Last updated: February 2, 2026
One prominent yoga teacher said
One of the primary dangers of Yin Yoga practice, in general, is that it encourages extended periods of flexion of the spine—something that should be avoided by someone with low bone density, osteopenia or osteoporosis.[1][2]
This quotation comes from Margaret Martin’s 2012 blog post. Margaret has since updated her views, and her current position is more nuanced than her earlier statements. In her recent writing she does not dismiss Yin Yoga outright, and she usefully distinguishes between poses she considers generally safer and those she considers higher risk for people with osteoporosis. Her concerns focus primarily on spinal flexion, rotation, and prolonged end-range loading, especially when these stresses are applied without appropriate modification or awareness. This refinement is helpful, particularly in reminding teachers that not all bodies tolerate the same stresses in the same way.
However, even with this added nuance, there remains a tendency toward broad generalization. Labeling certain movements or postures as “unsafe” can unintentionally suggest that they are unsafe for everyone with osteopenia or osteoporosis, when in fact risk varies widely between individuals. The movements in question—spinal flexion, rotation, side bending—are not exotic yoga shapes; they are movements people perform every day when tying shoes, getting out of bed, gardening, or reaching for objects. To suggest that these movements must always be avoided risks replacing thoughtful risk management with fear-based restriction.
It is also important to clarify what Yin Yoga teachers usually mean when they invite students to “play their edge.” In Yin Yoga, the edge is not a demand to move to end-range or beyond, nor is it an invitation to engage muscles forcefully while under load. On the contrary, Yin Yoga explicitly discourages strong muscular engagement, which is known to significantly increase stress on bones and joints. Students are encouraged to find a modest, sustainable degree of sensation, well short of pain or strain, and to remain attentive rather than forceful. This distinction matters: a gentle, gravity-based stress held without muscular contraction is mechanically and physiologically very different from loaded, repetitive, or forceful movements that have been shown to increase fracture risk.
Bones and connective tissues require some stress to remain healthy. Remove stress entirely and tissues weaken. (This phenomenon is well known and even has a name: disuse osteoporosis.[3]) For people with mild osteoporosis or osteopenia, eliminating all spinal flexion may do more harm than good. For people with severe osteoporosis, previous vertebral fractures, or pronounced spinal deformity, caution is clearly warranted.
Opinions on this topic vary widely. Greg Lehman, a well-known physical therapy teacher and trainer, has said, “Spinal flexion under low loads (like stretching) has not been proven to be a risk factor for disc pathology.”[4] Indeed he has written extensively on this topic and considers the concern to be unwarranted.[5]
On the other hand, in his book Yoga for Osteoporosis, Dr. Loren Fishman, a yoga teacher and M.D., cites a 1984 study done by researchers at the Mayo Clinic that show flexion of the spine is very bad but extension is very good.[6] These flexion exercises, however, were not gentle stretches. They were loaded, muscular, yang-style movements similar to sit-ups. The study is frequently cited to suggest that all spinal flexion is harmful for people with osteoporosis. That is not what the study actually demonstrated.
What the Mayo Clinic research did show clearly is that spinal extension exercises are beneficial for bone health and fracture prevention. This is a valuable takeaway. Extension-based practices such as Sphinx, Seal, and gentle backbending movements remain important tools for maintaining spinal strength and posture. What the study did not investigate is whether long-held, gentle, gravity-based flexion — the kind used in Yin Yoga — has the same risks as strong, repetitive, muscular flexion. To date, there are still no studies that directly examine the effects of long-held passive spinal flexion on bone mineral density or fracture risk. At best, we can say that we do not know.
Avoiding all flexion may be harmful to your spine! All tissues need stress to become or stay healthy. Too much stress can be harmful, but so can too little. The Mayo Clinic study above showed that yang stresses on the spine are not good for women with osteoporosis, but they did not study women with osteopenia (a precursor condition to osteoporosis) nor the effect of yin stresses. We have known since the time of Julius Wolff[7] that bones need some stress to remain strong: if we never allow any stress of the bones, they will atrophy.
Yang yoga can generate a large amount of transient stresses on the bones and joints due to the pulling power of the muscles. Indeed, a muscular stress on the bone generates several times more stress than the body’s own weight can generate.[8] However, Yin Yoga theoretically generates smaller stresses because they are only due to gravity, not muscular effort. In Yin Yoga, time is the magic ingredient, not intensity. There is a big difference between yang stresses and yin stresses. Whether long-duration, low-intensity stress is beneficial, neutral, or harmful to osteoporotic bone remains unstudied. In the absence of direct evidence, absolute rules are difficult to justify.
In 2015, Dr. Fishman and colleagues published a long-term observational study of more than 700 participants practicing a daily 12-minute yoga routine.[9] Approximately 83 percent of participants had osteopenia or osteoporosis. Bone density scans taken several years apart showed modest improvements in spinal and femoral bone density. Importantly, the poses were held briefly and emphasized standing postures, twists, and spinal extension rather than deep flexion. This study suggests that appropriately chosen yoga postures can be safe and potentially beneficial for people with low bone density. However, it does not answer the question of whether long-held spinal flexion is safe for everyone.
So, is Yin Yoga safe for people with osteoporosis? The most honest answer is: maybe.
Some stress is necessary for bone health. Too much stress can cause injury; too little can lead to further weakening. Where the “right amount” lies depends on the individual: bone density, fracture history, posture, age, symptoms, and how a posture is performed all matter.
Rather than issuing blanket prohibitions, a more reasonable approach is to individualize. Encourage people to work with their healthcare providers, proceed gradually, avoid pain or strain, and observe how their bodies respond over time. For some, gentle flexion may be appropriate. For others, it may not.
As teachers, our role is not to diagnose or to impose rigid rules, but to help students explore movement intelligently, cautiously, and with respect for their own bodies.
Return to Topics
[1] See Margaret Martin’s video on her website.
[2] In the Forum at www.YinYoga.com, I have written a longer response to Margaret’s blog called yin poses/osteoporosis.
[3] See NASA’s explanation of disuse osteoporosis.
[4] Greg Lehman, “If you want to stretch your hamstrings please continue to do so,” Reconciling Biomechanics with Pain Science (2012).
[5] See Greg Lehman’s articles here and here.
[6] A more recent, 2019 Mayo Clinic study on the same topic found that only extreme flexion or extension positions caused problems. “Yoga has many benefits. It improves balance, flexibility, strength and is a good social activity,” says Mehrsheed Sinaki, M.D., a Mayo Clinic physical medicine and rehabilitation specialist and the study’s senior author. “But if you have osteoporosis or osteopenia, you should modify the postures to accommodate your condition.”
[7] See the work of Julius Wolff, a German anatomist in the late 1880s.
[8] Again, I recommend Dr. Fishman’s book Yoga for Osteoporosis for a good overview of the cellular effects of exercise on our bone cells
[9] See Yi-Hsueh Lu, Bernard Rosner, Gregory Chang and Loren M. Fishman, “Twelve-Minute Daily Yoga Regimen Reverses Osteoporotic Bone Loss,” Topics in Geriatric Rehabilitation 00.0 (2015): 1–7.