Three yoga poses tied to stroke risk, including an intense bend that affected a 39-year-old influencer
Medical experts warn that extreme neck extensions and head pressure in some poses can injure arteries feeding the brain, underscoring caution for yogis
Three yoga poses may raise the risk of stroke, doctors warn, as rare but serious injuries to neck arteries have been linked to certain backbends and inversions. A cervical arterial dissection, a tear in the wall of a neck artery, can trigger a stroke by allowing a clot to travel to the brain. Experts say dissections account for roughly 1% to 2% of all strokes and for as much as 25% of strokes in young and middle-aged adults, a statistic cited in a 2022 case report describing a 63-year-old man who suffered arterial dissection after a yoga session. Spontaneous carotid artery dissection has been reported for a variety of reasons, from neck hyperextension during yoga to coughing, vomiting, alcohol use or chiropractic manipulation, researchers noted in a vascular surgery study published in 2022. Doctors warn that poses involving extreme neck extension or placing weight on the head can be hazardous, especially for older people or those with cervical spine disease.
Three moves have been linked to these injuries: the wheel pose, the deep backbend known as Upward Bow or Urdhva Dhanurasana, which arches the chest and extends the neck; the fish pose, Matsyasana, a reclining backbend that involves pronounced neck extension; and the hollowback handstand, where the practitioner arches the neck and spine while upside down. Each pose can increase stress on arteries that run from the neck to the brain, a risk that can be amplified by poor alignment, inadequate warm-up or attempting a more intense variation without supervision.
The wheel pose traces to earlier decades. A 1973 case report described a 28-year-old woman who developed narrowing of her left vertebral artery and suffered a stroke after performing the wheel pose. In another instance, physical therapist Susan Eaton recounted that attempting an advanced version of the fish pose with more weight on the head and neck led to a tear in her left carotid artery, with a stroke that followed four days later.
More recently, yoga influencer Rebecca Leigh described a hollowback handstand during which she said vision became blurry. She told doctors that she extended her neck, dropped her hips back and arched her lower spine while inverted, and that she was hospitalized after suffering a stroke at age 39.
Medical authorities urge caution. Before starting any exercise regimen, people should consult with a physician, particularly if they have cervical spine disease, high blood pressure or other risk factors. Stroke is projected to affect about 795,000 Americans this year and can cause balance, vision and speech changes along with facial droop or numbness. Risk factors include hypertension, diabetes and high cholesterol, as well as smoking, inactivity and heavy alcohol use.
Yoga remains a common part of stroke rehabilitation, and some forms may aid motor recovery when guided by clinicians. However, other poses that stress the neck and head can pose risks. Practitioners should avoid extreme neck extension and weight bearing on the head, and seek instruction from qualified teachers, especially if they have cervical spine issues.
Taken together, the findings suggest that yoga can offer health benefits but should be pursued with caution. The reported cases are rare, yet they underscore the importance of individualized assessment and proper technique for anyone practicing yoga.
