5 Ways Yoga Can Affect Your Health

by Baxter

Roots by Melina Meza

On this blog, we often address the health benefits of yoga, from its ability to support a generally healthy lifestyle to specific therapeutic benefits that yoga brings to a whole array of injuries, diseases, and conditions (see Common Minor Problems That Yoga Can Help With and Common Serious Problems That Yoga Help With). Therefore, how we are using yoga for health benefits can vary tremendously. So I feel it will be helpful to have a clear framework to describe yoga’s various roles in affecting our health. This will give us a better understanding of what yoga actually has the power to do—or not—for different types of conditions.

Within the world of yoga, Yoga Therapy is a rapidly emerging specialty. It is interesting to consider the origins of the word “therapy.” It comes originally from the Greek language, and literally means “healing” or “curing.” As I considered how yoga fits into modern concepts of healing and treatment for conditions and ailments, I came up five different categories. 

1. Preventative Medicine. Yoga can be “health promotion activity” that can prevent disease and create an overall sense of well-being. In choosing to practice yoga, you may not be targeting a specific disease or condition, but rather in a more general way you are promoting your general health and supporting a sense of well-being. We could say that in this way, yoga is acting as a form of primary prevention, addressing your overall health before any problems develop. Yoga can also be a form of secondary prevention for specific conditions that are present in a latent form or a presently asymptomatic, but if were left unaddressed, could progress to a more serious form. High blood pressure is one example of this. If we apply yoga to high blood pressure and it helps to normalize our blood pressure numbers, it could prevent the development of more serious conditions like Coronary Artery Disease and heart attacks. In this case, ongoing yoga practice will hopefully prevent future disability from the more serious consequences of untreated high blood pressure. 

2. Curative Medicine. Yoga certainly can help with complete healing, as is often noted with musculoskeletal conditions, such as common sprains and strains, and even more complex issues, such as back and neck pain. In addition, in some individuals, yoga seems to resolve serious issues like anxiety and depression, although it often does so as an “adjunct,” in combination with other forms of treatment. However, unlike an antibiotic prescribed for a specific infection for which it cures, yoga usually is not just used for two weeks and then discarded. So there is an ongoing “maintenance” aspect of yoga that differs from western pharmaceutical treatments. And before prematurely pronouncing yourself “cured,” you might consider monitoring your “cured” conditions for 1 to 5 years as they do with cancer treatment.

3. Maintenance Therapy. Yoga can be helpful as a maintenance treatment for ongoing conditions that are in a remission state. For example, someone with MS can practice yoga between flares of symptoms in order to help maintain the relative symptom-free remission periods. Or someone with asthma during could practice during symptom-free periods with the goal of extending those remission times. During flares, people with these types of conditions might also do a modified, gentle, restorative practice, which would fall into our next category.

4. Supportive or Palliative Therapy. This refers to a therapy that does not treat or improve the underlying condition, but instead increases the patient's comfort. Palliative care often refers to serious or terminal conditions, but is nonetheless related to supportive therapy. As an example, some of my students with chronic low back pain, often from ruptured discs that are not going to heal, benefit dramatically from the pain and stress-relieving aspects of their ongoing yoga practice. And for more serious situations, I think of a student of mine who had Lou Gehrig’s Disease, and used his pranayama and meditation practices even into the last stage of his life with some benefit.

5. Rehabilitative Therapy. Yoga is being used more and more to aid recovery from all sorts of acute conditions, such as following major surgeries to post-heart attack and post-stroke rehabilitation. In such cases, yoga is often introduced for certain periods of time, say two to four months, to accelerate recovery, and hopefully adopted for longer-term maintenance or supportive purposes after that.

Now, you might want to add more categories, or divide some of these into several, but my hope is that this organization, however simple, helps you to think in a clearer fashion about how you apply your yoga to health conditions. 

