The Science of Yoga

hold her head jutting forward and to the side all day long in an unnatural position that had resulted in her neck troubles. He prescribed yoga positions in which she would lie on her stomach and raise her head up and backward—the motion opposite of her daily grind. He said it would strengthen her neck and counteract the degeneration, letting the damaged tissues heal.
    “I prescribe a lot,” Fishman said. He had an unfair advantage over most yoga therapists, he added, because he could use all the diagnostic tools of modern medicine to pinpoint the problem, after which he could come up with yogic remedies of unusual specificity.
    “A lot of yoga therapists don’t have that ability,” Fishman said. “They treat in a very generic fashion that can be dangerous.”
    The woman that morning with the neck pains illustrated the importance of good diagnostics, he said. An electromyogram revealed nerve damage in her neck and allowed him to prescribe the right physical treatment. By contrast, a diagnosis that was more informal might have blundered into a yoga treatment with false promise and possibly bad side effects.
    Fishman said he never distributed handouts showing yoga postures, though sometimes he handedout yoga books. Instead, he said he gave out prescriptions of the kind used for drugs and medicines. But instead of writing down names of pills, he drew pictures.
    He searched his desk, found a pad, and sketched away. After a minute, he showed the results. It was a three-step plan for battling spinal stenosis—the condition that had struck Glenn Black, where the spinal canal narrows, causing serious problems.
    His sketch featured happy little stick men. The first stood, arms out, and the next frame showed it bent over sideways, hand to foot. The second sat upright on the floor with one leg stretched out and an arm reaching back in a spinal twist. The third lay flat and lifted the legs with a belt. The stick figures were informative but only rough outlines. Fishman said his usual method was to go over the details with patients.
    Every Tuesday in the late afternoon, he held a yoga session at his Upper West Side office. He called it a three-ring circus and invited me to visit.
    The office was slightly chaotic amid the transition from regular hours to yoga therapeutics. Patients came and went. A portly man hobbled around on crutches, his leg in a large cast. A young man sat on the floor, rubbing a bad ankle. “Undefeated in the Playoffs,” read the back of his bright red T-shirt. A big cardboard box overflowed with colorful yoga mats. The receptionist folded up a room divider and the area suddenly became large enough for a small class.
    Patients drifted in, put down mats, and began stretching. Maybe six or seven showed up, from their twenties to their sixties. There were also two yoga teachers, both women. One was a regular assistant. The other had recently met Fishman at a meeting in Los Angeles on yoga therapy and wanted to observe him in action.
    Fishman came in, bouncy and engaging, immediately the ringmaster. He chatted and led warm-ups, wearing bright yellow gym shorts and a gray muscle shirt. Nothing about him appeared to be sixty-six.
    When the visiting teacher volunteered that she had recently had surgery for a bunion—the painful curvature and swelling of the big toe—he showed us a simple treatment. It consisted of stretching both toes toward each other and then back to their normal straightforward positions; back and forth, back and forth, stretched and relaxed.
    Everyone tried it. Hesaid the exercise worked to strengthen a specific muscle, the abductor hallucis. On the sole of his own foot, he showed us its location and confidently predicted that pumping it for twenty to thirty seconds each day would prevent bunions and might reduce or undo them. Fishman said he developed the method four years ago after discovering a bunion forming on his own foot. It went away. He predicted that the yoga teacher would never need surgery on her other foot if she did the exercise. Fishman added that, for a study, he was tracking about twenty patients with bunions who regularly did the stretch. “It seems to be working,” he remarked.
    Fishman divided the class into groups. In the smallest, his assistant worked with a petite woman who had multiple sclerosis. This degenerative disease of the central nervous system leaves its victims weak, numb, poorly coordinated, and prone to vision, speech, and bladder problems.