Overview

What Is It?

Yoga is a physical and mental practice that involves the body, mind and spirit. The practice, which originated in India, is designed to enhance awareness, create a mind-body-spirit balance, cleanse, heal and strengthen the body, liberate the true self and, as practiced today, improve fitness. The most common form practiced in the United States is hatha yoga, which includes specific movements or postures (asana) and various breathing techniques (pranayama) and is often complimented with meditation (dhyana).

Yoga's gentle, mindful and controlled movements can provide a non- or low-impact workout for people in almost any physical condition. Yogic exercises—and there are many—can ease tense muscles, improve flexibility and enhance strength, balance and endurance. Poses, breathing practices and meditation can also increase concentration, reduce stress and, among other therapeutic benefits, relieve back pain.

No one seems quite sure when yoga began, but it goes back thousands of years. Stone carvings in the Indus Valley depicting yoga positions date back 5,000-plus years.

Traditionally, yoga was a spiritual practice, its goal being union with the absolute or the divine. The various exercises we associate with hatha yoga were performed to prepare the body for long periods of meditation. The word "yoga" means to join or bind together, and the practice joins together the body, mind and spirit. On a spiritual level, it can refer to the union of the individual with the absolute truth or true self (Atman). It's often associated with Hinduism, but yoga predates the religion. Hinduism has incorporated elements of yoga into its practices, as have other religions.

As it's typically practiced in the West, the focus of yoga is more on the physical fitness aspects. Of course, it can be a spiritual experience, if you choose to use it as such.

Yoga is now practiced around the world for its psychological, physical and spiritual benefits. Americans have practiced it for more than 100 years, but it gained popularity in the 1960s as young people developed a taste for all things Eastern. According to results of a 2012 survey conducted by Sports Marketing Surveys USA on behalf of Yoga Journal, 20.4 million Americans, or 8.7 percent of U.S. adults, are believed to practice yoga.

Although this report focuses on hatha, here are some other traditional types of yoga:

• Raja: Called the "royal road," its focus is primarily on meditation; it incorporates exercise and breathing practice with meditation and study.
• Jnana: Called the path of knowledge or wisdom, it is the path of yoga that uses the mind to get beyond the mind by asking questions such as, "Who am I?" "What is reality?" and "What is permanent and unchanging?
• Bhakti: The path of love and devotion focuses on devotion to and concentration on the guru or chosen deity and often includes chanting.
• Karma: In the yogic system of action and service, everything (including the yoga postures) is done with the mind centered on the divine; activities are done selflessly for the greater good.
• Tantra: The path of ritual, it's based on the principle of consciously embracing the whole of life to unite with deity. It uses the energies of the body— including sexual—to transcend worldly attachments.

There also are many contemporary styles of yoga, most of which are variations of hatha yoga. All yoga styles seek balance of body, mind and spirit, but they may differ in how the asanas are done and in other ways, such as the focus on postures, alignment, flow of movement or breathing. Some may be designed to suit particular groups, such as pregnant women or older people, while others may use props or vary temperature.

Many websites offer detailed descriptions of the styles available; www.yogiseeker.com lists nearly two dozen traditional styles, 42 contemporary styles, and 10 others. The site www.yogamovement.com takes an objective and instructive approach to yoga and may be a good place for beginners to start.

Do your research and visit some classes if possible to decide which style and teacher best suits your needs. A few examples of some of the more popular modern yoga styles are:

