Inversions in Yoga: Headstand, Shoulder Stand, Plow and Legs-Up-the-Wall
Yoga inversions such as headstand, shoulder stand, plow and legs-up-the-wall: neck, eye-pressure and blood pressure cautions and what case reports and small studies show.
Content last updated . This page has not been medically reviewed.
What inversions are
An inversion is a pose in which the head is lower than the heart or the body is upside down. Headstand (Sirsasana), shoulder stand, plow (Halasana) and legs-up-the-wall (Viparita Karani) are the best known; downward dog and standing forward fold are also head-down poses. Headstand is the example one source gives for inverted asanas, with its earliest description in the 11th-century Yogasastra of Hemacandra. [1] See What Are Asanas?.This page does not teach inversions. They are among the poses where published case reports and clinical advice raise cautions, and we give only what sources say.
Urgent note
Sudden vision loss or change, a very severe headache, new weakness, numbness, trouble speaking or severe neck pain during or after an inversion needs urgent medical care. In the US call 911. Case reports in yoga describe eye and nervous-system events. [2]What the evidence shows
| Question | What the source found | Strength |
|---|---|---|
| How often are inversions implicated in adverse events? | In 84 events from 70 case reports and series, headstand was the most frequently implicated practice (15 cases, 18%), with forceful pranayama second. [3] An earlier review of 76 cases listed headstand and shoulder stand among the most cited postures. [2] | Case reports; cannot give rates |
| Eyes | In 10 people with glaucoma and 10 without, four head-down poses each raised eye pressure within a minute; downward dog rose from 17 to 28 mmHg, plow from 18 to 24, and legs-up-the-wall from 17 to 21 in glaucoma eyes. Pressure returned to baseline within two minutes of sitting. [4] | Small observational study; effect on glaucoma progression untested |
| Eyes, healthy volunteers | A 107-volunteer observational study over 12 weeks reported that headstand raised eye pressure while legs-up-the-wall and standing forward bend lowered it; timing of measurement is unclear in the abstract. [5] | Observational; conflicts with the study above for legs-up |
| Eye blood vessels | One case report describes a branch retinal vein occlusion after headstand in a person with high blood pressure. [6] | Single case |
| Neck load | In 45 practitioners, the head carried a maximum of 40 to 48% of body weight in headstand entries. [7] | Lab measurement |
| Spinal cord | A case report in JAMA Neurology links headstand to compressive myelopathy (spinal cord compression). [8] | Single case; we read the title only |
Eyes: glaucoma and eye pressure
The 2013 case-report review advised that people with glaucoma should avoid inversions. [2] NCCIH lists glaucoma among conditions that may call for modification. [9] The eye-pressure study found a pressure rise in healthy eyes too, and authors noted the question of whether the changes raise the risk of glaucoma progression is open. [4] Label: mixed, with a plausible, short-lived physiological effect and no outcome trial. Proper evidence not found for long-term eye harm from legs-up-the-wall specifically; two small studies disagree in direction.Blood pressure, heart and neck
NCCIH lists severe high blood pressure as a condition that may call for yoga modifications. [9] The retinal case report involved a person with systemic hypertension. [6] Proper evidence not found for specific blood-pressure thresholds for inversions; we searched PubMed for yoga head-down blood pressure studies. For neck risk, the headstand load study shows the head and neck bear a substantial share of body weight in that pose. [7] Beginners are advised by reviewers to avoid extreme practices such as headstand. [2]Benefit claims
Sirsasana is claimed to increase blood flow to the brain and improve memory; the case report that notes this treats it as postulated, not shown. [6] Label: traditional use only / marketing claim. Legs-up-the-wall is sometimes offered as restful; see Restorative Yoga. We found no trial testing these claims.Asking questions
Ask any teacher about training and how they modify for eye, blood pressure and neck conditions. We do not list teachers.Frequently asked questions
Is headstand dangerous?
It was the most frequently implicated practice in a 2026 review of case reports, but case reports cannot give a risk rate. [3] Check with a clinician if you have eye, neck or blood pressure conditions.
Should people with glaucoma avoid inversions?
Reviewers say so, and a small study showed eye pressure rises in head-down poses. [2][4]
Is legs-up-the-wall safe?
It raised eye pressure less than other head-down poses in one study but still raised it. A second study reported the opposite. [4][5]
Can inversions help circulation or the brain?
Proper evidence not found. A case report mentions the claim as postulated. [6]
Can I do inversions while pregnant?
Ask your provider. NCCIH advises avoiding long periods lying on your back and checking first. [9]
More details: evidence, limits and cautions
The details behind this page: cautions, limits of the evidence and where sources disagree. Open any note to read it.
Bone, pregnancy and others
A review notes that people with compromised bone should avoid forceful yoga practices. [2] In pregnancy, NCCIH advises talking with a provider and avoiding poses with long periods lying on your back. [9] Also check first with a clinician if you have neck problems, recent surgery, a head or eye condition, or high blood pressure. See Poses to Avoid or Modify, Yoga Safety and Prenatal Yoga.
References
- Wikipedia, Asana (encyclopedia article rated Good Article; a secondary summary of scholarly books such as Singleton, Sjoman and Mallinson, which we did not read directly). Read 2026-10-22.
- Cramer H, Krucoff C, Dobos G. Adverse events associated with yoga: a systematic review of published case reports and case series. PLoS One 2013. PubMed abstract read 2026-10-22.
- Sharma S, et al. Yoga and its risks: A systematic review of adverse events reported in case reports and case series. Journal of Integrative Medicine 2026. PubMed abstract read 2026-10-22.
- Jasien JV, et al. Intraocular Pressure Rise in Subjects with and without Glaucoma during Four Common Yoga Positions. PLoS One 2015. PubMed abstract read 2026-10-22.
- Effect of Asanas in Yoga on Intraocular Pressure of Practicing Healthy Individuals: a Prospective Observational Study. Maedica 2023. PubMed abstract read 2026-10-22.
- A rare case of branch retinal vein occlusion following Sirsasana. International Journal of Yoga 2016. PubMed abstract read 2026-10-22.
- Sirsasana (headstand) technique alters head/neck loading: Considerations for safety. Journal of Bodywork and Movement Therapies 2015. PubMed abstract read 2026-10-22.
- Sirsasana (headstand) pose causing compressive myelopathy with myelomalacia. JAMA Neurology 2013. PubMed record (title only, no abstract) read 2026-10-22.
- National Center for Complementary and Integrative Health (NCCIH, US), Yoga: Effectiveness and Safety. Read 2026-10-22.
Education, not medical advice. This page is for general information. It does not diagnose or treat any condition and is not a substitute for care from a qualified health professional. Natural does not automatically mean safe. Ask a clinician or pharmacist before changing your care, especially if you take medication, are pregnant or breastfeeding, or have a health condition.