My thoughts on an article in the NYTimes re Yoga

Women’s Flexibility Is a Liability (in Yoga) Published in the New York Times 11/2/13 

In this article author William Broad states that there are osteopathic surgeons seeing women who do yoga as patients, with injuries such as sharp pain in the hips that sometimes require hip surgery. They have arthritis and other injuries. They are predominately in middle age. The author feels it is because women are more flexible than men. It does not state explicitly what is causing these injuries other than "extreme leg motion" and the article one yoga teacher in Hawaii who equates it with "deep lunges." 

I feel there are not enough facts about this topic stated in this article and it is unclear whether the data is interpreted accurately since there are no specific studies targeting the topic sited. The author just says that women who do yoga visit osteopathic doctors at a seemingly higher rate. I wondered, would these same women have hip problems and arthritis if they did not do yoga? 

Women who do not do yoga yet have come to me to ask if yoga can help with their hip problems as an alternative to surgery. In general I do not have an answer to that. Specifically, I believe yoga could be helpful if practiced safely with the condition in mind. I also have older students-mostly women- who have already gone through hip surgery and came to yoga afterwards. The hereditary nature of this problem leads me to believe that even with a comprehensive program involving diet, yoga, and other medical and alternative elements this kind of degeneration can only be slowed down. How much it can be slowed down depends on the person. We are all individuals.

In the article the author also says that "reports from hospital emergency rooms showed that, proportionally, men got injured more often than women and suffered damage that was far worse, including fractures, dislocations and shattered backs." The author thinks this to be due to a "macho" attitude, and men having less flexibility and more strength than women. He warns men to exercise caution. 

For me the term "shattered back" is not specific enough. However, I agree with caution. In regards to being macho or competitive in yoga classes, I thought this was no-no number one. Don't most yoga teachers state phrases like "don't compare yourself to other people," over and over again? Mine did. I also agree with the idea of doing a gentler yoga practice especially in middle and older age. The article was just not helpful in finding ways to do that or specific enough in its claims of injuries yoga was causing and what styles of yoga the injured people were practicing.

Its true that repetitive motions whether for work or sport are known to cause problems such as injuries and arthritis. And "extreme" motions could not only cause these over time, but injuries in the moment. If one has to do a repetitive motion for work, then I recommend physical therapy relaxation and/or a yoga or other alternative practice that counteracts this motion and balances the body. For example if one has to use right arm and shoulder, I recommend working with a specialist teacher or trainer to come up with a work out for the left side and core of the body and stretches and relaxations for the right arm and shoulder. In yoga or sport I feel it best to practice varied movements and series. For instance I often will work on a Warrior I series with my classes one week and then a Warrior II the next week. I like to give my students a balance of seated, standing and lying down poses in each class and not repeat the same postures in the same order everyday.

My thoughts on Deep Hip Stretches is mostly to avoid them in my classes containing older students. However, the positive for stretching the hips is that it often feels very good and brings release(to old stored emotions and experiences) and can even release endorphins that cause you to feel good directly afterwards for a while as well. So my ideas and suggestions involve focus, breath work, proper training, acceptance and humility so that each person is responsible for tailoring their practice according to their individual needs.

Focus

A mindful practice allows you to go as deep into a stretch as is good for your body in the moment because your mind is right there to gauge your pain and tension and moderate when to back off. Competition and machismo need to be left outside the door of the room that contains your yoga mat. Also instead of pushing through the door of pain, you can instead knock on it, introduce yourself, and wait to be asked to enter. Then continue to check in as to whether to back off or go further. I recommend to meet your pain but not "push through it" or "breath through it." Expectations are also left out of the yoga studio, because everyday and circumstance is different. Don't expect that because yesterday you were able to enter the living room of your pain, that today is also appropriate to do the same. Mindfulness is focus and keeps you in the moment while in a posture or flow and this must be practiced and honed. Mindfulness or meditation practiced just 10 minutes a day improve health.

Breath

Along with being mindful, breathing is useful in this process of communicating with your edge. The cells in your muscles need oxygen. Your body needs energy. Your mind directs the flow of energy. Yoga books from past generations that I have read recommend a year of breath work before any posture is practiced. This is just unheard of in our current fast paced society. People think of yoga as exercise and don't realize that proper breathing can enhance their physical process. Learning to breathe can mean the difference between suffering through a yoga class verses sailing through while gaining the benefits such as strength, flexibility and balance. The recent studies in yoga also equate breath with the health benefits of yoga. Interestingly enough, the physical element of yoga did not alone correlate with increased health benefits. According to Bo Forbes (a clinical psychologist, yoga teacher and yoga therapist) as well as other faculty at Kripalu in Lenox, MA, breathing techniques, a mindfulness activity-meditation or other(such as a gentle yoga or Tai Chi practice,) and relaxation all contributed to health and longevity.

