Yoga

Yoga is a set of exercises and breathing techniques that is practised by millions of people around the world. Many people find it useful for stretching their muscles, relaxing and to manage their pain. There is also growing evidence for yoga’s benefits for chronic low back pain and improved balance in older people.

--What is yoga?

Yoga originated in ancient India but has become a popular form of exercise in Western societies. While ancient Indian traditions emphasise spirituality and breathing in addition to the physical aspects of yoga, there is a widespread perception that yoga is simply another way to get moving. In reality, yoga means lots of different things to different people. However, to get all the physical benefits of yoga, it is important to listen to your body. Some element of spirituality is therefore needed!

The poses or physical elements of yoga are known as asana.

The breathing techniques are known as pranayama, and the meditation is called dyana.

Poses can range from those that focus on stretching your muscles to those that build strength. Often the type of yoga will determine whether you do more stretching or more of a physical workout. However, all yoga is beneficial for your fitness, strength and general wellbeing.

Research from 2016 showed one in 10 adult Australians now practise yoga, which is a twofold increase since 2008.

--What are the types of yoga?

There are more than 14 types of yoga, however most of them will feature common asanas (poses) that are simply performed in different styles.

The most common styles of yoga are:

  • Hatha
  • Vinyasa (or flow)
  • Ashtanga
  • Power
  • Bikram (or hot yoga)
  • Iyengar
  • Yin

--Where yoga is practised?

Yoga classes are often held in specific yoga studios, as well as in gyms and community centres. Many people also practise yoga at home with the help of online videos or DVDs. If you’re new to yoga, it’s worth going to a class with a qualified instructor before you try it at home.

Most classes run for an hour or an hour and a half.

The cost to attend a class varies depending on where you live, the setting in which the class is held and the class size, but you can expect to pay between $10 and $25 per class.

--Who teaches it?

Yoga teachers that are registered with Yoga Australia must have undergone at least 200 hours of training before they can teach classes. Many courses involve 350 hours or more of training.

You can check your yoga teacher’s qualifications and experience via Yoga Australia’s database of yoga teachers.

--What does yoga have to do with physiotherapy?

With yoga’s focus on whole body wellness, preventive health and a combination of stretching and strengthening, it has some overlap with the principles of physiotherapy.

Physiotherapists prescribe exercise for the treatment of specific problems and as a general part of maintaining your health and preventing disease. Your physiotherapist will often encourage you to find some exercise that you enjoy so that you’re more likely to continue doing it on a regular basis in the long-term.

For many people, yoga is it! The various types of yoga and the inbuilt scope to progress at your own pace, meeting goals that you set, make it a great option for all different ages and levels of fitness.

Many physiotherapists are also taking note of the research linking yoga to pain management and other conditions like asthma or falls in older people.

However, it’s important to remember that physiotherapists have undergone many years of training in the movement and functions of the body. If you’re thinking about trying yoga for a specific health condition such as low back pain, you should always be cautious about taking the advice of a yoga teacher who may not be as knowledgeable about what could aggravate your condition. Many yoga teachers will encourage you to speak to your health professional in these circumstances.

--How do I know if I should do yoga?

Many different people practise yoga, either attending classes or doing it at home. The variety of yoga styles makes it easy to find a good fit for you. However, it’s worth speaking to an instructor about how they run their class if you’re unsure whether it’s right for you.

Some people try a few different classes, instructors or studios before they settle on one that suits them.

People find yoga beneficial for:

  • flexibility
  • muscle tone and strength
  • balance
  • posture
  • circulatory and cardiorespiratory health
  • mental health
  • sleep
  • energy levels
  • chronic pain
  • reducing injury
  • improving athletic performance
  • relaxation

Note that most yoga instructors recommend regular attendance to notice the benefits of yoga and to see improvements in your asanas.

--When should I avoid yoga?

