One of my closest friends, fellow ballplayer and trainer, and occasion contributor to this site, Andrew Sacks, just underwent PCL surgery on his right knee. He is chronicling his recovery, which I think is a great idea – one that I wish I had done myself with my elbow. Unfortunately, Andrew has an even longer road than most, as his left knee needs at least one ligament replaced as well, so two or three months into rehab on his right, he is going to be on the surgeon’s table again to get his left knee repaired. For a lifetime athlete, he is in for a long battle with inactivity and rehab.

Apparently Andrew bruises easier than grandma.

So, check out his blog entitled Life After Knee Surgery. Andrew writes well, and if you’ve ever laughed at one of my random thoughts or jokes, then you’ll enjoy his brand of humor as well (we basically share that brand). And if you further find yourself wondering about the difficulties of going to the bathroom while in a straight-legged knee brace, look no further.

March 22 – Good, not sore

March 24 – Good, not sore

March 26 – 7 months – Good, not sore

March 28 – 15 Changeups; good, but not perfect

March 30 – 10 changeups, discomfort on 1/3 of them

April 1 – 3/4 speed; no changes, no pain, 66-71 mph. felt ok, not perfect next day

April 3 – felt good, not perfect; 45 pitches @ 3/4 (speed)

April 6 – 1st two digits had pain when pressure applied

April 9 – mid to upper 70s, little pain; felt good after 4 days off prior

April 17 – no pain! 65 pitches at 3/4

April 19 – long tossed to 240 no pain

April 21 – felt good. into low 80s maybe

April 23 – gun read 75-77. TIRED! but no pain

April 25 – 8 months – Hit 81, consistent 76-79 50/30 pitches

April 28 – long toss to 270, 45 pitches at 85%

April 30 – 30 + 45 vs hitters. 82-84. Felt good

May 2 – VERY tired from April 30.  Arm achy and slight pain, very dead. threw 70 at 2/3 speed

May 4 – flat ground, 15 curves at 50 ft. pain still, arm not recovered from previous.

May 7 – Hard pen, felt good. 80 pitches at 90%

May 9 – good long toss, felt great.

May 11 – 100% from mound, 100% changes, 50% curves (15). felt good, no pain, but knotted up on forearm after.

May 14 – 100% fast + cu, no curves. Still knot in forearm but no pain

May 16 – 45 fast-curve-change, 75-75-50% respectively. less tightness, no knot next day.

May 18 – Light pen, 30 curves

May 20 – In game, 28 pitches. 30 curves beforehand. Bicep Dead, big knot afterward.  No throw 21-24.

May 25 – In game 35 pitches, no knot after, felt good

May 27 – 70 pitch pen, 30 90% curves, felt good, bicep better

May 29 – 50 pitch, 70%, curves getting sharper!

May 31 – 60 in game; arm felt slow, but great after. 55 fb/ 5 curves. No tightness at all.

June 2 – Long toss, hard but not too many throws. Need to get intensity up and let go. Felt good next morning.

June 4 – Bullpen 20 max effort, 85-90.  Arm felt achy, some occasional pain twinges, and very dead.  Decent next day. Fatigue in bicep/tricep still, but not terrible.

Thats the whole log.  Wish I had done more of that during it all, but I was more interested in getting after it than writing it all down.  Hindsight…

As I was in there, it suddenly dawned on me: Pitchers are just unlike everyone else in the sense that what they do is so physically violent, that they have to do what is called “prehab” just to reduce the likelihood (or in reality, delay) injury.  

Its pretty much a fact that if a pitcher doesn’t do regular rotator cuff, scapula, and forearm work (basically the whole pitching arm), he is doomed to inevitable, catastrophic arm injury.  Doing prehab doesn’t guarantee health by any means, as tons of diligent pitchers still injure themselves regularly, but its our insurance policy, and at the very least gives us a better chance of not being injured.Other athletes don’t do this.  Soccer players play soccer, and when they get hurt, they do rehab and return to action.  Lacrosse, football, tennis, you name it, these sports all allow their athletes to play, with nothing intrinsic in the sport that injures them.  Sure, football and martial arts are violent and injurious, but the injuries are general and not caused by any specific physical act.

Baseball position players are also allowed to play.  Sure, they come down with the occasional arm problem, but with not nearly the regularity as the pitchers. 