Proper training 

In The 8 limbs of Yoga written about by Patanjouli in the Yoga Sutras, asana-the physical practice of yoga is only one limb. In terms of the physical practice of yoga I recommend proper training and believe that less is more. Once your body learns proper alignment it will give you more, but if you start off by pushing it, it may be a continual fight to find the flexibility you need for postures. There was an excellent article in the NYTimes called Advice on Practicing Yoga in Middle Age, Part 1. In the article Dr. Loren Fishman recommends to "stabilize before the stretch." He has several books on healing spinal conditions using specific yoga postures. The proper balance of strength and flexibility is needed to achieve proper postures. From my training those who are more flexible need to work more on strength and stabilization in the joints to practice safely. Those who are stronger than flexible need to stabilize, but also need to work on more relaxation in the muscles. However, when I say less is more I truly mean you can do very little and still get strong and flexible. Also proper training in yoga incorporates meditation and Pranayana(breath or life force energy) as well. And yoga is more than just Asana. There are yogis who practice only using their intellectual capacity, or those who practice community service or compassion-the path of the heart. These are only a few other kinds of yoga. The goal is not showing off that one can get into a pretzel like posture, but selflessness and eventually bliss or Samadhi.

Acceptance

We all need to be humble and accept what a given posture will be for us due to the limitations of our unique lives and bodies and the circumstances of any given day. I know getting older is difficult. I am in my middle age too. Yoga is a great tool for our aging. However, practicing unsafely can not only hinder our progress, but cause unnecessary pain and injury. And life is just not fair. Acceptance of our own body types and physical limitations is not only imperative, but an added benefit to our well being. When we accept who we are, it is a relief. We want to go deeply into postures. We want to because we have seen it, we compete with it, we think its the right way to do it, we should ourselves, etc. Except for the few lucky supple focused people, more time is needed than our Western Culture really allows for most of us to achieve advance postures safely. And it isn't necessary to go that deeply to experience the benefits of yoga. Again the recent yoga studies are saying a gentle mindful practice incorporating relaxation breath and meditation is what is bringing health and longevity to those who practice yoga. It is not the physical exercise that yoga is becoming known for that causes these kinds of benefits.

Humility

Yoga is not about right and wrong. There are at least 2 ways to do most things in yoga. Yoga is more about being mindful. It is important to stop and examine how what you are doing is affecting you, and if it is adversely affecting you, changing to a different way or backing way off to observe...as usual without judgement.

We must ask ourselves, "why go deeper?" And then, "Is it appropriate to go deeper at this time?" Asking for and observing without judgement the answers to these questions before going deeper can be invaluable in terms of keeping ourselves free from injury. It will also eventually help us to go deep safely when we are able to; if we chose to.

For example: While doing a Deep Hip Stretch, if the question is "Why do I want to go deeper?" And the answer is "Because I can." Great. This is a wonderful place to be if it is true. However, even if true this answer can coexist with, "Because I want the attention it will bring me." Then there is a double edged sword inside your hip that prevents you from being free to humbly be "able to." Once this dichotomy is examined and resolved-i.e. the need for attention is let go or satisfied in other appropriate ways-then it is safer to go forward to experience the true expression of the posture. Being humble does not mean to not go for that expression, but to do it for the right reasons in an appropriate and healthy way for all involved.

And finally, we embark on a practice of yoga without the proper preparation and we expect to do it in the time period we have-once a week, 3 times a week, possibly once a day. But yoga in India where these extreme postures came from is often a way of life. Yogis spend their days in meditation, doing breathing exercises and postures. It was not traditionally practiced after work without the foundation of breath and meditation. How can we expect to achieve the same extreme posture in our class, that we have seen yogis and teachers with supple bodies doing, after a 40 plus hour work week, busy family life, and/or other hobbies? 

I am not asking you to sell yourself short. Through proper focus, training, breathing, and acceptance you might surprise yourself.

(Please feel free to see my older posts for foundations in Pranayama relaxation and meditation to begin your practice.)