Monday, December 24, 2012

Yoga Injuries Debate: 5 Common Themes Explored




by: Victoria McColm, Founder & Editor - Prevent Yoga Injury



William Broad published another piece in the New York Times yesterday on "The Perils of Yoga for Men." This time he's found evidence to suggest that men are at a much higher risk of injuring themselves through asana practice, and are leaving class with not only more injuries comparatively to women, but with more severe injuries, too.


Why the gender disparity when it comes to injury? Broad writes:


Women say men push themselves too far, too fast. Men admit to liking the intensity but say the problem is pushy teachers who force them into advanced poses while urging them to ignore pain.
It's been nearly a year since the marketing piece used to launch his book, The Science of Yoga, started a firestorm. Since then, many well known teachers have disputed the claims Broad makes about injuries (the risk of stroke, especially) and the International Association of Yoga Therapists (IAYT). Why write another provocative piece now? 



It looks as though we will finally get to hear Broad’s formal response to those who have raised questions about or criticized his work. It also seems the yoga community is definitely not done debating yoga safety, injuries, teacher preparedness and contraindications. A quick Twitter search of his article turns up comments ranging from vitriolic to alarmist. Happy 2013! 

I’ve been following the back and forth over this book for most of the year. The discourse is passionate and that passion has sometimes made it difficult for either side to see the forest for the trees. These are serious issues that deserve objective and critical attention, and especially, dialogue. As the yoga community responds to this recent article and in anticipation of the arguments and potential bombshells  Broad may have up his sleeve in his afterword, it’s important to keep these issues in perspective. By framing the debate and highlighting common themes we begin to diffuse the rhetoric, understand what we are really talking about, and hopefully, can begin to work toward tangible solutions that will make the practice safer for everyone.

1) We're talking about asana injuries. 

“Yoga” is much more than asana. Saying “yoga” causes injury tends to upset serious practitioners, because what's really being discussed is the physical practice of yoga; which is asana. It is possible to suffer physical injury while practicing asana, and most yogis and yoginis don’t dispute that.

The semantics of the yoga safety debate are challenging because commercial yoga culture in the United States has been mostly successful in equating asana and yoga in the minds of many practitioners/consumers. While there aren't reliable numbers available, it’s safe to assume that a majority of Americans (and perhaps even a majority of the estimated 20 million yoga practitioners in America) believe “asana” to be “yoga” and view “yoga” as little more than a physical exercise or relaxation technique. Those who study yoga or who are on the 8 limb path know the difference clearly. In raising awareness about the potential for asana injuries, it is as important to speak in a language that the majority understands, as it is to have voices correcting or clarifying the meanings of these words. Beginners and practitioners who don’t know the difference are the most at risk for injury, but that also means running a “Prevent Asana Injury” campaign would be lost on them since they don’t know what that means yet.

Here's a quick video from Glenn Black, who's been studying and teaching yoga for over 30 years, that explains the risk of asana injury more eloquently than I ever could:



   
2) We're talking about ego

Ego is at the root of yoga injuries, but in many more ways than typically stated. It’s a common argument that asana injuries can be attributed to competitive ego. Students (and as Broad reports in his latest piece, men) push themselves and compete with one another, especially in group class settings, which leads to injury. This is absolutely true, but is not the only dilemma of ego in yoga and it should be explored in greater depth. Students with low self esteem (lack-of ego) are also at higher risk of injury since they may not have the confidence to speak up about a medical condition or to push back when a teacher encourages them to hold a pose that causes them pain.

The student-teacher relationship in yoga is complex and must also be examined. A teacher inherently holds power over his or her students. Students convey trust to their teachers and will endeavor to please them. Many teachers experience the challenge of ego and this is evident in the many scandals and controversies of 2012 (Anusara Yoga and Bikram Copyright as two examples). As the saying goes: with great power, comes great responsibility. 

3)  We're talking about responsibility for yoga safety.

But who's responsible for ensuring student safety in yoga class? Yoga studios and gyms typically require new members to sign a waiver of liability. New students state that they are healthy enough for yoga practice and have consulted their doctor to ensure this. But how many doctors know enough about yoga asanas and the hundreds of different kinds of yoga taught today to advise a patient adequately? In theory, yoga teachers are bound by ahimsa, but in practice, it's not fully expressed. Students still expect their teachers to ensure their safety, but many teachers don't even ask their students about medical conditions or contraindications before class starts. And what about all of the students who have a home practice with DVDs or streaming online videos? Who's keeping them safe?

In commercial yoga, there isn't a clear or generally accepted answer to this question. Doctor's have the Hippocratic Oath. Yoga Alliance has a code of conduct for RYTs. Yogi J Brown took a stab at creating a Yoga Student's Bill of Rights. But are any of those enough? Until commercial yoga finds a way to conduct ahimsa, and not just conduct risk management, it's important that students and practitioners take responsibility for their own yoga safety. To do this, they need tools and resources, but they also need to be made aware of the risks involved with an asana practice. Whether you agree with Broad or not, he deserves credit for leveraging his position at a major media institution to raise awareness about the potential for injury. 

