After graduating from Christ Church, Oxford, in Foundations of Mathematics, a philosophical subject, it seemed to me the most related field was grammar: only language-users know numbers and they both have rules for well-formed expressions, etc. It turned out that the first grammar book was written by a man named Patanjali.

I resolved to go to India and learn Sanskrit. I was there only about three weeks when I realized the average three-year old would know more Sanskrit than I would ever learn, and this was just about that time that I came upon Mr. Iyengar’s book. The yoga stood head and shoulders above any I had ever seen. A few weeks later I went to his house, and after an electric meeting with him, stayed in a hotel for about a year and learned all this highly intelligent and righteous man could teach me. Among many other things, I learned that the same Patanjali had written the Yoga Sutra and was a physician.

Even then, I was using yoga to help substance abusers and those with orthopedic injuries in the “expatriate” community, but after returning to the United States for medical school, my interest in how yoga works deepened.  

Curious stories attend each of the topics in this workshop. Risking a spoiler effect, the following descriptions show my pathway to healing.

Scoliosis 

My first patient was a little bird of a woman, a hospital administrator whose yoga-teaching daughter had brought her from another state. She had a back curve above 100°, and was dying due to the constricting effects on her heart and respiration. I tried to slow down the progression, thinking perhaps we could stop it. After five months, I thought maybe I was fooling myself, but she looked better. A follow-up x-ray showed her curve to now be 68°!

Possibly 20 years later, my neighbor had a niece with scoliosis whom I treated successfully just about the same way. When she improved the neighbor, a Yale MBA exclaimed, “you’re a genius! The world must know about this!” That had never occurred to me but then I started recruiting patients to see if this was more broadly applicable. 

Now I’ve seen all kinds of scoliosis and believe that it is based on muscular asymmetry in the vast majority of cases. I treat it by equalizing the muscular strength on both sides of the curve. Currently I’m doing an FDA approved study, using both yoga to strengthen the weak side and botulinum toxin to temporarily weaken the strong side.   The results are so striking I’ve already published it, although I’m still accepting patients. 

Osteoporosis

Just before leaving India I had a goodbye party for the Iyengar community in my rooftop rooms at the hotel. It was a great party and afterward, when I blew out a candle in one of the lanterns, I had a vision of Mr. Iyengar’s bones. Their strength and integrity made them glisten. They were not at all grisly, but rather strikingly wholesome and robust. 

In my residency, another wonderful teacher, Edward F. Delagi, taught me Wolff’s Law—“The architectonic (basic support) of bone follows the lines of force to which the bone is exposed.” It explains many biological phenomena, including why we have that curious crook in our hip bones.

I put Wolff’s Law together with the vision on the hotel roof and surmised that yoga might help with osteoporosis. My friends said, “Loren, you’re crazy. Yoga for people with osteoporosis—you’ll break their bones!”  So I did a controlled pilot study with my own patients after office hours. I used poses that put pressure on the hip, the femur, and the spine, the most common and serious sites of fracture, and not coincidentally, the ones measured in the DEXA (dual-energy X-ray absorptiometry) scan.

Examining the data one evening I found no fractures, no herniated disks, nothing but a few sore muscles. My middle son walked by my desk and asked me what I was doing. When I told him he asked if I was going to publish it. I said, “No, this is just to see if yoga is safe.” He said, “Give me the data.” Five minutes later he came out of his room: “Dad, it’s significant!” I went to do my next study on the subject, making 1000 discs and gave them away to interested parties.  Eight years later it too was significant.

Rotator cuff syndrome

This time I was the first patient, having ripped my shoulder apart in what they called a massive tear. I could not raise my left arm. Even though I’m a doctor, it took months to get an appointment with the leading orthopedic surgeons. In the meantime, I missed some yoga poses so much that one day I stood on my head despite my injury. Maybe three minutes later my wife came downstairs and gasped, “Loren! What are you doing?” When I got up, I could raise my arm in a vertical position. And painlessly! This requires more explaining than we have room for here; it too will be a point of  discussion in the workshop. And coincidentally, we just completed an NIH (National Institutes of Health) study with 167 patients: highly significant.

Mic drop

Superimposing these empirical results on the highly theoretical and spiritual practice of yoga was not difficult. Painlessly adapting yoga to medical ends is greatly simplified by Mr. Iyengar’s work perfecting the poses: they are elegant, physiologically relevant, and safe.  What I will present is both the end of these troubling conditions for many people, and the beginning of the quest to refine and improve the yoga. We know the poses discuss in the workshop are effective, but there is no reason to believe that they are the only ones, or the best ones for the task.  

Learn more about Dr. Fishman at  sciatica.org or manhattanphysicalmedicine.com.