No, pitchers are the only athletes that aren’t just allowed to just play their sport.  They simply can’t show up at the ballpark and leave when they are done.  They have to spend extra time strengthening and stretching their throwing arm just so it’s less likely to rip itself out of the socket.  Ever seen a pitcher’s arm lay back, parallel to the ground in external rotation?  Try replicating that in your living room, and you’ll start to understand…

The pitching motion is just ungodly stressful and unnatural for the human body.  Its  interesting how in the entire athletic community, this one position in one sport is so different from the rest.  Sure, all athletes have to strengthen their bodies to compete at a high level, but none but the pitcher are at such an injury risk where they must go above and beyond just to have a chance at longevity, and even then it’s often a losing battle.  

The only other trends like this are in knees of female athletes and football linemen.  Women are predisposed to ACL injury due to their natural body shape and unique biomechanics, and have an ACL injury rate something like 10x that of men.  A good friend of mine just tore hers for the second time.  Football linemen are so heavy and get pushed around so much that they suffer a similar fate.  

I, for one, am ready for titanium ligament replacements.  Maybe one day that will be possible.  I’ll gladly call myself a cyborg if it allows me 20 more good years.  

I remember the first time I threw off the mound.  It was timed so that I started in Florida, during our spring break trip, and I can recall my 3rd bullpen session, which I threw on the side at the University of Miami.  That day I felt really fresh, and was confident in my arm after having two mound sessions already under my belt.

So I did my 45 throws or whatever at 60 feet, and I remember feeling like I was popping the ball.  It was on a line, and it had a nice crisp sound, and I was just pleased as shit about it.

3 or 4 weeks later, I was still doing largely the same routine, but throwing with more intensity.  I felt like it was time to get out the radar gun.  I was throwing 75%, so I figured I should be around 70 with very little effort.  So I start throwing, and they start shouting back my velocities…

64.  62.  61.  64.  Really?  So now I try to throw a little harder.  64.  64. 63.  What?  I just muscled up and its still only 64?  This is ridiculous.  Thing was, I didn’t feel like I was throwing 75%, I felt like I was throwing 100%.  It was the hardest I had thrown in 6 months, and it looked and felt like I would never again throw a ball over 65 mph.  Not happy.

So next time out I did the same thing, and this time it was 65-68.  An improvement, but still terrible, and it still felt like I was throwing as hard as I could.  Everyone else said it looked like I wasn’t trying, but I sure felt like I was.

This was how the next month or two went.  I would feel like I was throwing my hardest, but I really wasn’t recruiting much of my arm or body.  Velocity crept up in each bullpen, and I gained 3-4 mph per session for a couple of weeks.

But even as velocity crept up, I felt so far away from throwing the way I used to. After seeing 75 mph leave my hand and feeling like it was the best I could muster, I couldn’t believe how I ever used to throw a ball 90, or would again.

I still suffered from that months later, and I had been sitting in the upper 80s for about 2 weeks.  The velocity has been stabilizing in my outings, but I still wasn’t where I once was.  So I wondered, had I finally plateaued?  Everyone said no.

At that time I was doing nothing but pitch from a mound, and I had no idea how little extension I was getting until I finally long-tossed.  What a difference.

Since I was throwing so much on my rehab program, I also had no idea how fatigued my arm had gotten. It wasn’t until I took 5 days off that I realized, again, what a fresh arm felt like. What a difference.

Those little victories came and went, and over such a long time of throwing and rehabbing I had forgotten the little nuances of my delivery, such as really reaching out, and how to schedule my throwing, including when to rest up.  I finally broke through my plateau and started throwing a few ticks harder because of it.  It just took a new stimulus and a little rest.

Little plateaus will happen, and it’s hard to not get frustrated when you wonder if its finally THE plateau at the end of the recovery, when the new you is finally fully baked.  I’m still not there yet, even 13 months later, because I had a 2 month battle with forearm tendinitis.   I decided after taking care of that and going to a tryout, I was gonna take my off-season rest, which I am currently enjoying.

Doctors and trainers say that a lot of times it takes that first off-season before the new elbow reaches its full, and hopefully greater, potential.  As much as seeing the changes throughout rehab was exciting, man, it feels nice to not worry about it for a little while, and focus on myself in other ways.  To be continued.

For the athletic population, and especially one-side dominant athletes like baseball players, a big differential can develop between legs.  Pitchers will often have increased tightness in their stride leg, especially in the hip joint (from rotating on it with each pitch), yet higher strength in their balance leg (chiefly from balancing, loading, and pushing off with it 100 times per game).

