Yoga Injuries – On The Rise?

Following our discussion last month about the current conversation in the yoga industry (and in the broader community) about the incidence of Yoga injuries, I have done a bit of research on whether or not there truly is an increase in Yoga injuries and, if so, how we can be safer teachers and students in our practice.

I’ve done some preliminary research on the incidence of yoga injuries in the ‘West’, including Canada, the United States, and Australia. At present there is not a lot of good data available, but I’ll do my best with the data that I’ve got.  Depending on your sources, between 3-6% of the population is taking part in either organized or unorganized (studio or home practice) yoga on a regular basis. Current statistics on yoga-related injuries indicates that about .02% of that 3-6% of the population has experienced an injury as a result of either an acute incident in a class or a chronic injury as a result of long-term or repetitive use. Is that number rising? Well, it’s hard to say. Data in America only addresses hospital visits related to yoga injuries and does not consider people who went home and iced a sore muscle, visited their physio, or just waited an injury out. However, looking at the data available, the incidence of yoga injuries fluctuated up and down over the course of a few years, and over the time period that I looked at, there was a slight – but not significant – rise in the reported injuries. Note that the most common injuries reported were strained muscles, rotator cuff injuries, the exacerbation of pre-existing conditions like carpal tunnel syndrome, torn cartilage in the knees, and lower back and neck injuries. Perhaps these are areas to be particularly aware of in your practice and teaching.

So, are yoga injuries on the rise? As more people participate in yoga, there will be more yoga-related injuries. That’s a given. Yoga is exercise and all forms of exercise carry a risk of injury.   But that doesn’t mean that we are safer if we don’t practice yoga. We are now becoming increasingly aware that a lack of movement is also quite hazardous to our health. So, move and risk injury – don’t move and risk ill health. What to do? Interestingly, as I did my research I stumbled across some other injury-related data; at the same time that yoga injuries rose slightly, there was a dramatic rise in the number of head injuries caused by falling computer monitors. Based on the current data, I don’t think its cause to stop practicing yoga or stop using a computer. However, it might be time to address how you practice yoga (and also…what you might be doing to have a computer fall on your head!).

So, I suppose the conversation we need to be having is; are we as a group and as individuals engaging in appropriate movement in our yoga classes?

The past few years I have been noticing a trend. Not in the rise of yoga injuries, but in the increase in the frequency that I hear people say things like, “oh, she/he is really good at yoga”. Can you really be ‘good at’ yoga? Sure, you can have a good-looking practice, but what a practice looks like is not always an indicator of proficiency or safety or mindfulness. What postures a person can or cannot do, how someone looks in their tights, and what famous yoga teachers a person has studied with are not badges of honor or points on a scoreboard. Yoga is a personal practice, and to be not only safe but truly life-enhancing and transformative it must remain that way. Otherwise, doesn’t yoga become yet another place where we have to be ‘good enough’ and we fall into the pattern of practicing what is ‘right’ as opposed to what is ‘right for me right now’? In my own practice I have definitely had occasion to struggle with wanting to know more, be more, do more. But, the race to be up on the latest book, the latest teacher, or the latest style is just too exhausting – and in many cases takes me far away from my real practice – to be myself. As far as safety goes, when yoga – whether in a class, in a private session, or on a dvd – is just about you, an injury will rarely occur, and if it should, then that is what you are learning about now.

Students often come to yoga for the many fitness benefits, and there certainly are many. But, there is a difference in practicing for fitness and practicing as a set of techniques designed to lead each individual to self-evolvement; and that difference shows up in the variety of techniques used.

