Common Yoga Injuries, and How to Avoid Them

Once a fringe activity, yoga is now as mainstream as mocha lattes, and with good reason. Numerous studies have shown that the practice can enhance strength, balance and flexibility. Yoga helps reduce stress and may even help lower high blood pressure.

But to reap the benefits, you have to do it right—as all too many people are now discovering. Do it wrong, and you could end up as one of the growing number of casualties. According to the U.S. Consumer Product Safety Commission, there were more than 5,000 yoga-related injuries in 2005 that resulted in visits to doctors' offices, clinics and emergency rooms—up from 3,700 in 2004. Those numbers are largely a function of more people, especially aging boomers, taking up yoga. The cost of treating these injuries in 2005 came to nearly $90 million.

As holiday excesses yield to New Year's resolutions to diet and exercise, it's a good time to review some basics that can help ensure a safe yoga practice. NEWSWEEK's Anne Underwood spoke with Dr. Johnny Benjamin, chief of orthopedic surgery at Indian River Medical Center in Vero Beach, Fla., and a fellow of the American Academy of Orthopaedic Surgeons. Excerpts:

NEWSWEEK: How common are yoga-related injuries in your community?
During the winter season, when people come to Florida for the warm weather, I see three or four cases a week.

Are any particular people more susceptible?
In my practice, 70 to 80 percent are women—not because their bodies are more vulnerable to injury than men's, but just because they do more yoga.

How do they get injured?
There are two scenarios I see frequently. One is that a group of girlfriends gets together, and one woman says to another, "Come to my yoga class." The woman who extended the invitation has been doing yoga a while, and the friend who comes along finds herself in a class that's too advanced for her. She ends up in our office.

The other scenario is that people buy home instructional tapes and DVDs. If you've already been to yoga classes and understand the basics, that might be a great way to exercise. But it's not a great way to learn yoga in the first place, because you get no feedback. There's no one telling you how to do it correctly. People think yoga is not vigorous exercise, just stretching. But these are real injuries.

Are there particular types of injuries that you see a lot?
I'm a spine specialist, so I see a lot of back sprains. I've seen some herniated disks related to yoga. There are also a lot of elbow injuries and shoulder injuries. Anything around the joints can be a problem, because people injure ligaments and tendons. If you just overstretch, it's a grade one sprain. If there are micro-tears in a ligament or tendon, that's grade two. A complete tear is grade three.

Are there particular poses, or asanas, that cause problems?
Believe it or not, the lotus pose is most problematic among my patients. Unlike some other poses, it doesn't look tough, and practically everybody did it as a kid. They get lulled into a false sense of complacency. But when you're 50 or 60 years old, the lotus is a lot harder on the joints.

In addition to the lotus, what other poses cause problems?
They can all cause trouble, but when I ask patients how they got injured, the lotus is number one, two and three. There are other poses that are much more technically demanding, but people know without trying that they can't do them.

Is part of the problem that people are competitive with others in the class?
Yes. A good yoga teacher will tell you, don't push beyond your limits. But if you go with a girlfriend, you might feel competitive with her. Yoga is not a competition. The only person you should be competing against is yourself. And even then, you shouldn't see it as a competition.

Trainers tell you to warm up before stretching. Should you warm up before yoga?
Ideally, you should get there 15-20 minutes ahead of time to warm up. The elliptical machine and StairMaster are great for that. They don't take you through the full range of motion, but allow you to slowly warm up by moving in what we call short arcs, which give you minor stretches. Then you can move on to the bigger stretches with greater range. Stretching increases the elasticity of tendons, which hold muscles to bone, and ligaments, which hold joints together.

What types of stretches do you recommend?
Simple things. If you lie on your back, bring each knee up independently, hold it close to the chest to a count of 10. Then repeat that with the other knee. You can also lie on your back again, let one knee fall across your body. Hold it for a count of 10.

If someone is just starting yoga, what advice do you give them?
First, make sure you're going to a reputable instructor. [There is no licensing body for yoga teachers, but registration with the Yoga Alliance indicates a certain level of training.]

Second, if you're a beginner, take a beginners' class. You can't just skip those steps.

Third, if you have any questions about pre-existing injuries, such as a rotator cuff injury or herniated disk, ask your doctor first. [People with carpal tunnel syndrome, for example, should not do poses that require supporting the weight of the body on a flattened palm.]

Finally, if you feel pain, don't press any further. You know the phrase, "No pain, no gain"? In yoga, that's not true. Pain is protective. If a move hurts, don't do it. I put a different twist on the phrase. I tell patients, "No pain, no sprain."

You're not trying to warn people against doing yoga, are you?
The benefits of yoga far outweigh the risks. My point is just that if you're going to do yoga, you should do it safely.

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