Pseudoscience & Religion

Do We Need Yoga?

If you are a yoga enthusiast, it may be worthwhile asking the following questions

  • With so many varieties of yoga being promoted today, each one claiming to be superior and pure, do they have any semblance to the yoga that was practiced in ancient India?
  • Has the therapeutic or preventive efficacy of yoga in any of the states of human health and disease been conclusively proven?
  • Is the practice of yoga totally safe?

Yoga, in its myriad forms, seems to be everywhere. It is being made out that yoga has a very wide presence and acceptance, from Health columns in newspapers to dedicated TV channels, from India to the US, from children to the elderly. The contributions of ancient Indian civilisation to science, mathematics and philosophy are passe; yoga is being branded as India’s greatest contribution ever to humanity. And yoga has opened up great business opportunities for many. While some have opened up exclusive, ‘patented’, yoga schools in corporate style, some others, savvier and adept in feeling the ‘pulse of the masses’, have metamorphosed into big time Poojya Jagadgurus (with the prefixes of Baba or Sri Sri or His Holiness by hijacking and renaming one or two methods of yoga practice. Not to be left behind, the Governments in India, in several states and even at the Centre, have decided to introduce yoga as a compulsory curriculum in physical training, right from the first standard. And the Hindutva Brigade, ever so eager to garner publicity from anything anciently Indian, has usurped yoga into its folds and posits itself at the vanguard of promoting yoga; any skepticism about yoga is branded by these forces as anti RSS, anti BJP, anti Hinduism, anti Indian and even anti national and unpatriotic.

But is the practice of yoga beneficial and necessary? Is it safe?

What is Yoga?

The practice of yoga was prevalent in ancient India, probably among the sages, who lived a very rigorous life, meditating for long lengths of time. It was sage Patanjali (2nd Century BC) who codified this into the Yoga Sutras, considered as the principal treatise on yoga. The practice of yoga has significantly evolved since then, particularly with the Hatha Yoga Pradipika written by Yogi Swatmarama, a sage of 15th century India and a disciple of Swami Gorakhnath. In this treatise, Swatmarama introduces Hatha Yoga as ‘a stairway to the heights of Raja Yoga‘ (of Patanjali), hence a preparatory stage of physical purification that renders the body fit for the practice of higher meditation. In the modern times, along with Patanjali’s Raja yoga, there are innumerable schools and styles of yoga and meditation, namely Agni yoga, Anahata yoga, Artistic yoga, Ashtanga Vinyasa yoga, Bhakti yoga, Bikram yoga or Hot yoga, Disco yoga, Divya yoga (of Baba Ramdev), Dream yoga, Hatha yoga, Hip-Hop yoga, Integral yoga, Iyengar yoga, Jnana yoga, Karma yoga, Kriya yoga, Kundalini yoga, Natya yoga, Power yoga, Restorative yoga, Siddha Samadhi yoga of Rishi Prabhakar, Six yogas of Naropa, Sahaja yoga, Silver yoga, Sivananda yoga, Sudarshana Kriya of Ravishankar, Surat Shabd Yoga, Tanscendental Meditation of Mahesh Yogi, Viniyoga, Yantra yoga, Yoga Nidra etc. Needless to say, each school claims its virtues and their individual popularity is commensurate with the marketing and networking abilities of the proponents. If Baba Ramdev Swamiji Maharaj is said to teach a set of seven pranayamas in a special sequence[1] with some stress on Kapalbhati pranayam, His Holiness Sri Sri Ravi Shankar apparently had to ‘spend 10 days in deep contemplation and silence to gift to the world the Sudarshan Kriya’, branded as a ‘powerful revitalizing breathing technique’.[2-5]

Is there anything common between these several forms of ‘yoga’ and the yoga as practiced in its original form in ancient India? Are they yoga at all?

Is yoga beneficial to health?

Well, a practice that apparently started as a technique of helping the sages to concentrate in meditation has evolved into a all-curative ‘science’. If Baba Ramdev is to be believed, he (His Holiness Swami Ramdevji Maharaj) ‘is first in the world health history, to use freely available Pran (Oxygen) as a medicine and in turn remains successful in treating thousands of grief stricken persons suffering from lethal diseases like Diabetes, H.B.P., (high blood pressure) Angina, Blockages in Arteries, Obesity, Asthma, Bronchitis, Leucoderma, Depression, Parkinson, Insomnia, Migraine, Thyroid, Arthritis, Cervical Spondalities, (that should be spondylitis) Hepatitis, Chronic Renal Failure, Cancer, Cirrhosis of Liver, Gas, Constipation, Acidity etc. which are still a challenge in modern medical science. And his incessant endeavors to measure medicinal value of Pran (Oxygen) will soon give new turn to modern medical science.'[6] And one can learn this heal-all technique by attending his camps (with different rates for front to last rows, usually in thousands) or even learn them free on his TV channel. Mass yoga for mass relief. And the marketing is so effective, even the so called educated and the elite seem to accept these claims without questions. Latest is the relatives of the Union minister Priyaranajan Das Munshi, now on a ventilatory support following a heart attack and stroke, seeking the services of Ramdev.[7] The ministers at the central and several state governments in India are so much convinced about the benefits and safety of yoga that, very soon, training in yoga will be compulsory curriculum for students, right from the first standard.[8,9] But is there any unambiguous evidence that yoga is indeed beneficial for health?

Several studies have been done on the effects of yoga on health and disease. Most of the studies have been done, naturally, in yogic institutions in India[10], and a few in prestigious institutes like the All India Institute of Medical Sciences (AIIMS), Delhi, National Institute of Mental Health, Neuro Sciences (NIMHANS), Bangalore and abroad. Most of these studies have been published in Indian journals and some in International journals too, particularly the journals of complimentary and alternative medical practice. Most of these studies have been small, short term, uncontrolled, non randomised, open with possible bias and without standard inclusion and exclusion criteria, without any standardised yoga modality and most have not provided any details of adverse outcomes.

Effect of yoga on breathing, heart rate, blood pressure, autonomic system, immunity etc. and on diseases like diabetes, high blood pressure, obesity, lipid disorders, cancers, asthma, chronic obstructive airway disease, epilepsy, mood, aggression, anxiety, depression, schizophrenia, obsessive compulsive disorder, attention deficit disorder, eating disorders, bowel diseases, pancreatitis, pregnancy, menopause, fibromyalgia, drug addiction, osteoarthritis, low back ache, thyroid disease, sleep, stroke, multiple sclerosis, carpal tunnel syndrome, kidney and urological disease, geriatrics, migraine, tuberculosis, filariasis etc., have been studied. And as mentioned, many different methods of yoga, like the Ashtanga yoga, Sahaja yoga, Hatha yoga, Kundalini yoga, Iyengar yoga, Silver yoga, Restorative yoga, Siddha Samadhi yoga, Sudarshana Kriya, Integrated yoga etc., and individual practices like Pranayama, various asanas (Shavasana, Sheershasana etc.), Kapalbhati, Kunjal kriya, Anuloma viloma, Mukh bastrika, as well as meditative methods of Mantra, Mindfulness, Transcendental meditation(TM) and Vipassana have been used in these studies.

As it is not possible to cite each and every paper, the conclusions of the various meta analysis and literature review of these studies is provided here.

