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Yoga for What Ails You

Soft Indian music plays in the background as New Yorkers of varying ages settle into their seats at a prominent yoga studio on a balmy September afternoon. They've come to hear yoga teacher, lecture-circuit veteran, and Western-trained medical doctor Sandra Amrita McLanahan talk about what yoga can do for their health.

The eager participants are right to be intrigued. Today, growing numbers of respected Western researchers are enthusiastically pursuing studies on the therapeutic, disease-specific benefits of the special breathing, chanting, poses, and relaxation techniques that the practice of yoga entails.

Even the prestigious National Institutes of Health (NIH) has gotten involved. The NIH's National Center for Complementary and Alternative Medicine is currently funding clinical trials to study the effects of yoga for everything from back pain and insomnia to chronic bronchitis and emphysema (conditions collectively known as chronic obstructive pulmonary disease, or COPD).

This disease-oriented approach to yoga's benefits is an exciting new take on a practice developed centuries ago by Hindus in India for other purposes altogether.

From Philosophy to Fitness
Yoga was originally a means of pursuing personal transformation and spiritual development, note experts on yoga, including Indian-trained Dr. Ramesh Raghavan. Indeed, in the Sanskrit language, the word yoga means "yoke" or "to bind or join together." Today it is interpreted more broadly to mean a nurturing of the union between mind, body, and spirit.

"Yoga is a system of philosophy," Dr. Raghavan explained in a recent WebMD LIVE chat. There are dozens of branches of yoga. Hatha yoga is the most popular in the West, and it is also the most physical, using poses (asanas), breathing (pranayama), and meditation (dhyana) to heighten the connection between mind and body.

Notes Dr. Raghavan, "Hatha yoga evolved out of the desire of the Mystics to attain enlightenment at the same time they were ensuring that their bodies cooperated with this mystical process."

In the modern Western world, however, it's primarily the physical benefits of this ancient practice that have caught the public's attention. And, in just the last decade, Americans have increasingly turned to yoga in growing numbers, choosing it as their preferred method of exercise. In fact, as of 2001, surveys estimated that more than 18 million people were practicing yoga regularly--and participation has undoubtedly increased since then.

In fact, yoga is now a "hot" fitness trend and yoga classes are the most popular feature at many health and fitness clubs nationwide. "In relatively little time, a practice that was once considered sort of weird is now a mainstream fitness approach," marvels Trisha Bauman, a professional dancer, movement therapist, and certified aerobics instructor. "For such a thing to happen in 5 to 10 years is amazing!"

Yoga's Healing Powers
Beyond its potential to get the body fit, yoga also has a role to play in getting and keeping it well. The use of yoga as a balm for human ills may be a novel concept in the West, but it has long been considered a basic approach in many Eastern healing traditions, where illness is generally seen as a disruption in the alignment of mind, body, and spirit.

Evidence for the longstanding inquiry into yoga's healing powers can be found in the countless studies published in Indian medical literature or, more recently, in international medical journals. Many address the power of yoga to control blood pressure, heart rate, respiratory function, skin resistance, and even body temperature.

For Western-trained doctors accustomed to approaching the body in terms of relatively separate body parts and physiological systems, this Eastern holistic approach can be challenging to accept and awkward to examine in an objective, research-based way.

"Although the conventional medical journals aren't exactly packed with articles about yoga, doctors are learning about it from their family members and their patients," says Dr. David Edelberg, a Chicago internist and chief medical advisor of WholeHealthMD. "In a country where 60% of the population is stressed out and overweight, and at risk for many related diseases, patients who practice yoga regularly tend to be calmer, slimmer, and usually healthier than those who don't exercise at all."

Antidote to Stress
While much of the source of yoga's therapeutic action remains a mystery, there are some sound indicators as to why it helps in healing. Perhaps most important, the successful practice of yoga gets to the core of what experts contend contributes significantly to 80% or more of all diseases--namely stress.

"That's what's beautiful about yoga," notes Dr. McLanahan. "When done regularly, yoga affects the number one cause of disease--beyond alcohol, cigarettes, poor diet, a sedentary lifestyle--and that's stress."

It's widely recognized that stress wreaks havoc on the body in many ways, from causing blood pressure to rise to generating a release of catecholamines, hormones and neurotransmitters charged with regulating numerous metabolic processes in the body.

By turning off stress and activating the relaxation response, yoga deactivates the body's fight-or-flight response, allowing healing mechanisms to become engaged. Numerous studies also indicate that the practice of yoga helps in healing by promoting the drainage of lymph in the body (the lymph system carries a fluid made up of infection-fighting white blood cells and waste products).

Benefits of Therapeutic Yoga
So far, results of the recent Western-based clinical trials show that regular yoga practice can significantly help people with a range of disorders, including arthritis and other chronic pain conditions, multiple sclerosis, asthma, cardiovascular disease, hypertension, insomnia, digestive problems, and mood disorders such as depression.

Variations on hatha and Iyengar yoga (which stresses precision and uses props) are sometimes the most effective for certain ailments. However, practices that involve what can best be described as "therapeutic yoga" appear to be the most beneficial.

Gentler than the intensely physical yoga offered at most health clubs, therapeutic yoga typically doesn't cause sweat to pour off the body. Instead, its aim is to gently increase lung capacity, improve strength and balance, broaden and maintain range of motion, increase flexibility and balance, and promote relaxation and meditation to calm the mind.

Keep in mind, however, that whatever type of yoga you practice, it alone is not a cure for a medical condition.

