Yes, suffering a stroke after doing yoga can happen.
An experienced Maryland yogi is making headlines after having a stroke in 2017, which hit after she did a challenging hollowback handstand that calls for extending your neck, dropping your hips back and arching your lower spine all while in a headstand.
Rebecca Leigh, 40, told media outlet SWNS (as reported by the Daily Mirror) in a new interview that, “I felt that I had really nailed (the pose) but as I walked inside my house, my peripheral vision went out and the rest of my vision became blurry. It was like a curtain coming down all around me. I sat down and tried to put my hair into a ponytail but my left arm flopped around without any control.”
Turns out, she had torn her right carotid artery, one of two arteries on either side of the neck that carries blood to the brain, which sent a blood clot to her brain that caused the stroke. “After decades of focusing on working out and my diet and making as many healthy decisions as I could for my body, having a stroke by doing yoga just didn’t seem fair,” she said.
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A 2001 review in the New England Journal of Medicine included yoga as one activity that can trigger a stroke from an arterial tear like this. The New York Times noted that a similar case was reported in 1973, when an otherwise healthy 28-year-old woman suffered a stroke while doing a “wheel” pose, which involves lying on the back and arcing the body up in a semicircle while balancing on the hands and feet, with the head resting on the floor. The woman had bent her neck too far back. A few years later, a 25-year-old Chicago man who practiced yoga daily for a year and a half also suffered a stroke, and doctors found evidence of neck trauma and bruising from, “repeated contact with the hard floor surface on which he did yoga exercises.” And a 2009 Columbia University study counted four cases of yogis suffering brain damage from extreme bending and contortions.
While rare — carotid dissections, as these are called, strike only two or three people out of every 100,000 for all age groups every year — they are among the most common causes of stroke in young and middle-aged adults, according to Cedars-Sinai Medical Center. While they are usually the result of neck injury from car accidents, they can also stem from extreme neck rotation or extension during physical activities such as skating, swimming, dancing and yoga — as well as giving birth, sneezing or having your head tilted back too far or jostled too much during a salon shampoo.
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Symptoms of a carotid dissection can include a pounding headache or scalp pain; piercing neck pain; eye pain, or one eye having a droopy lid and a small pupil (known as partial Homer syndrome); weakness or numbness on one side of the body; having trouble understanding speech or speaking; trouble swallowing; an abnormal or lost sense of taste; and a pulsing sound in the ear.
The signs of a stroke resulting from this are the same “F.A.S.T.” warning signs as any other stroke, including:
Face drooping: Does one side of the face droop, or does it feel numb? Ask the person to smile; is the smile uneven or lopsided? Arm weakness: Is one arm weak or numb? Ask the person to raise both arms. Does one drive downward? Speech: Is speech slurred? Is the person unable to speak or hard to understand? Ask the person to repeat a simple sentence. Time to call 911: If the person shows any of these symptoms, even if the symptoms go away, call 911 and get them to the hospital ASAP. The faster a person is treated, the more likely they are to recover.“This is very rare, and most yoga is safe,” Dr. Loren Fishman, the medical director of Manhattan Physical Medicine and Rehabilitation who has studied yoga’s effect bone health, told MarketWatch. “But at the same time, when you move to the extreme of normal, you can open yourself to injury.”
And as more people are picking up a yoga practice — a 2017 National Health Interview Survey found that number of U.S. adults doing yoga jumped from 9.5% in 2012 to 14.3% in 2017, and Americans now spend $16 billion on yoga classes, clothing, equipment and accessories each year — more people are now also saying “ow” instead of “ohm.” A 2016 study of U.S. yoga-related injuries between 1991 and 2010 found that 73% of these cases occurred after 2005. And the study noted that only a fractured of those who get hurt practicing yoga visit hospital emergency rooms, as many who get less serious injuries either take care of themselves, or they primary care physicians, chiropractors or physical therapists, so it’s hard to say how many people get hurt by getting overzealous in their flow. A 2012 survey found that only one-third of adults who practiced yoga even told their health-care providers about it.
Still, health experts don’t want people to be scared off from doing yoga. The low-impact exercise has many health benefits, such as relieving low back and neck pain, easing anxiety and depression symptoms, managing sleep problems, plus increased flexibility and muscle tone. In fact, an Australian study published in Future Neurology last fall urged stroke survivors and those at risk of stroke to do mindfulness-based interventions like yoga and tai chi to help lower their blood pressure, blood sugar and cholesterol, which are all risk factors for stroke. And many poses can be modified so that people of any age or experience level can practice some version of them.
The risks come when people try to push themselves too far, particularly in inverted (upside-down) positions — such as a headstand or backbend that puts your neck at an extreme angle. “The essence of yoga is to pace yourself. Yoga is about gaining control, not losing control,” said Dr. Fishman. “Be more conservative, and gradually increase (the intensity of a pose) millimeter by millimeter. Try each pose once (a day), and do not obsess over trying again and again, which sets yourself for an overuse injury, at the very least, or the most dire kind of injury, which is a stroke. If you can’t do a pose perfectly, tomorrow is another day.”
The National Center for Complementary and Integrative Health also recommends practicing yoga under the guidance of a qualified instructor who can make sure that your body is aligned properly in each position, and that you aren’t forcing yourself into a pose that your body needs more practice to hold safely. And older adults, pregnant women and people with health conditions may also need to avoid or modify some poses. Yoga newbies should avoid extreme practices such as headstands, shoulder stands, the lotus position and forceful breathing.
Dr. Fishman also suggests visiting YIP.guru, his yoga injury prevention site, where users can see the do’s and dont’s for more than 90 poses, as well as recommendations for whether a position is safe for certain medical conditions.
As Leigh, who is still suffering daily headaches and has severe memory loss more than a year after her stroke, later added on Instagram, “No pose or picture is worth what I have been going through. Don’t be so tempted to push over your limits.”
