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Yoga vs. Yoga Therapy

Not every yoga class is appropriate for students with injuries. Those students with special needs should instead try yoga therapy.

By Timothy McCall, M.D.

In 1998, the Journal of the American Medical Association (JAMA) reported that an eight-week yoga program had positive results for people with carpal tunnel syndrome. These promising results got a lot of publicity, sparking interest among the general public and health care professionals about yoga's potential as a therapeutic modality. After hearing about such a study, many people—including doctors—might believe they can walk into any yoga class with a medical malady and be healed. But the fact is, if someone with carpal tunnel syndrome shows up at a hatha yoga class that includes poses that are weight-bearing on the hands and wrists (think Plank, Upward-Facing Dog, and Handstand), they could easily wind up worse than when they started. So, while such studies help raise awareness about yoga, it's crucial that we discern the difference between a typical yoga class and yoga therapy.

In the JAMA< study, one of the key components that led to the positive results is that senior Iyengar teacher Marian Garfinkel carefully designed a therapeutic yoga program tailored to the specific needs of carpal tunnel patients and, when necessary, adapted it to the individuals in the group. There are exceptions, but for the most part, this kind of personalization is rarely possible in a class setting.

Yoga therapy is typically conducted one-on-one or in small groups. Often, a session more closely resembles an appointment with a physical therapist or rehabilitation specialist than it does a typical yoga class. What sets this healing modality apart from others is the focus on linking movement to deep, rhythmic breathing. Another difference is the emphasis on relaxation. In fact, when someone is gravely ill, a therapist may suggest that the entire practice consist only of breath awareness and relaxation until the patient is ready to tackle more.

If you're looking for a yoga therapist, it's important to be aware that there are many different kinds from a wide variety of yoga traditions and, as of yet, there is no universally accepted certification system. So, the type of training and number of hours a therapist has studied varies from person to person. For this reason, word of mouth is still an effective way to find the right yoga therapist—ask around or call yoga studios for leads. Here are some specific qualities to look for.

APPROPRIATE TRAINING If you have a condition that requires knowledge of the physical body, like back pain or arthritis, find someone with substantial anatomy training. If you have a more serious medical condition—such as cancer, heart disease, or lupus—you'll need a therapist who understands the disease, the effects of medications, and contraindications to practicing. Look for someone who has sought additional training in your specific condition or who has a background in a health care profession, like nursing or physical therapy.

EXPERIENCE Ask potential therapists how long they've been practicing yoga therapy and how often they have worked with people who have your condition. As with most anything, the more experience someone has, the more equipped he or she will be to help you.

AN ACTIVE YOGA PRACITCE An effective yoga therapist must have this.

AN INSPIRING APPROACH A good yoga therapist is knowledgeable, but a great one will be able to design a personalized program that motivates you to practice on your own. The key to success in yoga therapy is to feel connected to your own healing.

Timothy McCall is Yoga Journal's medical editor. You can find him through his Web site, www.drmccall.com.


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