Practicing Yoga While Sick

Can I practice when I’m sick?

It’s a question we get at the studio often. As with most yoga-related questions, there’s no one-size-fits-all answer.

First and foremost, if you have something contagious, please stay home and keep it to yourself. We once had a student undergoing treatment for a persistent MRSA infection practicing at the studio for four months without telling us.

Lucky for all who were practicing at that time, our sweat contains powerful antiseptic peptides in dermcidin. The best feature of dermcidin is that it attacks the microbes’ cell walls, not something to which a microbe can develop resistance.

Can you guess how many students have contracted MRSA at our studio? You’re right. None. The sweat-effect is amazing and powerful. With that said, the chance of transferring a few microbes on the door handle as you leave just isn’t worth the risk.

As a general rule, we say, “From the neck up, come to class. From the neck down, stay home.”

If your symptoms are sneezing, post-nasal drip, cough, even a head ache, you should be okay to take class. If your symptoms include vomiting, diarrhea, fever, body aches, and chills, you’re probably better off in bed. Or at your doc’s office.

Why you should practice.

  • Circulation: The “miracle cure” of yoga lies in it’s direct stimulation of the circulatory system. Through tourniquet-like compression and release of tissues in the body, we encourage and improve the movement of blood through the body, helping the human body’s systems to do their jobs better. Chronic stress and lack of movement can limit circulation to “non-essential” systems like the digestive, immune, endocrine, and reproductive systems. Yoga helps to restore circulation to better-than-normal levels. This improves your ability to heal.
  • Lymph: One of our most important components of the immune system doesn’t have it’s own pumping mechanism. Our lymph nodes circulate lymph and white blood cells, filter invading microbes and mutant cells, and remove edema from the body. This powerful system only works if you move your body. Through postures that flex and extend the trunk and the hips, we directly palpate the lymph nodes and facilitate the movement of lymph throughout out the body. The great news is that this movement doesn’t need to be intense or strenuous to get the desired effect. Gentle movement is enough to produce benefits.
  • Breathing: Breathing exercises also have positive effect on the lymph nodes. Simple abdominal breaths where the belly rises and falls can move four times more lymph than chest breathing. Most common colds and flus also include symptoms that restrict the breathing or allow mucus to settle in the chest. The deep and rhythmic breathing practiced in a yoga class can help to keep the bronchi clear. Don’t be surprised if breathing exercises make you cough. It’s not necessarily a bad thing.
  • Decongesting: Chronic congestion can lead to ear or sinus infection. Postures that invert the head can help to drain the sinuses and eustachian tubes. Many students find postures like Rabbit or Separate-leg stretching cause a sense of clearing. For students with an active sinus infection, theses poses might be torture. The moist, humid air of a hot yoga class is the only place many students recovering from a cold or the flu can actually breathe for a few minutes a day.
  • Mood: Being ill, especially chronic illness, can do a number on your mood and outlook. Yoga has been shown to improve levels of the “happy hormones” like dopamine, GABA, serotonin, and oxytocin in practitioners. A preliminary study at Mass General in Boston shows a direct negative correlation between numbers of classes taken and reduction in depression symptoms. Not only will your hormones get a boost, you’ll get out of the house and be around a community of healthy people who can offer you emotional support and even a few laughs during your recovery.

Why you should stay home.

While we appreciate the concept of sharing-is-caring, when it comes to disease, we don’t buy it. If you have something contagious, please don’t share it with your yoga friends. Just like in school, if you’ve vomited in the last 24 hours, stay home and wash your hands a lot. Meningitis, MRSA, lice, TB, flu, strep, and stomach bugs are just a few of the highly contagious diseases you should enforce a self-quarantine over.

Next, we get into the questions. Are you a chronically over-scheduled person? Are you over-worked, under-slept, and over-trained? For some of us, the most compassionate thing we can do for self-care is to stay home, make a cup of tea, and binge watch Shameless on Netflix.

What about chronic illness and fatigue?

You sweet, suffering yogi. You have all of my compassion. I know how difficult it is to suffer day-after-day with no end in sight. Living with chronic disease and adapting your life to this “new normal” while simultaneous searching for answers and cures is exhausting physically, mentally, and emotionally.

In my experience both as a teacher of students with chronic illness and as a patient suffering from chronic fatigue, I don’t think you can afford to cut yoga out of your self-care routine just because it makes you tired and is hard.

At the request of my doctor, I cut yoga out of my life for one week during my recovery. I rested, ate well, walked, and took my supplements. Each day, I felt worse than the last. It was a wonderful wake-up call for me. When I returned to class, I didn’t feel good or strong. I wasn’t even able to string more than two poses together in a row. After class, I didn’t get the yoga high I was used to, but I didn’t feel as terrible as when I didn’t have yoga in my life.

Practicing yoga with a chronic illness requires a radical shift in how you view yourself and your practice. Yoga is a healing modality. Yoga has the ability to support your body, your mind, and your healing. It also has the power to deplete and exhaust you. The difference is in how you approach your practice.

The beauty of yoga is that you can tailor each class to your exact abilities on that day.

The first phase in my healing was the mental shift. It took a long time and a lot of work to ignore the voice in my head who said, “It doesn’t matter how you feel. Keep going.” That powerful voice of perseverance that had helped me through so many challenging times in my life, was now destroying my health. If I pushed too hard in class, I couldn’t do anything for the rest of the day. I’d get shaky and my teeth ached.

