Imagine a 240-pound professional football player stretching his sweat-drenched body to its limits in heat of more than 110 degrees. This scene doesn’t take place on a football field, but in a heated Bikram yoga studio where many athletes and everyday people are going to cure and prevent aches and pains.

Yoga, as a way to achieve higher self-awareness, was around as early as 200 B.C. in India and has been gradually growing in popularity in the western world over the past four decades. Traditional styles of yoga, including Hatha yoga, which consists of thousands of poses, have long been studied as an effective form of complimentary or alternative medicine (CAM).

The biggest yoga boom has occurred over the past decade according to statistics from the International Association of Yoga Therapists. The Association estimates there were 20 million Americans practicing some form of yoga in 2002 compared to 6 million in 1994.

Increased awareness of yoga as a healing method along with high-profile celebrity endorsements have contributed to the growing numbers of yoga users recently. Madonna and Kareem Abdul-Jabbar are some famous yogis that have been students of Bikram Choudhury, who founded his own style of hot yoga in India.

Dina Lancour, a Hatha yoga instructor from Agawam, Massachusetts, took a Bikram yoga class under Choudhury.

“It reminded me of Indian sweat tents,” Lancour said. “It becomes very meditative and deep.”

Proponents of Bikram yoga and medical specialists have noted the health benefits of hot yoga. Other yoga practitioners and teachers have expressed concerns about the safety of practicing yoga in a hot room and some ‘yoga purists’ question the motives of the founder, noting that his style is too outwardly focused.

According to an article in the Charleston Gazette (March 24,2004) some yoga traditionalists believe the attention yoga has received in mainstream media and business is damaging to the ancient practice.

Newer students of yoga are more concerned about how they look rather than the spiritual basis for yoga the article stated. Yoga purists believe focus on the outward image overlooks the true goals of yoga, which are more spiritually focused.

Bikram yoga incorporates 26 of the Hatha poses and two breathing exercises in a “specific order to get the maximum benefit for the body,” said Megan Cooney, a certified Bikram instructor, who teaches at three studios in the Boston area.

Choudhury developed the Bikram style after he suffered an knee injury from weight training. He first practiced Hatha yoga in his native India at age 4. In the late 1960s he brought the 26 posture series, that he claims restored his health, to the U.S.

Today Bikram’s College of India has graduated over 2,500 students who teach at more than 350 affiliated studios worldwide.

Teacher certification is a grueling process that takes place in Los Angeles. Teaching Bikram yoga without going to his school is considered fraud since Bikram has a copyright on the specific sequence and conditions under which it must be practiced. The 26 poses, or asanas, and two breathing exercises, or pranayamas, must be done in a heated carpeted room.

Cooney described the training as “intense.” You are immersed in the environment full time for nine weeks she said.

The challenge was “well worth it” Cooney said. Three and a half years after her certification she still finds Bikram a constant challenge.

“It never gets boring. You can always challenge yourself to hold a posture longer or deeper,” she said.

The benefits that Bikram enthusiasts boast are what are attracting some of today’s professional athletes to this style. An article in the Worcester Telegram and Gazette (October2, 2004) profiled Peter Sejna of the Worcester IceCats hockey team. Sejna spent a lot of his off-season training practicing Birkram exercises. He said it helped him to recover after intensive workouts.

According to an article in the Seattle Times (August 29,2004) Seattle Seahawks football players believe that this style of hot yoga will curb injuries and rejuvenate them after a tough workout. Seahawk wide receiver Bobby Ingram, quarterback Matt Hasselbeck, and safety Terreal Bierra are three team members who have reported positive results from the Bikram sessions recommended to them by their strength coaches. Other NFL teams are considering making some form of yoga mandatory as an off-season workout routine.

Studies state that yoga is beneficial for flexibility, strength, depression, and lower back pain, among others. Currently research is being done at Harvard Medical School to measure it as CAM for those who suffer from insomnia.

Dr. Sat Bir S. Khalsa is heading the study at Harvard Medical School and sent his comments on yoga practice in an email.

“There are some studies evaluating the physical improvements with yoga practice (e.g., flexibility) and therefore, it is not unreasonable to assume that yoga would be preventative for physical injury,” Khalsa said. Khalsa, like other doctors, was not aware of any studies that verified Choudhury’s claims about the benefits of hot yoga, but said that he has found the benefits offered by practicing any type of yoga “far outweigh the risk of injury.”

Yoga is among one of the ten most commonly used CAMs according to a study by the Center for Disease Control and Preventio’s National Center for Health Statistics based on data from a 2002 National Health Interview Survey. The study defines CAM as “therapies not usually taught in U.S. medical schools or generally available in U.S. hospitals.”

The study suggested that use of untested CAM therapies could have negative affects. It found that patients often do not share information about alternative medicines and therapies they receive with their health care providers. This increases “the possibility of serious interactions,” according to the NCHS study.

Dr. Richard Barton, and orthopedic surgeon who specializes in sports medicine at Massachusetts General Hospital, said that his patients often ask about yoga as a treatment.

“I usually recommend physical therapy for stretching,” said Barton. But if a patient asks him about yoga he encourages it if it is low-impact.

“A lot of people participate and benefit from [yoga],” Barton said. He believes if an individual is healthy yoga will benefit him/her.

