Yoga as Therapy?

“In search of wholeness, health and happiness”, Georg Feuerstein

What is yoga?

or

History of yoga Originated in India 5-6000 years ago.

Aim - to achieve one’s full potential as a human being.

Early yoga practices - Meditation, breathing and concentration techniques.

Metamorphosis of these techniques led to the popular development of physical postures of Hatha Yoga around 1500s.

Since then, has been continuously developed and modified to meet the changing needs of society.

Brought to the West in the early 1900s.

Components of yoga practice

Postures (Asana)

Components contd.

Meditation

Breathing exercises (Pranayama) eg. Abdominal breathing, alternate nostril breathing.

Internal cleansing techniques eg. Neti, nauli

Relaxation techniques eg. yoga nidra

Styles of yoga Hatha yoga – Slow paced, introduction to most basic yoga

poses, good for beginners.

Ashtanga – Fast paced, aerobic style of yoga, set sequence, moving quickly from pose to pose.

Vinyasa – Flowing style of yoga, sun salutes to warm up the body, followed by deep stretching poses.

Iyengar – Strong emphasis on alignment, use of props and supports. Poses held for longer periods.

Yin yoga – Long duration in mainly seated poses to improve flexibilty in the joints, main focus on hips, back and legs.

Restorative yoga – More relaxing form. Use of props and supports to ensure comfort, emphasis on deep breathing and relaxation.

Bikram – Hot yoga. Set sequence of yoga poses carried out in 100O F. Aim to loosen tight muscles and cleanse through profuse sweating. NOT FOR THE FAINT HEARTED!

Major benefits of yoga

Improved flexibility, strength, joint mobility.

Improved posture, core strength.

Increased body awareness

Slower, deeper breathing, increased use of

respiratory muscles.

Release of tension

Improved focus/concentration.

Uses of yoga To aid injury recovery

Treatment of chronic physical conditions

Maintenance of healthy body – balance between strength and flexibility.

Treatment of psychological ailments – improve sleep, reduce stress, anxiety, symptoms of depression.

Yoga for back pain

Comparing yoga, exercise, and a self-care book for chronic low back pain: a randomized, controlled trial. Sherman et al. Ann Intern Med. 2005 Dec 20;143(12):849-56 Yoga for chronic low back pain: a randomized trial.

Tilbrook et al. Ann Intern Med. 2011 Nov 1;155(9):569-78 Yoga for low back pain: a systematic review of randomized clinical trials.

Posadski and Ernst. Clin Rheumatol. 2011 Sep;30(9):1257-62

Clinical trials on chronic lower back pain sufferers have shown: • Improved back function • Reduced pain levels • Improved self efficacy

Using a 12 week yoga program vs alternatives (GP exercise and pain control regime/ self help booklet.)

Yoga for joint mobility

Case studies - arthritis Osteoarthritis

9 patients who participate in an 8 week yoga course displayed significant reductions in WOMAC (Western Ontario and Mc Master Universities

Osteoarthritis) pain, physical function and AIMS2 (Arthritis Impact

Measurement Scale2) Affect.

Iyengar yoga for treating symptoms of osteoarthritis of the knees: A pilot study.

Kolasinski, S.L., et al. 2005. Journal of Alternative and Complementary Medicine, 11 (4), 689–93

Iyengar Yoga for Young Adults with Rheumatoid Arthritis: Results From a Mixed-Methods Pilot Study. Evans et al. Journal of Pain and Symptom Management 2010; 39(5), 2010, 904-91 The benefits of yoga for rheumatoid arthritis: results of a preliminary, structured 8-week program. Badsha et al. 2009. Rheumatology International, 29(12), 1417-1421. Improvement in hand grip strength in normal volunteers and rheumatoid arthritis patients following yoga training. Dash M, Telles S. Indian J Physiol Pharmacol 2001; 45(3) Measuring the effects of yoga in rheumatoid arthritis. Haslock et al. Br J Rheumatol 1994; 33(8):787-788.

• Rheumatoid arthritis Participation in 8 week yoga program resulted in reduced disease activity, reduced fatigue and ability to reduce medication when compared to control group. Badsha et al.

Yoga to strengthen bones

Yoga for Osteoporosis. A pilot study. L. Fishman, 2009. Topics in Geriatric Rehabilitation Vol. 25, No. 3, pp. 244–250

“Yoga helps grow bone mass, but because yoga poses pull and stretch the bones from every conceivable angle, yoga also may stimulate the formation of a bone structure that is able to resist greater amounts of pressure, as well as many different types of challenge”. Loren Fishman MD (Medical director, Manhattan Physical and Rehabilitation Centre)

spine

hip

DEXA scan scores

Injury recovery

Yoga Therapy – adapting traditional yoga poses as therapeutic tools to aid injury recovery.

International association of yoga therapists (IAYT), International Journal of Yoga Therapy.

Case studies – “Structural Yoga Therapy” Mukunda Stiles

“Ankle Inversion injury” Robert N. Cory 2006

Safety considerations

Recent controversies over yoga injuries – Causes? Competitiveness – pushing the body too far, too fast, ignoring feedback from the body and over stretching. Choosing the wrong style of yoga class or teacher. Overstrain due to unbalanced yoga practice. How can injuries be avoided? Student: Care in choice of yoga class and teacher. Ensure teacher is properly qualified

and that class type is suitable eg. If a beginner, dealing with injuries etc. Teacher: Teaching of greater body awareness- empower the student. Allow recovery time between stretches, ensure balanced practice. Ensure students don’t push themselves too far.

2007 US study: # injuries out of every 10,000 practitioners: Yoga - 3.5, Weight training – 15, golf - 39

Yoga is a generally safe activity. It could, in my opinion, be prescribed by more

physicians as a means of maintaining health and wellness. And it has an important role to play in (injury) prevention, because maintaining strength and flexibility can be a big help in avoiding injuries.“ Debbie Turczan, M.S.P.T., clinical specialist in physical therapy, New York Presbyterian Hospital/Weill Cornell Medical Center, New York.

Ultimately:

Yoga and yoga therapy useful in injury recovery and treatment of chronic physical and psychological conditions.

Yoga as a Tool to increase body awareness and empower individuals to maintain the health and longevity of their physical and mental bodies.