I learned to treat yoga as a “get to” (not a “have to”) and class-after-class struggled to let go of my long-held view of myself as someone who is strong, tough, and steady. I learned to use yoga as my therapy and to tread gently with my tenuous health and strength.

I heard from many specialists, loved ones, teachers, and friends during my recovery that maybe I should stop practicing Hot Yoga. I heard that Bikram Yoga was too Yang, too Pitta, too much internal fire. People told me it was a depleting practice.

Trying not to be pig-headed, I tried heeding their advice, but my experience did not match their hypotheses (which, I must add, were based on conjecture, not science). Luckily for me, at the same time I was suffering from Post-Viral Syndrome and heart damage, I also had two students with serious illnesses practicing by my side. One woman suffered from Chronic Fatigue linked to Chronic Lyme and another woman suffered from Adrenal Fatigue after major life stressors and breast cancer treatment.

We were all told the same things. Each of our doctors told us to stop practicing Hot Yoga. As each of us tried limiting our practice or cutting it out all together, we each returned to the hot room feeling no better and looking for answers. Not-practicing didn’t heal any of us. It didn’t calm our inner fire. It didn’t balance our Yang and promote healing. It just took away our yoga. I took strength from those women, my compadres in suffering, to continue on the path that felt right for me despite the unfounded advice of our physicians.

A good first step for yogis with chronic disease, chronic fatigue, lyme, adrenal fatigue and the like is to start by practicing only one set of each posture. For Type-A yogis, this will not be easy, so you’ll need to solicit help from your teachers. My teacher (husband) used to stop the class until I sat down. That was the kind of loving-firmness I needed to take my health seriously. It only took holding back the class twice for me to self-regulate.

When you reflect back on all of the “reasons to practice” when you’re sick above, they’re all aspects of healing that you need during chronic illness. You simply must be more gentle, kind, and less demanding of yourself. There is no way to bully your way through chronic illness.

You can use yoga as a tool in your compassionate healing.

Sara Toe Street



Sara Curry is the owner of a Bikram Yoga studio in Portsmouth, New Hampshire. She has been teaching yoga since 2003 after her recovery from herniated discs ignited a desire to share the healing power of yoga with others. She is also Vice President of Seacoast Area Teachers of Yoga in Action, a local non-profit making yoga accessible to at-risk and high-needs populations on the Seacoast of NH and ME.


BBL Gets a Makeover!

In 2012, we started a program at Bikram Yoga Portsmouth called Bikram’s Biggest Loser. This program was motivated by my older sister’s inspiring story. Read it here.

In a nutshell, my sister, Gina, found her way to the yoga on a regular basis nine years after taking her first class and hating it/herself. She battled self-hatred and obesity most of her life and found love and respect for herself on her yoga mat.

In the world of yoga, fat people are greatly underrepresented. Did you notice I said fat? I said it on purpose. “Overweight” implies that there’s “right” weight and, frankly, I’m done with that dogma.

While more than a third of Americans are categorized as “obese“, the percentage of practicing yoga students who fit those characteristics hover near the single digits. I wanted to change that.

Around the country, “Fat Yoga” studios have opened catering to obese yogis. Studios added “Curvy Yoga” or “Yoga for Round Bodies” and that never sat well with me. At our studio, we never differentiated between kids and adults. We don’t offer special classes for athletes or the elderly. Why would we exclude people from our regular schedule based on their weight?

How would it serve anyone to isolate fat people to a single class once a week?

A beautiful thing happens when all yogis practice together. It promotes the understanding that we are all the same on the deepest levels. I wanted something different for BYP. I wanted inclusion.

I wanted people to know that BYP was a safe place to practice yoga for anyone. I wanted students who had a BMI over 30 to know they wouldn’t be the only fat person in the room. I wanted to spread the word that my teachers knew how help people get into poses if there were big breasts or big bellies in the way, or how to approach a pose if thick thighs made the traditional execution impossible. I wanted people to understand that no matter who you are and what struggles you face, we were not going to judge you.

We modeled the program, at first, after the popular TV show The Biggest Loser. Not for the rapid (and reportedly dangerous) weight loss, but for the trainers’ intense belief in the participants’ abilities to achieve that which they did not yet believe in themselves. On TBL people’s ideas of themselves as quitters and losers transformed to that of achievers and athletes. We saw that happen in our students every day at yoga.

We knew the tantalizing draw of weight loss would bring in lots of clients. We were featured on the morning news and 43 people registered for our first challenge. Nationally, most people report that they try their first yoga class for either weight loss or fitness goals.

And people did lose weight. A lot of it. Our first winner lost 71 pounds and cut his cholesterol in half. One woman dropped eight dress sizes, four inches off her thighs. In five years, participants have lost nearly a collective ton of weight.

Some people didn’t lose weight. Not a pound. A few students even gained weight, but something else important was happening. People’s lives were changing. They were standing up for themselves at work. They were lowering dosages of blood pressure medication or going off anxiety meds. BBL participants found community, made friends, and felt a part of something. They rallied each other when they wanted to quit. They quieted that evil critic in their own heads. They learned to look in the mirror with pride, not shame.

I have a secret to share. I never cared if anyone lost any weight.  

I only cared that people found health and wellness and happiness. I knew that the potential for weight loss would draw people to the program because that is the song of our culture. Lose weight and be worth something! My vision was that if I could get them to show up, people would learn to love and respect themselves on the mat and the rest would fall away.

My vision came true. It worked.

