Musings from the Mat: Does Yoga Heal or Hurt?
How Yoga Hurts HOT YOGA DRAWS FIRE Heat allows you to stretch more but once you stretch a muscle beyond 20-25% of its resting length, you begin to damage a muscle. Dr. Robert Gotlin, director of orthopedic and sports rehabilitation at Beth Israel Medical Center in Manhattan, says he sees as many as five yoga-related injuries to the knees or the lower back. The problem, he says, is that if you stretch any muscle too far beyond its resting length, it will cause damage.
As more and more people take up Bikram or Hot Yoga to lose pounds and gain strength, however, medical professionals are expressing concerns about the demands of yoga contortions performed in extreme heat. Low back pain, injuries to hamstring muscles, knee sprains and damaged cartilages are some of the Bikram-related injuries that have been reported by physiotherapists. They also come across quite a few neck and shoulder strains.
David Bauer, a physical therapist, said ''When you are in a hot studio filled with hard-core Type A personalities, and everyone's adrenaline and endorphins are pumping, you're not feeling any pain and it may mask how far you can go.'' In the heat, you are lulled into a false sense of security. You can stretch muscles beyond their natural limit, and in the process you can tear or strain them.
''The extreme range of motion yoga develops does not necessarily have an advantage, and it may be counterproductive,'' said Dr. Shirley Sahrmann, a professor of physical therapy at the Washington University School of Medicine in St. Louis. ''I have more problems with people who have excessive mobility than limited mobility.'' What looks good may not be what is best for the body.
Ligaments, tough bands of fibrous tissue that connect bones or cartilage at a joint, do not regain their shape once they are stretched out. A loose joint can be like a loose door hinge that prevents the door from closing tightly.
Physicians caution that exercising in heat 2 to 7 degrees above the body's core temperature of 98.6 can be dangerous. Dr. Nieca Goldberg, chief of women's cardiac care at Lenox Hill Hospital in New York, said that because of the stress that extreme heat places on the heart through the demand for increased circulation, people with medical disorders should not do Bikram yoga.
Dr. Catherine Compito, an orthopedic surgeon, said that over time, adherents of hot yoga may be able to condition their bodies to work out safely in the heat, but she questioned whether the practice offered any advantages over other types of exercise.
NOT ALL YOGA POSES ARE CREATED EQUAL
If you haven’t read it already, you might want to check out the article “How Yoga Can Wreck Your Body” in the New York Times Magazine. The article sparked not only blogs, online articles, newsletters, and social media discussion but also spots on national broadcast television and public radio. I think it’s also important to point out how NOT doing yoga can wreck your body. The benefits of yoga unquestionably outweigh the risks.
So let’s differentiate between relatively safe poses that can be done frequently by most people (you’re probably not going to hurt yourself doing Savasana unless you’re practicing near a bookshelf during an earthquake or something). And there are other poses that should probably be done less often due to their tendency to provoke injury. Poses that combine external rotation of the leg with a forward bend, such as One-Legged Seated Forward Bend (Janu Sirsasana) or the Standing Forward Bend with External Rotation of the Bent Leg (see photo left) and maybe even Triangle and Extended Side Angle poses, if done too frequently really do have the potential to cause injuries.
There is another common practice that is particularly encouraged in Bikram classes - repeatedly hyper-extending the knees. Hyper-extension is a prescription for overstretching the soft tissue of ligaments and tendons. While the pose looks superficially impressive, does her left knee look healthy?
While the Bikram Hot Yoga practice heals thousands of injuries in the first 2 years of practice, students frequently end up re-injuring the body in the 3rd & 4thyears of practice. It doesn’t matter what type of yoga you practice. If your body mechanics suck, you’re a risk for injury!
