Thursday, May 22, 2014

The Dangers of Yoga Revisited

(11/11/2013)

I hurt myself getting out of bed today. It was a freak accident. I wasn’t fully awake yet and rolled over to step onto the floor, but miscalculated and instead stubbed the toes of my left foot on the wooden frame of my waterbed, causing extreme pain and fairly profuse bleeding. I had previously broken two of those same toes while playing soccer on the beach. I felt foolish for managing to injure myself while getting out of bed – what a klutz!

And it wasn’t the first time I've been injured in bed, but not for the fun reason you are probably thinking. I have a “wonky” right shoulder which I have hurt severely enough to require narcotics, merely by “sleeping wrong,” either on my side or with the arm over my head. I don’t know how the shoulder was originally hurt; it first came to my attention when I sent the requested photograph for enrollment in Self Realization Fellowship yoga program at age 17, and they commented that my right shoulder was lower than my left. Maybe I was born that way, or maybe the shoulder was originally injured during one of my many high-speed buck- or bail-offs from a galloping horse during childhood. In any case, now that I am 50 all I need to do is “sleep wrong” to aggravate it severely.

But as it turns out, bed injuries are far more common than I had imagined and in fact, beds are a major source of injury in America! “There were an estimated 218,619 bed or bedframe-related emergency-room visits from people aged 17 to 70 in 2010 alone, according to NEISS (National Electronic Injury Surveillance System).”

I ran across this surprising fact while doing research subsequent to an argument with one of my friends and fellow yoga teachers after reading yet another alarmist NY Times article by William Broad, whose now-famous article from 2012, “How Yoga Can Wreck Your Body” has since been analyzed by many yogis and doctors and has been found, to put it politely, “lacking from a factual standpoint.” ** I have previously responded to that article in my blog post, “How Fear Can Wreck Your Fun.”

Broad’s latest article addresses specifically the dangers of yoga for flexible women who allegedly, because of yoga, ended up needing hip replacements. The factual content of this article, too, has already come into question because, for one thing, the women referenced had a preexisting hip abnormality.

I said, “Oh, here goes the NY Times with more fear-mongering about yoga!” My friend took offense at my words, but as I explained, the level of alarm being raised is way out of proportion to the actual amount of danger involved. Statistically yoga is one of the least dangerous activities. Danger, after all, is relative; if you tell me something is “dangerous,” the next logical question is, “Compared to what?”

My friend responded, “First of all, yoga is not a ‘physical activity.’ And you can’t say it is less dangerous than other activities. Statistics can be manipulated. We have no way of knowing because nobody is keeping track of it.” My friend is convinced that “literally millions” of people have been hurt by “yoga.”

With regard to the first objection, you’ll get no argument from me, as I have discussed at some length in my blog and my website. Real Yoga as taught by the traditional schools like Heart of Yoga and Advanced Yoga Practices is a spiritual discipline of which asana is just one branch which, when practiced correctly, involves pranayama, bandha and mindfulness and leads to meditation. We are in perfect agreement that the activity in question which is being called “yoga” is not Real Yoga. The activity labeled “yoga” by NEISS as the source of the injuries is asana as physical exercise, practiced out of context and often incorrectly. The “yoga” statistics don’t include straining your brain while contemplating nonduality, or damage to your self-esteem from being taught that you’re not ok just the way you are, or a swollen ego from successfully doing a difficult pose. We are only talking about the physical activity and consequences of asana here. And yes, I actually can say with some confidence that it is a “relatively safe activity” (even when done incorrectly) because in fact somebody is keeping track of it!

Every time you go to the doctor, alphanumerical codes are assigned to your medical record. There are basically three different codes corresponding to: the nature of your illness or injury, the treatment given, and if an injury, how it happened. These codes are entered on a computer and they are analyzed on a yearly basis. The medical code for “yoga” (i.e. asana) as a cause of injury is E005.1. The number of injuries documented with this code in 2010 was 7948, while the total number of people practicing “yoga” was around 22,000,000. Therefore, while we certainly are not happy that 7948 people were injured, it is a very tiny percentage compared to the number of people doing the activity (less than 0.04%), ranking well below golf. And as far as “literally millions” being injured, even if we assume the statistics are “off” by 100 times, that’s still fewer than one million. And, what happened to all their medical records?

NEISS may not be a perfect system but it’s the best we have, and it is good enough for the insurance companies. Now, knowing how cynical I am, you may well ask, why would I take their word for it? Greed. We can trust the insurance companies to act in their own best interest. They exist to make a profit, and the only way to do that is by making sure the premiums charged are more than the claims paid out. They look at the NEISS report and calculate their rates according to the per capita number of injuries for any given activity. This is why, for example, my liability insurance for teaching horseback riding was $100/month, whereas my yoga teacher liability insurance is about $10/month – because horseback riding actually is dangerous compared to a lot of other activities, as the injury statistics clearly demonstrate.

I was worried that my yoga liability premium would go up after the NY Times published all those alarming articles, but it didn’t. Not one cent. This is because the insurance companies don’t base their rates on fear-mongering articles or sensationalist books; they use the 2012 NEISS data which did not support the Times’ allegations of increased dangers from yoga.

Which again, as my dear friend correctly points out, is not Real Yoga anyway. The Yoga that we teach, from Krishnamacharya, is all about the breath, which contains and guides the movement; the asana exists for the breath, and the asana is adapted to the needs of the individual – not the other way around, as it is too often taught in many “yoga” studios. But this only makes my case stronger, because despite the fact that “yoga” or “asana” is being taught incorrectly, without the proper safeguards, the number of injuries resulting from even this Faux- or Pseudo-yoga remains quite low relative to other activities!

My friend said that if yoga were taught according to the principles of Krishnamacharya there would be no injuries. I don’t believe that, based on my own experience. I managed to re-injure my wonky shoulder while attending a teacher training intensive by Mark Whitwell, IMO the best yoga teacher alive today. The old injury had been exacerbated a few weeks previously by carrying too many bags of groceries at once, and then I “slept wrong” on it and awoke in horrible pain, unable to even lift my arm above shoulder level. It had begun to heal when we attended the training, where I was trying to hold Down Dog for 4 breaths. Turns out 4 was too many; 2 would have been fine; partway through the third breath my shoulder suddenly collapsed. Mark was quite alarmed but it wasn’t his fault; I told him it was just an old injury and it would be ok. And eventually it was, until the next time I carried something too heavy and then “slept wrong.”

Stuff happens. We live in a perfectly imperfect world and as I’ve pointed out before, existence is inherently unsafe. Being born is dangerous and it only goes downhill from there. And some of us are born klutzes. So yes, caution is recommended in all our activities, including sleeping, getting out of bed and doing asana. But let’s keep things in perspective.

**
My 2 Cents about “How Yoga Can Wreck Your Body by Leslie Kaminoff

PUTTING YOGA-RELATED INJURY RISKS IN CONTEXT OR YES, I SAW THE ARTICLE IN THE NEW YORK TIMES by Jason Amis

Yoga, Truthiness and the New York Times by Dr. Timothy McCall

Yoga, Injuries, and William J. Broad’s Trainwreck by Karen Macklin

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