September 25, 2023   3:24pm

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Those who know me also know I’m NOT a Yoga enthusiast (twisting bad for my hip). All the more reason to read this if you’re afflicted with rotator cuff, bone issues, and lower back pain. Because if Yoga truly can provide answers, I’m there …

Many years ago, the author Jane E. Brody of this New York Times current article: “Ancient Moves for Orthopedic Problems,” wrote about Dr. Loren Fishman’s nonsurgical treatment of piriformis syndrome, crippling pain in the lower back or leg caused by a muscle spasm in the buttocks that entraps the sciatic nerve. The condition is often misdiagnosed as a back problem, and patients frequently undergo surgery or lengthy physical therapy without relief.

Dr. Fishman, a New York Presbyterian and Columbia hospital physical and rehabilitative medicine specialist, developed a simple diagnostic technique for piriformis syndrome and showed that an injection into the muscle to break up the spasm, sometimes followed by yoga exercises or brief physical therapy, relieves the pain in an overwhelming majority of cases.  In this newer article, Dr. Fishman show how Yoga performs beautifully in other orthopedia areas as well:

To quote:

“…It is the rare physician who both endorses [yoga] and documents its value in clinical test,” reads this recent New York Times article,”Dr. Fishman has done both.” After studying yoga in India for over three years, Fishman found that certain yoga poses could “help prevent, treat, halt, and he says, often reverse conditions like shoulder injuries, osteoporosis, osteoarthritis and scoliosis.”

For instance, have problems with your rotator cuff? This is pain that occurs when you try to lift your arm above shoulder height. Consider practicing this yoga pose that Dr. Fishman says has successfully treated a former basketball player and 40-year old photographer with severe rotator cuff pain:

Triangular Forearm Support:

Instead of an operation that can cost as much as $12,000, followed by four months of physical therapy, with no guarantee of success, Dr. Fishman’s treatment, is an adaptation of a yoga headstand called the triangular forearm support. His version can be done against a wall (see illustration above) or using a chair as well as on one’s head. The maneuver, in effect, trains a muscle below the shoulder blade, the subscapularis, to take over the job of the injured muscle, the supraspinatus, that normally raises the arm from below chest height to above the shoulder.

The doctor discovered the benefit of this technique quite accidentally. He had suffered a bad tear in his left shoulder when he swerved to avoid a taxi that had pulled in front of his car. Frustrated by an inability to practice yoga during the month he waited to see a surgeon, one day he attempted a yoga headstand. After righting himself, he discovered he could raise his left arm over his head without pain, even though an M.R.I. showed that the supraspinatus muscle was still torn.

Dr. Fishman, who has since treated more than 700 patients with this technique, said it has helped about 90 percent of them. It doesn’t work on everyone” not on string musicians, for example, whose shoulder muscles are overtrained, he said in an interview.

In a report published this spring in Topics in Geriatric Rehabilitation (an issue of the journal devoted to therapeutic yoga), he described results in 50 patients with partial or complete tears of the supraspinatus muscle. The initial yoga maneuver was repeated in physical therapy for an average of five sessions and the patients were followed for an average of two and a half years.

The doctor and his co-authors reported that the benefits matched, and in some cases exceeded, those following physical therapy alone or surgery and rehabilitation. All the yoga-treated patients maintained their initial relief for as long as they were studied, up to eight years, and none experienced new tears.

Yoga for Bone Disease

Perhaps more important from a public health standpoint is the research Dr. Fishman is doing on yoga’s benefits to bones. Bone loss is epidemic in our society, and the methods to prevent and treat it are far from ideal. Weight-bearing exercise helps, but not everyone can jog, dance or walk briskly, and repeated pounding on knees and hips can eventually cause joint deterioration.

Strength training, in which muscles pull on bones, is perhaps even more beneficial, and Dr. Fishman has observed that osteoporosis and resulting fractures are rare among regular yoga practitioners.

In a pilot study that began with 187 people with osteoporosis and 30 with its precursor, osteopenia, he found that compliance with the yoga exercises was poor. But the 11 patients who did 10 minutes of yoga daily for two years increased bone density in their hips and spines while seven patients who served as controls continued to lose bone. He noted that yoga’s benefits also decrease the risk of falls, which can result in osteoporotic fractures.

Medical guidance here is important, especially for older people who may have orthopedic issues that require adaptations of the yoga moves.

So, have orthopedic pain? Dr. Fishman’s may have written the book worth reading for that:

Yoga for Arthritis: The Complete Guide

Yoga for Osteoporosis: The Complete Guide

Yoga and Multiple Sclerosis: A Journey to Health and Healing

Sciatica Solutions: Diagnosis, Treatment, and Cure of Spinal and Piriformis Problems

Relief is in the Stretch: End Back Pain Through Yoga

Hey, along with a cure for your back pain, you may just get that spiritual enlightenment others seem to be raving about — no incense required.


The New York Times, “Ancient Moves for Orthopedic Problems,” The New York Times, Jane E. Brody, August 2, 2011

Illustration: Jason Lee

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