Yoga has been popular for a while now, and its popularity around the world is still growing. In the scientific community, interest into the impact of yoga on numerous health conditions continues to grow. In the general population yoga is widely accepted to be of benefit to one’s physical, mental, and emotional health to various degrees. Regular practitioners of yoga would enthusiastically agree that it can have even profound impacts on these domains. Preliminary evidence also shows that yoga has a positive impact on those suffering from anxiety, depression, panic disorder, chronic pain, PTSD, cancer, deconditioning secondary to old age, neurological disorders, brain structure, and more.
Yoga As Physical Therapy
Although I began practicing yoga before attending physiotherapy school, it was as a physiotherapist that my interest in yoga became a passion. I believe that in a physiotherapy setting, yoga can be very helpful for the treatment of chronic, gradual onset conditions, which is what I see of most of the time in my practice. This includes neck and back pain from sitting at desks for long hours, shoulder pain experienced following a summer of slo-pitch or volleyball, aches and pains that never fully resolved after a motor vehicle accident, and so on. For traumatic injuries, such as fractures, muscle and ligament tears, yoga can be a very useful tool in later-stage rehabilitation to maximize tissue integrity and overall recovery.
With ‘traditional’ physiotherapy exercises, compliancy is a challenge. This is especially true when there are multiple areas that need to be dealt with (i.e. someone with neck, hip, and knee pain following a motor vehicle accident, or an office worker with both shoulder pain and plantar fasciitis). It can really become a tedious chore when you’re told that in order to get better, you have to do a few minutes of foam rolling, then several elastic band exercises, followed by stretching, and sometimes then balance and proprioceptive work. This commitment often requires several weeks or months of consistency as well. It can feel like a daunting task when our schedules are already quite busy, and to be frank there is minimal joy involved in doing the work required. We can’t really judge anyone who struggles to do their exercises. It is a struggle. While there are occasional over-achievers out there who complete every exercise and repetition to a T, although my hat’s off to you, many of us fall off the wagon over time. We then beat ourselves up over it, stop going to physiotherapy, and then sometimes never even fully recover. I’m not saying that traditional physiotherapy exercises aren’t important or that they don’t have their place in rehabilitation; its just that many patients struggle to engage with this kind of work. These kinds of exercises also do not address the other factors that may be interfering in the healing process and amplifying the pain experience such as stress, poor sleep, altered breathing patterns, anxious thoughts, and negative perceptions towards ourselves and our bodies. Yoga can address all of these areas.
While attending yoga classes as a physiotherapist, I noticed how so many of the areas for improvement that I commonly saw in my patients could be easily addressed with much less planning and effort by completing a short yoga sequence a couple of times a week. Yoga is a great way to address common sources of pain and injury, such as poor thoracic mobility, hip and shoulder mobility, scapular and core stability, and so on. The warrior postures, when cued well, can help with scapular, core and hip stability while simultaneously improving mobility and balance. Downward dog strengthens and mobilizes the wrists and shoulders, improves the mobility of our hips and ankles, and promotes postural awareness. Eagle improves balance and proprioception, hip, ankle, and core stability, and shoulder mobility. Child’s pose stretches the lumbar extensors and latissimus dorsi muscles while we calm down our fight-or-flight system with full, steady diaphragmatic breaths. I could go on.
While attending yoga classes as a physiotherapist, I noticed how so many of the areas for improvement that I commonly saw in my patients could be easily addressed with much less planning and effort by completing a short yoga sequence a couple of times a week.
A well-sequenced and thoughtfully instructed yoga class can easily cover of all the bases needed to recover from a wide variety of musculoskeletal conditions and injuries, all while promoting a sense of empowerment and bringing a higher level of physical, mental, and emotional well-being to the table. It also gives us greater physical awareness of our bodies so that we are better able to determine what factors are aggravating our problem and allow us the physical literacy to control and modify unhelpful movement patterns and postures. Furthermore, yoga practice brings us into the present moment and promotes mindfulness. It is by being mindful and living in the present that we can begin to witness our thoughts, actions, habits and beliefs and how they might be contributing to our situation and recovery. Once we become self-aware, the road to recovery becomes much clearer. See my blog post on meditation for chronic pain for more information on this topic.