Maria B. Ospina et al., [11] have reported on the meta analysis of published literature on five broad categories of meditation practices, namely Mantra meditation, Mindfulness meditation, Yoga, Tai Chi, and Qi Gong. Eight hundred and thirteen studies on the therapeutic use of meditation practices, published between 1956 and 2005, were included of which 67% were intervention studies (286 RCTs, 114 NRCTs and 147 before-and-after studies), and 33% were observational analytical studies (149 cohort and 117 cross-sectional studies). Of these, sixty-five intervention studies examined the therapeutic effect of meditation practices for hypertension, other cardiovascular diseases, and substance abuse. Overall, the methodological quality of meditation research was found to be poor, with significant threats to validity in every major category of quality measured, regardless of study design. The majority of RCTs did not adequately report the methods of randomization, blinding, withdrawals, and concealment of treatment allocation. Observational studies were subject to bias arising from uncertain representativeness of the target population, inadequate methods for ascertaining exposure and outcome, insufficient follow-up period, and high or inadequately described losses to follow-up. The authors found that TM had no advantage over health education to improve measures of systolic blood pressure and diastolic blood pressure, body weight, heart rate, stress, anger, self-efficacy, cholesterol, dietary intake, and level of physical activity in hypertensive patients; Yoga did not produce clinical or statistically significant effects in blood pressure when compared to non-treatment and Yoga was no better than physical exercise to reduce body weight in patients with cardiovascular disorders. The authors also analysed 311 studies that evaluated the physiological and neuropsychological effects of meditation practices, the majority of which have been conducted in healthy participants. Although the meta-analysis revealed some consistent physiological effects of meditation practices in healthy populations on the reduction of heart rate, blood pressure, and cholesterol and neuropsychological effect in the increase of verbal creativity, the authors caution that the overall low methodological quality of the studies may result in overestimations of the treatment effects or compromise the generalizability of the study results and therefore, results from meta-analyses of the physiological and neuropsychological effects of meditation practices should be interpreted cautiously. The authors conclude that the field of research on meditation practices and their therapeutic applications is beset with uncertainty, the therapeutic effects of meditation practices cannot be established based on the current literature and firm conclusions on the effects of meditation practices in healthcare cannot be drawn based on the available evidence and it is imperative that future studies on meditation practices be rigorous in the design, execution, analysis, and reporting of the results.

Yoga and Diabetes Mellitus

A review by Innes KE et al., [12] of the possible protection offered by yoga on the risk indices associated with insulin resistance syndrome (IRS) and cardiovascular disease (CVD), identified 70 eligible studies, including 1 observational study, 26 uncontrolled clinical trials, 21 nonrandomized controlled clinical trials and 22 RCTs. According to the authors, collectively, these studies suggested that yoga may reduce many IRS-related risk factors for CVD, may improve clinical outcomes, and may aid in the management of CVD and other IRS-related conditions. However, the methodologic and other limitations characterizing most of these studies preclude drawing firm conclusions and the authors suggest that additional high quality RCTs are needed to confirm and further elucidate the effects of standardized yoga programs on specific indices of CVD risk and related clinical endpoints.

Another review by Innes KE and Vincent HK[13] included 15 uncontrolled trials, 6 non-randomized controlled trials and 4 randomized controlled trials (RCTs) (19702006) that evaluated the metabolic and clinical effects of yoga in adults with type 2 diabetes mellitus (DM) and clinical populations with cardiovascular disorders that included adults with comorbid DM. Although these studies suggest overall beneficial changes in several risk indices, the limitations characterizing most studies preclude drawing firm conclusions. The authors suggest additional high-quality RCTs to confirm and further elucidate the effects of standardized yoga programs in populations with type 2 DM.

A review of yoga programs for four leading risk factors of chronic diseases by Kyeongra Yang [14] included 32 articles published between 1980 and April 2007. Although the studies found that yoga interventions were generally effective in reducing body weight, blood pressure, glucose level and high cholesterol, only a few studies examined long-term adherence and not enough studies included diverse populations at high risk for diabetes and its related common health problems.

Another review of yoga in Type 2 diabetes mellitus by Aljasir et al.,[15] included five trials with 363 participants that met the inclusion criteria with medium to high risk of bias and different intervention characteristics. Pooling of the studies was not possible due to the wide clinical variation between the studies. The studies showed improvement in outcomes among patients with type 2 diabetes, but these were mainly among short term or immediate diabetes outcomes and not all were statistically significant. The results were inconclusive and not significant for the long-term outcomes. No adverse effects were reported in any of the included studies. The authors conclude that short-term benefits for patients with diabetes may be achieved from practicing yoga, but further research is needed in this area and a definitive recommendation for physicians to encourage their patients to practice yoga cannot be reached at present. They further suggest that factors like quality of the trials and other methodological issues should be improved by large randomized control trials with allocation concealment to assess the effectiveness of yoga on type 2 diabetes.

Yet another review by Alexander GK et al.,[16] concluded that although yoga has a positive short-term effect on multiple diabetes-related outcomes, long-term effects of yoga therapy on diabetes management remain unclear.

Yoga and Cancer

An evidence-based review of yoga as a complementary intervention for patients with cancer by Smith KB and Pukall CF [17] included ten studies of which six were RCTs. Across studies, the majority of participants were women, and breast cancer was the most common diagnosis. Methodological quality ranged greatly across studies, with the average rating indicating adequate quality. Studies also varied in terms of cancer populations and yoga interventions sampled. The authors concluded that although some positive results were noted, variability across studies and methodological drawbacks limit the extent to which yoga can be deemed effective for managing cancer-related symptoms and suggested that further research in this area is certainly warranted.

Yoga and Hypertension (High Blood Pressure)

According to Dosh SA,[18] the limited studies evaluating yoga and meditation in the treatment of hypertension have focused on reduction in blood pressure rather than patient-oriented outcomes, such as a reduction in morbidity and mortality. Although Transcendental meditation and yoga may have been shown to reduce blood pressure, the studies of these modalities are small and the experimental designs have a limited capacity to detect an independent treatment effect or a placebo effect. Therefore, physicians who include any of these modalities in their hypertension treatment plan should carefully monitor each patient for adequacy of blood pressure control, development of risk factors, and evidence of end-organ damage. At this time, alternative therapies should be considered experimental adjuncts to lifestyle modification and medical therapy that have not been shown to improve patient-oriented outcomes.

Yoga and epilepsy

A review of yoga for control of epilepsy by Nandan Yardi [19] concluded that there is a dearth of randomized, blinded, controlled studies related to yoga and seizure control and that a multi-centre, cross-cultural, preferably blinded (difficult for yoga), well-randomized controlled trial, especially using a single yogic technique in a homogeneous population such as Juvenile myoclonic epilepsy is justified to find out how yoga affects seizure control and quality of life (QOL) of the person with epilepsy.

A Cochrane Review of yoga for epilepsy could not draw any reliable conclusions.[20]

Yoga for anxiety and depression

A review of the studies on yoga in the treatment of depression by Karen Pilkington et al.,[21] included five randomised controlled trials, each of which utilised different forms of yoga interventions and in which the severity of the condition ranged from mild to severe. All trials reported positive findings but methodological details such as method of randomisation, compliance and attrition rates were missing. No adverse effects were reported with the exception of fatigue and breathlessness in participants in one study. Although the initial indications are of potentially beneficial effects of yoga interventions on depressive disorders, variation in interventions, severity and reporting of trial methodology suggests that the findings must be interpreted with caution and further investigation of yoga as a therapeutic intervention is warranted. The authors also opine that several of the interventions may not be feasible in those with reduced or impaired mobility.

A review of complimentary therapies for depression by Jorm et al.,[22] identified thirty-seven treatments and found some limited evidence to support the effectiveness of yoga breathing exercises. None of the treatments reviewed was well supported by evidence as for standard treatments such as antidepressants and cognitive behaviour therapy, and many warrant further research.

A review of eight studies on the effectiveness of yoga for the treatment of anxiety and anxiety disorders by Kirkwood et al.,[23] found that although some positive results were reported, there were many methodological inadequacies. Owing to the diversity of conditions treated and poor quality of most of the studies, the authors of the review concluded that it was not possible to say that yoga was effective in treating anxiety or anxiety disorders in general and recommended further research.

A Cochrane Review on meditation therapy in anxiety disorders [24] could not draw any conclusion in view of the availability of only two RCTs of moderate quality that ranged from 12-18 weeks. The overall dropout rate in both studies was high (33-44%) and neither study reported on adverse effects of meditation.

Yoga for asthma

Use of complementary and alternative medical (CAM) practices by the patients of asthma is quite common, with some reports suggesting that as many as 30-40% of asthmatics have tried CAM.[25] Breathing exercises and yoga have been widely used to treat asthma in Eastern and Western societies for many years, and generally centre on manipulating the respiratory pattern to reduce respiratory frequency and hyperventilation. It is still, however, far from clear whether or not breathing exercises can improve asthma outcomes, in which groups they may be effective, or what the mechanism of effect may be.[26]

A Cochrane review of breathing retraining in asthma[27] included seven randomised or quasi-randomised controlled trials in patients of all ages, two of which were on yoga. The techniques of teaching breathing retraining as well as the length and frequency of the treatment interventions varied considerably; 45 minute sessions of yoga breathing training three times a week for 16 weeks in the one and for 2.5 hours for two weeks in another. As the outcome measurements also varied considerably, the authors concluded that at present no reliable conclusions could be drawn concerning the use of breathing exercises for asthma in clinical practice.