The disparity can be in flexibility, mobility, or strength, but no matter the symptom, unilateral training is always a big part of the cure.  And, if you have a weak leg your regular bilateral lifts (squats, deadlifts, etc.) are needlessly suffering.  Big strength gains can happen in those regular lifts from strengthening the weak link.

The two most prevalent uni-leg squats are the Pistol Squat and the Peterson Step-Down, but I’m also going to throw the rear-reaching uni-leg squat into the mix, which is a better variation of the pistol squat for a few reasons.

Pistol Squat

Take a close look at the above video.  It’s important to notice two things about the pistol squat:

1. The back is very rounded, which might not cause problems if done with bodyweight, but would be a serious injury risk if additional weight is used.

2. Weight shifts way back on the heels, which puts more force on the knee than if the weight was more centered.

For the above reasons, I am not a fan of pistol squats.  If the off-knee is bent it allows better weight distribution, but even then I think there are better options.

The Rear-Reaching Uni-Leg Squat

Rear-reaching variation of the one-legged squat

The key to this exercise is to touch the knee down before the back foot.  Usually range of motion calls for a 2 inch pad (maybe higher, depending on the squatter’s height) to touch the knee to before coming back up.  Because the weight is shifted backward, the quads really get worked, and there is a high degree of difficulty in getting that knee down first.  The thigh gets to parallel, which is perfect, but if you wanted to go deeper, this wouldn’t be the exercise for you.

Notice anything about this picture?  The back stays super straight with relative ease, which is a big plus for this rear-reaching version.  A far cry from the rainbow back of the pistol squat.

Because of the difficult mastery of this one, adding weight is usually not necessary, though it would be easily tolerated with such good spinal posture.

This is definitely a quality exercise, and worthy of addition to one’s unilateral repertoire.  It was developed and is frequently used by Nick Tumminello at Performance University.

The Peterson Step Down

Who is Mr. Peterson?  I have no idea.  I just know that I learned these by that name.  By most accounts these are probably just referred to as box step downs, or one-leg squats from a box.

There are a few reasons I like this version the best:

1. The back is straight, which allows additional weight to be used

2. The weight stays more centered, which won’t put extra stress on the knees

3. It just feels comfortable and fluid throughout the range of motion, which encourages the use of extra weight.

4. Allow a large a range of motion as desired

The Final Word

Pistol squats may be okay for some people, but in my experience they catch up with you in the form of knee pain.  I’m a fan of squatting deep with all variations of squats, but pistols just seem to make a lot of people’s knees angry at them.

The rear-reaching variation is an excellent choice, but just isn’t my personal favorite.  I prefer the Peterson, which allows for complete ROM, a middle center of gravity, and the easy addition of extra weight.

Which variation is right for you?  I would recommend avoiding the pistol altogether, which leaves two great alternatives that can really give a boost to one’s unilateral leg training.

Shoulder pops and clicks when you move it? Those  are a result of weak stabilizers. Good thing is, the following shoulder circuit is going to make those a thing of the past, and add a few MPHs in the process.

This shoulder circuit is done for 2-3 complete cycles of 12-15 reps per exercise.  For beginners, this is going to probably require only 2lb dumbells, and the goal is to build up to using 3, and then 4lb dumbbells with perfect form for 3 sets of 12-15. The circuit is performed straight through, but I have grouped the exercises according to the body position (prone or standing).

Prone Segment

This segment is performed on a tall bench, training table, or bent over with a flat back. Notice it consists of the LYT circuit plus prone skiers and scapula pushups.

L-Raise

Start with back flat. Pinch shoulder blades and raise arms. Finish by externally rotating

Y-Raise

Keep shoulder blades tight and reach out with hands

T-Raise

Tightly pinch shoulder blades together

Prone Skiier

With arms straight, extend arms back toward your butt and up to the sky

Scapula Push Up

In pushup position with arms locked, let shoulderblades slump together, then press up fully keeping arms straight

Standing Segment

Front Raise (thumbs up)

Thumbs up front raise

60° Scaption (thumbs up)

60 degree raise on the scaption plane

30° Scaption (thumbs up)

30 degree scaption plane

Abduction (palms down)

Side raise with palms down

Rotation Raise

Start with arm at opposite side, palms down; Raise and gradually rotate to finish with palms up

Sword Raise

Start with arm on opposite side, raise up as if unsheathing a sword. Be careful to not go behind the body, which would stress the elbow.

