Study Finds Yogā(sana) Can Help Back Pain

Study Finds Yogā(sana) Can Help Back Pain, but Keep It Gentle, with These Poses by Allison Aubrey

New research finds that a yogā(sana) class designed specifically for back pain can be as effective as physical therapy in relieving pain. The protocol includes gentle poses and avoids more difficult ones. Comstock Images/Getty Images

If you’re tired of popping pain medicine for your lower back pain, yogā(sana) may be a good alternative.

New research finds that a yogā(sana) class designed specifically for back pain can be as safe and effective as physical therapy in easing pain.

The protocol was developed by researchers at Boston Medical Center with input from yogā(sana) teachers, doctors and physical therapists.

During the class, trained instructors guide participants through gentle poses, including cat-cow, triangle pose and child’s pose. Simple relaxation techniques are part of the class as well. More difficult poses, such as inversions, are avoided. A guidebook that details the poses taught during the class is freely available, as is a teacher training manual.

The findings, published Monday in the Annals of Internal Medicine, are in line with new guidelines for treating back pain from the American College of Physicians. The group recommends that people with back pain should avoid pain medicines if possible, and instead opt for alternatives such as tai chi, yogā(sana) and massage. As we’ve reported, those guidelines are aimed at people with run-of-the-mill back pain, rather than pain due to an injury or other diagnosed problem.

Who was in the study? Researchers recruited 320 racially diverse, predominantly low-income participants in the Boston area, all of whom had chronic low back pain. The study lasted one year.

What did participants in the study do? Participants were divided into three groups. One group was assigned to a weekly yogā(sana) class for 12 weeks. Another group was assigned 15 physical therapy (PT) visits. The third group received an educational book and newsletters. For the remainder of the year — roughly 40 weeks — participants in the yogā(sana) group were assigned to either drop-in classes or home practice. The PT group was assigned to either “PT booster sessions” or home practice.

The skinny: Researchers assessed changes in pain and function using a 23-point questionnaire. The participants in the yogā(sana) and physical therapy groups had about the same amount of improvement in pain and functioning over time.

When the study began, about 70 percent of the patients were taking some form of pain medication. At the end of three months, when the yogā(sana) classes were wrapping up, the percentage of yoga and PT participants still taking pain medication had dropped to about 50 percent. By comparison, the use of pain medication did not decline among participants in the education group.

“It’s a significant reduction,” says study author Rob Saper, director of integrative medicine at Boston Medical Center.

“I’m not recommending that people just go to any yogā(sana) class,” Saper told us. He pointed out that their research has helped nail down poses and relaxation techniques that are helpful and safe.

Saper says he chose to compare the effects of yogā(sana) with physical therapy because “PT is the most common referral that physicians make for patients with back pain. It’s accepted, it’s reimbursed, and it’s offered in most hospitals.”

Saper says if research shows that yogā(sana) can be as effective, “maybe yogā(sana) should be considered as a potential therapy that can be more widely disseminated and covered [by insurance].”

An editorial published alongside the study points out that treating low back pain is complicated and improvements documented in the study were modest.

“Any single treatment approach is unlikely to prove helpful to all or even most patients,” writes Stefan Kertesz of the University of Alabama at Birmingham School of Medicine and his co-author, Douglas Chang of University of California, San Diego. Nonetheless, as this new study has shown, “yogā(sana) offers some persons tangible benefit without much risk,” they conclude.

How Yoga Works


We all know that yoga does a body (and a mind) good. But up until recently, no one could really say with any degree of certainty why—or even how—it improves conditions as varied as depression and anxiety, diabetes, chronic pain, and even epilepsy.

Now a group of researchers at Boston University School of Medicine believe they’ve discovered yoga’s secret. In an article published in the May 2012 issue of Medical Hypotheses journal under an impossibly long title, Chris Streeter, PhD, and her team hypothesize that yoga works by regulating the nervous system. And how does it do that? By increasing vagal tone—the body’s ability to successfully respond to stress.

The Study:

The Effects of Yoga on the Autonomic Nervous System, Gamma-aminobutyric-acid, and Allostasis in Epilepsy, Depression, and Post-traumatic Stress Disorder.

What Is Vagal Tone?

Most of us don’t even know we have a vagus that needs toning, but we most certainly do. The vagus nerve, the largest cranial nerve in the body, starts at the base of the skull and wanders throughout the whole body, influencing the respiratory, digestive, and nervous systems. Often thought of as our “air traffic controller,” the vagus nerve helps to regulate all our major bodily functions. Our breath, heart rate, and digestion—as well as our ability to take in, process, and make sense of our experiences—are all directly related to the vagus nerve.

We know when the vagus nerve is toned and functioning properly because we can feel it on different levels: Our digestion improves, our heart functions optimally, and our moods stabilize. We have an easier time moving from the more active and often stressful states of being to the more relaxed ones. As we get better at doing that, we can manage life’s challenges with the right blend of energy, engagement, and ease. When we can consistently maintain this flexible state we are thought to have “high vagal tone.”

…low vagal tone is correlated with such health conditions as depression, post-traumatic stress disorder, chronic pain, and epilepsy.

