WAWADIA UPDATE #11 /// Methods to Reduce Injury: An Interview Subject Speaks Out
I’ve been asking a lot of questions in the course of conducting this project. The one question I’m most frequently asked in turn is: “What should we do as a culture to reduce incidence of injury?”
This is thorny. It immediately provokes a conversation about the pros and cons of tighter regulations for studios and training standards for teachers. In the seeming absence of any concrete external pressure to regulate from governmental agencies, it’s a conversation that quickly reveals the basically libertarian bias of yoga culture. For the most part, yoga’s primary stakeholders — senior teachers and prominent studio owners — are strongly resistant to the idea that an art form for personal growth should be subject to collective oversight. Perhaps North American yoga is so rooted in 1960s countercultural ideal of self-expression that talk of self-regulation will always be distasteful. And where’s the money in it, really?
In 2010, I was a co-director of Yoga Community Toronto. One night we organized an open forum for the city’s studio owners who ran YTT programmes to meet and discuss the meaninglessness of collectively paying thousands of dollars every year to the Yoga Alliance rubber-stamp mill, in another country. We wanted to gauge interest in organizing a more local regulatory agency or guild. We spent a lot of time that night discussing the inadequacy of the YA 200-hour curriculum in terms of producing well-rounded teachers and safe classes. There were a lot of nodding heads.
We were happy about the cordial spirit in the room — up until that point, many would have said that the city’s studio owners would never have had tea together. But in the end, talks fizzled. Not a single studio owner or YTT director saw any personal benefit in collectivizing standards. The harsh truth was that as much as folks loved to complain about the YA, its irrelevance (at the time — things might be changing) had the priceless value of allowing the culture to pretend it was self-regulating, when it had no intention to.
I think it’s inevitable that in bits and pieces, yelling and screaming, yoga culture will be dragged down the road — probably through personal injury litigation — towards higher regulatory standards. But the raw stories that are emerging from my interviews and research are just too poignant to gum up with this particular acrimony. So I don’t think I’ll be giving much space to the regulation issue in the final WAWADIA book, because I don’t want a perceived political agenda to obscure accounts of great psychosocial complexity.
But if an interview subject offers some really interesting advice for studios and trainers about injury mitigation from a best-practices perspective, I’ll definitely pass it along. The following manifesto was tagged onto the end of an email I received from a subject that began with an account of the injuries she’d sustained in practice.
Background: she’s been practicing yoga for 13 years, starting with a devoted Ashtanga practice in the Jois tradition, then moving on by force of curiosity (as well as injury) to its modifications by North American teachers, and private viniyoga and traditional hatha yoga instruction. Since 2011, she has completed over 600 hours of YTT with certifications to teach hatha yoga, restorative yoga, and yoga philosophy. She currently teaches 3 times weekly or more in a commercial studio, as well as in a therapeutic setting where her students are young adults dealing with trauma or mental health challenges. She also works full-time in a corporate, hi-tech job.
Here’s what she has to say. Comments are most welcome.
Methods to Reduce Injury
Start small. This is not popular in North American cities where rent economics make large group classes a necessity if studio operators are to remain afloat financially. Regardless, this makes sense considering that yoga studios rely on a stable membership payees and drop-in students to function financially. As you pointed out in the chapter you contributed to 21st Century Yoga, most studio customers will drop out after 3 years. In many cases, injury or lack of personal attention will be the cause.
Strongly recommend Intro class attendance before Level 1 group classes are possible, or make them mandatory. In smaller European studios, I know of teachers who don’t allow students to take a full length class when they are new. An area is reserved in the back where they can be sent to do closing postures once the instructor notices they’ve reached their limit, with an assistant to lead them through these asanas quietly. Students gradually move from 30 minutes of regular practice to 45, then one hour etc., building endurance. This is explicitly stated in the studio’s “About” section, and adhered to.
Empower your front desk person to be a friendly, enthusiastic risk manager. When customers who are new to yoga show up for a first class that’s not a ‘Yoga Basics’ or a restorative session but an intermediate or advanced Level 1, don’t pussyfoot around. Encourage them to sign up and return for a more appropriate class, or explain that what the instructions they encounter might be difficult to follow, and they should accept that, if they choose to attend this session, it will be an observation and learning experience where they will need to respect their physical limitations.