Another review by Thomas Ritz of Stanford University [28] included six controlled and three uncontrolled studies done between 1980 and 2000 that employed a variety of methods, such as progressive relaxation, functional relaxation, autogenic training, or yoga. Most studies had low sample sizes and suffered from one or more methodological deficiencies, such as suboptimal data analysis, high dropout rates, problematic measurement procedures, or insufficient descriptions of methodology and results. Overall effects on parameters of lung function, symptoms, medication consumption, and health care use were generally negligible.

Another review by Lane DJ and Lane TV [29] concluded that there is no place for any alternative approach in the management of the vast majority of cases of acute, severe asthma. However, some patients of persistent asthma could benefit from such approach and techniques such as yoga deserve further evaluation. The authors suggest that as all asthmatic patients cannot respond, it is important to find ways of identifying those who will. They also suggest that some form of regulation should be exercised over non-medicinal alternative medicines to ensure that they are marketed only when they too have statutory standards of efficacy and safety.

Claudia Steurer-Stey et al.,[30] also opine that except for four controlled trials, most of the studies showing beneficial effects of yoga in asthma were short term, uncontrolled and qualitative trials, and even though breathing techniques and muscular relaxation may have some potential, it is not possible to make a firm judgment.

Yoga for chronic pain

A review of eight mind-body interventions for chronic pain in older adults [31] concluded that there is not yet sufficient evidence to conclude that these interventions reduce chronic nonmalignant pain in older adults and that further research should focus on larger, clinical trials of mind-body interventions.

Yoga and children

A systematic review of the literature on the effect of yoga on quality of life and physical outcome measures in the pediatric population by Galantino ML et al.,[32] included 24 studies of which none could be considered as of high quality. Although description of randomization was clear throughout all studies, there was little data that described outcome assessments with regard to the method of blinding, no information on intent-to-treat analysis, and what happened to withdrawals and dropouts. None of the reviewed studies provided adequate data to assess improvements in QOL over a significant part of childhood and adolescence, as most were of short duration. Also there was a wide variability in study interventions with many different types of yoga regimens prescribed. A further limitation was the non-specificity with respect to the timing of the yoga intervention. Clinical heterogeneity was evident, particularly, in trials carried out during treatment for asthma raising concern about confounding issues. The reviewers also felt that the poor adverse event reporting in most of the studies limited any conclusions about the relative safety of yoga as an exercise, and the small samples provided insufficient power to detect meaningful differences in rates of rare adverse events. Even though all the studies showed an effect, this may be due to researcher or selection bias and the promising preliminary results are based on a relatively small number of trials with significant methodological weaknesses. Therefore, the authors recommend that research is needed to determine the best forms of yoga for children with specific impairments and to establish a doseresponse relationship for children of different ages.

Yoga and memory

The most appealing benefit ascribed to yoga and meditation is that the practice enhances memory and concentration. Interestingly, there are no studies that prove any such benefit! While some very small and short studies on limited functions have shown some benefit [33-36], other studies have shown no benefit at all.[37,38]

Research of Ramdev

‘Baba’ Ramdev claims that his research has “proven yog results”.[6] And this is the research he has quoted on his website: Ten patients of diabetes, results of blood sugar done 8 days apart; eight patients and cholesterol, studied after 8 days; cold and flu, “coming soon”; arthritis, “coming soon”; Osteoporesis (?), “coming soon”; depression, “coming soon”; kidney disorders – studied in 6 cases, most are near normal and improvements not significant; and of the ‘research’ on ECG and pulmonary function tests – no details available, except the mention that results were abnormal and some improved.

Two papers from Ramdev’s Patanjali Yog Peeth have been published, not as full papers, but only as Letters to the editor. The study by Manjunath Krishnamurthy and Shirley Telles [39] had drop out of 22% and 47% cases from yoga and ayurveda groups respectively and yet claimed significant improvement compared to wait-list controls, who had 13% drop outs. And one wonders how the pilot study on the impact of yoga and pranayam on obesity, hypertension, blood sugar, and cholesterol [40] ever got published as the authors themselves have admitted that there were ‘several drawbacks, short comings’, that it was not controlled, that the ‘glucometer was malfunctioning'(!?), that the ‘measurements were done at 6-7 days’ (and yet showed significant weight loss and other benefits (?!), that ‘it was not known whether they were sustained’ and that the ‘weight loss could also be due to dietary modification’ etc. Other samples of ‘research’ by Ramdev and his ‘disciples’ are also of similar quality [41,42] and if these can be called as ‘research’, anything else shall pass.

Research on Sudarshan Kriya

Some pilot studies have been reported on the benefits of Sudarshan Kriya of Ravishankar and almost all authors have recommended larger, randomised, controlled studies with robust design to confirm the findings. [43] However, the Art of Living Foundation proclaims that independent medical research has demonstrated significant benefits of these programmes and this explains why the workshops taught by the Art of Living are such a rage the world over![44]

Marian Garfinkel,[45] Director at BKS Iyengar Yoga Studio of Philadelphia, PA, USA feels that most alternative therapies have not been evaluated using clinically controlled trials and that as a result, a National Institutes of Health expert panel concluded that current evidence is inadequate for the development of high quality trials. Quoting Fontanarosa and Lundberg [46] that ‘some advocates of alternative medicine argue that many alternative therapies cannot be subjected to the standard scientific method and thus, instead must rely on anecdotes, beliefs, theories, testimonials, and opinions to support effectiveness and justify continued use,’ he asserts that the lack of complete studies and the lack of evidence on safety and outcomes are unacceptable and additional research should be completed. He feels that as yoga and other alternative therapies are difficult to evaluate, these investigations should not simply assess symptomatic relief but must take advantage of modern research techniques and look at objective effects on cells and organs.

Why do we then have to believe the claims that yoga is a tonic for each and every problem of mankind?

Is Yoga Safe?

On the one hand, most of the published studies on yoga do not provide much information on the adverse outcomes and some of them have had high drop outs for unexplained reasons. On the other, there are several reports to show that the practice of yoga can result in complications, from simple headache to severe, irreversible neurological damage. The Consumer Product Safety Commission of the US reported over 13,000 cases treated for yoga-related injuries in an emergency room or a doctor’s office in three years.[47,48] Cases of musculoskeletal injuries and fractures[49-52] (even among yoga teachers[52]), stroke [53-55], cervical spinal cord injury[56], foot drop[57], pneumothorax[58], subcutaneous and mediastinal emphysema[59], rectus sheath hematoma[60], dental erosion[61], increased intraocular pressure and glaucoma[62-66], fatal air embolism[67] etc., have been reported.

It is an accepted fact that injuries do occur while practicing yoga. These have been blamed on the too ambitious participants who try to force their bodies into positions they are not ready for or who are inattentive to the ‘messages of their bodies or instructors’ or on failure of the instructors to give proper modifications.[68] Muscular injuries like pulled hamstrings are said to be commonly seen in yoga classes, strains of the hip flexors, the neck and the low back are also said to be common. Certain yoga postures can place a lot of stress on bursae in the shoulders, elbows and wrists and overuse can lead to bursitis or tendinitis around the shoulder or elbow, exacerbate carpal tunnel syndrome or produce wrist strain. Hyperextension of the knees or elbows may cause tear or pinch of the menisci, ligaments or the joint cartilage. Herniation, fractures and degeneration of intervertebral discs are some of the more serious yoga injuries.[68]

In a survey of musculoskeletal injury among 110 Ashtanga Vinyasa yoga practitioners, a total of 107 musculoskeletal injuries were reported and 68 practitioners (62%) reported having had at least one injury lasting longer than one month, and some practitioners reported more than one injury. The rate of new practice-related injuries was 1.18 injuries per 1,000 hours of practice. If recurrence of pre-existing injury and non-specific low back pain of unknown origin were included, the injury rate became 1.45 injuries per 1,000 hours of practice. The three most common injury locations were hamstring, knee, and low back.[49]

A case of a fracture separation of the epiphyseal plate of the distal tibia in a 15-year-old girl during the execution of a yoga posture has been reported[51], raising concerns about the safety of yoga in growing children.