“Low vagal tone,” on the other hand, brings with it a sense of depletion. Our digestion becomes sluggish, our heart rate increases, and our moods become more unpredictable and difficult to manage. Not surprisingly, low vagal tone is correlated with such health conditions as depression, post-traumatic stress disorder, chronic pain, and epilepsy—not coincidentally, the same conditions that show significant improvement with yoga practice. Researchers hypothesize that it is vagal stimulation through yoga that improves these conditions.

To test their theory, the researchers investigated practices they believed would increase vagal tone. For example, they found that resistance breathing, such as ujjayi pranayama, increases the relaxation response, as well as heart rate variability (another marker of resilience). And a pilot study conducted on more experienced yogis showed that chanting Om out loud increased vagal tone and the relaxation response more than chanting it silently to oneself. Studies such as this one begin to reveal how different yogic practices impact human physiology in different ways.

A Pilot Study Conclusion

A Pilot Study

In 2004 David Shapiro, Ph.D. and Karen Cline, B.A., published a study in the International Journal of Yoga Therapy (No. 14) with two objectives. First, “examine changes in self-reported moods and emotioinal states from before and after Iyengar Yoga classes and how they are affected by the practice of different types of Yoga poses” and second, “to deternine whethere observed changes in mood depend on one’s personality traits”.

“The main objective of [this] study was to test the hypothesis derived from Iyengar Yoga teaching and theory that the practice of back bends results in increases in positive emotional states (feeling happy or elated) and decreases in negative emotional states (feeling sad or depressed).” “To control for nonspecific factors, the effects of back bends were compared with the effects of two other typical Yoga practices (forward bends and standing poses). In this way, [it] could [be] determine[d] whether the expected changes in moods would be more pronounced in or specific to the practice of back bends.”

“By comparing the effects of the different class types within the same subjects, we could determine whether changes in self-reported moods from before to after a session would vary as a function of the specific focus on a given Yoga practice.” “A second aim was to test the hypothesis that mood changes asso- ciated with the different Yoga prac- tices would be related to personality traits. For this purpose, individual differences in anxiety, depression, and hostility were examined. These traits are related to emotional behavior and experience and may predict how a person’s mood changes with the practice of the different poses.”


“The practice of Yoga appears to result in increases in positive moods, decreases in negative moods, and increases in energy level regardless of the âsana practiced. Despite the effort and sustained physical exertion in Yoga, psychological wellbeing is enhanced after a Yoga class, which no doubt reinforces further participation. These effects tend to last at least for a few hours after a class. The specific poses also appear to result in differences in how moods are affected, although these results need to be replicated in a larger sample. The topic of social, psychological, and physiological mechanisms of movements is worthy of further attention. Moreover, the fact that mood changes may be in part dependent on one’s characteristic coping styles deserves further investigation. Back bends appear to be effective in increasing positive moods in general and in individuals who are relatively hostile or depressed. Yoga should be investigated for its potential clinical application in mood disorders and depression and in the management of hostility.”

Try It, You’ll Like It

Lower Your Shoulder Blades?
In his How to Heal (and Prevent) Shoulder Injuries (2007) Doug Keller begins, “Each time you lift your arms, your shoulder muscles- both big and small -initiate a dance full of subtle nuances. The complex interaction of those muscles, coupled with the unique structure of the shoulder joint, give our arms a wide range of motion. In fact, the shoulder is one of the loose joints in the body.”

“But this freedom of movement comes at a price: shoulders are vulnerable to injury both from sudden falls and from repetitive action such as throwing a baseball. The muscles of the rotator cuff, the most delicate movers of the shoulders, are particularly susceptible. But here is the good news: a regular, targeted asana practice can help you maintain healthy rotator cuffs by bringing awareness to your alignment, strengthening your shoulder muscles, and opening your chest.”

Early on, I struggled with where to place the scapula on bringing the arms over head. Directions to “lower the shoulder blades” appeared to be correct but this never felt quite right. Later, instruction to turn the upper arms by rotating triceps in, or biceps out, helped tremendously and eventually made my own teaching clearer.

One can hear John Schumacher giving a very similar instruction in his Urdhva Hastasana video. Within a Daily Bandha posting by Ray Long (Shoulder Kinematics in Yoga, Pt. 1), the video clearly shows that scapular rotation allows for maximum lift of the upper arm bone, collar bones and ribs. This very same action is also necessary when doing Downward Facing Dog, Full Arm Balance, Upward Wheel and others.

Doug Keller writes much the same and more in the PDF below, Shoulder to Shoulder. Explaining in detail, “When the arms come fully overhead, a slight reversal of direction has to take place: the shoulder blades should slightly depress, posteriorly tilt, and adduct in order to complete the motion to 180 degrees.” Keller precedes this with, “There is some elevation (‘shrugging’) of the shoulders as the arms come overhead, but not during the ‘setting’ phase of flexion and abduction.”

Try it, you’ll like it.


D. Keller- Shoulders.pdf

Savasana from LoP

These instructions for Savasana are a modified version of Chapter 30 in Light on Pranayama (LoP). This script uses Mr. Iyengar’s words, but turns some of the descriptive passages into instructions so that when recorded, you can have an experience of Mr. Iyengar’s words leading you into Savasana when playing it back. All of this was originally prepared by Denise Weeks (Intermediate Junior II, IYNAUS Board member) for her students, whom she asked not to follow habitual patterns but instead to stay alert and implement the instructions.

