NY Times writer at it again: This time, it’s women in danger from yoga

William Broad, the New York Times writer who ticked off a bunch of yogis (including Eddie Stern) with his book last year, and excerpted article in the Times, highlighting the dangers of yoga, is at it again.

Last time, it was mostly men who were at risk from yoga. With less flexibility than women, many tended to use their muscles to wrench them into poses, he said, resulting in injuries.

Now, it’s women he’s got his eyes on. From a piece in this Sunday’s Times:

Earlier this year, the picture of female superiority began to blur when a prominent yoga teacher in Hawaii wrote me about a poorly known threat to women.

The teacher, Michaelle Edwards, said that women’s elasticity became a liability when extreme bends resulted in serious wear and tear on their hips. Over time, she said, the chronic stress could develop into agonizing pain and, in some cases, the need for urgent hip repairs. Ms. Edwards sent me her book, “YogAlign.” It described her own hip pain long ago and how she solved it by developing a gentle style of yoga.

Her warning contradicted many books, articles and videos that hailed yoga’s bending and stretching as a smart way to fight arthritic degeneration.

I put her cautions aside. Finally, in late summer, I got around to making some calls.

To my astonishment, some of the nation’s top surgeons declared the trouble to be real — so real that hundreds of women who did yoga were showing up in their offices with unbearable pain and undergoing costly operations to mend or even replace their hips.

“It’s a relatively high incidence of injury,” Jon Hyman, an orthopedic surgeon in Atlanta, told me. “People don’t come in often saying I was doing Zumba or tai chi” when they experienced serious hip pain, he said. “But yoga is common.”

[snip]

Women’s hips showed particular vulnerability. By nature, their pelvic regions support an unusually wide range of joint play that can increase not only their proficiency in yoga but, it turned out, their health risks. The investigators found that extreme leg motions could cause the hip bones to repeatedly strike each other, leading over time to damaged cartilage, inflammation, pain and crippling arthritis. They called it Femoroacetabular Impingement — or F.A.I., in medical shorthand. The name spoke to a recurrence in which the neck of the thigh bone (the femur) swung so close to the hip socket (the acetabulum) that it repeatedly struck the socket’s protruding rim.

[snip]
Surgeons agree that women who moderate their practice can probably avoid hip trouble. Unfortunately, yoga teachers too often encourage students to “push through the pain.” That’s not smart. Pain is nature’s warning system. It’s telling you that something has gone awry.

Better to do yoga in moderation and listen carefully to your body. That temple, after all, is your best teacher.

This piece strikes me as having many of the same issues as Broad’s earlier work: It doesn’t put any of the number of surgeries in context. For instance, it quotes one surgeon as saying he does 50 to 75 surgeries on mostly women who were dancers or did yoga each year. But it doesn’t say how many patients, total, he has.  Another doctor sees roughly 100 middle-aged women per year. But how many total patients does he see? It doesn’t say.

There’s no baseline.

And that makes it sloppy journalism, which I can’t help saying seems to be Broad’s M.O.y

It also contains the same logical fallacies of Broad’s earlier reporting. There is a problem with causality here. You can’t just assume because women come in to an orthopedic surgeon’s office complaining of hip problems and these women also do yoga that yoga caused them. Or, following the line that Broad draws, that their teachers caused them by forcing these seemingly powerless women to push through the pain.

I should also note that the Times is famous, in its Style section, for doing “trend” stories that are anecdotal. There’s a whole arena of media criticism on those Times trend stories: Moms are drinking more often during the day; men are waxing their bodies more; kids are asking for more feng shui design.

Nothing to suggest, actually, that there are any trends. Just that the journalists heard these stories from a couple of people, typically in their NY social circles.

Broad’s work seems to fall firmly into this “trend” at the Times.

But… I’m sure it still will get lots of attention, beginning with us.

Posted by Steve

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Two Ashtangis write about their practice and their teachers.

35 thoughts on “NY Times writer at it again: This time, it’s women in danger from yoga”

  1. As annoying as Wm Broad is, he’s onto something here. I’ve been dealing with a mild case of this for over a year, and first discovered that it was even yoga related after hearing one of the Confluence teachers talk to another student about her- the student’s- lower back and hip pain. It’s a tricky injury because there’s no pain at the time of the forward fold, so knowing/ remembering to back off is hard.
    Any physical activity- asana, running, Crossfit- is going to have repetitive stress injuries. I wish Broad’s emphasis were on choosing a seasoned teacher rather than painting ‘yoga’ as inherently dangerous.

    1. Kathryn! I’m glad you could be candid about your personal injury and I’m sorry to hear you’re dealing with an injury. Look into Michaelle Edward’s YogAlign approach and see if her adaptations can help.

