In a 2010 survey paper, researchers found that at least when it comes to VO2 max, Yoga asanas are inferior1 to physical exercises2. VO2 max, maximum oxygen consumption, is a standard measure for the physical fitness of an individual. But in most of the other health outcomes covered in the “meta-analysis”, yoga was just as good if not better than exercise.
Below is a comprehensive table from that 2010 survey paper3 comparing the Health Benefits of Yoga and Exercise (see here for pdf version of the table below):
Here is a brief description of the studies the researchers reviewed:
Table 2 provides a summary of the studies comparing yoga and exercise by outcomes measured. Nearly half of the studies have been conducted on healthy populations, and yoga interventions have yielded positive results in both healthy and diseased populations. Nearly every study utilized a yoga intervention that combined physical asanas (standing, seated, or inverted) and restorative or relaxation poses. Seven of the 12 studies also incorporated meditation and/or breath work. Three studies did not specify the type of yoga intervention used. The remaining studies utilized Hatha yoga (N=4), Iyengar yoga (N=3), and Integrated yoga (N=2). While five of the studies provided specific sequences of yoga poses used in the intervention, the remainder offered few details.
… Most of the studies involved some form of aerobic exercise: walking, running, dancing, or stationary bicycling, plus some form of stretching. Two studies compared yoga with gentle, nonaerobic exercises and stretching.
(1) The researchers found that “… yoga interventions appeared to be equal or superior to exercise in nearly every outcome measured except those involving physical fitness. The studies comparing the effects of yoga and exercise seem to indicate that, in both healthy and diseased populations, yoga may be as effective as or better than exercise at improving a variety of health-related outcome measures.”
(2) Granted, none of the subjects performed Rodney Yee’s extreme example of 108 sun salutations in a row!
(3) The health benefits of yoga and exercise: a review of comparison studies, pdf version here.
One of the enduring myths in yoga circles is the notion that the proper execution of breathing techniques (Kapalbahti and other forms of Pranayama), can flood the body and brain with revitalizing amounts of oxygen. As an example, Indian TV Guru Baba Ramdev recently made such a claim in a BBC program (jump to minute 2:20 below):
To understand why such claims are misplaced1, consider the following summary from William Broad:
… The atmosphere of our planet is 21% oxygen, That’s a lot. In comparison, the levels of carbon dioxide are 500 times smaller. The human body exploits this ocean by means of hemoglobin — the remarkable protein inside our red blood cells that soaks up oxygen like a sponge and carries it from the lungs to the tissues. Typically, the refreshed hemoglobin of a resting person is nearly saturated with oxygen, holding virtually as much as it possibly can. The usual figure for the level of absorption is 97%.
For yoga the glut of oxygen in the air and the saturation of hemoglobin in the lungs mean that fast or slow breathing does little to change the levels that enter the bloodstream — as Gune found at his ashram and as I found in the University of Wisconsin. The vital gas is available in large quantities no matter what.
The body’s consumption of oxygen does go up and down. But science demonstrates that it does so in response to changes in muscle activity, metabolism, and heart rate — not breathing styles. As we saw in the last chapter, cardiovascular fitness can raise peak oxygen consumption2.
(1) When the lungs are diseased or impaired, “slow breathing may aid oxygenation”. See here.
(2) A 2010 paper (The health benefits of yoga and exercise: a review of comparison studies, pdf version here), found that “… yoga interventions appeared to be equal or superior to exercise in nearly every outcome measured except those involving physical fitness. The studies comparing the effects of yoga and exercise seem to indicate that, in both healthy and
diseased populations, yoga may be as effective as or better than exercise at improving a variety of health-related
This seems to be a recurring theme in modern Yoga, the hierarchical structure of many schools results in a single point of failure. Instead of encouraging students to study books and papers written by credible scholars (historians, anthropologists, and scientists), most teacher training programs rely on shoddy information2. I always tell my yogi friends that one can appreciate solid interdisciplinary scholarship and research, AND still love/enjoy yoga. Diversify your information sources. Yoga doesn’t need to be defined only through the lens of your teachers and your teachers’ traditions.