• Ananda: Emphasizes meditation through breath awareness, affirmations and yoga postures. Its distinct feature is the use of affirmations while in the postures.
• Anusara: Means "following your heart" and respects each student's abilities and limitations. It integrates the celebration of the heart, principles of alignment and balanced energetic actions in performance of the postures.
• Ashtanga: Sometimes known in the United States as power yoga. It's a fast-paced, physically demanding series of postures designed to create heat and energy flow.
• Bikram: Sometimes known as hot yoga. This form consists of a series of 26 postures and two breathing exercises performed vigorously in a studio heated to 105 degrees with 40 percent humidity.
• Forrest: Intense long-held poses designed to develop skills in awakening the senses. It uses heat, deep breathing and vigorous sequences to sweat out toxins, while also focusing on strengthening and centering your core.
• Integral: Focuses on the healing power of relaxation. This form emphasizes control of breath and meditation almost as much as the postures.
• Iyengar: Uses props such as straps, blankets, wooden blocks and chairs to achieve postures that focus on symmetry and alignment. Poses are usually held longer than in most other yoga styles.
• Jivamukti: Uses vigorous poses in a flowing series while incorporating a variety of ancient and modern spiritual teachings. Classes provide a "yoga education" with chanting, meditation, readings, music and affirmations.
• Kripalu: Emphasizes proper breath, alignment, coordinating breath and movement and honoring the body's wisdom. It involves three stages, the final one being surrendering to the body's wisdom, by which time the student should be able to do the postures spontaneously and unconsciously.
• Kundalini: Designed to awaken kundalini energy, which is stored at the base of the spine and is often depicted as a coiled snake. The emphasis is on chanting and breathing, rather than postures.
• Sivananda: Takes a gentle approach that includes postures, chanting, meditation and deep relaxation in each session. Students are encouraged to lead a healthy lifestyle that includes a vegetarian diet.
• TriYoga: A systematic flowing yoga with an emphasis on the wave-like movement through the spine and on maintaining alignment through meditative transitions. Practices include basics through advanced asana, pranayama and meditation techniques.
• Viniyoga: A gentle flowing form of yoga that emphasizes coordinating breath with movement. It is often used with beginners and in therapeutic settings.
• Vinyasa: A general term referring to many styles of yoga that use a series of flowing postures combined with rhythmic breathing for an intense body-mind workout. It doesn't adhere to a specific sequence of poses, but is usually based on a series of postures that together are known as sun salutations.

Is It Right For You?

Yoga is both gentle enough and athletic enough to appeal to many people. The beauty of yoga is that you don't have to be able to do all the positions; you can work within your own limitations and tailor your practice to your specific needs.

If you decide to try yoga, finding a teacher won't be hard. Classes are available through recreation centers, senior centers, YMCAs, YWCAs, hospitals, health centers, community centers, meditation centers and dedicated yoga studios. Many classes are relatively inexpensive—they may even be free with your membership at a gym, community center, etc. And check your health plan; some insurance companies cover the cost of classes.

Ask your regular health care professional for suggestions. He or she may know of a yoga class that meets your particular needs. There are also resources on the Web for finding classes, including www.yogafinder.com and the Yoga Journal online directory at www.yogajournal.com.

You can take individual lessons, too, but they will be more costly. Whether you decide to learn in a class or one-on-one, try to do so in person. Books, tapes and DVDs abound, but ideally, they should supplement what you learn from class, and they can help you as you establish your practice at home.

Before your first class, consider sitting in on a session, if this is permitted. Would you be comfortable in the class with this teacher? Is the pacing right for you? Make sure you find a class and teacher that feel right for you. If you have a particular medical condition, make sure the instructor has experience dealing with other folks in your situation. And once you find a teacher you like, be sure you tell him or her about any health problems.

Be advised, however, that there's no licensing requirement to teach yoga, and many teachers may have done little more than complete a weekend training or correspondence course. If a yoga teacher is untrained, you may be at a higher risk of sustaining an injury in his or her class. A teacher-organized group called Yoga Alliance (www.yogaalliance.org) recommends 200 to 500 hours of expert training. Teachers who complete the recommended training can register with the Yoga Alliance, which provides an online directory of teachers. If you have a special need, the International Association of Yoga Therapists (www.iayt.org) can help you find a specialist.

Health Benefits

Yoga's most obvious benefits relate to stress reduction, flexibility and relaxation. But as more studies are conducted, there is evidence of other tangible health benefits. While it's no cure, yoga can be an effective adjunct therapy for a variety of conditions, including cancer, heart disease, arthritis, asthma, diabetes, depression, fibromyalgia and migraines. Even if you are in perfect health, you can benefit from yoga. It improves strength, flexibility, coordination and range of motion. And since yoga promotes relaxation, improves circulation and reduces stress and anxiety, it enhances cardiovascular health and benefits the respiratory and nervous systems. Because it promotes relaxation, yoga also aids sleep and digestion.

