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Savasana is also known as “corpse pose”. But is it really trying to make literal corpses out of us? Well, apparently some people would have us think so!

I’m exaggerating here, of course. No one is actually suggesting that savasana - the relaxing, peaceful pose in which we lie and rest for several minutes at the end of every yoga practice - could potentially kill us. But as difficult as it may be to believe, people are seriously proposing that this classic yoga pose could injure us. And so in the interest of some education on interpreting research papers, a little pain science primer, and a continued encouragement for less fearmongering in the yoga world, I’ve decided to examine this intriguing topic today.

IS SAVASANA OUT TO GET US?

I was prompted to write this piece because of a recent widely-read blog post that was brought to my attention. This blog post cited a research paper that seemed to suggest that savasana could potentially be a harmful pose. In order to support this study’s suggestion, the blog post proposed that because our bodies have adapted to the activity of sitting in chairs, most of us are not well-suited to lying flat on the floor. As a result, when we lie in savasana, our back arches and our spine is “compressed” and “overloaded”. The author writes: “For many, lying on the floor creates much higher loads on weakened tissue than you might expect for something as ‘simple’ as lying on the floor.”

The author proposes that instead of lying flat on the floor, most people should bolster their head and shoulders up higher in savasana in order to re-arrange the position of their body and avoid potential injury in the pose.

Before we examine this claim further, let’s first take a look at the research paper that was cited in order to justify the notion that savasana is injurious.

THE RESEARCH PAPER ON YOGA & INJURIES: A VERY PROBLEMATIC STUDY

I obtained a copy of the full study in question in order to explore its claims further. Titled “Soft Tissue & Bony Injuries Attributed to the Practice of Yoga” (Lee et al 2019), the researchers retrospectively reviewed the medical records of 89 patients who claimed to have experienced yoga-related injuries. According to the researchers, there were 12 “patient reported yoga poses that led to injury” (page 427), and one of these poses was savasana.

This study is significantly problematic for many reasons. First of all, it is a retrospective study, which is a very low-quality form of evidence that relies only on subjective recollections (i.e. anecdotes and not secondary data) to begin with.

Second of all, this study in no way establishes causation between savasana and injury. At most, the study might show that a handful of people claimed to experience a symptom of pain or discomfort while in savasana. This does not establish injury. Additionally, it does not establish time order between the two variables (a necessity for determining causation), and it does not examine any of the myriad alternate explanations that could be (and most likely are!) involved in the reported pain experienced during savasana.

Another important point about this study is that it was not done on a representative, random sample of people who do yoga, and is therefore not generalizable to the greater yoga population. The people selected for the study all attended the same medical clinic and they all had significant comorbid health conditions such as osteoporosis, cancer, and hyperlipidemia. Therefore we can’t make any inferences from this study about the general population of yoga practitioners.

Furthermore, the researchers did not include any non-injured patients, which means they selected on the dependent variable only. What about all of the people who went into the clinic who happened to practice yoga and were not injured? These patients weren’t considered in this study. And we can safely assume that they all did savasana at the end of every single one of their yoga classes. Why didn’t this injurious pose send them into the clinic as well?

For these and many other reasons that we don’t have time to discuss here, this study is not causal, is not valid, and is honestly not worthy of citing due to its extremely poor quality design. In fact, in the words of an academic researcher I consulted about this study (who just so happens to be my husband :) ): “From a causal standpoint, this study is garbage.”

FLAWED STUDY ASIDE - WHAT ABOUT PAIN SCIENCE?

We’ve established that the study in question is deeply flawed. But that major problem aside, where is an understanding of modern pain science in either this study or the blog post that cited the study? One of the most foundational insights about pain that we understand today is that the link between pain and tissue damage is quite tenuous. Many people experience pain in their bodies with no associated damage, and many people have damage in their tissues and no associated pain.

This means that just because something hurts or is uncomfortable does not necessarily mean that tissue damage is taking place. A helpful phrase commonly used in the therapeutic and rehabilitation worlds these days is “hurt does not equal harm”, and I believe this is a crucial insight that is missing from this discussion about savasana and injury.

Additionally, we know that in order to sustain an injury (tissue damage), the forces involved generally need to be significantly high and/or fast. The simple act of lying on the floor in savasana includes neither high nor fast forces. It is simply not plausible that this benign pose could actually cause tissue damage in our body.

Now I definitely don’t disagree with the blog post author that many people feel discomfort while lying flat on the floor in savasana. This is absolutely true, and many of us could find a more comfortable and relaxing pose by adding some props so that our body feels more supported.

But there’s an important difference between suggesting that people should prop their savasana up for comfort and suggesting that they should prop their savasana up in order to avoid injury. The former will help people find more ease and potentially embody more “yoga” in their pose; the latter will potentially serve as a nocebo - a negative expectation of an otherwise harmless event or action that causes negative consequences like pain.

Suggesting that savasana can harm us is nocebic because we understand today that pain is a multifactorial output of our nervous system that can be influenced by many factors beyond biomechanical ones. Beliefs and social influences are two well-established contributors to painful experiences (among many other psychological and social factors as well.)

The more that we spread a message about the fragility and vulnerability of our tissues (especially in low-load contexts that can not realistically injure us), the more we can influence people to have less confidence and trust in the innate strength and robusticity in their body. This can result in people’s nervous systems creating more painful perceptions than they otherwise would have in innocent yoga poses like savasana and beyond.

IN CONCLUSION…

It’s easy for well-meaning yoga and movement teachers to cause unintentional harm when communicating about the human body. The more we can educate ourselves about pain science and the potential negative effects of nocebos, the more likely we will be to teach about the body in productive, empowering ways.

Additionally, I encourage all of us (including myself!) to become more active consumers of knowledge. If we see a single study being used to make a broad claim, rather than taking that claim at face value, we would be wise to feel skeptical and potentially conduct some of our own research to investigate further.

And finally - setting the science and the flawed study aside, let’s not forget the power of common sense. I mean… savasana? Really? Have we become such feeble creatures that we can’t lie on the floor without harming ourselves? We should feel justified in using our common sense to question such claims.

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