Side Lying External Rotation

Pictured with left fist propping the right arm up. Use fist or a towel to keep the arm off the torso

Internal Rotation (pictured with band)

Starting position

Ending position. Note fist under the arm to bring humerus forward

Yes, the circuit is 13 exercises long and takes the better part of an hour,  but it is worth it.  Being diligent with this circuit 2-3 times per week is going to bombproof the shoulder and rotator cuff and make you a stronger, more durable, and more than likely, harder throwing pitcher.

I want to thank Michelle Daniels, who was my athletic trainer at UMBC.  She taught me these exercises and brought me back to life following my surgery.

So here I’ve compiled a list of the top 5 good things one can get out of a little elbow-slicing action…

1. A well conditioned arm

      -Doing the rehab is necessary for a full recovery, but will also leave one with a very well conditioned arm, assuming the shoulder is well taken care of as well. This is the reason many pitchers throw harder when rehab is complete.

2. Time to reinvent pitching mechanics

      -Especially if one is a college pitcher, it is hard to get enough time off to break down and completely berid oneself of bad mechanical habits.  Pitching all fall, spring and summer typically makes this difficult.  The time off during rehab can allow one to start back up as a clean slate.

3. Time to address flexibility/mobility problems

      -It is tough to get rid of joint mobility problems and tightness when one is playing year-round the sport that causes those problems.  Time off mixed with a little yoga and a dedicated stretching program can make tightness a thing of the past. Getting a functional movement screen from a trainer is a must.

4. Time to get stronger

      -Trying to be fresh for outings can prevent one from focusing fully on strength training.  The time off from surgery gives one a chance to focus on specific weaknesses and lay down a really good base of strength, which can be maintained once returned to action. 

5. A work ethic

      -People undergo surgery with varying degrees of commitment, and some finish rehab with a different perspective on what it means to take care of their arm and body.  As previously said, the reason many throw harder after surgery is because they take care of it for the first time.  Hopefully that result provides incentive to continue on a path of physical furtherance.  

The Common Theme?

Time.  You can do the required 20 daily minutes of  rehab and throwing, and spend the other 23:40 bullshitting, or you can use those months off to (re)build a better you. If you make the most of it, that arm injury can turn out to be a blessing.

That first throw was pretty scary, but I knew I was ready for it, and it went fine.  It felt just like it used to. I started out at 30 feet, progressing to 40 feet x 60 throws by the month’s end.  Month two moved me back to 50 feet, and month three to 60. Midway through month three, however, I switched to a different throwing program because I was progressing faster than my throwing program would allow.  

I talked earlier about falling on my arm when I was running and how important that was in trusting my arm.  The first day I let a ball go on a line was another such moment.  After every single throw was on a soft arc, letting one go on a line was one of the first tests of my new ligaments.  I can remember that first throw, and how liberated I felt when I did it without pain.  I only uncorked a few of these per session, but they always provided me with a release from the tension of wondering if my elbow was really strong enough to get me back to where I once was.  

In the middle of my third throwing month I jumped into Dr. Andrews’ throwing program, which my training staff had a copy of from a previous TJ patient.  It called to move up in distance and in throwing volume every time a stage was completed twice without discomfort.  On this program, one can move as fast as his arm is able, and if he has pain, he just backs off and slows down.  I moved through this program without a hitch until a month into the mound phase.

I started having some slight pain in my forearm once I was throwing about 3/4 speed from the mound.  It was only initiated through pressure on my fingertips, however, and not really with throwing, which assured me that it wasn’t a ligament problem, and was probably just one of those minor complications that accompany the surgery.  It only slowed me for a few days, and it later subsided.  My doctor told me it wasn’t something that I need to worry about, since I stopped having pain with it while throwing.  

I threw some long toss days in with the program, as long toss always helped my arm feel good and it keeps me in good mechanical timing.  The thing I realized most was that the throwing program was just a guide for incremental progression. Progressing continually was the key, and whatever I wanted to do was fine as long as it stayed within the confines of moving up in small steps.  Long tossing to 300 feet one workout after only long tossing to 240 feet before would not be OK, because that’s a big jump in the throwing load.  But from 240 to 270 is a better choice, and one after which your arm won’t hate your guts.  

You'll get there, one at a time

I wish I had a copy of the throwing program to post, but I don’t.  At first, I wanted to adhere to it 100%, and any deviation from it made me feel afraid that I might hurt myself.  But the farther I got in my rehab the more I learned that my arm would tell me what it could and could not handle, and that just moving progressively but prudently was what really mattered.