      I wasn’t quite sure what you meant by ‘wishing Broad’s emphasis were on choosing a seasoned teacher’ (for example, Michaelle has over 3 decades of experience.) I’m not sure I agree that he is painting yoga as inherently dangerous. Rather, he has claimed to doing the practice himself: “FROM my own practice and research, I know that yoga is generally a good thing.” And, he goes on to say that, “In short, the benefits are many and commonplace while the serious dangers tend to be few and comparatively rare.” I think he’s actually a big proponet of the practice and doesn’t want injuries to become even more commonplace in the practice but explore where they are originating and see how they can be alleviated and prevented.

  2. Well, I am an orthopaedic surgeon, and I have yet to see a female yogi with hip pain or FAI (femoroacetabular impingement). I have seen a number of male hip hop dancers and men who played football in their younger years with FAI. While I am a general orthopaedic surgeon and not a hip specialist per se, I do see a number of yogis since I practice ashtanga myself and word gets around. At a hip course I went to last year, there was a day devoted to FAI, and none of the specialists mentioned being female and a yogi as risk factors for FAI. There is thought that there may be some genetic component and there is a correlation with high impact sports. While anecdotal, I am a middle-aged female yogi who has been putting her legs behind her head for about four years now, and I have no hip problems. I know four years is not that long. However, there are a number of advanced practitioners practicing with Kate O’Donnell here in Boston and none have hip problems, except one who had arthritis prior to starting yoga. So I need to see more data before I believe Broad’s claims. It may be that some of the women seen by the nation’s top surgeons were active in other sport activities prior to starting yoga and the hip problems come to light as the women turned to yoga as they aged. Anyway, I’m not buying it.

    1. Interesting. I’ve visited two orthopedic surgeons, a physiatrist (also a clinical professor at Columbia Medical School and past president of the New York Society of Physical Medicine and Rehabilitation), and a specialist MD in Physical Medicine and Rehabilitation as well as a small handful of physical therapists and not a single one batted an eyelash when I stated my injuries were a result of doing yoga (repetitive strain injuries; no ego, pushing too far, bad/inexperienced teacher or any of that blame the student nonsense). In fact, all of these medical professionals nodded and said something to the effect of “yes, I’ve seen that before; you need to be careful about doing too much yoga”.

      I am glad you and your yoga classmates haven’t experienced injuries. Others have and your good experiences do not invalidate the experiences of those who have been injured. I played tennis for over a decade (years and years ago) and never once experienced tennis elbow and, to my recollection, neither did any of the players in my personal circle. Of course, my personal experience does not invalidate that people who play tennis can develop epicondylitis as a result of the repetitive motions employed in that sport. In fact, if you visit the USTA page there is a ton of information on this condition (and others) to help players both prevent and treat the condition. No knee-jerk denials or defensive posturing like I have seen with any article that speaks about yoga causing injuries.

      How about we put the same concern and interest into further exploring the injuries that ARE happening from doing yoga so we can provide this information to students and understand how we can address these issues? How about we put the welfare of the students first instead of some personal need to claim yoga as some mystical cure-all that only helps and never hurts? How about we elevate the mentality in the yoga community to respond with maturity and professionalism to published medical studies instead of ad hominem attacks on an unpopular writer who points to the studies further driving the conversation into the realm of why “we” think we are right and away from the health and welfare concerns of the students? A gal can dream.

  3. The correlation is only that more people are doing yoga. This is sensationalized fear for more buys of his book, in my opinion. In the article he briefly points out there are other causes, such as defects in the joint. I have an old dear friend who has never taken yoga but works out at the gym daily, she had a hip replacement at 40. Her doctor claimed it was caused from years of poor nutrition ( yo-yo dieting) and genetics. The fact that she was in decent shape at the time it happened, just helped her get on the mend faster. Yes it is important to listen to your body and be under the guidance of an experienced teacher. Patience and breath and practicing consistently have allowed me to work at ekapada and dvipada shirshasana, not flexibility. The lack of any empirical evidence just frustrates me because one thing that can injure someone is fear and increased muscle tension. This article stirs that pot.