Which brings me back to Anusaragate. Anusara is about to open a new complex in Encinitas, and I don’t think John Friend is going to walk away3 from that. Relative to other senior teachers, JF knows and understands the business side of yoga. He definitely realizes that the Anusara brand has taken a major hit. OTOH, he has been around long enough to know that there are ways of recovering from a crisis like this. Heck, Swamis Rama, Muktananda, Satchidandanda dealt with sexual misconduct lawsuits and survived.
Anusara will recover, just as Kripalu did in the late 1990’s. In fact Kripalu is bigger than ever! Anusara was one of the fastest-growing schools before this scandal, so there is clearly something about it that students love. If Kripalu can recover, there’s no reason to believe that Anusara won’t be bigger in 5 years.
For now though it’s all about brand crisis management. To avoid permanent brand damage JF is moving to cede sole control to a committee of peers. I for one wouldn’t be surprised if Anusara emerges with a governance structure that becomes the model for other yoga schools. (They need a radical overhaul to allay concerns moving forward.) That would be quite a comeback from where we are as of today. Anusara’s governance will still be hierarchical in structure, but not as bad as other yoga schools4.
(1) About a year ago, I perused the early editions of the Yoga Journal and found that many of the teachers/gurus they featured ended up being accused of sexual misconduct. So this is something old-time practitioners can’t blame on over-commercialization.
(2) I’m reading William Broad’s book and I keep coming across hilarious examples of famous yoga teachers peddling blatantly wrong information. In particular, he cites many examples of factually incorrect articles published by the Yoga Journal.
(3) Unless he starts getting sued right and left, in which case Anusara is hosed.
(4) While they’re at it, they’ll probably need to revisit the “tantric lineage” stuff JF has been peddling.
There will be many more stories on the “riskiness” of Yoga
Given that Broad’s article drew a huge number of page views, I wouldn’t be surprised if other publications exploit interest in the “yoga injuries” meme. Broad’s NY times article and the NYMag profile of David Regelin allude to (famous) teachers downplaying (even hiding) hip replacements and other surgeries. Would it surprise you if someone does an exposé? In this competitive media landscape, anything is possible.
Modern postural Yoga is a collection of physical exercises
I’ve touched on this before, but there have been a series of books that indicate that yoga asanas in modern postural yoga are not thousands of years old (see the recent books by Buhnemann, Sjoman, and Singleton). Once you demystify yoga asanas and place them in the realm of other forms of physical exercises, then to the general public it becomes hardly surprising that the risk of (serious) injury is present. By now I think most yoga insiders have at least heard that many of the poses and sequences they’ve come to love are fairly recent in origin (less than 100 years old). Unlike many forms of physical activity, modern postural yoga does emphasize the breath — but it is hardly unique in this regard.
It’s ultimately pointless to highlight Broad’s lack of (scientific) rigor
It has been hilarious to read and hear the reactions along these lines: “The FEW examples he cites are old.” Have you read the Yoga Journal? It is hardly rigorous or empirically-driven! Ironically one of Broad’s examples (problems with head stands) comes from the medical editor of the Yoga Journal, and appeared on its pages. As I noted above, once the public realizes that modern schools of postural Yoga aren’t descended from centuries-old traditions, then the thrust of Broad’s article is so obvious it becomes hard to nitpick: challenging poses & physical exercises can lead to serious injury.
[BTW, by most accounts Broad's yet unpublished book covers the risk of injuries in a single chapter. Most of the book is devoted to research extolling the positive benefits of yoga. It will be interesting to see Broad's detractors turn supportive after the book is released.]
For some poses, it is hardly surprising that alignment is critical
Show a non-yoga enthusiast poses like head stand, shoulder stand, forearm stand, and plow pose, and chances are his/her initial reaction would be “That’s nice, but it looks like you can get hurt doing that!” Let’s face it, shoulder stand is awkward (and dangerous) for most beginners, yet many vinyasa teachers routinely include it.
