Question

Today is International Day of Yoga -Patients can practice yoga but with precautions

Dr.Sajeev Kumar · Accepted Answer

Yoga is a science, which shifts one from sympathetic to parasympathetic mode. It is a combination of hatha yoga (asanas or postures), breathing and meditation. Meditation means concentrating on the object of concentration and giving preference to the object of concentration over thoughts. Mindfulness meditation, breathing awareness can shift from sympathetic to parasympathetic mode.

Breathing exercises in yoga can be both slow & deep breathing and fast breathing. Kapalbhati and bhastrika are fast breathing exercises.

In modern system of medicine, every movement in an exercise is accompanied by the opposite movement. The same is true for yoga. For every movement, there is a reverse movement.

Often when patients come to us for consultation or follow up, they ask if it is safe for them to do yoga. Yes, patients can do yoga but they should do it under the guidance of a trained yoga instructor. Teaching yoga is the job of an expert. In the hands of an untrained person, yoga may be risky. Also, it is important that patients observe specific precautions pertaining to their illness while doing yoga. They should practice yoga slowly and take care to not overdo any asana and avoid some postures that may aggravate their health problems

Here are some precautions, which patients should follow while doing yoga:
Yoga is not included as an aerobic exercise.
Fast breathing exercises stimulate the sympathetic system. Slow breathing stimulates the parasympathetic system. Therefore, cardiac clearance needs to be taken for all breathing exercises.
In three situations in hatha yoga (headstand, handstand, shoulderstand), the total body weight is put on head, wrist and shoulder. This requires medical clearance, especially for heart patients.
When you get up from a sitting position, nine times weight is put on the knees. Hence, patients of osteoarthritis should avoid sitting down, low height bed or chair or indian toilets. Yoga may prevent osteoarthritis, but once developed, hatha yoga practices need to be modified.
The lotus position, forward and backward bends need orthopedic clearance in selected patients.
Forward spine exercises may require orthopedic clearance in selected cases as they may precipitate sciatica, if done incorrectly.
Painful and/or difficult yoga postures should be avoided
Patients with cervical disc disease, glaucoma should avoid doing inversion postures (head stand, shoulder stand).
In case of worsening pain or paresthesia, stop and consult a doctor.

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