The first 3 months post-op were exciting in the sense that everything was new and changes were dramatic.  Things returned to normal rather quickly, and it was all building up to that fateful day when I would chuck that pill again, even if it was only for 30 feet at first.

Surgery Day

I was in and out of the O.R. in about 75 minutes, and I had minimal pain and wasn’t overly groggy or out of it.  I had a prescription for Vicodin and a sling on my arm that I was to keep on for two days.  I was told I could move my hand and arm around in any way I wanted, and I could squeeze a soft ball.  I went home and did all of the above, though I only had the strength of an infant with low blood-sugar.

I was worried about my arm not being immobilized, as I had previously mentioned, but I dealt with it, and I was quite nice after those two days passed and I had only an Ace bandage left covering my incision.

Week 1

I was given 4 different Thera-Bands  at my 7 day post-op visit and was instructed to perform 4 exercises with them every day.  I was to start light and move up once I could perform 2 sets of 20 reps with each exercise. The four, which I still do daily 9 months later, are: Wrist Flexion, Extension, Supination and Pronation.  I also continued to squeeze a soft ball.

Weeks 2 to 3

My other goal, beside strengthening my forearm, was to extend my arm.  As soon as the brace was off I was on my own to do this as tolerated.  All day I would just flex and extend, flex and extend, flex and extend.  The first 150 degrees or so of extension came within about 2 weeks, but the last 30 and then 15 degrees were tough to get.  By about 3 weeks I could fully extend my arm, but upon awakening It would usually be a little less than straight until a week or two later.

Since Dr. Morgan views glenohumeral internal rotation deficiency (GIRD) as a chief factor in elbow problems, I was instructed to resumed sleeper stretches and hip flexibility exercises at week 3.  Addressing and correcting flexibility problems before throwing was a necessity.

One of the most helpful exercises in getting my arm to extend was to prop a pillow under my tricep and hold a 1 lb dumbell in my hand, allowing gravity and the weight to extend it.

Weeks 3-6

At the week 3 check-up I was given the green light to start conditioning again, as my incision was closed and sweat would no longer cause an infection risk.  So I started running, doing Bikram yoga, and lifting weights to the extent I could without using my right arm.  I also started with light scapula exercises, which I also performed with Thera-Bands.

Slightly Swollen Elbow at Week 3

I was able to squat using a Top Squat attachment, and I did a lot of sled dragging with a harness, and body weight and weighted vest exercises.  I was happy to be active again.

Weeks 6-12

I was cleared to lift weights to my heart’s content at week 6, but again, I had to start light.  I started with wall pushups and worked up (or down) to floor pushups. Holding a 15 pound weight  would make my forearm nearest the elbow pretty tired, but over time that effect would only occur with heavier and heavier weights, until around week 10 I could hold 50s in each hand with no problem.  Most of my upper-body work was done with light dumbbells and bands until my strength was back up.  It was crucial to get my overall body strength up before the throwing phase started at week 12.

I also resumed my rotator cuff circuit at week 6.  This was the Orioles shoulder workout and is very extensive.  It takes about 30 minutes to complete 2 cycles.  I credit this with the fact that my shoulder has been perfect and very strong since.  Many pitchers return from elbow surgery just to tear a labrum or rotator cuff afterward because they neglect their shoulders while rehabbing their elbows.  While injuries are never totally controllable and preventable, I did everything I could to avoid any further arm problems.

What the doctor told me was that my elbow was fine, and that I could lift and run around and fall on it if I wanted.  I didn’t really believe this, but an important event took place around week 8 when I started running agilities and sprints with the team.  Within ten minutes in the first session of agilities I clipped a cone, slipped, and caught myself as I fell with my throwing arm.  I got up, finished the drilled, looked down at my arm, and let out a big sigh of relief.  It was a big moment, because I didn’t really trust my arm before that fall.  But fall I did, and nothing happened.  No pain, no soreness, no stiffness, nothing.  It was a blessing in disguise, and I trusted my arm from that point on.

At week 10 it was swelling-free and ready to go

At Week 10 I was feeling pretty strong, with full range of motion and no swelling left in my arm.  It felt normal and ready to go.

At week 12 I had another check-up and was cleared to start throwing.  It was exciting yet nerve-racking at the same time.  It was the next step, and I was physically ready for it, but mentally was a slightly different story…

Bikram Yoga makes a lot of health claims, some of which may or may not be true, but overall I think it’s a great practice and will improve the health, flexibility, and recovery time of those who might bring a chronic injury into the studio.

