March 05, 2010

"Unsubstantiated" Yoga Injuries

Translation: article 没有证据的瑜伽伤痛, originally from Southern Metropolis Weekly. Some of the later parts abridged

The cobra pose--Chinese medical experts believe many yoga asanas are harmful to joints

Zheng Xinyuan had to undergo a surgery that placed 4 nails inside her body

What does yoga, which spread from India to every corner of the world, mean for modern day urbanites?

According to Shanghai woman Zheng Xinyuan (郑欣媛), yoga might just be the root of her illness.

One of the basic postures that used to cause her difficulty required extending legs straight, grabbing feet with two hands, and touching forehead to the knees. However, even after practicing for more than 6 months, she still could not master it.

Once when she was attempting the asana, the dark skinny Indian teacher walked towards her to press her back downwards. The man considered the force he used to be negligible--after all, he occasionally even sat on students' back to correct their wrong postures.

"In reality, I felt discomfort." Zheng recalled half a year after the incident, "Since then I tried to avoid any sessions he led."

Today, one year into her yoga journey, spinal disc herniation is forcing 36 year-old Zheng to stay completely away from the asanas. Furthermore, 4 alloy nails have been insert next to the L4 and L5 segments of her vertebrae to replace the lost movement there. She can no longer bend down like she did before in yoga gyms.

Zheng Xinyuan is one of the many Chinese who practice yoga. The "fever" that started in the 80s of last century has made huge inroads in China. An April 2008 China Youth Daily report claims that globally, the number of people who take up yoga increases yearly by 50%. In U.S, 700,000 join the ranks every year, and in China, 80% of the fitness gyms offer yoga programs.

Though exercisers may be many, only 10% of yoga practitioners know that improper techniques can lead to bodily injuries. China's orthopedists can attest to this ignorance, as they treat more and more patients who receive injuries while practicing. Among those who seek treatment are yoga students as well as teachers.

Unexpected Paralysis

In October 2007, a new yoga studio opened business in Zheng Da Home (证大家园), a large Shanghai Pudong residential area where Zheng Xinyuan lives.

This studio had an attractive decor. Indian wall hangings combined with soft lighting created an atmosphere that was simultaneously mysterious and warm. Even though Zheng Xinyuan had never been a fan of exercise, she decided to sign up for formal membership after taking one trial class. Unlike members who have clear goals, she just wanted to sweat a little and exercise her body.

She never advanced beyond the beginner's level, limiting herself to basic asanas such as the "Sun Salutation," which is the most suitable routine for beginners, according to China's Yoga Bible Light On Yoga. "I just wanted to sweat. I never had any great aspirations. The asanas that the intermediate classes practiced scared me." Said Zheng.

Zheng Xinyu quickly fell in love with yoga and even got membership cards for her husband Ji Ping (季平) and daughter. The family practiced 2 to 3 times per week. "The teacher talks softly, while music plays. It makes me relaxed, and I really enjoy it."

More than once, Zheng and husband recommended yoga to friends. The unwitting couple never thought any harm would come out of this sport.

In January 2009, Zheng began to feel pain in the waist region. She paused her yoga sessions but thought nothing more. Two weeks later, her left calf felt numb. Then finally one morning she found herself "paralyzed" in bed.

On January 16, 2009, husband Ji Ping took Zheng to Shanghai Zhangzheng Hospital (长征医院), a reputable medical establishment in China. Ji told the reporter that as soon as the doctor saw Zheng's MRI results, he questioned the couple: "What sports were you practicing to incur these injuries? They make sense for athletes, but why would a 30-something housewife receive them?"

The couple replied that Zheng practiced yoga for a year. "The doctor immediately told us yoga must be practiced with care." It was the first time that they heard about "sports injuries."

On January 21, Zheng Xinyuan underwent the surgery ("posterior lumbar spine decompression and pedicle fixation") that placed 4 nails inside of her body. They will accompany her for the rest of her life. The entire process cost them almost 100,000 yuan.

Ji was puzzled, "She is a housewife. Hasn't worked for many years. Never did hard labor, sat for prolong periods of time, or had any accidents. Why would this happen to her?" Zheng said that she never had any previous related illness and a physical check-up few years ago did not reveal any spinal abnormality.

