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10 Absolutely Excellent Physical Therapy Improvements to Bikram's Hot Yoga Poses

10 Absolutely Excellent Physical Therapy Improvements to Bikram's Hot Yoga Poses. 


By Kim ByrdRider, PT 


Shhhhh…don’t tell anyone…many short years ago in a Norman, Oklahoma, I used to bootleg teach the Bikram series daily at 6:00am. Oh boy, did I look forward to the heat on cold winter mornings as I snuck out of my house leaving a sleeping husband and two children snug in their beds. My only reference was Bikram’s book. I had the book spine cut off and spiral bound so the book could lay open on the floor while I taught. I turned the pages as we practiced to make sure the order was right! It was out of necessity. The only Bikram studio in the state was two hours away in Tulsa. 

It’s a new day, now. Bikram and hot yoga studios grace at least two corners in every city. I must confess, 20 years later, I love this series and practice it regularly (from a real Bikram teacher). I became a physical therapist 10 years later and began to see yoga through a different lens. 

Remember, Bikram Chudhury crafted this yoga series in the 1970s and it has never been changed, even though we have new orthopedic research. Listed below are 10 Quick fixes to update your Bikram practice to match current orthopedic research. 




Awkward Pose 

1st improvement: This is not a functional knee/leg position and is controversial in the literature. There is no point in lowering this far at the expense of the knee joint. Fix: Lower half of this distance. During the third section where you squeeze the knees together, the heels have to be wider than the toes to keep the knees in their hinge alignment.  Plus, this heel position increases vastus medialis quad (inside quad) contraction, improving patellar (knee cap) glide alignment. Make sure you feel the vastus medialis contracting, if not squeeze the knees together more until you do.  





Eagle Pose 

2nd Improvement: the knees are a hinge joint and need to be trained on that hinge to stabilize the knee. Both knees in the Eagle are off of their hinge plane (sagittal plane) of action.  They are twisted. Fix: point the standing knee forward and do not wrap the foot around the calf to keep the top knee on it’s hinge too. Do squeeze the top knee toward your body to massage the lymph at the inner hip.  





Standing Head to Knee 

3rd improvement: bending the spine forward in standing and putting a load in the hands maximally loads compression into the discs.  There is too much disc compression in this pose.  Disc compression leads to disc herniation.   Instead: stand up tall, place arms at sides and hold the leg up (hip flexed to 90 degrees). You can do it with the knee bent too. This strengthens the typically weak spine stabilizing psoas muscle. We all need to strengthen the psoas. Remember, at 90 degrees or more of hip flexion, the psoas is almost isolated for maximal strengthening benefits. 




Standing Bow 

4th improvement: the standing knee has a tendency to lock and even bow backward in this pose (knee hyper-extension). Because of the forward weight too many backward forces are placed on the standing knee. Fix: unlock the standing knee slightly. Do this in the other one legged balances as well. Many people do not have the flexibility to get the knee straight anyway. If not, don’t worry about this fix. 







Toe Stand 

5th improvement: toe stand has both of the previous knee issues.  The high knee is twisted and the standing knee is in a non-functional stressed position. Fix: just do the first half. Go into the tree pose. Touch your hands to the floor with a standing slightly bent knee and that’s it. Make sure the ankle or foot is on the thigh to decrease lateral sheering forces at the knee. The pose now becomes a hip, glut, piriformis stretch.  That’s great because the sequence is missing a good piriformis stretch.  A tight piriformis is a big contributor to sciatica pain. 





Locust Pose 

6th improvement: the elbows can hyper-extend here and the body weight adds overpressure. The ligaments will elongate and destabilize the elbow joint. If the shoulders lift from the floor the problem worsens. Fix: widen the hands apart to thigh width, keep the shoulders on the floor at all times. If your elbows feel like they are hyper-extending, bend them slightly. 




Fixed Firm Pose 

7th improvement: your feet do not belong beside your hips for any reason.  The knees are twisting and hyper-flexing. Body weight is applying overpressure forces through the knees in a misaligned position. This contributes to destabilizing the knee joints and should not be done.  Either sit on your feet or a block. You can also do what I do and skip it completely.  It is a nice time to take a break in savasana. 






Spine-Twisting Pose 

8th improvement: spine twisting can be done safely if in neutral spine or straight up and down. In the above picture he is bending forward (flexing) and twisting. More back injuries occur when spine flexion plus rotation couple together. Fix: sit up tall and rotate. The spine always takes priority in every pose.  The leg placement is secondary. Rock to the front edge of your sitting bones to remove the forward curve (flexion) from the low back. Don’t sit on your foot. Both sitting bones (ischial tuberosities) need to be on the floor to provide a level base for the spine. 


9th improvement: beware of hyper-extending the elbow as you grab your knee. If you feel any backward pressure at the elbow…let go of the bottom knee. I never hold the bottom knee. I hug the top knee. 






Sit Up 

10th improvement: bouncing (ballistic stretching) has been proven to cause tearing of the tissues. Straight legged sit ups can be back straining as well.  Fix: Come up slowly, segmentally and make sure you exhale hard the whole way (to increase transverse abdominis contraction) with no bouncing.  If it hurts your back, bend your knees too. 




Bonus Tip:  Always retract (make a double chin) your head before neck extension (back-bending) or neck rotating (turning). You want the extension to be in the low neck, not the high neck. If you do it this way, you will be strengthening and stretching in a way that counters a forward head posture helping you create perfect posture. Forward head is low neck flexion + upper neck extension. Retraction + extension is the opposite and improves forward head posture. 


Double Bonus Tip: Ignore words like “push”, “bounce” and “lock”.  As a yoga teacher, I understand the cue “lock” because people need to visualize straightening but if you can reach the lock, “unlock” slightly. The joint will still look straight. 


Triple Bonus Tip: Be aware of where you are feeling the stretch.  If it is near the bony attachment, back off.  You are pulling at the tendon and will create tendonitis. Shift and change your alignment until you feel the stretch near the belly of the muscle. 


Have a fantastic safe productive time in hot Bikram yoga, especially on a cold winter morning. You can apply this information in other yoga classes and to other poses, too. If the teacher tries to change your new modifications just tell her/him it hurts the other way and they will leave you alone. If you want the research that backs up these statements email us at 

Be Well, 

Dr. Kim ByrdRider, PT 




I'm Dr. Kim
Byrd-Rider, PT

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