A lithe, 5'9" brunette in a workout tank and tights strides to the front of a studio in the suburbs of Orlando and unfurls her mat, as if she's about to lead a vinyasa flow class. Instead, she opens a PowerPoint file and begins to teach the six criteria doctors use to assess pain.
Acupuncturist and yoga expert Tiffany Cruikshank is a 35-year-old leader in yoga medicine (yes, medicine), which eschews the practice's trendy hot studios and splashy patterned leggings for gentle, clinical sequences of poses, breathing, and meditation to treat everything from chronic pain and IBS to heart disease and cancer. The past decade has seen an avalanche of research into yoga's medical power; as a result, a new generation of passionate doctors and yogis—many of them doctor-yogis—want asanas on MDs' prescription pads, often in place of pills. (Looking for natural remedies that really work?
The classes at Cruikshank's year-old "mini medical school for yoga teachers," which teaches yogis how to deal safely with any student in need of healing, sell out in less than 24 hours, with teachers from Des Moines to Dubai clamoring for access. Maryland University of Integrative Health has created one of the first master of science degrees in yoga therapy, and the debut medical textbook for mainstream doctors (coauthored by an MD and a professor of medicine at Harvard University) is set to publish early next year.
"Yoga therapy is one of the most effective medicines we have," says Ginevra Liptan, a fibromyalgia specialist in Lake Oswego, OR, who has prescribed restorative yoga to her patients ever since it quelled her own debilitating fibro symptoms. Cruikshank, who first recognized yoga's medicinal power when she started giving her acupuncture patients easy-to-do yoga "prescriptions" and they healed more quickly, agrees. "Yoga is medicine, and it's time more people started using it that way."
Inflammation
Chronic inflammation—the villain at the root of many modern ills, from heart disease to cancer to Alzheimer's disease—may be controlled with easy, gentle yoga. In one trial, 2 months of a twice-weekly practice reduced inflammation markers in heart failure patients by as much as 25%.
In another, two 90-minute sessions a week for 3 months lowered several inflammatory markers in the blood of breast cancer patients by up to 20%. Study author Janice Kiecolt-Glaser, director of the Institute for Behavioral Medicine Research at Ohio State University, explains that yoga reduces stress, a notorious contributor to inflammation, and changes the way we deal with stressful situations off the mat. In an earlier study, she and colleagues found that in response to a stressor (sticking their feet in cold water for 1 minute, followed by 5 minutes of mental arithmetic), experienced yogis produced 41% lower levels of interleukin-6, an inflammatory marker, than novices did. "Yoga also improves sleep," says Kiecolt-Glaser. "Fatigue and poor sleep throw off your biological rhythms, which then affects hormones that play a role in inflammation." Roll out your mat to douse your body's internal flames. (Here are six surprising causes of inflammation—and what you can do about it.)
Anxiety, depression, moderate hypertension, stress-related exhaustion, IBS, insomnia
Try a gentle yoga class—like level 1 or beginner Iyengar, restorative, yin, or hatha—with a teacher who incorporates breathwork and meditation. "The combination of yoga and meditation triggers the parasympathetic nervous system—the calming branch—and keeps your mind anchored in the present moment," says Jessica Hutchins, an integrative physician at Cleveland Clinic. Since depression is characterized by obsessing over the past and anxiety is fretting about the future, staying in the here and now can be a potent antidote, she adds. (Take our depression quiz to find out if you're just feeling blue—or if there's a real problem.)
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Arthritis, chronic pain, fibromyalgia
Aim for yoga therapy in a one-on-one or small-group setting, led by a yoga therapist (YT) or a seasoned teacher who has a deep understanding of anatomy and physiology. Reach out to an International Association of Yoga Therapists (IAYT)–accredited training program (iayt.org) or find an instructor who has gone through Cruikshank's program (yogamedicine.com).
Cancer, heart disease, severe hypertension, multiple sclerosis, diabetes complications
Look for a program through your treatment center or local hospital. More and more are offering on-site classes specifically designed for these conditions, and many of those programs have been vetted in scientific trials. "Many teachers are equipped to offer breathing and relaxation practices that will help with all of these conditions. However, you may find more expansive programming and benefits with a teacher who has at least 50 hours of training from a specialty program for using yoga to treat your specific issue," says Jill Pransky, director of therapeutic restorative teacher training for YogaWorks, which has studios in California and New York.
An acute injury, spinal stenosis, surgery recovery
See a trained yoga therapist one-on-one. "Look for teachers who have experience working in physical therapists' offices, hospitals, or rehab centers or who have special certifications in shoulder care or back care," says Pransky.
SO WHY ISN'T EVERY DOCTOR RECOMMENDING YOGA?
As a new frontier, yoga medicine is a bit like the Wild West: A lot of people have great ideas, and best practices are being decided, but there's still a lot of swirling dust. Here's what experts say needs to happen for more doctors to prescribe yoga therapy:
Standardized training.
Yoga schools issue their own certifications, and the result has been widely different standards. To address the issue, the IAYT recently published competency-based criteria for the training of YTs and began accrediting programs that meet those standards last year. "When someone says they're an IAYT-certified yoga therapist, you'll know they're able to safely treat sick or injured students," says IAYT executive director John Kepner.
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Proven protocols.
While many YTs feel that standardization could blunt yoga's magic, "clinicians need to feel they are prescribing safe treatments that are proven to work," says Heather Greysen, a nurse researcher at the University of California–San Francisco.
Interaction between doctors and YTs.
Others argue that doctors need to learn to trust YTs. "Yoga therapists are most effective when they can design a personalized practice," says Cruikshank. As doctors see patients benefit, they'll feel more comfortable referring their patients.
FIND YOUR YOGA CURE
No matter what your ache or pain, there's a practice for you. "While yoga teachers have been helping people heal for centuries, IAYT has recently created a standard for registered yoga therapists that can help you connect with well-trained teachers, as well as teachers who are grandfathered in with years of experience," says Pransky. "But remember, just as a medical degree doesn't make a great doctor, a certification doesn't make a great yoga teacher. Meet with the teacher first and make sure you click. It's the relationship between you and the teacher that makes the yoga healing."