People who do yoga expect a few sore muscles here and there.
Minor pains and even bruises might not be unusual.
But a stroke is one side effect of a yoga practice few consider when they roll out their mat for a session of Downward Dog and Frog Pose.
But that’s exactly what happened to advanced yogi Rebecca Leigh.
In 2017, Leigh had just completed a Hollowback Headstand, a variation on the traditional headstand that calls on you to arch your back and neck instead of keeping them vertical.
Leigh, then 39, stood up from her pose and immediately knew something was wrong.
She told South West News Service (SWNS), she had blurry vision and lost control of her arm.
Shortly after those symptoms subsided, she developed a tremendous headache.
“I tried to put my hair in a ponytail and my left arm was numb. I physically could not get my brain to tell my arm what I wanted it to do,” Leigh told SWNS. “I had an awful headache… I had some strange visual issues and felt a lot of pain in my neck and head.”
Two days later, the Maryland woman realized her right eye was drooping, and her pupils weren’t the same size.
She and her husband, Kevin, immediately went to the emergency room. There, a physician told them that Leigh had experienced a stroke.
“I couldn’t believe it,” Leigh said. “There was no way that someone my age, in my health, could have had a stroke.”
But she did — and she’s not the only one to experience physical trauma and injury as a result of yoga.
Rare but possible
A 2009 study from Columbia University found in a survey of more than 1,300 yogis worldwide, that four yogis had indeed experienced brain damage from extreme bending.
Leigh, as a CT angiography would soon reveal, had torn her right carotid artery, a blood vessel that’s vital for delivering blood to your brain. This is also known as a carotid artery dissection.
Carotid and vertebral artery dissections are rare. They occur in about 3 out of 100,000 people each year, but they’re one of the most common causes for stroke in young and middle-aged adults.
Indeed, cervical artery dissection (or a tear in the arteries of the neck) represents 1 in 5 cases of ischemic stroke in adults under age 45.
The tears are more commonly caused by overextension or manipulation from dancing, skating, swimming, car accidents, sneezing, coughing, chiropractic adjustments, giving birth, and, yes, yoga.
“It’s hard to know for sure what caused it,” Dr. Jessalynn Adam, a sports medicine physician at Mercy Medical Center in Baltimore, told Healthline.
“In some instances, it is a bit of a freak occurrence, but classically it’s caused by manipulation of the neck from trauma, or high-velocity, high-energy stretching of those vessels and tearing of the lining,” she said.
Adam adds that if someone has an underlying connective tissue abnormality, the risk for this type of stroke is also higher.
“There are certain conditions where people have stretchy skin or hyper-mobility of their joints,” she said.
Adam added that people with these issues may be more drawn to practices like yoga because of their flexibility, even if they don’t yet know of the condition that’s causing it.
“They may have an abnormality of the type of connective tissues around those vessels and they may be more likely to develop cervical artery dissection,” she said.
However, Dr. Loren Fishman, a specialist in physical medicine and rehabilitation in New York City, cautioned that overall this type of injury is rare.
“Given that close to 40 million Americans are currently doing yoga, the very news-worthiness of this injury begins to indicate its rarity,” he told Healthline. “Yoga injuries are less common per practitioner than injuries in weightlifting or golf.”