Everything I thought the program could be, it was and even more. Last year, we added the Fueled and Fit program with nutritionist Erin Holt. Erin’s life goal is to get everyone in the world to stop dieting forever and learn to eat and listen to their bodies so they can fuel themselves and feel good. She strives to help people heal their convoluted relationships with food.

With Erin’s work, the program dug even further into our deep-seated beliefs about food, body image, and self-worth. Last year’s program pushed us to make a big change in how we structure and name the program to better represent the power and efficacy of dedicating three months of your life to healing your self and setting your life on a new path for good.

Last season, we had optional EFT (Emotional Freedom Technique) sessions with Cheri Keirstead. This year, we’ll offer these tapping sessions as a criteria of the challenge. EFT is a psychological acupressure tool that allows you to practice calming your limbic system while simultaneously talking through issues and thought patterns that underlie your biggest challenges. Some participants worried that the tapping was a little too woo-woo-weirdo for them, but the folks who actually attended the sessions saw amazing results. Hey, sometimes the crazy hippie stuff works.

In this blog post, Erin Holt addresses the intersection between woo-woo weirdo and science. Tapping works because you calm unconscious stress responses to emotionally-charged thoughts and memories while allowing yourself to put words to your feelings. Studies clearly show a naming emotions reduces neurological and biochemical response to them.

We made the choice to model the program after our successful Sober Yogis program as a challenge, no longer a competition. The challenge is to commit to yourself for 90 days. To dig deep into the parts of your life that are holding you back. To look at food as your fuel, not your enemy. To stop dieting forever. To heal your body and your mind. To gain control of chronic illness. To let go of patterns that no longer serve you. To create habits that will drive the rest of your life.

Participants who meet the requirements of the challenge win a month of unlimited yoga at their host studio. There’s no longer a BBL winner. With our new program, we all win. The goal is to take three months of your life to make changes to the way you move, eat, and think that will lay the groundwork for how you live the rest of your life.

We won’t be taking weights or body measurements. Instead, we’ll measure depression and anxiety scales, and social-connectedness.

This new format allows us to expand our reach with this program from obesity to a myriad of challenges like: PTSD, disordered eating, chronic illness, debilitating injury, depression, anxiety, self-hatred, trauma, addiction, anger management, stress-reduction, body dysmorphia and more.

It is with great pleasure that our team introduces to you the new and improved Commit to 90 program.


Visit our website for more information and details on the challenge rules and resources.

We look forward to welcoming you to this supportive community,

Sara, Jaylon, Emily, Erin, Cherie and all of the teachers at Bikram Yoga Portsmouth and Epping

BBL 3.0 Yeah


Can I practice yoga if I have MS?

yoga myth monday (6)


I am Not Good in the Heat and Other Excuses

“I’d try hot yoga, but I’m not good in the heat.” I’ve heard that at least a hundred times or variations on the theme.

“I hate heat.”

“I can’t handle heat.”

“No, really, I hate the heat.”

“I tried it and I couldn’t handle the heat.”

I am the bearer of both good and bad news.

These are not reasons. These are excuses.

The good news is that now that you understand it is an excuse, you can take action. The bad news is that this is just an excuse and not a reason not to go to class.

The human body has a tremendously efficient and responsive thermoregulation system. Except in cases of illness, it does a wonderful job of constantly adjusting to changing external and internal temperature changes.

Your body is no different than any of billions of humans on the planet.

All along the equator, humans live in climates with a heat index much higher than a Bikram Yoga class. People survive Texas in the summer. Just a few decades ago, most did it without air conditioning. You, too, could survive there.

“But I am a special case….”

My friend, John, has a spinal cord injury that severed communication with his sweat glands. He cannot sweat. He uses a spray bottle to mist his skin when he gets hot and the water causes evapotranspiration to cool his body, just like yours. John can do hot yoga. You can, too.

Being in a hot yoga class is uncomfortable.

It’s hard to do yoga. It’s hard to look at yourself. It is hard to feel a body you have been trying to ignore for decades. You are hot and you think you might suffocate. You think your body just can’t handle it. These are thoughts. That doesn’t make them reality.

The secret to it all is, you can do it. You can show up and learn to breathe and focus on your body and not your mind. You can acclimate to the heat and take it one breath at a time and become more comfortable in your body. You can learn to do what you can today and not what you think you should be able to do by now, goldangit! You can become more comfortable in this moment, even if this moment is uncomfortable.

“I am not good in the heat” is a phrase that means “I am not comfortable being uncomfortable,” and this is normal. The human brain is designed to avoid discomfort. Within a fraction of a second, your body can classify any sensation as one to avoid or to seek. Before you even have time to rationalize, your mind will lead you toward avoidance.

If you are chased by a tiger, Avoid! Avoid! Get away and get safe. If you don’t want to take out the trash, well, its time to learn to control the mind and get the job done.

Reason, logic and patience are all gifts of our higher brain function. We can use our brains to either help ourselves in the moment or to hurt ourselves. It is the self-awareness that yoga brings that helps us to experience the present moment and act from a place of understanding and reason.

This is one of the greatest gifts of a hot yoga practice. We train over and over, pose by pose, to pause and to breathe in conditions of challenge and discomfort. We learn to quiet the mind, control the breath and listen to the body. “Am I safe? Am I okay?” we ask our bodies over and over in class.

When the answer is yes, we induce neuro-plasticity and retrain our brains not to fidget, hold our breath, or increase our heart rate under stress. This is why, in scientific testing, yogis have shown significant reductions in the stress hormone cortisol. This is why so many yogis report that yoga “reduces stress” even though their lives are as stressful as others.

