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Dr. Timothy McCall Responds to Yoga Dangers Controversy, William J. Broad’s ‘Numerous mistakes and Exaggerations’

in YD News

While many agents of opinion have spoken out in favor or in protest of William J. Broad’s book and conquest to push the debate of safety and injuries in yoga, along with its proverbial buttons, others have stayed mostly mum on the subject. Timothy McCall, MD was one of the latter. A board-certified internist, the Medical Editor of Yoga Journal and a successful author, McCall remained an observer of the Great Yoga Scare, up until recently when he shared his thoughts in a blog post. Dr. McCall expanded on his response tackling “numerous mistakes and exaggerations” over yoga causing weight gain, yoga and sex scandals and higher risk of injury for men in his latest newsletter. As a veritable addition to the conversation, we’re sharing it in it’s entirety.

Man Bites Downward-Facing Dog

Yoga Journal‘s Medical Editor Responds to The New York Times

by Timothy McCall, MD

William Broad, a science writer for The New York Times, is no stranger to controversy. Fact is, he cultivates it. He knows that being provocative sends his articles up the newspaper’s most-emailed list and gets people talking about him on Facebook and Twitter, and, of course, sells books. Broad’s latest screed, called ”Wounded Warrior Pose,” appeared just two days before the Christmas day release of the paperback version of his book, The Science of Yoga. In the article, he asserts “yoga can be remarkably dangerous — for men.” We’ll examine that claim in detail later, but first a little context….

For those who’ve forgotten, Broad is the guy who a year ago published an alarming and controversial book excerpt entitled “How Yoga Can Wreck Your
Body,” in the Sunday New York Times Magazine. Its numerous mistakes and exaggerations have been catalogued by me and many others. It’s all part of an emerging pattern of his making shocking, man-bites-dog claims that don’t hold up under scrutiny. No extraordinary evidence backs his extraordinary claims.

One, parroted by Maureen Dowd in her popular Times column prior to his book’s release, is that yoga could make you fat — particularly if you’re female. Broad based that assertion entirely on an extrapolation from the long-documented fact that practicing yoga can lower the metabolic rate. Why is that? When you are stressed, your sympathetic nervous system steels your body for fight or flight. Your heart beats faster, your blood pressure goes up, more blood is delivered to large muscles, all of which burns calories. Calm your mind and relax your body with yoga and your parasympathetic nervous system kicks in, and you don’t burn all those nervous-energy calories. Broad’s weight gain warning was pure speculation without an ounce of data behind it, and neglected much of the story.

Did Broad consider the effects of stress-related eating? Cortisol-induced binges, and what scientists studying rats call “food seeking behavior?” What about the stress hormone’s penchant for turning extra calories into belly fat, the most dangerous kind metabolically? And yoga’s proven ability to lower cortisol? None of it is discussed in The Science of Yoga. In fact, there’s only one brief mention in the entire book of this hormone so intimately tied to obesity (and many other diseases). He also failed to cite any of the scientific studies that have examined the issue of yoga and body weight. While that research is far from definitive, the preponderance of the evidence suggests that yoga can help people drop excess weight, and prevent unhealthy weight gain, as I pointed out in my 2007 book Yoga as Medicine (which he must have read since his book recommends it).

For example, Dr. Alan Kristal of the Fred Hutchinson Cancer Research Center in Seattle and colleagues surveyed more than 15,000 people in their fifties, 132 of whom had been regular yoga practitioners for at least four years. During the previous ten years, overweight people in the yoga group had lost an average of five pounds, compared to a 13.5 pound gain among overweight non-practitioners. A more recent study, published in The International Journal of Yoga (full text here) found that among more than 200 women, all long-term yoga practitioners over the age of 45, the more yoga they practiced, the lower the body mass index (BMI). The results held up even when adjusted for such factors as age and lifestyle. Among the 49 women who had practiced more than 25 years, there were no cases of obesity.

Then there was Broad’s Times article on yoga and sex scandals, which argued they were inevitable because yoga supercharges libido. While scientific studies have found the practice improves sexual function and satisfaction, Broad’s notion that any of this explains inappropriate sexual behavior is once again speculation without data. And, his assertion in The Science of Yoga that “the entire discipline [of yoga] itself began as a sex cult,” is false and an insult to millions of Hindus.

If this guy weren’t writing for the most prominent newspaper in the country, none of us would be paying any attention to him. But he is, so we do….

In making the case that men are at higher risk of yoga injuries in the recent Times article, Broad examines 18 years of data — from 1994 to 2011 — from a federal program that monitors emergency room visits. He didn’t provide any raw numbers (making it hard to interpret the results since we don’t know if we’re talking about 12 or 12,000 cases) just the relative percentages for males and females in 4 categories of “major” injuries 1) strains or sprains 2) dislocations 3) fractures, and 4) nerve damage. So, for example, men had 24 percent of the dislocations in the reports — more than expected — as Broad estimated they comprised just 16 percent of yoga practitioners (though no peer-reviewed scientific journal would accept his method for calculating that 16 percent).

