The term "Medical Yoga" is popping up in the news and in yoga classes. This is part of a trend to look at the ancient practice of yoga and recognize its medical and health benefits. The scientific, medically applicable benefits of yoga are being studied and show promise for helping reduce low back pain, depression, improve cholesterol levels, reduce stress and help with weight loss. Additionally, yoga may help promote cardiovascular fitness.^(1,2)

What should you look for in a "medical yoga" teacher? Any individual delivering a "medical yoga" class should have health care training that qualifies them to assess all client history, screen current status and examine the client for posture, strength, stability, tone, flexibility and stamina. Anatomy and biomechanics knowledge are essential. Medical yoga is therefore a customized, one size fits only you approach! I will share some medical yoga pearls while revealing a few of my own roadblocks I have encountered along my own path with yoga. I am in a Professional Yoga Therapy (PYT) 900 - hour certification track that follows a commons sense yet profound application of science to yoga.⁽³⁾ I prescribe PYT "medical yoga" to many of my clients as needed to help them meet their goals in Physical Therapy. I am also practicing self -care with a home yoga practice.

1. A key yoga guideline you can practice: non-violence to yourself and others.⁽⁴⁾ Interpreted into a yoga pose (Asana), this means any negative feeling such as pinching, burning, shaking or wobbling in a pose is not safe. Non-violence may be applied to any exercise that you practice. During yoga, muscle fatigue and a mild sense of feeling the muscle "heat up or burn" is acceptable. My mistake: I partially tore both Achilles while performing down dog on one leg in a hot yoga class and it took over a year to heal (My Achilles were weak and stiff and I had no business balancing on one leg in downward dog for 90 seconds per leg, while trying to force my heel down.) I am not very flexible, so I do not look like the models on yoga magazines. I'm also naturally competitive and in a class with individuals 20 or more years younger than me, I try to "keep up" which causes me to be violent in pushing my body.

What is the natural alignment of your kneecaps (patella)? Do they face inwards or outwards? Honoring your comfortable range of motion of all joints is important. The hip can be strained in "violence" forcing it to turn in or out too much if that is a limit that is pre-determined by your bones and ligaments. In this picture the individual on the right is "turned in" at the knees, and the other is "turned out". This will determine limitations in ranges of motion for the legs and back.

2. PYT Precepts or foundation rules: Breath mastery and stability with transverse abdominus activation must be mastered before moving into poses. Poses must demonstrate optimal biomechanical alignment and stability. The practitioner must be able to "stabilize" with co contractions of opposing muscles around a joint and/or use external props or supports. Therefore, extreme shakiness or wobbling is demonstrating a lack of ability to stabilize and the pivot points may be compressed following the yoga class. My own realization during PYT training is that I may "throw myself into a pose" and actually be in poor biomechanical alignment feeling a sense of strain and imbalance in the pose. Now I breathe and practice a pre-set of transverse abdominus and other key muscles before I move into a pose of a sustainable range of motion that I can control. I must admit that I am not stable in Warrior 3 pose, leaning forward on one leg and attempting to place my body parallel to the floor. I must use props and supports as I work into this pose due to tight hamstrings and a lack of adequate co-contraction and stability from the foot up to my knee, hip, and spine. I used to force myself into this pose and fall out of it with a big wobble and then my back and hip would hurt.

3. Pranayama is the yoga discipline of breath control. Breath control is useful for calming, relaxing, winding-down scenarios as needed, but also for exertion and energizing. The easy diaphragm breath is the starting practice point. From there, one may learn to lengthen the inhale and the exhale phases for deeper relaxation then move on to engaging the deep abdominals for support and power, with transverse abdominus training. The ujaii breath technique involves slight vocalization during exhale and/or inhale, which has a warming effect on the body. While some yoga classes do not involve attention to the breath, medical yoga must focus on individual needs and custom training in pranayama.

Please honor yourself with non-violence, self-care and safety if you are stepping onto a yoga mat at home or in a class. Consider your breath control and stability as you move through postures and you should be pain free after your yoga program, optimally feeling lighter and focused. You may schedule with me for PT needs that can involve medical use of yoga poses and practices, to help with spinal and pelvic pain, mind-body calming for muscle relaxation and stress management and perinatal fitness. Yoga may also help with cancer related fatigue and restoring strength and endurance. Check in with the CTS blog and Facebook to see further posts on PYT pearls for your yoga practice, for your health and wellness.
Om, Namaste.