  4. I still think Broad is funded by the religious right and that they are using his platform to stop the tide of people turning away from Judeo Christian based religions to Eastern Religion. I don’t want to start any rumors or anything but…………………

  5. I completely agree with Kathryn re: any physical activity one does regularly is going to have a potential repetitive stress component attached to it. The rationale given for FAI in female yogis is a little loose. Women (or men, for that matter) that live in a state where their ribs are slightly flared up and their pelvis is anteriorly tilted forward have a hamstring that is over-lengthened (this is simple anatomy. The semimembranous, semitendinosis, and long head of the biceps femoris originate at the ischial tuberosity on the pelvis. In a person with an anterior pelvic tilt as a regular position, the front of the pelvis tilts forward, moving the back of the pelvis up, moving the attachment points of the muscle away from each other). This lengthened position causes the hamstring muscles to be weak- one of the jobs of the hamstrings is to posteriorly tilt the pelvis (done in conjunction with the internal obliques and transverse abdomens, which pull the front of the pelvis up, out of the anteriorly tilted position). When you stretch the hamstrings repeatedly without addressing the pelvic position or rib position in a person with this extension pattern as a regular posture, the hip socket (which isn’t in a neutral position anyway) moves back and the femur head moves forward. When the femur head moves forward, you end up with a risk of impingement. While I have not suffered from FAI, I have had hamstring strains as a result of my non-neutral position. Now, after working extremely hard to gain the mobility and strength necessary to maintain a much more neutral position, I always make sure I am neutral before I start my yoga practice. Instead of sensationalizing injuries, educating people people on why they happen and helping them understand what to be aware of would be more beneficial, in my opinion. Unless a person gets private lessons with a teacher, it is difficult for even the best of teachers to assess and address each student’s individual position issues. The extension pattern I am referring to here is definitely a pattern that is a little more high risk for “stuff.” (One of the teachers I study neuromuscular techniques with told me, “if you were a male, you would have groin strain, not hamstring strain,” so this is not just a female problem- just different presentations).

    1. Well said, I am Michaelle Edwards, the yoga teacher referenced in William Broads article. Finding neutral is what is most beneficial whether one has a tendency towards an anterior or posterior tilt in the pelvis. Bending forward with both knees straight is not going to help you find that place. Humans are designed to move and these poses are like driving with the brake on and what gets stretched are the ligament forces needed to keep hips stabile. Do you realize how many famous yoga teachers have had hip replacements? There are many.
      What I focus on in YogAlign is making sure that an aligned pelvis is the focus of the pose not ‘pulling on the parts’ . What is very clear to me is that stretching the hamstrings as in seated or standing forward bends does not address the global nature of the human body and undermines the necessary tensile strength of the hamstrings needed to help keep the pelvis from rotating anteriorly. So many yogis are pulling themselves apart at the seams and I see the injured every day in my world. The injuries are not isolated or uncommon. People are undermining how the human body is a tensegrity model and is strung together by a balance of extension, flexion, and expansion forces. What if yoga poses could evolve to consider the curving global nature of the human body? What is the anatomical advantage of doing poses that require one to engage the body in right angles and straight lines more akin to a static building than the human body design? There are no straight lines in nature.

      1. Michelle I am going to study your method as I have had si joint problems along with hip problems – not caused by yoga but maybe aggravated by some yoga poses. I need to learn all I can to prevent them – at age 66 I can’t be too careful.

      2. “So many yogis are pulling themselves apart at the seams” is such an apt description. I also see injured people on a daily basis, which has led to an exploration of different movement techniques. It seems to me that in the yoga world while bandhas are encouraged and breath is discussed, how to find neutral using these things isn’t really explored. My studies, coupled with my own experience, have led me to strongly believe that both the tensile strength of the hamstrings as you mentioned and the power of the ribs in an expiratory position to utilize the anterior oblique chain/IOs/TAs are critical for a “safe” practice. As I mentioned previously, I still practice and because of what I know and what I see regularly, my interest in putting my chest on my thighs is nil; rather, I try to keep a good spinal position via my breath, my fold is gentle, and I let go of any interest in poses like supta kurmasana. I care more about longevity in the practice than what the postures look like. I think what you are doing is admirable, and I am glad you are creating a space for people to practice in a safe manner without ego.

    2. ” Instead of sensationalizing injuries, educating people people on why they happen and helping them understand what to be aware of would be more beneficial, in my opinion. ”

      Hear, hear.