In his analysis, Broad only included “major injuries,” but how he decided what to include and what to exclude seems idiosyncratic at best. Ankle sprains, for example, can be painful, but most of them shouldn’t be categorized as major injuries, and strains are essentially less serious versions of sprains. In contrast, syncope (fainting), which Broad found disproportionately affects women, he categorized as “minor,” and thus didn’t include in his analysis. The question is whether Broad decided which categories to include after examining the data — perhaps okay in journalism but a serious no-no in scientific research, as there’s the risk of cherry-picking the data that support your theories.

Most surprisingly, Broad’s latest Times article failed to mention the lifethreatening condition that was the subject of one of his book’s most shocking claims. Using unscientific methodology, he calculated that yoga causes 300 strokes a year. That would be over 5000 cases of yoga-induced strokes in 18 years. You would think that if Broad had found support for that claim in the government’s emergency room tracking data he would have reported it.

As I wrote on the Yoga for Healthy Aging blog , I believe men, in comparison to their proportions in the yoga world, are more likely to take more strenuous and acrobatic classes where injuries would appear to be more common. And, in my experience, men are more likely to push too hard for results (although women can do this too), and this is a well-known precipitant of injury. Most yoga teachers with whom I’ve spoken believe that more flexible students (disproportionately women) are far more likely to get such injuries as hamstring muscle tears and overstretching of pelvic and spinal ligaments, serious (and often nettlesome) but probably less likely to result in a trip to the ER. These factors — and poor methodology — more than any inherently greater male susceptibility to injury, could explain Broad’s findings entirely. The bottom line that there isn’t enough evidence at this point to say which gender is at higher risk for yoga injuries. And we certainly should not, based on relative percentages in a few
categories of injuries, be labeling yoga as “remarkably dangerous” for men.

“Some yoga practitioners will surely see my analysis as unconvincing,” Broad writes. “It’s the kind of topic,” he says, “that can only benefit from thorough discussion* — as well as rigorous new studies that can rule out the possibility of false clues.”

Finally something we can agree on.

Board-certified internist and yogi Timothy McCall, MD teaches yoga therapy seminars worldwide. He is the medical editor of Yoga Journal and the best selling author of Yoga as Medicine. This article appeared in his email newsletter, available at DrMcCall.com, where you can
download the PDF of this article, with hyperlinks. The pdf version can be found here.

*In conjunction with the publication of this article, Yoga U, an online educational resource, will rebroadcast free of charge on February 9th, 2013 at 9 AM PST (noon EST) a 4-hour telesummit on yoga injuries recorded last year, featuring Timothy McCall and many of the country’s leading yoga teachers.

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10 comments… add one

  • To me the book seems pretty fair and even handed, at 37% through. It strikes me as more of an open-minded examination than anything else. I’ll agree the newspaper article was presented in a sensationalist manner, but he’s not selling his idea of examination any harder than career teachers are selling their workshops.

    I just exited the Ashtanga world after eight years of immersion, where knee and shoulder surgeries are very common place. Sure I don’t know anyone personally who had a stroke, but I know several who were practicing with some of the most reputed teachers in the world who had to have muscles reattached, suddenly couldn’t get out of bed for three weeks etc. Perhaps if there had been more of this kind of dialogue a bit earlier on they’d have known when to quit before surgery and/or major rehabilitation was necessary? Who knows!

  • I have reapproached my own practice after I hit forty and the subsequent years since. It is easy to get swept up in a kind non-yogic way, to make it to the next posture. Having suffered non-major injuries related to repetitive motion and suffering pains and aches in the quest for “pushing my edge”I have learned to back it up a little and enjoy the yoga for the yoga. I know people who have torn their miniscus and injured their shoulders, hurt their wrists or even displaced lower lumbar verterbrae in the quest for a solid forward bend. While there is a sensationalistic aspect to Broad’s work, I think the conversation has been open and it can do a whole lot to change our perspectives as teachers and students when we realize that we can get injured and cause ourselves harm when we do things to our bodies that our bodies may not like or are capable of doing. I for one love yoga so much that I want to keep on doing yoga throughout my life so I am going to be kind to myself. You can apply this thought process to any sport or activity that you love doing. Think of all the athletes you know who may push so hard they become injured. That same mind-set creeps onto the mat as well.

  • “Think of all the athletes you know who may push so hard they become injured. That same mind-set creeps onto the mat as well.”

    Agreed! Except no one ever wanted to pay me an endorsement contract of millions of dollars for “earning” 3rd series three times over. I still practice a LITTLE, but after coming back from my last workshop (during which time I thought I practiced very moderately) with a persistent injury, I settle mostly for stretching that feels good, rather than any kind of a serious practice.