Yoga can make you more aware of your own body—more conscious of its strengths, weaknesses and needs.

Medical experts aren't exactly sure why yoga offers so many health benefits, but more studies are under way. Some of its physiological effects can be attributed to stress reduction and relaxation; since many health problems are triggered or aggravated by stress, stress-reduction can only help. And when you do yoga, especially meditation and breathing exercises, you often induce what is known as the relaxation-response, a stress-neutralizing physiological state that boasts a wide range of physical and mental benefits.

Yoga requires no special equipment or clothes, though an inexpensive yoga mat may help provide cushion and grip. You can do the exercises at home or at the office. If you have limited mobility, you can even do them from a chair or bed.

Here's a look at how yoga can improve some specific conditions affecting women. As always, consult with your health care professional before beginning any new exercise program.

Arthritis and fibromyalgia. Yoga may ease the pain associated with these conditions, and there are classes designed specifically for people with arthritis or fibromyalgia. Few studies have been done, but anecdotal evidence indicates that arthritis sufferers find relief from yoga. A Stanford University study suggests that mind-body techniques (including yoga) are effective complementary therapies for musculoskeletal disorders, including osteoarthritis. For both arthritis and fibromyalgia, the stretching can temporarily relieve stiff joints, improve flexibility and circulation and stimulate the release of endorphins. The deep breathing and meditative aspects can help you deal with the stress of illness, especially something as frustrating as fibromyalgia.

Asthma. The breathing exercises that are an integral part of yoga seem to give some people an element of control over their breathing, thus reducing the symptoms of asthma. It also strengthens the respiratory system.

Back pain. Yoga can provide temporary relief from back pain. It can also help you avoid certain kinds of back pain by making your back and abdominal muscles stronger. Yoga stretches and strengthens back muscles; yoga and physical therapy use some similar movements. Some postures strengthen abdominal muscles, which help support the back. Moreover, through regular practice, yoga will help you learn to spot potential trouble spots. For instance, you may be able to identify tense muscles and relax them before they become tight and sore. Alignment yoga can help realign posture, diminishing the chance of reinjury both in yoga classes and in daily life. It can also offer relief from nerve compression, which can cause back pain and sciatica.

Carpal tunnel syndrome. Research indicates that yoga is an effective treatment for this repetitive stress injury. One study, reported in the Journal of the American Medical Association, revealed that carpal tunnel sufferers who regularly attended yoga classes experienced less pain, greater flexibility and a stronger grip than those who used the usual treatment, a wrist splint.

Endometriosis. Yoga, like some other relaxation and meditative techniques, seems to provide some women with relief from the pain associated with endometriosis.

Epilepsy. Some studies suggest that yoga may help patients manage epilepsy. It may come down to stress reduction; stress can be a precipitating factor for some seizures, and yoga promotes relaxation and stress reduction. But researchers haven't drawn any conclusions yet, contending that more studies are needed.

Chronic pain. Yoga and other relaxation techniques have been shown to help reduce chronic pain. They are especially effective for chronic headache and muscle tension.

Diabetes. Yoga is well suited for diabetics in that it improves circulation and promotes a regular exercise regimen.

Heart/coronary artery disease. Yoga improves circulation and, as a stress-reducing or stress-management technique, it may play a role in halting or reversing heart disease. Health care professionals often recommend yoga or something similar for their heart patients.

High blood pressure. Evidence suggests that yoga reduces stress and increases relaxation, which may have a favorable effect on blood pressure rates. And there are studies suggesting that yoga may be effective in controlling hypertension, but more research needs to be done.

Menopause. Yogic breathing techniques seem to help some women reduce hot flashes and other symptoms. And according to the American Yoga Association, some yogic exercises stimulate the glandular and reproductive systems, helping balance body chemistry.

Insomnia. According to the National Institutes of Health, relaxation therapies and physical exercise, including yoga, can help alleviate insomnia.

Multiple sclerosis. Yoga may help women with MS to increase physical functioning. Some chapters of the National Multiple Sclerosis Society offer yoga classes, and there are specialists in yoga for MS around the country.

