Claim Check: "Everyone Should Do Yoga"

What is solid: being active

The WHO says people who are insufficiently active have a 20% to 30% increased risk of death compared with sufficiently active people. [1] The NHS recommends that adults aged 19 to 64 do at least 150 minutes of moderate-intensity activity a week, or 75 minutes of vigorous activity, plus muscle-strengthening activities, and it lists yoga among examples of muscle-strengthening activity. [2] That supports being active, not yoga in particular. Many activities count, and the best one is the one you can do safely and will keep doing.

What research shows about yoga's benefits

• Back pain: compared with no exercise, a Cochrane review found small, clinically unimportant improvements, and probably little or no difference compared with other back exercise. [3]
• Anxiety: small short-term effects in some groups, with inconclusive evidence for people with anxiety disorders. [4]
• Overall: NCCIH describes possible benefits for stress, mood, sleep and balance, and "promising" evidence for some chronic conditions. [5] See Yoga Evidence by Outcome and Does Yoga Work?.

Note who was studied. NCCIH says much of the US research has been in predominantly female, non-Hispanic White, well-educated people with relatively high incomes, so results may not apply to everyone. [5]

Injuries and harms: what records show

• Emergency department data (US, 2001 to 2014): 29,590 yoga-related injuries were seen in hospital emergency departments. Sprains and strains were the most common diagnosis, and the trunk was the most injured area. People aged 65 and older had the highest injury rate. [6]
• Canada, 1991 to 2010: 66 people with yoga injuries presented to participating emergency departments. The authors said such injuries are not common but are increasing. [7]
• Case reports: a systematic review of 35 case reports and 2 case series (76 cases) found problems most often involved the musculoskeletal system, nervous system and eyes; the authors advised that beginners avoid extreme practices such as headstand, lotus position and forceful breathing. [8]
• Back pain trials: the Cochrane review found low-certainty evidence of more adverse events, mainly increased back pain, than with no exercise. [3]

These records cannot tell us the true risk, because they count injuries without knowing how many people practice. NCCIH concludes that yoga is generally safe for healthy people when performed properly, that serious injuries are rare, and that risk is lower than for higher-impact activities. [5]

Who should talk with a clinician or modify first

NCCIH says pregnant women, older adults and people with health conditions should talk with their health care providers and the yoga instructor about their needs. [5] Conditions that may call for modifications include preexisting injuries (such as knee or hip injuries), lumbar spine disease, severe high blood pressure, balance issues and glaucoma. [5]

• Glaucoma and bone loss: authors of the case-report review advised that people with glaucoma avoid inversions and people with compromised bone avoid forceful practices. [8]
• Osteoporosis or osteopenia: a systematic review found very low-certainty evidence overall and reported case series of vertebral fractures linked to yoga poses involving spinal flexion in older adults at increased fracture risk. [9] See Yoga and Osteoporosis: Spine Cautions.
• High blood pressure or heart conditions: see Yoga and High Blood Pressure or Heart Conditions: Cautions.
• Hypermobility: see Yoga and Hypermobility: Instability Cautions.
• Pregnancy: NCCIH says to avoid hot yoga during pregnancy because it can cause overheating, and to avoid poses with long periods lying on your back. [5] See Yoga in Pregnancy: Cautions and Warning Signs.
• Eating disorders or body image concerns: a systematic review of 12 cross-sectional studies had inconsistent results. Yoga practice was usually associated with healthier eating behaviors, but other studies suggested that a high dose of yoga practice may be associated with more disordered eating behaviors. [10] See Yoga for Eating Disorders and Body Image.
• Trauma, psychosis or dissociation: see Trauma-Sensitive Yoga and Yoga and Mental Health Risks.

Other reasons yoga may not fit

• Access and comfort: in a small NCCIH-cited survey of Hispanic adults with low incomes, cost was the most common barrier to yoga. [5] Some people also worry about flexibility or feeling like an outsider. [5] You do not need to be flexible to begin; see Yoga for Beginners.
• Cultural and personal choice: yoga comes from Indian traditions, and some people prefer a class framed as exercise only while others want the broader tradition. See What Is Yoga? and Cultural Respect in Yoga.
• Other options: for chronic low back pain, the Cochrane review found probably little or no difference in function between yoga and other back-focused exercise. [3] See Yoga vs Tai Chi and Yoga vs Physical Therapy and Strength Training.

A balanced bottom line

Yoga can be a good choice for many people when taught appropriately and adapted. It is not a requirement for health, and it is not a substitute for medical care: NCCIH advises not to use yoga to postpone seeing a health care provider about a medical problem. [5] See Adapted Yoga and Movement and Yoga Safety.