Yoga does not fix everything

"My back is feeling mostly better. Now I just need to get back to yoga to stretch and strengthen my core."

This, a direct quote from a former physical therapy client, is the type of statement that I hear fairly often. In two physical therapy sessions, this patient had made fair progress in terms of pain control and basic function. She would have gained a lot from a few more weeks of PT.

Yoga can be challenging. Yes, I've done yoga. Three times. I'm not anti-yoga. Let it be known that I'm definitely pro- good yoga. What I'm against is the many yoga instructors and their followers who preach yoga as the magical end-all, be-all solution to every ailment.

With yoga, the total body movement is quite limited. It doesn't burn many calories as compared to other forms of activity like a modest walk or cleaning the house. The intensity is limited. Jogging up a hill or a few minutes of step-ups will better increase your muscular and cardiovascular endurance and rev your metabolism. Although better than nothing, the benefit of yoga for strengthening is limited as there are no external forces to control. Even in terms of improving flexibility, yoga is far more limited than you may think.

Creepy yoga.

-Gasp- He won't even concede that yoga is good for flexibility?

Yes, I said yoga is limited in its ability to appreciably effect flexibility. I know from experience, that for every person who learns how to bend their body into an inverted, single leg wobogong, there is someone who achieves minimal gain in flexibility. People who are already quite mobile gravitate toward yoga because they are good at it. They are usually not powerhouses in activities that require running, jumping, and change-of-direction. But for those with average or below average flexibility, the chances of improving is truly about 50/50.

How could this be? Well, here are a few reasons why yoga may fail to appreciably improve flexibility.

1. When there is true stiffness at a muscle or joint, the body will take the path of least resistance unless given a darn good reason not to. I often see this in the clinic: people who frequently do yoga still have spines that move too little at some segments and too much at others. I see people who stretch their legs daily yet their ankles and hips move horribly. They unknowingly stretch and move in the path of least resistance. Getting the tightest segments to contribute to the movement requires much intent.

2. The feeling of tightness may be from inadequate strength elsewhere. A common example of this is that errbody wants to stretch their tight hamstring, when in reality the hamstring are on over-drive in order to help stabilize hypermobility (too much movement) at the spine. If this is the case, more stretching of the spine will not help the situation, and aggressively stretching the hamstring may make matters worse.

3. The feeling of tightness may be from too much flexibility elsewhere. This happens often. An overly flexible foot will present as tightness or shin splints in the lower leg. A too flexible spine will present as chronic muscle spasms in the back and hips. Again, stretching will do little to correct this and definitely has the potential to worsen the issue.

There are more examples of when a yoga type stretch is not ideal for addressing perceived inflexibility. The important thing is not to simply stretch or strengthen, but to concern yourself with the details of exactly how you're moving when you stretch and strengthen.

Please understand that my claim is that yoga, in a generic sense, is by no means a magical cure for every ailment, including poor flexibility. While I'm picking on yoga, the same could be said for many other forms of exercise. And here we arrive at what I believe is the heart of the matter.

Some version of this comes up fairly often in this time of escalating copays and less financial margin. I get it. The alternatives are enticing: the $50 per month boot camps, the $10 per session or $5 per month gym membership. It's certainly more affordable than the cost of having an expert professional (yes me, but not only me) assess an individual structure and way of moving, and match that up with what that person needs and wants to do in life.

Can *good* yoga take the time to perform an individualized assessment and come up with a detailed exercise and form prescription? Absolutely! But it's rare within most fitness settings. This level of service demands a certain skill set, time, and attention. There is no trainer or facility that will stay in business providing this level of care for $10 per month.

The guy to the far right is approaching ideal form.
The rest of them could use a detailed assessment. 

But does $10 per month work well? Can a person effectively manage their own pain and recover function armed with a membership and maybe some knowledge from a friend or YouTube? Sometimes they can, quite honestly. But the success is often short-lived. Problems seem to resurface with a vengeance.

The adage holds true in the fitness realm: You get what you pay for.