4) We're talking about the adequacy of yoga teacher training

Is a 200 hour training enough time to fully understand ahimsa, anatomy, contraindications, alignment, adjusting, assisting and develop a safe teaching style? The issue of undertrained teachers and the risk of inexperience leading to injured students is a key part of the debate over asana injuries. The experts who participated in YogaUOnline's Telesummit on Yoga Injuries believed lack of teacher experience to be the primary risk to yoga students and practitioners.  

A contributor to a current discussion thread on the Yoga Alliance LinkedIn page cites "fearing consequences" from the yoga community for reporting RYS teacher trainings that don't stick to the YA curriculum. Quite a sad state of affairs in yoga when students and trainees fear reporting situations or conditions they find unsafe or training that's inadequate, isn't it? The debate over the quality and content of 200hr teacher trainings is particularly sensitive, because many local studios rely on profit from teacher trainings to stay in business. Major changes to the curriculum or increases to the minimum time requirements could put the time or monetary commitment out of reach for many potential trainees so it's important to keep the needs of local studios in mind when debating this issue. Ahimsa means to do no harm. Putting someone out of business and taking away a family's livelihood causes harm and attempts to improve training should take this into account and mitigate such harm as best as possible.

5) We're talking about the direction of modern yoga

Modern yoga exists in a capitalist, free-market society and in many ways, it has been commodified. This unfortunate truth is often the most difficult for many yogis to accept. The philosophy of yoga is the antithesis of the philosophy of capitalism. A miniscule number of yogi’s today renounce worldly possessions, spend time at an ashram or make the serious lifestyle changes requisite of the Sutras. Anytime a yogi's livelihood is dependent on yoga, he or she will be faced with conflicts of interest. At the same time, yoga as an industry will respond to consumer demand or what the majority wants.

There are things that can’t be changed. But is it fair to allow frustration and blame over the commodification of modern yoga to be thrown at the beginner students, moms with a home practice or senior citizens who may arrive to class with a litany of medical issues contraindicated for the practice? All Yoga Alliance certified teachers are bound by the code of conduct, but our own yogic philosophical beliefs should lead us to the conclusion that what's most important here is to engage in dialogue and meaningful debate on yoga safety so that the students we serve can have access to the information they need and to a safe practice.

Detachment is a key pillar of yogic philosophy, and the state of yoga in America causes many people suffering – both physical and emotional. Before we continue arguing over yoga injuries, let's all pause a moment and consider whether what we have to say is a contribution or distraction from what's really needed - a dialogue.

I hope this article will help to frame discussions on yoga safety. There are likely elements that I have overlooked, this is not meant to be all-encompassing, just to share my thoughts on the issue and how it breaks down in my own head. I encourage you to please leave your own thoughts or observations in the comments section. 

Happy holidays to all! I'm looking forward to continuing this dialogue in 2013!



2 comments:

  1. Appreciate this post. Indeed, a better frame for the discussion is in order. Here are a few thoughts:

    - When we are talking about teacher training, it can't be about hours. Simply increasing the hours to the criteria will not make yoga safer when teachers are being trained to teach injurious practice. And science is not the answer either (see http://yogijbrown.com/2012/02/is-your-yoga-safe/). We need to talk about competences and apprenticeship. You do not need extensive hours of training to make yoga safe, just good information. As you suggested, teachers actually having dialogue with students is one small example.

    - When it comes to safety, we have to distinguish between different approaches. I find it interesting that after a decade of being known for his overly aggressive a bullyish teaching, Mr Black now decries yoga as injurious. I profoundly disagree that yoga practice is about achieving a transcendent state and believe that this misperception is the very reason why he has hurt himself and others. As for Mr. Broad, his reductionist assertions about the safety and origins of yoga and the sensationalizing of the data actually serves to obfuscate the issues more then educate anyone about safe and unsafe asana practice (You are right to make the distinction - Yoga doesn't hurt anyone.)

    If we want to ensure more safety in yoga classes, we must establish the asana practice as separate from physical fitness mentality. We must educate the public so they can make informed decisions. And we must train teachers to take full responsibility for what happens in their classes.

    Thanks for including me in this. I value the dialogue. Cheers.

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  2. Ok, here are my thoughts on this issue...not that I am an expert, by all means I am still learning and I am the eternal student. My students teach me about injuries, variations & how to move & groove with limitations. But I do find it kind of hilarious that Mr. Black talks about this issue now. I remember having him as our anatomy teacher in my Teacher Training and he was hard as hell on us pushing the edge, making a lot of the trainees cry because they couldn't hold ankle to knee for as long as he wanted to. Then making fun of them and talking about a real yoga practice. He didn't teach me much about anatomy but what he did teach me was that I never want to be that kind of bully in our Teacher Training.
    Dear Mr. Black, I truly hope you have learned and can pass on a little bit more compassion. Yoga is not just a physical practice but also involves the heart, the mind & the spirit.
    For all of you teachers out there...200 Hours is only the beginning, then the real study starts by teaching, watching, listening, honoring what yoga is all about...LOVE jj

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