When a 14 year old boy died at a yoga camp organised by Baba Ramdev[69], the self-styled yoga guru initially refuted it to be due to yoga, only to turn around the very next day to caution his followers to be careful with the practice of yoga![70]

The fact that yoga may not be safe is acknowledged by many who have expertise in yoga. According to Vijai P. Sharma, PhD, of the Behavioral Medicine Center, Cleveland, TN,[71] slow-breathing pranayama, including techniques such as bhramari, shitali, sitkari, or nadi shodhana, pose relatively low health risks as long as the practitioner employs steady attention, patience, discipline, and, above all, does not exceed his or her comfortable capacity. But kapalabhati and bhastrika, both rapid breathing techniques, (extensively mass propagated by Ramdev and Ravishankar respectively) pose greater risk. He cautions that some practitioners seem to throw all caution to the wind in their enthusiasm for pumping their breath faster and faster, thereby increasing the risk of hyperventilation. Furthermore, he says, indiscriminant practice of kapalabhati and bhastrika may reinforce or worsen preexisting structural or functional problems and excessively strain the cardiopulmonary system. Cautioning that rapid breathing pranayama techniques may aggravate a pre-existing structural or medical condition, or cause significant pain and discomfort, he suggests to avoid practicing kapalabhati and bhastrika in conditions such as lung disease, pregnancy, recent unhealed surgeries, especially of head, neck, and trunk, significant degree of scoliosis, low or high blood pressure, diabetes, kidney disease, seizures/epilepsy, ear, nose, or eye diseases, chronic head pain, migraine, or cluster headaches etc., (what is left?!). Unless practitioners exercise out-of-the-ordinary patience and self-control, he says, rapid breathing techniques such as kapalabhati and bhastrika are likely to be performed incorrectly and prove harmful in the long run.

Marian Garfinkel [45] feels that if performed incorrectly, asanas can be injurious and exacerbate the problem being treated. According to him, it is critical to know how to begin yoga for treatment. As all yoga is not the same, the wide variation among teachers and practitioners who offer yoga-based approaches to treatment can confuse both physician and patient and picking a yoga teacher may be more difficult than picking a physician. He also cautions that many Western-oriented presentations about yoga that exaggerate and make extravagant, inappropriate claims should be viewed with caution.

Is Yoga Necessary?

Considering the above, the following are clear:

  1. The practice of yoga was developed by the sages and yogis in ancient India who meditated rigorously and led a punishing life. The need and applicability of these practices in the day-today life of commoners of the present day is unclear.
  2. Today, there are several schools of ‘yoga’ that claim to offer the benefits of the Ancient Indian Yoga. Many of them have modified, simplified, renamed or repackaged the original practices mentioned in the Yoga Sutras of Patanjali or the Hatha yoga Pradipika. The basis of such modifications remain unclear and it is also not clear whether these modern versions have whatever utility that the ancient yoga practices had. David Shapiro, PhD of Geffen School of Medicine, University of California, Los Angeles, a long time academic researcher and teacher, and an Iyengar Yoga practitioner for more than ten years, feels that the diversity of Yoga schools, methods, and theories is a serious complication.[72]
  3. The many studies that have been published have used different yogic practices in different settings in different patient groups, selected on differing criteria. All the meta analysis and reviews of the published research have concluded that most of these studies are of poor quality and not standardised. Therefore, it is not possible to arrive at any sweeping conclusions about the utility or adverse effects of yoga based on these studies.
  4. Many studies on yoga have had very high drop out rates, as high as 50%, with no mention made about adverse outcomes or reasons for drop outs and many studies are silent on complications and adverse outcomes. On the other, there are many case reports of serious complications from yoga and some practitioners and experts of yoga advise caution in the practice of yoga.
  5. All studies of yoga in children are small, short and open without any details on adverse outcomes and no studies are available in very young children. Absence of data on the safety of yoga in children and reports such as a case of epiphyseal fracture separation in a 15 year old girl should alert us to be cautious. In addition, there are several restrictions regarding food, dress and time of practicing yoga, making it almost impossible for kids to perform yoga at school. Also, several yoga practices are restricted during menstruation and hence complusory yoga tarining in schools may be awkward and embarrassing for girls and their parents.

It is therefore reasonable to suggest the following:

  1. Yoga may have limited use on individual basis, and the type of yoga or its asanas etc., should be carefully chosen on the basis of the individual’s health status and needs, in due consultation with the treating doctor and well trained yoga therapist, choosing whom may be a daunting task..
  2. Sweeping statements that yoga is effective for all, in all ages, for all diseases and that it is totally safe are not supported by evidence and the practice of yoga on the basis of such belief may not be advisable.
  3. There is no data on safety of yoga in young children. Diseases like congenital heart disease, childhood asthma, deformities of the joints and especially the spine, may pose risk among kids.
  4. Therefore, practice of yoga in mass sessions or in front of the TV or in school premises, without proper evaluation of the subject and proper interaction with the trained yoga therapist may not be useful and may be even risky.
  5. Therefore, compulsory yoga education for students by physical education teachers from class 1, as is being planned by many states and even the Central government of India, is not desirable under any circumstances.


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About the author

Srinivas Kakkilaya

Physician practicing at Mangaluru, South India


  • Dr. Srinivas.
    You have bought out some points I have not thought of before.
    But one I can comment on regarding Yoga for All- it’s true there is no one approach or therapy that is a cure all for any and everyone. It is true yoga can not be practiced by all for a number of reasons- one being it does take a certain personality and constitution to want to practice yoga.

    Your other point on how yoga can affect ‘commoners’ is interesting. I never thought about that angle before as that is the only angle that has been presented to me. Though, when you look at yogis living in the Himalayas – unclothed and able to control their own circulation and live in those environments, there is truth that a commoner- a person living in the day to day modern would would really have a challenge to do something like this if it is possible at all…

  • Hi Ajit, Junk cannot be science, it is only junk. Rishis (at least some of them in the olden times, not the yogis of modern times) were men of learning and some of them were even atheists. Many of these things have been passed down through verbal communications – smritis.

  • Srini, We hear of the the yogis of those days only through stories. Data through verbal communications is always corrupted along the way. Vedic science etc is all very primitive. Evidence is clear that the body of knowledge is far ahead today than in the days o the yogis. Here is an interesting website btw. 🙂

  • Dear sir,
    If vedic knowledge is true than where is it now .and if it is in verbal form but nobody knows which is authentic and unanimous among yogis also.
    rubish without evidence and trials is not a science.

    • Don’t you think so called yoga of today is simply the extended and twisted form of physical exercise? Moreover it appears to be a convenient tool of political mobilization in the hands of Religious right in the Indian context.

      • Certainly. The so called Divya yoga of Baba or the renamed yoga of Sri Sri or any other similar ones have nothing in common with the original Yoga sutra or Hatha yoga. These are more of circus.

  • Do we need a cellphone?

    Have the companies done enough studies on the effects of cellphone use on human health, which conclusively show that cellphones are 100% safe to use? Why, then, do they have certain warnings regarding cellphone use involving kids? Were these studies done by independent organizations with no conflict-of-interest? What is the environmental impact of using a cellphone for a year or two and then casually tossing it in garbage, including its battery which is toxic to soil and water? Am I contributing, or did I contribute to the bloodshed in Congo by buying a cellphone, since it requires coltan? Ethical concerns stemming from that?

    Funny that the phone companies never address any of these issues in their glossy ads.

  • Sure, all legitimate questions. But completely irrelevant to the topic here 🙂

    Im not sure if you are implying the postmodernist perspective that all things have equal truth value or the nihilist perspective that there is no truth to anything.

    In either case, it is not useful to anyone and does not contribute to the conversation. Science and reason work when people consider specific issues and debate the evidence, not when people dismiss all dialogue as meaningless.

  • “Im not sure if you are implying the postmodernist perspective that all things have equal truth value or the nihilist perspective that there is no truth to anything.”

    Neither. I don’t care for such labels. It’s just food for thought.

  • “Science and reason work when people consider specific issues and debate the evidence, not when people dismiss all dialogue as meaningless.”

    Exactly my point, and I’m not dismissing all dialog as meaningless – where do you get such idea from? It’s a good test to see whether those, who advance reason and claim to be its champions, themselves applied reason to their own actions and asked some scientific questions, or did they simply jump on the “I got a cool cellphone” bandwagon without giving their decision some thought. That’s all.

