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Yoga Headstand - A Controversial View

Submitted by dave on Tue, 06/03/2008 - 9:30pm


It is widely known that the yoga headstand posture can double intraocular pressure and therefore presents a great risk for glaucoma patients. It is my understanding that performing a headstand will double eye pressure for virtually everyone, even people with normal eyes and even young healthy people. The great debate is whether that spike in eye pressure a normal person experiences will eventually lead to optic nerve damage and glaucoma. Ophthalmology researchers are now conducting research to attempt to find out whether it is safe for a person with normal eyes to do these inverted yoga postures.

We know that a person who already has glaucoma should not do inverted yoga postures because elevated intraocular pressure is the number one risk factor for glaucoma. Generally, the potential danger posed by inverted postures for glaucoma patients is not open for much debate.

In the context of that knowledge, I want to entertain a very controversial question. This question was raised today in an email discussion where someone (a glaucoma suspect with elevated intraocular pressure and high myopia) said to me, "I have also started doing yoga. I go a once a week to a class on Iyengar yoga. I have read his books and he mentions in one of the books that sirsasan (head stand) is very good for glaucoma - provided it is done the right way."

The person asking the question is quite an intelligent person and he is under the care of one of the top glaucoma specialists in the world. However, he understands that modern science is not always infallible. Scientific "facts" do sometimes turn out to be wrong -- occasionally even grossly wrong. And Ayurveda (which is a part of yoga) has held up for thousands of years for good reason. So is there a chance that Iyengar could be right about the potential value of the headstand?

I want to share the reply I gave as part of this discussion.

If there is one magical way to transform the headstand into an activity that benefits glaucoma, this would represent new knowledge. The interesting question is, What could possibly differentiate the normal headstand, which research has indicated can lead to optic nerve damage in certain situations, from a similar headstand that becomes healing? In my view, the most obvious differentiating factor is one's state of consciousness while practicing the headstand. To make that more concrete, let me initially focus on the presence of any effort, any subtle strain, as a defining characteristic of one's state of consciousness.


Regarding Iyengar approach to yoga practice specifically, I have heard his technique involves a bit of effort/strain -- he is pretty strict about holding postures, breathing, etc. It is good to do the techniques correctly, but in my experience yoga can be done effortlessly, with absolutely no strain, and still be done correctly. I believe it is even more correct to do yoga effortlessly -- when done that way, the experience of bliss guides the practice.

I mention this because any strain (even if it is so slight that we might think we can ignore it) will raise intraocular pressure for me and for others I have talked with. In fact, I am now completely sure that intraocular pressure will rise in response to strain that is so very slight and very subtle that it would go undetected -- unless one has developed some skill in noticing subtle states in one's body. Have you had the experience of feeling tension in your neck muscles at the end of the day? While you were busy during the day, the stress that produced those tight neck muscles might have been out of your awareness. That is an example of gross strain that can go undetected. However, there are lower levels of strain that we get used to and that become "normal" for us. This strain is so normal for us that we cannot notice it easily. That level of strain will increase intraocular pressure -- and the effect can be quite dramatic. Likewise, we can learn to do yoga in such a way that we incorporate a slight amount of effort into our technique and it comes to feel so normal to us that we don't even think of it as strain.

The concept of effortless action is largely forgotten in many modern yoga traditions. My friend, who posed this question is quite familiar with Ayurveda, having been treated for elevated intraocular pressure by an Ayurvedic clinic in India. With that in mind, I went a little deeper into the discussion.

To master intraocular pressure management you must master Yogastha Kuru Karmani. In my translation of that key phrase, it means that you must carry out all actions while established in that state of pure present moment awareness, of pure Being. This is a state where the egoic mind is quiet, and where one's experience is bliss. The idea is that action is performed without strain, without effort, and one's mind is so clear that the action is performed with great efficiency. This is not unlike being "in the zone." Athletes speak of maximum performance -- even all-time best performances -- without effort, without trying, when they get into the zone while competing.

