1 79 59 A LOW-ENERGY FEMORAL SHAFT FRACTURE FROM PERFORMING A YOGA POSTURE. THE FEMORAL SHAFT IS RARELY THE SITE OF A LOW-ENERGY FRACTURE IN A HEALTHY INDIVIDUAL. THE VAST MAJORITY OF THESE FRACTURES ARE DUE TO MAJOR TRAUMA SUCH AS MOTOR VEHICLE ACCIDENTS. ALTHOUGH LOW-ENERGY FEMORAL SHAFT FRACTURES DO OCCUR, THEY ARE TYPICALLY IN PATIENTS WITH OSTEOPOROTIC BONE, OR PROSTHESIS RELATED. IN THIS CASE REPORT, WE PRESENT A MAN IN HIS LATE 30S WHO WAS PRACTISING A SPECIFIC YOGA STANCE WHEN HE EXPERIENCED A FEMORAL SHAFT FRACTURE. 2015 2 2777 21 YOGA SPINAL FLEXION POSITIONS AND VERTEBRAL COMPRESSION FRACTURE IN OSTEOPENIA OR OSTEOPOROSIS OF SPINE: CASE SERIES. OBJECTIVE: THE OBJECTIVE OF THIS REPORT IS TO RAISE AWARENESS OF THE EFFECT OF STRENUOUS YOGA FLEXION EXERCISES ON OSTEOPENIC OR OSTEOPOROTIC SPINES. WE PREVIOUSLY DESCRIBED SUBJECTS WITH KNOWN OSTEOPOROSIS IN WHOM VERTEBRAL COMPRESSION FRACTURES (VCFS) DEVELOPED AFTER SPINAL FLEXION EXERCISE (SFE) AND RECOMMENDED THAT SFES NOT BE PRESCRIBED IN PATIENTS WITH SPINAL OSTEOPOROSIS. METHODS: THIS REPORT DESCRIBES 3 HEALTHY PERSONS WITH LOW BONE MASS AND YOGA-INDUCED PAIN OR FRACTURE. RESULTS: ALL 3 PATIENTS HAD OSTEOPENIA, WERE IN GOOD HEALTH AND PAIN-FREE, AND HAD STARTED YOGA EXERCISES TO IMPROVE THEIR MUSCULOSKELETAL HEALTH. NEW PAIN AND FRACTURE AREAS OCCURRED AFTER PARTICIPATION IN YOGA FLEXION EXERCISES. CONCLUSIONS: THE DEVELOPMENT OF PAIN AND COMPLICATIONS WITH SOME FLEXION YOGA POSITIONS IN THE PATIENTS WITH OSTEOPENIA LEADS TO CONCERN THAT FRACTURE RISK WOULD INCREASE EVEN FURTHER IN OSTEOPOROSIS. ALTHOUGH EXERCISE HAS BEEN SHOWN TO BE EFFECTIVE FOR IMPROVING BONE MINERAL DENSITY AND DECREASING FRACTURE RISK, OUR SUBJECTS HAD DEVELOPMENT OF VCFS AND NECK AND BACK PAIN WITH YOGA EXERCISES. THIS FINDING SUGGESTS THAT FACTORS OTHER THAN BONE MASS SHOULD BE CONSIDERED FOR EXERCISE COUNSELING IN PATIENTS WITH BONE LOSS. THE INCREASED TORQUE PRESSURE APPLIED TO VERTEBRAL BODIES DURING SFES MAY BE A RISK. EXERCISE IS EFFECTIVE AND IMPORTANT FOR TREATMENT OF OSTEOPENIA AND OSTEOPOROSIS AND SHOULD BE PRESCRIBED FOR PATIENTS WITH VERTEBRAL BONE LOSS. SOME YOGA POSITIONS CAN CONTRIBUTE TO EXTREME STRAIN ON SPINES WITH BONE LOSS. ASSESSMENT OF FRACTURE RISK IN OLDER PERSONS PERFORMING SFES AND OTHER HIGH-IMPACT EXERCISES IS AN IMPORTANT CLINICAL CONSIDERATION. 2013 3 2359 21 VERTEBRAL COMPRESSION FRACTURES ASSOCIATED WITH YOGA: A CASE SERIES. BACKGROUND: THE IMPORTANCE OF EXERCISE IN SKELETAL HEALTH IS INCREASINGLY RECOGNIZED BY BOTH PATIENTS AND PROVIDERS. HOWEVER, THE SAFETY OF PRESCRIBED OR RECREATIONAL EXERCISE IN AT-RISK POPULATIONS REMAINS UNDER-REPORTED AND UNDER-PUBLICIZED. YOGA HAS GAINED WIDESPREAD POPULARITY DUE TO ITS PHYSICAL AND PSYCHOLOGICAL BENEFITS. WHEN PRACTICED IN A POPULATION AT INCREASED FRACTURE RISK, HOWEVER, SOME YOGA POSES MAY INCREASE FRACTURE RISK, PARTICULARLY AT THE SPINE, RATHER THAN INCREASING BMD AS NOTED IN RECENT POPULAR PRESS REPORTS. CASE REPORT: NINE SUBJECTS (8 WOMEN) WITH A MEDIAN AGE OF 66 YEARS (RANGE 53-87), DEVELOPED VERTEBRAL COMPRESSION FRACTURE (VCF) ONE MONTH TO SIX YEARS AFTER INITIATING YOGA-ASSOCIATED SPINAL FLEXION EXERCISES (SFE). VCF PRESENTED WITH BACK PAIN AND OCCURRED IN THE THORACICSPINE (N.=6), LUMBAR-SPINE (N.