Focus on breathing long and moving small initially, expanding to deeper asana as the body gains in suppleness and strength as well as alignment knowledge. Instruct with very clear markers as to “end of realistic movement range”, such as: “if you can do this, you can try this next step. If not, stay in this variation until it’s so comfortable you can move into this next stage”.
Break the rule of focussing on your own mat space and invite students to look at others. Start more advanced classes by telling attendees: you can move forward even if you can’t do an asana fully. Do just what you can. Then watch someone who can go further carefully (and respectfully). You will learn a lot just by doing this. You’re not just learning from me but from each other. Watch. Your body can learn how to move from other bodies. This is not envy. This is learning through observation. The brain gets this non-verbal stuff.
Integrate injury prevention and healing in YTT programs. And by this I don’t mean teach asana with variations. I mean survey your YTT students from the start to find out what their current and previous injuries are. Match them in pairs: one injured, one learner/teacher. Make them work together and report on results in their therapeutic dealings while a YTT teacher supervises them. Make it an obligation for YTT students with injuries to also report them to program leaders and to work with them to heal these issues. Create a standing forum in the training weekends or sessions for all to share and learn.
And finally: what I think is my most useful suggestion. In my professional life outside of teaching yoga, I work in technology services that support customer interaction with a large business’s offerings. We take customers’ money, we offer them software to connect with us and what we sell. With every software implementation, we deliver new features and also imperfections, which has become expected by every computer, software and smartphone app user over the past 20 years. Part of my job is very simple: Track complaints. Measure their frequency and prioritize them. Propose and design changes. Implement fixes and resolve them. Train staff to do better. Customers expect no less of us and we know that we won’t retain them unless we address their issues.
From a yoga perspective, this translates into the following: invite your students to report injuries sustained in class – not just by speaking with teachers afterwards, which is often impossible or too intimidating for many, quite apart from the fact that you may not realize you hurt yourself until later. Make it part of your studio’s membership benefits that you will help you address yoga injuries. Create an online form where students can report on what happened, how they are hurt, and who taught the class. Follow-up on these complaints. Reserve core teacher time to meet with these students and offer a therapeutic solution, direct them to other classes, suggest that they consult a doctor or a physiotherapist as necessary, etc. Consider it the cost of doing business and ensuring customer loyalty.
Offer regular workshops on injuries most often reported and how to avoid them. Give feedback to teachers invoked in complaints so they may learn what they are teaching incompletely, incorrectly, with insufficient variations, etc. Track results. Start again. Delight your students by making them feel they are looked after when they subscribe to your studio, and improve your teachers’ instructions all the while.
Last time I checked, there is no precedence for personal injury litigation in yoga practice. Years ago I came across one case involving a personal trainer. But outside of the story on Alec Baldwins wife and the guy who put his foot through a window trying to jump into a handstand, which did not amount to any litigation, I see no evidence for your prediction.
Which brings me to just one small bone to pick in your interview subjects suggestions. I agree with almost all except I bristle when she speaks of starting more “advanced” classes by having people observe others. I get that its about observing others working carefully but question telling students that they can move forward without doing an asana “fully.” Again, I understand that her point is that asana can be done incrementally, I just want us to get away from associating advanced practice with “moving forward” in asana. Maybe just semantics but the language matters.
All in all, I agree that our best course is to have more open dialogue. And to have yoga teachers and yoga centers taking more responsibility for the outcomes of their offerings.
I didn’t include this in my post, J, because it’s part of a larger issue of social taboos around reporting, but in my community people have been whispering about litigation for years, and wondering when it will start.
Fair points about observing and advancing. Thanks for commenting…
J–it’s not entirely unprecedented:
It’s no great secret that I do not love wading through Stewart Lawrence’s prose, but once I got past the gnashing of my own teeth, he did have an interesting conversation with Matthew Taylor, former IAYT president, who counts six lawsuits.
May be worth looking into if you or Matthew R are interested..
A quote from Matt Taylor’s facebook page regarding this interview “To all my yoga colleagues, beware that if Stewart writes or calls, his level of professionalism should be suspect as the only conversation we ever had was by his words “off the
record”…consequently what I am quoted as saying is several times not true, and regularly taken from context into his very skewed and angry world view.”
