Once we know how to read research, we start to see how many research studies conclude with a list of limitations and a call for further investigation. The more we know, we also see how much more there is to learn and confirm about yoga’s benefits. For skeptical yogis, this can be frustrating. For curious yogis, this is good news!
Don’t give up
Don’t give up on following and understanding yoga research. Evidence-based practice is common currency for institutional change. No matter how slow, this is how we make the case for the dissemination of best yoga practices. It’s also where we can create a well-informed yoga teaching practice, and perhaps even find ways to contribute to what’s understood about how and why yoga works.
Play the Long Game
Look at the example of the MBSR (mindfulness-based stress reduction) program developed by Dr. John Kabat-Zinn at the University of Massachusetts Medical Center. MBSR includes not only body sensing and other forms of meditation, but also standing and lying-down movements from yoga, as well as social support. Decades of good research now show that MBSR is a replicable, effective, and evidence-based practice. Over many years, it has become a regular program at medical and mental health centers and other settings across the US. I’d say that MBSR, and research on MBSR, have been pivotal for the mainstreaming of mindfulness and yoga as wellness practices.
So what is it that we expect from research in the first place? (And is that realistic or better sought elsewhere?)
I want solid information to offer my students and clients the practices that will be helpful and not harmful. And particularly as a yoga therapist, I want to offer yoga education that will engage their minds as well as their bodies.
I look to research for bigger-picture context. The types of studies being reported can reveal how and where yoga is being tested, and what’s of most interest (e.g., yoga research questions or topics, practices, populations). Also, what is or isn’t known about whether yoga is helpful or neutral in comparison with other modalities. One study on its own probably won’t tell us this, and yet looking at several studies or a systematic review may offer a snapshot of what’s getting attention now.
One area of research with a particularly strong track record looks at yoga and back pain, one of my specialties. A solid body of evidence in this area literally changed my teaching trajectory— where I teach, how and what I teach, and even my decision to become a yoga therapist. There is evidence that specific yoga asana protocols help back pain. Even so, the types of practices and lineages, the settings, and the specific outcomes vary. It’s still difficult to generalize a personalized, adaptive practice as with yoga therapy. The mechanism (or how the change happens) still isn’t understood conclusively. Yet at a time when medicine is looking for non-pharmacological options for pain relief, the research on therapeutic yoga and back pain is important and promising.
Personally, I haven’t found journal articles to be useful for designing specific sequences, or selecting which type of practice to emphasize (e.g., asana, as compared with pranayama). There are some exceptions. The Yoga During Chemotherapy (YCTX) study that I’m part of is among the few to look at that, as it will compare eight yoga practice combinations (or “conditions,” in research-speak) to try to determine the effects (if any) of each for a person in cancer treatment. Here’s a simplified list of the eight conditions: no practice; breathing only; flowing only; restorative only; breathing + flowing; breathing + restorative; flowing + restorative; breathing + flowing + restorative…. For each condition, the investigators made choices (ideally, informed by yogis) about which practices (i.e., which specific forms of pranayama, or which restorative postures) to include. You can see how this makes the investigators’ job quite challenging, both to design the study and analyze/synthesize findings. And as we’ve seen, articles may not give details of their protocols.
In summary, here’s how yoga educators create a well-informed teaching or therapy practice even when research is limited:
- Search for and read current research articles on the topics that interest you. Make notes about its key findings, strengths, and limitations. (And what this means for what you can or cannot tell students with confidence.)
- Clarify your language for students and clients. Use phrases like, “according to yoga theory… “ and “this is being looked at by medical research…” or “preliminary studies suggest…” or “many yogis experience this, and it’s not yet confirmed by medical/health research….”
- Make a regular practice of noticing how media use medical research: what’s left out, what’s emphasized. Find the source articles (or even contact the researchers) to compare what investigators found with the information being reported.
- Consider writing down your own questions and observations! With guidance or collaboration with researchers, design your own informal research or write case studies. It’s important to have guidance on ethics and confidentiality, as well as effective design.
- Seek out mentorship from experienced yoga therapists to understand best practices and gain deeper understanding of how specific lineage transmission relates to research.
Next week’s post offers a quick list of pros and cons for yogis who are considering whether to teach or work in medical research settings… read on!
(© 2019 Rachel Lanzerotti, Five Rivers Yoga LLC.)
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Rachel Lanzerotti (MSW, eRYT500, IAYT-Certified Yoga Therapist) is the Founder of Five Rivers Yoga Therapy and creator of The RE/ST Method for Pain Recovery™. She is a Body-Mind Yoga Therapist, meditation teacher, counselor, health educator and specialist in back pain relief.
Rachel has taught at UCSF Osher Center for Integrative Medicine and Spirit Rock Meditation Center, and was a featured presenter on “The Modern Science of Yoga” at the SF Asian Art Museum. She also launched the Aging Well program of San Francisco Village. She is a faculty member of Essential Yoga Therapy, where she mentors and teaches yoga teachers and therapists-in-training.
Rachel has been published in numerous journals, research studies, and periodicals including Stanford Magazine, and with the Boston Women’s Health Book Collective on topics ranging from yoga, health, aging, and sexuality to gender, racial justice, and human rights.
She holds a BA in Human Biology from Stanford University and Master of Social Work (MSW) from San Francisco State University. For a decade prior to founding Five Rivers Yoga Therapy, Rachel ran an organizational consulting practice with community-based groups. She spent many years focused on direct action work for nonprofit and social change organizations.