Is Savasana Trying to Kill Us? Learning to Recognize & Debunk Fragility Fears

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Savasana is also known as “corpse pose”. But is it really trying to make literal corpses out of us? Well, apparently some people would have us think so!

I’m exaggerating here, of course. No one is actually suggesting that savasana - the relaxing, peaceful pose in which we lie and rest for several minutes at the end of every yoga practice - could potentially kill us. But as difficult as it may be to believe, people are seriously proposing that this classic yoga pose could injure us. And so in the interest of some education on interpreting research papers, a little pain science primer, and a continued encouragement for less fearmongering in the yoga world, I’ve decided to examine this intriguing topic today.

IS SAVASANA OUT TO GET US?

I was prompted to write this piece because of a recent widely-read blog post that was brought to my attention. This blog post cited a research paper that seemed to suggest that savasana could potentially be a harmful pose. In order to support this study’s suggestion, the blog post proposed that because our bodies have adapted to the activity of sitting in chairs, most of us are not well-suited to lying flat on the floor. As a result, when we lie in savasana, our back arches and our spine is “compressed” and “overloaded”. The author writes: “For many, lying on the floor creates much higher loads on weakened tissue than you might expect for something as ‘simple’ as lying on the floor.”

The author proposes that instead of lying flat on the floor, most people should bolster their head and shoulders up higher in savasana in order to re-arrange the position of their body and avoid potential injury in the pose.

Before we examine this claim further, let’s first take a look at the research paper that was cited in order to justify the notion that savasana is injurious.


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THE RESEARCH PAPER ON YOGA & INJURIES: A VERY PROBLEMATIC STUDY

I obtained a copy of the full study in question in order to explore its claims further. Titled “Soft Tissue & Bony Injuries Attributed to the Practice of Yoga” (Lee et al 2019), the researchers retrospectively reviewed the medical records of 89 patients who claimed to have experienced yoga-related injuries. According to the researchers, there were 12 “patient reported yoga poses that led to injury” (page 427), and one of these poses was savasana.

This study is significantly problematic for many reasons. First of all, it is a retrospective study, which is a very low-quality form of evidence that relies only on subjective recollections (i.e. anecdotes and not secondary data) to begin with.

Second of all, this study in no way establishes causation between savasana and injury. At most, the study might show that a handful of people claimed to experience a symptom of pain or discomfort while in savasana. This does not establish injury. Additionally, it does not establish time order between the two variables (a necessity for determining causation), and it does not examine any of the myriad alternate explanations that could be (and most likely are!) involved in the reported pain experienced during savasana.

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Another important point about this study is that it was not done on a representative, random sample of people who do yoga, and is therefore not generalizable to the greater yoga population. The people selected for the study all attended the same medical clinic and they all had significant comorbid health conditions such as osteoporosis, cancer, and hyperlipidemia. Therefore we can’t make any inferences from this study about the general population of yoga practitioners.

Furthermore, the researchers did not include any non-injured patients, which means they selected on the dependent variable only. What about all of the people who went into the clinic who happened to practice yoga and were not injured? These patients weren’t considered in this study. And we can safely assume that they all did savasana at the end of every single one of their yoga classes. Why didn’t this injurious pose send them into the clinic as well?

For these and many other reasons that we don’t have time to discuss here, this study is not causal, is not valid, and is honestly not worthy of citing due to its extremely poor quality design. In fact, in the words of an academic researcher I consulted about this study (who just so happens to be my husband :) ): “From a causal standpoint, this study is garbage.”



FLAWED STUDY ASIDE - WHAT ABOUT PAIN SCIENCE?

We’ve established that the study in question is deeply flawed. But that major problem aside, where is an understanding of modern pain science in either this study or the blog post that cited the study? One of the most foundational insights about pain that we understand today is that the link between pain and tissue damage is quite tenuous. Many people experience pain in their bodies with no associated damage, and many people have damage in their tissues and no associated pain.