So you know what to expect, instructions will take about 10-12 minutes. Be sure give yourself at least an additional five minutes of silence.

Parenthetical #s = page number and instruction number from LoP.
Bracketed info = where Ms. Weeks rearranged words or added transitional words.
Italicized font = Mr. Iyengar’s words that offer explanations or alternatives.
In many cases, these instructions use “your” where Mr. Iyengar used “the.”

1. Spread a blanket on the floor.

2. Before starting, remove constricting garments, belts, glasses, contact lenses, hearing aids, and so on. (234 #3)

3. [Remember, though Savasana means corpse, it] is intended for complete relaxation, and therefore recuperation. It is not simply lying on one’s back with a vacant mind and gazing, nor does it end in snoring. It is the most difficult of yogic asanas to perfect, but it is also the most refreshing and rewarding. (232 #1)

4. [To get started, visualize a straight line through the center of the blanket], and sit on the line with your knees drawn up and feet together. Gradually lower your back along the [imaginary] line, placing your body accurately so that the middle of your spine lies exactly on that line (235-236 #5)

5. Press your feet on the floor, lift your hips as well as the sacroiliac region, and manually, move the flesh and the skin from the back of the waist down towards the buttocks. (236 #6)

6. First adjust the back of the body. Then adjust the head from the front. From birth the back of the head becomes uneven, because babies lean to one side, resulting in one side of the head more compressed than the other.

Hence it is important to learn to adjust the head from the front and feel it from the back. (236 #7)
Make sure that your head is straight and parallel to the ceiling. If it tilts up, the mind dwells in the future. If down, it broods in the past. If it leans to one side, the inner ear follows. This affects the midbrain, and one tends to fall asleep and lose awareness. Learn to keep the head level with the floor so that your mind remains always in the present. (249 #23)

7. Fully extend one leg first and then the other. Join both the heels and knees. The joined heels, knees, crotch, center of the coccyx, the spinal column and the base of the skull should rest exactly in line. Then adjust the front of your body, keeping the center of the eyebrows, the bridge of the nose, chin, sternum, navel, and pubis’ center also on that line. (236 #7)

8. [Keep your body] straight and level. [To keep it straight,] draw an imaginary line straight along the centre of your forehead, eyebrows, root of the nose, middle of the lips, chin, throat and sternum, centre of the diaphragm, navel and pubis, and then through the space between the inner sides of the thighs, knees, calves, ankles and heels. To keep it level, start with the head, keeping your ears, the outer corners of the eyes, the lips and the base of the jaw bone parallel to the floor. Stretch and adjust the back of the neck, so that it is centrally placed on the floor. (239 #8)

9. Pin the [inner point] of each shoulder blade to the floor. Roll the skin of the top chest from the collar bones towards the shoulder blades and adjust your back to rest perfectly on the blanket. See that the dorsal and lumbar areas of your spine rest evenly on either side and that your ribs spread out uniformly. Rest evenly on both buttocks. Rest the center of the sacrum on the floor so that the buttocks relax evenly. Draw a line between the nipples, the floating ribs and pelvic bones to keep them parallel to the floor. (239 #9)

10. Keep your feet together and stretch the heels’ outer edges; now let the feet fall outwards evenly, letting your big toes feel weightless and non-resistant… Persons with stiff legs may keep their feet about a yard apart, as this will enable them to keep the back rested on the floor.

Keep the back outer corner of your knees touching the floor. If [the legs] cannot rest use a folded blanket or pillow behind them. If the legs do not feel relaxed, place weights on the upper thighs (25-50 lbs). This removes tension or hardness in the muscles and keeps the legs quiet. (241 #10)

11. Keep your hands away from the body, forming a 15 – 20° angle at the armpits. Bend the arms at the elbows, [and touch] the shoulder tops with your fingers. Extend the triceps at the back portion of your upper arms and take your elbows as far as you can towards the feet. Keep your whole upper arm, with the outer edges of the shoulders and elbows, on the floor. Do not disturb the elbow points. Lower your forearms. Extend your hands from the wrists to the knuckles, palms facing upwards. Keep your fingers passive and relaxed, with the backs of the middle fingers touching the floor up to the first knuckles. See that the median plane of the arms, elbows, wrists and palms are in contact with the floor.
The feeling of lying on the floor should be as though the body is sinking into Mother Earth. (242 #11)

12. [Watch for tension in the palms, the fingers, the soles of the feet, and the toes, and] when and where it occurs, drop these parts back to their correct position. (242 #12)

13. Relax the back of your body from the trunk to the neck, arms and legs. Next relax the front of your body from the pubis to the throat, where emotional upheavals take place, and then from the neck to the crown. Learn to relax your entire body this way. (246 #13)

14. Experience the feeling of non-existence or emptiness in the pits of the arms, the inner pits of the groins, diaphragm, lungs, spinal muscles and the abdomen. The body then feels like a discarded stick. In correct Savasana the head feels as if it has shrunk. (247 #14)

15. [Be serene] in all parts of your body. Silence in the body will bring about silence in the mind. (247 #16)

16. Gently move the upper [eye] lids towards the inner corners of the eyes [to] relax the skin just above the eyes and create space between the eyebrows. Treat the eyes gently like petals of a flower. Raise the eyebrows just enough to release any tightness of the skin in the forehead. (248 #18)

