Scientific Truth of Yoga — Show Me The Evidence

I proudly identify as a practitioner of yoga, while simultaneously maintaining a skeptical disposition. The coexistence of these two realms often sparks contemplation within me. There are instances when I find myself recoiling as instructors assert that contorting into a twist expels “toxins” from my organs—an assertion that strains the boundaries of my credulity.

Yet, across the span of eight years, I persistently return to the mat. The aftermath of a yoga session bestows upon me a profound sense of tranquility and an enhanced kinesthetic awareness. This transformative effect ripples through the tapestry of my existence, imprinting its essence upon every facet: my professional endeavors, my interpersonal interactions, and even my fundamental habits of nourishment and slumber.

The latest survey indicates that over 20 million Americans are engaged in the practice of yoga, solidifying its status as one of the most widely embraced forms of physical activity. Even Vladimir Putin, known for his affinity towards “macho sports,” has incorporated the downward dog pose into his repertoire.

However, the question arises: does yoga genuinely warrant its reputation as a health-enhancing regimen in comparison to alternative exercises? Does it truly deliver on its promises of stress reduction and the rectification of poor posture? Perhaps our perception of yoga is tinged with bias. Alternatively, as discerning critics have underscored, there may exist unfavorable aspects linked to yoga. The indelible memory of the contentious New York Times exposé in 2012, highlighting instances of severe injuries, and even fatalities, sustained on yoga mats, comes to mind.

Seeking a more impartial perspective on the health impact of yoga, I embarked upon a journey through scientific inquiry. Immersed in the study of more than 50 research articles and review papers, and engaging in conversations with seven preeminent yoga scholars, I was immediately struck by the fragility of the foundation upon which yoga research stands. Many of the studies exhibited shortcomings due to their small scale or suboptimal design and were further tainted by the prevalence of self-selection bias. Compounding this, the multitude of diverse yoga styles makes it arduous to extrapolate meaningful conclusions about one style onto others.

Nevertheless, the insights gleaned from the available research yield certain assertions about yoga’s effects. Contrary to detractors’ claims, yoga is unlikely to bring harm, and it seems to confer health benefits akin to those offered by comparable physical activities.

Furthermore, yoga emerges as an effective measure in ameliorating lower back discomfort, augmenting muscular strength and flexibility, and curtailing bodily inflammation — a facet that holds the potential in averting chronic ailments and mortality. Emerging inquiries imply that yoga enhances bodily consciousness, heightening individuals’ attentiveness to internal sensations and processes. This, in itself, holds significant import: experts posit that an elevated sense of bodily awareness might foster superior self-care practices.

However, it’s important to acknowledge that other contemplative exercises, like tai chi and meditation, also contribute to heightened body awareness and inflammation reduction. This constitutes the crux of the issue with much of the extant yoga research: it remains insufficient in delineating how distinctly superior yoga is, or is not, in comparison to other physical regimens in terms of various health metrics. Lastly, several of the extravagant claims associated with yoga, such as its purported ability to alleviate constipation or expel toxins, either lack empirical support or have eluded rigorous investigation.

In the realm of understanding

Yoga, with its multifaceted benefits, stands as a formidable contender among various modes of physical activity that contribute to overall well-being. Yet, its true potential is unveiled in its remarkable ability to alleviate lower back pain and, of paramount significance, mitigate bodily inflammation. This pivotal function not only bolsters one’s defense against ailments but also manifests yoga as an exceptional instrument of health. Additionally, yoga intricately refines the perception of one’s corporeal state, nurturing a heightened “body awareness,” an acute cognizance of inner processes.

However, the terrain of knowledge remains veiled in uncertainties

Unveiling the nuances of this ancient practice, we find ourselves in contemplation of whether certain variants of yoga wield greater efficacy than others. The contemplative inquiry extends to the realm of medicinal employment – should yoga be prescribed to address diverse health conditions? Comparative evaluations beckon, entreating us to discern how yoga measures against alternative physical endeavors, specifically tailored to yield a plethora of distinct health outcomes. Amidst this scholarly exploration, we are confronted with an unsettling truth: the very bedrock supporting many acclaimed health advantages attributed to yoga lacks empirical substantiation. Assertions of expelling toxins and invigorating digestion are, regrettably, built upon an unstable foundation.

