Leta Koontz, of Hampton, left, assists as Monique Richards, of Shaler, does a back bend at Schoolhouse Yoga in the Strip District Monday. Experts say the best way to avoid yoga injuries is to choose a good instructor and remember that your practice is not a competition.
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Some measure the soaring popularity of yoga by the skyrocketing sales of yoga books, classes and equipment. Others note that yoga classes are overtaking traditional aerobics classes in popularity in health clubs throughout the nation.
Dr. Johnny Benjamin, chief of orthopedic surgery at the Indian River Medical Center in Vero Beach, Fla., measures the popularity of yoga by the increasing number of patients coming to him for treatment of yoga-related injuries.
"The health benefits of yoga far outweigh the risks," Dr. Benjamin said in an interview. "But like anything in life, it has risks. Anything that's done frequently you'll see in the [doctor's] office frequently."
In 2005, the Yoga Journal commissioned a survey by the Harris polling firm. It indicated that 16.5 million people (7.5 percent of U.S. adults) now practice yoga, an increase of 5.6 percent from the year before and 43 percent from 2002.
Another 25 million people said they plan to try yoga within the next 12 months.
Americans spent $2.95 billion on yoga classes and products in 2004, the Harris survey said.
In 2002, the IDEA Group Fitness Trendwatch survey of health club owners indicated yoga and Pilates classes are surpassing in popularity martial arts-based aerobics and mixed-impact aerobics classes.
According to IDEA, 85 percent of fitness facilities in North America had yoga classes in 2002, up from 31 percent in 1995.
In 2002, Leta Koontz, founder of Schoolhouse Yoga, offered 10 yoga classes per week at one location in Pittsburgh. Today she offers 25 classes per week at two locations, 2401 Smallman St. in the Strip District, and 2010 Murray Ave. in Squirrel Hill.
About 70 percent of the patients with yoga injuries he treats are women, Dr. Benjamin said. This stands to reason, since the surveys indicate about 77 percent of yoga practitioners are women.
The most common yoga injuries are caused by repetitive strain or overstretching and occur chiefly at the wrists, shoulder, neck, along the spine, hamstrings, knees and at the sacroiliac joint (which links the spinal column and the pelvis). Dr. Benjamin said the injury he treats most often is strain of the lower back.
The primary reason for yoga injuries is that the practitioner attempts to do a pose (asana) for which his or her body is unready.
"People will start at a level that is not appropriate for them," Dr. Benjamin said. "A lady might go to a yoga class with a friend who's been practicing yoga for some time, and try to do what she does, and her body isn't ready for it."
"The biggest cause is people doing yoga that they're not knowledgeable enough about," said Dr. Betsy O'Neill, medical director of the integrated medicine program at Allegheny General Hospital, and an avid yoga practitioner.
"It can happen because someone pushes themself too far, or because the teacher is not skilled enough to realize what the student's needs and capabilities are," Dr. O'Neill said.
"What you don't want to do is to tell a person in yoga that they absolutely have to do something," Dr. O'Neill said. "You have to take into account their fitness level and previous experience."
As the popularity of yoga has exploded, so has the demand for instructors. Not all are well qualified.
In a 2002 interview with the BBC, the head of the British Wheel of Yoga, the governing body of yoga in that country, estimated that only half of the roughly 10,000 yoga teachers in Britain at that time had proper qualifications.
The British Wheel of Yoga recommends that instructors complete a four-year training course before teaching others.
There is no governing body for yoga instruction in the United States, but the Yoga Alliance, based in Clinton, Md., maintains a national registry of yoga instructors who have completed at least 200 hours of training.
Dayna Macy, communications director for the Berkeley, Calif.-based Yoga Journal, said yoga instruction in the United States is more "mature" than it is in Europe, so a higher proportion of yoga teachers here are well qualified.
But, Ms. Macy added, "With yoga, it's important to be an informed consumer. You have to be very careful in your choice of a yoga teacher."
The third major contributor to yoga injuries is pre-existing medical conditions in people when they first come to the yoga studio.
"I have blood pressure issues, which can be aggravated by certain poses," Ms. Macy said. "It is critically important to inform your instructor of any medical condition you might have."
The type of yoga practiced can contribute to injury. Bikram yoga, which is conducted in an overheated room, facilitates flexibility, but also can cause practitioners to go beyond a safe range of motion.
Bikram yoga is a series of 26 tightly controlled postures developed by Bikram Choudury, a yoga teacher from India who opened a studio for celebrity clients in Beverly Hills in the 1970s.
More than 300 studios have been certified to teach Bikram yoga worldwide, but none are in western Pennsylvania.
Dr. Sonja Stilp, an orthopedist in Aspen, Colo., who practices Bikram yoga herself, said weak but flexible people are more at risk for injury than strong, stiffer people.
"The weak cannot control their movements, or they have poor control," Dr. Stilp told the Denver Post in a 2004 interview. "Sometimes tight muscles are actually protective."
Yoga is perfectly safe if done properly, and is safer than lifting weights, which is his favorite form of exercise, Dr. Benjamin said.
Perhaps the best way to avoid yoga injuries, Dr. O'Neill said, is to remember that yoga isn't a competition.
"People approach yoga in a typical American way, very competitive, very comparative," she said. "It's almost the opposite of what yoga was designed to be."
Jack Kelly can be reached at firstname.lastname@example.org or 412-263-1476.