Yoga Should Be Accessible to All
The media presents yoga in a narrow light—many people associate yoga in North America with someone who is slender, fit, young, affluent, and often female. This demographic of course has every right to practice and enjoy yoga, and has undoubtedly helped in bringing yoga to the mainstream; however, yoga is of equal benefit to a middle-aged blue-collar male, an older adult with Parkinson’s disease, a hockey player with a history of concussion, a previously sedentary adult with cancer, a young child with anxiety, a paraplegic looking to improve their upper body strength, a stay-at-home mom trying to achieve a better level of physical fitness, or devout Hindu practitioner on the other side of the world. Yoga is for everyone. This is a belief I hold strongly, and is in line with that of B.K.S. Iyengar, one of the most well-known and well-respected yoga teachers of our time, who worked tirelessly to introduce yoga into the Western world.
The reality is that we all can benefit from yoga, and we all have a right to practice yoga free of judgement, even we are just ‘dipping our toes’ into the practice. The stiff and stocky dad attending for the first time belongs in a yoga class just as much as the svelte former dancer who can kick effortlessly up into a headstand. While it is important that we respect the philosophy, origins, traditions, and history of yoga, and that we are mindful to avoid cultural appropriation, you don’t need to learn Sanskrit, or chant, or take on a new school of spiritual thought outside of your own to make yoga a beneficial part of your life. The person completing yoga at home for twenty minutes a few times as week is just as authentic to the advanced practitioner who has been practicing daily for years. You do not need a baseline level of mobility and physical fitness. Neither do we need all of our yoga teachers to act as our gurus on a path to spiritual enlightenment (I feel like us teachers can sometimes get a little heavy-handed with respect to this). It is possible to take on what feels right for you and leave what doesn’t fit with you at the door. I personally keep my classes very Western in style to accommodate a range of people from a variety of walks of life, and to avoid leaving anyone who may be new to yoga from feeling alienated or out of place in the room. Maybe over time you will want to explore yoga more deeply, or maybe you won’t. Maybe it will just be something you do every one or two weeks. Its okay either way, and you will still grow and feel better irrespective of which path you take.
It is possible to take on what feels right for you and leave what doesn’t fit with you at the door. I personally keep my classes very Western in style to accommodate a range of people from a variety of walks of life, and to avoid leaving anyone who may be new to yoga from feeling alienated or out of place in the room.
Tips for a Safe Yoga Practice
The most important step to practicing yoga safely is to leave your ego at the door. It doesn’t matter how often I say this, it still comes up in almost every class I teach. The point of tree pose isn’t to stand on one foot in perfect stillness for 10 slow and controlled breaths. The point is to gently challenge your mind and body relative to where you’re at right now. For some this might mean first keeping both feet on the ground and focusing on a steady gaze with your arms overhead. If you collapse into your back and can’t stop your elbows from flaring out during a full chaturanga, just put your knees on the floor and work on your core and shoulder stability for a while. Cut yourself some slack! You’ll see greater physical improvements over time, experience a greater level of enjoyment and presence, and have much smaller chance of ending up in pain. No one is going to judge you if you take a break and hang out in child’s pose, either.
Don’t stretch aggressively. So many ‘cool’ looking yoga postures involve tremendous amounts of mobility, and I see many people trying to force themselves into positions that their bodies are not ready for. I’m guilty of this myself now and then. Our muscles are like Chinese finger-traps; if you pull too hard or too forcefully your body is going to respond with more tension and resistance. Slow, gentle movement will convince the body to gradually open up and let go of resistance. You do not need to eventually be able to touch your toes with ease to benefit from yoga. Any improvement is a positive improvement.
Imbalances between mobility and stability are some of the most common causes of pain and injury that I observe in yoga practitioners who come to me for physiotherapy. While ‘yin’ classes that focus primarily on prolonged stretches have their place in yoga, strength and stability are just as important as flexibility and mobility. While it is admirable to have mobile and open hips that allow for full expressions of advanced postures, it doesn’t mean much for the health of the joint if the person can’t keep their hip strong and stability throughout its full range of motion. These imbalances may often lead to a sense of ‘tension’ around the joint in question, as the body tries to stabilize itself against all the movement. Unfortunately, we intuitively believe the answer is more stretching, which may further aggravate the problem, whereas the real solution is often in getting stronger in that area. Those ‘hips and hammies’ classes should spend just as much time (if not more) in postures that strengthen the hips as they do in those that open them up.
