Musicians' Health Collective

Musicians' Health Collective: Supporting the health of musicians

Rethinking Headstand

image from Leslie Kaminoff's Yoga Anatomy.

image from Leslie Kaminoff's Yoga Anatomy.

The two yoga asana that are often touted as "the mother and father of yoga poses" are shoulderstand and the headstand, neither of which I teach.  You may remember my thoughts on shoulderstand risks for musicians, and due to some additional questions this past week, I thought it was time to tackle (and retackle) headstand and its risks (for musicians and normal folks too).  I used to practice headstand and it *always* flummoxed me.  I asked teachers about my alignment constantly, and yet I usually left class with a dull headache.  I stopped practicing it unless absolutely necessary (like when a teacher comes over to you and asks what's wrong with you and why you aren't doing a particular pose in class), and even then, have often put up a fight.  (PS. Any teacher, whether it be crossfit, yoga, Pilates, whatever, that doesn't respect your actual mechanical limits is probably not the right teacher for you).

Here are some of the health claims that headstand supposedly provides:

  • Builds strength in the shoulders, neck and core
  • Slows and reverses signs of aging
  • Stimulates the pituitary and pineal glands
  • Improves digestion
  • Calms the mind and relieves stress and mild depression
  • Relieves some symptoms of asthma, menopause, infertility, insomnia and sinusitis
  • Reverses the effects of gravity on the lungs, diaphragm and skin
BKS Iyengar in supported headstand.  Iyengar's teachings touted shoulderstand and headstand as the most important asanas, yet, they are precarious, and perhaps should not be held for as long a duration as has been taught in the last 50 or so years.

BKS Iyengar in supported headstand.  Iyengar's teachings touted shoulderstand and headstand as the most important asanas, yet, they are precarious, and perhaps should not be held for as long a duration as has been taught in the last 50 or so years.

-Courtesy of MyYogaOnline.com

And now a few (of many) risks: 

-Cervical vertebrae damage from an inability to support weight correctly

-Additional soft tissue/nerve damage (muscles, ligaments, etc.) to upper extremity

-Dangerous for those with high blood pressure who can experience ruptured blood vessels in the eyes and upper body

-Anti-inflammatory drugs  can add to risk

Courtesy of Performance Sports Care

Many of the supposed benefits may be true, but there's not much evidence based research out there.  I do have colleagues who believe to have injured themselves from this posture, and certain styles of yoga encourage students to hold this posture for 5-10 minutes daily.  More and more research based and anecdotal evidence is coming to light in regards to the hazards of headstand (and shoulderstand).

Here's a few reasons why I've never taught it in a group class:

1) First of all, it always gave me headaches.  Yup- It actually caused pain afterwards which usually subsided.  Why?  Because I found out two years ago that I have a pituitary tumor (non-cancerous), which means I shouldn't put weight on my head like that.  No amount of "benefit" is worth that for me, even though it should balance the very system that I have a tumor on.  Did headstand cause my tumor?  Most unlikely.  Did headstand cause my headaches and occasional neck pain?  Most likely.  In a group movement class, you have NO idea what students are working with, and students may not themselves know what their limitations are.  I certainly didn't know I had a tumor, and other students may not know they have "forward head position" or that they lack the strength to support themselves.

Forearm balance- strength and range needed before even thinking of headstand!

Forearm balance- strength and range needed before even thinking of headstand!

2) It requires a huge amount of shoulder strength in external rotation, protraction, and upside down to name a few.  A student would need to have impeccable alignment in forearm planks and dolphin, coupled with an ability to have stable shoulders in forearm balance before adding in a headstand.  In addition, some classes and styles of yoga have students hold this pose for 5-10 minutes in class.  We don't know what the long term damage can be to the neck and spine from holding a pose like this daily for that duration, so use your judgment!  

Lacking the range to attempt headstand or forearm stand.

Lacking the range to attempt headstand or forearm stand.

A starting range for attempting such postures- forearms can be parallel to the floor, shoulders protracted and supporting.

