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It’s thought of as being ultra-healthy. But can some of the dangers of yoga postures be putting your health at risk?
By Jody McCutcheon
Yoga is different things to different people. For some, it’s a stress reliever; for others it’s a means of honing mental focus and muscle strength (including the body’s most important muscle, the heart). Yoga helps improve flexibility and endurance, lowers blood pressure, creates antidepressant chemicals to balance your mood, counters aging and even enhances one’s sex life. It’s undeniable that yoga is a health booster for many reasons.
Ironically, though, for an activity that physicians recommend to patients who require rehabilitation from sports and other injuries, yoga may in fact cause significant harm to your joints, bones and potentially more. So what are the potential dangers of yoga postures?
The Potential Dangers of Yoga Postures
First Hints of Danger
With the accumulating evidence for risk, yoga’s pristine reputation as a mental and physical booster has taken a bit of hit. More and more data suggests yoga has a dark side – but let’s make on thing clear: this applies only to the contemporary yoga that’s been practiced since the early 20th century. The yoga of the ancient Indians is quite different, with their poses representing an extension of the cross-legged and squatting postures commonly employed in daily life back then.
Yoga practice is much different now. Rather than a delicate combination of mental, physical and spiritual practices, yoga today melds religion and spirituality with western concepts of athletic and physical training. The result is a form of exercise that’s more American than ancient Indian. To be sure, yoga’s popularity has grown big-time. America’s practitioners grew from around 4 million in 2001 to as many as 20 million a decade later.
Modern living is far different than it was for ancient Indians. Rather than squatting and sitting cross-legged for most of the day, we now tend to sit in chairs, our muscles tightening up and losing necessary flexibility. Then, two or three times a week, we go to yoga classes and strain to contort our rigid selves into nearly impossible poses, leaving ourselves susceptible to injury.
The first hints of yoga dangers emerged a few decades ago in such reputable journals as Neurology, The British Medical Journal and The Journal of the American Medical Association–a case here, a case there, from minor injuries to major damage. The possibility that yoga could be associated with risk must have been something of a shock to its adherents, considering the lack of mention of potential danger in any of yoga’s 20th century foundational literature–from Jagannath G. Gune’s writings in the 1920’s and ‘30’s, to Indra Devi’s 1953 bestseller, “Forever Young, Forever Healthy,” to B.K.S. Iyengar’s 1965 book “Light On Yoga”–or how-to manuals by Swami Sivananda, K. Pattabhi Jois and Bikram Choudhury, among others.
Statistics support the notion of risks from modern yoga: as practitioners increase in number, so do the injuries. Yoga isn’t regulated, so there are no reliable statistics, but a recent study suggests yoga-related Emergency Department visits have increased significantly since 2001, especially among people 65 and older.
Even yoga instructors are beginning to agree. Glenn Black, a teacher for four decades, counts celebrities and yoga gurus among his many clients. Black believes many commonly taught yoga poses can do great damage to people, as they twist our bodies into unnatural positions. He should know, as many of his clients are rehabbing from previous yoga injuries, as is he himself.
Michaelle Edwards is another expert who counts herself among the wary. With four decades of practice and twenty-five years of teaching under her belt, Edwards recently wrote a book called YogAlign, Pain-free Yoga from Your Inner Core. Many of the traditional poses being taught, she says, such as shoulder stands and headstands and downward-facing dog, simply aren’t in synch with how our bodies work. If the experts are concerned, the general public would do well to take heed.
Types of Injuries
As Ms Edwards suggests, many traditional poses carry injury risks, such as osteoarthritis, nerve damage and repetitive strain injuries like tendonitis. A type of kneeling position known as vajrasana can lead to nerve damage resulting in foot weakness, a condition that has earned the name yoga foot drop. Inversion poses such as headstands and handstands can cause degenerative arthritis of the cervical spine and lead to increased eye pressure, which can produce retinal tears.
Despite a persistent, common belief in its ability to stimulate the thyroid–a belief for which there’s no actual medical evidence–plow pose is another risky one, as it creates a right angle between neck and trunk and hips. The cervical spine is designed to hold no more than fifteen pounds at a time, forcing the cervical discs to hold more pressure than they can endure for minutes on end. This type of sustained spinal flexion increases the risk of spinal compression and even spinal fractures, as well as impingement of the vertebral arteries and overstretching of nerve tissue.
These types of poses that emphasize extreme ranges of motion represent a big concern. In 2009, a Columbia University College of Physicians and Surgeons research team compiled a worldwide survey that asked yoga teachers, therapists and doctors about the most serious yoga-related injuries they’d seen. (The frequency numbers themselves don’t suggest a high probability of injury, but they do indicate that a risk nonetheless exists.) The largest number of injuries occurred in the lower back, followed by shoulder, knee and neck. The next most common yoga-related consequence? Stroke.