    • Then we are in agreement! I guess I was wondering where you were coming from, and jumped to the premature conclusion that you were dismissing this very relevant article on postmodernist grounds. A true skeptic should indeed be critical of all popular claims.

      • This is very interesting!

        The topics are dead once some 10 to 12 comments fly this way and that way.

        The balancing poses of yoga are known to enhance the neuron activity and benefit growths in left and right lobes of brain.

        Active component of Yoga may cause some discomfort and also may be harmful to some, definitely.

        Most cultures practice their ancient arts and are not much apologetic about them.

        The karate is a very violent sport needing years of practice, and potentially every bit injurious.

        Is it common for rationalists to pass such “balanced” comments about these things also or the balanced comments reserved for Yoga alone.

        Collecting a group of totally uninitiated 500 or thousand persons and getting to do them a vigorous routine should be prima-facie risky for any physical activity. Isn’t it amazing that bad press is almost negiligible for Ramdev brand of Yoga?

        So is yoga beneficial or not? Is it harmful or not? Do we have to take precautions and not expect much? Or do we need to do it carefully , with benevolent hopefulness, and evaluate the benefits against the possibility of not doing it at all and avoid the ill effects if any.

        We are ofcourse free to take the life as it comes and enjoy the benefits of rationalism. In the meanwhile stress of modern life can keep claiming its young victims dying at 35 years of heart attack etc.

        • I am not sure who you are addressing with your comment, because nothing in it is relevant to my comment although you seem to have replied to it. Regardless, the one thing I will say is that the argument that we should not criticize one idea because other ideas may be as bad or worse, is not logically consistent. This article is about yoga, not karate or sandwiches or bollywood movies. There are specific claims in the article none of which you address in your dismissal of the criticism.

        • >>The balancing poses of yoga are known to enhance the neuron activity and benefit growths in left and right lobes of brain.
          What is the evidence?

          Yoga is today branded as an alternative system of treating and preventing diseases! And the statements like the ones you have made, quoted above, are used to support such attempts and that is what I have tried to expose.
          Yoga did not originate as a means of preventing or healing ailments, nor as some form of exercise nor as a sport. Karate originated as a martial art and remains so (or as a sport) even to this day. Why should anyone object to that? If attempts are made to promote karate as an alternative system of medicine or anything else than what it actually is, that has to be questioned. If it has to evolve into something else, let it be proved first. Ditto yoga.

          It is NOT amazing that yoga or Ramdev do not get bad press. Skepticism is a rare thing. Our attempt is to change that.

          By not doing yoga one is not going to lose anything.

          • Dear Srinivas,

            Skepticism is not so very rare with highly educated.

            I think, and this is a general observation, not directed at any particular individual,
            it applies to myself also in equal measures:

            The highly educated tend to over-rate their own work. An MBA in Lehman brothers thinks he is doing greatest of services to mankind. A bully HR or IT manager makes his own rules of ethics. Corporate entities are known to force good people to do bad things.

            A famous rule has been “dont do to others what you will not like to be done to you.”

            Most people know this, but to be effective in the “real world” they willingly break the above rule.

            What has this got to do with yoga?

            ‘Knowing’ what is ethical is not enough for ‘Being’ ethical. Yoga makes the change possible at physiological level, and therefore more durable.

            Yoga is a subtle change maker. Just in ‘one day’ after doing yoga you do not become most ethical or most saintly. But after trying to follow the Eight-fold dicsipline even for six months or so, you start noticing many things.

            I am a scientist ( a physicist doing reasonably well in my profession 😉 ) and a yoga teacher for last 30 years.

            I have seen the changes and I am familiar with stages in which it occurs for a varied set of people.

            The highly strung often say that before doing yoga, they did not even know that they were “tense” all the time.

            They, so to say could perceive two different states of their minds, one very tensed, very aggressive, very intelligent; but intolerant of any thing other than own thoughts.

            (Even if it was a exactly opposite to what they held a minute before, such is the sense of supremacy that ‘they’ are right all the time.)

            The transformation to a bully from a rational reasonable person takes very short time. Opposite needs more effort and takes much longer.

            After ‘doing’ yoga for a month to six months these very individuals start seeing folly of what they were doing, they are able to experience a “different” and really ‘reasonable’ state of their being. They start becoming better managers and more creative as individuals.

            The mechanics of creativity : how it oscillates from ‘passionate go getters’ to ‘relaxed meaningful achievers’ it self is a subject matter of study. I have not seen many perceptive articles on this.

            So is yoga a mere physical, low impact, exercise? or Does it enhance mental activity? Is meditation different than yoga? Can you perform a yogasan in a meditative state of mind? Is there a scientific proof of enhancement of brain activity by yoga and/or meditation?

            Perhaps a google search can yield reference to few positive articles.




            Ravi Khardekar


            Dear Ajita Kamal, As a strategic decision I avoid making point by point answers, . The ‘rigourous’ and ‘precise’ language obscures meaningful aspects of life more, therefore.

          • Dear Khardekar, Skepticism and levels of education may not have much in common. A rocket scientist consulting an astrologer to fix the time of take off is the best example of a highly educated non-skeptic! On the other, one need not have any formal education to be a skeptic. Being skeptical is also the humblest thing, not the greatest.
            >>Perhaps a google search can yield reference to few positive articles.<<

            Please go through the list of references that I have provided.

            If yoga can indeed transform bullies into reasonable ones, the best candidates to try yoga upon would be the criminals lodged in jails. Have such attempts been successful?

            As for individuals finding benefits etc., please read the last paragraph of my article again.

          • Dear Dr. Srinivas,

            Your article is a well researched article and it addresses a serious concern. The claim by ‘alternative healing’ groups of treating diseases and claiming to replace established scientific medical knowledge is not altogether correct.

            I am however approching the subject from other side. The May 12, 2009 article in Phys Org ( an extract is reproduced at the end of my comment)


            is again a scientific study about enhancement of beneficial brain function by meditation. The clear signature of left lobe activity leading to lasting happiness is significant.

            There can be two views on this.

            Pro-view : is that such physically altered state of mind is just the beginning of a totally new series of experiences. The “brain” is the ultimate instrument human beings possess. Like a nuclear physicist, who devotes years in developing a new detector with totally new and sensitive electronics having unprecedented low noise, and then detects new particles, new phenomenon. Tuning of brain as detector-cum-analyser ( system-on-a-chip paradigm) is the main goal of yoga/meditation systems. New research with highly modern ‘high resolution MRI’ is confirming this.

            Contrary View: The achievement is just that- an alteration of brain function. And it is the source of “delusion” that all spiritualist suffer from.

            I am aware that on a site like NIRMUKTA devoted to mainly removal of ‘andha shraddha’ and to ‘breaking the spell’, the second view may find more favor.

            But I am for breaking all kinds of spells , ‘irrational’ as well as ‘rational’, therefore I like to investigate this research from first ‘pro’ view point.

            One thing is clear , before May 12, 2009 report with high resolution MRI, even saying that meditation alters brain at physiological level would have been questionable.

            The difficulty in my view is, that very sophisticated instruments and very unbiased investigators are needed to definitely be able to say that ‘yoga is harmful’, or ‘yoga is beneficial’. Collection of thousands of studies below the threshold of detection, will never be able to prove a point.

            Conducting studies on a mixed population is also a serious mistake. It is like making a meta statement that ‘fruits have very low sugar content’ by including unripe fruits prominently in the studies.

            University of california has rightly selected meditators with long practice and they must have spent good amount of funds in carrying out a proper study.

            In India studies of this level will not be possible. Therefore I like to filter out the noise and ‘below threshold’ work, to form my opinions.

            I am very hopeful that as science progresses, the veracity of most yogic percepts will be established scientifically. The lead will also come from western scientists only.

            Ravi K

            “Other research by Paul Ekman, of the University of California San Francisco Medical Center, suggests that meditation and mindfulness can tame the amygdala, an area of the brain which is the hub of fear memory. Ekman discovered that experienced Buddhists were less likely to be shocked, flustered, surprised or as angry as other people. Flanagan believes that if the findings of the studies can be confirmed they could be of major importance. “The most reasonable hypothesis is that there is something about conscientious Buddhist practice that results in the kind of happiness we all seek,” Flanagan said in a report in New Scientist magazine.

