Gesellschaft für Orthopädisch-Traumatologische Sportmedizin

Yoga aus sportmedizinischer Sicht

GOTS – Pressenewsletter 16.03.2013

Sehr geehrte Damen und Herren,

Yoga galt lange Zeit als unbedenklicher Freizeittrend – bis zu einem weltweit Aufsehen erregenden Artikel der New York Times vor einem Jahr. Nun haben sich auch die europäischen Sportmediziner mit dem Thema beschäftigt. Der nachfolgenden Pressetext ist honorarfrei verwendbar.

Zudem erhalten Sie die Einladung zum 14. Jahreskongress “Technische Orthopädie”, der vom 10. bis 12. Mai 2013 in Garmisch-Partenkirchen stattfindet.

Yoga aus sportmedizinischer Sicht

Ein Artikel der New York Times hat Anfang 2012 unerwartet viel Aufsehen erregt, in dem Yoga als schädlich dargestellt wurde. Unter dem Titel „How Yoga can wrack your body“ wurde anhand exemplarischer Fälle sehr kritisch vor potenziellen Verletzungen von Gelenken, Sehnen, Muskeln sowie der Wirbelsäule mit neurologischen Ausfällen gewarnt. Die dadurch weltweit ausgelöste Debatte veranlasste die GOTS Österreich, eine Pressekonferenz zu diesem Thema abzuhalten, um die Hintergründe zu beleuchten und verunsicherten Yogapraktizierenden sowie betreuenden Sportmedizinern als Diskussionspartner zur Verfügung zu stehen.

Allein in den USA wird die Zahl der Yoga-Praktizierenden auf 30 Millionen geschätzt, auch in Europa gibt es einen vergleichbaren Yoga-Boom. Auf vielen medizinischen Gebieten werden die präventiven und therapeutischen Wirkungen von Yoga erforscht und erfolgreich eingesetzt. Im Gegensatz zu vielen anderen Sportarten treten akute Verletzungen äußerst selten auf und sind meist auf unzureichende Anleitung zurückzuführen. Regelmäßig und unter qualifizierter Betreuung durchgeführt, kann durch Yoga eine Verbesserung der allgemeinen Belastbarkeit und Regeneration erzielt werden.

Bewegungsform mit zahlreichen Varianten
Die im Fitnessbereich vorherrschende Variante der aus Indien stammenden Meditationsform ist eine Weiterentwicklung des Hatha-Yogas, das vorwiegend aus Yoga-Körperübungen besteht. Mittlerweile ist die Anzahl der unterschiedlichen Yoga-Formen – von gängigen wie Ashtanga- und Bikram- auch Partneryoga, Hormonyoga -, die im Fitnessbereich angeboten werden, kaum mehr zu überschauen.

Yoga im Leistungssport
Mit einem breiten Spektrum an Kräftigungs-, Dehnungs- und Mobilisierungsübungen sowie Entspannungs- und Stabilisierungstechniken fördert Yoga die Entwicklung von Körpergefühl und Koordination. Durch die Verkürzung von Regenerationsphasen, Steigerung der Konzentrationsfähigkeit und mentalen Ausgeglichenheit einerseits und den Ausbau der konditionellen Fähigkeiten (Kraft, Ausdauer und Schnelligkeit) andererseits bietet Yoga auch für intensiv Sporttreibende eine vorteilhafte Ergänzung zur Steigerung der Trainingseffizienz und der sportartspezifischen Fertigkeiten und wird stellenweise auch im Leistungssport ins Training integriert.

Selten akute Verletzungen
Obwohl bisher eine Vielzahl von Arbeiten variabler Qualität über gesundheitsfördernde Aspekte von Yoga veröffentlicht und die therapeutischen Wirkungen von Yoga auf vielen medizinischen Gebieten erforscht wurden, finden sich nur wenige randomisierte Studien, die spezifische Verletzungsmechanismen und -häufigkeiten zum Thema untersuchen.

Die bei Yoga akut auftretenden Verletzungen sind im Vergleich zu anderen Sportarten selten und werden am häufigsten am Kniegelenk (26,8 Prozent) beobachtet. In den meisten Fällen wird hier eine Läsion des Innenmeniskus dokumentiert, die durch die Einnahme des Lotussitzes ausgelöst oder verstärkt werden kann. Diese typische Yogaposition verlangt von den Bändern und Muskeln der benachbarten Gelenke einen relativ hohen Grad an Flexibilität und sollte je nach individueller Dehnbarkeit langsam beziehungsweise nur teilweise oder unter Zuhilfenahme von Polstern oder Keilen eingenommen werden.

Am zweithäufigsten finden sich Zerrungen an der Hals- und Lendenwirbelsäule (19 Prozent). Oft neigen Ungeübte dazu, bei bestimmten Positionen mit reklinierter Halswirbelsäule oder Hyperlordosierung der lumbalen Wirbelsäule den gesunden Bewegungsumfang zu überschreiten und den stabilisierenden Bandapparat zu überlasten. Vorwiegend an der unteren Extremität werden yoga-assoziierte Zerrungen oder Sehnenirritationen beobachtet. Unter Yoga-Fans wird die Insertionstendinitis am Sitzbein als „Yoga-butt“ bezeichnet, oft ausgelöst durch zu intensives Training, zu langes Verharren in Endpositionen oder unzureichende Anleitung durch einen Lehrer.

Beschwerden vorbeugen
Die Durchführung der Yogaübungen sollte unter qualifizierter Betreuung erfolgen und ist nicht im Selbststudium ohne vorherige Anleitung zu empfehlen. Erfolgt eine adäquate Schulung, Überwachung und Sensibilisierung für individuelle Grenzen durch den (adäquat ausgebildeten) Yoga-Lehrenden, ist das Risiko für Schädigungen vernachlässigbar. Obwohl es keine absolute Kontraindikation bei Yoga gibt, ist es für das Praktizieren von Yoga wichtig, individuelle Einschränkungen der Belastbarkeit in das Trainingskonzept einzubeziehen und bei Bedarf auch Hilfsmittel in Anspruch zu nehmen.


Beispiel für den Aufbau einer Yoga-Übungseinheit


Risikofaktoren, die beim Yoga zu Verletzungen führen können


Empfehlung der AAOS zur Minimierung von Verletzungen oder Überlastungserscheinungen bei Yoga


Der Autor: Dr. Stefanie Syré, Universitätsklinik für Unfallchirurgie, Medizinische Universität Wien, ist seit 2006 GOTS-Mitglied

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