I was in a yoga teacher training workshop over the weekend, and our teacher mentioned off-hand that a number of senior teachers in a certain yoga tradition that he chose not to name were getting hip replacement surgery! I was, of course, extremely curious to know what tradition he was talking about, but did not want to waste his time after class to ask him about “yoga gossip.” After the workshop, however, I regretted not asking, as it would be a good thing to know if a particular type of yoga was likely to cause such devastating injury.
So what was he referring to? I racked my brain to consider the options. Was it Bikram? Well, Bikram might cause some issues due to the hot room, but I don’t think there are enough hip openers in Bikram to cause major hip problems. What about Anusara? I don’t know enough about it, but with its focus on arm balances, perhaps the bigger danger there would simply be falling on your face! Iyengar seems unlikely, considering its focus on alignment and props. Kundalini yoga certainly entered my mind as a good possibility – there’s no alignment, and doing too many frogs could possibly not just cause hip problems but tweak your knees. But I felt that he wasn’t talking about Kundalini yoga, since for many yogis, Kundalini is a bastard off-shoot and not really considered a true yoga “tradition.”
Ashtanga was the last thing to come to my mind, and – apologies to you die-hard Ashtanga practitioners – the one that immediately registered an “a-ha!” Who knows if that’s what he was really talking about, but I decided to take a trip through the Internet to see if there was any correlation at all between Ashtanga and hip replacement. I found one very interesting thread on an Ashtanga discussion forum.
One person shared the following:
Yup, I’ve given up ashtanga as of 7 months ago. Got too old. My left hip disintegrated and I had total hip replacement surgery. Ashtanga may have contributed but if it hadn’t been ashtanga, it would have been something else, maybe. I’m able to exercise at the gym on a stationary bike, treadmill, and elliptical machine but agree with neti that nothing gives you the total mind /body workout of ashtanga. I plan to go back to a light, gentle yoga practice starting with an appointment I have coming up with a teacher who has hip replacement students. Would love to hear from any other board posters who have had hip replacement surgery.
Right off the bat, this post shows one of the problems with assessing the long-term effects of strenuous yoga practices. Was this person’s hip replacement due to Ashtanga or something else? We really can’t know. But someone with a medical background weighed in to say:
After working in orthopaedics I could never justify, let alone recommend, this form of practice for any length of time. It was really the beginning of the end for me.
If I could offer any advice it would be to enjoy it in youth, and prepare to let it go completely in maturity.
And someone else chimed in:
…some primary series poses can be problematic to older people with disintegrating bones. Many of the standing poses, especially the one leg balancing poses, are not good. Poses that place a strain upon the hips, like bjujapidasana and the maris, contribute to the problem. When I showed my David Swenson primary series practice card to my physical therapist she recoiled in horror and started pointing out all the poses that would further injure my hip. I’m not saying that ashtanga causes hip replacement surgery, just relating my personal experience.
Now here’s the big elephant in the living room, not just for Ashtanga but for many yoga traditions. Much of the way we teach yoga now has nothing to do with how yoga was traditionally taught for centuries. It’s only been in modern times that we’ve had big drop-in classes where anyone on the street of any fitness level could jump into a yoga class. We really haven’t done enough studies to know whether certain yoga poses are actually good for long-term practice or some are just good “for show.” By that, I mean, I suspect many of the more complicated and eye-popping yoga poses were created not for regular exercise, but to demonstrate the power of yoga to an audience.
I mean, really, is there any real benefit in terms of physical health or improved quality of meditation by doing the Ashtanga posture karandavasana shown in the picture above? Is lotus pose in and of itself necessary to achieve deep meditation? No.
One study on Ashtanga Yoga has shown that more than half experienced an injury lasting longer than a month:
The 110 practitioners surveyed, 68 (62%) reported having had at least one injury lasting longer than one month, and some practitioners reported more than one injury. A total of 107 musculoskeletal injuries were reported. The rate of new practice-related injuries was 1.18 injuries per 1,000 hours of practice. If recurrence of pre-existing injury and non-specific low back pain of unknown origin were included, the injury rate became 1.45 injuries per 1,000 hours of practice. Injuries related to the practice of Yoga were most common in the lower extremities, especially in the hamstrings or knees. None of the practitioners reported suffering permanent impairment from their injuries; however, this may be a consequence of the sampling procedure (see Limitations of the sample and survey, below).
I presume one of the limitations of the survey would include the short-term vs. long-term nature of the study. A short-term study would not be able to judge the effects of the body into old age.
Now, I can imagine some Ashtangis will complain and say that this doesn’t really represent Ashtanga or that people who get injured aren’t listening to their body and it’s “their” fault, not the fault of the practice. Look, I’ve done some Ashtanga prep classes where you learn the primary series. There are many things I like about the primary series. But you are in denial if you think that Ashtanga doesn’t have a bit more possibility of injury vs. a more gentle form of yoga, especially when it comes to the more advanced poses.
Granted, I’m not an Ashtanga Yoga devotee. I haven’t personally experienced the benefits of a regular Ashtanga practice. But my impression (as an outsider) is that there are some, not all, but some Ashtanga practitioners who let their Ashtanga affiliation go to their heads a little bit. They identify too much with the yoga practice as not just a badge of honor, but their identity. But achieving a challenging pose isn’t about being spiritual, it’s about ego. And from that attachment to the Ashtanga egoic “high,” some Ashtangis seem to have lost their objectivity.
Here’s just one example – a blog post by an Ashtanga teacher who claims that Ashtanga yoga practitioners who turn to Iyenger for help on proper alignment are simply trying to “distract” themselves from their yoga practice! This sentence totally blew me away:
I feel what is really going on is not a wish to learn about alignment but a wish for distraction in what is happening in our own Ashtanga practise, perhaps a wish for distraction for the lack of ‘progress; or the injuries that keep occurring.
Seriously? If someone is having recurring injuries, isn’t it probable that something is wrong? And maybe they really do need to go to a qualified Iyengar teacher for some help!
This teacher then goes on to claim that many injuries in Ashtanga are simply psycho-somatic, and blames this on some sort of deficit of will upon the part of the student:
Again the experience of viewing oneself on the mat daily has become too intense or reached an uncomfortable place and the welcome distraction now comes from injury/pain with the blessing of the healthcare practitioner.
Seriously, if you find a teacher like this, who blames your dislike of a practice and your actual injuries on your own personal failings, run, don’t walk, out the door.
Now, I’m sure most Ashtanga teachers are not this insensitive and clueless. I’m also not trying to wholesale condemn Ashtanga here. If you are physically fit and flexible, and you want a challenging yoga practice, Ashtanga may be for you. But I don’t think Ashtanga is for everyone – certainly not older people who have never done yoga, not people who are injured, and not people who aren’t talented physically (meaning, people who simply aren’t athletic in nature and have a hard time with basic yoga postures).
Yoga practitioners under 50 who have been athletes, gymnasts and dancers may be the best candidates for rigorous Ashtanga practices. But even then, I wonder if perhaps over time those who have been fit and athletic in their youth might benefit from dialing it down a bit as they get into middle age and beyond.
The most important takeaway in all of this is: BE CAREFUL! Perhaps you are starting out in Ashtanga with a very strict teacher who, like the person I quoted above, doesn’t take injury seriously. Listen to your own body! If you feel Ashtanga (or any other yoga practice) is pushing your body too hard, find another type of yoga! Don’t let someone guilt trip you into injuring yourself. Yoga should not be about achieving difficult postures. Yoga isn’t about asana for the sake of asana. It should be about a whole mind/body practice that nurtures and inspires you, not one that leaves you bruised and battered.
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