Repetitive use syndrome
Do something poorly, and repeat it with enough frequency, and guess what happens? Glenn Black has pointed out that the repeated execution of Chaturangas can be detrimental. That’s bad news to many flow/vinyasa/power yoga teachers. Many students love these more vigorous styles, and to take away the heavy use of a critical pose (used in sun salutations) is going to be met with resistance. In a recent discussion on SF’s KQED Forum Glenn Black repeats this point, gets agreement from Baxter Bell, only to have an annoyed Jason Crandell pushback strongly. Crandell didn’t really provide a good counter argument to the concerns raised by Black and Bell.
[Jump to minute 36:00 in the audio clip below.]
Modern postural Yoga is very hard to teach SAFELY, at scale
One of the reactions from yoga insiders has been that yoga students themselves should take more responsibility, by listening to their bodies. I agree with that. But walk into a vigorous yoga class (say with 15 students), chances are during large portions of the class, sequences are being called out in quick succession. It becomes hard for a student not to try to keep up, and attempt to execute modifications to the poses being called out in real-time. (“Do pose X, for those of you who can’t do that, do pose Y instead.”) In most cases, fast-paced verbal instructions have to be delivered over loud music.
Now imagine being in a larger class (or even learning from a DVD or an online class), who’s going to check on you then? As I mentioned in my previous post Krishnamcharya preferred to teach one-on-one or very small classes.
One of the fallouts will be smaller classes that emphasize safety
I think a market will emerge for classes that emphasize proper technique, coinciding with students opting for more intimate settings. Some teachers will initiate this shift, a recent example is the NYMag profile of David Regelin. But because the yoga “industry” wants a mass market for its products and offerings, I think that students themselves have to drive this change. Business people can sense an opportunity: Broad’s article has led to potential books deals for Glenn Black. Look for safety to become the next big marketing tool.
The New, New Thing: Casual practitioners will move on to something else
Among tech hipsters in SF and other enclaves, rock climbing is taking off like crazy.
Inspired by William Broad’s recent NY Times article, here are some reasons why safety is a growing problem in the yoga community.
Many yoga teachers are undertrained: To put it bluntly, 200-hours of training isn’t enough. If you map that to a 40-hour week, that’s 5 weeks worth of training. Five weeks may be enough to teach English in a foreign country, but many modern yoga classes involve poses that can cause serious injury. I suggest to friends that they seek experienced teachers with 500-hours of training. Ideally 200-hour teacher training should be followed by a year of apprenticeship, assisting a senior teacher.
Yoga classes have gotten too big: Towards the end of his life, the esteemed teacher Krishnamacharya mainly taught individual and small classes. In a large class a teacher just can’t scan the room fast enough to catch every unsafe alignment. I currently have primarily a home practice that I supplement with regular, one-on-one sessions with my (very experienced) teacher. Because individual sessions can be expensive, the other option is to find a small class in your local studio. Unfortunately small classes tend be held during inconvenient time slots (which is the main reason they are small to begin with).
Mass media hypes Celebrity teachers: Not all famous yoga personalities are great teachers. Many become famous for reasons other than their teaching skills or knowledge of safety. In addition their classes tend to be extremely large and fast-paced.
Large, fast-paced classes bring out competitive juices: With music blasting and the teacher yelling instructions, it’s not uncommon to scan the room and compare yourself with other students. “Hey that person can bend far, I can do that too!”
Many standard poses are actually not as safe as you think: In previous posts I highlighted the headstand (sirsasana) and the seated forward fold (Paschimottanasana). In Broad’s recent NY Times article, he has stories of yoga teachers who’ve gotten injured while executing seemingly standard poses.
Strict vegan diet and intense yoga practice: I admit this is pure speculation on my part, but somewhat based on anecdata. Many of the busiest yoga teachers are also strict vegans (or vegetarians). If you’re practice puts you at the level of serious athletes, then you have to make sure you have the diet to sustain your level of physical activity. As a group, Vegans probably need to be more conscious that they’re getting enough nutrients.
Not enough yoga practitioners study history and anatomy: In some circles, there might be too much emphasis on the idealized/spiritual roots of modern asana practice, and not enough on recent academic research into the origins of modern yoga. The result is a physical practice that downplays science and empirical data. Fortunately there is also a growing number of experienced teachers who have assembled materials on yoga anatomy and gentle assists. Consult my reading list for possible resources.