  • I am NOT saying that nothing Broad says is true or that yoga can’t cause injuries, and sometimes even serious ones. I’ve been writing about that for years. My book Yoga as Medicine included a chapter on Doing Yoga Safely and a lengthy appendix on Avoiding Common Yoga Injuries. If you read the review I wrote of the Science of Yoga for Yoga International, which is now posted on Amazon.com [http://www.amazon.com/review/R3UOQYGXMMSQP0/ref=cm_srch_res_rtr_alt_1], you’ll see that there were parts of his book that I liked a lot. He’s a good writer, and did some interesting research. And I do think, bringing attention to the issue of injuries, which some yoga teachers were clearly not talking about enough, was a service. The point of my latest article is it’s now becoming clear that Broad is a sensationalist. And it seems like the more sensational his claims (yoga could make you fat, it causes hundreds of strokes per year, etc.), the more likely they are to simply not be true. But those false claims has gotten worldwide publicity, misinformed the public, and have led some people who might benefit from yoga to shy away. And that’s a shame.

  • Honomann

    Dr. McCall is that really you? If so…cool!

    It appears as though Mr. Broad does not want people to practice yoga at all. But he’d love it if you bought his book.

  • Have you read it? It’s sort of witch-hunty, kill the orgre to say that if you haven’t.

  • the hell??

    I’m trying to understand why McCall feels he is so imminently qualified to comment on yoga injuries. The few injuries that do occur are mostly musculoskeletal in nature (and quite rare, as someone treating such conditions knows). McCall is an internist. Most internists refer musculoskeletal injuries to someone trained to diagnose and treat them, (and vice versa for medical problems) for the simple reason that there is little in their training that prepares them to manage musculoskeletal problems. Maybe he could comment on his training in that area. As they say, “a little bit of knowledge…” well, you get the picture.

  • Stewart J. Lawrence

    Let’s be real and let’s be blunt. It’s Dr. McCall’s JOB to promote the yoga industry.

    There are doctors that flak for the tobacco, chemical, oil, and pharmaceutical industries. It’s their job to promote industry gospel and industry studies and to shoot down contrary evidence. That’s what they get paid to do.

    Dr. McCall had the gall to suggest that no one would “ever” have taken two-time Pulitzer winner William Broad’s views on yoga seriously except that he writes for the New York Times?

    What a bunch of arrogant piffle.

    Doctor McCall, let’s return the favor: no one should take your views seriously until you sever your ties to Yoga Journal and any other institution whose primary interest is to promote yoga as a business.

    Fair enough?

  • Stop the hubris

    It’s quite “in” right now to bash Broad. All the best yogis are doing it. It is a real shame because I have been involved in the world of asanas and meditation sinc3 1975 and I very sad at the lack of growth in these communities when self knowledge and negative feedback or input is offered. It reminds me of why so many went to Eastern philosophy in the first, because Western belief systems were so dogmatic and inflexible.

    Stop shooting the messenger. Let’s get asana training cleaned up with better teacher standards, educated consumers, and tailoring it for those who approach with the wrong mind set, like so many Western men do (myself included). Broad’s book could be better, a lot better, but he did put a light on a number of areas that really need addressing.

    Good practice to all.

  • I wrote this when Broad’s article first appeared, and I’d like to add my 2 cents:

    Caution, Yes. Fear, No!
    A likely apocryphal account tells of a fire in the lab of Sir Isaac Newton. In the story, Newton’s dog Diamond knocked over a candle, burning 20 years of research. Newton is thought to have said, “O Diamond, Diamond. thou little knowest the mischief thou hast done!”
    William Broad, A Pulitzer Prize winning senior science writer for the New Times may be doing something like Diamond did, creating mischief by inducing fear into the Times readers that yoga will cause injuries, even strokes.
    Caution, yes. Fear, No!
    By now you have probably seen, read or heard some feature about the dangers of yoga. Media outlets have jumped on excerpts of Broad’s book entitled “The Science of Yoga.” “Good Morning America”, CNN, all the network news outlets have run stories.
    It is said that any publicity is good publicity. It may be good for sales of Mr. Broad’s book, but I would not wish to have Mr. Broad’s “Karma” if his focus on injuries and accidents were to turn people away from yoga, rather than informing people of its benefits as a safe and healthful activity. Yoga is a healing art, and for many, a lifelong spiritual practice.
    Diamond never knew the damage done, but the New York Times should know better.
    We must first acknowledge that ANY activity can cause injury. People injure their lower backs getting out of bed or tying their shoes. Contrary to the impression left by the publicity, yoga is a way to heal injuries and adjust to physical, and emotional challenges. A central tenet to the practice of yoga poses (asanas) is to slow the breath down and consciously explore the stretch; more correctly, explore the release of the tight, congested area. Working this way allows healing of areas injured in other activities and sports; some which cause a myriad of injuries: like skiing, or tennis, golf, boxing!, football! – almost any sport other than tiddly-winks; and you can take an eye out playing them.

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