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Sanga: The Importance of Community

by Baxter

The Transmission of Teachings

I’m penning this blog post from 35,000 feet on my way home to Oakland from an amazing four-day convention in Austin, Texas called the SYTAR Convention. I’m writing it now because I am feeling so full of excitement and information and gratitude for the experience that I didn’t want to wait until tomorrow to do this! I didn’t want to lose any of the energy I felt from this amazing gathering of yoga teachers from around the world who came together to share the developments in the emerging field of yoga therapy. For those not familiar with this term, it was coined about 25 years ago, when yoga teachers Richard Miller, PhD, and Larry Payne hatched the idea of an organization and journal dedicated to the potential of yoga for both the maintenance of health and the treatment of disease. And slowly over the past 25 years, a community of like-minded yoga teachers, some already working as healing professions and others with the desire to work with those in need, has grown to the point where the International Association of Yoga Therapy, or IAYT, now has over 3000 members, in many countries around the world.

In the yoga tradition, a dedicated community is known as a sanga, and sometimes is also called a kula, per the Sanskrit language of yoga. I wanted to write about this concept as a first installment of things I learned at the conference because it came up on so many levels over the course of the four days in Austin. It began on a personal level in the form of the first person I ran into 10 minutes after my arrival: our own guest writer Shelly Prosko (see Urinary Incontinence and Organ Prolapse and Yoga among others), whom I had never met in person, only via email. What a delight to be welcomed by her amazing smile and kindness! My personal community grew quickly, as I connected with four new colleagues from Omaha and reconnected with old friends I had not seen in some time, like IAYT “Yoga Today” editor Kelly Birch. And at least a dozen people came up to me to thank Nina and me for this blog, which many had been following for years and were finding useful for their teaching and their students—thank you all for this feedback and encouragement! So Yoga for Healthy Aging is now, I feel, a part of the IAYT global community!

I witnessed many smaller communities coming together with common purpose and clarity of purpose: new yoga therapy training programs looking for guidance and support from those that have been at it for a while, yoga therapists specifically interested in bringing more yoga to the armed services, and teachers looking for new ways to work with special populations, such as those with depression or Type 2 Diabetes. If you follow us here at YFHA but are not a yoga teacher, I am hoping this information is helpful in expanding your awareness of what “yoga therapy” is and the kinds of skills these teachers who are learning additional yoga healing techniques beyond their basic yoga teacher training have to offer you.

But perhaps the most powerful use of sanga was illuminated again and again in the research and practical experience that those in the field were reporting on the role of “community” in healing.  Regular support group meetings, weekly and then monthly, are a part of the four pillars of healing of all of the heart studies conducted by Dean Ornish’s group over the last 35 years, along with yoga, exercise and diet. It was part of similar studies on prostate and breast cancer. Michael Lerner, the director of Commonweal, which hosts six week-long residential programs each year for those living with cancer, spoke movingly about the role of the group in the transformations that he as witnessed over the past 20 years at their center near Bolinas, in Northern California. Their program includes yoga, massage, healing arts, group work, and healthy food, all in a beautiful setting. He mentioned the long-lasting transformations he sees arise from one week together, and attributed some of that power to the work that take place in the ideal group size they have come to discover: only eight people! He mentioned two kinds of group dynamics that had strong effects: 

• Generous listening and compassionate attention without interruption that occurred in group sessions for the deep work
• More superficial levels of interaction that occurred in the provided space for conversation 

Another powerful presentation as made by the keynote speaker on the first day of sessions by Lorenzo Cohen, MD, an oncologist from MD Anderson Cancer Center in Houston (whose grandmother just happened to by Vanda Scaravelli!), who presented several studies demonstrating the effects of yoga on cancer outcomes. One clear statement he made regarding the effect of community on cancer outcomes was the social influences on cancer survival: if folks are connected with a social group, they have better survival outcomes. He cited a specific study on ovarian cancer, which showed less norepinephrine, a stress hormone that encourages tumor growth, at cancer sites in those with group support. 

Community, community, community. And even San Francisco yoga therapist Chase Bossart, in his talk on yoga for Type 2 Diabetes, suggested the motivational potential of regular attendance of group classes (sounds like community to me!) in supporting the shift from inactivity to improved physical activity in those with Type 2 Diabetes. It made me reflect on how challenging it was for me in my family practice to find ways to motivate my patients with Type 2 Diabetes to change their habit of inactivity. These days, I know that the sense of community that my students experience in their regular attendance of classes is a powerful motivator, and many positive physical and mental benefits result from that regular practice.

