Five pranayama mistakes that can genuinely cause harm

Pranayama is the most potent tool in the yogic toolkit and the one most casually taught. Every few months someone arrives at our clinic having made themselves genuinely unwell through enthusiastic breath practice learned from a video. These are the five patterns I see most.

1. Retention before smoothness

Kumbhaka — breath retention — is introduced in the classical progression only after the inhale and exhale are long, silent and effortless. Beginning ratio work while the breath is still ragged produces chest tightness, palpitations and headache, and in a few cases genuine panic. If your exhale is not yet smooth and audible-free for a comfortable count of eight, you have no business holding the breath.

2. Kapalabhati with hypertension or glaucoma

Forceful abdominal exhalations sharply raise intrathoracic and intracranial pressure. In uncontrolled hypertension, glaucoma, retinal disease, recent abdominal surgery, epilepsy or pregnancy this is straightforwardly contraindicated. Kapalabhati is widely taught as a general warm-up. It is not one.

3. Bhastrika as a stimulant habit

Bellows breath is genuinely energising, which makes it appealing as a coffee substitute. Practised in volume by an already anxious, sympathetically-dominant nervous system, it reliably makes anxiety worse. If your baseline state is wired and tired, you need bhramari and extended exhale, not bhastrika.

4. Practising after eating

All pranayama should be done on an empty or near-empty stomach — a minimum of three hours after a full meal, two after something light. Diaphragmatic movement against a full stomach causes reflux, nausea and, over time, real oesophageal irritation.

5. Mouth breathing during practice

Unless a technique specifically calls for it — sheetali, sheetkari — pranayama is done through the nose. Nasal breathing conditions air, generates nitric oxide, and engages the mechanisms the practice is designed to work with. Mouth breathing through nadi shodhana defeats the entire point.

The general rule

If a breath practice leaves you dizzy, agitated, headachy or breathless, stop. Those are not signs of progress or purification, whatever you may have been told. Sit, breathe normally, and find a teacher who will assess you before prescribing.