17. [Keep your eyes] passive, and [keep your ears] quiet and receptive. (248 #19)

18. Keep the root of your tongue passive as in sleep and resting on the lower palate… Keep the corners of your lips relaxed by stretching them sideways. (248 #20)

9. [Release] tension from your facial muscles, especially around the temples, the cheekbones, and the lower jaw. [Experience] a feeling of quietness between the upper palate and the root of the tongue. [Let the] pores of the skin shrink [so that] your nerves can rest. (248 #21)

20. See that the breath flows evenly on either side of the nostrils. Start by inhaling normally, but exhale softly, deeply, and longer.
[If you feel] restless, perform deep, slow and prolonged in and out breaths until quietness is attained. The moment quietness is felt… stop deep breathing and let the breath flow by itself. (249 #22)

21. When the art of exhalation is perfected, [you may] feel as if the breath is oozing from the pores of the skin on your chest, which is a sign of perfect relaxation. [Let] each out-breath take your mind towards your own self and purge your brain of all its tensions and activities. (249 #22)
22. Let the breath be like a string holding the pearls of a necklace together. The pearls are the ribs which move slowly, very steadily and reverently… When in that precise state, your body, breath, mind and brain move towards the real self, the Atma, like a spider returning to the centre of its web. Equanimity of mind, intellect, and self is felt at this juncture. (232 #3)

23. [Allow your mind to] dissolve and merge in the self, like a river in the sea… (250 #27)

24. [Experience a feeling of] equipoise between the two tides of emptiness of emotion and fullness of intellect. (251 #28)

25. [ …Some call this the “eternal now, beyond space and time,” in this state allow your body to be at rest as if in deep sleep, allow your senses to feel as if in a dream, but keep the intellect alert and aware.] (233 #8)

26. [In this state of discrimination, experience greater clarity and more and more relaxation. In this state, allow your doubts to vanish, feel a sense of illumination, and allow yourself to be merged in the Infinite.] This is the nectar of Savasana. (251 #29)

Set aside and additional 5 – 10 min. of silence, then end with more of Mr. Iyengar’s words.

27. Remain a silent observer until normal activity creeps into your brain and body. Gradually and gently open your eyes, which are at first unfocused. Remain in that state for a while. Then bend your knees, turn your head and body to one side and stay for a minute or two in that position. (252 #31)

28. In correct Savasana there is a minimum wastage of energy and maximum recuperation. It refreshes your whole being, making one dynamic and creative. It banishes fear (bhaya) of death and creates fearlessness (abhaya). (254 “Effect”)

29. [Now turn to the other side.]

30. [When you push into the floor to come up,] do not raise your head quickly. (252 #31)

31. [Sit quietly for a moment] and experience a state of serenity and inner oneness. (254 “Effect”)

3 Kinds of Deep Breathing

Get a Hold of Yourself

By Therese Borchard

Deep breathing has become increasingly important in my recovery from depression and anxiety because I recognize that shallow breath contributes to my panic. In fact, at my worst hours, I would use a paper bag to keep from hyperventilating.

The practice of deep breathing stimulates our parasympathetic nervous system (PNS), responsible for activities that occur when our body is at rest. It functions in opposite to the sympathetic nervous system, which stimulates activities associated with the flight-or-fight response. I like to the think of the PNS as the calm sister and the sympathetic nervous system as the non-sympathetic crazy sister on the verge of a nervous breakdown. You know that woman in the movie Airplane,

and the line of people awaiting with weapons while a few shake her saying “Get a hold of yourself.” The woman represents the sympathetic nervous system, and the long line of folks with bats, ropes, purses, etc. are members of the parasympathetic nervous system trying to calm the panicked passenger.

Of all the automatic functions of the body—cardiovascular, digestive, hormonal, glandular, immune–only the breath can be easily controlled voluntarily, explain Richard P. Brown, M.D. and Patricia L. Gerbarg, M.D. in their book, “The Healing Power of the Breath.” They write:

By voluntarily changing the rate, depth, and pattern of breathing, we can change the messages being sent from the body’s respiratory system to the brain. In this way, breathing techniques provide a portal to the autonomic communication network through which we can, by changing our breathing patterns, send specific messages to the brain using the language of the body, a language the brain understands and to which it responds. Messages from the respiratory system have rapid, powerful effects on major brain centers involved in thought, emotion, and behavior.

In their eight substantive chapters, the authors discuss several techniques of deep breathing to reduce stress and anxiety. They start off with three basic approaches which provide the building blocks for the others:

Coherent Breathing
Coherent breathing is basically breathing at a rate of five breaths per minute, which is the middle of the resonant breathing rate range. I achieve this if I count to five inhaling and count to five exhaling. The five-minute rate maximizes the heart rate variability (HRV), a measurement of how well the parasympathetic nervous system is working. Brown and Bergarg explain that changing our rate and pattern of breath alters the HRV, which causes shifts in our nervous system. The higher the HRV the better because a higher HRV is associated with a healthier cardiovascular system and a stronger stress-response system. Breathing at a rate that is close to one’s ideal resonant rate (around five breaths per minute) can induce up to a tenfold improvement in HRV.