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This means that just because something hurts or is uncomfortable does not necessarily mean that tissue damage is taking place. A helpful phrase commonly used in the therapeutic and rehabilitation worlds these days is “hurt does not equal harm”, and I believe this is a crucial insight that is missing from this discussion about savasana and injury.

Additionally, we know that in order to sustain an injury (tissue damage), the forces involved generally need to be significantly high and/or fast. The simple act of lying on the floor in savasana includes neither high nor fast forces. It is simply not plausible that this benign pose could actually cause tissue damage in our body.

Now I definitely don’t disagree with the blog post author that many people feel discomfort while lying flat on the floor in savasana. This is absolutely true, and many of us could find a more comfortable and relaxing pose by adding some props so that our body feels more supported.

But there’s an important difference between suggesting that people should prop their savasana up for comfort and suggesting that they should prop their savasana up in order to avoid injury. The former will help people find more ease and potentially embody more “yoga” in their pose; the latter will potentially serve as a nocebo - a negative expectation of an otherwise harmless event or action that causes negative consequences like pain.

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Suggesting that savasana can harm us is nocebic because we understand today that pain is a multifactorial output of our nervous system that can be influenced by many factors beyond biomechanical ones. Beliefs and social influences are two well-established contributors to painful experiences (among many other psychological and social factors as well.)

The more that we spread a message about the fragility and vulnerability of our tissues (especially in low-load contexts that can not realistically injure us), the more we can influence people to have less confidence and trust in the innate strength and robusticity in their body. This can result in people’s nervous systems creating more painful perceptions than they otherwise would have in innocent yoga poses like savasana and beyond.


IN CONCLUSION…

It’s easy for well-meaning yoga and movement teachers to cause unintentional harm when communicating about the human body. The more we can educate ourselves about pain science and the potential negative effects of nocebos, the more likely we will be to teach about the body in productive, empowering ways.

Additionally, I encourage all of us (including myself!) to become more active consumers of knowledge. If we see a single study being used to make a broad claim, rather than taking that claim at face value, we would be wise to feel skeptical and potentially conduct some of our own research to investigate further.

And finally - setting the science and the flawed study aside, let’s not forget the power of common sense. I mean… savasana? Really? Have we become such feeble creatures that we can’t lie on the floor without harming ourselves? We should feel justified in using our common sense to question such claims.

Questioning Yoga Journal's Reasoning Regarding Weight-Training

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The yoga community tends to be a tad uninformed about human movement & strength training physiology, and when established yoga entities like Yoga Journal publish misinformed articles like this one, this doesn’t help matters much!

This article features a yoga sequence that is claimed to be “better than most weightlifting programs” for building muscle & strength.

And unfortunately, that claim simply isn’t true and only serves to confuse people.

Weightlifting is actually much better than this yoga sequence for strengthening because unlike the yoga sequence, weightlifting utilizes close to maximum force production & progressive overload, which are the ingredients you need for true strengthening.

And due to time constraints on this mini-post, I won’t go into how “strength” and “building muscle” (i.e. hypertrophy 🤓) are not actually the same thing, even though the YJ article lumps them together as though they’re interchangeable.

To be clear, the YJ sequence definitely offers many benefits 👍🏽, but it is not significantly strengthening or muscle-building.

Now I know that it’s very common for people to use the term “strengthening” loosely - I do this myself at times too!

But my main issue with this article is the way it misleads people into thinking that yoga is *better* than weightlifting for strength, which promotes the long-outdated idea that yoga is the only practice we need to be healthy.

Yoga has many amazing benefits, and we can even make it *strengthening* if we make some conscious additions & changes to it. But the sequence as featured in the article does not accomplish this, nor is it better in any way than weightlifting for strength.

Let’s be clear with our terms so that people who really DO want to strengthen won’t be misled into thinking that sequences like this will do the trick!

EXPERT Q&A ON YOGA, STRETCHING & INJURIES W/GREG LEHMAN

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As a member of the yoga community for many years, I regularly hear claims made about how stretching affects the body. These claims vary widely, and I’ve heard everything from “stretching is a magical cure that will heal all of your ailments” to “stretching is damaging for the body, and therefore yoga is bad for us.”