The ramifications for your path become evident

Should the harmonious practice of yoga resonate with your sensibilities, the prudent choice is to embrace it unfalteringly. Absent any indications of deleterious repercussions, it unfurls a panorama of health advantages. In pursuit of bespoke objectives, a sagacious approach dictates the selection of a fitting style. Be it the vigorous dynamism of Ashtanga or the serene composure of hatha, the choice reverberates with personal aspirations. Conversely, if the art of yoga fails to kindle your enthusiasm, be not disheartened; alternative avenues for physical engagement remain abound. The tapestry of choices allows for a seamless transition toward other invigorating pursuits.

The Lancet — 1975

In the annals of medical research, a seminal moment unfolded in 1975 within the pages of The Lancet when the curtain was first lifted on a randomized trial, a beacon of rigorous experimentation. This study unveiled the potency of yoga, eclipsing even relaxation techniques, in taming the tempestuous waters of high blood pressure. However, this revelatory endeavor encompassed merely a cohort of 34 participants, each already entangled within the labyrinth of hypertension. Hence, the question lingers, a whisper carried through time: would the symphony of yoga’s effects resound as eloquently in the grand theater of a larger trial, a trial whose canvas consisted of the hale and hearty?

Since that epochal juncture, the tapestry of yoga studies has expanded exponentially, yet the specter of the past continues to cast its shadow upon the realm. A recurrent quandary emerges, reminiscent of yore, as many studies remain ensnared within the embrace of diminutive participant counts. Within this tangle, the absence of a guiding star—a control group—diminishes the compass of validity. Furthermore, the symposium of comparisons often rings hollow, failing to orchestrate yoga alongside domains of genuine intrigue. In an ideal choreography, the waltz of scrutiny would unfold between yoga and its kindred forms: an alternative exercise or the mindful practices of the somatic realm. A poignant illustration of this shortfall lies in the divergence of one study that sought to appraise whether yoga’s salve for back pain outshone the bestowal of a mere tome on back pain management.

Short Terms Studies

Existing studies on the subject often exhibit temporal brevity, lacking the scope required for comprehensive understanding. Long-term investigations into matters of mortality and the prevalence of severe ailments remain conspicuously absent. Equally scarce are protracted inquiries into the potential detriments that yoga might visit upon the human physique. In the words of Holger Cramer, a distinguished figure in the realm of yoga research hailing from the University of Duisburg-Essen in Germany, the prevailing quandary is the dearth of substantiating evidence for a majority of conditions under scrutiny.

Delving into the realm of yoga research presents a formidable challenge. The prevailing consensus among researchers esteems studies employing a blinded approach as the pinnacle of rigorous investigation. This methodology ensures that participants remain unaware of the specific intervention, such as a therapeutic agent, thereby preventing personal biases and perceptions from tainting the resulting conclusions. However, when it comes to yoga, the inherent nature of the practice defies this principle of blinding.

Yet, towering above all is the fundamental quandary that pervades yoga research: the very definition of yoga itself. As Karen Sherman, an eminent researcher affiliated with the Group Health Research Institute, cogently remarked, yoga assumes multifarious forms for different individuals. The outcomes of a yoga intervention are inevitably molded by the nuances injected into the practice.

Yoga, in its essence, entails a fusion of several elements: the graceful contortions of postures and poses (asanas), the rhythmic regulation of breath (pranayama), and the serene domains of meditation and relaxation (samyana). Nonetheless, myriad classes interweave additional components, ranging from mellifluous chants to heightened temperatures and accompanying melodies. Moreover, the landscape is marked by a proliferation of instructional styles, each characterized by its unique caliber and approach. The domain of Hatha and Iyengar yoga predominantly involves deliberate stretches and rejuvenating poses, whereas the domains of Ashtanga and vinyasa lean towards more spirited and athletic engagements. In contrast, Yin yoga steers clear of inducing perspiration, emphasizing prolonged posture-holding to attain profound stretches. Conversely, Bikram yoga, composed of a series of 26 postures iterated twice within a room heated to 105 degrees, guarantees a sweat-soaked attire as an incontrovertible consequence.

Lorenzo Cohen

Lorenzo Cohen, the eminent head of the integrative medicine division at MD Anderson Cancer Center, conveyed his insightful perspective to me, highlighting a noteworthy concern: “Numerous scholarly works pertaining to yoga lack the requisite depth in explicating the essence of ‘yoga’ itself. Gaps persist in detailing the proficiency of yoga therapists and their methodologies in selecting distinct postures and respiratory exercises.”

