WARNING: Yoga can lead to crippling injuries
from unusual and excessive stress
on joints and blood vessels.
Yet, Yoga is now highly recommended by all opioid guidelines and is highly touted in the media as a “cure” for chronic pain.
Anyone with a connective tissue disorder is especially vulnerable to yoga injuries and should think carefully about the risks before taking up yoga.
Glen Black is, in many ways, a classic yogi: he studied in Pune, India, at the institute founded by the legendary B. K. S. Iyengar, and spent years in solitude and meditation.
Black, I’d been told, was the person to speak with if you wanted to know not about the virtues of yoga but rather about the damage it could do
Many of his regular clients came to him for bodywork or rehabilitation following yoga injuries.
while doing the extended-side-angle pose, a posture hailed as a cure for many diseases, my back gave way.
With it went my belief, naïve in retrospect, that yoga was a source only of healing and never harm.
At Sankalpah Yoga, the room was packed; roughly half the students were said to be teachers themselves.
His approach was almost free-form: he made us hold poses for a long time but taught no inversions and few classical postures.
Throughout the class, he urged us to pay attention to the thresholds of pain.
In India, he recalled, a yogi came to study at Iyengar’s school and threw himself into a spinal twist. Black said he watched in disbelief as three of the man’s ribs gave way — pop, pop, pop.
Black has come to believe that “the vast majority of people” should give up yoga altogether. It’s simply too likely to cause harm.
Not just students but celebrated teachers too, Black said, injure themselves in droves because most have underlying physical weaknesses or problems that make serious injury all but inevitable.
Instead of doing yoga, “they need to be doing a specific range of motions for articulation, for organ condition,” he said, to strengthen weak parts of the body.
“Yoga is for people in good physical condition. Or it can be used therapeutically. It’s controversial to say, but it really shouldn’t be used for a general class.”
Indian practitioners of yoga typically squatted and sat cross-legged in daily life, and yoga poses, or asanas, were an outgrowth of these postures.
Now urbanites who sit in chairs all day walk into a studio a couple of times a week and strain to twist themselves into ever-more-difficult postures despite their lack of flexibility and other physical problems.
“Today many schools of yoga are just about pushing people,” Black said.
When yoga teachers come to him for bodywork after suffering major traumas, Black tells them, “Don’t do yoga.”
He spoke of well-known yoga teachers doing such basic poses as downward-facing dog, in which the body forms an inverted V, so strenuously that they tore Achilles tendons.
“One of the biggest teachers in America had zero movement in her hip joints,” Black told me. “The sockets had become so degenerated that she had to have hip replacements.” I asked if she still taught. “Oh, yeah,” Black replied.
“There are other yoga teachers that have such bad backs they have to lie down to teach. I’d be so embarrassed.”
Among devotees, from gurus to acolytes forever carrying their rolled-up mats, yoga is described as a nearly miraculous agent of renewal and healing.
These devotees now include the CDC, which has succeeded in convincing almost everyone that yoga can reduce, and even “cure”, chronic pain.
While this may be true of a minority, most people are more likely to suffer more pain from forcing their bodies into poses that are “unnatural” for their bodies and lifestyle, unlike the Indians whose bodies are accustomed to them.
Without more than the scantiest scientific evidence and against common sense, yoga is now urged upon ALL pain patients without any consideration of the factors mentioned here.
Doctors are treating pain patients under orders of the DEA and self-anointed addiction experts, even when it contradicts their own professional judgement.
Especially with a connective tissue disorder, like EDS, yoga poses can displace joints and blood vessels. I “opened my chest” so much, that I subluxed a rib where it connects to the sternum.
But the yoga community long remained silent about its potential to inflict blinding pain.
Reassurances about yoga’s safety also make regular appearances in the how-to books of such yogis as Swami Sivananda, K. Pattabhi Jois and Bikram Choudhury.
“Real yoga is as safe as mother’s milk,” declared Swami Gitananda, a guru who made 10 world tours and founded ashrams on several continents.
But a growing body of medical evidence supports Black’s contention that, for many people, a number of commonly taught yoga poses are inherently risky
The first reports of yoga injuries appeared decades ago, published in some of the world’s most respected journals — among them, Neurology, The British Medical Journal and The Journal of the American Medical Association.
The problems ranged from relatively mild injuries to permanent disabilities.
In one case, a male college student, after more than a year of doing yoga, decided to intensify his practice. He would sit upright on his heels in a kneeling position known as vajrasana for hours a day, chanting for world peace. Soon he was experiencing difficulty walking, running and climbing stairs.
Sitting in vajrasana deprived the branch that runs below the knee of oxygen, deadening the nerve. Once the student gave up the pose, he improved rapidly. Clinicians recorded a number of similar cases and the condition even got its own name: “yoga foot drop.”
In 1972 a prominent Oxford neurophysiologist, W. Ritchie Russell, published an article in The British Medical Journal arguing that, while rare, some yoga postures threatened to cause strokes even in relatively young, healthy people.
Russell found that brain injuries arose not only from direct trauma to the head but also from quick movements or excessive extensions of the neck, such as occur in whiplash — or certain yoga poses.
Normally, the neck can stretch
- backward 75 degrees,
- forward 40 degrees and
- sideways 45 degrees, and
- it can rotate on its axis about 50 degrees.
Yoga practitioners typically move the vertebrae much farther. An intermediate student can easily turn his or her neck 90 degrees — nearly twice the normal rotation.
Hyperflexion of the neck was encouraged by experienced practitioners.
Iyengar emphasized that in cobra pose, the head should arch “as far back as possible” and insisted that in the shoulder stand, , “the body should be in one straight line, perpendicular to the floor.” He called the pose, said to stimulate the thyroid, “one of the greatest boons conferred on humanity by our ancient sages.”
