The Science of Yoga

colorful bow tie.
    We went into his office and he spread out trays of carryout sushi. The wall behind his desk was cluttered with the usual diplomas as well as a large photograph of Iyengar. The famous yogi sat in a Full Lotus, his head high and eyes open, a picture of pride and vitality. Nearby photos also showed two grown children in graduation caps and gowns. From my research, I knew Fishman had achieved quite a bit in his career. In addition to treating patients, he held a clinical professorship at the Columbia College of Physicians and Surgeons, the medical arm of Columbia University. He had published more than a hundred papers and articles. At one point, Fishman led the New York Society of Physical Medicine and Rehabilitation, serving as itspresident. His thriving practice, Manhattan Physical Medicine and Rehabilitation, employed physicians at four offices around the city—on Park Avenue, on the Upper West Side, in Queens, and on City Island. He also served as treasurer of the Manhattan Institute for Cancer Research, a charity.
    While eating, Fishman told of his therapeutic work. Often, he would jump up from his desk to show what he meant, either doing a pose or demonstrating his point on a human skeleton hanging nearby. He said he was sixty-six but looked to be in his fifties.
    Yes, he said, he learned much from Iyengar. But as Fishman spoke, it became clear that his guru was no guru in the sense of being a role model he followed slavishly. Instead, Fishman honored his mentor by exhibiting the same kind of pigheaded independence that Iyengar did, trying things on his own, experimenting on himself and his patients, arriving at cures and treatments in a roundabout way. It seemed that Iyengar provided the context, not the content. Fishman seemed to be a modern thinker who liked to tinker, a kind of Thomas Edison of yoga therapy.
    He told of his own painful experience with torn rotator cuffs, and how that led to what he called a miracle cure. He used the phrase with a wry smile.
    The shoulder is the most flexible joint of the hundred and fifty in the human body. It lets the arm achieve an astonishing range of motion—up, down, sideways, rotated—through a clever but risky stratagem that centers on a shallow ball-and-socket joint. The rounded head of the humerus, the main arm bone, rests in a very modest socket on the scapula, or shoulder blade, which children like to call angel wings. The shallowness of the socket gives the humerus wide freedom of movement but also raises the risk of the ball popping out. The job of holding it in place goes mainly to the rotator cuff. Its four or five muscles (the number depends on the authority) originate on the scapula and fasten to the head of the humerus through the tough cords known as tendons. Atop the humeral head, the tendons merge to form a taut cap of connective tissue that not only holds the shoulder tightly in place but also, in something of a contradiction, helps move the arm.
    Tears of the rotator cuff usually involve the tendons, limit arm motion, and can be quite painful. Athletes who raise their arms in repetitive patterns—swimmers, tennisplayers, baseball pitchers—know the problem well. The tears most often occur in the tendon of a muscle known as the supraspinatus, which lies above the rotator group. Its name derives from its origin just above a bony spine that runs across the scapula.
    Fishman said he tore his right rotator cuff while skiing. He had surgery on it and then, a few years later, tore his left rotator cuff as well. His surgeon judged the tear quite serious and suggested he get an appointment with the city’s best specialists. It was a total supraspinatus tear, and Fishman experienced the usual pain and arm limitations. Without assistance, he could raise his arm no higher than eighty degrees—a bit less than perpendicular to his body.
    One day at home, during the month-long wait for a surgical consultation (yes, even physicians get caught in that kind of delay), Fishman was doing yoga and decided to attempt a Headstand. He found he could do it. Getting his head down and arms into the right position was no problem.
    “My wife said, ‘What are you doing? ’ ” he recalled. “I got up to tell her and found I could raise my arm. Before, I couldn’t. I went to the office and did it again. It kept working.”
    Astonished, Fishman threw himself into a program of research and confirmation, including visits with top surgeons. Both said he no