Update (1/13/2012): Yoga teacher Glen Black, who was quoted extensively in Broad’s NY Times article, elaborates further in this excellent Huffpost interview.
A NY Times article about safety and Yoga asanas briefly quotes, Timothy McCall (medical editor of the Yoga Journal), on the dangers posed by Sirsasana. It reminded me of an article he wrote on Sirsasana way back in 2003 (yep, 2003 was 8 years ago).
Headstand is one of those poses that many teachers introduce and include, without thinking twice. Most teachers are aware that it’s a pose not to be taken lightly, and safety precautions tend to be emphasized. Nevertheless, as McCall’s article below warns, even students who are comfortable executing the pose need to be aware that there are medical risks that come with Sirsasana. Unfortunately many teachers aren’t aware of those medical dangers!
From the Sep/Oct 2003 issue of the Yoga Journal, page 34:
by Timothy McCall
Last year, after developing a nerve blockage in the chest called thoracic outlet syndrome, I stopped doing Sirsasana (headstand). In the months prior, I’d worked up to holding the pose for 10 minutes, and I’m now convinced that the resulting compression of my chest led to the nerve problem. Shortly after stopping Headstand, the intermittent tingling in my arm went away.
Looking at the faces of people doing Headstand, I often see little of the ease, sukha, that Patanjali stresses should be part of every asana. Some people appear to be straining or breathing erratically; and many students look like they can’t wait for the teacher to tell them to come down and rest.
Even though the pose was never comfortable for me either, I had stayed with it because ofthe purported benefits. T. Krishnamacharya, the guru of K. Pattabhi Jois, B.K.S. Iyengar, and T.K.V. Desikachar, called Headstand the king of the asanas, and practicing regularly is stressed in Iyengar Yoga, the main style I’ve studied. Headstand is believed to calm the nervous system and promote a yogic mind (that is, foster equanimity), and has numerous physiological effects, including reducing the breathing and heart rates, slowing brainwaves, and enhancing the drainage of lymph from areas below the heart. It also induces reductions in norepinephrine, aldosterone, and antidiuretic hormone levels, and so tends to lower blood pressure.
Interestingly, the pose is rarely taught by Desikachar and his followers, due to safety concerns, including neck problems such as herniated disks and arthritis in the cervical vertebrae (bones ofthe neck). Of greater significance is the potentially heightened risk of stroke in people with inadequately controlled high blood pressure and of retinal bleeding or detachment in those with some types of eye disease. For people with glaucoma, Headstand may further increase pressure in the eyes, contributing to loss of vision.
Should you dare to go up? I tend to view the question in light of my own medical training. Doctors are used to the risks and benefits of any intervention before deciding what to do, and I suggest you do the same when contemplating potentially risky poses. For a certain group of yoga students, I have little doubt that headstand can be safe and of great value. These students have enough openness and strength to be able to lift out of the shoulders and thoracic spine and skillfully use their legs to bring further elevation. They are also able to maintain good alignment of the arms, head, and neck and to keep their feet directly over their heads. When the feet drift, it can generate an unhealthy torque on the cervical vertebrae.
Given how tiny and fragile these vertebrae are, I wonder if it is advisable to teach this pose in open classes, in which students of varying levels may be participating. In a class setting, some people may end up doing what isn’t safe for them or what does not feel good. The desire to persevere with a pose that your body is indicating is not right (or not yet right) for you ought to elicit some serious self-study or svadhyaya. You might ask yourself why you are doing yoga and what you hope to gain from it. In this light, putting off or forgoing a pose you’d like to do can be an opportunity for growth and greater self-knowledge.
If you have no strong contraindications but alignment is a problem, using a mirror, wall, or comer to give proper support can help. If they are available, wall ropes and props, such as two chairs, can provide excellent alternatives for those with neck or thoracic spine problems (see ‘Everybody Upside Down’ in our September/ October 2000 issue). If maintaining alignment is an issue, come down as soon as you lose sukha, then slowly build up gradually. More time on preparatory poses is also advisable. For those with poorly controlled high blood pressure, glaucoma, or retinal problems, however, Headstand may simply be too risky in any form.
Luckily, there are many altenatives that can give you a wonderful yogic experience even if the pose isn’t right for you. Ask your teacher for recommendations.