There are a few rare occasions when avoiding yoga completely is advised. Most of the time you can simply modify your poses to suit you or the condition you’re in, but it’s best to avoid yoga until you’ve spoken to a health professional if:

  • you’ve just had surgery
  • you have a recent injury that is still causing you pain
  • you’re pregnant
  • you have a chronic pain condition.

Your health professional will advise you whether it’s safe to do yoga or if there are any poses to avoid.

A teacher can assist you with modifying poses during the class if need be.

--How can yoga help with low back pain?

There is a small but growing body of clinical evidence to support the use of yoga for chronic low back pain. The type of yoga that’s been evaluated has included Iyengar and Viniyoga (also referred to as hatha yoga).

The gentle stretches and gradual strengthening of your core that occurs in yoga may have some benefits for your low back pain.

Yoga may be helpful for the pain you experience, your ability to complete certain tasks, or both.

--How effective is yoga for low back pain?

A large 2013 review of 10 randomised control trials found that there was strong evidence for the short-term effectiveness of yoga on pain and disability in those with low back pain. Over the long-term, yoga was shown to be highly effective on pain but moderately effective for disability. The review covered close to 1000 patients and included many different types of yoga. This review also found that yoga is mostly safe for those with low back pain.

It’s important to note that a 2015 systematic review found only short-term effectiveness for back and neck pain using Iyengar yoga.

The difference in results between the two reviews could be due to the fact that back and neck pain were examined together in the 2015 review, whereas the 2013 review focused solely on low back pain.

The most important thing to remember is that managing your pain is often about finding a routine that works for you. If yoga is part of a helpful routine, you should continue practising it safely, ensuring that you listen to your body.

--How can yoga help with balance in older people?

There’s some limited evidence that yoga can help to improve balance among older people. Balance is important because it’s associated with helping to prevent falls. While falls are not a normal feature of ageing, they can be detrimental to older people’s health, wellbeing and independence, so preventing them is worthwhile.

Balance may be improved by yoga’s effects on the awareness of your posture and where your body is in space (proprioception), alongside the improvements in muscle strength gained from yoga asanas.

--How effective is yoga for balance in older people?

Several studies have examined the benefits of yoga classes for older people. One found that beginners who attended Iyengar yoga twice a week for 12 weeks showed noticeable improvement in their balance on one leg as well as other measures that have been linked with falls. The people involved were relatively healthy and independent (ie, they lived at home). A positive side-effect was the enjoyment the people got out of participating in yoga. Yoga could therefore be a more successful option for exercise programs with older people, given people’s enjoyment of the activity.

Another review of many different types of exercise, including yoga, found that any exercise that older people participated in had a small to moderate effect on their fear of falling.

However, all of these results should be interpreted with caution as the quality of some studies has been questioned by researchers and there is an identified need for more study into this area.

--What can I do at home?

While there are many online yoga videos and DVDs available for people to practise at home, it’s much safer and more beneficial for beginners to attend some classes first. Often your teacher can work with you on your poses and breathing while you’re learning.

However, going away to practise at home will have huge benefits for your yoga practice, so it’s worthwhile incorporating some time for yoga into your routine if you don’t want to attend several classes each week.

Many people find particular yoga poses are useful for relaxation, stretching certain muscles, or releasing tension as part of their daily routine. In the morning or when you get home from work, you could perform some of your favourite poses. Take care to warm up and ensure you’re focused when you’re doing yoga, otherwise you might risk injury.

--How long until I’ll see results?

If you’re trying yoga as a solution for a specific problem, it’s worth remembering that many clinical studies evaluate people after completion of 12 weeks of yoga performed at least twice a week.

Like many forms of exercise, doing yoga regularly (2 to 3 times each week) over several months (3 to 6 months) is the most likely way to see improvements in your strength and flexibility. However, many people immediately notice the mental benefits of taking an hour out of their day to relax and be aware of their body.

Clinical content reviewed by APA physiotherapist Janice Moore