Yoga Practitioners Older Than 45 Have Increased Risk Of Hip Injuries: A 20-Year Epidemiological Study

PURPOSE: The objective of this study is to determine the incidence and risk factors of yoga-related injuries to generate guidelines for safely practicing yoga. METHODS: The National Electronic Injury Surveillance System (NEISS) was searched from 2004-2023 for injury codes describing exercise “activity or apparel” and “exercise equipment.” Narrative descriptions were reviewed by two authors to select entries addressing yoga practice. Descriptive statistics were performed, and the Stata svyset function (SE 17.0, StataCorp LLC) was used to calculate national estimates. Athletes were also categorized into <45 years of age and ≥ 45 years of age, and significance between age groups was determined using adjusted Wald tests to compare proportions in the setting of complex weighted survey data. RESULTS: The initial data search yielded 160,521 entries. The narrative review process (Cohen’s kappa = 0.76) resulted in 1615 entries for analysis, corresponding to a national estimate of 63,280 yoga-related injuries. Patients were disproportionately female and White (mean age = 46.5, SD = 18.0). Most injuries occurred in places of recreation (42.4%) and the home (10.0%). The most common type of injury was strains/sprains (32.5%). The trunk was the most injured body region (lower trunk = 24.2%, shoulder = 9.0%). In the lower limb region, the knee was most often affected (9.4%). Wald tests revealed that for body region injured, in the <45 category, head injuries were a significantly larger proportion of total injuries (p < .005). In the ≥45 category, hip injuries (subset of trunk) were a significantly larger proportion of total injuries (p < .001). CONCLUSION: Yoga can involve strenuous physical activity resulting in injury, especially strains/sprains. Given that hip injuries comprised a significantly larger proportion of injuries in patients ≥45, athletes in this age range should be counseled about these risks to maximize the safety of all participants. - Summary of Demographics of Yoga Injuries in the U.S. from 2004-2023 Unweighted [n] Weighted [N] Percentage of Total Age 18-44 786 28,621 48.7 45-64 540 21954 33.5 65+ 288 12705 17.8 Sex Male 345 11906 21.4 Female 1269 51374 78.6 Race White 739 31842 45.8 Black/African American 133 4370 8.2 Asian 35 1066 2.2 American Indian/Alaska Native 1 75 0.1 Native Hawaiian/Pacific Islander 1 93 0.1 Other 44 1826 2.7 Not stated 661 24008 41 Injury Diagnosis Strain/sprain 524 22009 32.5 Fracture 82 3213 5.1 Dislocation 65 2533 4 Contusions/abrasions 53 1906 3.3 Other 171 7095 10.6 Not stated 719 26525 44.5 Body Region Trunk 785 30495 48.6 Upper limb 116 4546 7.2 Lower limb 327 13008 20.3 Head 288 10549 17.8 Other 98 4683 6.1 Location Home 162 6591 10.0 Place of recreation or sports 684 27230 42.4 Other 768 29459 47.6 Disposition Treated/examined and released 1474 57748 91.3 Treated and admitted/hospitalization 98 4319 6.1 Other 42 1214 2.6