=4) AND CERVICAL-SPINE (N.=1). FOUR PATIENTS HAD OSTEOPOROSIS BY BMD CRITERIA PRIOR TO VCF AND 2 HAD OSTEOPENIA (MEDIAN T-SCORE -2.35; RANGE -3.3 TO +2.0). INTERESTINGLY, ALL PATIENTS HAD THEIR LOWEST T-SCORES AT THE SPINE. THREE PATIENTS HAD A HISTORY OF FRAGILITY FRACTURE PRIOR TO THE INDEX VCF. WHILE ONE PATIENT HAD PRIMARY HYPERPARATHYROIDISM AND ANOTHER WAS TREATED WITH HIGH DOSE PREDNISONE, NO OTHER RISK FACTORS FOR BONE LOSS INCLUDING MEDICATIONS OR SECONDARY OSTEOPOROSIS CAUSES WERE IDENTIFIED IN THE OTHER PATIENTS. CLINICAL REHABILITATION IMPACT: THIS STUDY IDENTIFIED PATIENTS IN WHOM INCREASED TORSIONAL AND COMPRESSIVE MECHANICAL LOADING PRESSURES OCCURRING DURING YOGA SFE RESULTED IN DE NOVO VCF. DESPITE THE NEED FOR SELECTIVITY IN YOGA POSES IN POPULATIONS AT INCREASED FRACTURE RISK, BOTH SCIENTIFIC AND MEDIA REPORTS CONTINUE TO ADVERTISE YOGA AS A BONE PROTECTIVE ACTIVITY. ACCORDINGLY, YOGA IS MISCONCEIVED AS A 'ONESIZE-FITS-ALL' PRESCRIPTION. INSTEAD, THE APPROPRIATE SELECTION OF PATIENTS LIKELY TO BENEFIT FROM YOGA MUST BE A CORNERSTONE OF FRACTURE PREVENTION. 2018 4 443 24 CERVICAL ARTERIAL DISSECTION AND TRAUMATIC MYELOPATHY FOLLOWING YOGA: SURGICAL CASE REPORT. INTRODUCTION: CERVICAL SPONDYLOSIS CAN PREDISPOSE PATIENTS TO CENTRAL CANAL STENOSIS. IN THIS SETTING, MYELOPATHY THROUGH FURTHER FLATTENING OF THE CORD FROM EXTRINSIC COMPRESSION CAN BE PRECIPITATED BY RELATIVELY MINOR TRAUMAS. ARTERIAL DISSECTION IS SIMILARLY CONSIDERED A RESULT OF HIGH VELOCITY OR MOMENTUM DURING TRAUMA, COMMONLY ASSOCIATED WITH FRACTURES, CERVICAL HYPERFLEXION, OR DIRECT BLUNT FORCE TO THE NECK. OVERALL, PRECAUTIONS FOR BOTH ARTERIAL DISSECTION AND MYELOPATHY ARE RARELY CONSIDERED IN LOW-VELOCITY, STATIC ACTIVITIES SUCH AS YOGA. CASE PRESENTATION: THE AUTHORS REPORT THE CASE OF A 63-YEAR-OLD MAN WHO SUFFERED CONCURRENT CERVICAL MYELOPATHY FROM MULTILEVEL SPONDYLOPATHY, RIGHT VERTEBRAL ARTERY DISSECTION, AND LEFT CERVICAL CAROTID ARTERY DISSECTION FOLLOWING A YOGA SESSION. SYMPTOMATOLOGY CONSISTED OF ACUTE ONSET NECK PAIN, UPPER EXTREMITY SENSORY PARESTHESIA, WORSENING GAIT AND BALANCE, AND IMPAIRED DEXTERITY FOR SEVERAL WEEKS. CERVICAL MRI WAS OBTAINED GIVEN MYELOPATHIC SYMPTOMS AND REVEALED SPONDYLOSIS WITH COMPRESSION AND T2 SIGNAL CHANGE AT C3-C4. CT ANGIOGRAPHY OF THE NECK REVEALED AFOREMENTIONED DISSECTIONS WITHOUT FLOW LIMITING STENOSIS OR OCCLUSION. A THERAPEUTIC HEPARIN INFUSION WAS STARTED PREOPERATIVELY UNTIL THE PATIENT UNDERWENT C3-C4 ANTERIOR CERVICAL DISCECTOMY AND FUSION. ASPIRIN AND PLAVIX WERE THEN STARTED WITHOUT INCIDENCE AND THE PATIENT HAD SIGNIFICANT BUT GRADUAL IMPROVEMENT IN MYELOPATHIC SYMPTOMS AT 6-WEEK FOLLOW-UP. DISCUSSION: THE STATIC YET INTENSIVE POSES ASSOCIATED WITH YOGA PRESENT A RARE ETIOLOGY FOR ARTERIAL DISSECTION AND MYELOPATHY, BUT PATIENTS WITH PERSISTENT AND PROGRESSIVE SYMPTOMS SHOULD BE SCREENED WITH THE APPROPRIATE IMAGING MODALITY. CERVICAL DECOMPRESSION SHOULD BE EXPEDITED BEFORE INITIATING AN ANTIPLATELET MEDICATION. 