The Basics

My sister wrote a nice piece for school explaining the Bikram phenomenon, and it’s a good read.  But the class is relatively straight-forward : 90 minutes in a 105 degree, 40% humidity room which consists of 26 postures, each repeated twice.  If it sounds difficult, that’s because it is.  However, nothing worthwhile is easy and Bikram is no exception.  

To class one brings a large jug of water, a yoga mat and towel to cover the mat, and a scant outfit to allow ease of movement and a cooling effect.  One class costs about 14-20 dollars depending on the studio, which is actually pretty reasonable considering the length of the class (most yoga classes are an hour) and the intensity of the workout.  Buying class cards brings down the cost per class down even more.

My Reason for Sweating

I turned to Bikram Yoga to help both with my hip and inflexibility and my elbow rehab.  I needed something drastic to loosen up my hips and quads, which were very tight and limiting my torso rotation in my pitching motion, which in turn was adding to my elbow pain.  I needed my hips to loosen, but my own stretching wasn’t making a dent.  

I also hoped that the extensive bloodflow promoted by the heat would aid my elbow recovery, as well as reduced the chance for tightness in the surrounding muscles. Tommy John patients notoriously get tricep tightness, yet I never had any.  Maybe it was the yoga.  

The Postural Procedure

Bikram Yoga is hot and intense.  The postures are demanding, as many are balance oriented.  Check out 30dayyogi’s blog for some good pictures and insight into all of this.

This pose got my heart rate soaring

The above posture, the standing head-to-knee, is just one of many that challenge by requiring balance, strength and flexibility at the same time.  For this reason athletes can really benefit, as sports are performed on the feet, not laying on the ground.  My balance was amazing after just a week or two.

I can’t really say that I enjoyed the yoga- it was so demanding that it just wasn’t something that I looked at as fun.  Many people really enjoy it, but I wasn’t one of them.  However I did believe it was good for me, and I definitely saw results.  I also felt great when the class was over.  These reasons were enough to keep me coming back for a while.  My hips, quads and hamstrings loosened tremendously, and I still enjoy the enhanced flexibility to this day from maintenance stretching.  

The Shrinking Yogi

I once wore a heart rate monitor to the class, and my heart rate averaged 140 for the entire 90 minutes, peaking at 184 during the standing head-to-knee pose.  I burned over 1000 calories, though I can’t remember the exact number.  While this large energy expenditure is great for those who want to lose weight, it was not a good thing for me.  Ever wonder why yogis are thin? I don’t.

I eat 4000-5000 calories each day to maintain my 185 pound bodyweight.  I work out an awful lot, which when combined with a naturally voracious metabolism, requires me to eat a ton while staying lean.  Add on another 1000+ calorie deficit from yoga and I was getting into the stratosphere of calorie intake to prevent weight loss. 185 is the playing weight I have settled on, and while I can easily add on, I try not to dip below it too much.  So going to Bikram Yoga while in the same week running intervals, lifting 3-4 times, having 5 practices and additional conditioning was just too much activity.  I found I could maintain my newly gained flexibility through a daily stretch routine, and so I left Bikram behind.

For many, Bikram Yoga is their only form of exercise, and that is perfectly fine.  But it couldn’t replace any of my training, and so as an add-on it was too much.

A Problem of Instability

One thing that concerns me about Bikram Yoga and yoga in general is the stretching of the lumbar spine, or lower back.  From all my weightlifting experience, I was always told that keeping a tightly arched lower back is crucial to preventing back problems when lifting.  Roman arches were used to support great weights, and the principle is much the same with your lower back.  If it arches (not round like a cat) and stays short and strong, it keeps the lower back stable, and the ligaments and muscles from straining, stretching and becoming injured when lifting.  

If one stretches the lumbar spine too much, it can put the back at risk.  Much of this was brought to light by this article by Mike Robertson, who is a top strength coach, and a chiropractor with whom I had a conversation.   

The Bottom Line

Bikram yoga is pleasant for some, but a tradeoff for others. The heat is oppressive, but also works wonders.  The postures are demanding, but make you stronger in different ways than other exercise.  The class is long, but you leave feeling accomplished and refreshed.  I don’t think it is perfectly suited to everyone, but can be great for many populations. For athletes, it can be that jumpstart that is needed to loosen up severely tightened joints, which is often the ticket to higher performance.  And if you want to lose weight, it’s definitely the ticket.  Take some ice water and give it a go.