            Meditation mapped in Monks – March 1, 2002 – BBC

            During meditation, people often feel a sense of no space. Scientists investigating the effect of the meditative stateon Buddhist monk’s brains have found that portions ofthe organ previously active become quiet, whilst pacified areas become stimulated. Using a brain imaging technique, Dr. Newberg and his team studied a group of Tibetan Buddhist monks as they meditated for approximately one hour. When they reached a transcendental high, they were asked to pull a kite string to their right, releasing an injection of a radioactive tracer. By injecting a tiny amount of radioactive marker into the bloodstream of a deep meditator, the scientists soon saw how the dye moved to active parts of the brain.
            Later, once the subjects had finished meditating, the regions were imaged and the meditation state compared with the normal waking state. The scans provided remarkable clues about what goes on in the brain during meditation. “There was an increase in activity in the front part of the brain, the area that is activated when anyone focuses attention on a particular task,” Dr Newberg explained. In addition, a notable decrease in activity in the back part of the brain, or parietal lobe, recognized as the area responsible for orientation, reinforced the general suggestion that meditation leads to a lack of spatial awareness.

            Dr Newberg explained: “During meditation, people have a loss of the sense of self and frequently experience a sense of no space and time and that was exactly what we saw.” The complex interaction between different areas of the brain also resembles the pattern of activity that occurs during other so-called spiritual or mystical experiences.

            Brain Images provide painless study”

          • I must appreciate your keen interest! Several hundred studies have been done on the effects of yoga, mostly in India. Most of these are uncontrolled, small, short term and inconsistent. There have also been studies on plasticity of the brain and changes in the brain with relations to different human activities. It is not surprising that brain tissue shows changes in some, but how much of these are due to a single factor is to be further probed. That would require larger sample size, better controls and comparison between different human activities, like non-meditative concentration techniques, various forms of exercise etc. This applies to the sense of loss of space too; it is well known that anything that involves deep concentration, even reading or music, can lead to similar experience. Until such studies are available, over enthusiastic promotion of yoga as a panacea for all ills should be withheld. Meanwhile, individuals are free to experiment, fully aware that such practices may not be effective or safe.

  • It sounds like you’re creating problems yourself by trying to solve this issue instead of looking at why their is a problem in the first place.

  • I have been doing/practicing yoga as a form of exercise and thats all it is, a low impact exercise and thats what i treat it as till there is any evidence to support any of the claims that “yogi’s” make.
    On the other had as to whether yoga as its currently practiced is what was formalised by by Patanjali; I would assume so, due to the oral transmission techniques used for the vedas tended to use a lot of error checking and redundancy.

    • Patanjali’s Yoga Sutras are about dhyanas and control of mind. The Asanas are described in Swatmarama’s Hatha Yoga Pradeepika. The original texts (without interpretations) make interesting read in the present context. Both these are at least 1500-2000 years post vedic. The very many schools of yoga that are prevalent today have nothing much in common with these texts, except quoting them for authenticity.

  • nothing wrong with yoga. yogis are the problem. especially the likes of dhongi sadhus who are homophobic. such as one popular bearded one lately who thinks he can expound on the sex lives of others, not having one himself.

  • Remove the superstition and the practice of yoga for physical health and clamness of mind is very practical.
    A lot of the health claims are unverified. As physical exercise … with a proper and cautious approach, as we should approach all exercise, yoga practice can be very helpful.

    • Yoga is a practice rooted in ascetic movements of India, not designed for health promotion in its origin. All the hype is very recent and unconfirmed so far. Those who believe these claims and try it do so at their own risk. And not necessarily with any benefits. There are many other safer, easier, proven methods of exercise/techniques for the body and the mind.

      • Your article is very much research based on medical science and good.Here only, you have mentioned about real purpose of yoga. It was formulated for ascetics to reach heaven and merge with god. Not to family holders. Tibetan yoga text termed Yoga as Art of dying. In Tamil, Thirumoolar detailed very clearly purpose and methods of Yoga in book called Thirumanthiram. Patanjali adopted only some portion for his Yoga sutra during Bhakti movement in 9th century CE. Today, yoga is nothing but physical exercise with false notion with lot of imaginary medical terms to cure all diseases. Using name of Patanjali or other Hindu religion is cheating the world.

  • I reread your last paragraph and while I do agree asana practice can be dangerous for certain people, I do not see a simple yoga practice for a healthy individual with simply and good physical exam and approval by hi or her physician to be that risky.

    I question the safety of some practices, like headstand … which I no longer do … and abdominal “pumping” exercises like khappalbhati if the person has a hiatal hernia.

    I think the “dangers” of yoga have been greatly exaggerated and simple common sens is required.

    Incidentally, I am 53 years old and have practiced yoga for 20 years. I have bipolar disorder and I think it is helpful at times.

    • Benefits of yoga do not outweigh its risks and these risks are not mentioned at all in most of the yoga related literature. I have not exaggerated the ‘dangers’, but only brought them out for our readers. With so many riders attached to the practice of yoga, there are much better options available instead of yoga.

  • With all due respect,what other options are better? It’s not that different if approached properly. It’s really a matter of what’s appropriate for the person and personal preference. When I first became a skeptic I rejected yoga. I now enjoy my practice more than before … without the superstitions.

    At one point in my life I did no other exercise, only yoga, and was in the best physical condition of my life. I did this for 15 years. I was in better shape than in my youth when I lifted weights, ran and practiced martial arts.

    Sure, other exercises are good, but even those can be dangerous for people with health issues like you mention. Some should start with walking because they are not fit to run. As a teacher I’ve had physicians as students. We’ve discussed the concerns and they are not much different than other forms of exercise.

    Yoga, stripped of its superstition and mythology yoga is merely a very organized system of calisthenic, breathing exercises and stretching. Certainly there are bad teachers, just as there are bad fitness instructors. Actually risks are mentioned in some of the literature, mostly around practicing incorrectly and involving superstition, much like those regarding mispronouncing a mantra. Most of the fears around yoga practice are superstitions, such a “premature awaking of kundalini”.

    • The calisthenics and gymnastics and aerobics and the like are NOT yoga, but different types of exercises. YOGA is NOT EXERCISE.

  • Everything has its risk.

    Any modern medicine substantiates the above statement.

    A medicine or procedure that is safe for a person can be fatal to another.

    Allopathic medicinal practice itself is experimental – starting from the development of the drug, trials and to consumption by the sick – but this doesn’t stop us from prescribing or consuming them.

    I have personally benefited from yoga and meditation for my insomnia. My insomnia has its roots in day to day stress and the practice of yoga and meditation helped a lot.

    • But modern medicine takes care to inform about the adverse effects beforehand, it never claims itself to be safe! And the database on such adverse effects are regularly updated by the practitioners of modern medicine. Side effects of yoga are NOT highlighted by most of the studies conducted on yoga and are most probably pushed under the carpet, giving a false impression that the practice of yoga is safe. That is THE difference.

  • What about bakhti yoga?
    here in west this yoga is practiced by Krishna devotes. ISKCON, for example.
    I ask because this kind of yoga is not like astanga or hata, I mean, it`s a way of life also, but it`s a religious way to livre and it involves everything in your life, I mean eating, dreassing, hair cut, philosophy, reading, etc.
    So, I`d like if someone speak about this yoga also.

      • The entire article by Dr. Kakkilaya is motivated.

        He poses a question in the beginning “() Is the practice of Yoga totally safe?”

        The answer is obviuosly No.

        Yet, This “No” applies to Yoga only as much as, to any other activity, human beings engage-in, either voluntarily or through compulsion of employment etc. No more and No less.

        Later on in the article the learned Doctor poses a question ” But is the practice of yoga beneficial and necessary? Is it safe?”

        He goes on to demolish each of these three premises, making it out that Yoga is not beneficial, it is not necessary, and that it is not safe.

        Nothing is backed up by real statistics.

        The dull and simplistic routines of physio therapy (and totally injurious practice of hanging weights etc. by implication) is attempetd to be proven to be superior to the totally unaided, slow, rhythemic movements of Yoga.

        Coming to Bhakthi Yoga proper, No where do the Shastras restrict yoga to phyisical activity. The concept of yoga as “Yuja” or to join the ‘mind-body-complex’ to its supposedly ultimate driving force the ‘Atman’ will remain very very alien to the learned Doctor.

