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New Study Finds Bikram Yoga Poses Potential Threat of Causing Heat-Related Illness

in Science, Thanks for the tip, YD News

bikram-yoga-safety-screenshot

Well here’s something potentially unsettling. Kind of a no-brainer headline (maybe?). Not to make your blood boil, ahem, but research is showing that your internal body temperature and heart-rate could reach super dangerous levels in this type of class causing the risk of heat-related illness if you’re not careful. A new study, sponsored by the American Council on Exercise (ACE) and published in the Gundersen Medical Journal, examined the physiological responses to Bikram Yoga, specifically heart-rate and core-temperature.

The team of researchers at the University of Wisconsin—La Crosse’s Department of Exercise and Sport Science monitored 20 healthy and willing men and women between the ages of 28 and 67, all regular Bikram practitioners, as they did their 90 minute practice in the standard 105 degree room. The participants all voluntarily swallowed a core body temperature sensor and wore a heart-rate monitor during their class to help determine whether or not the practice is really healthy for you. (By the way, we’re not so sure swallowing a thermometer is healthy, but hey, science says it’s ok!)

The participants’ core body temperature was checked every 10 minutes during the class and their heart rate every minute. By the end, the study revealed some potentially startling results:

The researchers found that many of the volunteers’ core temperatures reached higher than 103° F. One man in the study had a core temperature that was over 104° F. None of the men or women had symptoms of heat intolerance, but the researchers note that heat illness and heat stroke can happen when core temperatures reach 104° F. “Although there are potential benefits associated with practicing Bikram yoga, the potential for heat intolerance among some students, including those who may not yet be acclimatized to the heat, should not be entirely overlooked,” the study authors wrote.

In addition, the researchers found that average heart rate was 80% of the predicted maximum heart rate for men and 72% of the predicted maximum for women. The highest heart rate for women in the class was 85% of the predicted maximum heart rate for women and 92% for men.

Note: Increased heart rate is not necessarily a bad thing. In fact, it can help strengthen your heart muscle and is usually what happens when you do any kind of cardio (though we know yoga is just as good as for your heart aerobics). But in this case, the drastic increase in body temperature coupled with the lack of cardio due to mostly standing still, causes reason for concern. Also, the sweating that everyone does in buckets, our natural cooling mechanism, is not enough to do the job of cooling the body in these conditions which can be a problem. Emily Quandt, M.S., who led the study, explains:

“The dramatic increases in heart rate and core temperature are alarming when you consider that there is very little movement, and therefore little cardiovascular training, going on during class,” says Quandt. She goes on to explain that, while the excessive perspiration that participants experienced during class is often cited by those who practice this style of yoga as a benefit in terms of the release of toxins, the results of this study show that this sweating was insufficient to cool down the body.

While the study was done on Bikram classes which have a strict 105 degree, 40 percent humidity rule, these findings would likely apply to any hot yoga class with extremely high temps. Now don’t go throwing in your sweat-soaked yoga towel just yet. There may be hope. Quandt’s suggestions? Shorten the class (60 mins or less), lower the temperature (like, maybe less than the Sahara Desert?) and hydrate, hydrate, hydrate.

Bikram teachers are notorious for allowing only a few (scripted) water breaks. But scientists say that’s not cool.

“Nothing is gained from withholding water in any setting,” says Dr. Porcari, head of the University of Wisconsin’s Clinical Exercise Physiology program. “Exercise leaders must actively encourage hydration, particularly when classes take place in extreme environments like those seen in Bikram yoga classes.”

“Knowing the risks associated with things like blood pooling and vasodilation, as well as the signs and symptoms of heat-related illness, is absolutely essential,” Porcari added.

In addition, Cedric X. Bryant, Ph.D., Chief Science Officer at ACE, agrees, “Bikram teachers should recognize that participants’ thermoregulatory systems will be challenged in this environment,” he said. “It is essential that they are aware of the early warning signs of heat intolerance.” Of course, anyone who has ever practiced Bikram or hot yoga, has likely experienced one, a few, or all of these symptoms which include: cramps, headache, dizziness and general weakness.