Extreme motions of the head and neck, Russell warned, could wound the vertebral arteries, producing clots, swelling and constriction, and eventually wreak havoc in the brain.
Reductions in blood flow to the basilar artery are known to produce a variety of strokes. These … can severely damage the body’s core machinery and sometimes be fatal.
In 1973, a year after Russell’s paper was published, Willibald Nagler, a renowned authority on spinal rehabilitation at Cornell University Medical College, published a paper on a strange case.
A healthy woman of 28 suffered a stroke while doing a yoga position known as the wheel or upward bow
An intermediate stage often involves raising the trunk and resting the crown of the head on the floor. While balanced on her head, her neck bent far backward, the woman “suddenly felt a severe throbbing headache.” She had difficulty getting up, and when helped into a standing position, was unable to walk without assistance.
Her doctors found that the woman’s left vertebral artery, which runs between the first two cervical vertebrae, had narrowed considerably and that the arteries feeding her cerebellum had undergone severe displacement
Nagler concluded that such injuries appeared to be rare but served as a warning about the hazards of “forceful hyperextension of the neck.” He urged caution in recommending such postures, particularly to individuals of middle age.
The experience of Nagler’s patient was not an isolated incident.
A few years later, a 25-year-old man was rushed to Northwestern Memorial Hospital, in Chicago, complaining of blurred vision, difficulty swallowing and controlling the left side of his body.
The patient had been in excellent health, practicing yoga every morning for a year and a half. His routine included spinal twists in which he rotated his head far to the left and far to the right. Then he would do a shoulder stand with his neck “maximally flexed against the bare floor,” just as Iyengar had instructed, remaining in the inversion for about five minutes.
Diagnostic tests revealed blockages of the left vertebral artery between the c2 and c3 vertebrae; the blood vessel there had suffered “total or nearly complete occlusion” — in other words, no blood could get through to the brain.
Healthy individuals could seriously damage their vertebral arteries, they warned, “by neck movements that exceed physiological tolerance.” Yoga, they stressed, “should be considered as a possible precipitating event.”
These cases may seem exceedingly rare, but surveys by the Consumer Product Safety Commission showed that the number of emergency-room admissions related to yoga, after years of slow increases, was rising quickly.
They went from 13 in 2000 to 20 in 2001. Then they more than doubled to 46 in 2002. These surveys… reveal trends rather than totals — but the spike was nonetheless statistically significant.
Only a fraction of the injured visit hospital emergency rooms. Many of those suffering from less serious yoga injuries go to family doctors, chiropractors and various kinds of therapists.
stories of yoga-induced injuries began to appear in the media. The Times reported that health professionals found that the penetrating heat of Bikram yoga, for example, could raise the risk of overstretching, muscle damage and torn cartilage.
One specialist noted that ligaments — the tough bands of fiber that connect bones or cartilage at a joint — failed to regain their shape once stretched out, raising the risk of strains, sprains and dislocations.
Those with EDS are very vulnerable to overstretching because the defective connective tissues of tendons, ligaments, and blood vessels tear easily.
In 2009, a New York City team based at Columbia University’s College of Physicians and Surgeons published an ambitious worldwide survey of yoga teachers, therapists and doctors.
\survey’s central question — What were the most serious yoga-related injuries (disabling and/or of long duration) they had seen?
the largest number of injuries (231) centered on the lower back. The other main sites were, in declining order of prevalence: the shoulder (219), the knee (174) and the neck (110).
Then came stroke. The respondents noted four cases in which yoga’s extreme bending and contortions resulted in some degree of brain damage.
One of the most vocal reformers is Roger Cole, an Iyengar teacher with degrees in psychology from Stanford and the University of California, San Francisco. Cole has written extensively for Yoga Journal and speaks on yoga safety to the American College of Sports Medicine
Cole ticked off the dangers of doing an unmodified shoulder stand:
- muscle strains,
- overstretched ligaments and
- cervical-disk injuries.
Timothy McCall, a physician who is the medical editor of Yoga Journal, called the headstand too dangerous for general yoga classes.
He found that doing the headstand led to thoracic outlet syndrome, a condition that arises from the compression of nerves passing from the neck into the arms, causing tingling in his right hand as well as sporadic numbness. McCall stopped doing the pose, and his symptoms went away.
Almost a year after I first met Glenn Black at his master class in Manhattan, I received an e-mail from him telling me that he had undergone spinal surgery.
The injury, Black said, had its origins in four decades of extreme backbends and twists.
He had developed spinal stenosis — a serious condition in which the openings between vertebrae begin to narrow, compressing spinal nerves and causing excruciating pain
One surgeon said that without treatment, he would eventually be unable to walk.
The surgery took five hours, fusing together several lumbar vertebrae. He would eventually be fine but was under surgeon’s orders to reduce strain on his lower back. His range of motion would never be the same.
Black is one of the most careful yoga practitioners I know. When I first spoke to him, he said he had never injured himself doing yoga or, as far as he knew, been responsible for harming any of his students. I asked him if his recent injury could have been congenital or related to aging. No, he said. It was yoga. “You have to get a different perspective to see if what you’re doing is going to eventually be bad for you.”
Black recently took that message to a conference at the Omega Institute, his feelings on the subject deepened by his recent operation.
But his warnings seemed to fall on deaf ears. “I was a little more emphatic than usual,” he recalled. “My message was that
‘Asana is not a panacea or a cure-all.’
The CDC is ignoring these and other dangers posed by so-called “alternative” medicine.
This article is adapted from “The Science of Yoga: The Risks and Rewards,” by William J. Broad, to be published next month by Simon & Schuster. Broad is a senior science writer at The Times.