Resistance Breathing
Resistance breathing is exactly what its name suggests: breathing that creates resistance to the flow of air. Per the authors:

Resistance can be created by pursing the lips, placing the tip of the tongue against the inside of the upper teeth, hissing through the clenched teeth, tightening the throat muscles, partly closing the glottis, narrowing the space between the vocal cords, or using an external object such as breathing through a straw.

All that sounds a bit complicated to me. Breathing should be easy, right? So I simply breathe out of my nose, which, according to Brown and Bergarg, creates more resistance than breathing through the mouth. I do think it’s interesting when they explain that singing and chanting – all musical sounds created by contracting vocal cords—are forms of resistance breathing, and that is why they provide that relaxed sensation you can get meditating (if you CAN meditate).

Breath Moving
Breath Moving is when, well, the breath moves. Courtesy of your imagination. Brown compares this exercise to an internal massage. I’m not sure I’d go that far. I like the real deal. However, I do think sending your breath on a little journey around your body – as long as it doesn’t get too lost — does help you keep your concentration on the exercise and not on your to-do list because counting to five can get a little old. For example, here’s part of a circuit the authors offer in their book:

•As you breathe in, imagine you are moving your breath to the top of your head.
•As you breathe out, imagine you are moving your breath to the base of your spine, your perineum, your sit bones.
•Each time you breathe in, move the breath to the top of the head.
•Each time you breathe out, move the breath to the base of the spine.
•Breathe in this circuit for ten cycles.

The history of Breath Moving is fascinating. According to the authors, the technique was created in large part by the Russian Christian Orthodox Hesychast monks around the eleventh century. The monks would teach the technique of moving the breath to the holy Russian warriors to help protect them from harm and to empower them as they defended their territory against invaders.

Yoga Poses for Your Health

Ayurveda and Asana:
Yoga Poses for Your Health

by Mark Halpbern

Have you ever wondered why some yoga poses seem to leave you calm, centered, and balanced, while others make you agitated, sore, and off center? Or why your best friend flourishes in a rousing “Power Yoga” workout, while you do best on a regimen of slow, gentle, stretching?

The ancient Indian healing system known as Ayurveda can help you answer such questions. According to Ayurveda, different people require very different yoga practices. As a yoga teacher and doctor practicing Ayurvedic medicine, I’ve experienced firsthand how Ayurvedain addition to the dietary and lifestyle advice that it is best known for can shed light on the practice of yoga.

Take the case of the 31-year-old woman who came to me complaining of nervousness and chronic neck pain. She had been practicing yoga for six years and still could not understand why she was still experiencing these difficulties.

Our work with Ayurveda helped this woman understand how the asanas she had been practicing had aggravated the subtle energies of her body. She also learned new asanas that were more in harmony with her unique energetic balance. With this new knowledge, she was able to modify her practice and eliminate her neck pain and nervousness, bringing greater well-being to her body and mind.

Sister Symptoms
Yoga and Ayurveda are two paths intertwined in such a close relationship that it is hard to imagine traveling down one of these paths without knowledge of the other. Ayurveda, which means “knowledge of life,” is the ancient art and science of keeping the body and mind balanced and healthy. Yoga is the ancient art and science of preparing the body and mind for the eventual liberation and enlightenment of the soul.

Like hatha yoga, Ayurveda teaches how to keep the physical body healthy, and how this health relates to our spiritual journey. Both yoga and Ayurveda spring from the ancient Sanskrit texts called the Vedas. According to Vedic scholar David Frawley, “Yoga is the practical side of the Vedic teachings, while Ayurveda is the healing side.” In practice, both paths overlap.

In fact, Ayurveda and yoga are so closely related that some people argue that Patanjali, the first codifier of yoga, and Caraka, the first codifier of Ayurveda, may have in fact been one and the same person. Philosophically, both yoga and Ayurveda are rooted in Samkhya, one of six schools of classical Indian thought. The foundation of this philosophy can be described as follows:

1. There exists a fundamental state of pure being that is beyond intellectual understanding and which all life consciously strives for. This is the state of enlightenment or self-liberation.
2. Suffering is a part of our lives because of our attachment to our ego or self-identity (ahamkara).
3. The path toward ending suffering is the path of dissolving or transcending the ego. In doing so, all fear, anger, and attachment are eradicated.
4. To achieve this goal, we must live a purely ethical life. (Ethical guidelines are listed as the yamas and niyamas in the Yoga Sutra of Patanjali.)
5. Any disturbance within the mind or body interferes with this path. Ayurveda is the science of keeping the biological forces in balance so that the mind and body may be healthy.

Fundamentals of Ayurveda
According to Ayurveda, the universal life force manifests as three different energies, or doshas, known as vata, pitta, and kapha. We are all made up of a unique combination of these three forces. This unique combination, determined at the moment of conception, is our constitution, or prakruti. The three doshas constantly fluctuate according to our environment, which includes our diet, the seasons, the climate, our age, and many more factors. The current state of these three doshas most commonly defines our imbalance, or vikruti. Since we all have a unique constitution and unique imbalances, each person’s path toward health will be unique. In addition, what will keep each of us healthy is also unique. Understanding our prakruti and vikruti offers each of us the potential to make correct choices.