I try to be as evidence-based as possible in my approach to yoga, so I’m naturally skeptical of claims that appear to lack scientific support. In order to clarify some of the truth versus fiction regarding stretching for both myself and the greater yoga community, I decided to consult with an expert who is extremely up-to-date on the most current scientific research on stretching.

Dr. Greg Lehman, BKin, MSc, DC, MScPT, is a Clinical Educator, Physiotherapist, Chiropractor, and Strength and Conditioning Specialist. He travels the world teaching his Reconciling Biomechanics with Pain Science course to health & fitness professionals. He is also the creator of the “Recovery Strategies” pain workbook, which is an amazing, informative, and free resource for anyone in pain. Greg’s work has had a profound impact on the therapeutic, fitness, and yoga/movement worlds, and I am incredibly honored to feature his insight on my blog!

YOGA & STRETCHING Q&A W/GREG LEHMAN

QUESTION 1: In the yoga world, there is a widespread claim that stretching can lengthen connective tissues like ligaments & tendons, causing them to become lax and leading to "joint instability". Is this a biologically plausible assertion?

ANSWER: There is no evidence that this actually happens.  Pretty unbelievable, eh? There is certainly more evidence that suggests when you pull (apply tension) to connective tissue it responds by getting stiffer, stronger and sometimes thicker.  Old research by Dr. Woo has shown this consistently.  The only consistent thing that can make connective tissue less stiff is immobilization and injury.  So, it is possible that people who gain massive amounts of flexibility may have at some point damaged their tissue. 

If people feel “lax” because they stretch I would guess that it would be more of muscle or nervous system change.  People may not have the strength in those ranges to control the motion rather than the idea that they lengthened connective tissue constraints.

 

QUESTION 2: What exactly does "stability" mean when it comes to our joints, and is there evidence to support that a lack of joint stability causes pain and/or dysfunction?

ANSWER: A stable joint system just means when it gets perturbed or jostled it comes back to its resting place.  But, people have expanded the definition to mean that a joint just moves a lot when you don’t want it to move.  Joint instability is a problem when a joint pops out of place and does not readily go back into place.  It certainly does happen but I doubt it’s that common.

 

QUESTION 3: Can passively stretching a muscle compromise its strength (i.e. decrease its ability to produce force)?

ANSWER: Not significantly, meaning 1-5% of max force production [if stretching immediately prior to a strength activity].  And since we regularly don’t need to produce max force it’s not really an issue.  And you only get this transient force reduction when you hold a static stretch for 45 or more seconds.  Some research (Blazevich) even suggests that these max force/power losses are mitigated or completely ameliorated provided you do a warm up.

There is no reason to think that long-term stretching will make you weak.

 

QUESTION 4: Aside from concerns about lengthening ligaments & tendons that we've already covered here, is it inherently injurious or damaging for the body to spend time in passive end range stretches? What about for someone with a connective tissue disorder such as generalized joint hypermobility (GJH) or Ehlers-Danlos Syndrome (EDS)?

ANSWER: I think with EDS it makes sense to limit those movements and get strong instead.  That’s one of those conditions where shit really does pop out of place.  But for other people, who cares if you hang out at end range. You are just applying tensile load to tissue (pretty much what strength training does but at other ROMs) and the tissue will adapt by getting stronger. 

We aren’t made of taffy.  We don’t really “stretch” that way with applied loading like end ROM stretching.  I don’t think it’s injurious but you could certainly argue that there are better options to achieve health and mobility – like adding strength training or even resistance throughout the range of motion.

 

QUESTION 5: There is a growing dialog in the yoga world about the distinction between active & passive stretching, with a new emphasis being placed on the benefits of training active strength & control through our ranges of motion ("active stretching") and a de-emphasis being placed on passive stretching. The reasoning goes that if we have more passive ROM available at a joint than active ROM, we are more susceptible to injury because we lack "control" in those end ranges. Would you agree with this line of thought?