  6. Just feel the need to mention that Broad’s article is not in the Style section, but in the Sunday Review, which USED to contain thoughtful intelligent writing on the week’s events but has lately been filled more with fluff. It’s a stunningly bad piece of writing too, unworthy of the Times, or at least the Times I grew up with…

  7. PS and today, in that same Styles section mentioned above there is a lovely conversation between Alec Baldwin and Dick Cavett… I often find more to read in this section now than in the supposedly more hard-hitting Sunday Review

  8. Broad’s article is thoughtfully based in documented research which shows evidence that there are risks involved in doing hatha yoga postures that can destabilize joints. It is a good thing that responsibe journalists like Broad and dedicated teachers like Edwards are speaking out. Having been in the yoga world as a student and teacher for 40 years, it is refreshing to see truthful and caring analyses of hatha yoga. There has been far too much blind acceptance that this form of exercise, hatha yoga, is completely safe. Sound bio-mechanics and common sense says that contorting the body in gymnastic positions could result in injury. Many postures are nothing more than just that: contortionistic gymnastics. Singleton’s book “Yoga Body” shows documented evidence of this fact. Many postures do not translate into functionality that can be translated into every day activity. A yoga make-over is in order so that more people benefit and fewer people get injured. YogAlign makes good body sense and is good common sense. Broad is doing everyone a service in his scientific research findings. Only those with eyes to see and ears to hear can evolve along with Broad and Edwards. Denial is a powerful thing, and resistance to change is to be expected. Ego gets in the way of opening the mind and heart, even when the truth is presented clearly. Kudos to Broad and Edwards for their courage to be on the cutting edge of a needed hatha yoga revolution!

  9. I don’t know many Ashtangis who deny that injuries occur — with Ashtanga and every other yoga lineage or every sport, for that matter. The absence of numbers and documentation in Broad’s reporting, however, undermines its credibility for readers, whether they practice yoga or not.

    1. Since the practice of yoga is not regulated by the government, there are NO reliable statistics for either side so using this point to discredit William Broad holds no ground. Anyone that has been around the yoga world knows there are injuries and many people with serious chronic pain even though they practice. Besides yoga is a healing practice and why would anyone be getting hip replacements who practices yoga? Something is wrong.
      This is one of the points that William Broad has covered in his book The Science of Yoga, the Risks and Rewards. I think that many of the injuries will show up in the longterm as joints become unstable from the repetitive practice of body positions and poses that compress the spine and over-stretch the ligament forces that hold the hip joint together. At first I thought it may be isolated incidences but in the last year, I have been inundated with emails from yogis writing to tell me they have labrum tears, chronic back pain, SI joint destabilizations and hip replacement surgeries.
      I do have a website called http://www.yogainjuries.com that has a survey for those injured by practicing yoga and I will publish the findings soon. People who have been injured are taking the survey designed to get a baseline on what the injuries are, what pose or style and severity of the injury etc. If anyone has been injured, please take the survey so we can all get a better understanding of where this is coming from. Attacking William Broad, a Pulitzer Prize winning science journalist who has exposed medical research fraud in one of his books, and Star Wars deception by the US Military in another is a sincere, intelligent man who seeks to find the truth and help others understand it. Comments to attack him personally serve no purpose and are not kind, necessary or a good reflection of the yoga community.
      Osteoporosis patients are warned by MDS that doing yoga forward bends may cause compression fractures for those who have lost bone density. There are many reasons to look outside the yoga box and consider that the hip replacements of Beryl Bender, Dharma Mittra, and Judith Lasater had something to do with their yoga practice. Many will say yoga did not cause hips to deteriorate but it did not prevent it either.

      1. The problem I have with Broad’s book is that it states the obvious. I think that all logical people understand that intense repetitive exercise done without the proper alignment can injure you. This being said jumping on a bike and riding for 5 hrs straight without having ridden for years could bring on an injury, training for a marathon, playing weekend ultimate Frisbee, skiing etc you get injuries. Working a hard physical labour job can also injure you or leave you with life long physical challenges. Anything done without mindfulness will have contradictions. What my take is on Ashtanga Asana is that there should be no goal, there should be mindfulness and ahimsa for ones self. As time goes by the practice will open up. If you push the practice too far to fast in a competitive manner you could injure yourself. In my case i’m 50 and put far more emphasis on doing a sport, lifting weights etc than on stretching so it’s crazy to think that after a couple of years I could be where a 20 year old is or another 50 year old that has been practicing for 30 years. There are supposedly 20 million asana practitioners in the U.S. so there will be some injuries yeah and? It just seems like an angle to sell a story more than information to further or protect ones practice.

  10. Call me “heartless” or whatever you will, but I for one will be glad when all the “exercise” yogis have moved on and yoga can once again return to its real purpose and activity of self-realization.

    1. Achieving Self-Realization requires practicing the eight limbs of yoga. Asana, the 3rd limb, means simply right posture. The spine must be aligned in order for energy to freely flow through the spine, and for consciousness to be raised. Hatha yoga is not at all required
      to align the spine. Maintaining the spinal curvatures and practicing Kriya breath (very similar to YogAlign SIP breath) is key to a ateing and upliftes spine and to making progress in the path to Self-Realization.