Barton emphasized that people should account for their general physical health. He believes that anyone with cardio problems may be at risk when practicing yoga, especially any hot yoga.

Cooney, the yoga instructor, said that if a person has any health conditions they should consult a doctor first. She pointed out that instructors are not medically certified and it’s up to the individual and his or her physician to make any medical decisions.

“I like [Bikram] a lot, but it’s not the greatest for mainstream,” Lancour said. Even in the Hatha classes she teaches, students should take into account any heart problems or high blood pressure, but in extreme heat these issues are heightened, she said.

At 5:15 p.m. on a Thursday night Melissa Mao signed a form claiming she was in good health and would not hold the Bikram studio responsible for any injury. She was about to embark on her first hot yoga class at Bikram Yoga Boston.

The heat seeped into the hallway as she walked into the tiny lobby to sign in and rented a mat. Many of the students headed into the 100-degree and rising studio a few minutes early to stretch out or meditate. The carpeted studio was quickly filled with college students and professionals just getting out of work.

Bikram veterans shared their experiences with Mao and the other new students. The seasoned yogis encourage the newer students to stay in the room for the whole 90 minutes, even though they might be tempted to escape the heat. Their advice came in handy when new students begin to feel dizzy and nauseous.

One woman in Mao’s class, who has been going to Bikram classes for three years, ran the New York City marathon the week before. She said she couldn’t imagine getting through it without incorporating hot yoga into her training schedule.

“Yoga works really well with athletes,” said Ben Miller, a physical therapist at Northeastern University. Miller works primarily with the NU football team as an athletic trainer. In his 18 years at Northeastern he has worked with swimmers, hockey players, basketball players, and other athletes.

Miller said that athletes benefit from the flexibility, movement, balance, and joint positioning yoga focuses on. As far as Bikram yoga, he believed the heat was beneficial in helping move the ligaments, tendons, and muscles to make them more mobile.

There is no program within the athletics department for athletes to use yoga, or hot yoga in their specific training programs, but Miller said that some Northeastern athletes take advantage of yoga classes offered by Northeastern and outside studios.

Trainers from the sports medicine departments at Harvard University and Boston College also recognized yoga as a benefit to athletes but noted that it is not currently part of their training programs.

Not every medical professional is convinced that hot yoga is completely safe. In a recent New York Times article (March 30, 2004) Dr. Robert Gotlin, director of orthopedic and sports rehabilitation at the Beth Israel Medical Center in Manhattan stated the dangers that hot yoga poses.

In very hot temperatures our bodies stretch and bend further than they normally can. Some experts see this stretching as a benefit, but Gotlin said stretching a muscle too far beyond its resting length will cause damage. Gotlin said he sees about five yoga-related injuries per week.
Yoga is about “listening to your body,” said Cooney. When people don’t listen to their bodies they push themselves too far and cause injuries she said.

“It’s not about how good you look. It’s about form and depth,” Cooney said. In her training at Bikram’s College of India she learned to guide people safely through the postures.

Shannon DiLauro, 28, has practiced Hatha and Ashanga yoga regularly over the past four years and has never heard of anyone being injured in class.

DiLauro said she got into yoga when it became mainstream and has seen it grow in popularity since. “You can buy yoga mats at TJMaxx and yoga fashion includes bags and shirts now,” she said.

DiLauro’s friend started doing yoga for a different reason. Her friend’s doctor recommended yoga to help her get pregnant.

Seven years ago a man came to Diane Ducharme’s Bikram studio in West Roxbury with a pregnancy problem of his own. His doctor told him the possibility for him to have children was very bad due to his serious kidney problem. His doctor told him he needed a kidney transplant. Bikram was a last ditch effort to heal his body.

As a result of Bikram “his kidney stopped deteriorating,” Ducharme said. Today his kidney is completely normal and he has two children.

But hot yoga doesn’t appeal to everyone. Mao went to her first, and last, Bikram class and decided it wasn’t for her.

“I guess I’m just not a yoga person. I didn’t like the heat and I got dizzy a few times. I didn’t like that either,” she said.

“I was destined to always do this,” Shannon said about practicing yoga. “It fits who I am,” she said.

Brad Kootz, the owner of Bikram Yoga Boston, said that he has been practicing different types of yoga for 17 years. As a professional tennis player Kootz relied on yoga to keep him flexible and healthy.

Kootz claims Bikram is the ultimate way to repair old injuries, give the body an internal organ massage, open joints, and care for muscles.

According to a literature review printed in the Journal of Alternative and Complementary Medicine yoga proved to be beneficial to healthy people as well as patients who suffer from musculoskeletal and cardiac problems. The review looks at many different studies done and highlights the results. Overall, Hatha yoga proved to be a way to improve exercise capacity as well as prevent and treat musculoskeletal injuries, including back pain and joint stiffness.

The Journal of Family Practice cited a survey of 3,000 people who use yoga to treat health ailments. According to the survey 98 percent of the participants claimed yoga benefited them. The Journal also said “no reports of harm from yoga in low-back pain therapy were reported in the few studies found.”

“Yoga is absolutely a good way to achieve good health,” Barton said. “We suggest hot whirlpools and saunas to our patients so why not hot yoga?”