The three doshas are generally described in terms of the five elements: earth, air, fire, water, and ether (the subtle energy that connects all things). Vata is said to be made up of air and ether. Likened to the wind, it is said to be light, drying, cooling, and capable of movement. Pitta is said to be made up of fire and water. Considered to be mostly fire, it is hot, light, and neither too dry nor too moist; it does not move on its own, but it can be easily moved by the wind (vata). Kapha is said to be made up of water and earth, which combine like mud. Kapha is heavy, moist, cool, and stable.

The three doshas fluctuate constantly. As they move out of balance, they affect particular areas of our bodies in characteristic ways. When vata is out of balancetypically in excesswe are prone to diseases of the large intestines, like constipation and gas, along with diseases of the nervous system, immune system, and joints. When pitta is in excess, we are prone to diseases of the small intestines, like diarrhea, along with diseases of the liver, spleen, thyroid, blood, skin, and eyes. When kapha is in excess, we are prone to diseases of the stomach and lungs, most notably mucous conditions, along with diseases of water metabolism, such as swelling.

When working with the doshas, remember these basic principles: Like increases like, and opposites balance each other. In other words, foods, weather, and situations that have similar characteristics as the doshas will increase them; those that have opposite characteristics will decrease them. Knowing this, you can adjust your yoga practice, diet, and other environmental factors to affect these forces in ways that create greater balance and harmony. (For example, vata types who are dry, light, and airy should avoid foods with similar qualities, like popcorn, and consume foods with opposite qualities, like warm milk).

The Three Gunas
Another fundamental Ayurvedic principle is the idea of the three gunas, or qualities of nature. The three gunas sattva, rajas, and tamas are used to describe emotional and spiritual characteristics.

That which is sattvic is light, clear, and stable. Sattva is the state of being which comes from purity of mind, and leads to an awareness of our connectedness to God, a state in which we manifest our most virtuous qualities.

That which is rajasic is active, agitated, or turbulent. Rajas arises when we are distracted from our truest essence, and manifests emotions such as fear, worry, anger, jealously, attachment, and depression.

That which is tamasic is heavy, dull, dark, and inert. Tamasic actions include violent or vindictive behavior, along with self-destructive behaviors such as addiction, depression, and suicide.

All movement or activity is by nature rajasic (agitating) and heating to the body. Yet some movements are more agitating and others less so. Generally speaking, the slower the movement, the less rajasic and the less agitating to the body and mind. The faster the movement, the more rajasic and the more heating it will be.

Any movement practiced with great awareness becomes more sattvic. Movements done with distraction or less attentiveness are more rajasic. Thus, one way to enhance our experience of yoga is to practice slowly and with awareness.

No movement can be purely sattvic. The inherent nature of movement is rajasic, as rajas is the principal of energy, and movement requires energy. Hence our sattvic qualities are most nurtured in meditation and in the stillness of holding a pose, where we can find pure awareness.

The rajasic nature of movement does not necessarily make it bad for us. Rajas serves the useful purpose of stimulating our bodies and minds. We could not function in our world without a part of us being rajasic.

What Sort of Yoga is Right for You?
When determining the kind of yoga practice that is right for you, the most important factor is your vikruti, or imbalance. Your vikruti is, in fact, the single most important determinant of your entire regime. Once you have corrected your imbalance, you can stay in good health by choosing a yoga practice that balances your constitution, or prakruti. (It’s sometimes hard for the lay person to distinguish between characteristics that are inborn, or constitutional, and those that result from an imbalance. For best results, consult a trained Ayurvedic physician.)

People of vata constitution or imbalance are most supported by a yoga practice that is calming, quieting, and yet warming. People of pitta nature or imbalance are most supported by a yoga practice that is calming, quieting, and cooling. And people of kapha nature or imbalance are most supported by a yoga practice that is stimulating and warming. Each individual has different needs. To practice in a way that does not support you is to invite greater imbalance.

Asanas for Vata
The asanas which are most suitable for balancing vata are those that are calming and grounding by nature. They will counter the tendency for those with a vata imbalance to be “spacey,” agitated, or nervous. These asanas will help allay fear, worry, and anxiety and also improve vata physical imbalances such as constipation, lower back pain, and joint pains. The lower abdomen, pelvis, and large intestine are the main residence of vata in the body, so many of these asanas compress the lower abdomen or cause the lower abdomen to become taut. In addition, asanas that strengthen the lower back help alleviate vata.

In general, most yoga asanas are good for balancing vata, since most asanas are calming to the mind. There are, however, some that are particularly good and some that should certainly be avoided.

Uttanasana (Standing Forward Bend) is an exceptional asana for vatas. Stand with your feet about shoulder-width apart. The arms may be raised over the head as you reach to the sky, or you may wish to bend the elbows, clasping the opposing arms just above the elbow and letting your forearms rest on or just above the crown of your head. Keeping your back straight, slowly bend forward from the hips as you exhale. Bend as far forward as you comfortably can. Your hands may remain crossed, touch the floor in front of your feet, or, if you are very flexible, be clasped just behind your heels. For the less flexible, the hands may be placed on blocks which rest on the floor. Let gravity assist the lengthening of your spine. All standing asanas tend to be grounding if awareness is placed on the feet, honoring the connection between your body and the Earth.