Here are some other excuses, parading as “reasons”:

  • I am too old.
  • I am inflexible.
  • I am too fat.
  • I can’t.
  • Yoga hurts people.
  • I have __fill in the blank__ injury.
  • I am tired.
  • I have __fill in the blank__ disease.
  • I don’t have time.
  • My family needs me.
  • I don’t know what I’m doing.
  • I can’t afford it.

These excuses are all of the exact reasons that you need to do yoga. These are all factors in your life that yoga will help you heal from or deal with. I have never met a yoga studio owner who wouldn’t accept work/study or trade for yoga. If you are truly too busy to do yoga, you had better get to class before you die.

If you have seen yourself in one of those excuses, it may have started a diatribe in your head against me and how I don’t know what I’m talking about or, worse, about you and what a loser you are to have made an excuse.

You are not a loser; you are a human. While I take responsibility for saying some things that may have made you uncomfortable, I am not sorry in the slightest. That’s my job. I have made a career of helping people find comfort in their lives through uncomfortable acts and facts. I paid for the mirrors, but you’ve gotta do the work.

The payoff of all of that work is big. Peace. Well-being. Freedom from pain. Health.

In the words of my teacher, “You deserve to have the best life. I feel cry when I say that.” I feel a little cry myself, now that you mention it….

sara headshotSara Curry is the Owner and Director of Bikram Yoga in Portsmouth, New Hampshire. She is Vice President of Seacoast Area Teachers of Yoga in Action, a non-profit that improves accessibility of yoga to traditionally under-served populations. She is also one of the creators of the Sober Yogis yoga and recovery program.


Why do some yoga poses hurt?

Yoga should never hurt.  

Your back is gonna hurt like hell.

Ask any teacher and they’ll give you a strong argument about why one of those answers is correct. With the myriad of bodies and experiences we see on a daily basis, a yoga teacher learns quickly that as we think there is only one right answer, we couldn’t be farther from the truth.

I like to say, yoga should never hurt you. It should never be damaging to your body. That doesn’t mean it doesn’t hurt sometimes.

How do you know when yoga is healing or hurting?

We often confuse pain and stretching

Yoga is all about getting to know you.  Your body. Your mind. Your Self. Much of our daily lives revolve around ignoring the way we feel so we can get through the day and get our work done. We ignore our aching hips on the two hour commute as much as we avoid movements that remind us of what it feels like to live in this body.

When we first start to move every part of our bodies in yoga, the sensations are unfamiliar and we can frequently categorize the uncomfortable sensation of stretching or moving a joint through full range of motion as pain.

Backbending when you haven’t done it in twenty years hurts. Clearing mineral deposits from your elbows hurts. Tensing up when you are trying to stretch hurts. Bringing back full range of motion to a hip that only sits in a chair or a couch hurts.

Ask yourself, is this pain or the sensation of stretching?  As a general rule, pain means stop and discomfort means go.

Sore muscles become stronger muscles

Muscles need stress to become stronger. One of the side effects of that stress is delayed onset muscle soreness. While it is certainly possible to over-exert yourself in yoga, DOMS is a natural part of increasing strength. This form of discomfort initiates within 24-48 hours of exertion and should resolve itself within three days.

Tolerable sore muscles mean progress. Don’t be scared.


Our brains are designed to seek avoidance of anything that causes us discomfort. Cramps are no exception to this rule. Inadvertent and strong contraction of muscles in a cramp can be abruptly painful. It causes us to immediately cease the activity and often violently avoid the sensation.

There are three main causes of cramps, excluding medications and preexisting conditions:

  1. Dehydration. This is a serious condition and is accompanied by a host of other symptoms like the inability to uncurl the fingers, vomiting, confusion and difficulty breathing. Individuals who are dehydrated need immediate intervention. This is not the cramp you get during cobra.
  2. Mineral deficiency. These cramps are generally not experienced during exercise. Nighttime leg cramps can often be attributed to a deficiency or imbalance in calcium, magnesium or potassium. Talk to your healthcare provider about an appropriate supplement if you experience nighttime cramping.
  3. Exercise intensity. Dr. Martin Schwellnus proposes that as you increase the intensity with which you are using a muscle, it can take time for the brain and body to synchronize, resulting in over-contraction of the muscle. This occurs particularly when the muscles are fatigued. This period is known as “altered neuromuscular control” and was originally theorized because studies have shown no correllation between hydration and electrolyte levels with muscle cramping in extreme athletes.

The first two causes of cramping rarely apply in a  yoga class. This leaves us with muscle fatigue and exercise intensity. We often seek muscle fatigue to get a muscle to “let go” before stretching it, so the cramp is a sign we are on the right track, just maybe a little to far too fast. Deepening muscle strength through increased length or intensity of contraction can, at times, be accompanied by cramps.

As unpopular as this may make me, I am a fan of cramps in class. It means I’m doing something new. Going somewhere I haven’t before. Finding new depth or strength I didn’t know I had.

Keep your breathing regular and slowly decrease your intensity and watch that cramp melt away. In a nutshell, cramps in class are not dangerous. Don’t panic.

Rusty hinges, adhesion and scar tissue

After we finish development, it is use it or lose it with range of motion and flexibility in the body. In our adult lives, we sit or stand in the same position for hours at a time, sometimes a majority of our day. It is a rare individual that uses their body through full range of potential movement each day. Most people use much less than even half of potential movement.