For good measure, it shall be noted that a 2013 study also sponsored by ACE and also overseen by Bryant, found results to be the total opposite – that core temperatures and heart rates were not adversely affected in hot yoga. However, the key factor to note is that the previous study tested yogis in a 60-min hot yoga class with an average of 92 degrees, nowhere near the Bikram 105. The biggest takeaway from that one, too? DRINK LOTS OF WATER. And, if you asked us, if you feel like crap in the class like you’re going to simultaneously barf, combust and pass out, maybe it’s not the right kind of yoga for you.

Here’s a video about the most recent study.

In case you needed some help, the folks at ACE created this pretty infographic on hot yoga safety. Click the image to enlarge.

bikram-yoga-safety-infographic

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31 comments… add one
  • Am I missing something? Did there really need to be a study on whether Bikram/hot yoga can have ill effects? No one has ever heard of heatstroke? I got heatstroke at a Rolling Stones concert when I did not have enough water. Who can’t figure this out?

    • Wondering

      The same people needing help figuring out slow yoga.

    • Wondering

      The same people needing help figuring out slow yoga.

    • Casey

      The purpose of a scientific study is to generate empirical evidence to help us to replace assumptions with actual knowledge. When it comes to health, it is not sufficient make general guesses about the effects of heat. We want to answer specific questions, such as what temperature range is safe, how long can a person safely remain in a specific temperature, what level of activity can they participate in, how do water and electrolytes affect all the above.

      It is not sufficient to say “I got heatstroke at a concert, therefore hot yoga is bad for you.” An anecdote is not scientific evidence.

    • Casey

      It is not sufficient to say “I got heatstroke at a concert, therefore hot yoga is bad for you.” An anecdote is not scientific evidence. Consider the fact that the vast majority of people at that same concert most likely did not get heatstroke. Should we then assume, “All these people did not get heatstroke at the concert, therefore hot yoga is safe”? (Answer: No, because it’s entirely anecdotal, and there has been no control of variables.)

      The purpose of a scientific study is to generate empirical evidence to help us to replace assumptions with actual knowledge. When it comes to health, it is not sufficient make general guesses about the effects of heat. We want to answer specific questions, such as what temperature range is safe, how long can a person safely remain in a specific temperature, what level of activity can they participate in, how do water and electrolytes affect all the above.

  • mike hunt

    I was struck about how the authors don’t care to post their name on the article. Also, duh? One can get heatstroke in any exercise or even just sightseeing on a hot day. Its up to the individual to take care of his or her own body.

  • bill fiarchild

    “Bikram teachers are notorious for allowing only a few (scripted) water breaks”

    There are thousands of studios out there, but at the 7 or so in the US and the 1 in Europe I have attended, no one has ever denied me water. Yes, there is a scheduled break, but after that, all of the teachers I have had from east to west have said to have water when you need it. They ask that you don’t drink in between sets, but I’ve never seen anyone criticized.

    “Listen to your body” is the best advice given for any yoga class.

  • Graham C

    I am a Bikram yoga teacher and I never tell students to not drink water. Some teachers go on about not drinking until “party time” after the first three postures but I let my students drink what they want when they want. But what I *do* talk about in class is hydration. Too many students wait for class to hydrate and that’s too late. You need to be hydrated before class. I’ve found that if I am hydrated when class starts I will be less inclined to drink water during class. The more I drink during class the harder class becomes for me. So I encourage my students to come to class hydrated. And to drink what you need during class but know that you will probably drink less water and have a happier practice if you’re hydrated. The other thing around water is that it plays a part in the practice of non-attachment. It’s easy to start attaching oneself to that water-bottle and make a grab for it whenever things get hard in the room. I encourage my students to learn to distinguish if they are “wanting” water or “needing” water. If you’re just grabbing for the water because it’s something to distract you from the challenge you’re experiencing, try not to. But please have water if you need it.