        He will continue raising frivolous objections to randomly picked up sentences from any where.

        KENJI, we have only one life: We can choose to spend it by regimens dictated by medical councils, and stop jogging (running) when they declare it unsafe; stop breathing fast for fear of hyper- ventilating; and definitely stop quietening our mind by chanting/meditation/yoga nidra for fear of exciting brain waves not normally observed in control groups.

        We can choose to live sanitaized life that the motivated doctor Kakkilaya suggests, because even if his prescription is dangerous, the good doctor is “ethical” enough to announce it “before-hand”.

        (Unlike the charlaton Rishis who ‘never said a word of caution’ about yogic practices….. If you are an honest and careful student, you would know that enough precautionary information and guidance on how to avoid pitfalls do exist in yogic literature. But a motivated opponent “chooses” to see no merit in ‘the other side’. )

        Therefore even unsafe practices of modern medical science ( and the quiet infamous pharma and drug industry) are good, because “contra-indications” are printed and circulated – albeit in such fine prints that a person with 6×6 vision will find it very difficult to read.

        The Rishis ( passed away atleast a couple of thousand years back )obviuosly do not follow this very legal binding of printing contra-indications in their books.

        Perhaps you may want to sue the Rishis, Doctor?

        • Dear RKK, Your assertions are only your assumptions, far from facts.
          1. I have provided references for whatever I have written, anyone is free to read them. If anyone has any evidence to the contrary, kindly show it.
          2. “Therefore even unsafe practices of modern medical science are good”
          This is your statement, not mine. I do not support such an idea nor do I hold any brief for any pharma co. You may kindly visit or (in Kannada) for more.
          3.”Unlike the charlaton Rishis who ‘never said a word of caution’ about yogic practices”
          Far from it. Both Patanjali’s Yoga Sutras and Swatmarama’s Hatha yoga Pradeepika,(are they the rishis that you are hintng at?) have enlisted the contraindications for performing yoga and if these strict conditions are to be followed, as desired by these rishis, most cannot perform yoga today. Read these texts in the original, without the later day revisions or interpretations.
          4.”The concept of yoga as “Yuja” or to join the ‘mind-body-complex’ to its supposedly ultimate driving force the ‘Atman’ will remain very very alien to the learned Doctor.”
          I will be grateful if you can kindly enlighten me on this “supposedly” “ultimate” “driving force”. (and why do you sound unsure of it?)

          • Dear Dr. Srinivas,

            I am duty bound to reply to you.

            Actually Very properly done research on Yoga does exist. I think your very comprehensive 72 references have not been able to cover those.

            There is a good reason for this, also.

            But before I proceed, just take into consideration what TATE says below. He thinks that this forum does not have qualification to prove or disprove whether Yoga is good or bad.

            “I dont think anyone in this forum has the complete qualifications to prove or disprove a thing, except for flinging Wikipedia links at each other.”

            It is difficult to prove our qualification to audience that has made up its mind though….

            I learnt Yoga in 1978. I joined a one year comprehensive Yoga Teachers’ training course with Yoga Vidya Niketan, at Mumbai, in 1979. This teachers course was taught by Mumbai’s best medical practitioners, cardiologists and experts of Yoga. I was taught full course on relevant anatomy, physiology, and the yoga theory from classical texts of patanjali, gherand, and swatmaram et al. We were trained to teach yoga in least harmful way, to suit even to a medically debilitated person. We were also taught Education Technology, to understand the level of students and to tailor our instructions for maximum effect.

            Contra-indications and differential benefits of each posture, kriya, bandh, and pranayama were drilled into even naive practiotioners. We teachers from Yoga Vidya Niketan, Mumbai, together have trained thousands of persons in mixed age groups, in 3 month courses and year long follow up courses in last thirty years.

            Although I have full capability and knowledge to conduct a fault less scientific study on beneficial effects of Yoga, the lack of funds, shoratage of trained volunteers at each location, and most importantly a prevalence of very diffident attitude towards conducting research in a non conventional subject like yoga, came in the way.

            As teacher of ‘Yoga for Health’ I have very positive experience with hundreds of thankful students who benefitted in several ways medically, psychologically, and in their carreers, which they attribute to a good training in Yoga they received at Yoga Vidya Niketan.

            Now let me pickup the thread of record of actaul medical research on benefits of Yoga, which for a ‘very good reason’ does not form part of your anthology.

            Dr. Dean Ornish MD, in 1977 undertook a research that became biggest ever and most accurate study of effect of yoga on CORONARY HEART DISEASE reversal.

            It is the largest study with involvement of hundreds of MDs , cardiologists who employed latest technique of “Positron Emission Tomography” to measure smallest changes in cardiac output and published their research in LANCET.

            ON page 132 of paperback version of his book “DEAN ORNISH’S PROGRAM FOR REVESING HEART DISEASE” Dr. Dean ornish explains that he wanted to call his research project as “EFFECT OF YOGA AND VEGITARIAN DIET ON CORONARY HEART DISESE”.

            He was advised gently against such title by his guide, who did not want to tell his patients that ‘they were being referred to a SWAMI for treatment.

            Dr. Dean Ornish then conducted his research on yoga’s role in reversing heart disease by calling it by another name ” EFFECT OF STRESS MANAGEMENT TECHNIQUE AND DIETARY CHANGES ON CORONARO HEART DISEASE”

            Dr. Ornish makes a particular mention of this on page 132 of his book. He also has written a full chapter entitled “WHY DONT YOU DO SOMETHING MORE CONVENTIONAL?” to underline the reluctance of scientific world to be associated with some thing archaic like yoga etc.; not withstanding its good effects.

            In your 72 references, the only scientifically valid studies are those, which found bad effects of yoga. The ones which recorded good effects, mysteriously, made inadvertent mistakes, of poor statistics or of errors in methodology etc.

            If you are able to convince yourself that LANCET study by Dr. Dean Ornish MD is actually about ‘effects of YOGA’ on reversal of heart disease, you will have one substantial modern study to quote for supporting yoga.

          • Hi RKK, First of all, let’s us not certify each other’s abilities on this forum, for no one knows about what the other has read/studied. Although I have cited wikipedia too for ease of reference, I have also quoted many others and not quoted even a far bigger number. I suggest that the discussion be restricted to the issue at hand.

            In my conclusions, I have written this right at the beginning:
            “Yoga may have limited use on individual basis, and the type of yoga or its asanas etc., should be carefully chosen on the basis of the individual’s health status and needs, in due consultation with the treating doctor and well trained yoga therapist, choosing whom may be a daunting task.”

            If you think it has helped you, do continue. But claiming that yoga is a cure for any or all ills and safe is what I have questioned and I stand by it.

            I had asked for any single refernece to contradict my position and you have quoted Dean Ornish. Please read his published papers for yourself (not his book alone). If you find any paper from him that is about yoga alone, kindly provide me the full citation, for I did not find one. Science is not about extrapolating results based on anecdotes. Give us evidence is all we ask.

            And you say:
            “In your 72 references, the only scientifically valid studies are those, which found bad effects of yoga. The ones which recorded good effects, mysteriously, made inadvertent mistakes, of poor statistics or of errors in methodology etc.”

            Let there be no mystery. Please provide citation of ONE long term, randomised, controlled, preferably blinded study on the effects of yoga alone on any health/disease condition. Also please provide me a quote from any ancient scripture/text that mentions yoga as treatment for any ailment. Learned men share their knowledge and knowledge grows by sharing. The argument that yoga is beyond such studies is not acceptable and in support, I have cited none other than a yoga expert himself in my article.

          • Mr.rrk was taught yoga to train others. He adopts them totally as true. No ancient treatise talks about medical disease. The first eligibility is purity of inner soul by virtues and no external attachments any desires and family commitments. Yoga is for salvation , not survival.The asana is physical posture for meditation, not for body building , gymnastics. Today yoga training centres are gym clubs with mates ,without any equipments.

  • Good article and well researched references. I seriously doubt all the claims made by ramdev and other magic bullet advocates of yoga. But if any silver living, the people who used to watch TV and bitch about neighbors are at least going to parks doing some physical exercises in the park. This will improve their health, since people from Indian subcontinent are susceptible to heart diseases and diabetes very much. So there is a bit of positive outcome. I dont think anyone in this forum has the complete qualifications to prove or disprove a thing, except for flinging Wikipedia links at each other.

    so long ..

