Thoughts on the new Mayo Clinic research on yoga injuries

A new study from the Mayo Clinic was recently released entitled, Soft Tissue and Bony Injuries Attributed to the Practice of Yoga: A Biomechanical Analysis and Implications for Management. While I’m glad to see more research being done on the effects yoga has on the body, I get concerned when some of the information shared can be easily misinterpreted and spread without sufficient context. In this study, 12 yoga poses are shown in Figure 1 of the publication with the caption “patient-reported yoga poses that led to injury.” Because the chart shows simple drawings of the poses and not technical or obscure yoga jargon, it’s easy for the general population to seize on this information and determine that these poses should be avoided, or generalize that yoga is a hazardous choice of exercise for certain populations. The charts like the one in this study depicting the poses often end up floating around the web and in print attached to titles like “12 Poses to Avoid” or “12 Dangerous Yoga Postures.” Now, let me be clear: the practice of yoga is not without risks. The risks further increase when yoga instructors lack anatomical knowledge and perpetuate teaching poses and giving one-size-fits-all cues without offering modifications. In addition, when those practicing yoga ignore warnings from their body or doctors about poses that might be contraindicated for them, yoga is also less safe. Still, yoga can be practiced safely – even by those who have medical conditions or concerns. To practice safely, yoga teachers and yoga practitioners need to understand that all poses are not for all people so they can avoiding being unnecessarily scared by the titles of studies and misleading charts of yoga poses.

Years ago, if I had read that the Mayo Clinic had conducted research and identified 12 postures that caused injury, I would have been mortified to see postures in that study that I had taught to my classes. Just think of all the injuries I must have caused! While my past teacher self may have thrown those poses out of my sequencing to keep my classes “safe” – the experienced teacher I am now recognizes that there are risks to practicing yoga, but risks are a part of any physical activity. I will absolutely work to mitigate those risks, but I can’t completely remove them. I simply can’t know everything about all the different bodies practicing in my classes.

Likewise, those wanting to practice yoga should not assume that yoga is a completely benign form of exercise that is somehow exempt from the potential for injury. Yoga students should also not assume that their yoga teacher knows everything about every condition and how to adapt every pose to make it 100% safe for everyone. That’s simply not realistic. Some teachers lack the training or experience necessary to modify poses, or the awareness of what poses may be problematic for some individuals. While there is responsibility on the part of the teacher to do their best to sequence and cue poses with appropriate cautions, there is also a responsibility on the part of the participant in group yoga classes to recognize some poses might be higher in injury potential than potential benefit. In other words, don’t do poses you feel are too risky, regardless of what your yoga teacher says. If your teacher doesn’t offer modifications that work for you, then you might need to find another teacher, or just get use to modifying the poses on your own.

The Mayo Clinic study largely focused on risks those with osteoporosis or osteopenia may have in yoga practice. However, most of the 12 poses in the study’s findings can be cued and modified in ways that are safer for those with compromised spinal health – and for the general population as well. Don’t throw these poses out of yoga sequencing simply because they found their way into this study. Yes, there are risks in practicing yoga whether you have a spinal or other health condition or not. Rather than completely abandoning a pose because it is listed in a study as one that caused injury, seek to understand the risks and benefits and decide how, or if, you will practice it. If you take group yoga classes, find teachers that know and offer modifications for postures. If you are a yoga teacher, encourage your students to know and listen to their own bodies (and doctors) about what’s right for them. Those are the keys to safely practicing, or avoiding, the 12 poses the study lists – and for all the ones it does not.

It’s worth noting that the authors of the study conclude: “We are not proposing that patients quit yoga. … Rather, we are simply recommending that patients modify their poses to better accommodate their physical limitations.” Kind of sounds like what many yoga teachers have been saying to their classes for some time! I’d love for that to be the take-away from this study, except I might strike the word “limitations” from that recommendation. Instead, let’s think of it as encouraging people to find the yoga teachers and yoga practice that will help them discover more about what their bodies can do.

 

References:

Lee, Melody et al. “Soft Tissue and Bony Injuries Attributed to the Practice of Yoga: A Biomechanical Analysis and Implications for Management.” Philosophical Transactions of the Royal Society B: Biological Sciences, The Royal Society, 18 Feb. 2019, doi.org/10.1016/j.mayocp.2018.09.024.