  • Brian

    The following is from Dr. Brian L. Tracy. Dr. Tracy is arguably the worlds leading authority on medical science as it relates to hot yoga. This is his response to the ACE study:

    Greetings all. I’m the prof at Colo State who has done some hot yoga research and also TT hot yoga physiology/neuromuscular lectures. First, of the many internet pieces written internationally (just google Bikram and ACE) about this release of new hot yoga physiology data from the American Council on Exercise, the story in The Atlantic seems to be the most responsible,vcI’m biased…they even took the time to interview me about the work we’ve done on this topic to get a third party opinion.

    I have MANY thoughts about this recent data released by ACE. Seven of their subjects got to a core temp of 103 deg, one got to 104 deg. Pretty high core temperatures, higher than what we recorded under VERY CONTROLLED conditions (105deg, 40% RH). None of their subjects (experienced practitioners) exhibited heat illness or distress. Right now, as of this writing, the scientific paper that would provide more detail than ACE’s release is in press and not available and I haven’t yet received the final manuscript galleys I just requested from the authors (Porcari et al at UW Lacrosse). Thus, we don’t know 1) what the room temperature and relative humidity was in the studio during data collection nor how consistent the instruction was across subjects (critical info!), 2) the age distribution, sex, years of practice, relative exertion level, body mass index (how heavy for their height), pre-session hydration status, and fluid ingested, of the subjects who exhibited the high core temperatures. Maybe we’ll get that information and then know either to believe the data and incorporate it into our thoughts about hot yoga physiology, or totally discount these data due to lack of control and/or lack of methodological detail. We’ll see – and you can bet I will hit these Facebook groups with my analysis. We need to do more quality research on hot yoga ! (but you knew that). – Dr. T

    • Alejandro Enciso

      You got it Dr T!

  • allise

    Better tell the Tantra crowd!!

  • Brian L. Tracy, Ph.D.

    Hot yoga danger? Show me some good evidence.
    Warning: this is very long post.

    A scientific critique and commentary on the ACE/UW Lacrosse hot yoga study – May 9, 2015.

    Greetings once again to the hot yoga community. I am the professor at Colorado State University who published the first study on Bikram yoga in 2008 and another in 2013. My group has done other research recently on hot yoga physiological responses. I regularly lecture at Bikram Teacher Training and also during visiting lectures at hot yoga studios.

    Below is my critique of the study on hot yoga that was released in April 2015 by the American Council on Exercise (ACE). ACE commissioned the study, which was performed at the University of Wisconsin, Lacrosse (Porcari et al). The scientific paper describing the study is currently in press in the Gundersen Medical Journal. I have avoided scientific jargon to the extent possible. This is a pretty lengthy document. I felt it necessary to provide completeness and the expense of brevity.

    Conflict of interest statement, for context: I have lectured at Bikram Yoga Teacher Training regularly since Fall 2011, but for that I have never received financial compensation. I have enjoyed conveying research information to yoga teachers in a digestible way. Bikram’s Yoga College of India (BYCOI) funded 75% of our recent study on heart rate, metabolic, and core temperature. Our data collection, analysis, and interpretation was performed independently of influence from the staff of BYCOI. Nobody got rich from this grant….the funds were used for personnel, equipment, and supplies to accomplish the project. Currently I have no financial relationship with BYCOI and am not being compensated for this critique by BYCOI or any other hot yoga organization.
    I am a weekly practitioner of hot yoga – a weekend warrior. I like the way it makes me feel. I like the challenge. I’m not super serious about my practice but I like to try. I do other forms of exercise. I don’t have a particular axe to grind or a particular reason to defend hot yoga, per se. But as a professor at a research university and a researcher/teacher in this area I do have a desire to 1) communicate the proper interpretation of scientific data and 2) promote critical thinking.

