March 10, 2010

"Unsubstantiated" Yoga Injuries, Cont'd

Continued from previous post

The culprit is not yoga


In the past three years, more than 13,000 people in the United States had to seek medical attention due to yoga injuries. But Dr. Gary Dorshimer, Director of Internal Medicine/Sports Medicine Fellowship in Pennsylvania Hospital, does not think the situation is as grave as it sounds.

Southern Metropolis Weekly: What sort of cases have you observed in the past? Where were the injuries located and what caused them? Was there any pattern?

Dr. Dorshimer: The yoga patients I have treated in the past all had foot injuries, and most were muscle strains. Severe muscle damages and tendon ruptures are very rare.

Every sport carries some kind of risk, but I have not seen related statistics for yoga. I believe these injuries only occur occasionally, because yoga is not an intense sport. It doesn't require jumping up and down and so rarely causes serious damages like spinal cord injuries. However, old people will get hurt more easily. Past studies show that compared to other age groups, old people will be more likely to receive injuries when practicing the same moves. This is like people who sit on a boat. When the boat suddenly shakes, some older folks can suffer spinal fractures.

Another reason is that yoga is classified into advanced and beginner levels. For a newbie, practicing demanding asanas make them more prone to injury.

Southern Metropolis Weekly: A 2001 issue of Time magazine talked about the yoga fever in the States. Did the U.S. reach any conclusions regarding the injury rate? In the recent years, had any of the overseeing departments or medical experts given out warnings about the associated risks?

Dr. Dorshimer: In the U.S., be it about caffeine intake or gun usage, we warn everyone of the risks at every opportunity. Risk reports are typically given out during sports lessons, but I have not heard of any such thing for yoga, which in my opinion means that yoga injuries are low in occurrence.

Southern Metropolis Weekly: Some Chinese experts say that the asanas violate the human physiological structure. For instance the plow. Not everyone can practice yoga, which can potentially damage his/her spinal cords. These injuries are hard to heal. Therefore, before taking up the yoga, everyone should all arrange for a back examination to rule out any existing spinal problems. But even a prior checkup can not gaurantee that people won't get hurt. What thoughts do you have on this?

Dr. Dorshimer: In the U.S., these difficult poses are practiced by very few. Common people can't do them. All they need are some postures that will improve their balance and flexibility. Asanas like the plow require athletes or someone with good flexibility. I can't do it either. It is just risky and difficult for an ordinary trainer or a 60 year old man.

Southern Metropolis Weekly: From a sports/physiological perspective, will yoga ever be as universal as jogging?

Dr. Dorshimer: The answer depends on individual exercisers. Avoid overly demanding postures, warm up properly beforehand, stay away from asanas that overstretch the body, and be patient. Then I think yoga can become as universal as jogging.

Southern Metropolis Weekly: Some medical professionals believe that middle aged people should not practice yoga because of their aging spinal cords. What do you suggest?

Dr. Dorshimer: Many people believe that middle aged people can become good at yoga regardless of their profession. The fault does not lie with yoga but with the intensity with which you practice yoga. If you attempt asanas that are beyond your capability, you will get hurt. The standards for different bodies in different age groups will vary too. Even when a 20 year old college student and a 30 year old young man practice the same pose, they should follow appropriate criteria. For people in their middle age or older, yoga is safe if well-controlled. And the benefits outweigh the dangers.

Southern Metropolis Weekly: Given your expertise in sports medicine, can you give exercisers some suggestions?

Dr. Dorshimer: Nothing in particular. Again this mostly depends on the individuals. For example, soccer players need strength training to become stronger and to have better balance, but they are not good candidates for yoga, because they lack the flexibility. It is the opposite for young gymnasts and hockey players. So it all comes down to the exercisers' physiological conditions and the particular asanas.

The problem is that many young people are excited by new things, and they always want to try the postures they have never done before just to exercise all of their muscles. I think this is the major reason why people get hurt. No matter what their age is, I would recommend that people stay away from difficult poses, such as this kind of rotation (stands up to demonstrate the move), because it poses a risk. Don't attempt asanas that exceed the body's limit, then the probability of receiving injuries will be less.

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)

March 01, 2010

Guangxi Official Suspended from Duties Because of "Porn Diary Gate"

No doubt this will serve as a deterrent to some future officials keeping such detailed records of their decadent and corrupt lives.

