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I had a wonderful teacher, Lucy, when I trained as a yoga instructor. The course was thoughtful, supportive and gave me a strong foundation in yoga philosophy, teaching and practice. I came away with respect for the profession and for the care that many yoga teachers bring to their work.

So this article is not a criticism of my teacher or any individual training provider. It is, however, a question I’ve found myself returning to since qualifying: why isn’t osteoporosis routinely covered in foundational yoga teacher training?

I was shocked when I first found out that one in two women over 50 will experience a fracture due to osteoporosis, according to the Royal Osteoporosis Society. The ROS reports that osteoporosis is the fourth biggest cause of disability and premature mortality in the UK, after cardiovascular disease, cancer and stroke. However, awareness of osteoporosis is generally very low until a fracture occurs.

This is particularly relevant because many yoga classes are attended by women in midlife and beyond who are actively investing in their health, strength and wellbeing. These are also the years when bone density often begins to decline more rapidly due to hormonal changes associated with menopause.

As a result, some women attending yoga classes may already have osteopenia or osteoporosis without knowing it. They likely have the best of intentions, exercising and looking after their health, while remaining unaware that certain movements may need adapting to reduce fracture risk.

This is important because fractures can have a huge impact on mobility, independence and quality of life. For some people, the consequences can be life-changing. At the same time, many people who attend yoga classes are actively trying to support their health and wellbeing. They’re exercising, managing stress, improving balance and maintaining strength. Some may be unaware that certain movements can increase fracture risk for people with osteoporosis or low bone density.

Yoga teachers can’t be expected to understand every health condition that a student may bring into the room. They’re not doctors, physiotherapists or osteoporosis specialists, or even yoga therapists or personal trainers. However, osteoporosis is not a rare condition and many women in midlife and beyond who attend yoga classes may be at risk of it, or be unaware they have low bone density already.

There are a handful of simple movement principles that can help reduce fracture risk for people with low bone density. Some common movements taught in yoga classes, particularly deep forward rounding of the spine and certain twisting movements, can increase vertebral fracture risk for people with osteoporosis. Some postures also place substantial forces through the hips and may need adapting depending on an individual’s circumstances. In many cases, simple alternatives can be offered. Many people use these same movements in daily life too, whether gardening, lifting a child, reaching into an oven or picking something up from the floor.

The challenge is that many people do not know they have osteoporosis. Despite years of campaigning by the Royal Osteoporosis Society and others, access to diagnosis, prevention and post-fracture support remains inconsistent. The promise of universal Fracture Liaison Services has not been realised across the country. As a result, many people only discover they have osteoporosis after experiencing a fracture.

Nor is this solely an issue for older women. Peak bone mass is typically reached by around the age of 30. Bone density then gradually declines throughout adult life, with the rate of bone loss often accelerating during the perimenopausal and menopausal years due to hormonal changes. As a result, some women in their forties may already have osteopenia, the stage before osteoporosis, without being aware of it.

The problem is that bone health receives far less attention in public health messaging than many other aspects of healthy ageing.

I became interested in this issue following my own experience of Pregnancy Associated Osteoporosis, a rare condition that caused a fracture in my thoracic spine shortly after the birth of my daughter. Like many people with osteoporosis, I faced multiple hurdles before receiving a diagnosis and also had to cope while adjusting to life as a new mum.

Over time I explored various ways to rebuild strength, mobility and confidence, and yoga is what really helped me to do this. It helped me reconnect with my body, release tension and gradually rebuild trust in movement. It also made me question whether osteoporosis deserves a more prominent place within teacher training.

I should be clear that I’m not suggesting yoga teachers need to become osteoporosis specialists. No movement professional can be expected to understand every health condition they encounter. Osteoporosis stands out for me because of my personal experience, and also because of its prevalence, the potential consequences of fracture, and the fact that it wasn’t covered in my foundational teacher training. At the same time, yoga, approached the right way, can have enormous benefits for physical and mental wellbeing, and it played a pivotal role for me, and still does.

What I am suggesting is that, given how common osteoporosis is, and given the significant impact fractures can have on people’s lives, there is value in ensuring that all yoga teachers have a basic awareness of osteoporosis and osteoporosis-aware movement principles, know how to offer appropriate options and cues in classes, and understand where to signpost students for further information and support.

Nor is this solely a conversation for yoga teachers. Many professionals who support health, movement and wellbeing could benefit from a greater awareness of osteoporosis and how simple adaptations can help people move more calmly and confidently. Equally, these principles are useful knowledge for anyone. They extend beyond yoga studios and into daily life. If awareness can help people move more confidently, reduce fracture risk and maintain independence for longer, then surely it’s a conversation worth having.