So, I begin my reports from the 2014 SYTAR meeting with this post on the power of sanga with you all, one of my most important communities. I hope to share a few more posts on other exciting aspects on yoga’s healing potential that I learned about in Austin soon. In the meantime, get to that community class you enjoy so much or start looking for one that fosters a sense of community, initiate a gathering of friends and family to share and listen to one another’s stories, or accept an invitation to a gathering you were wavering on. Experience the power of your kula directly, and regularly—it’s good for your health!

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Medical Yoga Symposium at the Smithsonian

by Timothy

Greetings from India! I've come to Kerala once again to study with my Ayurvedic doctor and to get some treatments. It is so nice to be back in this lush, semi-tropical setting and to see my teacher and many old friends. But just before I left the States, I had the privilege of taking part in a weekend symposium on modern and medical yoga at the Smithsonian, in Washington, DC. The symposium was held in conjunction with their groundbreaking exhibition, Yoga: The Art of Transformation. (The symposium is available for online for on-demand viewing.)

The event started off with a keynote by Dean Ornish, in which he summarized his more than 30 years of scientific research that has found that a yoga-based program, including a yogic vegetarian diet, can reverse heart disease. More recently his work has focused on men with prostate cancer, and is again showing very encouraging results. And due the similarities between breast and prostate cancers, Ornish believes that his comprehensive lifestyle program may benefit woman with breast cancer. That's speculation at this point, but other research is finding beneficial effects of yoga for those with the disease, including allowing them to tolerate chemotherapy and other medical treatments with fewer side effects.

The program included Richard Miller and Larry Payne, long-time yoga therapists and the co-founders of the International Association of Yoga Therapists, which has become the leading organization in the field.  Miller has garnered significant experience in recent years using the guided meditation practice Yoga Nidra with veterans with Post Traumatic Stress Disorder (PTSD). Payne founded and directs the graduate program in yoga therapy at Loyola Marymount University in Los Angeles.

Also significantly represented were top yoga researchers, including Sat Bir Khalsa of Harvard Medical School and Lorenzo Cohen of the M.D. Anderson Cancer Center and the University of Texas. As those of you who read my online newsletter know, Khalsa, Cohen and I, along with the world's most prolific yoga researcher (with more than 100 published articles!), Shirley Telles of the Patanjali Yogapeet in Hardiwar India, have agreed to co-edit the first medical textbook of yoga therapy. (We're just getting started, so it will likely be a year or two until it's published.)

The event was hugely popular, filling the Smithsonian's auditorium and selling out months in advance. More than 100 people attended my Yoga As Medicine workshop on Sunday, and I was struck by how many physicians and other health care professionals were present. One incentive was that, under the auspices of the event's co-sponsor, the George Washington University Medical School, physician attendees were awarded Continuing Medical Education (CME) credits, highly unusual for a yoga conference!

All of this speaks to the growing acceptance of yoga as a therapeutic modality. Indeed, there is now so much yoga research being published that Sat Bir, one of about a dozen full-time yoga researchers in the U.S., says he can't keep up with it all. This doesn't mean that yoga is already being fully integrated with modern medicine, but we are getting there much faster than any of us would have predicted 10 or 15 years ago, so stay tuned….

By the way, if you were unable to see the show at the Smithsonian, which was fabulous, it will be coming to San Francisco's Asian Art Museum from February 21 to May 25, 2014  and then travels to the Cleveland Art Museum from Sunday, June 22 to Sunday, September 7, 2014.

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Wondering What to Practice at Home? Consider a Private Lesson

by Timothy

Door by Brad Gibson

In a recent post Home Practice: The Best Way to Improve Your Health and Well-Being, I wrote about the value of a regular home practice. Practicing at home is particularly important for people with a medical condition who can’t do (or at least probably shouldn’t be doing) most public classes. But medical condition or not, the question remains, which yoga practices should you be doing at home?

One of the best ways to find the answer is to get a private yoga lesson. As it turns out, yoga goes about prescribing home practice in a very different manner than doctors prescribe medications or other treatments. In western medicine, we always try to diagnose the condition first, and then give drugs or other treatments to address that problem. If we can’t diagnose the condition, then all we can do is give treatments to relieve the symptoms.

