There is much to like about yoga. It helps make you limber, and stronger and calmer. It is even used to ease medical conditions and prevent injury.

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THERE IS MUCH to like about yoga. It helps make you limber, and stronger and calmer. It is even used to ease medical conditions and prevent injury. And just about anybody can do it.

Yet yoga can lull you into not paying attention. And it is hardly as simple as it looks. There are so many forms, teaching styles, demands, levels of understanding and shades of quality in instruction. In a sick way, some allow competition to creep in. Yoga magazines, showing off human pretzels, can send the same sort of look-at-me messages as those abs-and-buns fitness covers.

As with any physical challenge, you must pay attention to your limits.

According to a U.S. Consumer Product Safety Commission report, there were more than 3,700 yoga-related injuries costing a total of almost $11 million in medical care in 2004. The most common injuries involve repetitive strain, overstretching the neck, shoulders, spine, legs and knees.

The American Academy of Orthopaedic Surgeons (AAOS) believes the rewards of basic yoga outweigh the risks as long as participants exercise in moderation and according to their own flexibility and strength levels.

“Yoga can help improve strength, balance and flexibility and may be beneficial for certain bone and joint problems like carpal tunnel syndrome, tennis elbow and arthritis,” says Dr. Nicholas DiNubile, an orthopaedic surgeon and AAOS fellow. “However, the old adage of ‘no pain, no gain’ does not apply to this activity.”

DiNubile says serious muscle damage and related injuries can occur if people, especially those with pre-existing musculoskeletal ailments or conditions, don’t take proper precautions.

Injuries don’t solely hit beginners, says Brad Jones, a Seattle rolfer and a longtime yoga practitioner who has struggled through periodic back trouble.

“Hyper-mobility develops in areas like SI (lower-back) joints, necks, wrists and shoulders,” he says. “This can lead to chronic pain. It is like when you bend a piece of plastic back and forth repeatedly. Eventually it becomes very weak and breaks. Complementing yoga with some other forms of strength training is important in my mind.”

Yoga consists mainly of static instead of dynamic movements, so ligament injuries are relatively infrequent. But Seattle physical therapist Bart Simons has seen an increase in yoga-related injuries the past three years.

Injuries tend to be caused by joint over-compression and pushing soft tissue past anatomic limits. Patients with lumbar disc injuries should be careful with extreme forward bending. Those with neck pain might want to avoid or modify their Cobra pose. The meniscus cartilage in the knee has been injured when people sit too far back on their heels. Weight-bearing poses can cause pain in the carpal bones or the wrist.

Simons says yoga is an important rehabilitation tool, but he advises his patients to seek appropriate advice before they jump in. Ask what style of yoga will you be performing. Some are more strenuous than others, so choose the one that suits you. What’s the instructor’s style? Is he or she attentive? What’s the vibe of the class?

AAOS recommends the following:

• Speak to a physician before participating in yoga if you have any pre-existing injuries or conditions.

• Work with a qualified yoga instructor. Inquire about experience and credentials.

• Warm up well because cold muscles, tendons and ligaments are vulnerable.

• Wear clothing that allows for proper movement.

• Start slowly while you learn the basics, such as proper breathing, before you see how far you can stretch.

• Ask questions if you are unsure of a pose or movement.

• Know your limits. Do not go beyond your experience or comfort level.

• Drink plenty of fluids, especially if participating in Bikram or “hot” yoga.

• Listen to your body. Stop or take a break if you experience pain. If pain persists, call a medical professional.

Richard Seven is a Pacific Northwest magazine staff writer. He can be reached at Paul Schmid is a Seattle Times news artist.