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Bikram Yoga: What's it All About?

 

Lauren A. Weddle

Date:10/14/2006

 

Picture from www.bikramyoga.com

 

                                                                       

Introduction: What is Bikram Yoga?

 

Bikram yoga is a specific yoga regimen envisioned by Yogiraj Bikram Choudhury.  Its roots are in Hatha yoga, another yoga discipline, and it was created with for purpose of healing pain.  Bikram yoga involves a series of twenty-six ordered postures performed in a room with a recommended minimum temperature of 105oFahrenheit and 40% humidity (http://www.bikramyoga.com).  This heat requirement is what makes Bikram yoga unique among the yoga disciplines, and has also earned it the name “hot yoga” in popular culture. 

 

 

Why the Heat?

 

The official website for Bikram’s Yoga College of India ™, available at http://www.bikramyoga.com, lists the following reasons for the hot, sticky temperature:

 

And…

 

 

If I Practice Bikram, What is it Supposed to Do For My Health?

 

The official website for Bikram’s Yoga College of India ™, claims that practicing Bikram “automatically” means a person will achieve “proper weight, muscle tone, vibrant good health, and a sense of well-being”.  It’s most repeated claim, though, is that practicing Bikram yoga can reduce or eradicate chronic pain.  The site tells the story of founder Yogiraj Bikram Choudhury, and how doctors told him he would never walk again, but through yoga he was completely healed in six months.  Elsewhere on the website, it does warn that you must regularly perform Bikram’s workout to see the results, but if you do so, your chronic symptoms will never return.  The website also, conveniently, provides information on how to sign up for a seminar with a certified Bikram instructor, purchase books or tapes providing Bikram instruction, and even allows surfers to order official Bikram exercise clothing.

 

Whereas the official website specifies “regularly” as every day, the website for Bikram Yoga NYC, a certified Bikram studio, recommends people seeking the healing benefits of this program practice the exercises at least three times a week (http://www.bikramyoganyc.com).

 

As for what specific diseases Bikram is alleged to improve, a few examples are: heart disease, poor circulation, diabetes, hypoglycemia, hepatitis C, chronic shoulder pain, knee injuries, anxiety attacks, kidney conditions, PMS, arthritis, and many more.  For an exhaustive list, follow the link to http://www.bikramyoga.com and look in the testimonials section.

 

The site does caution that there is no such thing as a “cure,” just symptom relief.  It also promises, though, that symptoms will be relieved if you follow Yogiraj Bikram Choudhury’s directions.  

 

 

How Is This Supposed To Work?

 

Bikram’s Yoga College of India ™ offers very extensive descriptions of how Bikram yoga effects the body.  The site says Bikram provides its effects via the “tourniquet effect,” and then gives a convoluted, confusing explanation of what the tourniquet effect is.  The definition boils down to the idea of pressure and release; pressure is applied and released when the postures are held and transitioned, causing the blood to “flush out” the system during the release phases.

 

Bikram is also supposed to “reoraganize” lipids and proteins in an “optimal” manner, as well as massage the lymph nodes and stimulate the brain by “improving circulation and by varying blood pressure” (http://www.bikramyoga.com).

 

As to how exactly Bikram can help repair physical injuries, the key, according to the official Yoga College of India ™ website, bringing proper circulation to the injured areas is the key.  By maintaining the proper alignments, your body should gain in flexibility and strength.  In regards to knee pain, if you complete the postures properly, “you’ll find that little by little you knee pain goes away and soon you’ll realize you can walk, climb up and go down stairs, even run a little without pain!”( http://www.bikramyoga.com).

 

 

What Evidence Do They Offer?

 

Although the word “scientific” is used to describe how the movements were chosen and compiled, the support offered on the yoga websites consisted entirely of self-proclamations by the practitioners or personal testimonies from students of the discipline. 

 

To read testimonies about how people were cured of specific diseases, visit Bikram Choudhury’s official Yoga College of India ™ website by clicking one of the links within the paper.  The site for Bikram Yoga NYC also features numerous personal testimonies.  One reads:

 

I began practicing Bikram Yoga a year because of severe back pain.

It was recommended to me by a friend and I have been attending 3-5

classes per week ever since. Any physical pain is completely gone,

but I have discovered many mental benefits of the yoga as well. At

work I can handle stress better than ever and I am more focused and

happy at work.

 

This particular testimony is not attributed to a specific individual.  To read this from the site, or to read other testimonies the site offers, follow this link: http://www.bikramyoganyc.com.

 

An American Fitness article about the benefits of Bikram mentions that one proponent of the exercise, a man named Tim Johnson, says that “Bikram’s repetitive nature—90 minutes, 26 poses, twice each—lends itself to medical testing,” but so far none has been done on this specific discipline (Mostay 2003).

 

 

What Does the Scientific Research Say?