Osteoporosis. Since yoga is a low-to-no-impact exercise, some of the gentler postures may be appropriate even if you already have the condition; yoga may help lessen the pain associated with osteoporosis. Certain poses that position part of the body's weight on the hands may also aid in retaining bone density in the upper extremities and spine. Care must be taken, however, to avoid excessive pressure or range of motion, such as spinal extension. Each woman's condition varies.

Premenstrual syndrome and menstrual cramps. Yoga, when practiced regularly, can reduce symptoms of severe PMS, including anxiety and depression in some women. Some postures can reduce pressure on the uterus, relieving cramps, and yoga's gentle stretching can ease stiffness and tension in the lower back. According to the American Yoga Association, irritability, depression and moodiness can be eased by regular meditation, which is a part of many yogic practices. The association also explains that some yogic exercises stimulate the glandular and reproductive systems, helping balance body chemistry. And, of course, a regular exercise program of any sort helps lessen the severity of cramps for many women.

Pregnancy. Prenatal yoga classes are generally gentler than regular classes, and there's a greater focus on breathing and relaxation. Mild-to-moderate exercise during pregnancy is important for both you and your baby, and yoga's gentle, relaxing movements may be ideal. And it can help you deal better with the stress associated with pregnancy. Consider looking for a course designed for pregnant women, and talk to your health care professional before starting any exercise program. Some methods and teachers caution that women who are pregnant or breastfeeding focus on breathing and meditation exercises rather than the more strenuous yoga poses, particularly cautioning against inverted poses for pregnant women. However, many serious yoga schools offer women's classes with modified, supported poses that may bring strength, confidence, rest and relief to pregnant and nursing women. Yoga Alliance requires at least 85 hours of specialized training for prenatal yoga instructors.

Treatment

If you have a medical condition for which you are receiving treatment, yoga should be considered an additional therapy, not a replacement. Talk to your health care professional if you have arthritis, multiple sclerosis, fibromyalgia or other serious medical conditions. Many places offer special classes designed just for people with these conditions.

Even if you don't need a specialized class, you need to be aware of certain warnings before starting a class. For instance, high blood pressure, glaucoma or a history of retinal detachment or heart disease may mean that you should not perform certain exercises or positions (the ones that turn you upside down, like a handstand). Again, talk to your health care professional first.

For the vast majority of women, yoga is an ideal way to improve overall health. It requires little advance preparation, so once you find a class, you can jump right in.

What To Expect

Wait at least two hours after eating before starting your yoga workout. Don't worry about the "proper" outfit. Wear something comfortable that will allow you to move—leotards or yoga pants are good choices, but you can wear a T-shirt and shorts, too. Some instructors may not want you to wear baggy clothes because they want to be able to watch your form as you practice the postures. Also, baggy tops tend to fall up over the head during semi-inverted poses. Most people practice yoga in their bare feet.

The session will probably start with gentle warm-up exercises, probably a series of breathing exercises and gentle stretches. From there, the instructor will take you through several postures (asanas). You may hold these positions for a few seconds or a few minutes. Depending on the specific posture, you will start from a seated, standing or prone position.

You may already know some of these movements—for example, the cross-legged seated Lotus position. Others will feel like the shoulder rolls or stretches you may already do. Some will be unfamiliar, though.

Don't worry if you can't do each posture perfectly—as long as you keep it safe and mindful, the pose is always perfect. Yoga is about the process itself. You don't have to do everything the class does. Go at your own pace. Eventually, you will perfect your form. Remember, the point isn't to push beyond your limits.

During the process, be sure to breathe slowly and deeply from your diaphragm and move gently. Take breaks as often as you like, and never do anything that causes any genuine pain or discomfort.

Most yoga classes will end with a final relaxation or "corpse pose." There may also be a short meditation.

Classes generally last 60 to 90 minutes, and you may attend class once or several times a week. It's important to develop a daily practice. This means doing yoga on days you aren't in class—shoot for about 30 minutes. If that sounds daunting, start with five or 10 minutes and work up. If your schedule doesn't allow for daily practice, try for four times a week for about 45 minutes.

Aside from your regular practice, you can work on some of the seated postures during the day while at the computer. And you can practice the deep, diaphragm-based breathing techniques anywhere.