2022 5 573 15 DELAYED UNION OF STRESS FRACTURE OF THE FIRST RIB IN A YOGA INSTRUCTOR: A CASE REPORT. CASE: WE DESCRIBE THE CASE OF A 38-YEAR-OLD WOMAN, A YOGA INSTRUCTOR, WHO HAD PAIN IN THE RIGHT SHOULDER AND SCAPULAR REGION OF 4 MONTHS' DURATION WHILE PERFORMING YOGA. RADIOGRAPHY AND COMPUTED TOMOGRAPHY DIAGNOSED DELAYED UNION OF A FIRST RIB STRESS FRACTURE. THE DELAYED UNION OF STRESS FRACTURE OF THE FIRST RIB WAS SUCCESSFULLY TREATED WITH THE LIMITING OF YOGA ACTIVITY AND LOW-INTENSITY PULSED ULTRASOUND (LIPUS). CONCLUSIONS: PHYSICIANS SHOULD BE AWARE THAT EVEN YOGA POSING CAN CAUSE STRESS FRACTURES OF THE FIRST RIB. LIPUS THERAPY MAY BE EFFECTIVE FOR DELAYED UNION IN ADDITION TO REST. 2021 6 2853 25 YOGA, VERTEBRAL FRACTURES, AND OSTEOPOROSIS: RESEARCH AND RECOMMENDATIONS. BACKGROUND: OSTEOPOROSIS IS CHARACTERIZED BY DECREASED BONE DENSITY THAT LEAVES BONES FRAGILE AND HIGHLY SUSCEPTIBLE TO FRACTURE. GLOBALLY, 1 IN 3 WOMEN AND 1 IN 5 MEN OLDER THAN 50 WILL SUFFER FROM AN OSTEOPOROTIC FRACTURE, AND THOSE INDIVIDUALS WILL EXPERIENCE A CONSIDERABLY HIGHER RISK OF POSTFRACTURE MORTALITY THAN WILL THE GENERAL POPULATION. GENTLE, WEIGHT-BEARING EXERCISES SUCH AS YOGA CAN HELP PREVENT OR CEASE THE PROGRESSION OF OSTEOPOROSIS; HOWEVER, THERE IS INSUFFICIENT DATA REGARDING WHICH YOGA POSES PRESENT THE LEAST RISK AND ARE MOST BENEFICIAL TO INDIVIDUALS WITH REDUCED BONE DENSITY. OBJECTIVES: REVIEW THE EXTANT LITERATURE ABOUT THE RISKS AND BENEFITS TO THE SPINE OF PARTICULAR FORMS OF MOVEMENT AND CONSIDER RECOMMENDATIONS RELATIVE TO THE PRACTICE OF YOGA. METHODS: A REVIEW OF THE PUBMED, MEDLINE, AND COCHRANE DATABASES WAS CONDUCTED THAT IDENTIFIED MANUSCRIPTS PUBLISHED BETWEEN 1966 AND 2011 ABOUT TOPICS RELATED TO OSTEOPOROSIS AND SPINAL MOVEMENT. CONCLUSIONS: MOVEMENTS INVOLVING SPINAL FLEXION CAN INCREASE RISK FOR VERTEBRAL COMPRESSION FRACTURES; HOWEVER, A COMBINATION OF MILD SPINAL FLEXION AND EXTENSION MAY PROVE BENEFICIAL. MODERATE, WEIGHT-BEARING ACTIVITIES THAT STRENGTHEN THE MUSCLES SUPPORTING THE SPINAL COLUMN, PROMOTE BALANCE, IMPROVE POSTURE, AND ENHANCE QUALITY OF LIFE APPEAR TO BE OF GREATEST BENEFIT. AMPLE EVIDENCE SUPPORTS THE IMPORTANCE OF VARIED SPINAL MOVEMENT FOR PRESERVING THE HEALTH AND STRENGTH OF THE VERTEBRAL BODIES. EXERCISE MODIFICATIONS SUITABLE FOR HIGH-RISK INDIVIDUALS MAY BE COUNTERPRODUCTIVE FOR THOSE AT LOW RISK FOR VERTEBRAL FRACTURES. YOGA THERAPISTS ARE CAUTIONED TO NOT APPLY A ONE-SIZE-FITS-ALL APPROACH WHEN WORKING WITH THIS POPULATION. WELL-DESIGNED EMPIRICAL STUDIES ARE NEEDED TO FURTHER OUR UNDERSTANDING OF WHICH YOGA POSES PRESENT THE LEAST RISK AND ARE OF GREATEST BENEFIT TO INDIVIDUALS WITH OSTEOPOROSIS. 2013 7 1984 22 SOFT TISSUE AND BONY INJURIES ATTRIBUTED TO THE PRACTICE OF YOGA: A BIOMECHANICAL ANALYSIS AND IMPLICATIONS FOR MANAGEMENT. OBJECTIVE: TO ANALYZE INJURIES THAT WERE DIRECTLY ASSOCIATED WITH YOGA PRACTICE AND IDENTIFY SPECIFIC POSES THAT SHOULD BE AVOIDED IN PATIENTS WITH OSTEOPENIA OR OSTEOPOROSIS. PATIENTS AND METHODS: WE RETROSPECTIVELY REVIEWED THE MEDICAL RECORDS OF PATIENTS WITH INJURIES THAT WERE PRIMARILY CAUSED BY YOGA. PATIENTS WERE SEEN FROM JANUARY 1, 2006, THROUGH DECEMBER 31, 2018. INJURIES WERE CATEGORIZED INTO 3 GROUPS: (1) SOFT TISSUE INJURY, (2) AXIAL NONBONY INJURY, AND (3) BONY INJURY. PATIENTS UNDERWENT EVALUATION AND WERE COUNSELED TO MODIFY EXERCISE ACTIVITY. RESULTS: WE IDENTIFIED 89 PATIENTS FOR INCLUSION IN THE STUDY. WITHIN THE SOFT TISSUE GROUP, 66 PATIENTS (74.2%) HAD MECHANICAL MYOFASCIAL PAIN DUE TO