In yoga therapy, the western medical diagnosis certainly can influence the treatment, but it’s only one of the many factors we consider. Two women, for example, may have the same diagnosis of Stage 1 breast cancer, and would likely get very similar recommendations from their doctors about how to treat it. But the appropriate yoga approach (used as a complement to medical therapy) might vary a lot depending on how fit they are, how much yoga they’ve done (and what styles), how much time they have to dedicate to their practice, how spiritually oriented they are, and so on.

Good yoga teachers always consider the broader context. When I evaluate a student, after interviewing them, I often start out by looking at them structurally. How is their posture? Are their shoulders rounded? Is the head forward of the spine? Are they stiff or flexible? Are there certain joints that are giving them problems, and, if so, how well are the bones on either side of those joints aligned?

After structure, I tend to move onto the nervous system (and breath, since the two are intimately linked). Are they suffering from excessive stress? Agitated? Sleeping poorly? Can’t get out of bed? What’s the balance of the sympathetic nervous system (fight or flight) vs. the parasympathetic (rest and digest)? Is their breathing smooth and deep or is it shallow and choppy? Is it primarily in the upper chest or does the abdomen move out and in with each breath?

In a similar manner, I evaluate each student’s balance as seen through the lens of Ayurveda, India's indigenous holistic medical system, as well as their psychological functioning and such spiritual matters as their level of joy, compassion and fulfillment. In my Yoga as Medicine workshops, we divide our student assessments into five categories, using the acronym SNAPS: Structural, Nervous system, Ayurveda, Psychological, and Spiritual. Each student winds up with a different constellation of findings, which we then try to address with the yoga routines we recommend.

Although I developed the SNAPS protocol to use on people seeking yoga therapy, the same process can help determine a good routine for someone who is simply interested in using their yoga as preventive maintenance, to build strength and flexibility, or to work off some of life’s inevitable stressors.

Say a student looking for a home practice has a slumping posture, a restless mind, shallow upper chest breathing, and an increase in the Ayurvedic dosha of vata or air (see my post on vata, Autumn, Healthy Aging and the Ayurvedic Dosha Vata). If I considered only structure and breathing in developing her routine, I might think that focusing on backbends would be helpful. But too many backbends, or more intense ones, like full Wheel pose (Urdhva Dhanurasana), could increase her mental agitation and push her vata further out of whack.

Perhaps I would end up settling on some gentle, restorative backbends done over folded blankets to open her shoulders and chest, while simultaneously allowing her to rest physically and mentally. I might also recommend daily alternate nostril breathing to balance her nervous system, and quiet her mind to the point that seated meditation would be more effective. Often, we reach the final recommendations based on trial and error, for example, putting the student in a potentially helpful pose and seeing what it looks like and how it feels. Maybe we change the blankets a bit and look again or try a different pose entirely.

What I am describing is what a good yoga teacher or therapist would do in a private lesson. Not everyone can afford a private lesson (price varies based on the experience of the teacher, the length of the session and the geographical area), though some teachers have a sliding scale, or take on a few cases as karma yoga for those in need. But once you get home, yoga is free, of course, so a lesson could end being cheaper than a series of classes. (If you don’t know a suitable yoga teacher or therapist in your area, check out the database of the International Association of Yoga Therapists at iayt.org.)

Although science has yet to test the idea, it is my belief that a well-designed practice tailored just for you will likely be better than a standardized protocol used in a study or a sequence printed in a magazine. All those approaches, good as they may be, are determined without ever laying eyes on the student—and that’s simply not the best yoga has to offer.

To me, it’s a testament to the power of yoga that so many people are helped by these one-size-fits-all yoga fixes. However, to most of us working in the field, there is little doubt that a tailored approach can be safer, more efficient, and much more effective. As a scientist, I’m all for testing these notions, but yoga research hasn't progressed to the point where such studies are being done (or funded). In the meantime, my advice is, whenever possible, to tailor your practice now, and ask questions later.

Even if you don’t have a medical condition, working one on one with a teacher can help you create the home practice that suits your particular body, needs, and goals. And if such a tailored approach moves you more efficiently in the direction you’d like to go than an off-the-shelf routine, you’ll likely notice the benefits and be more motivated to stick with it. And that, of course, is the key to success in yoga.

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