Translation: Tencent 广西“局长香艳日记”男主角被停职审查(already "harmonized",first reported by ChinaNews Nanning. Entire diary available at Ifeng (Don't mind the photo. Someone pointed out it might be false)


Han Feng is the first man on the right, wearing glasses

On the evening of March 1st, a spokesperson for Guangxi's Tobacco Monopoly Bureau (广西烟草专卖局, Guangxi division of China National Tobacco Corp) told the press that branch director Hanfeng (韩峰) from Laibin city (来宾市) has been suspended from his duties and is now under formal investigation for possible illegal conduct. Han Feng recently came under fire when his explicit diary entries about personal sexual encounters somehow leaked to the internet.

Written from the first person point of view, the diary has caught on like wild fire on websites both domestic and overseas. The entries are terse a la the currently fashionable microblogs, but their contents are "very yellow (Chinese expression for pornographic) and very violent." They span a time period from 2007 to 2008, recording in great detail Direct Han's daily life. Besides going to work and spending time with family, a noticeable chunk of his time was consumed by the following three activities: imbibing alcohol, sleeping with women, and accepting bribes. In the diary, this official mentioned 6 women with whom he maintained intimate relationships, their real names, as well as some of these women's addresses and door numbers.

Netizens quickly initiated the "human flesh search." They determined that writer of the diary was Han, who was at first Laibin city's branch director for National Tobacco Corp, then became the director of the Laws and Regulations Department of the Guangxi Zhuang Autonomous Region's Tobacco Monopoly Bureau and finally, prior to "Diary Gate," director of sales at Guangxi's Tobacco Monopoly Bureau.

On February 22, Guangxi's Tobacco Monopoly Bureau convened for a special session after officials heard about the diary. Because the scandal severely interfered with Han's normal work, he was suspended and subsequently subjected to initial investigations by the Ministry of Supervision. Guangxi Zhuang Autonomous Region's Tobacco Monopoly Bureau admitted: "Preliminary investigations revealed that contents of "Director's Diary" were not groundless." Formal investigation is currently under way.

Excerpts from the diary:

September 16, Sunday 4-31oC, Sunny

Sha (莎) went grocery shopping this morning. At noon, Wang Shucheng (王书城) called me up for lunch at Guijing Hotel (桂景大酒店). It was just the two of us. He gave me two bottles of Maotai and 50,000 yuan. I deposited 30,000, and took 20,000 home.

September 18, Sunday 21-32oC, Sunny

Spent the morning at the dormitory. Reserved a room at Guo Da (a reference to some hotel) before going to the office this afternoon. Rong Riqian (容日谦) and others came. Tomorrow they will take the civil service exam. Drank a lot of wine with them in the evening. Arrived at Guo Da sometime past 11. Xiao Tan (小谭) was already there. She is having her period, so she used X to do it with me (either anal or oral sex)."

November 6, Tuesday 11-25oC, Sunny

Organized materials for the "Civility and Politeness" seminar in the morning. At noon, Li Dehui (李德辉) came from Xiamen, so I had lunch with them, and we drank. Afternoon was at the dormitory. In the evening I ate dinner with Huang Guiting (黄桂廷) and others, drank a lot. Huang's group is leaving for Chongqing and Chengdu tomorrow. I am letting A Su (阿苏) and Tan Shanfang (谭善芳) go too. Around 10 P.M., Tan Shanfang drove me to her house. We fucked 3 times at night, and one more time at dawn. Did not ejaculate.

January 22, Tuesday 3-5oC, light rain

In the morning went directly from Guo Da to office. Attended the State Council's 10 o'clock teleconference on security. Enjoyed some shots with A Dong (阿东) at noon, and then went to tea at Liao Feng's (廖峰) place. Came back to Nan Ning at 3:30 PM. Got a Nokia 6300 from Gao Xiang (高翔), because I promised Liao Feng [a phone].

January 25, Friday 4-7oC, rain

During the morning discussion, we talked about me getting the group leadership in Yu Lin (玉林), Wu Zhou (玉林) and Laibin (来宾). Summary and recognition meeting in the afternoon. We are advanced level (先进) again. That means full salary this year, about 250,000 yuan. Son arrived in the morning; dinner at Da Hui Feng (大惠丰) for three of us. Came back after dinner to finish up my work report. After I revise a little tomorrow will hand over to them.

These are only a few of the entries.
 
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