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Not Just Any Yoga Class: Three Steps to Safe Practice

September 27, 2017

By Carol Krucoff, C-IAYT, E-RYT

As a yoga therapist, I wasn’t surprised to see recent headlines asserting that “Yoga Can Help Back Pain.”  I’ve taught many people with back pain and other health challenges—such as heart disease, insomnia, and arthritis–how to use yoga breathing, movement, and meditation techniques to find ease in body and mind.

This new study, published in the Annals of Internal Medicine, found that a yoga class designed specifically for back pain can be as safe and effective as physical therapy in easing pain.  This research is part of a growing body of evidence supporting the therapeutic benefits of yoga for varied conditions—including reducing heart rate and blood pressure, relieving anxiety and depression, and easing chronic pain.

As a result, more and more people—of all ages and abilities—are turning to yoga to enhance their health.  Yoga is now one of the “Top 10 Complementary Health Approaches” in the United States, where it is practiced by 13 million adults, according to the National Center for Complementary and Integrative Health (NCCIH).   Nearly 60 percent of practitioners say they do yoga “to maintain health and well-being” and 16 percent report using yoga to treat a specific condition.

For those new to the practice, however, it’s essential to recognize that yoga classes vary widely in style—from vigorous and athletic to relaxing and restorative—and in substance—from “yoga-flavored” exercise to meditation in motion.  Yoga’s booming popularity has resulted in a broad array of offerings including hybrids, such as yoga on a stand-up paddle board, as well as classes taught by instructors whose training consists of a weekend yoga workshop.  Even yoga instructors who are adequately trained to teach able, fit students typically have a limited understanding of the important safety considerations Western medicine recognizes as vital when working with older adults and people with health issues.

“I’m not recommending that people just go to any yoga class,” physician Robert Saper told National Public Radio in an article about the back pain study, in which he was lead author.  Director of Integrative Medicine at Boston Medical Center, Dr. Saper noted that the yoga study protocol involved gentle poses and relaxation practices that were developed specifically for back pain with input from yoga teachers, doctors and physical therapists. [Click the link for a guidebook that Saper and colleagues have made freely available that details these poses: Guidebook.]

In my work teaching yoga to people with health challenges, I have heard numerous stories about negative experiences in a yoga class—frequently because the class was too difficult for the participant and/or taught by an inexperienced or poorly trained instructor.

To practice yoga safely, here are some tips:

Talk to your care provider.

This is particularly important if you have a serious health condition, so you can get guidance about any specific movement precautions.  For example, people with glaucoma may be advised to avoid “head-down” positions, which may increase pressure in the eye.  Recognize, however, that many physicians don’t know much about yoga and may assume that you’re planning to stand on your head.  Let the provider know that you’re interested in starting with a gentle yoga class consisting of simple movements, stretches and breathing practices.

Find a well-trained and experienced yoga teacher.

Ask prospective instructors how long they’ve taught yoga and whether they have any special training in working with vulnerable populations—such as older adults and/or people with health challenges.  The basic credential for yoga teachers is “RYT,” which means registered yoga teacher from the Yoga Alliance, and can be earned after just 200 hours of training.  Experienced teachers can earn an “E-RYT.”  Advanced trainings, such as the Integrative Yoga for Seniors Professional Training offered at Duke Integrative Medicine, provide continuing education for yoga teachers who want to learn how to work safely and effectively with older adults.  Graduates of this program receive a certificate of completion.

Consider beginning with some individual sessions.

Working one-on-one with a yoga therapist who will individually tailor a practice designed to help you reach your health goals can be a helpful introduction—particularly if you have health challenges.  The initials C-IAYT stand for Certified Yoga Therapist, from the International Association of Yoga Therapists.  Many hospital-based wellness centers and integrative medicine centers, offer yoga therapy, such as the services provided by Duke Integrative Medicine. Click on this link to find a Certified Yoga Therapist in your area.


Are you interested in advanced yoga training?

Join us at Duke Integrative Medicine for our Integrative Yoga for Seniors Professional Training. This training is an eight-day experiential program for registered yoga teachers that combines the best of evidenced-based medicine with the ancient wisdom of yoga.   Click here to learn more about Integrative Yoga for Seniors Professional Training.




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