Physician Heal Thyself: An Interview with Yoga's Michaelle Edwards

New York Times science journalist William Broad has scandalized the yoga world for much of the past year with his claim that yoga, while often beneficial to practitioners, can also seriously injure them. Many yogis have strongly disputed Broad's claim, including the injury statistics that Broad cites to support it. They even accuse Broad of engaging in "sensationalism" by exaggerating the injury threat merely to sell more copies of his controversial book, The Science of Yoga.

But Michaelle Edwards, a 40-year practicing yoga veteran with 25 years of yoga teaching and experience in massage therapy, biomechanics, and posture therapy, says that Broad's actually right. Author of YogAlign, Pain-free Yoga from Your Inner Core (2011), and the forthcoming Stretch Smart, Edwards has been documenting - and treating -- yoga injuries for years. She says that many of the traditional yoga postures currently being taught - everything from shoulder stands and headstands to the ubiquitous downward-facing dog and triangle poses - simply aren't in synch with the way our bodies are "naturally" designed to move.

Reached at her home in Hawaii, Ms. Edwards took time out to discuss her work.

Q. Most yogis claim that their teaching methods are steeped in ancient sacred traditions that few Westerners understand, and as long as yoga teachers know what they're doing and students don't push themselves too hard, yoga is perfectly safe. Are all of these people wrong?

A. Many of them are, actually. Historian Mark Singleton has documented in his book Yoga Body, that most of what we know as "Hatha" yoga is derived from the global fitness culture that emerged in the early 20th century in the wake of the Industrial Revolution. The seated lotus position, bow and cobra can be found in ancient texts from around the 14th century, but many of the standing poses, sun salutations, inversions, arm balances, and bound twists were influenced by Western physicality such as military drills, women's gymnastics and contortionism.

The Yoga Sutras only say that posture should be steady and comfortable. That's it. But in the West, the practice of yoga has become an intense workout which in many cases involves putting the body under an enormous amount of stress and strain to accomplish poses. The benefits can come at enormous cost, especially long-term.

Q. But a lot of contemporary yoga seems fairly mellow actually. And some traditions, like Iyengar, do place a strong emphasis on precise body alignment. You're saying a lot of these poses are still dangerous, at least potentially?

A. Yes, because they don't actually fit the way our bodies' are designed. Poses like "Plow" are particularly dangerous because we create right angles between the neck and the trunk and the hips all at the same time. The weight of the lower body is dangerously positioned above a cervical spine that is not designed to hold more than about 15 pounds. People do use blankets and try not to compress the neck, but there are nerves getting tugged on passed the limit they can stretch, as well as cervical discs not designed to have that much pressure in extreme neck flexion for minutes at a time. Ligaments do not have a lot of sensory nerves, so we cannot feel when they are getting overstretched.

The biggest reason for yoga injuries is that the human body is not designed to be in the right angle poses that make up a huge percentage of modern yoga asana practice. I have a saying: "The world is round and so are our bodies." Forcing our curving bodies into square linear positions can cause an over-stretching of the ligaments of the spine, in particular ones that attach your sacrum to your hips. The lumbar spine and sacrum form an important shock-absorbing curve needed to keep your hip socket and knee joint from compressing.

The problem isn't just with a few "extreme or "advanced" poses. There's a wide range of poses -- Triangle, Tree, Warrior, Pigeon - to name a few - that put unnecessary stress on our bodies. In the method I teach, I either abandon these poses, or severely modify them so that they correspond to the body's actual functionality. A pose doesn't have to be painful to be good for you. If it hurts, it generally isn't.

Q. You even criticize the way Down Dog is taught? That's probably the most foundational pose in contemporary Hatha yoga. What's left?

A. What's left is to evolve the way we practice yoga. The desire to form a deeper connection with our bodies is authentic. It's what leads so many people to try yoga. But instead of performing harmful poses, we need to be tuning our bodies to our natural alignment and breathing processes. Nobody should be getting hurt doing yoga.

For example, many people 'hang' in their joints when they do poses like the Down Dog. They drop the chest towards the ground, which can dangerously hyper-extend the the shoulder joint as well as strain the lumbar spine. I know there are people that work diligently to make the Down Dog technically perfect, but there is no healthy way to put our curves into a linear 90-degree angle.

