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Yoga Therapy: The Next Wave in Yoga

by Nora Isaacs

It started with a pop. This was the sound of Harvey LeSure’s disk rupturing, and the beginning of months of excruciating pain in his back and running down his leg.

Soon the formerly athletic LeSure, a 57-year-old social worker from Bellevue, Wash., couldn’t walk more than a hundred yards. Two surgeries and lots of painkillers later, LeSure realized that he needed to find the cause of his problem — and do something to prevent it from happening again. He found yoga therapist Robin Rothenberg, who runs The Yoga Barn in Issaquah, Wash.

At his first 90-minute private visit, Rothenberg learned LeSure’s health history and observed his gait and posture. After determining that habitual off-kilter body mechanics had led to his ruptured disk, she taught him a sequence of yoga poses, breathing exercises, and meditation techniques over an eight week course.

LeSure’s pain disappeared. Today he’s training to walk the Seattle Marathon. “It’s astounding to me,” LeSure says.

Many people start yoga because of an injury. But the average yoga teacher doesn’t have much background in advanced anatomy, or the time to address individual problems in a packed power yoga class.

The therapist will see you now.

An emerging field in America, yoga therapy hovers somewhere between a doctor’s visit and a stretching class. Yoga therapists work in small groups or private sessions, addressing specific health problems and adapting poses accordingly. A steady stream of interest has become a flood: According to the trade group International Association of Yoga Therapists (IAYT), membership has more than tripled in the last three years, and the number of schools offering training has doubled over the past two years.

“Yoga therapy is really just blossoming,” says Larry Payne, Ph.D., a yoga therapist since 1982 and founder of Samata Yoga. “It’s the next great thing in yoga.”

Modern yoga therapy can be traced back to the yoga master T. Krishnamacharya, who produced students that became the West’s most influential teachers of therapeutic yoga, including his son TKV Desikachar and BKS Iyengar.

Many have since used yoga for managing high blood pressure, coping with the effects of cancer treatments, or treating symptoms of HIV, depression, or anxiety. But lately it’s become especially popular for musculoskeletal issues like lower and upper back pain, sciatica, and shoulder, neck and hip pain.

Physical therapists use many methods, from targeted stretches to deep tissue massage; exercises with a Theraband, foam noodles, belts, physioballs, bobbleboards, Bosu Balls, or a wall; and heat and/or ice therapy at home. After a physical therapy session, you’ll usually leave with a photocopied sheet of exercises.

A yoga therapist works primarily with yoga moves, and clients typically leave with instructions on a custom series of poses that change each week according to the student’s progress.

Yoga therapy advocates believe that since yoga is a holistic discipline — teaching that the mind, body, and spirit are connected — yoga therapy can go beyond the results that are possible with physical therapy.

“Yoga therapy is very much about the whole person,” says Janice Gates, president of the International Association of Yoga Therapists and author of Yogini. “It is complementary to physical therapy, but we take into account that back pain may be related to an emotional element, or it may be from lifestyle, some pattern that is not serving them, physical movement patterns or other patterns.”

What are a yoga therapist’s credentials?

“Anybody can hang their shingle and say they are a yoga therapist,” says Julie Gudmestad, a yoga and physical therapist in Portland, Ore. Indeed, yoga therapy encompasses many different schools, teachers and ideologies. Many yoga therapists are licensed physical therapists or nurses, or have advanced training in Iyengar yoga. Some use the title CYT, certified yoga therapist, after graduating from a yoga therapy teacher training program such as Integrative Yoga Therapy. Others are yoga teachers who declare themselves yoga therapists.

“Buyer beware,” says Gudmestad. “I’ve seen some strange things done in the name of yoga therapy.”

It’s this minority that worries some healthcare professionals. Inexperienced teachers who lack the ability to correctly diagnose a problem are the biggest danger, according to physical therapist Robert Forster in Santa Monica, Calif.

“I have patients who say, ‘My yoga teacher told me to push through the pain,’” says Forster. “Often that’s the worst thing to do.”

“Everybody should be seen by a medical professional first, without question,” says Leslie Bogart, a Santa Monica yoga therapist with a nursing background.

Do the numbers on yoga therapy add up for you?

Yoga itself is being embraced as a health and wellness practice in America:  Yoga is offered at 93 percent of 755 integrative medical centers, which combine western and alternative healthcare methods, according to Cary Wing, executive director at the Medical Fitness Association in Richmond, Va.

While it’s unclear how many of those centers offer yoga therapy specifically, there is evidence that some yoga poses offer effective treatment for one of the most common complaints that lands patients in physical therapists’ offices: chronic back pain.

In a study reported in the Annals of Internal Medicine in 2005, patients given a sequence of yoga poses by yoga therapist designed by Gary Kraftsow improved more than did patients given a self-care book or sent to exercise class. The National Institute of Health has allocated $1.2 million for a larger follow-up study on yoga therapy’s effectiveness for back pain.

Loren Fishman, M.D., director of the Flushing Department of Physical Medicine and Rehabilitation in New York and coauthor of “Relief is in the Stretch: End Back Pain Through Yoga,” prescribes downward-facing dog for osteoporosis, twisted triangle pose for piriformis syndrome, and side plank pose for scoliosis.

“It calms people down,” Fishman says. “Just being calm is a tremendous asset when you are in pain.”

Fishman believes yoga and western medicine are naturally well matched — and can help patients avoid unnecessary surgery, medication, and suffering.

Bottom line: Ask for references from your yoga therapist and get details on his/her training, credentials and experience with yoga therapy treatment plans for your type of injury or health issue. For help finding a yoga therapist, visit http://www.iayt.org.