Note that this asana can put quite a strain on an injured lower back, so care should be used. If the lower back is simply tight, a condition related to aggravated vata, this is an excellent asana. The seated version of this asana, Paschimottanasana (Seated Forward Bend), will have similar value and may be easier if your back is sore.

Balasana (Child’s Pose) is another excellent asana for compressing the pelvis and the vata region. Sit upright with your knees flexed and placed underneath your buttocks. Keeping your arms to your side, bend forward from the hips until your head is resting on the floor in front of you. If you do not have the flexibility to place your head on the ground, place a folded blanket or a pillow on the floor in front of you for your head to rest upon. Compression asanas are excellent for constipation and for chronic gas.

Supta Virasana (Reclining Hero Pose) is another good asana for vata. Kneel with your knees together and your buttocks resting on your heels. Move the legs out to the side of the pelvis so that the buttocks slide down in between both legs. Place the hands on the soles of the feet and lean back onto the elbows. This may be enough extension for many people. If you are flexible enough, gradually lower your back down to the floor. Your hands may lie by your side or be stretched above the head to lengthen the spine.

While this stretch does not compress the pelvis, it creates a mild extension of the lower abdominal muscles and lower back. This action increases the pressure in the pelvis, again alleviating vata. According to Ayurvedic doctor Vasant Lad, this asana is particularly useful as a part of treatment for vata-type asthma conditions.

Dhanurasana (Bow Pose) also extends the lower back and places pressure on the pelvis. Lie on your stomach with your arms at your sides. Lift the head, shoulders, and chest off of the mat and bend both knees. Reach back and take hold of the ankles. Let your legs draw your chest farther into the air so that your body weight rests on the pelvic region. This is essential for the maximum relief of vata.

Virasana (Hero Pose), Siddhasana (Easy Pose), and Padmasana (Lotus Pose) are very calming poses which sedate vata’s agitated nature. These meditative poses are excellent for calming the nervous system, which aids in the healing of anxiety, nervousness, sciatica, and muscle spasm. The most calming pose of all is, of course, the supine Savasana (Corpse Pose).

People of vata nature should avoid asanas that are overly stimulating to the nervous system, such as repetitive Sun Salutations, and those that place excessive pressure on sensitive joints in the body. The cervicothoracic junctionthe bony region where the neck meets the shouldersis one of these areas. Here, large vertebrae stick out like “sore thumbs.” People of vata nature and imbalance tend to have weaker bones, less fatty padding, looser ligaments, and more susceptibility to pain. For these reasons, Salamba Sarvangasana (Shoulderstand) and Halasana (Plow Pose) should be avoided or modified by placing a blanket under the shoulders for extra padding. This also decreases the extreme flexion the neck is placed in. Even so, people of vata nature or imbalance should not hold these poses for very long, or they will risk injury.

Asanas for Pitta
The best asanas for pitta are those that are calming and not overly heating. People of pitta nature or imbalance tend to be more assertive and intense. Calming poses help sedate their intensity and ease the emotions of anger and resentment that they are prone to. By alleviating pitta, these asanas are good as part of the treatment for conditions such as ulcers and hyperacidity, liver disease, and acne.

Asanas that help balance pitta are those that place pressure on the naval and solar plexus region, in the small intestine where pitta resides. These asanas directly affect the liver and spleen and help regulate the strength of the digestive fire.

Ustrasana (Camel Pose) is very beneficial for pittas. Kneel with the buttocks lifted as though you were standing on your knees. Place your palms on your buttocks. Move your thighs and pelvis forward as you extend the lower back, bringing your hands to your heels. Gently extend your neck. Remember to breathe. This asana opens up the abdomen, solar plexus, and chest, allowing for freer movement of energy through these regions.

Bhujangasana (Cobra Pose) and Dhanurasana (Bow Pose) are also excellent solar plexus extension poses for pitta. These asanas can play a role in the treatment of ulcers and hepatitis.

To perform Cobra Pose, lie face down with your feet together and ankles extended. Bend the elbows and place your hands flat on the floor by your lower ribs. (Less flexible people may choose to place the palms on the floor at shoulder level.) Upon inhalation, extend the elbows and raise the head, chest, and abdomen off the floor while keeping the pelvic bones on the floor. The head may be held in a neutral position or in extension.

Headstand should be avoided for people of pitta imbalance or constitution. Headstands heat the body, and much of this heat accumulates in the head and the eyes. The eyes are an organ controlled mainly by pitta. For this reason, Headstands can help cause or worsen diseases of the eyes. If a person of pitta constitution with no serious imbalance chooses to do Headstands, then the Headstand should be held for a very short period.

Asanas for Kapha
To balance the heavy, slow, cold, and sedated nature of kapha, practice asanas that are more stimulating and heating. Asanas best suited to individuals of kapha nature or imbalance are those that open up the chest. The stomach and chest are the areas where kapha accumulates. In the chest, kapha takes on the form of mucous. These asanas are excellent for the prevention and treatment of congestive conditions like bronchitis and pneumonia as well as constrictive conditions such as asthma and emphysema.

Ustrasana (Camel Pose) and Setu Bandha (Bridge Pose) are useful asanas for kaphas. To perform Setu Bandha, lie flat on your back with your arms to your sides, with palms facing down toward the floor. Using your elbows and forearms, raise your pelvis off the mat as you keep your shoulders and feet grounded. Try to stay on the tops of your shoulders and increase the height of the pelvis by extending evenly through both legs.