The yoga studio owner who had become friends with Zheng dropped out of touch when she learned about Zheng's problems. After that, Zheng and husband were more inclined to believe their doctor. "We live in the same neighborhood. As a friend, wouldn't it be normal for her to at least drop by after Zheng's big surgery?" said Ji.

Without mentioning the studio name, Ji posted their experience on the neighborhood forum as a precaution to others who practice yoga. Two residents immediately replied that they too had spinal problems that surfaced while they were taking yoga classes, but they could not be sure that yoga was the cause.

After Googling online, Ji Ping was surprised to find out that keywords "yoga injuries" generated 560,000 posts. Media coverage from Chengdu, Shenzhen and Taiwan mention people who sustained similar spinal injuries, and some have become paralyzed. In all cases, "yoga" was the one common factor linking them together.

Insufficient Evidence

A similar tragedy befell 30 year old Li Li (李丽), whose yoga experience started in Shenzhen 2003. With previous background in dance, she quickly learnt the basic asanas. The teacher encouraged her to try out more advanced postures. In 2006, she felt sharp pains in the waist after coughing and was later diagnosed with lumbar spine injury.

"The doctor asked me straight if I was practicing yoga, because no long ago he treated a trainer who had the same symptoms. I was dumbfounded when he mentioned her name. The lady had published yoga books and DVDs. She also instructed us when we were doing yoga performance rehearsals."

Si Chuan girl Wang Yi (王依) taught herself yoga in order to cure insomnia. "The instruction materials only warned high blood pressure patients and those with heart troubles need stay away. It never said anything about joint injuries." After two months of yoga, Wang Yi developed lumbar disc herniation and also went to the hospital. "I cannot prove that yoga caused this. All the information I found do not talk about this either. I hope medical authorities can come up with definitive research results and offer some explanations."

The reporter met 8 people who have come to harm when doing yoga, most of whom female. The youngest is 21 year old, and her yoga experience lasted 8 days. They found one another after reading posts written by Netizen "Ban Lu" (半路). The posts pointed to yoga as the cause of injuries. In blogs, Ban Lu propounded his theory: "The cleansing process makes me think of butchers and chefs, because no other person will treat bodies like this: using all types of method to purge the human digestive system--dealing with living bodies as though they are corpses."

Ban Lu, whose real name is Cheng Songfeng (程松峰), is a 39-year-old man in the aquaculture business of Nanyang, Henan. He was a member of the "Tibetan Yoga Research Society" as early as 1990. At that time, yoga was thought to be a type of qigong and did not exert as much influence as it does now. Nobody thought it could be so heavily commercialized and lucrative.

"What they teach nowadays in gyms is very different from the yoga back then. Tibetan yoga did not put as much emphasis on asanas as Indian types."

In 2006, Cheng Songfeng was living in Shenzhen. One day he came upon a training studio that was hiring instructors. He applied for the position and was easily admitted, even though he did not have any certification. Working as the trainer for a few weeks made him realize that many asanas contradicted both the traditional Chinese health regimens and sports principles. He also noticed that some instructors sported injuries on their bodies.

He wrote about the dangers of yoga on forums and blogs, from its unscientific beginning to the malpractices in its current commercialization. These theories, however, met strong doubts and opposition. Soon, both his Tianya and Sina blogs were shut down. "Yoga has developed into an industry that generates huge revenues. Their public relation policies are formidable," Cheng Songfeng explained.

Ji Ping and Li Li contacted Ban Lu, who gained the reputation as "The First to Question Yoga on Internet." Ban Lu established a QQ group for these people. The chat group is typically quiet. Whenever the IDs speak up, it is either to console one another, or to share tips on recuperation. Strangely, suing trainers and studios has never come up in group discussions.

"It is difficult for these people to receive any reparations, because they do not have much power. Also, linking yoga to their injuries is hard due to the lack of evidence." Cheng Songfeng only knows of one case where the patient successful.

Misinterpreted Yoga

"Yoga" means to "unite" and has the connotation of being one with nature. It balances the body through asanas and breathing techniques, ultimately achieving the control of mind through control of body so that the practitioners feel tranquil and joyous. When yoga was exported from India, however, its face became altered. Because promoters must demonstrate quantifiable, perceivable results, such as weight, sleep time, and physical wellness, they only focus on a small aspect of yoga. As a result, many people think of yoga as simply a fitness exercise.