OVERUSE. ROTATOR CUFF INJURY WAS SEEN IN 6 (6.7%), AND TROCHANTERIC BURSOPATHY WAS OBSERVED IN 1 (1.1%). IN THE AXIAL GROUP, EXACERBATION OF PAIN IN DEGENERATIVE JOINT DISEASE (46 PATIENTS [51.7%]) AND FACET ARTHROPATHY (N=34 [38.2%]) WERE OBSERVED. RADICULOPATHY WAS SEEN IN 5 PATIENTS (5.6%). WITHIN THE BONY INJURY CATEGORY, KYPHOSCOLIOSIS WAS SEEN ON IMAGING IN 15 PATIENTS (16.9%). SPONDYLOLISTHESIS WAS PRESENT IN 15 PATIENTS (16.9%). ANTERIOR WEDGING WAS SEEN IN 16 (18.0%), AND COMPRESSION FRACTURES WERE PRESENT IN 13 (14.6%). THE POSES THAT WERE MOST COMMONLY IDENTIFIED AS CAUSING THE INJURIES INVOLVED HYPERFLEXION AND HYPEREXTENSION OF THE SPINE. WE CORRELATED THE KINESIOLOGIC EFFECT OF SUCH EXERCISES ON SPECIFIC MUSCULOSKELETAL STRUCTURES. CONCLUSION: YOGA POTENTIALLY HAS MANY BENEFITS, BUT CARE MUST BE TAKEN WHEN PERFORMING POSITIONS WITH EXTREME SPINAL FLEXION AND EXTENSION. PATIENTS WITH OSTEOPENIA OR OSTEOPOROSIS MAY HAVE HIGHER RISK OF COMPRESSION FRACTURES OR DEFORMITIES AND WOULD BENEFIT FROM AVOIDING EXTREME SPINAL FLEXION. PHYSICIANS SHOULD CONSIDER THIS RISK WHEN DISCUSSING YOGA AS EXERCISE. 2019 8 2911 19 [PSEUDOARTHROSIS OF THE FIRST RIB IN A PATIENT WHO PRACTICES YOGA. A CASE REPORT]. INTRODUCTION: PSEUDOARTHROSIS OF THE FIRST RIB IS A RARE CONDITION THAT MAY OCCUR IN ATHLETES AS A RESULT OF REPETITIVE ACTIVITIES, MAINLY OVERHEAD. THE USUAL CLINICAL PRESENTATION IS PAIN IN THE NECK OR THE IPSILATERAL SHOULDER. CASE REPORT: THIS IS THE CASE OF A 19-YEAR-OLD FEMALE PATIENT WHO HAD SUDDEN PAIN OF THE BASE OF THE NECK WHILE DOING YOGA. PSEUDOARTHROSIS OF THE FIRST RIB WAS DIAGNOSED WITH X-RAYS AND CAT SCAN. TREATMENT CONSISTED OF A REHABILITATION AND PHYSICAL THERAPY PROGRAM THAT WAS SUCCESSFUL DESPITE THE PERSISTENCE OF THE PSEUDOARTHROSIS. DISCUSSION: CASES OF FIRST RIB FRACTURES HAVE BEEN REPORTED IN ATHLETES PRACTICING MULTIPLE ACTIVITIES; HOWEVER, PSEUDOARTHROSIS CASES ARE RARE SINCE MOST OF THEM PROGRESS TO BONE HEALING. THIS IS THE FIRST REPORTED CASE OF A FRACTURE OR PSEUDOARTHROSIS IN A PATIENT PRACTICING YOGA. AS IN MOST REPORTED CASES, CONSERVATIVE TREATMENT WAS SUCCESSFUL. CONCLUSION: FRACTURES AND PSEUDOARTHROSIS OF THE FIRST RIB ARE RARE IN ATHLETES AND SHOULD BE INCLUDED IN THE DIFFERENTIAL DIAGNOSIS OF ATHLETES PRESENTING WITH SHOULDER AND NECK PAIN. CONSERVATIVE TREATMENT IS SUCCESSFUL IN MOST CASES. 2009 9 2873 21 YOGA-INDUCED MYOSITIS OSSIFICANS TRAUMATICA OF THE SCAPHOLUNATE LIGAMENT. BACKGROUND MYOSITIS OSSIFICANS TRAUMATICA (MOT) INVOLVES THE HETEROTOPIC DEVELOPMENT OF LAMELLAR BONE AFTER A TRAUMATIC INJURY. DESPITE BEING TERMED "MYOSITIS," MOT IS NOT LIMITED TO MUSCLE BUT RATHER CAN INVOLVE TENDONS, FAT, AND FASCIA. "TRAUMATICA" REFLECTS THAT LESIONS ARE USUALLY ASSOCIATED WITH A HISTORY OF SIGNIFICANT TRAUMA, THAT IS, FRACTURES OR SURGERY; HOWEVER, MANY REPORTS SUGGEST THEY CAN ALSO BE LINKED TO REPETITIVE LOW-ENERGY INSULTS. IN BOTH CASES, THE INFLAMMATORY RESPONSE SECONDARY TO TISSUE INJURY GENERATES A PROLIFERATIVE OSTEOBLASTIC CASCADE. CASE DESCRIPTION WE PRESENT A CASE OF PERSISTENT WRIST PAIN IN A 43-YEAR-OLD WOMAN ASSOCIATED WITH YOGA ACTIVITIES. HER RADIOGRAPHIC STUDIES DEMONSTRATED PARTIAL SCAPHOLUNATE (SL) LIGAMENT TEAR AND AN ASSOCIATED MASS LESION. SURGICAL PATHOLOGY REVEALED