Health benefits
Research on yoga’s benefits helps Western medicine loosen up WHEN YOGA HURTS
After a sudden move during a tennis match triggered a slipped disc in his back, Dr. Raza Awan found himself in excruciating pain. It radiated from his lower back down his left leg.
Awan, a rehabilitation medicine specialist, sought help from the city’s best physiotherapist, chiropractor, osteopath, acupuncturist and massage therapist. Nothing worked.
“I was desperate,” he says, recalling the injury eight years ago. “I even went to a woman who was humming on my chest.”
Doctors wanted to operate, but Awan refused.
On the suggestion of a patient, he tried Pilates and yoga.
Finally, he found relief. Pilates treated the sciatica and yoga eased chronic neck pain from years of playing sports and sitting in front of a computer.
The experience changed how he practises medicine.
He’s proof, he says, that when doctors get injured, they become better doctors.
Awan, now the medical director of Synergy Sports Medicine and Rehabilitation, has designed a rehab model that incorporates yoga and Pilates.
The sports medicine clinic is among Toronto’s first to fully integrate yoga into its rehab model — something that would’ve been seen as “unorthodox” a decade ago, Awan says.
Now, more than 250 doctors refer people to his clinic, including neurologists whose patients have severe headaches triggered by neck pain.
Western medicine has loosened up, with a growing number of doctors prescribing yoga to ease and treat illness and prevent injury.
The increase has happened as the sciencific evidence continues to mount showing the health benefits of yoga.
Many of the studies are pilot studies with small sample sizes. Experts say more randomized controlled
“Yoga improves mood. The ladies come in, and they are obviously sad and tired and worn out. And I can give them some pleasure and joy — that’s beautiful to watch.” KATHY FELKAI YOGA TEACHER
trials, the gold standard in research, are needed. But still, the research is compelling.
Yoga is prescribed for musculoskeletal disorders, such as carpal tunnel syndrome, osteoporosis, arthritis and back pain.
It helps those living with chronic conditions such as HIV and cancer better cope with the disease. And for those with multiple sclerosis or Parkinson’s disease, it can ease chronic pain, reduce blood pressure and improve posture and balance. The proven mood booster and stress reliever is also used to treat psychological issues, such as anxiety and depression, and to help fight addiction.
Research even suggests yoga’s stress-busting capabilities can slow the biological clock on a cellular level, according to The Science of Yoga: The Risks and the Rewards by U.S. science writer William Broad. Scientists have discovered telomeres, which sit at the ends of chromosomes, get shorter as cells divide and age. One thing that erodes telomeres is stress.
Broad, a Pulitzer Prize-winning journalist at the New York Times, notes yoga’s flexing poses and slow breathing stimulate the vagus, one of the most important nerves in the body.
The nerve regulates the body’s immune system and its response in fighting illness, including inflammation.
He also addresses the benefits of yoga in fighting heart disease, saying studies show those who practice report fewer visits to hospital, less need for drug therapy and fewer coronary events.
Dr. Awan recommends yoga as a sort of preventive medicine, saying patients of his who are weightlifters and runners report less injury. Even medical schools are taking note, says Awan. When he was in school — he graduated from the University of Toronto in 1995 and completed residency training at the Mayo Clinic in 2000 — students weren’t introduced to yoga as a therapeutic option. Today, he says, medical schools offer courses on complementary medicine that include acupuncture, naturopathy, homeopathy and yoga. Yoga teacher Kathy Felkai says “the medical profession is now listening.” To illustrate this point, she notes she was invited last year by The Canadian Pain Society to speak at its annual chronic-pain refresher course on the benefits of yoga. Felkai began practising yoga after being diagnosed with chronic fatigue syndrome and fibromyalgia around 2000. Her recovery motivated her to teach therapeutic Hatha yoga. She now teaches at Mount Sinai Hospital’s Marvelle Koffler Breast Centre and the Wasser Pain Management Centre, as part of its cognitive behavioural therapy program. Her students have included breast cancer survivors, those with spinal injuries and people suffering from severe arthritis. “(Yoga) gives them the tool to cope with whatever they have to cope with physically, emotionally and mentally,” says Felkai, who also runs a yoga class for hospital staff — half of whom attend because they have health problems. For breast cancer survivors, yoga relieves anxiety and helps them get through treatments, she says. It also alleviates muscle and joint tightness and eases tension in areas where they’ve undergone surgery. “And it improves mood,” says Felkai. “The ladies come in, and they are obviously sad and tired and worn out. And I can give them some pleasure and joy — that’s beautiful to watch.” Western medicine, she says, cannot link body, mind and spirit the way yoga does. Restoring that link is key to overcoming addiction, because addicts tend to be restless and live in their heads, disconnected from their bodies. When Dr. Gabor Maté was the physician at Vancouver’s Onsite detox facility, located above the supervised drug-injection clinic Insite, volunteers taught yoga to addicts. “They loved that calmness, that contact with themselves that they were gaining for the first time,” says Maté, author of In the Realm of Hungry Ghosts: Close Encounters with Addiction. Maté is now collaborating with naturopathic doctor Sat Dharam Kaur to teach Kundalini yoga techniques as part of addiction recovery. The five-weekend program, Beyond Addiction: The Yogic Path to Recovery, starts April 6 and 7, with Maté speaking at the University of Toronto’s Hart House. “Yoga puts you in touch with your body,” says Maté. “It puts you in touch with the part of you . . . that was there before the addictions even arose.” And, he says, yoga promotes a “calmer state of mind that actually allows you to be with your pain rather than escape it . . . That’s when the healing happens.” Yoga heals. But it can also harm.
That’s why Raza Awan, a sports medicine doctor, and Riki Richter, a Pilates and yoga instructor, created a yoga injury prevention workshop for teachers and studio owners.
The idea came after the duo, who co-own and run Synergy Sports Medicine and Rehabilitation, noticed yoga-related injuries at their Toronto clinic, near Lansdowne Ave. and Bloor St. W.
They wanted to show practitioners the more common injuries — rotator cuff, cervical disc, lower back, wrist, hamstring and knee — and how to prevent them.
The benefits of yoga outweigh the risks, but awareness of its potential dangers is needed, especially since the yoga community hasn’t traditionally tracked injuries.
“We need dialogue (with the community) because (yoga) is growing in popularity,” says Awan. “And there are going to be injuries.”
Yoga poses can cause injuries or exacerbate existing conditions. Often injuries are linked to a sudden spike in activity, such as teacher trainings, weekend workshops and retreats. Since most are the result of repetitive strain, people can hurt themselves when they increase activity level.
Damage to the rotator cuff results from weight put on the arms and can be brought on during poses such as plank, chaturanga, handstand and arm balances. Cervical disc issues occur from extending and flexing the head and compressing the neck. Poses that can result in injury include camel, upward dog, cobra, plow, headstand and shoulder stand.
Lower back pain is common because of extreme forward and backward bends. Weight-bearing poses such crane and downward dog can hurt the wrist; standing or seated forward bends can injure the hamstring; and twisting and hyper flexing during warrior, hero and pigeon can damage the knee.
American science writer William Broad, also a longtime practitioner, explores the dark side of yoga in his 2012 book The Science of Yoga: The Risks and the Rewards.
One of the biggest myths about yoga is that it’s safe, says the New
York Times writer. Some poses have caused nerve damage resulting in disabilities that range from relatively mild to permanent. And although rare, some poses restrict blood flow to the brain, which can cause a stroke and result in death, he says.
“Yoga can kill and maim — or save your life and make you feel like a god,” writes the Pulitzer Prize-winning author. “That’s quite a range.”