  • good article. very informative. i strongly second the idea that yoga should be dis-continued in schools because the teacher would’nt be able to pay individual attention and it will do more harm than good if done incorrectly.

  • lets be critical . why in the hell do one has to believe the research publications. I am also research student and i know very well how articles will be published. secondly is there is a possibility that this research has been funded by vested interests.
    I still agree with the fact there are no conclusive evidences of therapeutic uses of yoga. but in most cases we don’t need medicines as well, because nature has this amazing ability to heal by itself.
    does anybody did research about how a physical activity like yoga has its effects on the emotional state of mind??
    If one travels with his/her own brand of medicines when visiting different places (although you can always find some at that place)what in this world make you think 2BC cures to work in present day as the anatomy , the food and lifestyle of human race has changed a lot to say the least.
    the only thing that might have not have changed a big deal is the relation between the mind and the body.
    So any further research towards this subtle understanding will be appreciated.

  • On the issue of yoga in schools – I wasn’t good at sports in school and was bullied during competitive games and PE. I wish that yoga had been available to me as a child.
    Today I am a yoga teacher (and yes, I agree that there are many fraudulent claims made by some yoga practitioners). I have worked with young people who have been in trouble with the police and schools – some of these kids have made an enormous amount of progress since discovering yoga.
    Perhaps yoga isn’t for everyone but for many people it can be life changing.

    • The two reviews seem to be focussed on meditatative practices generally. One lists ‘yoga’ as a generic term alongside qi gong and other meditative practices, taking no account of the range of physical exercise (or lack of) that could be covered by the term. What kind of ‘yoga’ was being practiced? The other review mentions the esoteric, religion based practice of ‘kundalini’ yoga.
      Had the studies looked at physically demanding styles of yoga such as ashtanga, or power yoga, the results would probably have been very different.

  • The reviews considered reliable RCTs and other studies and found none to support the claims of benefits. If there are any, please cite.

  • Is Narendra Modi trying to propagate Hindutva ideology by trying to promote Yoga Day in a secular country like India? Just cool down and read it…

  • Another TRASH topic by this gentleman, possibly a secularism maniac, which I like to call him after regularly practicing YOGA for 25 years from childhood.

    It is the best option for an exercise for a strong internal health. My 60 years life had passed with rarely any medicine, not even antacids (by GOD’s grace) except for fever reducing type medicines only, that too rarely, once in 5 years in average. Off course, I have psoriasis (genetically, most likely) and YOGA could not cure it, but, I do not blame YOGA, psoriasis is almost incurable.

    What you do not know, please do not spread venom on that and confuse / misguide people. It will generate bad KARMA for you. I hope still these is time for you to start. Best of luck my friend.

  • What is Kundalini – Plugging into the Source of Creation

    A seeker asks yogi and mystic, Sadhguru, what is Kundalini – a question that is seldom answered satisfactorily or in terms easily understood. Sadhguru takes us through the explanation of what Kundalini is, using an everyday analogy that should strike a chord in every one of us.

    Coiled snake, the symbol of Kundalini

    Question: Can you please explain what is Kundalini?

    Sadhguru: The word “kundalini” generally refers to that dimension of energy that is yet to realize its potential. There is a huge volume of energy within you which is yet to find its potential. Let me take you from your own experience of life because the stories about it are many. In your house, there is a plug-point in the wall. This plug-point does not actually produce any power. There is a huge power station elsewhere that is producing power, but it cannot give you that power directly. It is the plug-point that gives you the power. Though most people have not even thought about the power station and have no conception of what it is, they know that if they plug an appliance into the plug-point, the appliance will run.

    Plug into the ultimate source

    Kundalini is the plug-point. It is not a 3-pin point, it is a 5-pin point. You might have heard of the seven chakras. The muladhara is like a plug-point. That is why it is known as muladhara. Muladhara means “fundamental” or “basic.” Five of the remaining six chakras are the plug. What is the seventh chakra? It is like a light bulb. If you plug it in, then everything about you glows. If you are properly plugged in, keeping the lights on twenty-four hours of the day is not an issue anymore. You don’t have to turn off your power because you are worried the battery might run out. You can just keep it on blatantly, recklessly, because you are plugged into the power source.

    Even right now, you still have energy. You can hear what I am saying. That means life energies are functioning, but in a very miniscule way. Just a small part of it is functioning. If the whole of it becomes available to you, if it is properly plugged in, there is no limit to what you can do out of it. Even with the plug-point at home, once you are plugged in, you can make the light happen, you can get the air-conditioning going, you can have the heater, you can have the television – anything you want. Just one power point. You can do so many things.

    Unfortunately, most human beings are not plugged in. They are trying to generate their own power. So they eat five times a day, but still they are tired most of the time. It is a struggle to keep life going. Energy is not just in terms of physical energy or activity, energy is in terms of life. Existence is energy, isn’t it? The basis of existence is energy. If you know that basis, it is like knowing the foundations of life. If you understand the ways of the energy, you know the whole mechanics of creation. So if you are plugged in, you know what the power is, what it can do and what you can make out of it. You are plugged into an endless source of power – that is what is Kundalini.

    What does it take to plug in?

    Now to plug in an appliance, if your hands are shaky, you will scratch the whole wall but you will not get the plug in. In the same way, to put the 5-point plug into the plug-point is difficult for a lot of people because there is no steadiness in their body, theirmind, theiremotions or their energies. All this yoga is just to get the necessary steadiness so that you can just plug it in there. Once you plug it in – boundless energy! You don’t have to go and learn about or understand the power station. You plug it in and everything is fine.

    Yoga is just the science of getting the plug properly in so that there is an uninterrupted source of power. Once you are connected to this uninterrupted source of power, naturally you will proceed in the way life should. You will naturally proceed towards the goal of what life is longing for. You will not get lost with your fancy ideas, dreams, thoughts, emotions or entanglements of the world.

  • What is Yoga?

    “I think it is better I tell you what is not yoga. So much misinterpretation of the word has happened that speaking about what is not yoga is more relevant. Standing on your head, holding your breath or twisting your body is not yoga. Yes, these are various yogic practices, but when we say “yoga” we are referring to a certain state—a certain way of being. The word “yoga” means union.

    Union means you begin to experience the universality of who you are. For example, today, modern science proves to you beyond any doubt that the whole Existence is just one energy manifesting itself in various forms. If this scientific fact becomes a living reality for you and you begin to experience everything as one, then you are in yoga. Once you experience yourself as everything, or everything as yourself, after that nobody has to tell you how to be in this world. If you experience all the people here as yourself, does anybody have to teach you morals as to how to be? Does anybody have to tell you “don’t harm this person, don’t kill this person and don’t rob this person?” So when you are in yoga, you experience everything as a part of yourself, and that is mukti; that is ultimate freedom.

    Can there be realization without Yoga?

    Yoga is a science. Yoga has nothing to do with any particular religion. As there are physical sciences to create external wellbeing, yoga is the science for inner wellbeing. This yogic science is of utmost importance now, like never before, because today we have tremendous power in our hands. With modern science and technology, tomorrow if we want, we can flatten a mountain or city. When we have this much power in our hands, it is very, very important that we have an inner sense, an awareness of life, and that we experience life and everyone as part of ourselves. Otherwise, we can create a calamity for ourselves and the world around us—which right now we are doing to some extent. This has happened only because we have attended only to the external science. We have never looked at the inner science within us. Just as there is an external science to create external wellbeing, there is an inner science to create inner wellbeing.

    Yoga can be transmitted on many different levels. One is towards one’s physical and mental wellbeing which includes health and other aspects. Or it could be transmitted as a tool for ultimate wellbeing; in the sense, you can use this system as a stepping stone to go beyond. If you want, you can use this yoga just to get rid of your backache or you can use this yoga to get better mental focus and a little peace of mind and happiness in your life, or you can use this yoga as a way of climbing up to the highest possibility within yourself.

    Using yoga just for health is not wrong, but it is a crime, because it can be a ladder to the divine. It is a way of approaching the Creator through the Creation. It can take you to places where you have never imagined. It is my wish and blessing that you should know the joy of being truly well, not just physical wellbeing, but to know and exude wellbeing in all dimensions of your existence.

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