ANSWER: I think you should do both.  I wouldn’t be worried about injury though.  I don’t think most people are getting injured because they have lost “control” of the joint.  Further, if you get injured because the joint suddenly goes to end ROM, it’s not strength at end ROM that would have helped you - it’s the strength and control that you needed before you went to end ROM. 

 

QUESTION 6: Many long-term yoga practitioners have discovered through imaging that they have a hip labral tear, and yoga is often blamed as the cause of this tear. Given that yoga is a low-load activity and that a majority of people in general will develop an asymptomatic labral tear as they age [Ref, Ref, Ref, Ref], is a long-term yoga practice a likely cause of a hip labral tear?

ANSWER: Labral tears are common. Heck, they might even be beneficial for performance.  It’s not unreasonable to think that ANY activity can predispose you to joint changes.  They happen and I doubt there is much we can do about it.  You will see labral tears and bony changes in most sports. 

So should we stop physical activity because of the chance of a labral tear? No. There are way too many benefits from a movement practice that far outweigh the negatives of a potential increase in the chance of having a labral tear.

 

QUESTION 7: In terms of stretching physiology, I believe that many people conflate the "muscle spindle stretch reflex" (reflexive muscular contraction during a stretch) with "stretch tolerance" (tolerating the discomfort of stretching) in their minds. Could you describe the difference between these two phenomena? Do they both play a role in stopping us at the end range of a stretch?

ANSWER: I’m not sure to be honest.  Stretch tolerance definitely plays a role as the stretch is stopped (in the experimental studies) when the participant says its too much.  What happens with long term stretching is that you are able to go farther without there being a dramatic change in tissue qualities.  Meaning we assume that the changes in ROM are due to your tolerance or perhaps habituation rather than a structural change.

The muscle spindle stretch reflex is assumed to not be occurring during end ROM stretching because in these studies they monitor muscle activity.  Meaning, they try to make sure there is no measurable muscle activity that occurs at end ROM.  We assume its just a passive resistance to stretch.  However, it is plausible that there is minor amount of activity that isn’t being picked up and this could be “putting on the brakes”.

 

QUESTION 8: Do you believe there are ways in which passive stretching could actually be beneficial for the body on a musculoskeletal level? If so, how?

ANSWER: Yes.  I think long term stretching is just passive tensile force and tension has the ability to create positive structural adaptations in tissue.  Some (Kubo) have argued that passive stretching can make tendon more efficient.  Others suggest that passive stretching influences muscle stiffness which might be good to balance the stiffness changes in a tendon that can occur with injury.

I certainly don’t view stretching as a negative which I once did.  I think if you argue against stretching you are really not “against” stretching but more pro some other intervention.  So, if you like to stretch and its helpful for you I would encourage you to keep it up. 

THANK YOU AGAIN TO GREG FOR HIS GENEROSITY IN SHARING HIS KNOWLEDGE AND INSIGHT WITH THE YOGA COMMUNITY. I HOPE YOU FOUND THIS INTERVIEW INFORMATIVE AND HELPFUL FOR YOUR YOGA PRACTICE & TEACHING! -JENNI

Learn much more from Greg Lehman on his website here, and follow him on Twitter!


Top Yoga & Movement Teachers to Watch in 2019

There’s an amazing list that just came out on the “Top 19 Yoga & Movement Teachers to Watch in 2019”, and I am honored and thrilled to be included in it!

This list was curated by the innovative online magazine Shut Up & Yoga, and their list includes many of my other favorite yoga/movement teachers as well - including fully half of the special guest teachers in my online class library! (Do I know how to pick ‘em or what? :) )

Click here to check out the article, and to find out what my favorite word is and why (and much more, of course!) I hope you enjoy reading more about my perspective on yoga & movement, as well those of all of the other interesting and innovative teachers who were featured.

Welcome to Kettlebells + Yoga and Our New Special Guest Teacher in my Class Library!

