PRACTITIONERS GUIDE

A PRACTITIONER’S GUIDE TO YOGA

By Sudhir Daya MCSP, Louise Dawson MSCP RCST IYA

INTRODUCTION The ancient discipline of Yoga is a vast subject and a full exposi- tion of Vedic (ancient Indian) culture would be needed to do it jus- tice. As the onslaught of New Year’s resolutions will be in full swing by the time you receive this issue of sportEX medicine, the aim of this article is to provide you with a concise but comprehensive review from a practitioner’s perspective to arm you with informed advice for the patients and clients that approach you for advice, particularly over the next few weeks. In this article, the authors draw on their experience of physiotherapy and Hatha Yoga, and speak from the interface between the two.

The aims are: ■ To present a broad account of Yoga ■ To provide insight into Yoga for clinicians working in the neuro- musculoskeletal sphere

■ To dispel popular misconceptions of Yoga ■ To stimulate discussion.

Growing numbers of people are accessing Yoga as a form of exercise and stress management. Patients may ask about Yoga and it may indeed be useful as part of the short and long term management of a plethora of neuromusculoskeletal conditions. We believe an under- standing of Yoga will enable the clinician to: ■ Manage a client more holistically ■ Have background knowledge when working with clients who are Yoga practitioners

■ Incorporate Yoga into the rehabilitation programme ■ Provide advice on return to Yoga classes ■ Advise on the prevention of Yoga-related injury.

WHAT IS ‘YOGA’? Classical Yoga is based within a philosophical and spiritual tradition going back thousands of years. It would be an injustice to its authenticity and integrity to reduce it to mere breathing and stretching exercises. ‘Yoga’ is a Sanskrit word that can be translat- ed as ‘to yoke, bind, join, direct and unify’ (1). Thus ‘Yoga’ can mean a practice that unifies mind, body and spirit. It can mean the joining of the individual soul with the universal soul in the lan- guage of Vedic cosmology (2). It is a tool for exploring the depths of our human nature and a process of introversion whereby an inherent peaceful state is accessed and experienced (3).

Within traditional Chinese medicine (TCM), T’ai Chi or Qi Gong can be prescribed as a form of treatment along with acupuncture, herbs and massage techniques. Similarly, Yoga has a place within Ayurveda, the holistic system of medicine indigenous to and wide- ly practiced in India (4, 5). In this system, health is regarded as a state of balance in mind, body and spirit and is achieved through right living. Yogic practices are designed to detoxify the body and calm and focus the mind. Yoga has a spiritual dimension in that its philosophy deals with existential questions, and offers guidelines

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for living in harmony with oneself and the wider world (6). Traditionally Yoga was an ethical, disciplined way of life, taught within the close one-to-one relationship of guru (teacher) and sad- haka (student). The method of teaching, pace of progression and content was thus specific to the individual student.

It could be said that in its voyage from India to the modern west, Yoga has undergone a number of transmutations to appeal to the western appetite. Yoga is now usually taught in class format. Students are also customers, rather than disciples. It is subject to the changing fortunes of fashion. Currently, a common misconcep- tion may be that Yoga is exclusively about stretching, breathing and relaxing.

HATHA YOGA Several distinct categories of Yoga exist (1) and the emphasis in this article is on Hatha Yoga. “Hatha means to stick fast, to be devoted... Yoga means to unite... to join. It also means... fixing the mind on one point, holding the body in a steady posture, contem- plation and meditation.” (7).

Most present-day Hatha Yoga schools are based on a major philo- sophical work, the Yoga Sutras, attributed to the sage Patanjali, who is thought to have lived between 200 and 500 BC. He collated a system from centuries-old oral tradition (3,6). Hathayoga Pradipika, outlines the more practical aspects of Hatha Yoga (7). The word Hatha means ‘force’ (1). The student learns to channel life force (prana) by doing particular practices, categorised as asana, pranayama, dhyana and kriyas (Box 1). These categories are for ease of description only, as in practice and everyday life they are inter- woven.

Asana means pose or posture. Asanas are classified as: ■ Standing poses, including sidebends ■ Forward bends ■ Backbends ■ Twisting poses ■ Inversions ■ Balancing poses (9).

A few points about asana: ■ An asana practice or class usually includes poses from each of the groups outlined above

■ Asanas can be simplified and are taught in graduated stages according to individual capacity

■ Asanas can be practiced one at a time and/or practised in move- ment sequences (vinyasa). An example of vinyasa is the sun salu- tation sequence (Figures 1-12). Asana is thus a static and/or dynamic practice

■ Similar to Pilates, emphasis is placed on relaxation, alignment, co- ordination, centring, breathing, sequencing and lengthening (8)

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