    Read just this if you don’t want the details below: The numerous major flaws in the execution and description of the ACE/UW Lacrosse study render their conclusions about core temperature responses unsubstantiated. Due to these weaknesses in the research, I recommend that you do not incorporate these findings into your thinking about the physiological responses to Bikram-style hot yoga (26/2, 105deg, 40% humidity). A lengthy and detailed critique follows below.

    The study: The ACE-commissioned, UW Lacrosse study measured heart rate and core temperature in 20 people aged 28-67 yrs during a single Bikram yoga class in a Chicago area studio. They reported less than 1deg F change in studio temperature and consistent humidity for the 90 minute duration of the class. They used high quality ingestible devices to measure core temperature. The temperature values were manually recorded every 10 minutes. The physiological outcome focused on in the ACE release and voluminously in the lay press is the six subjects with core temps at the end of class > 103deg F, and one subject ~104deg F at the end of class.

    Our study: In contrast, our CSU study, performed in a controlled environmental chamber at 105 deg and 40%RH, found no core temperatures higher than 101.6 deg F in experienced 18-40 yr-old practitioners. Core temps steadily increased during the standing series and the average response across subjects was a “plateau” of temperature that averaged around 100.3 deg F during the floor series. These responses are well within the safe range for core temperature.

    Critical thinking is, well, critical: Well done science allows us to understand the nature of the world around us. In scientific inquiry, the worst mistake you can make, other than blatant misconduct, is to use data to say something is true when in fact it is not true, that is, to falsely reject the null hypothesis. The technical term for this is Type 1 error. An example would be doing a study on a cancer drug and concluding from your data that the drug cures cancer, when in fact it does not – giving false hope to cancer patients. This error is worse than Type 2 error, which occurs when you fail to confirm something that is actually true, or fail to find an effect that actually does exist. Both errors are bad, but Type 1 error is worse because it creates new but false information in the literature. The peer review process in science functions to assess the adequacy of an experiment described in a report/manuscript written by a scientist. Experts (other scientists) pass judgment on whether the data support the conclusions stated in the paper (are there strong grounds from which to say this thing is true?). If the experts agree, and the editor of the journal agrees, the paper is published and becomes part of the scientific literature. Part of my job is review manuscripts written by other scientists and render my opinion, that is, to carry out peer review. This is what I have done below, not for a journal, but for you. I hope you will think this is for the benefit of the worldwide hot yoga community. I have itemized my concerns about the ACE/UW Lacrosse study, followed by a commentary.