The truth is, as Time pointed out, yoga is not an all-around means to attain health. According studies published by American Council on Exercise, subjects' aerobic capacities were not much improved. Yoga is not the best way to lose weight either. Additionally, despite of its benefits in relieving stress and alleviating osteoarthritis, yoga does not treat osteoporosis.

Faced with Zheng Xinyuan's plight, Chen Shiyi (陈世益), director of Sports Medicine Center at Shanghai Huashan Hospital (the authoritative institution on treatment of sports injuries), could only express helplessness. "Without further research we really cannot say that her injury was caused by yoga. Any athletic activity has the potential to lead to injuries, among which spinal ones are the more serious. Why did these people get hurt? It could be their bodies were just not cut out for these types of motions, or it could be that the motions exceeded physiological limits."

Even if a correlation can be established, the small number of cases mean that these results lack statistical significance. While the risks of Taichi has long ago been studied, such numbers are lacking for yoga.

Both Chen Shiyi and Jia Lianshun (贾连顺), head of Orthopedics Department at Shanghai Changzheng Hospital, think that yoga is not suitable for the masses. "Adults' ligaments and bone structures have already matured. Postures that require flexibility of limb, joints and spinal cord, if they exceed the ability of the ligaments and bones to extend and compress, will lead to damage," Jia Lianshun explained. Every exerciser should carefully consider his/her age and the range of movement expected. People over 30 years of age are not suitable for yoga training.

Jia's hospital had to treat yoga exercisers for their injuries as early as 7 or 8 years ago.

As for the injured who have trouble linking their conditions to yoga, Jia Lianshun said: "A study on injuries caused by yoga will offend too many people. First, the operators. Second the fanatics. So no one conducts research in this area. What we can do is warn exercisers to be prepared and guard against injuries.

Born in China, trained in both Western and Chinese medicine, Huang Zonglong (黄宗隆) is now a licensed medical practitioner in Shanghai. He specialized in Chinese bone setting and traditional health techniques. His views on yoga differ slightly from those of experts Chen and Jia. "Even with correct practice, yoga is not intended for curing diseases. Rather it helps already healthy people to achieve a better state. For sick people, yoga might exacerbate their problems.

As far as Huang knows, more than half of the city dwellers are not healthy. Some even practice yoga with the goal of eliminating their illness. Huang Zonglong's clinic frequently receives injured yoga patients, "Some are students, and some are trainers. I will not mention any specific numbers though."

Contrary to his Chinese counterparts, Dr. Gary Dorshimer, Director of Internal Medicine/Sports Medicine Fellowship in Pennsylvania Hospital, has rarely met any exerciser who receives spinal injury because of yoga. He told the reporter, "Most of what I have seen are muscle strains. Severe muscle damages and tendon ruptures are very rare; the spinal cord injuries are uncommon too. I think the probability of these are very low."

In contrast to the American doctor's sanguine outlook, Cheng Songfeng said, "For someone who has a specific goal such as losing weight, how can he know the proper level of physical activity? The human spinal cord does not come with any alarm device. Only a professional coach can tell. Yet, Chinese coaches have neither the ability nor the motivation to make the proper judgments. They even sustain injuries in the process."

Chaotic Yoga Businesses

Chen Shiyi visited India on a business trip last November. "I told fellow Indian doctors that there are many people in China interested in yoga. They thought it was strange, because in India, most of the practitioners start when they are really young, sort of like China's acrobats. None of my Indian friends and families are into yoga. China has many fitness regimens, why is yoga [the only one] this popular? Because present day yoga caters to certain fashion trends. It can help people lose weight, it can do this and that, so people swarm to the gyms."

According the most accepted theory, yoga was originally a set of disciplines followed by ancient Indian monks. True mastery can be achieved only after 20 years of devoted practice. However, Chinese media indicate that in cities like Beijing, Shanghai, Guangzhou, and Wuhan, a few days to 3 months is enough to churn out one yoga coach. There is no unified or systematic certification.

During Zheng Xinyuan's one year stint with yoga, she has met several coaches. Each had a different teaching style--some stressed meditation, while others emphasized asanas. In the studio that Zheng went to, only one coach was permanently stationed; the rest just does guest teaching. "They can earn up to 10,000 yuan per month, but the work is hard. They have to do the routines many times." Said Zheng.

