Sirsasana (Headstand)

Sirsasana is the headstand, from sirsa, the head. The classical texts call it the king of the asanas, and that description has done more damage to more necks than any other sentence in yoga, because it turns a difficult, risky posture into a status object.

Here is the position I have arrived at after four decades. The headstand is a genuinely valuable practice for a small number of people: those with healthy necks, normal blood pressure, healthy eyes, sufficient shoulder strength, and access to a teacher who can catch them. For everybody else, the risk is real and the benefits are all available from safer poses.

The evidence is not neutral on this. A systematic review of published adverse events in yoga found the headstand to be the single most frequently implicated posture, with eye events dominating, and it documented strokes associated with headstand and shoulderstand. That is not a reason for panic, since millions of people practise safely, but it is a reason to take the contraindications on this page literally rather than as a formality.

If you take one thing from this page: a safe headstand is a forearm stand in which the head happens to be resting on the floor.

The forearms and the outer wrists press down hard. The shoulders lift strongly away from the ears. The crown of the head rests on the blanket with barely any weight in it, so lightly that a sheet of paper could almost be slid underneath. If somebody removed the blanket, you should be able to stay up.

What most self taught practitioners do instead is balance on their skull and use the arms as outriggers. It works, briefly, and it puts the whole body weight through seven small vertebrae that carry about five kilograms in ordinary life.

The test is simple and you should apply it before you ever lift your feet. Set up, walk the feet in until the hips are over the shoulders, and lift the shoulders. If the head lightens, you are strong enough to continue. If it does not, spend three more months in the dolphin position and try again. There is no way around this and nothing is lost by taking a year over it.

These are the two contraindications people ignore most often, so they are worth stating plainly.

The eyes. Turning upside down raises the pressure inside the eye, and in the headstand it roughly doubles it. For a healthy eye that is transient and unremarkable. For an eye with glaucoma, where the damage is caused by pressure over time, repeated large rises are exactly the mechanism of harm, and the adverse event review found orbital events to be the dominant category associated with this pose. If you have glaucoma, ocular hypertension or a family history of glaucoma, do not practise inversions without your ophthalmologist's explicit agreement. Many people over forty have raised eye pressure and do not know it, which is one good reason to have your eyes tested before you start.

The blood pressure. Uncontrolled hypertension and headstands do not belong in the same practice. The same review records strokes from occlusion of the arteries at the back of the neck in association with headstand and shoulderstand. These are rare events. They are also catastrophic ones, and there is no benefit here that justifies accepting that risk when Anulom Vilom and a legs up the wall rest give you calm without it.

You will be told with great confidence that women must not invert during menstruation. You will also be told, with equal confidence, that this is a myth. Both camps are overstating what is known.

Here is what is actually the case. The traditional prohibition rests on the idea that inverting encourages menstrual flow backwards into the pelvis, and that this could contribute to endometriosis. That idea has never been tested against posture at all. A systematic review published in 2024 examined whether retrograde menstruation is even a universal, recurrent phenomenon in humans and found the evidence extremely heterogeneous, with reported rates across studies ranging from nine percent to one hundred percent, and it contains no mention of posture or gravity whatsoever.

So the accurate statement is: nobody has studied whether inverting during a period causes harm, and nobody has studied whether it helps. There is no evidence either way, and the mechanism usually offered as justification is itself not established.

What I do in my classes is offer an alternative on those days and never ask why anybody has chosen it. Many students find inversions uncomfortable during a period and are glad to be excused. Some prefer to carry on. Both are reasonable, and neither should be presented as scientifically settled, because it is not.

If you have read the contraindications and none of them apply to you, this is the route I teach. It is deliberately slow.

• Months one to three: dolphin only. Forearms down, hips high, feet walking towards the elbows. Thirty seconds, three times, four days a week. Build the shoulders.
• Months four to six: the full setup with the head lightly down, walking the feet in until the hips stack over the shoulders. Hold thirty seconds. Do not lift the feet at all.
• Months seven to nine: at a wall, lift one bent knee, then the other, and hold the tucked position for ten seconds. Come down slowly. Never kick.
• Months ten to twelve: the tucked position for twenty to thirty seconds, and only then begin extending the legs upwards, with a teacher present.

Two absolute rules throughout. Never kick up, because a person who cannot get up under control cannot come down under control. And always rest in a child's pose with the head down for a full minute afterwards before standing, then finish with Savasana.

Most people who want a headstand want one of three things, and each has a safer route.

If you want the calm and the restorative quality: lie on your back with your legs up a wall and a folded blanket under the hips, for five to ten minutes. It is a mild inversion, it loads nothing, and in my experience it produces more of the settled feeling people are after than the headstand ever does, because you are not concentrating on staying up. Combine it with Yoga Nidra for a deeply restful practice.

If you want the strength: dolphin, plank and the forearm plank. All of the shoulder and trunk work, none of the cervical load.

If you want the achievement: that is a legitimate thing to want, and I say so to students rather than pretending otherwise. Then take the year, learn it properly with a teacher, and accept that the contraindications apply to you as much as to anybody.

What I would ask you not to do is learn it from a video, alone, on a hard floor, in your thirties, with an undiagnosed neck. That is the specific combination behind almost every injury I have heard about.

This table exists because the numbers published elsewhere are alarming. Every condition page on this site advises against the pose, and these are the durations for a healthy adult learning it under supervision.

Come down before you want to, and lie down afterwards rather than standing up. The way out is where most of the harm happens.

The headstand is the only pose that appears in the avoid list of all nine condition pages here. That is not squeamishness. It is the one posture where the mistake is not recoverable, and almost everybody who walks into a class arrives with at least one of the reasons.

• Yoga for beginners over 40 and yoga for neck and shoulder pain both rule it out on the neck: the load goes through a cervical spine that already has degenerative changes in most adults past forty.
• Yoga for high blood pressure rules it out on the pressure, and yoga for diabetes rules it out because of what raised pressure behind the eye does to a retina that may already be affected.
• Yoga for back pain, yoga for PCOS, yoga for thyroid, yoga for weight loss and yoga for anxiety all leave it out as well, in each case because what the pose is claimed to give is available from something safer.

If you want the inversion, the practical substitute is legs up a wall, and the counter pose after any inversion is Savasana, not the next difficult thing.