Performing action effortlessly is not just a nice idea or something to hope for. It is also not just for athletes. Performing all action effortlessly all day long every day is for every one. And this mode of living is especially important for anyone with glaucoma.

If you have not read Eckhart Tolle's definition of ego, I suggest that understanding what he says about ego is a crucial part of understanding Yogastha Kuru Karmani. Without present moment awareness there is no such thing as efficient action without strain.

I do not feel that it is acceptable to strive to reach that state of effortless efficiency by following (even if temporarily) the path involving strain. I have made that mistake in the past myself and it is probably part of the reason I have such bad optic nerve damage today. Once I started self-tonometry, I learned to distinguish between subtle strain and the true state of effortless action.This discovery, this essential skill, is one of the greatest blessing glaucoma has brought to me (and I am still working to master it).

If you want to be a pioneer and find out if the headstand can -- if done correctly -- be beneficial for glaucoma, please do not even think about doing the headstand without being able to do self-tonometry! I don't normally issue warnings like this, but the headstand is one instance where I must make a strong statement.

I do have an open mind that the headstand might have some magical properties, such as you mention, for helping glaucoma. Yoga can do many wonderful things that science is only beginning to understand. But trying to find this secret without a tonometer would be a big, big mistake.The one thing I believe strongly is that the pathway to finding those magical healing properties of the headstand is the path of no effort. It is the path of effortless action performed in the state of pure Being.

I believe self-tonometry has been essential in my process of learning about effortless action and living without strain. For any of us with elevated intraocular pressure (or even myopia), the evidence is overwhelming that we have adapted to living our lives in near constant strain -- without even being aware of this fact. Fortunately, I have found that self-tonometry can be a powerful way to become aware of that hidden strain and to discover the changes in attitude and lifestyle that we can use to break those patterns of strain. Other than self-tonometry, there are few ways most of us could make the required changes to remove that built-in strain from our lives.

Certainly, there is no way to discover a scientifically valid approach to safely and beneficially performing the headstand as a healing practice for glaucoma without relying extensively on self-tonometry.

And, in response to your other comment, there is no way to tell what one's intraocular pressure is without a tonometer. (Palpation is very unreliable.) Sometimes, when I have some eye discomfort and I would think that my eye pressure might be elevated, it is not. Other times when my eyes feel relaxed and I suspect my eye pressure is low, I find out it is high. If you are going to conduct potentially dangerous research such as performing the headstand, do not try it without absolutely reliable methods of monitoring intraocular pressure. And do not try it without the support of a team of experts. The community here at can be part of your support system, your excellent glaucoma specialist can be another part, and your yoga and Ayurvedic experts can be another part.

That concludes the [now edited] points I shared with my friend. To those reading this blog post, I would like to suggest an idea. What about starting a donation drive to purchase a community-owned tonometer? This would be a tonometer all of us could share! We could let the person who inspired this blog post use it while conducting some careful yoga research. We could let everyone who donated take a turn of a month or so using the tonometer. I would be willing start the donation drive off by pledging to donate $200 of my own money -- that's $200 that will go toward a tonometer you could have access to. What do you think?

[In addition to this, I think we should also have a raffle for a tonometer as a way of raising funding to support more research projects like this while also giving one lucky person the chance to win a tonometer at a very low cost. We could raffle 100 ticket at $75 each to raise $7500 for research. The winning ticket would claim a Reichert AT555 tonometer just like those we purchase from Reichert for our research program.]


DISCLAIMER: In no way am I encouraging anyone with elevated IOP or glaucoma to experiment with inverted yoga postures. I am only suggesting that for someone who is already determined that they are going to do these inverted yoga postures, they must proceed cautiously and they must monitor their IOP closely (as can only be done with a program that includes frequent self-tonometry). If they are willing to make themselves a guinea pig, then hopefully we will all learn something from the experiment. I understand this approach and the willingness to take some risks for the opportunity to learn because this is exactly what I did when I started self-tonometry several years ago. Therefore, I honor the attitude, but I also recommend caution and I discourage anyone who is not prepared to suffer the consequences.

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