 

With the phenomenal and ever increasing popularity of Bikram yoga in the past few years, there is a surprising lack of research on this particular discipline.  In collecting data for this assessment, the topics of yoga and heat were separately examined.  The goal is that through examination of the pain-curing capabilities of each of these treatment methods, a general assessment of Bikram yoga can be made.

 

Due to the exhaustive list of diseases on the official Yoga College of India ™ website, this review was limited to the efficacy of Bikram yoga in dealing with chronic pain, since the discipline was created with this goal in mind.  Other benefits of yoga may be mentioned if they were found during the search on curing pain.

 

 

Findings On Yoga

 

In assessing the claims made by Birkam yoga advocates, a PubMed search on the term “yoga” was used, then later the addition of the terms “pain,” “pain treatment,” and “chronic pain” were used.  Many of the results located were merely abstracts.  Most of them were not specific enough in their focus to be of much use. 

 

Since Bikram yoga is most closely related to Hatha yoga, it seems justified to examine the  known benefits of Hatha yoga to make a judgment on Bikram’s effectiveness.  One randomized pilot study of the effects of a six-week “modified” Hatha yoga program with twenty-two participants with chronic low back pain found that the yoga program resulted in “improved balance and flexibility and decreased disability and depression” (Galantino ML, Etal 2004) The group who did not practice yoga did not report these same benefits, but many participants in this control group did not complete the six-week experiment.  This pilot does provide some support for the claim that yoga can help people with chronic pain, but since it neither discusses the specific results, nor were there enough participants to make the trial statistically significant, it needs to be cautiously considered (Galantino ML, Etal, 2004).

 

An abstract from a review of the literature on interventions for patients with carpal tunnel syndrome found that traditional treatments can be aided by “supplemental participation in other exercise such as yoga” (Michlovitz SL 2004).  Again, this provides some evidence that supporters of Bikram yoga are not making unfounded claims, but this abstract alone is not clear enough to draw many conclusions from.

 

The first full-text article of relevance found was a review evaluating the role of yoga in the primary and secondary prevention of ischaemic heart disease and post-myocardial infarction patient rehabilitation (Jayasinghe SR 2004).  The author, Jayasinghe, searched all relevant articles examining yoga and cardiac health published between the years 1991 and 2003.  One of his findings from the literature supports the claim that yoga can help sufferers of hypertension deal with their condition.  According to Jayasinghe, the research shows that “even a short period (11 weeks) of regular yogic practice at 1h/day is as effective as medical therapy in controlling blood pressure in hypertensive subjects” (Jayasinghe SR 2004).  Jayasinghe also notes that these benefits may come from yoga’s effects on autonomic neurological functioning, pointing out that practicing yoga has been shown to restore baroreflex sensitivity.  According to an online medical dictionary, a baroreflex is “a reflex triggered by the stimulation of a baroreceptor,”  and a baroreceptor is “a sensory nerve ending in the walls of the auricles of the heart” and other places “sensitive to stretching of the wall due to increased pressure from within” and functions “as the receptor of central reflex mechanisms that tend to reduce the pressure” (http://www.medical-dictionary.thefreedictionary.com).  In other words, yoga can help restore pressure sensitivity in the heart. 

 

Jayasinghe also mentions that yoga can be beneficial in changing body density, providing some support for the idea that lipids are rearranged through practice of yoga.  In total, the Jayasinghe article says that combining yoga with traditional pharamcotherapeutic treatments for patients with ischaemic heart disease or post-myocardial infarction is the best option (Jayasinghe SR, 2004).

 

Another useful abstract describes randomized study of patients with osteoarthritis.  Patients were assigned to a control group of no therapy, or an eight-week yoga program.  The findings show that the group engaging in yoga experienced less pain during activity, less tenderness, and greater range of motion in the fingers at the end of the trial (Garfinkel MS, Etal 1994).  The limitation of using this abstract as support for the claims of Bikram yoga’s healing efficacy is that the number of patients involved in the trial and the statistical significance is not mentioned.  The findings, though, are generally supportive, and in considering the other supportive literature, seem to verify the claims. 

 

 

Findings On Heat

 

Since Bikram yoga is easily distinguished from other yoga regimens because of the hot condition of the room in which it is practiced, looking at the benefits of heat are important.  Since the research shows that yoga is generally beneficial in dealing with chronic pain, and possibly useful in the treatment of some other diseases, determining whether or not heat is an added benefit of Bikram is important. 

 

In a 2004 review by Scott F. Nadler, the research on nonpharmacological pain management techniques is examined.  One of the sections of the paper looks at superficial heat and its impact on pain (Nadler SF 2004).  Though the research compiled mostly examines heat wraps, since a “climactic temperature and pain” search on Medline was fruitless, looking at other superficial applications of heat is the next best step.  The review found that superficial heat can produce “heating effects” in tissue at a depth of only 1-2cm.  However, even this small penetration of heat has been found to diminish pain and decrease spasms in muscles, and is best used when “treatment and reduction of pain and inflammation are the primary goals” (Nadler SF 2004).  The review also found that continuous low-level heat therapy is beginning to be used, and while he neither specifies what “low level” means, nor what continuous means, practicing an hour of yoga in a room at 104oF might qualify.  This type of treatment has also been shown to be effect in reducing pain, increasing flexibility and decreasing muscle stiffness (Nadler SF, 2004).  While this seems to support the idea of using heat while practicing yoga to improve yoga’s effects, the truth will not be known until numerous studies prove that these two variables have an additive effect.