Joints that aren’t used through full range of motion are the perfect place for calcium oxalate crystals to deposit. This is a painful form of arthritis. As a rolling stone gathers no moss, so a moving joint keeps surfaces clear from crystalline arthritis. Clearing mineral deposits from the joints is not always a pleasant process. Take your time. It will get better.

Muscles that remain tightened in the same position for long periods of time can form hydrogen bonds between the muscle fascia that get more dense with time. Stretching those long-bonded filaments of connective tissue, like moving a crystallized joint, can feel much more intense than simple “stretching”. Again, move slowly, but don’t be afraid.

Scar tissue forms when the body heals from an injury. Scar tissue cannot be eliminated, but it can be remodeled. Through movement and stretching, one can realign the collagen fibers in the lumpy scar tissue so that it is both stronger and more plastic. Through this process, the scar tissue begins to act more like the original, flexible tissue that was in place before the injury. The older the scar tissue, and the more trauma to the area, the more uncomfortable this remodeling process can be.

On the mat, the yogi should practice with awareness and patience. When we want to achieve yoga “goals” too quickly, we can cause injury. Take your time. Move with awareness, and be patient. Start where you are and build strength and range of motion from there.


Osteoarthritis is the condition in which the protective cartilage in a joint is worn down, eventually to painful bone-on-bone contact within a joint. Osteoarthritis generally forms from uneven tissue-loading or repetitive movement. There is no cure for osteoarthritis, but yoga is a great tool to help strengthen the soft muscle tissue around the joint and reduce the amount of painful bone-on-bone contact.

In the practice of yoga, individuals with this condition should focus on precise alignment of the skeleton in poses and building strength around the joint. Range of motion exercises are helpful because they help palpate the circulation around the joint, maintaining and improving joint health. Individuals with osteoarthritis must practice to tolerance only.

Once the painful bone-on-bone compression is felt, going deeper will only exacerbate the wear and tear on cartilage and bone. This is not a pain to try to tough your way through. Through practice and attention you will find the places where you need to stop before you reach the pain.

Chronic Illness

Fibromyalgia, rheumatoid arthritis, lupus and other autoimmune disorders are often noted for unsourced, chronic pain. Practicing yoga with these conditions hurts. That’s the cold, hard truth.

The good news is that yoga also miraculously relieves the long-term pain. There is no clear explanation of why, but moving the body with awareness, increasing circulation, improving alignment and strength all help to eliminate the seemingly endless pain. Read more about Joseph Encinia’s inspiring recovery from RA.

Other forms of chronic illness are also notorious pain producers. Sometimes it is being unable to move for long periods of time or the way we hold ourselves in response to the illness that causes pain.

Take your time and move slowly, but get started with yoga. The body functions best when it is being used and yoga is one of the safest ways to find the limits of your body in any condition and begin to improve your health.

Chronic Misalignment

Duck-footed. Hunch back. Sway back. Ding-toed. Flat foot. Forward head.

These common misalignments are not in the original design template of the human body. “My father was duck-footed” is not a genetic precursor for you to turn your toes out. The human leg was not designed to be used in that way. We learn postural habits from our surroundings just like we learn syntax and social cues.

Some of these misalignments are caused by accident, injury or habit. You may have developed a habit of jutting the ribcage forward at the beach to appear thinner or have a forward head from working at a computer desk all day.

The most insidious component of chronic misalignment is uneven tissue load. Take this valgus, or abnormal rotation, of the heel below. Misalignment of the heel causes adjustment of the bones of the entire leg, hip and eventually the pelvis and spine. Uneven load in the tissues over time leads to failure of the muscle or tendon fibers. This flat foot might just be causing your migraine headaches.

As you work to change chronic misalignment, you may experience discomfort and pain. This is part of the process of realigning bones, strengthening muscles and healing connective tissue. With this type of pain, it is important to have a strong team of therapists helping you through the process to ensure you stay safe, progress at a rate appropriate for you and practice with a depth and attention to alignment that is not causing you further damage.

A good team includes experienced and educated yoga instructors, massage and physical therapists, maybe even a chiropractor, doctor or sports medicine specialist. Check out Dr. Mike Evan’s video on chronic back pain for more information on diagnosing chronic pain, creating a team and developing an attitude that will help you to heal.

You have bad alignment in class

I know it. You wanted me to say something nice. You expected something more supportive, and all you got was tough love. Get ready for more real talk.

Your alignment sucks.

I hope that is bold enough to get you to make a change. Your teacher said your foot should be pointing straight up over the top of your head in Standing Bow. Yours is pointing over at a boat moored across the river in Kittery and you are surprised your sacroiliac injury isn’t getting better?

You want to go higher in floor bow, so you leg your legs spread three feet wide. Yoga must be bad for knees.

You want to come down lower in half moon, so you turn your chin, twist your spine and collapse your chest. I guess yoga causes neck injuries.

You keep losing the grip, so you use a towel to augment your hand strength. Ah! It’s yoga, not tennis that causes rotator cuff injuries. Phew!

Or are your ready to take responsibility for your actions and use yoga to change your body and your life? There are very specific reasons for the way your yoga teachers cue the postures. The sequence of the cues is critical. The words we use intentionally to create specific actions in your body to keep you safe, and to help you maximize the therapeutic benefit of your practice.

Here are the steps to achieve a healing practice.

  1. Frequency: You have to show up. Regularly. Not once a week you show up and work so hard you pass out, puke twice and have to go home and take a nap. Regular, consistent, dedicated practice. You are worth it.
  2. Accuracy. Alignment is the first priority in any pose. Even if you can only move one inch into the pose. With no alignment, there is no therapy.
  3. Intensity. Only when you are showing up regularly, and executing the postures with accuracy and precision in your alignment, do you add the intensity and depth. Intensity is the privilege of the mindful practitioner.