    1. Inadequate control over hydration status: The authors did not assess the hydration status of the subjects before the class. It is known that hydration status can change the ability of the body to regulate core temperature during heat stress. This is something that should have been controlled or at least described, especially for the subjects who exhibited high core temps.
    2. No information on fluid intake: Although the authors recorded who drank water and who didn’t, they did not measure or report the amount of water ingested during the class. For the reasons stated above, this should have been controlled or described. The authors do report that the subjects who drank water (amount unknown) had significantly lower core temps than those who didn’t drink water. It’s really easy to measure the amount of water a person drinks.
    3. Age of subjects not adequately described or considered: The authors reported the age range of the subjects, but they did not report the age of the subjects who had the greater core temperatures. Heat stress studies have shown that older adults have a more difficult time regulating core temperature during exercise in the heat. This is a basic description of subject responses that was lacking from the paper. Note: With this criticism I am NOT saying that older adults should not do hot yoga or that they cannot acclimate to the heat stress inherent to hot yoga. That is obviously untrue given the populations of devoted older students at hot yoga studios around the world. That said, scientific studies have not systematically assessed the safety of hot yoga for older adults who are not acclimated to the heat stress.
    4. How hard were the subjects exerting themselves? The degree to which the students exerted themselves during the 90 minute hot yoga class was not adequately described. The average rating of perceived exertion (RP) for all 20 subjects averaged 8 on a scale of 0-10, but the perceived exertion values were not reported for those who exhibited high core temps. This is important because greater exertion produces greater muscle work, metabolic heat, and a greater challenge to the core temperature.
    5. Clothing? The authors do not describe the clothing worn by the subjects during the yoga session, which could obviously influence the core temperature. This would have been easy to either control or describe.
    6. Experience level of the subjects not well described or considered: They authors asked the instructor to “rate” the experience level of the subjects on a scale of 1-10. However, the authors did not describe the years and frequency of hot yoga for all subjects or for the subjects with higher core temperatures. With what quality were the postures being performed? How much time was spent out of the posture? This was not reported.
    7. Flawed analysis of temperature values: The devices they used to detect the core temperature are very good. They are ingestible, vitamin pill-sized sensors that pass through the GI tract and transmit the core temperature to a recording unit on the outside. We also used these gold standard sensors in our study. However, and this is important… the way they obtained the values from the devices was inadequate. During data collection, there were 20 subjects all doing yoga in the studio at the same time. A researcher moved from subject to subject, obtaining and manually recording a single temperature value (transmitted from the pill to the handheld logging device) every ten minutes in each subject. The handheld data-logging unit can communicate with and track a large number of individual sensors at one time. The problem with their strategy is that the single “high” temperature values were all recorded at the final sampling time point at the end of the class. These single, final values at the end of class are the entire basis for the alarmist conclusions they make about core temperature during hot yoga.
    Here’s why this is a problem. We have significant experience with these sensors. They are good devices, but from moment to moment, from logged value to logged value, the values obtained from these devices can vary somewhat (a little bit) around the average core temperature value. Also, the pill is constantly moving around inside the small intestine, perhaps encountering areas of slightly differing temperature. The body is also moving around during the yoga, sometimes lying on the back or on the front, sometimes sitting up. This is why we electronically logged temp values EVERY TEN SECONDS for 90 minutes in our study, because then we can smooth the frequently collected, varying values over time and get a much more representative sense of the moving average of the core temperature. In a human, core temperature does not change appreciably from moment to moment, it changes relatively slowly over minutes. Our strategy, to smooth very frequently sampled core temp data, captures the slowly changing actual temperature more appropriately. But even our smoothed temperature data fluctuated significantly during the floor series.
    The problem with sampling just one value every ten minutes is that by chance you might sample a value that is higher (or lower) and thus not representative. [Think of a normal person whose mood changes from day to day but you only meet them once on their very worst single day. You would falsely conclude that they are very unpleasant]. [Or think of daily fluctuations in the stock market; if you were interested in changes in stock value over longer periods of time, you would average, or smooth, the price over some time period to look at the trend over time and disregard the daily fluctuations]. Because of the sampling strategy in this study, we cannot be sure of the accuracy and representativeness of their final temperature values. This is a really important weakness because this is the measurement that is focused on here as a safety issue. I am not saying this sample-to-sample variability is the entire explanation of their findings, but it is a possible contributor. There is no doubt that they sampled the temperature values too infrequently and thus it is likely they captured one momentary value not adequately representative of the core temperature.
    8. Safety of hot yoga due to elevated core temperatures? The authors make conclusions about potential safety concerns and they issue precautions about possible heat illness during hot yoga. But, even if true, we do not know how long the high temps persisted after the end of class. It can’t have been very long, because normally students leave the room after class. Heat illness is typically produced by fairly prolonged exposure to dangerously high core temperatures, not a few minutes of exposure. Given the fluctuations that we observed in our own core temp data during hot yoga, for this study it is likely that the actual core temperature data was not elevated dangerously for any sustained period of time – or at least these authors failed to demonstrate that. Let us remember that a hot yoga class is not a forced 10-hour march through a remote jungle, it is 90 minutes of hot yoga in a studio in a developed city, with access to normal room temperatures before and after class and access to water/electrolytes before, during, and immediately after the 90 minutes. Students should listen to their bodies, hydrate before, during, and after class, and novices should carefully acclimate to the heat stress of hot yoga during numerous sessions over a few weeks. Many studies have clearly demonstrated that the average human being can successfully acclimate to repeated, safely applied exercise and heat stress in as little as two weeks.
    9. Any actual heat illness in these subjects? NONE of their subjects reported any ill effects from the yoga session. Like happens with most acclimated students in a hot yoga class.
    10. Environmental conditions in the study studio: The authors report a 0.9 deg F increase in studio temperature (104.9 to 105.8) and a 1% increase in relative humidity (37% to 38%) during the class. They took these measures only at the beginning and end of the class. This is remarkable environmental control for a typical studio heating/ventilation system, much less an experimental environmental chamber like we used in our study. Thus, I’m not sure I believe it. They do not say how or where they monitored the temperature and humidity. Was the temperature different around the room? Where in the room were the subjects who had the higher temps? How did the conditions change during the entire 90 minutes? What kind of thermometer was used and where was it placed? None of this was reported in the study.

