While yoga is gaining increased popularity in North America and Europe, its safety has been questioned in the lay press. The aim of this systematic review was to assess published case reports and case series on adverse events associated with yoga. Medline/Pubmed, Scopus, CAMBase, IndMed and the Cases Database were screened through February 2013; and 35 case reports and 2 case series reporting a total of 76 cases were included. Ten cases had medical preconditions, mainly glaucoma and osteopenia. Pranayama, hatha yoga, and Bikram yoga were the most common yoga practices; headstand, shoulder stand, lotus position, and forceful breathing were the most common yoga postures and breathing techniques cited. Twenty-seven adverse events (35.5%) affected the musculoskeletal system; 14 (18.4%) the nervous system; and 9 (11.8%) the eyes. Fifteen cases (19.7%) reached full recovery; 9 cases (11.3%) partial recovery; 1 case (1.3%) no recovery; and 1 case (1.3%) died. As any other physical or mental practice, yoga should be practiced carefully under the guidance of a qualified instructor. Beginners should avoid extreme practices such as headstand, lotus position and forceful breathing. Individuals with medical preconditions should work with their physician and yoga teacher to appropriately adapt postures; patients with glaucoma should avoid inversions and patients with compromised bone should avoid forceful yoga practices.

Background: Seniors age 65 and older represent the fastest-growing sector of the population and, like many Americans, are increasingly drawn to yoga. This presents both an extraordinary opportunity and a serious challenge for yoga instructors who must be both a resource and guardians of safety for this uniquely vulnerable group. A typical class of seniors is likely to represent the most diverse mix of abilities of any age group. While some may be exceedingly healthy, most fit the profile of the average older adult in America, 80% of whom have at least one chronic health condition and 50% of whom have at least two. Objectives: This article discusses the Therapeutic Yoga for Seniors program, offered since 2007 at Duke Integrative Medicine to fill a critical need to help yoga instructors work safely and effectively with the increasing number of older adults coming to yoga classes, and explores three areas that pose the greatest risk of compromise to older adult students: sedentary lifestyle, cardiovascular disease, and osteoporosis. To provide a skillful framework for teaching yoga to seniors, we have developed specific Principles of Practice that integrate the knowledge gained from Western medicine with yogic teachings.

Concussion imposes a substantial global health burden, and few evidence-based treatments that approach concussion treatment holistically are available. Moreover, early intervention is important before concussion symptoms become chronic and more refractory to treatment. In this pilot study, we evaluated the tolerability of a protocol called Mindfulness and Yoga for Treatment After Concussion (MYTAC), which was specifically designed for individuals with concussion. We also explored the possible benefit of the MYTAC protocol for concussion recovery. Participants were 15–60 years old with recent concussion and had presented to selected practices within a university health system. Participants used the video-based MYTAC protocol for 5 consecutive days and reported concussion symptoms on an abbreviated version of the Sports Concussion Assessment Tool version 3 (SCAT3). We compared the abbreviated SCAT3 scores across the intervention period, including immediately before and after each yoga session, using standard statistical methods for paired data. Of 25 participants enrolled in the study, 15 completed the MYTAC protocol and 1 completed 2 days of the protocol before withdrawing due to worsening symptoms; the remaining 9 participants did not complete the protocol. On average, total abbreviated SCAT3 scores decreased by 9.9 ± 7.6 points, or approximately 50%, over the intervention period (from an initial value of 18.8 ± 6.7 points prior to the yoga protocol). Although this pilot study had significant methodological limitations, we concluded that the MYTAC protocol had fair tolerability and possibly a beneficial effect on concussion recovery. However, future interventions should evaluate this protocol in larger, more rigorously designed studies.

Teaching yoga to seniors is often considered an entry-level job for a yoga instructor since older adults are unlikely to attempt complicated, “advanced” postures. Unfortunately, this ill-informed attitude puts the most vulnerable students with the least-trained instructors who may unknowingly put their students at risk. Even experienced yoga instructors often do not understand the vulnerabilities of older adults, and many commonly taught yoga poses may present risks for seniors. This could explain why participants aged 65 and older have a greater rate of injury from practicing yoga when compared with other age groups. This article discusses the safety principles central to the Integrative Yoga for Seniors program. Offered since 2007 at Duke Integrative Medicine, this professional training for yoga instructors is designed to help yoga teachers enhance the benefits of yoga for their older adult students by learning how to work safely with the increasing number of seniors coming to yoga classes. Drawing on specific Principles of Practice that we developed to integrate the knowledge gained from Western medicine with yogic teachings, we offer our evidence-informed Relax into Yoga Safety Recommendations to help reduce risk and thus enhance effectiveness when teaching yoga to older adult beginners. We highlight two areas that pose the greatest risk of compromise to older adult students: cardiovascular disease and osteoporosis.

No abstract