The time of day you practice depends not only on your schedule, but on your goals. In the morning, a yoga routine may energize you and prepare you for the day. That's the preferred time of day for many folks. In the evening, relaxing poses can lead to better sleep.

Many yoga classes offer a gentler workout. While yoga is not like an aerobics class, it will still be challenging. There is a great increase, too, in the number of physically strenuous, faster-paced classes on schedules these days. Regardless of which experience you choose, when you finish, you shouldn't feel exhausted. You should feel refreshed, relaxed and energized.

There are no negative side effects to yoga, but as with any exercise program, it's always possible to hurt yourself, especially if you try to explore advanced postures before you are ready. While you are practicing yoga, always listen and respond to what your body is telling you. One of the fundamental concepts in yoga is nonviolence or "ahimsa," and it begins with the self. This mindfulness will help you reduce the chances of injury, and it's really at the heart of yoga.

At first, it's natural to feel a little sore, especially if you haven't been exercising lately. But if the soreness is severe or persists, talk to your instructor. If you feel pain in your joints, talk to your instructor right away. A reasonable amount of muscle soreness is normal; joint pain is not. If the joint pain persists, talk with your regular health care professional.

It's always advisable to check with your health care professional before embarking on any exercise program, particularly if you are out of shape, over 65 or have serious health problems. You definitely need to do so if you have high blood pressure, glaucoma, arthritis (particularly rheumatoid arthritis), spinal disk injuries, a history of retinal detachment or heart disease, or if you are pregnant. And be sure to inform the yoga instructor, too. If you have any of these conditions, it may be a good idea to begin your journey with one or more private sessions so you can better understand how to tailor the practice to accommodate your needs.

You may notice that your general health improves as you continue to make yoga a regular part of your life. But no matter how good you feel, don't stop your regular treatments. Continue to take any prescribed medications until your health care professional advises otherwise.

Facts to Know

1. Yoga has been practiced in the United States since the late 19th century, but it gained popularity in the 1960s.
2. According to results of a 2012 survey conducted by Sports Marketing Surveys USA on behalf of Yoga Journal, 20.4 million Americans, or 8.7 percent of U.S. adults, are believed to practice yoga.
3. Yoga has been proven to reduce stress and anxiety; accordingly, it is often recommended to relieve the pain and anxiety of chronic conditions.
4. Yoga is thousands of years old. Stone carvings in the Indus Valley depicting yoga positions date back 5,000-plus years.
5. During your practice, focus on your breathing as well as the positions and stretching of the yogic postures. Breathing is as important a part of yoga as the stretching.
6. A fundamental tenet of yoga is that the body, mind and spirit are inexorably connected and need to be in a state of balance.
7. You can work on some of the techniques throughout the day—seated at your desk, in your car, even at the computer.
8. Since yoga involves weight-bearing postures, the practice is especially beneficial to your musculoskeletal system and may help prevent osteoporosis. It also benefits the organs of the body through the compression and expansion of the abdomen and inversions and rotation of the body in relation to gravity.
9. Yoga is not a religion, but many of its elements are incorporated into various religious traditions. Practicing yoga won't interfere with your religious practice—and it might enhance it.
10. Even within hatha yoga, there are various styles and approaches. When looking for a yoga teacher, it's helpful to check out different classes to find the one best suited to your needs.

Questions to Ask

Review the following Questions to Ask about yoga so you're prepared to discuss this important health issue with your health care professional.

1. Where did you learn to teach yoga? Are you certified? Do you have references?
2. May I try out a class before signing up?
3. Do you offer different levels of yoga? What are they?
4. Are you on my insurance plan?
5. Do you have a daily yoga practice yourself?
6. Do you suggest a particular attire?
7. How often do you offer classes? Do you recommend that I attend a certain number of classes a week?
8. I'm pregnant. How will that affect my participating in class?
9. I have arthritis. Do you have experience teaching yoga to people with my condition?
10. Can you suggest certain books, tapes or DVDs that will augment what I'm learning here?

Key Q&A

Organizations and Support

For information and support on Yoga, please see the recommended books listed below.

Books

Collins Alternative Health Guide
by Steven Bratman

Yoga for Dummies
by Georg Feuerstein and Larry Payne

Yoga for Pregnancy
by Theresa Jamieson