Summary

Yoga practice poses a salient risk of injury, especially sprain and strains, and athletes should be informed that a significantly larger proportion of yoga injuries in athletes over the age of 45 are hip injuries.

Abstract

Introduction

In recent years, the number of people practicing yoga in the United States has increased. Despite physical and mental health benefits, yoga practice poses a salient risk of injury. The objective of this study is to determine the incidence and risk factors of yoga-related injuries to generate guidelines for safely practicing yoga.

Methods

The National Electronic Injury Surveillance System (NEISS), a database of consumer product-related injuries from Unites States emergency room visits, was searched from 2004-2023 for codes describing exercise “activity or apparel, without equipment” and “exercise equipment.” Narrative descriptions were reviewed by two authors to select entries addressing yoga practice.

Descriptive statistics were performed, and the Stata svyset function (SE 17.0, StataCorp LLC, College Station, Texas) was used to calculate national estimates. Athletes were also categorized into groups younger than 45 years of age and 45 years of age and older, and significance between age groups was determined using adjusted Wald tests to compare proportions in the setting of complex weighted survey data.

Results

The initial data search yielded 160,521 entries. The narrative review process (Cohen’s kappa = 0.76) resulted in 1615 entries for analysis, corresponding to a NEISS national estimate of 63,280 yoga-related injuries. The number of yoga injuries has begun to recover following the COVID-19 pandemic.

The majority of injured patients were younger individuals (mean age = 46.5, SD = 18.0). Patients were disproportionately female (78.6%) and White (45.8%). Most injuries occurred in places of recreation (42.4%) and the home (10.0%). Most patients were treated and released (91.3%). The most common type of injury was strains/sprains (32.5%). The trunk was the most commonly injured body region (lower trunk = 24.2%, shoulder = 9.0%). In the lower limb region, the knee was most often affected (9.4%).

Wald tests revealed that there was not a significantly larger proportion of injuries in any of the locations (“home,” “place of recreation,” or “other”) for either the 45 and older or the younger than 45 age categories. For body region injured, in the younger than 45 category, head injuries were a significantly larger proportion of total injuries (p < .005), whereas in the 45 and older category, hip (subset of trunk) and “other” injuries were a significantly larger proportion of total injuries (p < .001).

Conclusion

Yoga can involve strenuous physical activity and result in injury, especially strains and sprains. Given that hip injuries comprised a significantly larger proportion of injuries in patients 45 and older, athletes in this age range should be counseled about these risks and ensure proper form in their yoga practice to maximize the safety of all participants.