Soft Tissue and Bony Injuries Attributed to the Practice of Yoga: A Biomechanical Analysis and Implications for Management

Jeffrey Wilson — Mon, 04 Mar 2019 17:57:31 +0000

Date Added:

March 4, 2019

Journal/Publication:

Mayo Clinic Proceedings

Publisher:

Elsevier

Publication Date:

March 1, 2019

Issue:

Volume:

Pages:

424-431

URL:

Soft Tissue and Bony Injuries Attributed to the Practice of Yoga: A Biomechanical Analysis and Implications for Management

Type:

Clinical Research Results

Format:

Article

DOI (1):

10.1016/j.mayocp.2018.09.024

Keywords

yoga

exercise therapy

PMID (1):

30792066

MeSH

fractures, compression

Spondylolisthesis

yoga

osteoporosis

bone diseases, mtabolic

This retrospective study documents the types of injuries that can occur as a result of yoga and the types of patients at highest risk for yoga-related injuries.

Commercial full text (fees may apply)

View

OBJECTIVE:

To analyze injuries that were directly associated with yoga practice and identify specific poses that should be avoided in patients with osteopenia or osteoporosis.

PATIENTS AND METHODS:

We retrospectively reviewed the medical records of patients with injuries that were primarily caused by yoga. Patients were seen from January 1, 2006, through December 31, 2018. Injuries were categorized into 3 groups: (1) soft tissue injury, (2) axial nonbony injury, and (3) bony injury. Patients underwent evaluation and were counseled to modify exercise activity.

RESULTS:

We identified 89 patients for inclusion in the study. Within the soft tissue group, 66 patients (74.2%) had mechanical myofascial pain due to overuse. Rotator cuff injury was seen in 6 (6.7%), and trochanteric bursopathy was observed in 1 (1.1%). In the axial group, exacerbation of pain in degenerative joint disease (46 patients [51.7%]) and facet arthropathy (n=34 [38.2%]) were observed. Radiculopathy was seen in 5 patients (5.6%). Within the bony injury category, kyphoscoliosis was seen on imaging in 15 patients (16.9%). Spondylolisthesis was present in 15 patients (16.9%). Anterior wedging was seen in 16 (18.0%), and compression fractures were present in 13 (14.6%). The poses that were most commonly identified as causing the injuries involved hyperflexion and hyperextension of the spine. We correlated the kinesiologic effect of such exercises on specific musculoskeletal structures.

CONCLUSION:

Yoga potentially has many benefits, but care must be taken when performing positions with extreme spinal flexion and extension. Patients with osteopenia or osteoporosis may have higher risk of compression fractures or deformities and would benefit from avoiding extreme spinal flexion. Physicians should consider this risk when discussing yoga as exercise.

Author/s:

Lee, Melody, Huntoon, Elizabeth A., Sinaki, Mehrsheed

Yoga as Antihypertensive Lifestyle Therapy: A Systematic Review and Meta-analysis

Jeffrey Wilson — Mon, 04 Mar 2019 17:52:18 +0000

Date Added:

March 4, 2019

Journal/Publication:

Mayo Clinic Proceedings

Publisher:

Elsevier

Publication Date:

March 1, 2019

Issue:

Volume:

Pages:

432-446

URL:

Yoga as Antihypertensive Lifestyle Therapy: A Systematic Review and Meta-analysis

Type:

Meta-analyses, Reviews, and Guidelines

Format:

Article

DOI (1):

10.1016/j.mayocp.2018.09.023

Keywords

PMID (1):

30792067

MeSH

antihypertensive agents

This meta-analysis suggests that yoga, especially when it includes breathing techniques and meditation/mindfulness, can reduce blood pressure by as much as 11 mmHg systolic and 6 mmHg diastolic.

Commercial full text (fees may apply)

View

OBJECTIVE:

To investigate the efficacy of yoga as antihypertensive lifestyle therapy and identify moderators that account for variability in the blood pressure (BP) response to yoga.

METHODS:

We systematically searched 6 electronic databases from inception through June 4, 2018, for articles published in English language journals on trials of yoga interventions that involved adult participants, reported preintervention and postintervention BP, and had a nonexercise/nondiet control group. Our search yielded 49 qualifying controlled trials (56 interventions). We (1) evaluated the risk of bias and methodological study quality, (2) performed meta-regression analysis following random-effects assumptions, and (3) generated additive models that represented the largest possible clinically relevant BP reductions.

RESULTS:

On average, the 3517 trial participants were middle-aged (49.2±19.5 years), overweight (27.9±3.6 kg/m2) adults with high BP (systolic BP, 129.3±13.3 mm Hg; diastolic BP, 80.7±8.4 mm Hg). Yoga was practiced 4.8±3.4 sessions per week for 59.2±25.0 minutes per session for 13.2±7.5 weeks. On average, yoga elicited moderate reductions in systolic BP (weighted mean effect size, -0.47; 95% CI, -0.62-0.32, -5.0 mm Hg) and diastolic BP (weighted mean effect size, -0.47; 95% CI, -0.61 to -0.32; -3.9 mm Hg) compared with controls (P<.001 for both systolic BP and diastolic BP). Controlling for publication bias and methodological study quality, when yoga was practiced 3 sessions per week among samples with hypertension, yoga interventions that included breathing techniques and meditation/mental relaxation elicited BP reductions of 11/6 mm Hg compared with those that did not (ie, 6/3 mm Hg).

CONCLUSION:

Our results indicate that yoga is a viable antihypertensive lifestyle therapy that produces the greatest BP benefits when breathing techniques and meditation/mental relaxation are included.

Author/s:

Wu, Yin, Johnson, Blair T., Acabchuk, Rebecca L., Chen, Shiqi, Lewis, Holly K., Livingston, Jill, Park, Crystal L., Pescatello, Linda S.