By Sean Michael Hall, L.Ac.

Those of you that know me through my acupuncture practice may not know that I taught yoga throughout the Bay Area for 13 years. I no longer teach public classes, but I continue to practice some form of yoga most days. It is a practice I started 20 years ago, and it has been one of the joys of my life.

Though Iyengar and Ashtanga yoga have been my greatest influences, a number of other yoga traditions have been very important in my development, especially Warrior yoga, Kali Ray Tri yoga and what some consider to be the black sheep of yoga traditions, Bikram yoga.

A Bikram yoga class includes the practice of 26 poses.

Most of the poses are done twice, and most are held between 30 and 60 seconds. The sequence and length of the poses are exactly the same every class and the room is heated to between 100 and 105 degrees.

Every yoga style has pros and cons.

For every style mentioned the pros far outweigh the cons. Unfortunately, Bikram yoga is the exception, as there is a lot in Bikram yoga to be critical about. It can be unhealthy for some, and even unsafe for others. There is, however, also a lot to like about Bikram yoga. I personally benefited greatly when I practiced Bikram yoga 4 to 5 times a week for a 6-month period many years ago.

When I first started my yoga practice, I spent three diligent years practicing Iyengar and Kali Ray Tri yoga, yet my muscles were still tight, tendinous bands that seemed resistant to stretching. Surprisingly, I was still unable to touch my toes without effort and Downward Facing Dog pose was still very uncomfortable for me due to hamstring and shoulder tightness. The repetition of the same poses and the heat in Bikram yoga helped me over those hurdles, and was a useful stepping-stone in my practice. Now I occasionally take a Bikram class when I want a cardiovascular workout combined with the additional benefits of yoga asana.

What follows is what I consider to be a fair critique of Bikram yoga. I also offer some guidelines for determining if Bikram yoga is right for you, and some tips for practicing safely if you choose.

Cons of Bikram Yoga

1. Most Bikram yoga teachers are not well trained in anatomy, pathology, or injury prevention. Nor are they well trained in yoga, body awareness or teaching techniques outside of the limited instruction they learn in the 9-week Bikram yoga teacher training. They know how to instruct a group in the practice of the 26 Bikram poses, but they have very little education in how to work individually with students, or how to modify poses for those who have injuries.

2. Bikram yoga teachers are trained to encourage students to sublimate the sensations of their body to the idea of how the pose should be done in Bikram yoga. Instead of the practice of yoga being one of exploration and body awareness, it becomes a practice of learning how to turn off one’s own faculties of discrimination.

Bikram yoga teachers often tell their students that it is okay to feel pain, without differentiating “good” pain from “bad” or dangerous pain. Students are not encouraged, or in some cases even allowed, to alter poses in a way that feels right to their bodies. This is understandable in some cases, but too often a student with an injury or structural issue is not permitted to make slight modifications that allow the pose to feel safer or more effective.

3. Bikram yoga can be depleting for some. Though the heat can have beneficial metabolic effects for many, that is not the case for everyone. In Traditional Chinese Medicine (TCM), even “healthy” people have constitutional patterns of disharmony that may make Bikram yoga a less healthy, or even harmful practice.

For example, someone who has moderate to severe Qi or Yin deficiency would not do well with the heat of a Bikram yoga class. And the loss of copious amounts of fluid through sweating that occurs would be especially damaging. Bikram strongly advises new students to do the practice every day, but a Qi or Yin deficient person could develop serious health problems if they were to follow that advice.

4. The heat can encourage those who are flexible but lacking strength to overstretch. In addition to overstretching muscles, there is risk of exacerbating or creating hypermobile joints, which will increase the wear and degeneration of those joints.

5. Near the beginning of class, from a standing position, there is a deep backbend followed directly by a deep forward bend. This is potentially dangerous for many; particularly those with current or past disc herniations, spondylolisthesis or hypermobile lower backs. Students are encouraged to ignore any pain they feel in those two poses, which of course, can be dangerous.

6. Bikram yoga teachers instruct students to lock joints, especially the knee. “Lock your knee! Lock your knee!” is yelled during most Bikram yoga classes. Unfortunately, this can be dangerous for many people with knee joints lax enough to hyperextend. If the knee joint is hypermobile, locking the knee will place it in a hyperextended and dangerous position, as shown in the picture below, on top.

Whether your knee joint is capable of hyperextending or not, “locking” the knee often involves disengaging the quadriceps. Instead of training yourself to lift out of the knee joint, all of the weight bears down and back into the knee joint. The picture on the bottom shows a woman not locking her knee. Her leg is straight, her quadriceps are engaged, and she is lifting up out of the knee joint. An ever so slightly bent knee with quads engaged would be preferred to the Bikram approach seen on the top.

7. Bikram yoga is potentially dehydrating, unless you are very persistent in hydrating before, during and after each class. Often, water with electrolytes is necessary due to the large amount of fluids lost in a typical Bikram class. Bikram yoga is essentially a 90-minute yoga practice in a sauna.