As a gentle alternative to this posture, lie on your back in extension over a bolster and a pillow. Both of these variations do an excellent job of opening the chest, allowing for greater circulation of energy through this region. These asanas also affect the flow of energy through the heart chakra, aiding the development of compassion and unconditional love.

For those of kapha nature and imbalance, the calming and sedating effect of most asanas needs to be balanced by other asanas that are more stimulating and heating. People of kapha nature are the best suited to handle strengthening poses, as their joints and muscles tend to be strong and stable. Increasing flexibility is extremely important for those of kapha nature, as kaphas tend to become overly stiff or rigid.

Suryanamaskar (Sun Salutation) is a very good aerobic exercise for kapha and helps in the treatment of obesity and depression, two common kapha conditions. The Sun Salutation is the ideal asana for kapha, as it is very active, creates heat, and opens the chest.

There are 12 parts to this sequence of poses. Begin by standing erect with the feet touching each other. Bend the elbows and bring the palms together in the middle of the chest. Raise the arms above the head and extend into a slight backbend. Bend forward into convex Uttanasana (head down) and bring the hands to the floor, bending the knees if you need to protect your back. From this position, arch the back and look up in concave Uttanasana.  Then jump with both legs or step backward with the right leg first.

Bring the left leg backward and place it by the right leg as you lift your back inner groins high into the air after coming into Adho Mukha Svanasana (Downward-Facing Dog). Pressing hands and keeping arms firm,  glide your body forward into Urdhva Mukha Svanasana (Upward-facing Dog). Then press into Chaturanga Dandasana (Four-limbed Staff). Return to Upward dog. Next, looking forward, jump with both legs or take the right leg forward. Bring the left foot forward, if stepping, as you return to concave Uttanasana. Follow with convex Uttanasana.  Come up to a standng position and raise the arms once again over the head in Urdhva Hastasana (Upward Arms), extending the back and neck. To complete the cycle, return the hands to the chest, palms together in Namaskarasana (Prayer).

People of all constitutions can benefit from Sun Salutations during the time of day that is dominated by kapha energy (6:00 to 10:00 a.m and p.m.), as long as there is not a serious imbalance in pitta or vata. People of kapha nature should do many repetitions and perform them with great speed. While in general people of vata nature should avoid the speed, performing it very slowly and with great awareness will decrease its vata-aggravating tendencies. Pitta types should do limited repetitions, as this series is very heating.

Few asanas are harmful to kapha, as kaphas benefit from all forms of stretching and movement. Two weak areas of the body for kapha individuals, however, are the lungs and the kidneys. Asanas that place excessive pressure on the lower abdomen, such as Dhanurasana (Bow Pose), can aggravate the kidneys if held for too long.

Other Factors
In some ways the prescription I have just given is overly simplistic. In developing a healthy yoga practice, you must take into consideration not only your constitution and imbalance but also your age, the season, and the time of day you are practicing.

At different times of our lives, different doshas play a greater role. This is a part of the natural fluctuation of these forces. From birth through puberty, our bodies and minds are more affected by kapha. From puberty until around our retirement years, the influence of pitta increases. The later years, post retirement, are most dominated by vata.

During each of these periods, we must pay attention to the effect our age has on us and modify our practice appropriately. When we are very young, our bodies can better tolerate the more aerobic styles of yoga. As we age, we need to practice more calming asanas.

The seasons also affect a healthy practice. The season of cold dampness increases kapha. The season of warm weather increases pitta. The season of cool dryness increases vata, as does the windy season. (In different parts of the country these take place at different times, so placing the names of traditional seasons upon them can be misleading.) During the kapha season, a practice that is more stimulating and warming is better. In the pitta season, a practice that is cooling is best. In the vata season, a calming practice supports greater health.

Finally, the time of day we practice will affect the balance of the doshas. Kapha naturally increases between 6:00 and 10:00 a.m and p.m, when we are moving slowly. Pitta naturally increases between 10:00 and 2:00 a.m. and p.m., when the digestive fire is at its height and, in the daytime, the sun is at its peak. Vata naturally increases between 2:00 and 6:00 a.m. and p.m., during the transition between night and day.

Most people practice yoga in the early morning, when the world is calm. Before 6:00, during the time of vata, a very quiet and gentle practice is recommended. After 6:00, during the time of kapha, a more stimulating practice is appropriate. Remember, though, that when designing a yoga practice for yourself, your overall vikruti, or imbalance, is more important than the influence of the season, your age, or the time of day. These should be seen as the factors that modify your practice but not the factors that create it. When you are in near perfect balance, you can create a program based almost entirely on your constitution, the seasons, and the time of day.

In Ayurveda, balancing the effects of the doshas is only half of the formula for creating health and well being. The other half is developing a more sattvic lifestyle and learning to express our sattvic nature: that aspect of ourselves that, through an awareness of our connectedness to Spirit, allows us to express our highest or most virtuous qualities.

Yoga, practiced in harmony with each person’s unique nature, is part of the Ayurvedic path toward balancing the doshas and enhancing sattva. Through this path each of us can reach our full potential.

Marc Halpern is the founder and director of the California College of Ayurveda in Grass Valley, California.