MOT INVOLVING THE SL LIGAMENT. LITERATURE REVIEW MOT LESIONS IN THE UPPER EXTREMITY ARE USUALLY LOCALIZED AROUND THE ELBOW, AND CASES IN THE HAND ARE RELATIVELY RARE. THERE ARE NO PRIOR REPORTS OF OCCURRENCES WITHIN THE WRIST JOINT OR IN ASSOCIATION WITH THE SL LIGAMENT. HOWEVER, BIOMECHANICAL STUDIES HAVE QUANTIFIED SIGNIFICANT MECHANICAL STRAINS ACROSS THE SL INTERVAL DURING VARIOUS YOGA POSES. THIS PATTERN OF MICROTRAUMA IS CAPABLE OF GENERATING MOT. CLINICAL RELEVANCE UPPER EXTREMITY WEIGHT-BEARING POSITIONS ARE COMMON IN YOGA AND SUBJECT THE WRIST, ESPECIALLY THE SL INTERVAL, TO HIGH MECHANICAL STRAINS. THIS PATTERN OF MICROTRAUMA SHOULD LEAD THE CLINICIAN TO SUSPECT MOT WHEN ENCOUNTERING A MASS IN THE WRIST, BUT MALIGNANCY AND INFECTION MUST BE RULED OUT. 2019 10 2393 12 YOGA AND BONE HEALTH. OSTEOPOROSIS IS A PUBLIC HEALTH PROBLEM AFFECTING INDIVIDUALS GLOBALLY. YOGA HAS BEEN FOUND TO PREVENT AND REVERSE BONE LOSS. YOGA MAY RESULT IN BETTER BALANCE, IMPROVED POSTURE, AND GREATER RANGE OF MOTION, STRENGTH, AND COORDINATION, ALL FACTORS THAT ALSO MITIGATE THE RISK OF FALLS AND FRACTURES. A 12-MINUTE, 12-POSE YOGA REGIMEN IS DISCUSSED IN DETAIL. ONCE LEARNED, THE ONGOING USE OF YOGA IS SAFE, WITHOUT COST, AND MAY BE DONE LIFELONG. 2021 11 1905 21 RETURN TO YOGA RATES ARE HIGH AFTER VOLAR PLATING OF DISTAL RADIUS FRACTURES. BACKGROUND: YOGA IS A POPULAR ACTIVITY INVOLVING EXTREME WRIST POSITIONING AND EXTENSION LOADING. OUR PURPOSE WAS TO QUANTIFY THE PREVALENCE OF PREOPERATIVE YOGA PARTICIPATION AND CHARACTERIZE SUBSEQUENT ABILITY TO RETURN TO YOGA IN PATIENTS UNDERGOING VOLAR LOCKED PLATING OF DISTAL RADIUS FRACTURES. METHODS: WE RETROSPECTIVELY REVIEWED ALL CASES OF DISTAL RADIUS OPEN REDUCTION INTERNAL FIXATION BETWEEN AUGUST 2015 AND MARCH 2017. PATIENTS WERE INCLUDED IF THEY WERE TREATED WITH VOLAR LOCKED PLATING AND IF THEY PARTICIPATED IN YOGA ON A REGULAR BASIS PREOPERATIVELY. PATIENTS WERE CONTACTED AT A MINIMUM OF 1 YEAR POSTOPERATIVELY AND SURVEYED ABOUT YOGA PARTICIPATION. RESULTS: A TOTAL OF 149 PATIENTS WHO UNDERWENT DISTAL RADIUS VOLAR PLATING WERE SURVEYED. THIRTY-ONE PATIENTS (32 PROCEDURES, 20.8% OF SURVEYED PATIENTS) PARTICIPATED IN YOGA ON A REGULAR BASIS PREOPERATIVELY. OVERALL, 90.3% RETURNED TO YOGA IN SOME CAPACITY. MEAN TIMES TO RETURN TO YOGA IN ANY CAPACITY, WITH WEIGHT-BEARING, AND IN A "STEADY STATE" WERE 5.7, 7.4, AND 10.0 MONTHS, RESPECTIVELY. OF PATIENTS WHO RESUMED YOGA, 65.5% RETURNED TO THE SAME OR BETTER LEVEL OF YOGA. SATISFACTION WITH PARTICIPATION IN YOGA WAS 8.9 (OUT OF 10). CONCLUSIONS: WE FOUND A RELATIVELY HIGH YOGA PARTICIPATION RATE IN PATIENTS UNDERGOING DISTAL RADIUS FRACTURE FIXATION, SUGGESTING THE NEED TO BE ABLE TO EFFECTIVELY COUNSEL THESE PATIENTS. OUR RESULTS DEMONSTRATE A HIGH RATE OF RETURN TO YOGA, ALTHOUGH APPROXIMATELY ONE-THIRD OF PATIENTS EXPERIENCED A DECREASED LEVEL OF PARTICIPATION. SURGEONS CAN USE THIS INFORMATION TO SET APPROPRIATE EXPECTATIONS. 