Intensity is the privilege of the mindful practitioner.


Injuries happen in life. We slip on the ice, aggravate a shoulder playing tennis or get too aggressive in a pick up basketball game. With few exceptions, a modified practice can be continued with an injury, but pain will be an important guide.

Last year, we had a student practicing with a broken leg. She did her practice in a chair for the standing poses and elevated the leg on the floor. After two weeks, her doctors told her the leg was ready for weight-bearing. After four weeks, the fracture was invisible on an x-ray. Her doctors were blown away by the speed of recovery for a woman in her fifties.

One of the main reasons yoga helps you to recover from an injury is blood flow. Increased circulation helps support and speed repair and rehabilitation. The tricky part is not letting a misguided ego tell you to go for it in floor bow even though your shoulder bursitis is bothering you.

The most important action to take when you have an injury is speaking. Talk with your doctor or physical therapists when they analyze or diagnose you. Ask questions like, what types of movement should I avoid? And, what movement should I do to rehabilitate from this injury? Many students bring in a printout of the poses they have questions about. Get specific and don’t leave without an answer. You may be the first patient they have had who really wanted to know.

Talk to your teachers. Any well-educated teacher has yoga therapy and yoga for the infirm in their training profile. They can’t help you with your whiplash if they don’t know your neck is bothering you. You are not a yoga expert, so you may not realize that forward folds are aggravating your herniated discs.  You might be great at aerodynamics or flag football. Let your teachers share their expertise and experience with you.

I can’t tell you how many students have complained that an injury was not healing and when I asked them to take it slowly or avoid a particular movement temporarily have replied with, “Well, I like to push,” with a cheeky smile. Apparently, you also like to stretch a twelve-week recovery out to eighteen months.

Bones take four weeks to heal. Muscles take around six weeks. Connective tissues can take up to sixteen weeks. The average woman recovers from a common yoga injury to the hamstrings tendon in eighteen months. Talk to your providers and listen to your body so you don’t end up in unnecessary pain for years.

Over-Aggressive Practice

This could be a sub-section of the injuries category. Like all physical activities, you can create injury in yoga. Yoga has tremendous therapeutic potential. It can also cause harm.

We see it and want to achieve it. We know if we work hard, we can pull ourselves up by our  bootstraps yoga mats and live the American yoga dream.

I hope you listen to what I am going to say next.

Too good is no good.

More is not always better for the human body. You might not be strong enough yet for headstand. Your body may not be genetically designed for full wheel. You can cause wrist injury by misalignment in handstand. Shoulderstand is not for people who have osteoporosis.

This kind of pain is the devil in the world of yoga. This kind of pain is not the walk-through-the-fire-and-emerge-clean kind of pain. This isn’t the suffering that leads to redemption. This is the antithesis of yoga: disunion of mind and body.

When you are in the posture, with healthy alignment, to the best of your ability today, that is the ultimate destination of yoga. It is meditation in it’s purest form: the mind in the body, one second at a time.

Take your time. Ask questions. Be patient. When we approach pain with awareness, we realize that in the words of the great Emmy Cleaves, “Pain is a gift.”

sara headshotSara Curry is a Bikram Yoga studio owner in Portsmouth, NH. A lifetime of back pain lead her to yoga at the turn of the millennia. The freedom and recovery she gained from yoga drives her daily practice and her determination to bring yoga’s healing potential to as many people as possible.


Bikram Yoga and Osteoporosis

We would like to believe that our bones will always be as strong and healthy as they were in our youth. Unfortunately, around the age of 30 we all reach peak bone mass. Our job at that point is to maintain at all costs as much bone as we can. Osteoporosis is not limited to women, but a much more common diagnosis. Bone loss begins for most women in perimenopause, but bone loss numbers jump dramatically during menopause due to dropping levels of estrogen and progesterone.


Bone density is no joke. The figure on the left shows healthy bone; the figure on the right shows osteoporotic bone. No one wants to enter their golden years on fragile pins. Luckily, there is hope.

In addition to a healthy diet high in calcium and Vitamin D, yoga can be an excellent tool in helping maintain peak bone mass, slow bone loss and prevent fractures. Yoga is a weight bearing activity that creates torque on the bones to help build bone density, much in the same way you build muscle strength, through Wolff’s Law. Bones get stronger and stay strong when they are called upon to do more.

Yoga also helps to improve balance to prevent falls as we age. Improving spinal alignment reduces the risk of wedge fractures in the vertebral bodies that lead to that stereotypical, kyphotic, osteoporosis look. Yoga improves flexibility, lubrication of the joints and range of motion, all of which contribute to preventing the most common hip, wrist and vertebral fractures associated with osteoporosis.

In a University of Southern California and Orthopedic Hospital of Los Angeles study published in June 2010, Bikram Yoga practitioners had above average bone mineral density at the lumbar spine, hip and in total body scores. Even more impressive, each of the subjects had a total body calcium Z-score one standard deviation above the norm for their age and ethnic cohort. These findings led researchers to suggest that Bikram Yoga may hold promise in preventing or arresting bone loss in women.