Furthermore, within the realm of a yoga class, an intricate interplay of multifarious elements transpires, rendering it arduous to discern the precise contributors to health outcomes. When individuals articulate heightened well-being subsequent to a class, one must contemplate whether it emanates from the collective participation in a larger community, the pedagogical approach of the instructor, the nuances of breathwork, or even the ambient warmth. These intricate constituents resist facile disentanglement, thereby posing challenges in quantifying the multifaceted benefits of yoga through conventional scientific metrics.

Nonetheless, the scholars vested in the study of yoga with whom I engaged underscored a marked amelioration both in the caliber and quantity of investigations underway, instilling optimism for more cogent elucidations in the near future. Cohen affirmed this positive trajectory, stating, “The cohort of researchers engrossed in yoga therapy inquiries has expanded appreciably, and the encouraging outcomes from preliminary endeavors precipitate the inception of more expansive and meticulously structured trials.” Furthermore, a concerted effort is underway to scrutinize the physiological ramifications of yoga, delving into its impact on biologically salient markers such as hormone levels. This trajectory promises a more objective delineation of the tangible benefits that yoga can bestow upon the human body.

Prominent Research

Questions & Answers

Question No. 1 — Can Yoga Pose a Risk of Injury?

Certainly not.

The year 2012 marked the emergence of a pertinent question, ignited by a compelling article unveiled by The New York Times. This piece, derived from the voluminous tome titled “The Science of Yoga: The Risks and Rewards,” posited the notion that yoga, far from bestowing wellness, had the potential to wreak havoc upon the human physique. The narrative expounded a distressing panorama, attributing grave afflictions to yoga practitioners, ranging from ruptured intervertebral discs to cerebral vascular accidents.

Yet, upon closer examination, it becomes apparent that this narrative was predominantly a mosaic of carefully selected anecdotes, artfully magnifying these aberrant instances to insinuate their typicality within the larger fabric of the yoga experience – a proposition far removed from reality.

Cramer, having meticulously scrutinized the compendium of documented injuries and adversities stemming from yoga, imparts his discerning insight: “Yoga’s safety quotient is on par with that of any other pursuit. It does not harbor more peril than any other manifestation of physical exertion.” He further expounds, “While it would be fallacious to assert absolute invulnerability in the practice of yoga, this caveat applies universally.”

A comprehensive review of case studies in 2013 by Cramer yielded 76 discrete occurrences of adverse events linked to yoga. His deductions succinctly conveyed that a majority of these untoward incidents manifested within the musculoskeletal, nervous, or ocular realms. Clinical denouements bore witness to more than fifty percent of the cases culminating in complete recuperation, with one exception being the absence of recovery and a solitary fatality.

Preponderantly, the precarious headstand posture emerged as the primary harbinger of the predicament, closely trailed by the shoulder stand, contortions necessitating the placement of one or both feet behind the cranium, the lotus position, and forceful breath modulation. Amongst the various yogic practices, Pranayama, Hatha, and Bikram incarnations exhibited the highest prevalence of associated adversities.

Informed by these meticulously investigated instances, Cramer and his co-author proffered pragmatic counsel to safeguard one’s well-being in the domain of yoga: Novices would be wise to eschew elaborate postures such as headstands, and individuals afflicted with chronic medical conditions such as glaucoma would be well-advised to seek their medical practitioner’s guidance before embarking on this journey. They further stipulated that the practice of yoga should not coincide with the influence of psychoactive substances.

Regarding the specter of prolonged yoga-induced detriments, Cramer alluded to two studies centered on the degeneration of joints and cervical intervertebral discs in long-term practitioners. However, these studies yielded incongruous results, leading Cramer to conclude, “The extant evidence does not yield unequivocal insights into the long-term health repercussions of yoga.”

When the Journalists at vox.com sought the perspective of MD Anderson’s Cohen, he opined, “Undoubtedly, erroneous execution can yield adverse repercussions, akin to any manipulation of the human form. However, in the presence of a competent guide, this pitfall can be averted.” Even if an extended tryst with yoga were to occasionally culminate in injury, the calculus of whether these liabilities eclipse the benefits or if the alternative pursuits of incessant running or weightlifting would have been more propitious remains a convoluted inquiry, devoid of a definitive resolution.