2021 12 197 14 A RARE CASE OF QUADRATUS FEMORIS MUSCLE RUPTURE AFTER YOGA EXERCISES. WE PRESENT A CASE OF A FEMALE PATIENT WITH LEFT GROIN PAIN AFTER INTENSE YOGA EXERCISES. THE PATIENT PRESENTED ABNORMAL PATTERN OF GAIT WITH NO SWELLING OVER THE GROIN, THIGH, OR BUTTOCK. MAGNETIC RESONANCE IMAGING DEMONSTRATED A TEAR OF THE QUADRATUS FEMORIS MUSCLE WITH AN ASSOCIATED EXTENSIVE HEMATOMA FORMATION. PATIENT WAS TREATED WITH A REHABILITATION PROGRAM CONSISTING OF NONSTEROIDAL ANTI-INFLAMMATORY DRUGS AND PHYSIOTHERAPY. AT THE FOLLOW-UP CONTROL, THE PATIENT HAD IMPROVED HER PAIN AND FLEXIBILITY OF THE HIP, AND GRADUALLY SHE RETURNED TO DAILY ACTIVITIES AND YOGA EXERCISES. SUCH AN ENTITY IS A RARE CAUSE OF HIP PAIN AFTER EXERCISE AND SHOULD BE KEPT IN MIND BY THE ORTHOPEDIC SURGEON, IN CASES OF GLUTEAL PAIN AFTER INTENSE PHYSICAL ACTIVITY. MOREOVER, SUCH A CONDITION SHOULD BE INCLUDED IN THE DIAGNOSTIC ALGORITHM OF UNKNOWN ORIGIN HIP PAIN. 2016 13 1546 14 LATE ANTERIOR PROSTHETIC HIP DISLOCATION DUE TO YOGA. THE POPULARITY OF YOGA AND THE PREVALENCE OF TOTAL HIP ARTHROPLASTY (THA) HAVE SIMULTANEOUSLY INCREASED IN THE UNITED STATES. ACCORDINGLY, ONE CAN ASSUME THAT THE NUMBER OF THA PATIENTS PRACTICING YOGA HAS INCREASED. CERTAIN YOGA POSES REACH THE EXTREMES OF HIP RANGE OF MOTION, POTENTIALLY LEAVING PATIENTS VULNERABLE TO DISLOCATION. TO DATE, 2 CASES OF LATE POSTERIOR PROSTHETIC HIP DISLOCATIONS DURING YOGA HAVE BEEN REPORTED; HOWEVER, THERE HAVE BEEN NO REPORTS OF ANTERIOR PROSTHETIC HIP DISLOCATIONS. WE PRESENT ONE CASE OF LATE ANTERIOR PROSTHETIC HIP DISLOCATION DURING YOGA IN A PATIENT WHO UNDERWENT THA VIA THE DIRECT ANTERIOR APPROACH. PROSTHETIC HIP DISLOCATION DURING YOGA MAY BE A GROWING CONCERN. WE PROVIDE ADDITIONAL EVIDENCE IN SUPPORT OF RECOMMENDATIONS FOR THA PATIENTS TO SAFELY PRACTICE YOGA. 2021 14 2288 15 THE YOGA MAT TECHNIQUE IN POSTLESS HIP ARTHROSCOPY. HIP ARTHROSCOPY FOR THE TREATMENT OF FEMOROACETABULAR IMPINGEMENT SYNDROME WITH ANTI-SLIDING TECHNIQUES AND WITHOUT THE USE OF A PERINEAL POST TO ACHIEVE HIP DISTRACTION HAS INCREASED GREATLY IN THE PAST 5 TO 10 YEARS. TO ACCESS THE HIP JOINT, DISTRACTION IS MANDATORY TO TREAT INTRA-ARTICULAR DISORDERS SUCH AS LABRAL TEARS, ACETABULAR CARTILAGE DEFECTS, LOOSE BODIES, LIGAMENTUM TERES TEARS, AND AVASCULAR NECROSIS OF THE HIP. IN HIP DISTRACTION, COUNTER-DISTRACTION IS NEEDED, AND THIS IS ACHIEVED WITH A BULKY AND CUSHIONED PERINEAL POST. MOST OF THE DESCRIBED TECHNIQUES IN HIP ARTHROSCOPY WORLDWIDE USE A PERINEAL POST, BUT IATROGENIC PUDENDAL NERVE, GENITAL LACERATIONS, HEMATOMAS, AND GROIN COMPLICATIONS HAVE BEEN REPORTED TO OCCUR. IN LATIN AMERICAN COUNTRIES, DISPOSABLE HIP PAD DEVICES ARE EXPENSIVE, AND NOT ALL THE ARTHROSCOPIC COMPANIES PROVIDE THEM. OUR YOGA MAT TECHNIQUE PROVIDES ENOUGH COUNTERTRACTION TO ACHIEVE ADEQUATE HIP DISTRACTION. LABRAL REPAIR, LABRAL RECONSTRUCTION, AND DECOMPRESSION OF FEMOROACETABULAR IMPINGEMENT SYNDROME HAVE BEEN ACHIEVED PROPERLY, RELIABLY, AND REPRODUCIBLY, AND NO TRENDELENBURG POSITION IS NEEDED. POSTLESS HIP ARTHROSCOPY IS MADE SIMPLE, AND POSITIONING THE PATIENT IS NOT DIFFICULT. HIP SURGEONS CAN ADAPT THIS TECHNIQUE TO A FRACTURE TABLE, A HIP DISTRACTOR, AND A STANDARD OPERATING ROOM TABLE. 