No pain in the asanas allowed!

With the increase in popularity of yoga and more people practicing there has also been an increase in reported injuries in the US. Unfortunately, the mainstream media has a tendency to report and focus on horrific & tragic events without offering fair balance. Headlines like: “How Yoga Can Wreck Your Body” can scare some people away from the practice who could benefit the most. William J. Broad wrote the former headline and “The Science of Yoga: the risks and rewards” with an emphasis on risks. After reading his book which reported alarming anecdotal case reports of yoga-associated injuries, I can understand how the cited cases could cause the aspiring yogi or healthcare provider to be concerned about the safety of yoga. The purpose of this article is to help you understand the common causes of injuries and offer 10 ways to minimize risk while maximizing the benefits of yoga.

Yes, you can get injured practicing yoga. Therefore, it is important to understand how yoga injuries can occur so that you can practice yoga safely. Loren Fishman & colleagues conducted a survey of 33K clinicians, yoga therapists & yoga instructors to try to understand the causes of yoga injuries. Responders of the survey believed:

  • Yoga injuries are most commonly caused by: 
    • overzealousness, ego or excess effort
    • poor alignment &/or technique
    • improper/ inadequate instruction &/or poorly trained teachers 
  • Areas of the body at greatest risk for serious injury & frequently associated yoga poses:
    • Lower back: twists; forward bends (uttanasana, paschimottanasana); backbends (ustrasana, urdhva mukha svanasana) 
    • Shoulder/rotator cuff: binding poses; arm & hand weight-bearing poses (chaturanga dandasana, vasisthasana, adho mukha svanasana)
    • Knees: (padmasana, virasana, eka pada rajakapotasana, virabhadrasana, trikonasana)
    • Neck: backbends (bhjangasana, urdhva mukha svanasana, ustrasana): inversions: (sirsasana,  sarvangasana, halasana) (Fishman 2009)

According to national survey of adult yoga practitioners in the US less than 1% of individuals who practiced yoga reported an injury that led to discontinued use. Injury due to yoga is an infrequent barrier to continued practice & severe injury due to yoga is rare. (Holton 2014)


10 ways to maximize the benefits of yoga & minimize risk of injury

1. Ask your doctor if yoga is right for you 

Like in those ads sponsored by the pharmaceutical companies which usually end in “Ask your doctor if [brand drug X] is right for you”, you should check-in with your healthcare provider (HCP) if you have any medical conditions or injuries prior to stepping into a yoga class. Your HCP will be able to advise you if there are any limitations such as precautions, warnings or contraindications.

2. Do your homework 

You get the green light from your HCP to proceed. Great! Now do a little research to find an appropriate style of yoga that will best fit your needs. Yoga practice can vary according to the lineage or style of yoga ranging from restorative to strenuous. Working one-on-one with a qualified instructor is a good idea for beginners to learn the basics prior to stepping into a fast-paced vinyasa class in a crowded studio. Check out Yoga Alliance to find yoga teachers in your area and view his or her experience and credentials.

3. Talk to your yoga instructor

It is extremely important for you to notify your yoga instructor about any illness or injury prior to stepping onto the mat and striking your first yoga pose. Most yoga instructors when they see a new face will greet you before class begins. Providing this information helps your instructor to modify yoga poses accordingly.

4. Move Mindfully

Slow & steady wins the race. Cold muscles, tendons and ligaments are vulnerable to injury. Ease into the practice to allow your body enough time to warm up. Move slow and fluidly between poses as injuries can occur during transitions.

5. Listen to your body 

Paying attention to your body is better than paying a specialist to fix an injury. In any yoga pose, go to the point of resistance where you may feel a little bit of discomfort but never beyond to the point of pain. “No pain, no gain” is not a motto used in yoga. Pain is your body trying to warn you something is amiss. Consider pain as your body’s check engine light flashing a warning you that you are exceeding healthy limits & heading toward injury-city. Would you ignore your car’s check engine light prior to taking a long road trip? Probably not. If you experience pain while practicing in yoga, ease up a little, stop or take a break. If any part of your body didn’t hurt before yoga practice it should not hurt afterwards.

6. Continue to breathe. 

Breathing is one of the functions of our body that can run on autopilot or we can actively take control. Holding your breath in a challenging pose sends stress signals to the brain leading to a cascade of “fight or flight” events in the body like muscle tension. Breathing in a challenging pose tells your brain “it’s all good” thus allowing the muscles to lengthen. If you find it impossible to breathe smoothly, you may have moved past your “edge” and need to ease off the pose a little.

7. Let your competitive side snooze 

Yoga is not a competitive sport. If you are in a group class, keep your eyes on your mat and focus on your body. Your pose does not have to look like your neighbor. Injuries occur when students strive to achieve a pose beyond their experience or comfort level. Beginners should avoid headstand (sirsasana), lotus (padmasana) & forceful breathing (kapalabati). Practice with ego or obsession, you can get hurt. There is no need to push limits. Yoga is a journey not a destination.

8. Play with props

Blocks are not just for kids. Grab a block, bolster or strap to add support and stability to your practice. Yoga props allow yogis of all levels to fully explore yoga poses while practicing safely.

9. You can just say no

Hands-on adjustments done improperly by unskilled yoga instructors can and have caused injury, you are within your right to ask a teacher not to touch you. If you are uncomfortable closing your eyes, keep them open. If chanting mantras creeps you out, it’s ok to sit quietly. If you are unsure of a pose or movement, you have permission to opt out or modify. This is your yoga practice, you are in the driver’s seat.

10. Remember yoga is a practice, not a perfect. 

Like any exercise regimen, it is good for you as long as you train properly, know your limitations & do not overdo it.

 

the rewards of basic yoga outweigh the potential physical risks, as long as you take caution and perform the exercises in moderation, according to your individual flexibility level ~American Association of Orthopedic Surgeons


RESOURCES

Broad, William J. The Science of Yoga: the risks & rewards (New York: Simon & Schuster, 2012)
Fishman L et al. Understanding and preventing yoga injuries. Int J Yoga Ther. 2009;19(1):47–53
Holton MK, Barry AE. Do side-effects/injuries from yoga practice result in discontinued use? Results of a national survey. Int J Yoga. 2014;7(2):152–154.