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What you need to know before you try a headstand

It can be medically risky for some people

(David Fuentes Prieto/Getty Images)

Many yoga practitioners tout the potential health benefits of the headstand, saying the pose clears the mind, energizes the body and improves blood flow to the brain.

Also known as Sirsasana, the headstand has a legion of celebrity fans: In a 2020 interview, Paul McCartney gushed about doing headstands to finish his workouts at the then-ripe old age of 78, and Dua Lipa capped a recent Vogue interview by performing one on camera.

But experts say you shouldn’t just try one on your own, because a headstand can be medically risky for some people.

Performing a headstand means your head must hold up to 40 to 48 percent of your body weight, according to research.

“In a headstand, blood flow refers back to the head from the legs, and this could cause neurological conditions including stroke,” says Robert Saper, a physician who chairs the department of wellness and preventive medicine at the Cleveland Clinic. Saper is also a certified yoga instructor.

“The dangers would include a significant amount of pressure on the spine and neck,” Saper adds. “If there’s degeneration of a disk, a headstand can exacerbate that.”

Staying flexible and healthy as you age

Those with osteoporosis — which could cause a bone fracture — or “poorly controlled blood pressure” also aren’t good candidates for headstands, Saper says. Patients with glaucoma, which involves high pressure in the eye that can lead to blindness, should also avoid the practice. One study confirmed that there is a twofold increase in intraocular pressure during a headstand, which can further damage the optic nerve.

“Also, if someone is on anticoagulants, a headstand is not a good idea,” says Timothy McCall, an internist and the author of “Yoga as Medicine: The Yogic Prescription for Health and Healing.” And, “a headstand is not a good idea for someone with neck arthritis.”

But what if your doctor gives you a clean bill of health and you don’t have any problematic conditions — and you want to try to learn the technique?

First and most important, find a qualified, professional yoga instructor and start slow.

“Headstands should only be performed under direct supervision, and only by individuals who have developed the necessary core and upper body strength,” says Michael L. Lipton, a neuroradiologist who serves as medical director of MRI services for Montefiore Health System in New York.

Who fits the criteria of a qualified instructor? “There’s no system for certification overall in yoga, although Iyengar yoga certifies teachers,” McCall says. “Choose an experienced instructor, as well as an instructor who’s skilled in observing poses.”

This is key, because your instructor should evaluate you completely, including looking at your physical frame.

Will exercise, meditation or reiki help if you can’t find a therapist?

“This evaluation does not necessarily just depend on your yoga experience,” McCall says. “A good natural neck curve is essential to make sure your body can handle different weights, so you don’t injure the cervical spine under pressure.”

As to how long to hold a headstand? Very briefly at first — listen to your instructor’s advice, and don’t shoot for any set amount of time. If you feel comfortable, you can build up duration gradually.

Some practitioners start with a three-point stance that doesn’t involve lifting the legs all the way up.

“Be aware, though, that halfway up, holding an L-shape, as is sometimes taught in yoga classes, is more difficult than the full pose,” McCall says. Balancing against a wall and having good support under your head is also essential.

And listen to your body.

“If you go into the pose and it doesn’t feel good, come out of it,” McCall says. An easier goal may be to learn a shoulder stand, which is a less ambitious inversion pose. Consult with your instructor on that, too — and do only what’s right for you.

Headstands aren’t for everyone

The following is a partial list of those who should avoid doing headstands:

  • Pregnant women, because of the risk of falling (although McCall notes that pregnant people with an established headstand practice sometimes continue into the third trimester).
  • People who suffer from acute or frequent migraines.
  • Those with neck or shoulder conditions or osteoporosis.
  • People with hypertension, because the pose can raise blood pressure further.
  • Those with glaucoma.
  • Anyone with a heart condition.
  • Children age 7 or younger.
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