Section 4: Adapting Pilates (Basics)

Yoga is an excellent form of exercise but it should be approached with caution by persons with osteoporosis or low bone mass. Although back alignment is usually emphasized, there are many forward-bending, twisting and side-bending postures that should be avoided or at least performed with an elongated spine under the supervision of a skilled teacher.

  • Although there is no “perfect” position in any posture, there are certain standards of body alignment to be considered for safety and to avoid injury.
  • Yoga instructors should carefully watch their student’s movement and give feedback, to make certain that they are keeping their back stable and elongated.


  • best alignment
  • proper sequence of muscle recruitment,
  • balance on the base of support and sustained breathing
  • supine postures or standing on both feet with a stable base of support emphasizing spinal alignment or extension should be the foundation, followed by progression to more challenging standing postures and then into prone postures.

Everyone should be encouraged to follow the above principles and focus on self-progress, slowly, rather than ‘keeping’ up with their neighbour!


  • Twists: perform slow, controlled, supported twists (e.g., knees on block, blanket, wall) in unloaded positions (e.g., supine)
  • Transitions – it is not always the end position but how you get in and out of the position that can be an issue (e.g., jumping feet to hands, and rolling up vertebra by vertebra)
  • Forward flexion – use a hip hinge, or modify to include support (e.g., downward dog with chair)
  • Any seated position – can you do it standing or supine?


  • Rapid, repetitive, weighted, end-range, forceful spinal flexion, rotation, and extension
  • Forced external rotation of hip
  • Any pose which has foot planted with a twisting action of leg/hip
  • Any seated position – can you do it standing or supine?
  • Also – caution with ‘jumping to’ transitions


  • Use of props to include blankets, chairs, walls and belts vs. perfect yoga book poses can create a culture of awareness and safety over competitive performance in the studio.
  • Props can be used where appropriate to provide support to prevent falls or promote balance – BUT should not be used to push to end range.
  • Have sturdy support objects (e.g., wall, counter) near by when doing positions requiring balance. Chairs can be used, but make sure they are not going to fold or collapse.