While yoga can be extremely helpful in preventing or stopping bone loss, some yoga postures are risky for individuals with osteoporosis or osteopenia. There is no reason to practice with fear, but a healthy dose of caution is wise. Individuals with osteoporosis or osteopenia should use the following guidelines:

  • Limit Flexion of the Spine. Flexion=Forward. Avoid deep forward flexion like plough pose or shoulderstand and limit flexion in poses like all versions of the head-to-knee poses or rabbit. In a Bikram Yoga class, you can still execute the poses, but bend forward at the hip joint, not with the spine and avoid the chin-to-chest compression. A pose like Padahastasana should be done with the back flat, even if the trunk is far away from the thighs (no more Japanese Ham Sandwich) to ensure that the forward bend occurs at the junction of the femur and pelvis and not in the spine. Head-to-knee pose can be done in the Ashtanga tradition where the back is kept flat as shown here.
  • Backward Bending Increases Bone Density. Work your back bends to help keep your vertebrae strong and healthy as you age. In cases of extreme osteoporosis, deep back bends or extreme hyper-extension of the neck may need to be avoided. Move slowly with strength and awareness.
  • Twist with Moderation. The flat bones of the body like the ribs can be prone to breakage. Spinal twists are a great addition to your practice, but don’t try to be the girl from the Exorcist. Everything in moderation.
  • Avoid Challenging Inversions or Arm Balances. Once diagnosed with osteoporosis, your bones are not as strong as they were. Most breaks come as a result of a fall. Now is not the time to try to perfect one-armed handstand. Move your body with care and awareness.
  • Avoid Postures that Weight Bear on the Neck. The spongy vertebral tissue in the neck is prone to fracture. No plough or shoulderstand pose. Headstand should only be attempted if you are adept at the posture and can bear the body’s weight in your forearms and not the top of your head. Rabbit pose is not appropriate for individuals with osteoporosis.
  • Sit with Good Alignment. Sitting is an activity that puts a lot of pressure on the spine. When sitting or standing, align the shoulder over the hip and the ear over the shoulder to accentuate the natural curves of the spine and utilize the inherent strength in the spine.

The more frequently you practice, the better you feel. See you in class!

sara and bella headstand

Sara Curry is a Certified Bikram Yoga Instructor, studio owner and mother of two from Maine. She started practicing yoga in 2001 to rehabilitate from herniated discs.


Practicing Bikram Yoga After a Mastectomy

Don’t let surgery limit your practice. Physical therapy is a must to improve range of motion and quality of life going forward. And, what do you know, the handouts and pamphlets with which I was sent home depict exercises straight out of the yoga tradition. Following are notations of how I modified the postures. Please incorporate what benefits your physical situation; don’t feel limited by my experience.

First, you will experience pain so move slowly into the postures. That being said, don’t let your fear of pain limit your achievements. Many times I stopped reaching at the same point I left off during the previous class, or even at a weeks old measure. I went through all sorts of pressure-relieving  modifications during the cobra series savasana because I assumed it would take months and months AND months to bear weight. It didn’t.

Test your limits every class. I’m not saying it’s okay to pop your stitches, but your body and your abilities change every day. It’s a good idea to check them every day so you don’t get stuck in last week’s temporary inability. For convenience, I’ll refer to a ‘well side’ and ‘surgical side’ to avoid all the rights and lefts.

Pranayama: One elbow will not be able to lift as high as the other, or as high as the class before you had surgery. Look in the mirror. Look. In. The. Mirror. Right away, with the first breathing exercise, accept where you are. You will be amazed how much the mirror helps the healing process. Lift surgical-side arm to tolerance and hold it. Focus on the expansion and stretching you feel in your chest on the inhale. With each class, continue to lift that elbow and breathe deeper. Don’t pay attention to the uneven appearance. Worst case scenario: with your arms at your side, shrug or lift your shoulders up and follow the same inhales and exhales. Tensing up or holding my breath amplified the pain. Slow, conscious breathing carried me through everything.

Half Moon: Think of your well-side arm as a stake, and your surgical-side arm as a vine that’s going to climb up that stake. Start by lifting your surgical arm as high as you’re able. Maybe you place your hand on your same side shoulder to form a stubby wing. Gradually creep your fingers towards the well shoulder, then the arm and pull yourself up on it. Your goal is to reach the top and interlock your fingers. I felt more when the surgical-side was on the bottom in the side bend. When it became too much, I lowered that arm and let it fold across my ribs. I used the same modifications with backward bending.

Hands to Feet: Don’t be in a hurry to fold forward with both arms stretched out in front of you. I started out squatting down and grabbed the back of the well-side heel. Surgical side arm was bent like T-Rex. Let it down slowly. Don’t go crazy pulling on the good side. It hurts to squish in the beginning.

Awkward: Think ‘I Dream of Jeannie’. Stretch well side arm out as usual. Fold surgical-side arm across your front and start by reaching up towards the opposite shoulder. Once there, start creeping your hand down well side’s arm. As you feel more comfortable, separate into two outstretched parallel arms.

Eagle: At first you’re not going to be able to swing your arms without popping a stitch. Do your best to entwine your arms in eagle formation. For me, this posture was the least effected. You may be surprised to realize prior to surgery you pulled your arms into your chest rather than down from your shoulders. The pain you feel now due to that compression will reinforce the need to make that correction going forward. Ahhhh, the silver lining.

Standing Head to Knee: As with Half Moon, the well-side knows what to do. I started out with my surgical-side arm pressed at my side and bent at a right angle. As I leaned forward surgical-side arm crept down my leg towards the ball of my foot until I was able to interlock my fingers. This was my screw-you-you’re-not-going-to-get-to-me posture. It was helpful to have a posture I wanted to attack; a posture I didn’t want to defeat me.

