Share with them the specific benefits you’re targeting by incorporating yoga poses into your sessions. They will love to hear that they are lengthening telomeres, increasing vascular pliability and curtailing bone loss by moving slowly and breathing deeply.



Incorporating Yoga Into a Program

It’s not complicated to incorporate yoga poses into a regular personal training session. Prepare stiff joints by using simple, rhythmic-breath movements as a warmup, and use balance or longer static holds in the body of a workout to build strength in the legs and core. Focus on stretching or simple, deep breathing in savasana to end in a manner that leaves clients feeling refreshed and renewed.

Start with short holds and small ranges of motion. In time, increase the time the client holds a pose, as tolerated. Always cue breath first and focus on slowing down both breath and movement. Encourage clients to connect to the muscles they’re using and relax the muscles that are not in use.

To help clients maximize quality-of-life benefits, put together a mini program with a few simple yoga moves that people can do at home. Choose one or two poses that address specific issues, as well as a couple to promote relaxation. Practice these in the session and then assign them as homework. Ask your clients to keep track and share, and change the assignment every few weeks. The following sample poses will you get you started.

Warrior II

Warrior 2 yoga pose

This may be the “friendliest” of the warrior series. The front foot points forward, with front knee softly bent, while the rear foot steps back into a wide stance, toes angled toward the front, foot grounded and knee straight. Arms are at shoulder height, running the length of the stance with palms down. Hold this pose while breathing deeply.

Modify by narrowing the stance and decreasing the bend in the front knee. You can also make the pose more dynamic by gently bending and straightening the front knee while matching breath to the movement or lifting and lowering the arms to warm the shoulders.

This pose may help with osteoarthritis and improve bone mineral density, balance, strength and neuroplasticity.

Mountain

Mountain yoga pose

This empowering pose is all about standing tall. Stand with feet hip-width apart, shoulders back and down, collarbone lifted, arms hanging at the sides, palms forward. Cue “soft eyes” with an inward focus on feeling long and stable and an outward focus on maintaining excellent posture and connecting to deep belly breathing that expands the rib cage.

Modify by practicing the same tall spinal extension and deliberate breathing while seated in a chair.

This pose may help with stress relief and activation of the parasympathetic nervous system.

Half Moon (variation)

Half moon yoga pose

Starting in mountain pose, inhale as arms lift overhead and come together as if you were diving into a pool. On an exhalation, lean laterally to one side, opening between the rib and hip on the other side, creating a half-moon shape with the body. Return to center on an inhalation; lower the arms on an exhalation.

Modify by practicing from a seated position or by raising only one arm overhead at a time (shown).

This pose may help with osteoarthritis and improve shoulder mobility, bone mineral density, balance and neuroplasticity.

Tree

Tree yoga pose

A challenge at any level, tree pose helps train and assess balance. Stand with one foot solidly grounded, while the other foot rests against the midcalf or just under the pelvic bone on the inner thigh—never against the knee joint. Bring palms together in front of the chest. Once settled in the pose, focus inward on deep and complete breathing.

Modify by holding onto a stable bar or lightly resting the toe of the lifted leg on the ground until strength and balance progress to allow a complete single-leg stance.

This pose may improve balance, bone mineral density, strength and neuroplasticity.

Chair

Chair yoga pose

A squat in disguise, this pose starts with the feet at hip width. With weight in the heels, take a deep breath, raising arms overhead, and slowly lower the hips back and down on an exhalation. Arms can lower into “prayer hands” in front of the chest or extend to shoulder level to counterbalance the pose at the bottom of the movement. Hold in the lowered position for one breath or longer, if possible. Cue clients to avoid gripping with the toes and to keep the center of gravity toward the back of the feet. Return to standing on an inhalation.

Modify by limiting the depth of the squat or holding onto a stable bar for balance.

This pose may improve bone mineral density, balance, strength and neuroplasticity but may need to be modified for clients with osteoarthritis.

References

Bankar, M.A., Chaudhari, S.K., & Chaudhari, K.D. 2013. Impact of long term yoga practice on sleep quality and quality of life in the elderly. Journal of Ayurvedic and Integrative Medicine, 4 (1), 28–32.

Bernstein, S. 2021. Yoga benefits for arthritis. Arthritis Foundation. Accessed June 2021: arthritis.org/health-wellness/healthy-living/physical-activity/yoga/yoga-benefits-for-arthritis.

Bezerra, L.A., et al. 2014. Do 12-week yoga program influence respiratory function of elderly women? Journal of Human Kinetics, 43, 177–81.

Bullock, B.G. 2021. Scientific research: Yoga, aging, and the brain. Yoga International. Accessed Apr. 30, 2021: yogainternational.com/article/view/scientific-research-yoga-aging-and-the-brain.

CDC (Centers for Disease Control and Prevention). 2021. Leading causes of death. Accessed May 4, 2021: cdc.gov/nchs/fastats/leading-causes-of-death.htm.

Cheung, C., et al. 2014. Yoga for managing knee osteoarthritis in older women: A pilot randomized controlled trial. BMC Complementary Medicine and Therapies, 14 (160).

Jeter, P.E., et al. 2014. A systematic review of yoga for balance in a healthy population. Journal of Alternative and Complementary Medicine, 20 (4), 221–32.

Kolasinski, S.L., et al. 2005. Iyengar yoga for treating symptoms of osteoarthritis of the knees: A pilot study. Journal of Alternative and Complementary Medicine, 11 (4), 689–93.

Lu, Y-H., et al. 2016. Twelve-minute daily yoga regimen reverses osteoporotic bone loss. Topics in Geriatric Rehabilitation, 32 (2), 81–87.

NIA (National Institute on Aging). 2017. Prevent falls and fractures. U.S. Department of Health & Human Services. Accessed June 21, 2021: nia.nih.gov/health/prevent-falls-and-fractures.

Padilla Colon, C.J., et al. 2018. Muscle and bone mass loss in the elderly population: Advances in diagnosis and treatment. Journal of Biomedical Science, 3, 40–49.

Patil, S.G., Aithala, M.R., & Das, K.K. 2015. Effect of yoga on arterial stiffness in elderly subjects with increased pulse pressure: A randomized controlled study. Complementary Therapies in Medicine, 23 (4), 562–69.

Rao, R. 2018. Yoga research: New studies show that yoga can improve balance in the 60-and-over crowd. Accessed Apr. 30, 2021: yogauonline.com/yoga-research/yoga-research-new-studies-show-yoga-can-improve-balance-60-and-over-crowd.

Rowe, P., Koller, A., & Sharma, S. 2021. Physiology, bone remodeling. Accessed June 2021: ncbi.nlm.nih.gov/books/NBK499863/.

Tiedemann, A., et al. 2013. A 12-week Iyengar yoga program improved balance and mobility in older community-dwelling people: A pilot randomized controlled trial. The Journals of Gerontology, 68 (9), 1068–75.

Tolahunase, M., Sagar, R., & Dada, R. 2017. Impact of yoga and meditation on cellular aging in apparently healthy individuals: A prospective, open-label single-arm exploratory study. Oxidative Medicine and Cellular Longevity, doi:10.1155/2017/7928981.

Woodyard, C. 2011. Exploring the therapeutic effects of yoga and its ability to increase quality of life. International Journal of Yoga, 4 (2), 49–54.

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Pamela Light, MA

Pamela Light is a group fitness instructor and personal trainer in Rancho Palos Verdes, CA with a bachelor’s in Exercise Physiology, a Master’s in writing, and 25 years’ experience in the fitness industry. You can find videos of Tape Box workouts in her Facebook group, Pamela’s Light and Fit Community.

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