Doctor's Call

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If I were to list everything I learned about yoga in medical school, I could stop right here. As far as I can recall, it was

never mentioned. Even with yoga's growing popularity, you can't expect the average doctor to know much about it. Does that

mean you should not discuss your yoga practice with your physician? Not necessarily. Knowing when to talk with her about your

practice—and what to talk about—can help you avoid potential physical problems.

The primary reason to communicate with your doctor is safety. If you are young and generally in good health, there is

probably not much you need to discuss. However, if you're pregnant or have a recent acute injury, such as a strained back, a

muscle pull, or a sore shoulder, you should ask your doctor if it's a good idea to restrict your practice for a while.

(Showing her a book that illustrates the postures you typically do can help her make an accurate assessment.)

Although yoga has enormous potential to heal, not all practices are advisable for everyone. For instance, if you are age 45

or older and haven't been exercising regularly, you might want to get a stress test before beginning a Bikram or Power Yoga

practice, since the intensity could precipitate a heart attack. A stress test is even more crucial if you have one or more

risk factors for heart disease—such as smoking, diabetes, high blood pressure, elevated cholesterol, or a strong family

history of premature heart attacks.

Your physician also will want to assess your practice in light of any medications you are taking. Blood thinners, for

example, can make balancing postures risky, since internal bleeding could result if you fall. Other medications, including

antihistamines, drugs to control blood pressure, and psychiatric medications can affect how quickly your blood pressure

corrects itself when you come out of forward bends or other postures in which you quickly lift your head.

Be sure to also mention any inversions you practice, as these may present particular concerns. For instance, if you've had

neck troubles, poses like Sirsasana (Headstand), Sarvangasana (Shoulderstand), and Halasana (Plow Pose) can be problematic.

Going upside down also raises pressure in the head; this can be risky if you have high blood pressure that isn't well

controlled or suffer from eye problems. You should consult an ophthalmologist before attempting inversions if you suffer from

diabetes, glaucoma, or elevated intraocular pressure; have had cataract surgery or problems with your retina; or are severely

nearsighted.

If you practice Pranayama, the major concern is breath retention, which may not be advisable if you have heart disease,

asthma or other lung conditions, or are weak from any disease and its treatment. The same may be true for vigorous breathing

exercises like KapalabhatiPranayama and Bhastrika Pranayama, both of which involve rapid breathing.

Finally, if you're using yoga to help treat a specific health condition, be sure to tell your doctor and mention any benefits

you believe it brings. Not only can this help ensure that you don't do anything dangerous, but it may educate your doctor

about yoga's possible therapeutic benefits. If she sees it's helping you, she might be more inclined to suggest yoga to the

next patient with a similar problem.

Timothy McCall, M.D., is Yoga Journal's medical editor; his column appears regularly in the magazine. His Web site

is www.drmccall.com.