    Commentary: the sum total of these flaws erases any confidence we can have in their conclusions about dangerously high core temperatures in 7/20 of their subjects during hot yoga. It is wrong for statements to be made as they were in this paper, statements about potential danger of hot yoga, precautions issued about participating in hot yoga. It is wrong for the lay press (internet mainly) to give voluminous, alarmist, and simply wrongly stated attention to ACE’s release. It is wrong because it creates a false impression in the lay reader’s mind about the potential danger of hot yoga. A Type 1 error – saying something is true without a solid foundation – the worst kind of error to make. Organizations like ACE should not promote the findings of studies of this quality. ACE should withdraw their support and promotion of these data, and either retract or extensively revise their public release.

    As with all human endeavor that differs in quality, in the world of scientific journals there are very high quality scientific journals with very stringent peer review, poor quality journals, and a range of quality in between. This paper should never have been accepted for April 2015 publication in the Gundersen Medical Journal, an obscure, low-tier journal. In this case, the peer review system has failed us.

    Context is important. Around the world, have some people suffered some degree of heat illness during hot yoga? Undoubtedly. Humans are human. They are imperfect. They are sometimes careless, sometimes they don’t listen to their bodies, sometimes they don’t take care of themselves, they under hydrate, they over hydrate, they do too much too quickly. Teachers are human. There is variability in how classes are administered from studio to studio. Do people injure themselves, sometimes severely, just walking down the sidewalk? Of course. Every day.

    Are there some people who will try hot yoga and conclude it’s not for them because they simply don’t like the heat? Sure. Might they feel faint when they try it? Quite possibly. It’s a hot room. The student should pay attention and act appropriately if needed. And if in the end they don’t like it, they should do something else. Common sense.

    Are the responses of some special patient populations to hot yoga well described scientifically? No.

    Do we know everything we need to know about hot yoga? No.

    But, the vast majority of the multitude of students who practice hot yoga, worldwide, on a daily basis…. 1) Became acclimated to the heat stress when they were a novice, 2) enjoy it, 3) suffer no ill effects, and 4) they keep coming back. To me, that says a lot.

    We need to do more high quality research on hot yoga. Lots of people do it. It is interesting physiologically, medically, and psychologically.

    We need common sense, level-headed interpretation of the small amount of quality scientific information actually available on hot yoga physiology and medical effects. We don’t need alarmist misinterpretation of poor quality studies combined with the viral promotion that only the internet can provide.

    In summary, I recommend that you do not include the core temperature results and the associated conclusions of the ACE/UW Lacrosse study in your thinking about the physiology of hot yoga.

    – Brian L. Tracy, Ph.D., Associate Professor, Colorado State University

  • Andrea

    This is a pitiful study I can’t even believe it was published. I’ve done Bikram yoga for 8 years, have NEVER seen one person fall ill from a class. What I have seen is several people lose weight and keep it off, treat diabetes, treat depression, gain strength and confidence! IF there were any reported cases of people dropping from heat stroke or a heart attack, please include them to validate the pathetic claims you are making and referencing (ACE). PS: thanks for telling us all what we can handle and what we can’t, us humans are clearly incapable of deciphering what we can tolerate on our own.