Another example is crow pose. The trunk of the body is compressed into a C shape with a lot of force on the spine, and it takes a huge amount of muscular force to hold it there. Abdominals ideally should be wired as trunk stabilizers, not flexors, and practicing these poses can actually pull your head and shoulders forward because of the way our fascia pulley system strings us together.

Downward dog can be a healthy pose, but only if it's done while preserving the secondary curves of the spine in the lower back and neck. Babies do a version of downward dog when they learn to crawl, and my adaptation of the pose looks very similar. One leg is lifted and the standing knee is bent.

Q. On your website, you ask people to report on injuries that they have suffered due to yoga. What are you finding so far?

A. I have lots of testimonials from people who came to me with serious injuries, either from their yoga classes elsewhere, or with chronic illnesses. Many had pain that no one in the medical profession could help them with. Many yogis in pain, especially, don't realize that their yoga practice might be the cause. Some may overstretch in a class and then develop a disc herniation later in the day when they lean over with poor bio-mechanics. Any back specialist will advise people to avoid back strain by always bending the knees deeply, extending the hips back, and not rounding the upper back when leaning over to sit down or pick something up. It takes muscle strength and flexibility in balance to do this.

Others are developing repetitive motion injuries simply by straining to do the same out of-synch poses over and over again. That's why it's not just newcomers who don't understand yoga and aren't practicing regularly who are getting injured. That's one of those myths.

I am compiling a database of yoga injuries to establish a statistical baseline for further study. So far, nearly three-quarters of the respondents report injuries in the low back, sacral-hip joint region. About half had torn ligaments, and a quarter had injuries to the shoulder. Of course, many people had multiple injuries.

One of the things I find disturbing is that students are so willing to blame themselves for their injury - or are too afraid to speak up. Only about a third said they told their teacher or studio about an injury that occurred after their pose was adjusted in class. That's shocking. Most people, if they're injured either stop practicing yoga or switch to a different style. But we need people to start speaking up and not be afraid to say that the yoga they received actually "hurt" them.

Q. Have you tried to communicate with the more established figures in the yoga industry about your findings?

A. Actually, most of my endorsements have come from elite athletes like Laird Hamilton and Gabriella Reese, physical therapists, and somatic educators and bodywork experts like Kathleen Porter, Mary Bond, and Thomas Myers of the Anatomy Trains. Some of them, like Myers, are skeptical of many of the claims of the yoga industry, and have advised me not to become involved in a big way. However, two well-known yogis, Erich Schiffman and Shiva Rea, have endorsed my work, and this is where I see myself contributing the most.

Q. Your claims are reminiscent of New York Times journalist William Broad's, of course, and he's practically radioactive in the industry now. You actually go much further in questioning the current asana culture.

A. Broad's book was a big step forward. He questioned the conventional wisdom and opened the door for more dialogue. That's why people are talking about injuries more. In addition, Victoria McColm at the organization Prevent Yoga Injury has compiled a compendium of "contraindicated" yoga poses - poses that should be eliminated or modified for people with different medical conditions. That's also having an impact.

We really need to go back to the basic foundations of yoga. We need to stop blaming either pushy teachers or over-eager students for yoga injuries. The problem is much more basic.

Q. Broad's called for some kind of regulation of teacher training but the yoga industry doesn't want to see anything regulated, certainly not by the government. Will regulation help?

A. Yoga teaching will need regulation at some point, because we are pushing to become part of the mainstream medical protocol. We need criteria to maintain standards and protect the public. We shouldn't be afraid of this. Right now, the business of yoga teaching is basically a free for all. Many of the yoga schools where people get their certifications are like asana mills. Future teachers are simply not learning enough about the ways the body really works, and some of these teachers are too young, too immature, and too caught up in the commercial culture. I would blame the teacher training system more than anything else for the current injuries we're seeing.

Q. Is real change possible?

A. Yes, with a serious, large-scale re-education effort, I think we can make the needed changes over time. We have to start by being honest, though. We have veteran teachers who are suffering chronic injuries after years of practicing and teaching yoga. They're getting double-hip replacements. Broad focused on one or two in his book, but trust me, there are many others. The old saying, "Physician, heal thyself"? This is something yogis need to practice. It starts with the example we set. We have some really good teachers and a growing niche market, but the industry as a whole hasn't set the kind of standard that will allow us to become part of the mainstream health care system at a time when so many Americans need us.