 

One very interesting abstract about the use of thermotherapy in the treatment of rheumatoid arthritis was found, but the full-text article was not available.  The review of literature included comparative controlled studies only, though abstracts were used as well as full text articles; seven studies were ultimately included in the review.  The findings showed that while the use of hot packs had no significant effect on treating rheumatoid arthritis, superficial moist heat could be a useful therapy (Robinson V, Etal 2002).  The implications of this finding are that, if this is heat can be climactic in nature, the humid, hot rooms in which Bikram yoga is practiced could provide an added benefit in treating conditions like arthritis, but this is merely educated speculation at this point.

 

Another review looked at the ability of thermotherapy techniques to reduce muscle pain and facilitate joint movement prior to exercise (Fransen 2004).  As in the review by Nadler, most heat therapies involve the direct application of heat, so there is a limited generalizability.  Fransen concludes that, from surveying the research, it is best to recommend heat treatments as additions to manual therapy or exercise treatments in dealing with musculoskeletal problems since there is no evidence that heat alone has benefits beyond short-term symptom relief (Fransen 2004).  Since in Bikram yoga, heat is already being used as an adjunct to exercise, this evidence provides a favorable view of how the heat may help further relax the muscles during yogic exercise.

 

 

Conclusions

 

Though the scientific literature has nothing to say about Bikram yoga specifically, there is plenty of information available about yoga, as well as heat, and the treatment of pain.  The scientific research generally supports the view that yoga can be helpful in reducing chronic pain, but its efficacy in eliminating all pain is unclear.  The effects of heat are more uncertain, though using heat in addition to an exercise program, such as yoga, may increase that program’s effectiveness.  The additive effects of heat on yoga, though, have yet to be examined, so no definitive conclusion can be reached.  It is safe to say, based on the research, that adding yoga to one’s lifestyle will probably help reduce chronic pain.  Whether or not Bikram is better at this than other forms of yoga has yet to be determined.

 

While it is not in the scope of this paper to examine all of the claims of Bikram yoga, its main claim of treating pain seems true.  However, there are many unverified claims made on the official website of the discipline, and it is doubtful that every one of them is completely true; even if Bikram is helpful in treating a broad spectrum of disorders, it is likely that its efficacy is overstated to entice more people to sign-up for classes or purchase other yoga merchandise.

 

 

Online Sources

 

Baroreceptor. http://www.medical-dictionary.thefreedictionary.com

 

Baroreflex.  http://www.medical-dictionary.thefreedictionary.com

 

Bikram’s Yoga College of India ™.  http://www.bikramyoga.com

 

Bikram Yoga NYC.  http://www.bikramyoganyc.com

 

Mostay, Emily (2003). A Yoga Heat Wave: Bikram Yoga Can Help You Turn Up the Heat During Winter.   American Fitness, Nov-Dec.   Available  [ONLINE]: http://www.findarticles.com/p/articles/mi_m0675/is_6_21/ai_113852512.

 

 

Journal Sources

 

Fransen, Marlene (2004).  When is Physiotherapy Appropriate?  Best Practice and Reasearch. Clinical Rheumatology, Aug: 18(4): 477-489.

 

Galantino ML, Bzdewka TM, Eissler-Russo JL, Holbrook KL, Mogck EP, Geigle P & Farrar JT (2004).  The Impact of Modified Hatha Yoga on Chronic Low Back Pain: A Pilot Study.  Alternative Therapies in Health and Medicine, Mar-Apr: 10(2): 56-9.

 

Garfinkel MS, Schumacher HR Jr, Husain A, Levy M & Reshetar RA (1994).  The Evaulation of a Yoga Based Regimen for Treatment of Osteoarthritis of the Hands.  The Journal of Rheumatology, Dec: 21 (12): 2341-2343.

 

Jayasinghe SR (2004).  Yoga in Cardiac Health (A Review).  European Journal of Cardiovascular Prevention and Rehabilitation, Oct: 11 (5): 369-375.

 

Michlovitz SL (2004).  Conservative Interventions for Carpal Tunnel Syndrome.  The Journal of Orthopedic and Sports Physical Therapy, Oct: 34(10): 589-600.

 

Nadler, Scott F (2004).  Nonpharmacologic Management of Pain.  The Journal of American Osteopathic Association, Nov: 104(11): 6-12.

 

Robinson V, Brosseau L, Casimiro L, Judd M, Shea B, Wells G & Tugwell P (2002).  Thermotherapy for Treating Rheumatoid Arthritis.  Cochrane Database of Systematic Review, 2002 (2).

 

 

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