Some of the most accepted therapeutic uses for yoga so far by Western practitioners include the following:

Yoga for Joint and Muscle Pain
Studies have shown yoga to be especially helpful for arthritis and other musculoskeletal disorders, such as low back pain, systemic lupus erythematosus (SLE), and fibromyalgia. All are leading ailments in causing disability among Americans 65 years and older.

The pain and stiffness characteristic of these disorders leaves many sufferers feeling as if the last thing they want to do is be more active. The ongoing pain often initiates a vicious cycle: tensing of muscles results in more stress and pain, which limits activity, which causes stiffness, and so on.

Yet yoga has proven critical in enabling many individuals to manage their pain more effectively, maintain or improve their ability to move about, and actually slow the progression of joint damage. The benefits are most likely due to the careful and deliberate stretching and the relaxing of the mind that yoga practice involves.

In one controlled study, published in the Journal of Rheumatology in 1994, yoga was shown to significantly reduce pain and tenderness during activity, and notably increase range of motion in people with osteoarthritis of the hands. In the study, 17 people were assigned to either a 10-week yoga program or no extra treatment beyond regular medications taken by both groups.

The eight 60-minute yoga group sessions involved stretching and strengthening exercises that emphasized upper body extension and alignment of bones and muscles. If you do have arthritis, experts note, it's particularly important to sequence the yoga poses properly and pay close attention to alignment.

Neuromuscular disorders such as multiple sclerosis (MS) have also been shown to benefit from the increased muscle awareness, strengthening, and stress reduction that yoga provides. A sense of control over pain can be attained with the deep, relaxing yoga breath, a technique that can be done at any time (even during a flare) when movement seems daunting.

In a study published in the Journal of the American Medical Association (JAMA), researchers found that eight weeks of twice-daily yoga poses outperformed wrist splinting or no treatment at all in reducing pain and increasing grip strength in people with carpal tunnel syndrome. The 11 yoga postures were designed to strengthen, stretch, and balance each joint in the upper body.

Yoga for Heart Health
Studies are showing that cardiovascular disease (CVD), a leading cause of death among Americans, can be very effectively approached with yoga--especially when it's combined with an overall lifestyle change that includes adopting a nutritious diet and getting regular exercise.

Yoga probably works by reducing many of the risk factors for CVD, such as being overweight and having elevated blood pressure or cholesterol levels. Dr. Dean Ornish, who has had two major studies on the subject published in medical journals since 1990, contends that yoga practice appears to even reverse artery blockage, a major indicator of cardiovascular disease.

In a 2000 study that involved yoga exercises twice daily for 11 weeks, blood pressure readings were reduced just as effectively as standard medical treatment. The study was published in the Indian Journal of Physiology Pharmacology. Many similar studies can be found in the medical literature.

Yoga for Asthma
Many published studies have shown that regular yoga practice that involves breath-control exercises in people with asthma can significantly improve lung capacity, lessen medication use, increase exercise tolerance, and reduce the frequency of acute asthma attacks.

For example, in one small study of 17 adults with asthma, those assigned to practice breath-slowing exercises and meditation were eventually less likely to need inhalers to open up their airways. Lung function tests indicated no difference between the two groups, but the yoga group scored higher on quality of life questionnaires.

In the end, the yoga studies showing the most benefit for asthma indicated that the more a person practiced slow yoga breathing, the greater the benefit that could be derived from it.

Finding the Yoga that's Best for You
Many instructors emphasize that one great appeal of yoga for anyone grappling with a medical problem, be it asthma or arthritis, is that this therapy can ultimately be self-directed. You can do yoga at your own level and ideally personalize it to your own needs.

Barbara Larkson, an experienced yoga instructor in New York City, routinely advises clients with specific health concerns to individualize their yoga practice by first trying out different classes and yoga styles. "There are so many options out there!" she exclaims. "Try a few of them, or rent some tapes to work with at home. Or start with an individualized class. Lots of yoga teachers have private clients. In fact, that might be the best way to begin if you have a specific health problem."

Other helpful tips for approaching therapeutic yoga:

 Make sure you find an experienced teacher (physical therapists sometimes teach yoga techniques) who is sensitive to your illness and capable of making any needed accommodations in the poses.

 Take care not to cause more injury. Especially when doing yoga on your own, make sure not to push beyond what you can comfortably do. Never perform poses that cause extreme discomfort or pain beyond the pull of a healthy stretch.

 Always check with your doctor first before starting on any new exercise regimen or movement program.
Finding an instructor skilled in therapeutic yoga can be challenging, but is often worth a thorough search. Suggestions on where to start include:
 The "Find a Practitioner" feature of WholeHealthMD (www.wholehealthmd.com/about/practitioners) lists credentialed yoga instructors in your area; simply enter your zip code in the search box.

 Another good resource is the Yoga Alliance (www.yogaalliance.org). Teachers listed there require at least 200 hours of basic certification to be included.

 The International Association of Yoga Therapists and Yoga Research and Education Center are linked associations that both offer insight into yoga for specific diseases as well as extensive education and resources for practitioners of yoga therapy. They can be found online at www.IAYT.org and www.YREC.org.

 There are many specialized books and tapes about yoga and its various styles. Browse through your local bookstore, library, or online. A book or tape may be a particularly helpful starting point for dealing with conditions such as chronic pain or insomnia. For more information, see the entry on Yoga in the WholeHealthMD Reference Library.

Date Published: 09/29/2003
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