8. There is no focus on personal or home practice in Bikram yoga. I think it is fair to say it is even discouraged. There is no possibility of evolving a cohesive, holistic yoga practice within this system.

9. I hate to say it, but… due to the large amount of sweat students lose and the carpeted floors, many Bikram yoga studios can be kind of stinky!

Pros of Bikram Yoga

1. The repetition of the same poses twice each class in a heated environment offers a great opportunity to increase flexibility for those who are especially inflexible or muscle-bound.

2. The heat offers a beneficial cardiovascular and metabolically useful workout that is unique in the yoga world. Bikram yoga will significantly raise your heart rate for the majority of the 90 minutes class. This can have healthy effects on many body systems that are less, or less directly, affected through other yoga asana systems.

3. If weight-loss is your goal, Bikram yoga is probably more effective than other forms of yoga that are not in a heated room. And though there are some cons to sweating a lot, sweating may provide unique detoxification benefits. Also, the Bikram sequence alternates poses that compress parts of the body with frequent repetition of Savasana, which opens and relaxes the body.

This alternation of compression and release feels great and may offer additional benefit. I wasn’t able to find any research supporting these presumed benefits, but there are lots of things that are healthy for us that haven’t been studied yet. Hopefully we’ll see more research in the future.

4. The sequence includes a 3-part “Awkward Pose” which can be especially beneficial for the knees. The trio of poses, repeated twice, offers a creative and challenging way to strengthen all of the muscles surrounding the knee joint. The 3rd part emphasizes the vastus medialis, or inner quadraceps. A weak vastus medialis is often overpowered by a stronger vastus lateralis and I.T. band, which can cause patellar tracking problems.

5. Bikram yoga avoids poses that put pressure on the neck, shoulders and wrists. Though hyperextension of the knee is a concern, over-rotation of the knee, for the most part, is not. Most other yoga asana traditions include inversions like Headstand and Shoulderstand, which if done incorrectly, or by a person with certain pathologies or structural issues, can be harmful to the cervical spine.

Poses like Chaturanga Downward, Facing Dog and full Backbend can challenge the wrists and shoulders; and poses with potential to over-rotate the knee, like Lotus variations and Pigeon pose are also a normal part of many other yoga asana systems. This is not a disadvantage or a critique of those poses or styles of yoga.

All of the poses mentioned, when done correctly and with proper instruction, are extremely health promoting. But, for those that have neck, shoulder or wrist injuries that are exacerbated by their asana practice, Bikram yoga may be a good alternative. Finding a good teacher in other traditions to show you how to modify the poses causing discomfort may be another option.

Is Bikram Yoga Right for You?

Bikram yoga is safest and most beneficial for:

1. Those who are especially muscle bound or inflexible.

2. Those who already have extensive yoga or body-awareness training, as they will have the knowledge necessary to know when not to listen to the instructor.

3. Those who, from a TCM perspective, are abundant in Qi, Blood, Yin and Yang, and are without excess or deficiency Heat. And, from an Ayurvedic perspective, those who have dominant Kapha dosha, and an absence of Pitta imbalance.

Approach Bikram yoga with caution if:

1. You are hyperflexible or have a history of lumbar disc herniation or unstable spondylolisthesis.

2. You have a hard time staying hydrated, even with regular water consumption.

3. You have chronic fatigue that is consistently made worse with exertion.

4. You have low blood sugar, low blood pressure, get dizzy, faint easily or get regular headaches. In these cases, you may benefit from Bikram yoga, but make sure you stay very well hydrated before, during and after each class. It’s normal for there to be some light-headedness during a Bikram class, but if any of those symptoms increase after class, Bikram yoga is probably not a good option for you.

Pregnancy and Post-Partum Recommendations:

I do not recommend Bikram yoga during pregnancy. There are many other styles of yoga that are more beneficial for pregnant women. Pregnant women need abundant Qi and Blood, and exercise and yoga practices that are not depleting in any way. Also, as the level of the hormone relaxin increases during pregnancy, there may be increased risk of stretching ligaments.

I also do not recommend Bikram yoga after giving birth. Please wait at least a month before starting any vigorous exercise program. In the post-partum period it is especially important that rest, a healthy diet, and herbal therapy be utilized to replenish the Qi and Blood lost during delivery.

If you take a Bikram yoga class be sure to:

1. Listen to your body. If there is sharp pain in a joint, it is bad, no matter what the instructor says. One should never outsource their ability to determine what is right or wrong for their own bodies. Trust yourself and your sensations and back out of a pose or skip it altogether if that is what feels right to you.

2. Go into class hydrated, drink water during class at the appropriate times, and drink more water than you think you should in the hour or two after class. To help your body absorb the water, add electrolytes in the form of a touch of sea salt, lemon juice and/or honey, or an Emergen-C packet. Coconut water is another good choice.

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