2021 15 1991 16 SPINE FUSIONS, YOGA INSTRUCTORS, AND HIP FRACTURES: THE ROLE OF DUAL MOBILITY IN PRIMARY TOTAL HIP ARTHROPLASTY. BACKGROUND: DESPITE THE INCREASED USE OF DUAL MOBILITY (DM) IN PRIMARY TOTAL HIP ARTHROPLASTY (THA), DEBATE EXISTS REGARDING THE INDICATIONS FOR ITS USE. NO SPECIFIC ALGORITHM EXISTS TO GUIDE THIS DECISION-MAKING PROCESS. THEREFORE, THE PURPOSE OF THIS ARTICLE IS TO SUMMARIZE THE CURRENTLY AVAILABLE LITERATURE REGARDING THE USE OF DM IN PRIMARY THA AND PROVIDE EVIDENCE-BASED GUIDELINES BASED ON SPECIFIC PATIENT POPULATIONS AND RISK FACTORS FOR INSTABILITY. METHODS: WE REVIEWED THE CURRENT LITERATURE FOR STUDIES EVALUATING RISK FACTORS FOR DISLOCATION IN PRIMARY THA, AS WELL AS THE CLINICAL USE AND RESULTS OF DM IN PRIMARY THA. BASED ON THE STRENGTH OF THE LITERATURE, WE DISCUSS THE USE OF DM IN SPECIFIC PATIENT POPULATIONS. WE PROVIDE A DECISION-MAKING ALGORITHM TO DETERMINE WHETHER A PATIENT MAY BE INDICATED FOR DM IN PRIMARY THA. RESULTS: SURGEONS SHOULD CONSIDER PREOPERATIVE PATIENT DEMOGRAPHICS, RISK FACTORS FOR INSTABILITY (EG, SIGNIFICANT HIP-SPINE ISSUES), TYPE OF PROCEDURE TO BE PERFORMED (EG, CONVERSION ARTHROPLASTY), AND INDICATIONS FOR SURGERY (EG, THA FOR FEMORAL NECK FRACTURE). BASED ON THIS ALGORITHMIC ASSESSMENT, DM MAY BE WARRANTED IN THE PRIMARY THA SETTING IF A PATIENT'S COMBINED RISK REACHES AN ESTABLISHED THRESHOLD BASED ON THE LITERATURE. CONCLUSION: THIS EVIDENCE-BASED ALGORITHM MAY HELP GUIDE CURRENT PRACTICE IN THE USE OF DM IN PRIMARY THA. WE ADVOCATE THE CONTINUED JUDICIOUS USE OF DM IN HIP ARTHROPLASTY. LONGER TERM STUDIES ARE NEEDED IN ORDER TO EVALUATE THE DURABILITY OF DM, AS WELL AS ANY COMPLICATIONS RELATED TO THE DM ARTICULATION. 2021 16 2333 13 TWELVE-MINUTE DAILY YOGA REGIMEN REVERSES OSTEOPOROTIC BONE LOSS. OBJECTIVE: ASSESS THE EFFECTIVENESS OF SELECTED YOGA POSTURES IN RAISING BONE MINERAL DENSITY (BMD). METHODS: TEN-YEAR STUDY OF 741 INTERNET-RECRUITED VOLUNTEERS COMPARING PREYOGA BMD CHANGES WITH POSTYOGA BMD CHANGES. OUTCOME MEASURES: DUAL-ENERGY X-RAY ABSORPTIOMETRIC SCANS. OPTIONAL RADIOGRAPHS OF HIPS AND SPINE AND BONE QUALITY STUDY (7 TESLA). RESULTS: BONE MINERAL DENSITY IMPROVED IN SPINE, HIPS, AND FEMUR OF THE 227 MODERATELY AND FULLY COMPLIANT PATIENTS. MONTHLY GAIN IN BMD WAS SIGNIFICANT IN SPINE (0.0029 G/CM(2), P = .005) AND FEMUR (0.00022 G/CM(2), P = .053), BUT IN 1 COHORT, ALTHOUGH MEAN GAIN IN HIP BMD WAS 50%, LARGE INDIVIDUAL DIFFERENCES RAISED THE CONFIDENCE INTERVAL AND THE GAIN WAS NOT SIGNIFICANT FOR TOTAL HIP (0.000357 G/CM(2)). NO YOGA-RELATED SERIOUS INJURIES WERE IMAGED OR REPORTED. BONE QUALITY APPEARED QUALITATIVELY IMPROVED IN YOGA PRACTITIONERS. CONCLUSION: YOGA APPEARS TO RAISE BMD IN THE SPINE AND THE FEMUR SAFELY. 2016 17 1757 17 POSITION OF THE HIP IN YOGA. BACKGROUND: YOGA IS GROWING IN POPULARITY AS A FORM OF EXERCISE THROUGHOUT THE WORLD. ORTHOPEDIC PATIENTS PARTICIPATE IN YOGA, YET LITTLE IS KNOWN ABOUT THE RANGES-OF-MOTION OF THE HIP WITHIN VARIOUS YOGA POSES. ORTHOPEDIC SURGEONS ARE UNSURE ABOUT WHAT POTENTIAL POSITIONS THEIR PATIENTS ARE PLACING THEIR HIPS DURING A YOGA PRACTICE. THE AIM OF THIS STUDY IS TO QUANTIFY THE DEGREE OF HIP MOTION WITH COMMON YOGA POSES. METHODS: TWENTY HEALTHY, REGULAR PRACTITIONERS OF YOGA PERFORMED 11 DIFFERENT YOGA POSES IN A STANDARDIZED FASHION. MOTION ANALYSIS WAS USED TO CAPTURE RANGE-OF-MOTION OF THE HIP DURING EACH POSE. RESULTS: MANY YOGA POSES PUT THE HIP IN EXTREMES OF MOTION. POSES SUCH AS DOWNWARD DOG, FORWARD FOLD, SEATED TWIST, AND PIGEON STRESSED THE HIP IN FLEXION. WARRIOR 1, WARRIOR 