August 20, 2019

Preventing yoga injuries

Madison, Wis. — The popularity of yoga continues to rise, and there are a lot of good reasons to roll out your mat. “Yoga is unique in that it is meant to be restorative for both the mind and body,” says Melissa Fischer, a UW Health physical therapist who also teaches yoga. “It can be helpful for things like back pain and arthritis, and there’s a lot of evidence that it’s good for mental health. It’s been proven to help with depression, anxiety, sleep disturbances and fatigue.”

At the same time, yoga isn’t without risk. A recent study suggests certain yoga poses, particularly those that involve extreme flexing or extending the spine, can lead to compression fractures in patients with osteopenia or osteoporosis. People with hypermobility — joints that allow too much mobility, or what’s commonly known as being double-jointed — are also more at risk for injury. “But the risk is quite low — less than 1 percent of people who do yoga develop an injury that stops them from participating,” Fischer says. “There’s a risk with any sort of physical activity, but because yoga is a low-impact and modifiable activity, the risk is a little bit lower than some forms of exercise.”

Muscle strains from overuse are the most common yoga-related problem, and research shows that people over the age of 65 are more likely to develop an injury, which is true with other forms of activity. “The most common injury across the board is lower-back injuries,” Fischer says. “The other common injuries are in the neck, wrists, knees and shoulders.”

Tips to Prevent Yoga Injuries

So when does a Downward Dog become a Downward Don’t? Fischer shares these tips:

Go slow initially. Try an introductory class or one-on-one instruction to get a good foundation before you move up to more advanced poses.

Look for a qualified teacher. While anyone can post a yoga video on YouTube, many yoga studios and fitness centers require their instructors to complete at least 200 hours of training to be a registered yoga instructor. Choosing a qualified instructor ensures that your teacher has been trained in injury prevention. There are also physical therapists, like Fischer, who specialize in yoga and can advise you on poses that are safe for your body.

Additional reading: Finding the yoga class that's right for you

Don’t overdo it. “A big yoga principle is not comparing yourself to others and checking your ego,” Fischer says. Even if you can go deep into a pose, that doesn’t mean you should. “Yoga should be a balance of strength and flexibility, but individuals who are hypermobile should avoid overstretching or going too deeply into certain poses because that might cause injury or flare up an existing injury,” she explains.

Avoid problematic poses. “Repeated and long held forward bend positions may be problematic for individuals with known osteopenia or osteoporosis or low back problems,” she says. If you have any sort of medical history that could affect your mobility, avoid end-range positions or taking poses to the extreme in any direction, suggests Fischer. But don’t give up. “Just because you have osteopenia or osteoporosis doesn’t mean you shouldn’t participate in yoga,” she says. “It just means you should be modifying some poses.”

Use props. Don’t be afraid to use blocks, straps and other yoga accessories. “Using props can also assist patients in modifying their practice to be appropriate for their medical needs,” she says. If you’re not sure how to use props, ask your instructor.

Mix it up. “Yoga is like any form of exercise — too much is too much,” she says. “Just like we don’t recommend high-impact running seven days a week, we don’t recommend doing yoga seven days a week. A varied exercise regimen is best. Doing yoga as well as some structured strength training is another good way to prevent injuries.”

Try a different style of yoga. “Because yoga is such a popular form of exercise it’s easier to find options. Just because you tried one and you didn’t like it or it wasn’t a good fit, that doesn’t mean you have to give up,” she says. “Continue to experiment and explore. Maybe try a chair yoga class where you don’t have to get on the ground.”

Listen to your body. “One way you know you’re getting into trouble is if a stretch goes from feeling like a good stretch to pain,” she says. “When you’re kneeling or doing a forward fold, it should feel like muscle engagement. Some poses can be challenging in the sense of muscle fatigue, but it shouldn’t feel like it hurts. If you have muscle soreness the day after exercise, that’s normal. But if something actually hurts, that’s a sign that maybe you overdid it or need a different type of class.”

UW Health offers a variety of yoga classes at the Sports Medicine Fitness Center at Research Park, and at UW Health at The American Center.

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