Seems I should’ve stopped reading when my teeth started gnashing.
Yes. The self-reporting of injuries alone would, in my opinion, dramatically change the dynamic in most yoga studios and go a long way toward protecting both teachers and students.
Thank you. This would help change the way people practice yoga and would help build compassion for our own sense of movement. The only piece is the students filling out injury forms and the teachers reserving time to address these issues. That is a great idea but IMO not realistic. Unless studio owners and teachers have time to go through forms, build out time for this in addition to time spent teaching, driving to teach, cleaning up and then offering one on one customer injury support all without getting paid for this – it really would be time consuming. I guess it goes back to the root of the conversation about the profession as a whole. Perhaps small studios and large studios need to be discussed differently when dealing with injury support. Currently small studios would drown even more than they are if they enforced this upon teachers. Again it would be lovely but so many new bendy teachers currently are so inexperienced in their own embodiment (generalization I know ) it’s a tough promise to keep to the public especially in big classes — thank you so very much though – this is a great step in changing the current model where nothing is done.
I agree with J about letting go of the association of going deeper as being “advanced.” Everything that I do as a teacher in a basic hatha yoga class is to encourage people to explore how their individual body works and direct them back to their own experience, which can take some time and coaxing. To break that focus and redirect them out of their bodies and into someone else’s doesn’t resonate with me, unless it is a teacher training setting where students need to understand how to see and observe movement habits and skeletal variety – this also requires a dialogue with the person around the choices that they are making, seeing if they are conscious or unconscious, the short and long-term possible impact of what those choices and an exploration around what it feels like to make different choices.
And I wholeheartedly agree with trying to put the right person into the right class, but not at the expense of turning someone away or appearing rigid and unwelcoming. As studio owners, you never know what the driving momentum is for someone to actually step over the hurdle of going somewhere new to do something new. We should be sensitive to this and think about the welcoming of a new student to include education.
As a trainer of teachers, injury prevention is a big part of what I do. But there is a fine line between giving TT’s information on skeletal variety, functional anatomy, pose adaptability/modifications and tips for sensitizing students to the different types of “ception” and end feels that are available to them for feedback versus turning them into a mini-yoga-PT. Letting a entry level TT think that during/after 200 hours of training that they are qualified to work with injured people is part of the bigger problem.
And while collecting data and attempting to identify cause/effect and be proactive about resolutation sounds great in theory, the idea assumes that the students are able to accurately report what they are feeling and perceiving as an injury (in my experience, when they do report, they do so without actually getting an allopathic diagnosis). The majority of injuries aren’t something that just “happen” all of a sudden in a class – they are a set of circumstances that happen over time, usually brought about by the poor movement (or lack thereof) patterns that a person carries with them every day. The actual feeling of the injury might come about in or after a class, but the environment that created the injury exists in all aspects of the person’s life.
As your research is showing, the cause/effect of injuries in yoga is far more complex that it looks on the surface, and what I reading in this particular summary oversimplifies the resolutions. But it’s a good starting point for looking a models being proactive and studios taking more responsibility, but I’d also like to see a dialogue around cooperative responsibility that is shared between the studios, teachers and students.
Agree with KJB. Looking at yoga injuries apart from daily life and other sources of repetitive stress etc does not make sense. And conceiving/sanctioning yoga studios or TTs as mini-PT could do more harm than good.
How are yoga classes different from other group fitness classes? Are they, in terms of possible injuries or litigation? At least with yoga, there’s likely to be at least some focus on body awareness and mindfulness.
MR how many of your case studies are really people who showed up at a studio and out of the blue got acutely injured (with no history of past accidents or strains in the area), and the teaching was clearly questionable (such as having beginners go into an advanced pose with little prep or body awareness coaching)? Versus injuries that were more, uh, cultural or occupational even sporting in nature, longtime intense practitioners who have encountered various injuries over the years?
I’ve made the point several times before: nobody occupies themselves in other “daily life” activities after being sold on the premise of therapeutic benefit. That said, I’m keeping careful track of my subjects’ overall movement contexts. My aim is not to propose causal relationships, but to excavate the broad spectrum of yoga injury contexts. Most of my case studies are longer-term practitioners. The case load for the book will total just over 100, which won’t generate clear demographic statistics — also subjects are self-selected. I’m not doing quantitative research. It’s not my field. I hope someone takes it up in earnest.