Standing Bow: For the surgical side, I grabbed my foot and kept my heel against my butt while stretching forward. Slowly I started to kick my leg back as far as my pectoral muscles and arm pit could tolerate the stretch. You will feel the difference between kicking back and up on your surgical side. Here’s where you realize just how much the kicking and stretching keep you balanced. For the well side, go back to the image of the T-Rex arm. As I healed I let the surgical-side arm hang straight down while the well side kicked. When the pain eased, I started raising the arm first with a bend at the elbow and then outstretched.

Balancing Stick: Refer to the hand/arm positioning in Half Moon. If it becomes too much, either wrap surgical-side arm around your torso and give a hug, or hold it against your side, parallel to the floor. As you feel better, allow surgical-side arm to hang straight down at a right angle to your body. Next step: slowly raise your arm.

Standing Separate Leg Stretching: Do what you can, what feels comfortable, but do something.

Triangle: This was my horror show. There’s just no comfortable place to put your arm. As with Standing Bow, you realize the importance of opposing forces: right arm stretch up, left arm stretch down. I couldn’t figure out what to do with my head and neck when the surgical-side arm was supposed to be stretching up. Don’t get discouraged. Do your best. It was a great opportunity to focus on patience and acceptance.

Standing Separate Leg Head to Knee: Treat it like Balancing Stick.

Tree: I kept my surgical side arm at my side and bent at the elbow.

Toe Stand: Scary at first because there’s a good chance you’re either going down face first, or you’re going to stretch surgical-side arm out to make a landing and be in pain. I tried to turn this posture into a positive challenge. Slow down the bent knee descent and try it with one good arm. It’s great preparation for the advanced entry in to the posture.

Savasana: It really helped me to regroup, slow down my breath and let go of what was upsetting me.

Wind Removing: Hold surgical-side arm folded in on itself; keep it close to your body. As you heal, open up the angle.

Sit up: Keep surgical side arm down, fold at elbow across your torso like a belt at your waist. You’ll be surprised how much more you use your abs! At first it’s really challenging to keep your spine straight, but that’s the goal. I chose attempting the sit up rather than rolling over. Rolling over leads to being belly down and the necessity of pushing up and I just didn’t want to deal with that.

Cobra: You know that saying ‘when a door closes, a window opens’? That was my Cobra. It was too much pressure to start cobra from a belly-down position. I was forced to squeeze my elbows into my side at a right angle and find the back muscles needed to stay lifted! Add in the arm strength and you got yourself a damned good Cobra.

Cobra Series Savasana: Oh good lord, really?! Just lie on your side fetal-style.

Locust: Ok, so I just panini-ed my tits in Savasana to *relax* and now I’m supposed to do it intentionally?! Do your best. As with Cobra….you’ll find those back muscles.

Full Locust: Rather than take off from a belly down position, I approached the posture with landing gear up. Surgical-side wing was tucked in at first.

Bow: Well-side hand grabbed a couple inches below the toes. Surgical-side arm was pressed to my side like I was going into a nose dive. My Bow was intentionally lopsided to keep pressure off the surgical side. It was more of a weeble roll at first, but gradually improved to where I could set up the posture and with healing, add the kick.

Fixed Firm: I lowered down into the posture with surgical-side arm folded over at my waist. With time and stretching I was able to reach for the opposite elbow.

Half-tortoise: Another T-Rex arm posture. You may feel like the entire ninety minutes is an exercise in futility because one side is laid up and you will be sorely wrong. Just as those with limited or no ability to see or hear often sharpen their other senses, you will locate those underutilized muscles and master a posture. Half-tortoise is one of those postures.

Camel: As if Camel isn’t emotionally or physically challenging enough to begin with! While Standing Head to Knee was my posture to rally the troops in the standing series, Camel was my touchstone in the floor series. It has all the elements: back bending, stretching, being upside down and completely exposing your chest. Attack it. The release feels so good.

Rabbit: Keep surgical-side arm close to your side for support. Add in the pull as you’re able.

Head to Knee: I used the same modifications for Standing Head to Knee

Final Stretching: I started to feel the feeling of accomplishment. I’m almost there! Don’t focus on the lack of range of mobility in your surgical side, turn your attention to how far you’ve come and how good it feels to flex your feet and stretch your calves, how good it feels to squeeze your quads and release your hamstrings and how good it feels to fold your torso over your legs. I started with BOTH arms in a pike position with my elbows by my hips. This was my release.

Half Spine Twist: My biggest challenge was for surgical-side arm to grab the knee. I hugged the top of my opposite side knee instead and stretched up like crazy. Add the twist.

Kapalbhati: Woo-hoooooooo! Give yourself a pat on the back, you did great!

So, that’s my practice, with a few peeks into my stream of consciousness during class. What I’ve noticed with my practice is that the past events have not limited my depth or expressions of the postures. As I mentioned earlier, I am extremely fortunate to be able to return to the place where I left off prior to surgery. Sure I feel a slight tug or tightness at times but no physical limitations. I have the mental ones! That is the crutch I grab for every so often. The one that says it’s ok to take it easy, the one that reaches for the modification not because I need it, but because I don’t feel like squeezing or kicking or sucking it in….the one that is still enjoying hiding in the back row. There it is, I said it.

bridget headshot 2Bridget Dubravsky is a Certified and Practicing Bikram Yoga Instructor from Maine. She is also the author of Bikram Yoga and Breast Cancer.