Yoga: does it promote or prevent injury?

Six years ago, I finished my 500 hour yoga teacher training and was unleashed on an unsuspecting public. I did not feel particularly equipped to be.
Had I not grown up immersed in sport or had a decade-long yoga practice, I wouldn’t have considered teaching. I wondered about many of those I’d done my training with, some of whom had only picked up a practice several months earlier. I wondered more about the many more who taught off the back of the shorter 200 hour teacher training course.
How equipped were any of us to deal with students, in various states of injury, who looked to their teacher as an expert and attended yoga as therapy? And what about those who were well and sustained injuries during a yoga class.
Formally, the statistics on yoga-related injury are relatively low, particularly compared with sports like cycling or running.
Anecdotally, it’s a different story; my personal trainer along with physiotherapists I have spoken with say the most common injuries they see are yoga-related, while entire books have been dedicated to the potential risks of yoga and the prevalence of injury.
On the other hand, many of us – myself included – have experienced the great mental and physical perks of yoga, leaving a class or our own practice feeling less stressed, more supple and a little more connected.
Studies have shown the therapeutic benefit of the ancient practice – from improved cognitive function to mental and physical health – and about 20 per cent of practitioners participate in yoga for a specific health or medical reason.
One new study found many people are self-prescribing yoga to improve back pain, unsurprising perhaps given about 90 per cent of us suffer from it at some point.
Lead author Susan Wieland, from the University of Maryland School of Medicine, said: “Our findings suggest that yoga exercise may lead to reducing the symptoms of lower back pain by a small amount, but the results have come from studies with a short follow-up.
“At the moment we only have low to moderate quality evidence for the effects of yoga before six months as a type of exercise for helping people with chronic back pain.”
The findings, suggested The Telegraph, “add further weight to calls for GPs to prescribe yoga for people with long-term discomfort as a matter of course”.
Really?
Be careful whose care you put your body in
In his 50 years practicing, 35 of which he has been a teacher, Simon Borg-Olivier says he has observed that injury “in most modern yoga is higher than in other exercise”.
“It is crazy for people, a few months or years of personal practice plus a 200 hour teacher training to be expected to fix people with problems and they should not try to do it in my belief,” says Borg-Olivier physiotherapist and co-founder of Sydney studio, Yoga Synergy.
When taught and practiced correctly however, it is a different story.
“I believe ‘good yoga’ can cure anything but most people simply do not have the knowledge to make it physically effective especially to cure physical problems,” he adds.
Yoga teacher with yoga therapy training at Sydney’s BodyMindLife Brooke Elliston, agrees.
“Most yoga teachers do not have specialised therapeutic or remedial yoga training, so one of the best tools that yoga teachers will offer is to continue to encourage the student to stay attuned to their own needs, and to cultivate modifications that are realistic in the immediate circumstances,” says Elliston, also a co-founder of Back2Roots yoga retreats.
“That said, an experienced teacher should be able to accommodate and help a student to modify the practice based on a student’s medical diagnosis, with the caveat that this help can be very limited in a classroom full of people.”
It can also be very limited because of the style of yoga taught – ancient styles taught to people with modern lifestyles, who aren’t necessarily aware of their bodies and limitations.
“Most people have an underlying  lower back problem due to the predominantly sedentary chair lifestyle that means that even simple yoga postures of India can actually cause problems in the ‘normal’ (but not natural) body,” Borg-Olivier explains.
There are two ways to address this (apart from getting up and moving more, which we all ought to do more of anyway). Be aware of your teacher’s qualifications, especially if you have an injury.
“If a doctor has recommended or prescribed yoga for an injury, the best option is for the student to seek out specialist therapeutic or remedial yoga sessions, where attention can be personalised and hands on guidance and support provided, at least until the student knows how to modify their practice in a safe way independently,” Elliston says, adding that beginner’s classes are important if you’re new or have never been taught the basics.
“It is here that students are first exposed to marrying awareness and alignment, strength and flexibility and creating an openness in the body that transforms the way they hold themselves in everyday life,” she says.
Be careful with your own body
The second part of the equation is learning to take responsibility for our own bodies and approaching the activity differently – after all, about 50 per cent of injuries are considered preventable, and the point of yoga is to gain awareness of the body and treat it with respect.
“The yoga practice encourages us to be present in our current physical, emotional and mental condition and to honour those realities rather than practicing with an expectation of what we think we should be able to do or have previously done,” Elliston says.
This shift in attitude, different to most other forms of activity, can take time to cultivate, but is as central to the practice as the physical postures.
“Most people are approaching life with a ‘no pain, no gain’ mentality that simply is not functional for the healing response and also not sustainable,” Borg-Olivier says.
Borg-Olivier’s basic guide to good yoga: 

• avoid painful practices
• avoid stressful practices
• move more naturally
• do more things like walk and swim and dance and climb

Look for teachers and practices that:

• improve flexibility without feeling intense stretch
• improve strength without feeling tense or stressed
• become more relaxed without needing to be completely passive
• improve energy levels without having to breathe more than normal
• promote circulation without needing to make the heart beat faster
• improve intelligence of the body cells without having to over-think
• satiate appetite and feel nourished without having to eat more
• feel rested and rejuvenated without having had to sleep more

When practicing try to:

• move actively into postures (rather than using external forces such as gravity or one limb pulling another or momentum to get into posture)
• move from the core rather than locking the core
• breathe naturally in the practice rather than forcing the breath
• move fluidly and smoothly in the practice

* This article was originally written and published on http://www.smh.com.au/lifestyle/health-and-wellbeing/fitness/yoga-does-it-promote-or-prevent-injury-20170116-gts5yn.html