2, CRESCENT LUNGE, PIGEON, AND TRIANGLE STRESSED THE HIP IN EXTENSION. EAGLE AND SEATED TWIST PUT THE HIP IN HIGHER ADDUCTION, WHILE HALF MOON, EAGLE, AND TRIANGLE PRODUCED MORE HIP INTERNAL ROTATION. CONCLUSION: MANY POSES WERE FOUND TO REACH EXTREMES OF HIP MOTION. THIS STUDY MAY HELP GUIDE THE ORTHOPEDIC SURGEON IN COUNSELING HIP ARTHROPLASTY AND HIP IMPINGEMENT PATIENTS ABOUT YOGA-RELATED ACTIVITY. BY KNOWING WHICH POSES POTENTIALLY STRESS THE HIP IN PARTICULAR PLANES OF MOTION, SURGEONS MAY BETTER INFORM THEIR PATIENTS WHO ARE RETURNING TO YOGA AFTER INJURY OR SURGERY. 2018 18 1547 14 LATE TOTAL HIP ARTHROPLASTY DISLOCATION DUE TO YOGA. YOGA HAS BECOME A POPULAR FORM OF EXERCISE, RECREATION, AND MEDITATION FOR ADULTS IN THE UNITED STATES. AS THE POPULARITY OF BOTH YOGA AND THE INCIDENCE OF HIP REPLACEMENTS HAVE BOTH COINCIDENTALLY INCREASED OVER THE LAST 2 DECADES, WE IMAGINE THAT THE NUMBER OF TOTAL HIP REPLACEMENT PATIENTS PARTAKING IN THE PRACTICE OF YOGA HAS ALSO INCREASED. THERE ARE NO CLEAR GUIDELINES AVAILABLE FOR YOGA PRACTICE FOLLOWING HIP REPLACEMENT. TO DATE, THERE HAVE BEEN NO PUBLISHED REPORTS OF PROSTHETIC HIP DISLOCATIONS DURING YOGA. WE PRESENT 2 CASES OF LATE TOTAL HIP DISLOCATIONS DURING YOGA AND PROVIDE A REVIEW OF THE AVAILABLE ORTHOPAEDIC LITERATURE AND OUR RECOMMENDATIONS ON PATIENT RESTRICTIONS AND EDUCATION WITH RESPECT TO PRACTICING YOGA AFTER A HIP REPLACEMENT. 2018 19 2722 17 YOGA MIGHT BE AN ALTERNATIVE TRAINING FOR THE QUALITY OF LIFE AND BALANCE IN POSTMENOPAUSAL OSTEOPOROSIS. AIM: OSTEOPOROTIC VERTEBRA AND HIP FRACTURES ARE MAJOR CAUSES OF DYSFUNCTION, DISABILITY, MORTALITY AND IMPAIRED LIFE QUALITY IN THE AGEING POPULATION. IN THE POSTMENOPAUSAL PERIOD, EXERCISES PREVENT RAPID BONE LOSS AND INCREASE MUSCLE STRENGTH, MOBILITY AND FLEXIBILITY THEREBY DECREASING THE RISK OF FALLS AND FRACTURES. YOGA EXERCISES, WHICH HAVE BEEN AN INSEPARABLE PART OF EASTERN CULTURE FOR HUNDREDS OF YEARS, ARE NOW BEING USED IN THE FIELD OF OSTEOPOROSIS REHABILITATION. YOGA HAS A POSITIVE EFFECT ON BALANCE, POSTURE, FLEXIBILITY, AND LIFE QUALITY RESULTING FROM ITS EFFECTS ON BALANCE, STRETCHING, RELAXATION AND STRENGTHENING. THE AIM OF THIS STUDY WAS TO EVALUATE THE EFFECT OF YOGA EXERCISES IN POSTMENOPAUSAL OSTEOPOROTIC WOMEN ON BALANCE AND LIFE QUALITY AND TO COMPARE THE RESULTS WITH A CLASSIC OSTEOPOROSIS EXERCISE PROGRAM. METHODS: TWENTY-SIX POSTMENOPAUSAL OSTEOPOROTIC WOMEN OVER 55 YEARS OF AGE WERE INCLUDED IN THE STUDY. A NEUROMUSCULAR TEST BATTERY AND THE QUALEFFO AS A LIFE QUALITY INDEX WERE USED FOR THE ASSESSMENT OF BALANCE AND LIFE QUALITY, RESPECTIVELY. RESULTS: THE RESULTS SHOWED THAT YOGA EDUCATION HAS A POSITIVE EFFECT ON PAIN, PHYSICAL FUNCTIONS, SOCIAL FUNCTIONS, GENERAL CONCLUSION: IN CONCLUSION, YOGA APPEARS TO BE AN ALTERNATIVE PHYSICAL ACTIVITY FOR THE REHABILITATION OF OSTEOPOROTIC SUBJECTS. 2010 20 2724 10 YOGA NEUROPATHY. A SNOOZER. SCIATIC NERVE COMPRESSION VERY RARELY OCCURS BILATERALLY. THE AUTHORS PRESENT A WOMAN WITH PROFOUND LOWER EXTREMITY WEAKNESS AND SENSORY ABNORMALITY AFTER FALLING ASLEEP IN THE HEAD-TO-KNEES YOGA POSITION (ALSO CALLED "PASCHIMOTTANASANA"). CLINICAL AND ELECTRODIAGNOSTIC FINDINGS ARE DISCUSSED IN DETAIL AND A BRIEF REVIEW OF THE LITERATURE IS PRESENTED. 2005