    2. Achieving Self-Realization requires practicing the eight limbs of yoga. Asana, the 3rd limb, means simply right posture. The spine must be aligned in order for energy to freely flow through the spine, and for consciousness to be raised. Hatha yoga is not at all required
      to align the spine. Maintaining the spinal curvatures and practicing Kriya breath (very similar to YogAlign SIP breath) is key to a strong and uplifted spine and to making progress in the path to Self-Realization.

      1. I have no idea what the hell “YogaAlign” is. But it sounds like something the new agey yoga posse has made up to glorify themselves and their endless desires to prove to themselves that they are “gods.”

        And no achieving self-realization does not require practicing Patajanali’s Eight Limbs although this is an established, i.e., founded in parampara, method unlike I’m guessing “YogaAlign.” There are many paths of yoga, many of which do not in any way rely on postures, although adherence to the yama and niyama are common denominator for all except by the most severe left-handed paths.

        Soon all these “fly by night” will go the way of the Dodo. I for one am very excited.

  11. YogAlign is a safe, painless, precise exercise system that increases vitality, strength and flexibility. A unique flow style yogic practice, it develops beneficial patterns and blueprints for core natural alignment, effortless breathing and a deep kinesthetic awareness of the body, mind and spirit. It is a transformational tool for loving and nurturing the self that develops deep core strength and graceful effortless posture

    YogAlign practitioners feel like they have been to a strength, flexibility and alignment session, done Pilates, had a massage and chiropractic adjustment, and undergone therapy with deep breathing while meditating all at the same time.

    YogAlign works on many levels so that everyone in the class is able to progress, transform and find an edge no matter their level of yoga.

    Many people are weekend athletes who unfortunately have to spend a great deal of time sitting in chairs or driving in cars with the spine collapsed and the head carried too far forward. Serious athletes also have posture problems from repetitive movements causing imbalances that set the stage for serious joint and muscle injuries. Most people have compensated for these activities by developing dysfunctional patterns in body alignment, muscle balance and breathing.

    Ease, comfort, strength and presence are the building blocks of YogAlign. The techniques guide people to first eliminate unnecessary tension in the body, relax the mind and develop the ability to reside fully in the present. YogAlign practitioners are taught to move from the core of the body from the psoas, diaphragm connection. Arms are kept deep in the socket while lifting from the core, increasing the range of motion while stabilizing the muscles and ligaments of the joints. Self-massage techniques are woven into classes to stimulate energy meridians and give the body the signal that it is not under attack and can release deeply held tension.

    1. Oh, I’m sorry Joe. You must have mistaken me for actually wanting to read a commercial. But, hey, here’s an idea…why don’t you eliminate some of the confusion in your own life and call a spade a spade. Good luck with your stretching.

  12. For what it’s worth to add — particularly for Michaelle and others who aren’t familiar with our blog — we certainly never deny that injuries are possible, even likely. (I’d encourage anyone to check out the “Ashtanga, injury and pain” link in our sidebar, above.) I’d also encourage folks to read Bobbie’s recent post, “Ashtanga as a woman ages.” I think both demonstrate our pretty eyes wide open perspective on asana.

    I think our reaction (and many others’) to Broad’s way of approaching things is, as I wrote in the post, that he doesn’t provide context — I suspect because doing so would wreck his argument. There’s no sense of how many patients those doctors have — that’s a big red flag for me. There’s no mention of how many yogis there are versus those claiming to be hurt.

    My guess is Broad knows he’s on to something but can’t nail it down. I guess that because we ALL know yoga can injury a person. For us, at least, this isn’t a controversial idea. (OK, it is, but for other reasons, i.e. should you avoid or embrace potential injury.) But from where Broad is writing, it is — in my opinion — poor journalism. I’m a former journalist, so I feel fairly comfortable making that judgment. It is overly sensational. I understand why that is — he has to get his editors to agree to publish it — but that doesn’t mean it is a good work of journalism, sadly.

    I’m also curious if the yogis named as having hip replacements blame their yoga practices in any way. Given the idea that much else could contribute, I’d think they would be in good positions to say what were contributing factors. It makes me nervous to attribute yoga to their issues without their first doing so. And perhaps the yoga helped slow the need for surgery. What’s “prevention?” Nothing we do, in the end, prevents our final demise, after all.

    Again, this isn’t to say that yoga is injury-less. It isn’t. But I don’t think that makes Broad’s piece helpful to the discussion except to get the most uniformed to think about things. Which is worth something, I suppose.

    Steve

      1. I love this blog its always interesting, informative and funny! “Yoga: a post-Cold War death machine. I’m a yoga teacher. A death dealer like Big Tobacco. And I look the other way when you stroke out in my class because it makes me the big money.”~ Steve

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