This is the status in most studios. The migrant coaches earn more fees, and at the same time the studio owners can cut down expenses. The popular business model first began in the United States and was introduced to China in the 1990s along with fitness gyms. Because yoga does not require fine motor skills, needs very little area to practice, is mysterious and full of wonderful healing powers, it blossomed from secondary programs to meriting independent studios of its own in only a few years. Yoga centers have spread from mega-cities to counties and towns.

There are large chains, medium-sized studios, auxiliary yoga programs in large fitness centers, and private tutors who offer individual training services. The cost varies greatly from 30 yuan per session to 300 yuan per session. More than 10 types have spawned off from the classic Hatha yoga, including but not limited to hot yoga and yoga for pregnant women.

Nevertheless, behind the striving yoga industry, there are almost no regulations or standards.

"The yoga coach training not only teaches postures but also a set of teaching methods. In fact, most studio owners value not so much the certification as the trainer's personal charisma. This is very subtle: a "good" coach will not only get personal obedience but also idolization." Cheng Songfeng explained, "In a quiet atmosphere, the combination of soft music and the coach's voice can be soporific." During his two month stint as yoga coach, he did not have any certification either.

Keeping track of the number of studios in major cities has become mission impossible since there is no supervising agency. Interestingly, to establish their authenticity, the many organizations in China--International Yoga Institute, the Asia-Pacific International Yoga Association, China yoga Industry Association, Asia Society Bo Lan Yoga, International Yoga Teacher Association ... ...--all invariably claim to be the first in existence and the one to guarantee pure Indian yoga teaching from start to present.

An employee working for the General Administration of Sports told the reporter that yoga has not been officially registered as a sport with the administration. As a result, the process of opening a training center is much simplified. The owner needs no permission from sports management agencies. Paperwork in Departments of Industry and Commerce, Taxation, Health and Fire will suffice. It is easier than opening up a cigarette kiosk.

Zheng Xinyuan, who believes herself a victim of yoga,, currently stays home. Under doctor's orders, she avoids any heavy lifting.

The yoga studio in her residential area is still operating, but she never entered it again. She was surprised to see that the two girls who used to be front desk receptionists are now the studio's coaches. (Names of the yoga victims are fake to disguise their identity)

(Part 3 "The culprit is not yoga" to be continued...the truth is I ran out of gas)

10 comments:

  1. If you wants to know more about the dangers of yoga ,go to dangeryoga.com
    R.Hendrickx-Belgium

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  2. I believe it is very dangerous. It is Hinduism. Search Google for 'yoga occultism' to find out more.

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  3. I believe meditating is good for our inner souls, someone said to me yoga is good for health since it's one of the highly reccomended type of meditation however religious beliefs linked to it as an part of occult making it dangerous for people is the thing that i don't know. That's why I'm looking forward for more studies and research about this confirmation. Thank you.

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  4. This comment has been removed by the author.

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  5. "The doctor immediately told us yoga must be practiced with care." This means that yoga are not for everybody. However, there are lots of yoga gurus out there teaching everyone without giving this information. I hope just for common sense, anyone wants to practice yoga should first ask their doctors advice.

    Regine Smith
    Pittsburgh Tax Attorney Help

    ReplyDelete
  6. Yoga is a very effective form of exercise. It does not only tone up your body, it also helps a person to relax their mind through meditation. However, this form of exercise should be done correctly to ensure safety and it's effectiveness.

    Sarah Cole of http://torisefromashes.blogspot.com/2010/03/unsubstantiated-yoga-injuries.html

    ReplyDelete
  7. Yeah. I agree on you anonymous that yoga is really an effective form of exercise..and people must know that. There's a lot of benefits that we can take from yoga. It soothes and relax our mind and at the same time, our soul and body. By the way, my wrongful death lawyer phoenix likes this. Thanks for sharing!

    ReplyDelete
  8. Yoga is one of the best exercise.. That give to power your body.. Yoga is meditation That clear your soul and you feel your self relax and active.. Yoga is the wonder full art..

    ReplyDelete
  9. A consistent yoga practice decreases blood pressure through better circulation and oxygenation of the body.Yoga improves blood circulation. By transporting nutrients and oxygen throughout your body.

    ReplyDelete
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