A: I assume that your friend is following the Tibetan school of Buddhism. Other schools of Buddhism, such as Theravada, which is practiced mostly in Southeast Asia, and Mahayana, including Ch'an in China and Zen in Japan, also include prostrations, but not to the extent found in Tibetan Tantra, where they may be repeated millions of times over the years.
Lama Je Tsongkhapa reportedly performed three and a half million full-length prostrations during a retreat with several of his chief disciples. And even into old age, Jhampa Rinpoche made 100 prostrations daily.
According to Geshe Kelsang Gyatso, a Tibetan meditation master and scholar, making prostrations is a powerful method "to purify our non-virtue and accumulate positive, meritorious energy." It has many benefits. Through prostrations, we can demonstrate homage and pay respect to enlightened beings--buddhas and bodhisattvas. The practice can help eliminate negative karmas, sickness, and other obstacles; improve physical health; increase happiness; and further one's journey on the path to liberation. Although we associate prostrations primarily with the body, they can also be mental or verbal. Mental prostrations refer to an attitude of respect and faith extended toward objects such as stupas, which contain sacred relics, to learned abbots and preceptors, and to fellow practitioners on the path. Prostrations of speech include praises to enlightened beings. Ideally, one would perform all three forms simultaneously for maximum effect.
There are two methods of physical prostrations. Half prostrations consist of kneeling down and touching both hands and the forehead to the ground. Complete full-length prostrations, in which the whole outstretched body is in contact with the ground, require special equipment: sliding boards, knee pads, mittens, head pads, and counting mechanisms. Perhaps you've seen the film that followed the Dalai Lama through his daily routine and showed him doing full-length prostrations. In some cases, the prostrator will carry out all the prostrations at one holy site, or go on a 1,000-mile pilgrimage, prostrating every second step.
To the uninitiated, prostrations can have the appearance of rote exercise, like someone engaged in mindless aerobic activity at a gym. That's why guided instruction and pure motivation are crucial. Patrul Rinpoche, a famous 19th-century Tibetan teacher, bluntly said that going through the motions with a distracted mind serves no purpose.
He also explained that because one does prostrations in the hope of benefiting from them, it is better to do fewer impeccably than to do many in a sloppy, vulgar, or meaningless way. It is only when we engage in a meditative ritual with sincere intention, rather than putting in time in a mechanical way, that genuine transformation becomes possible.