Hold that stretch - be safe about yoga

WALNUT CREEK, Calif. - Mark Goldman was a relative newcomer to yoga when he found himself teetering in standing lotus pose with an instructor barking over him like a drill sergeant.

"You can get into this pose," the yogi said. "Push harder."

Goldman, a "typical Silicon Valley" go-getter who works in high-tech sales, took the bait. The harder the better, he thought. He deepened his squat, forcing his knee down. Then - snap.

He'd torn his meniscus, the tissue that aids motion in the knee. Surgery would repair it. However, it would take Goldman, a longtime runner with a stiff body, years to develop a mindful yoga practice more in line with what Indians intended when they developed the lifestyle 5,000 years ago.

He listens to his body. And he doesn't compete with the person sitting next to him. "I'm much smarter," says Goldman, 61, of Los Gatos, Calif. "When I start feeling any discomfort now, I back off."

Yoga is a physical, mental and spiritual discipline with numerous styles. In the West, where the popularity of the postural component has helped yoga to stretch from 4 million practitioners in 2001 to as many as 20 million in 2010, injury - as with any exercise regimen - is a possibility.

Classes are too big, restricting one-on-one attention. Instructors often are inexperienced, missing opportunities to prevent injuries. And the ego - that inner-voice telling us to push - increases chances of pain, even for advanced students. However, experts say that if you develop a practice based on proper form and your own ability, you can avoid injury and reap yoga's benefits, such as stress reduction and heart health.

When you match the postural practice to the person's needs, then you're being true to the intention of yoga, says Roger Cole, a University of California-San Francisco-trained psychobiologist and certified Iyengar yoga instructor of 30 years. Iyengar encourages the use of props such as blankets, blocks and straps to help bring the body into alignment. Cole has studied and written extensively on the topic of yoga injuries. The most common injuries he sees involve the knees, lower back and neck.

"Injuries happen, but when they do either the teacher or the student did something wrong," says Cole, who lives in Del Mar, Calif. "The people I'd be concerned about especially are the ones who are trying to go beyond the limits that they once achieved."

Doris Livezey had been practicing yoga for at least five years when she popped into her San Jose gym for a class. The regular instructor, who often walked around the room adjusting improper form, was out sick, and the substitute had the students in a pose Livezey had never done.

It was a chest opener that involved using a strap to bring your hands behind your back while bending at the hips and allowing gravity to bring your arms forward and over your head. She tried it.

"My left arm didn't make it, and I tore my rotator cuff," says Livezey, who froze her gym membership because of the shoulder injury. It required a cortisone shot for pain. A simple strengthening exercise recommended by a surgeon eventually fixed the problem. By then, Livezey had traded in yoga for hiking and square dancing. However, she still loves doing the basic stretches at home.

"Yoga is a great workout," says Livezey, a 60-something. "But if you have a big class moving quickly through some poses, you can't rely on the teacher to help you. You have to know your body."

Tony Briggs strives to develop an intimate relationship with every student's spine. He brings 34 years of experience, including training under the legendary B.K.S. Iyengar, to every class he teaches at the Berkeley Yoga Center and Turtle Island Yoga in San Anselmo, where he trains soon-to-be-instructors. Injury prevention is one of the things he stresses most.

"I know all of their aches and pains," says Briggs, who uses teaching assistants when there are more than 25 people in class or he's having a hard time seeing everyone. "If I don't recognize someone, I go over and ask, 'Do you have any issues I need to know about?'"

Disclosure can be a problem. Once, he was guiding a student he had known for a few months in a shoulder stand for the first time. In the advanced pose, the student's upper back and shoulders are on the floor while their hips and legs are shooting up to the ceiling in a straight line.

"She looked up from the floor and asked me, 'You think this is OK for my pacemaker?'" Briggs says. He asked her to get out of the pose. Very carefully.

Briggs says the sad truth is that the competitiveness behind so many injuries is not necessarily driven by the students. It often is the teachers who have the ego problems.

"A lot of teachers have an investment in creating razzle-dazzle students," he says, referring to those who can do head stands, deep back bends and other difficult poses. "But yoga is done to make your life work better. It's not about getting better at yoga. Teachers have to be really careful with this."

Noelle Gillies learned that the hard way. She had been practicing yoga for 26 years when she enlisted in a teacher-training program in 2010. One day, the instructor asked her to take over for 20 minutes. Gillies thought she'd start her fellow trainees in a plank pose.

"I wasn't warmed up, and I felt a sort of crunch in my right shoulder," says Gilles, who developed rotator cuff tendinitis as a result. "It was inflamed, and I couldn't move my arm for a couple of days."

Physical therapy put her on the mend, and now, Gillies, 47, practices a therapeutic style of yoga that she loves. Looking back, she says too many people strive for the epitome of the pose.

"You have to take it in steps, not get hung up on the end result, but it's hard in this culture because we're always trying to get ahead," Gillies says.

In her three decades as an orthopedic physical therapist, Linda Meneken has seen hamstring tears and various strains and sprains as a result of yoga. Still, she sings its virtues over its potential dangers with the caveat that anyone who wants to start a yoga practice should consult their doctor. And they should focus on proper alignment and always ask for modifications if they can't do something.

"Pushing through the pain? No, no, no," she says.

5 postures worth pondering

 According to the research of Roger Cole, a UCSF-trained psychobiologist who teaches yoga and studies its effects, these are the five postures most likely to cause injury depending on body structure, previous injury, and fitness level.

Lotus. Avoid this seated pose if you are really stiff in the hips or leg muscles because it can put stress on the inner knee. Some people's joints are aligned and bones are shaped in a way that makes lotus difficult. If it hurts, don't do it.

Forward fold. This seated or standing bend can cause a hamstring tear or compressed or herniated disc in the lower backs of people who push too hard. Aim for a modest curve and gentle stretch of the back.

Shoulder stand. Because of the neck flexion involved in this pose, a stack of blankets should always be used to support and help to elevate the hips and lower back and avoid putting strain on the neck muscles. Otherwise, there is a risk for ligament tears, and, while rare, bone spurs in the neck.

Chaturanga. This flowing pose, which begins as a plank pose that you slowly lower to the ground, is not dangerous but because it's often done multiple times, form can be compromised, resulting in a repetitive strain injury in the back or shoulders.

Splits. Yoga instructors and other flexible types who practice the front-to-back splits and other postures where the pelvis tilts forward can retain muscle tears resulting in scar tissue.

Yoga tips

Practice with common sense. Move slowly, pay attention and ask for help. Poses can be modified.

Know your body. Don't just listen to it. Know your troubled spots and how to avoid irritating them.

The instructor is not king. You don't have to do everything the teacher says.

Practice at your own pace. Don't try to keep up with the person sitting next to you. There may be postures you are unfamiliar with that require more time and patience. Know your limits.

Yoga is about technique. Just like you learn proper technique before starting a weight-training program, you need to practice proper alignment to avoid a yoga injury.

It's all about the breath. If your teacher doesn't integrate breath work in class, find another instructor.

Pain is not good. Don't push into it. Don't hold your breath. Just get out of the pose.

Repetition increases injury risk. Some yoga disciplines employ a set number of the same postures at every class, such as Bikram. Others, such as Ashtanga, move rapidly from one posture to another and can compromise proper form. Both situations increase the chance of injury.

- Sources include Roger Cole and Tony Briggs