Often, my physiotherapy patients question whether yoga is a safe option for them while they are recovering from an injury. In most cases, the answer is yes, but there are exceptions: if you are in the early stages of an injury, where tissue integrity may still be weak, or the inflammatory process may still be running high, it is best to keep your yoga mat rolled up. A few gentle yoga-based movements may be of help, but you probably shouldn’t be heading into a 60-minute class. Once tissues have healed some, listening to your body, avoiding going beyond the point of mild discomfort, and being mindful not to move into positions that you know are aggravating to your injury or condition are important. This is again where it is important to leave your ego at the door. If you have chronic pain in one or more areas, it is always best to ease into things slowly at a level that doesn’t leave you feeling flared-up for the rest of the day. If you are still unsure of where to start, find a physiotherapist or similar health professional with experience in yoga who can provide some structure and guidance.
Finding the Right Class for You
I always encourage my patients to find an instructor that fits well with them, but if you are new to yoga it can be tough to know exactly what constitutes a ‘good’ instructor, just like it is tough to tell what constitutes a ‘good’ physiotherapist! I recently attended a class at a popular studio with a seasoned instructor, and despite being a relatively experienced yoga practitioner and a teacher myself, I was taken totally out of the moment as all that the physiotherapist in me could think was, “what on earth does this person have us all doing right now?!”
Since yoga has become so popular and varied, and instructors come from all walks of live with varied levels of experience, knowledge, and tenacity, there is probably going to be some trial and error involved in finding the teacher that is best for you. Start by looking for a class described as being for all-levels. If you are looking to improve your whole body’s health and fitness, the sequence should be well-rounded; this includes mat work (time on your back, hands and knees), some standing postures, an equal focus on strength alongside mobility and flexibility, and place some attention on breath work. Flow-based classes, where breath is linked with changes in movement, in my opinion usually offer the best benefit. Instructions should be easy to follow regardless of your experience level. If the instructions and cues constantly leave you feeling confused or awkward, that class might not best the best fit for you. The room should not be so crowded that the instructor does not have time to correct any mistakes that you are making.
Sometimes the right class for you is at home. A solid yoga practice does not necessarily require expensive classes or studio memberships either. There are now many internet-based yoga instructors that provide excellent instruction and offer classes for those with all levels of experience, for free of charge. It may of course be of benefit to go to a class from time to time to ensure that there are no major errors in your practice that you are overlooking. Feel free to get in touch with me by e-mail and I will be happy to direct you to some online instructors who may be a good fit for your current level of experience.
You should finish your yoga practice feeling like your entire body is a little loosened up and that most muscle groups have been put through some strengthening work. Your breath and mind more should feel calm and centred, and you should not be experiencing significantly more pain or discomfort than when you walked in. Maybe you learned a little more about your mind and body along the way too.
Yoga is One Tool in the Box
Yoga, like almost any intervention, is note a cure-all panacea. Too often in the world of research and healthcare we consider each treatment approach as a silver-bullet, or a one-stop fix for all of our problems. I believe that the best approach to any issue is a holistic one; when we combine various treatment modalities, the effect on improving recovery often gets stronger. Managing stress levels, getting adequate sleep, and maintaining good nutrition habits will also help in recovery and healing. If you can, incorporate other forms of physical activity into your routine, weightlifting, running, swimming, team sports, taking a walk, or just opting to take the stairs at work. Sometimes we do need to suck it up and do a few of those traditional physiotherapy resistance band exercises.
Gradually incorporate yoga into your routine and rather than feeling like you need to attend several classes a week. When taking on any new habit, the smallest changes that seem more insignificant at first will likely be the ones that stick for the long term and allow for the greatest amount of success. Pick easy changes and gradually add to them as they become routine. This might mean beginning with just 20 minutes of yoga once a week, and working up to 30 minutes of yoga 2-3 times a week over the course of 1-2 years. Slow changes are the most resilient to changes in our lifestyle and busy schedules.
Work with Mark
If you are looking for more information on how yoga might be a helpful tool in promoting recovery and over all health and well-being, feel free to get in touch with me directly by e-mail at mark@ascenthealth.ca, book in for a one-on-one physiotherapy session through our Jane app, or attend one of my lunch-time yoga classes, which take place at noon on Tuesdays and Fridays at our downtown clinic for only $5 per class. I am happy to help in any way.