Fitness Australia has guidelines for all programs that they approve as safe and effective fitness activities. When Fitness Australia recognizes a program, they are very clear as to what techniques are considered safe and what techniques are considered contra-indicated. When a student is taking part in a yoga class for fitness, I would recommend that the class is structured around the Fitness Australia guidelines. This means that techniques like headstands, shoulder stands, and unsupported forward flexion are modified or removed from the posture sequence. This will keep students safe and ensure that, particularly in a large class, techniques that teachers cannot give one-on-one instruction in are introduced gradually or modified so that they are safe for the general practitioner. Fitness based yoga classes like YogaFit and Body Balance have done an excellent job of delivering safe and effective yoga-based fitness programs, and can serve as a great introduction to the practice. When a student chooses to take part in yoga for the traditional multi-dimensional practice, smaller class sizes, more individual support, and a higher level of training and experience on the part of the teacher may help reduce the risk of injury and enhance the learning experience. But most importantly a consistent and regular practice by the student can allow some of the traditional ‘advanced techniques’ to become a safe part of a practice.

Be your own yoga coach. It’s your body, be responsible for it.

Let your breath guide you. If you are struggling with your breath, back off. Yoga is intelligent effort; avoid straining or striving.

Follow the rule “Have Pain, No Gain”. If you have pain, particularly in the joint, there is no gain to be had and you are at a much higher risk of injury.

Practice at your edge; the place between comfort and discomfort. If you are engaging in a dynamic practice, feel your muscles and your breath challenged, but not your joints. And keep in mind that the ‘edge’ is not always in the highest physical intensity. Sometimes the edgiest place is in backing off while the rest of the class moves on. This can be a powerful place to experience.

If you want to practice advanced asanas, use advanced safety. Study in smaller classes or get some private sessions to help you keep your unique body safe as you progress to more advanced postures.

Recognize the uniqueness of each individual in your class. Just because your body or your textbooks tell you that an asana should look a certain way doesn’t mean that a client can attain that technique now (or ever).

Know your anatomy and your asanas. Know when a particular body has the anatomical and functional foundation for performing an asana safely.

Develop a toolbox of modifications, props and variations that allow each individual to practice safely.

Apply hands on adjustments intelligently. Use your eyes, ears and hands to listen to what is happening in the body. Don’t insist. When adjusting use 10% of the energy you think you need to adjust, then together you can observe, discuss, and reassess.

Consider the difference between teaching yoga for fitness and yoga for meditation. The benefits are quite the same, but perhaps the techniques and the practice should look different, particularly if students are only attending yoga once a week.

Encourage yoga as a personal practice. With love and intelligence address the desire to compete or perform, and encourage students to bring their attention to ‘what is happening now’ in their body/breath/practice rather than focusing on the neighbor or the ideal.

Be an educator as well as an instructor. Regularly workshop techniques to explore how we can use them more safely for how our bodies are showing up today.

Consider what is appropriate for your class today. Perhaps in a group of round-shouldered computer users, postures like shoulder-stand need to be modified for the first few months or years.

Remind your students that progress in yoga is not measured by days but by lifetimes (if it could be measured at all)

Remember that Yoga is about union; bringing together the body and mind, the outer world and the inner world. If your practice has become a competition or an exercise in striving, maybe it’s time to re-examine your practice. Take instruction and support from the formative text, the Yoga Sutras, which says that “Yoga is the effort to still the fluctuations of the mind” and that “asanas should be steady and comfortable” (or steady and joyful depending on the translation). If your asana practice is not guiding you to this place, perhaps some reflection will help to re-inspire your practice and/or your teaching.

This conversation in the Messenger was prompted by a discussion in class about a recent article in Australia, but in the past few months I have also read a few North American articles that have had very dynamic discussions about the safety of yoga. In particular in a recent peer journal on mind/body fitness an article explored some of the poses that often are considered “contra-indicated” by the fitness industry, like shoulderstand, plough, and fish, and the author went on to detail how they could be performed safely. I thought the article was well written and the guidance was sound. However, the comments posted on the article were in some cases uncompromising in their response, including terms like “In Yoga we NEVER” and “In Yoga we ALWAYS”…and I wondered, do we NEVER or ALWAYS in Yoga? In some systems you are advised to use a stack of blankets for shoulderstand, while in others you use a modification until you can perform shoulderstand correctly without props. Are some yoga postures inappropriate for the modern practitioner or the less-than-regular student, and can we really say that we ‘should’ in Yoga?