Friday Q&A: Ostepenia of the Spine and Headstand

Q: I am 63 years old and have osteopenia of the spine. What are your thoughts of headstand for those of us with osteopenia of the spine? I have taken yoga for several years. My teachers are wonderful and all are Iyengar certified as senior teachers. I have not yet shared with them my recent diagnosis. I appreciate your thoughts on this question.

A: As a general rule, I’d say don’t do it. As we have written about before, the spine is the number one sight for fractures secondary to osteoporosis and osteopenia means your spinal bones are already thinning. And although the thoracic spine is the most common area for wedge fractures to show up in OP, lumbar and cervical fractures happen, too. The human cervical spine—as you probably already realize—is not structured to bear weight on the head, no matter how much you might love Headstands and Shoulderstands (also not a good idea if you have osteopenia of the spine) or what your teachers might like to believe. The cervical region of the spine has the shortest vertebrae and the thinnest discs of anywhere in the spine, because it is evolved only to have to bear the weight of your head, not your body resting down on your head.

I also recommend sharing your diagnosis with your teacher. Now. If your teachers are not particularly concerned about the possible negative effects of Headstand on your spine, you might seek out a new teacher. This does not mean that you cannot do certain inverted postures. Legs Up the Wall is generally safe as an alternative, and if you can get up and down by pivoting mostly at the hip joints to use a “Headstander” (a special prop that allows a variation of Headstand where the head dangles toward the floor but does not rest on the floor) to go upside down, you could give that a try. But do remember that you need be careful about forward folding and it’s potential negative impact on the thoracic and lumbar spine with OP. 

As senior Iyengar teacher Ramadan Patel once said during a workshop on Shoulderstand when someone was bemoaning the fact they might not be able to do the pose again, “Nobody ever attained enlightenment doing Shoulderstand! It is not big deal. Let it go.” It was helpful to actually hear that back when I was able to do Shoulderstand and Headstand without a second thought. These days, I myself skip Headstand to keep my delicate cervical spine happier.

—Baxter