    • Nancy

      I am surprised you have not heard of people having heat stroke from Bikram. I have. Besides, people are told they are not allowed to talk or leave. How would you know what is going on with the physiology of the others in the class. I know of people having heat stroke more than once, but the teachers say you need to stick it out.

  • Graham Coppin

    I’m a Bikram teacher and students can drink water whenever they want in my class. The only thing I caution is to notice one’s attachment to the water. We often get into patterns of reaching for water just because it’s something to distract us from what’s going on on our mat. So if I notice a student exhibiting a pattern of drinking lots of water, I may point it out to her. But I will never tell someone not to drink water. That’s just ridiculous.

  • Louise

    I practice bikram yoga regularly, I also have 3 children under 12 years old, all of which havehad fevers over 102 degrees. I say this because since I have begun practicing I have noticed that I rarely get sick and when I do it is for a very short time, even when others in my family are laid up for days. When my children have a fever they tend to stay pretty still but their heart rate is high. The reading I have done states that fevers are the bodies way of creating an environment in which virus and bacteria cannot thrive. I truly love practicing yoga, it has helped me with some back and neck issues, I enjoy it immensely, and it helps me release stress and focus. What studies have documented its benefits. I think this would require studies over long periods of time. Whats wrong with increasing your core temp for short periods of time….is there a benefit?

  • James

    Great comments. I too love hot yoga but may be forced to quit. I have dense musculature and a resting heart rate of 46 during bicycle season. After my hot yoga class I feel ok but exactly four hours later I get the yoga flu for six hours with thermometer temperature of 104 degrees and other hyperthermia symptoms. Why do the yoga gurus fail to address this as I have heard this from many other people

  • Crystal Trigaux

    I did hot yoga in Toledo in 2013, and am still suffering the effects. I wish someone would have told me about the ability to break ribs because of hyperextension injury due to the loosening of muscle at 105 degrees. I broke 3 ribs in the class and suffered blunt trauma to my gallbladder (causing pancreatitis) due to rib dislocation in a mere turning of my body from front to my back (we were instructed to try to turn 180 degrees.) I have done ballet for 12 years for hours daily, and am only 32 years old. Weigh 112 lbs and am 5’5″. So as a light human being who was fit, bikram destroyed me. I have had 4 surgeries to fix the problem, including mesh placed over my right flank abdominal wall because the ribs deinervated my abdominal intercostal nerves. The doctors said that what happened to me was “1 in a million,” but at my MRI I met two other practioners of bikram whom had broken ribs. So, there are other dangers to “hot hot hot” yoga. I would never recommend it to anyone.

  • CDaniels

    I’ve noticed two comments by Bikram teachers here noting they don’t forbid water but they warn of “attachment” to taking water breaks to avoid difficult postures. Unfortunately they don’t seem to see that “water shaming” is going to make people not drink for any time. You cannot say it’s Okay… But. You have to put up with the breaks in the name of safety. If someone overdoes it, so what? Does it really ruin the yoga so much that you have to endanger students’ health?

    • Graham C

      Hmmm, “water shaming” is a perspective. When I ask students to notice what they’re attached to, which includes but is not limited to their water bottle, I am simply teaching yoga. Attachment. Non-attachment. I am certainly not looking for the impact of wanting to shame them. And sure, I bet there are ways (tone of voice, looking at a student directly) to have that impact. But I am certainly not looking to shame. I’m looking to invite students to notice what they do on their mat (and off) and see how patterns emerge that might be getting in the way of them becoming even more brilliant than they already are. I challenge anyone to take my class and look for places where I shame a student in any way.

    • Graham C

      CDaniels I re-read my first post and I want to clarify what I said. I’d never single out a particular student in class about her water consumption or lack thereof. If she came to my class several times and I noticed a pattern, I might engage in a conversation with her after or before class and get curious about her relationship with the water bottle (or anything, actually. I’ve had conversations with students about where they always place their mats or their pattern of arriving late or leaving early. Anything.) Thanks for the opportunity to clean up what I wrote in the first post!

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