There are a couple of myths in the yoga world that are currently in the process of being exposed. The first is that the poses have evolved over thousands of years and are therefore “perfect.” In fact, if you read books like Yoga Body: The Origins of Modern Posture Practice by Mark Singleton or The Yoga Tradition of the Mysore Palace by N.E. Sjoman, you’ll learn that most of the poses we do in modern-day classes were developed during the early twentieth century. However, asana literally means “to sit down”, it’s the mastery of sitting still. Today’s yoga has many physical variations from standing to seated, inversions to twists. The second myth is that if you do a pose “properly” with the “correct alignment” it is always perfectly safe. And, conversely, that if you injure yourself, you must be doing something “wrong.” As you can see in the NY Times article, scientific research is backing up what many of us have already understood intuitively: that while there are certain robust individuals who seem to be able to do extreme forms of yoga without serious problems, that’s not really possible for the rest of us. For example, the Ashtanga Primary series is notoriously hard on the knee joints and Sun Salutations that include Chaturganga Dandasana (Pushup pose) are equally hard on vulnerable shoulder joints. What most people don’t realize is that this series was meant for young Indian boys who happen to have longer leg lengths not for the 30-something white women who flock to these power yoga classes. But does all that mean we should stop doing yoga? Of course not. Almost any physical activity you take up has the potential to cause injury. Unfortunately, people do get injured during yoga. Whether it’s going up too quickly to a headstand or repetitive stress injuries from chattarungas (plank), injuries happen. Not everyone can – or should – stand on their heads, but everyone can use their heads to yoke their body, brain and breath. It’s important that we proceed with our activities in a state of awareness. One of my favorite quotes is from yoga teacher David Swenson, “Are you practicing yoga or just making an asana out of yourself?” Even though there is a risk of injury in any physical activity, there are always preventative measures that can be taken. Here are some common sense guidelines:
First, and most important, find a qualified instructor who has had a long, thorough training and experience teaching. The meteoric growth of yoga has outpaced the training of quality teachers. There is not one agency that oversees safety and certification of yoga instructors in the US at this time; essentially the field is completely unlicensed and unregulated. However the next best thing is to check the registry of the Yoga Alliance which fills this gap. The Yoga Alliance is a non-profit list of registered schools and yoga instructors. Registered teachers must show that they have met the Alliance’s standards for 200 or 500 hours. The thing to keep in mind is that not all instructors are qualified to teach yoga and even if they are certified, some certification programs are not very thorough.
Don’t do a pose that hurts. Remember that yoga is not a sport of competition. If you push your body beyond what it can do just to keep up with someone else, you can seriously injure yourself. This is how many reported yoga injuries happen. That is also another reason to find a good, qualified instructor. A well-trained instructor can assist you in finding a modified pose if your body cannot fully attain the correct pose. Be sure to listen to your body for clues and it will tell you where the limits are.
Be present during your practice. Focus on exactly what your body is doing instead of allowing your mind to wander.
Use your breath to deepen your postures. Your breath is your greatest teacher. If your breath is strained or you are holding your breath, you are getting too deep into a posture.
It is necessary to move slowly with any type of yoga. If you have never done it before, be sure to move through the poses cautiously and pay attention to the instruction given so that you don’t do the pose incorrectly. This can put strain on joints and muscles and you may not know it. And always come out of a pose early if you need to.
Use props as needed to help prevent overstretching or strain
Don’t move up to that intermediate class too quickly. It is essential that you progress slowly for your body to get the full benefit from the stretches and to gain the flexibility it takes to move up to the next level.
Set your own goals for each class and concentrate on working towards them for your own health and enjoyment. Do not be swayed by what your instructor or classmate says you should be able to do. Don’t be pushed into anything your body isn’t ready for.
Don’t be afraid to ask questions! If you are unsure about a pose or position, ask the instructor before or after class, but do not perform that pose until you are certain it is being done correctly.
Obviously, inform your instructor if you have had any prior injuries, medical conditions, or limitations of any kind. This is especially important for hot yoga. There are some medical conditions that should not be mixed with 115 degrees and difficult poses! If for any reason you are not comfortable doing hot yoga, just stick to traditional yoga instead.
If it’s not for you then it’s not for you. Try a different style or a different teacher. As you travel on the yogic path, keep this in mind - if you go with an open mind you often leave with an open heart.
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