Risk for Stroke
Yes, you read that correctly. While rare, stroke is one potential consequence of poses that rely on extreme ranges of motion, even in young, healthy people. The potential for yoga-induced stroke has been known since at least 1972, when an article on the subject by W. Ritchie Russell was published in The British Medical Journal. But whether the cause of the stroke is properly attributed is another matter. Due to a lag between precipitating factors and the onset of symptoms–you may have done the yoga last evening and experienced stroke symptoms this morning–linking cause and effect may not be so simple.
The main factor for stroke is hyperextension of the neck. Normal backward neck extension is about 75 degrees, sideways about 45 degrees and forward about 40 degrees, with about a 50-degree rotation on its axis. Yet even intermediate yoga practitioners rotate their necks as much as 90 degrees. Severe neck hyperextension, as in cobra pose and the aforementioned plow pose, can occlude blood flow in the vertebral arteries, thus depriving the brain of blood.
These types of strokes don’t usually affect language or conscious thinking, but can severely damage the body’s core functioning, sometimes even causing death. Even those who recover a majority of functions can still suffer for years from headaches, dizziness, imbalance and difficulty in making fine movements.
Hip Injuries, Especially in Women
Another body area yoga can hurt is the hip. Generally, males tend to suffer more overall yoga injuries than women, but female yoga practitioners may suffer more hip injuries. This is due to a flexibility that allows for extreme range-of-motion bending. The resulting wear and tear around the hips can lead to severe pain and hip damage.
One particular condition called femoroacetabular impingement (FAI), in which the bones of the hips are abnormally shaped and don’t move together smoothly, can be exacerbated by doing yoga. Such movements can cause the hip bones to grind together, over time causing osteoarthritis and joint damage.
According to an article on the drawbacks of female flexibility by New York Times science writer William J. Broad (whose controversial story How Yoga Can Wreck Your Body is one inspiration for this piece you’re now reading), many top US orthopaedic surgeons say the number of women presenting with yoga-related hip pain has indeed increased. Experts–from physicians to yoga teachers–say the same thing: heed the body’s pain tolerance levels. This obviously applies to both men and women.
So why the potential for injury from an activity seemingly as beneficial as yoga? Some problems stem from the type of yoga being done. The New York Times has reported that the excessive heat of Bikram yoga (a kind of hot yoga) may raise the risk of muscle and cartilage damage and overstretching. Furthermore, overstretched ligaments can fail to regain their shape, increasing the potential for sprains, strains and dislocations.
It’s not so much that yoga is dangerous–although the risk for serious injury clearly exists, as with neck hyperextension–but simply that we’re overdoing it, especially with poses that rely on extreme ranges of motion. We push too hard to achieve a position, stretching and twisting and bending far beyond what our bodies are capable of enduring, over and over. Ligaments don’t contain many sensory nerves, so they don’t exactly advertise when they’re being overstretched and damaged. It’s no surprise that after decades of practice, yogis in their fifties and sixties are having their hips replaced.
One reason we may tend to overdo it is, ironically, ego. We just don’t want to looks inferior, especially in front of our peers, so we bend and twist, hoping to outdo others or better our own previous attempts. Another possible explanation is that the rapidly rising demand for yoga has produced a desperate need for teachers, many of whom may have received less training, and thus have less of a full understanding of the injury risks. These teachers may push students into more challenging poses, or generally encourage students to go to postural places where they aren’t used to going and aren’t ready to go. Good yoga teachers must balance a desire to push the student with a responsibility to ensure the student isn’t injured in practice.
A final reason we may overdo it is the old American workout phrase: ‘no pain, no gain’. Whilst this may apply to say, body builders, it’s not appropriate for yoga. You shouldn’t ‘feel’ your workout whilst you do it, or the next day, for that matter.
Listen to Your Body
Maybe the question isn’t about yoga’s safety, but rather whether the human body is designed to accommodate all the right angles yoga practice demands. Of course there are some who can bend themselves into the most advanced of yoga poses, no problem, but the main danger arises when we all think we can do so, ‘because it’s just yoga’ or ‘because even 80 year olds can do it.’ Considering that your body is more curved than right-angled–better shock absorption for your body’s natural movement–perhaps sticking to poses that represent how your body actually moves in real life is best.
Just as the teacher has a responsibility to protect the student, the student–you–have an equal responsibility to exercise caution in yoga. To exercise cautiously. To remain injury-free, to listen to your body, and don’t push beyond the pain. One available tool is Victoria McColm’s Prevent Yoga Injuries blog of contraindicated poses. Check it out to see what poses present the biggest risks to your health.
The bottom line? If a pose or movement hurts, it’s probably something to avoid altogether. Yoga can be your friend when you use it as a health strategy, not see it as a challenge.
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