From a marketplace perspective, I don’t think the liability considerations for safe yoga teaching should be any different from any other group fitness concern.
Are you addressing what styles of yoga injured practitioners are doing? Are your subjects a sampling from various styles?
Yes, a range of styles: Ashtanga, Iyengar, Kripalu, Jivamukti, Anusara, Sivananda. I’m also interviewing practitioners who practiced a range of styles, or who never affiliated with any one style in particular.
There is potentially great benefit for yoga studio directors/owners, yoga teachers and yoga practitioners in having a system for reporting and tracking injuries that may have been sustained in a yoga class. This would require a major overhaul of the structuring within commercial yoga studios and their relationship with the yoga teachers who teach in them and the students who attend the classes. In my personal experience so far of practicing in many different types of commercial yoga studios, there seems to be barely enough time to roll up my mat and move out of the way of the next group of students coming in for the start of the next yoga class. Rarely is there time enough to speak to the teacher. If you know them, it’s sometimes possible to email, but only if you are pro-active about it. How do you move from a situation where even if a student has a question or concern, but limited access to their teacher(s), to a system of reporting injuries that can be tracked? A great way to empower the students as well as improving the level of education and teaching skills in yoga studios, but can this type of system be implemented.
The collection of suggestions is very helpful for any studio or teacher and worthy of time spent considering how to integrate them.
I’d suggest that another approach to injury prevention is to encourage, teach, and support direct proprioceptive awareness by the student. Empower the student to adjust their pose based on their sensation and feeling-tone in the moment. If a student has permission to stop and start as they feel appropriate and the teacher creates a non-judgmental atmosphere in the class then the possibility of injury is significantly reduced.
Become mindful of movement, sensation and feeling; go as slow or as incrementally as you wish. Yoga is a practice for the rest of your life, don’t feel you need to rush, don’t let that teacher person at the front of the room rush you along, take time to digest what is happening-this will dramatically reduce your chance of injury. The role of the teacher at the ‘front’ of the room is to bring the student into contact with the teacher inside themselves and practice from that orientation. Wake up to the ‘teacher inside’ as the source of yoga, then you’re empowered where ever you are and whatever you encounter.
Modern postural yoga is too involved with the externalities of posture, the appearance of the pose; and gives insufficient attention to the inner experience of the practitioner. An ocean of inexperienced teachers produce injuries due to their lack of inner awareness-their attention full of rules and maxims ingested from compressed certification events but none of the material digested and made one’s own through inner work.
I teach that the overarching goal of yoga is to be aware of what is happening within/without you right now. To work on that we need mindfulness of sensation, feeling-tone, and breath. You don’t need the approval of the teacher, rather you need the support and assistance of the teacher. Both teacher and student need to practice letting go of judgements of performance and support each other in experiencing this moment and what can be done right now.
I’ve practiced yoga and zen for nearly fifty years, beginning as a teenager and continuing as a senior. Teaching most every day for the last twenty years, this is the approach that has avoided a serious injury in a class throughout that time.
Well. I THINK WE CAN DO BETTER.
For sure, Physical Therapy studios/practices/offices…. ARE RIFE with INJURIES sustained while following the dictates of P.T.’s and their interns/employees. LET US GET REAL. Nobody is lawsuiting PT offices, –yet. Since they are NOT offering Yoga Classes.
If you want to be a ‘TEACHER’ of yoga, then get a degree in P.T.
—–Then, with your PT degree ‘you’ will be working within the REAL LIVE WORLD of being LICENSED TO WORK in this way with BODIES MOVING IN SPACE AND TIME.
IF YOU ALL WANT TO BE Psychotherapists AND PRIESTS As WeLl as yoga teachers??? —Well it’s BACK TO SCHOOL.
THIS IS THE REAL future WAVE Of AnY –‘yoGa’– that is to gonna be sans major lawsuits . Yep. Lawsuits. They are ‘gonna come. Like a racehorse….
Get your giggle on, this is the Last of the ‘outlaw-west yoga’ you’ll ever see.
Unless you want to lose your ‘house’ and anything else you wish to ‘have’, Go Back To University.
Yup, because universities clearly teach medical doctors, and they never hurt anybody. Get real.