I thought the sentiment expressed also applies to modern-day hatha yoga teachers. I think many times yoga teachers relish being “exotic” (Sanskrit anyone?), when often the best pedagogical technique is to use familiar concepts.
In many cases authenticity is tied to Hindu concepts and formulations. Whenever you find yourself looking down on a particular style/lineage/school of yoga, consider that there have been so many systems of yoga, your favored system is just one of them. So embrace the yoga system that works for you, but realize that “authenticity” and “lineage” can be slippery slopes.
From Yoga in Practice pages 24-27:
Given the fact that the people who “do” yoga number in the tens of millions in the West alone, many students will come to a course on yoga with a number of preconceptions received from their teachers and trainers. Primary among these is the received notion that all yoga are one, and that one Yoga tradition has remained unchanged since its origins in the mists on antiquity. An alternative assumption is that yoga has evolved in a straight line and following some sort of historical determinism from the teachings of the Bhagavad Gita and the Yoga Sutra down through the classical works of hatha yoga and into modern-day Vinyasa, Astanga, Kriya Yoga and so forth. What a chronological reading of the outstanding translations and introductions in this volume makes abundantly clear is that there are as many discontinuities as there are continuities in the history of yoga, and that there are nearly as many yoga systems as there are texts on yoga.
… There are continuities — historical, philosophical, ritual, and so forth — between and among various yoga traditions … This being said, once cannot help but notice that even when they are seeking to refute one another, the authors of these words were clearly engaged in some sort of conversation. So, while there are distinctively Hindu, Buddhist, Jain, Tantric, non-sectarian, and even Islamic yoga traditions, there are a number of pervasive themes that recur across texts and time. … As the six contributions on yoga in South and Inner Asian Tantric traditions make clear, sectarian differences among Hindus, Buddhists, and Jains paled in comparison to the commonalities of their shared Tantric worldview, metaphysics, goals, and techniques.
… What distinguishes the principal types of yogic practice from one another are the components of the self that are the objects of one’s discipline. So it is is that in meditative traditions, the principal focus will be on immobilizing thought, usually in conjunction with breath control, the inner repetition of mantras, and so on. In most forms of Tantric yoga, thought, semen, and the body are highlighted to varying degrees. In hatha yoga, the focus can be on all four components as immortalized in a medieval vernacular poem attributed to the Nath Yogi Gopicand: “Steady goes the breath, and the mind is steady, steady goes the mind, the semen. Steady the semen, and the body is steady, that’s what Gopicand is sayin.”
… culture warriors from worlds apart are making the nearly identical claim that yoga is fundamentally Hindu. In the United States, a number of Christian evangelists are taking this position for the expressed purpose of controlling the bodies of Christian women, while in India, Hindu fundamentalists are doing the same in the service of their ongoing campaign of identity politics.
… As for their shared claim that Yoga is fundamentally Hindu, this can only stand if one allows that there has only ever been one “yoga” , and that yoga has remain unaltered since incepetion, i.e., the yoga being taught today in yoga studios across the globe is identical to the yoga of the Upanishads or that taught to Krsna in the Bhagavad Gita, the two earliest treatments of “yoga” in the Hindu cannon. However, upon inspection these two original Hindu teachings on yoga are found to diverge on several points, an so one must conclude that from the very outset there have been at least two Hindu systems of yoga. And, as the contributions to this volume make plain, the past 2,500 years have seen the emergence of many, many systems of yoga — the earliest of which may not have been Hindu at all, and many of which arose outside of India — whose theories and practices have often been diametrically opposed to one another.
… Now, it is the case that many modern-day yoga gurus have collapsed the rich and varied histories of the many yogas of India, greater Asia, and now the West, into a simplistic vision of yoga as an unchanging tradition grounded in the religion of the Vedas. However, the simple fact that some contemporary teachers and practitioners of yoga hold to such an untenable hypothesis does not make yoga Hindu, any more than the presence of a plastic Jesus on some dashboards would make all automobile drivers Christian.
(1) “… the task of the religious studies scholar is not only to make the strange seem familiar, but also to make the familiar seem strange.”