A starting range for attempting such postures- forearms can be parallel to the floor, shoulders protracted and supporting.

3) Not everyone has the range ability to get their arms over their head with elbows bent.  Take a look at these pictures below: see how the forearms aren't parallel to the ground in the first image?  If she then attempts a head stand, her body won't be able to get upright without some serious adjustments, possible with the neck taking too much load (poor delicate, highly mobile cervical vertebrae), her spine extending, or her shoulders getting shredded.  Before even considering head stand, a student should have the pure range of getting their forearms parallel to the ground in standing without compromising the spinal integrity.

This is a headstand adapter which takes the head and neck out of the equation.  I'd say that you still need shoulder strength, but it's a nice alternative for inversion junkies.

This is a headstand adapter which takes the head and neck out of the equation.  I'd say that you still need shoulder strength, but it's a nice alternative for inversion junkies.

4) Folks sometimes interpret headstand as time to jump on their head, literally.  Whereas you can kick into handstands relatively safely, headstand kicking is a big safety no-no.  Also, I hate being in a class where someone falls over backwards out of headstand-not only does it sound awful, it is painful.  (And never go upside down near a door, window, or an open flame, folks!). Let's just say I think that kipping handstand push-ups can also be silly and dangerous (just aim for a normal handstand push-up!  Plenty hard.)  In many ways, the foundations of handstands and forearm stands are much safer, both in terms of falling, and in terms of building long term strength for other poses and movements.

5) We've built up a false history for headstand- yoga asanas are not thousands of years old-most poses were "created" and studied in the last hundred years.  Attaching serious health and historical value to one or two poses is  ridiculous and unfair to practitioners for whom this is not suitable and will never be suitable.  You can have a full beneficial yoga practice WITHOUT headstand, shoulderstand, or even downward dog!  This doesn't mean that you (or anyone) can't practice that pose anymore, but be aware of the inherent risks involved and notice when it is not well instructed in a group class setting (in which the teacher doesn't know every student's body, injuries, or abilities). 

If you're a teacher and you have the range and strength to perform the pose, you have to ask, "do all of my students understand what is needed here, do they have the pure range of motion, do they have the strength in their shoulders and serratus anterior, and can I instruct this in a way that everyone feels safe and supported?"  

This poor neck has taken a beating from constant neck flexion!  Keep your neck happy instead with gentler inversions!  Pic from performancesport care.com

This poor neck has taken a beating from constant neck flexion!  Keep your neck happy instead with gentler inversions!  Pic from performancesport care.com

6) Lastly, most people have terrible standing and sitting posture, with necks forward and spine rounded.  If that misalignment exists, why are you going to add 150-200 pounds of weight to it?  Even if the student is not misaligned in standing, headstand goes full throttle rather than gradually adding weight in the head and shoulders.  A hundred years ago or more, people (especially in India!) moved differently- they might have carried loads on their heads, they might have had better posture, they might have moved more, walked more, etc.  Nowadays, things are different-without head carrying, there's no pre-training of neck strengthening to even see if you can support any weight, let alone your whole body weight.  If you're a musician who plays an asymmetrical instrument, you're more at risk for one side of your neck to be tighter/stronger/weaker than the other side.  Combined with typical musician shoulder range and strength issues, poses that stress the neck should probably be avoided for many (many!) other more beneficial movements.

Last thing- if someone of something tells you that a habit you have is perhaps unsafe or not beneficial, rather than getting defensive, look at the big picture.  Why is this unsafe for you?  What restrictions do you have?  Are they muscular or bone compression (i.e., you can't get full neck flexion because it's a structural issue which will not change!)?  Do you lack strength or stability?  If you lack the range of motion in the shoulders or strength to support yourself in headstand, these are separate things that can be cultivated over time.  If your neck vertebrae are fragile from previous injury, then it may not be worth it to take a risk.  You only get one spine and one set of vertebrae (and discs!).  Rather than seeing the pose as the end goal, look at the movements and ranges required to execute the pose and then ask yourself: am I so attached to a yoga asana that I am willing to risk my long term health?