I’m more than excited to welcome our newest special guest teacher to contribute to my online class library: the amazing Lizette Pompa!!

I have been a huge fan of Lizette for a long time, and I was thrilled when she said yes to the idea of contributing some kettlebell + yoga flows to my online class library!

Using a kettlebell is one way that we yogis can bring a form of external load into our yoga practice, and Lizette does a great job of unifying the feeling of a yoga flow with the added load / "prop" of the kettlebell.

Lizette is a yoga teacher and yoga studio owner based in Uppsala, Sweden who loves to incorporate strength into her yoga classes. She is incredibly strong and dedicated to her yoga practice, and she inspires me every day with her posts on Instagram.

I hope you love her first practice in my library (which is only $8.99/month for unlimited access to all classes & you can cancel anytime, by the way!) I've already taken this class two times, and my body is verrry happy!

My Biggest Wish for Yogis in 2019

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If I could have one wish for our yoga community in the coming year, it would be for us to intentionally *load our bodies* more. But what do I mean by that?

When I talk about loading the body, I just mean exposing the body to enough of a physical challenge that its tissues are stimulated to *adapt* to become stronger.

When our tissues become stronger, our whole body becomes more resilient.

We are less likely to experience injuries because we’ve increased the load-bearing capacity of our tissues, we have more confidence and trust in our body (which can decrease the likelihood of pain), and research suggests that higher levels of strength levels are associated with increased longevity and long-term health!

So all of those are excellent reasons to load our body regularly. But as amazing as yoga is (and I personally love this practice!), yoga is actually a *low-load* activity.

(Obviously for an inactive person, yoga might offer enough load for some adaptations, but at some point, we all adapt to our yoga practice and plateau, you know?)

For all of the talk we hear these days about injuries in long-term yoga practitioners, the reality is that it’s most likely *underloading*, and not overloading, that is the root cause of the bulk of these injuries. Crazy, huh?

And that’s why my biggest wish for yogis in 2019 is to load their bodies more! This could come in the form of integrating more strengthening moves right into our yoga practice (see my online class library for tons of yoga classes that do this!), and/or in the form of yogis taking on other additional activities that involve higher & varying loads (i.e. weightlifting, rock climbing, etc - the possibilities are endless!)

More load = more resilient tissues = happier yogis!

ANNOUNCING THE NEWEST SPECIAL GUEST TEACHER IN MY ONLINE CLASS LIBRARY!

I am extremely honored to have the opportunity to host and share classes from so many incredible science-based yoga teachers in my online class library! Today I’d like to announce the newest teacher to join the ranks of this innovative teaching faculty starting on October 10, 2018.

For many people, Francesca Cervero doesn’t need any introduction. But for those of you who don’t know her, a few points of note are that she runs a thriving yoga teaching mentoring business, she specializes in The Science of the Private Lesson™, and she also hosts the popular Support & Strategy for Yoga Teachers podcast.

One of the reasons I’m extra excited about Francesca’s classes is that they were actually filmed with live yoga students! And because she is well-known for her impressive skill of holding space in the yoga room in a grounded way, these classes will be a very helpful window into watching this skilled yoga teacher do her space-holding work.

Francesca is also well-known in the yoga community for expertly teaching yoga classes without demo-ing any poses at all. Many people wonder “how does she do it?”, and now we can finally watch her in her element and learn from her techniques.

Look for her first class to arrive in the library on October 10th! I hope you love it!

 
 

Expert Q&A On Yoga & Breathing Misconceptions, Part 2 of 2

Welcome to Part 2 of my interview with Rich Severin, PT, DPT, PhD(c), CCS on yoga and breathing misconceptions! As you might remember from last week, I recently reached out to Rich because I had accumulated a number of questions regarding claims about breathing that I commonly hear in the yoga world that seemed questionable to me. As a physical therapist and board certified cardiovascular and pulmonary clinical specialist, I knew that Rich would have an extremely informed perspective from which to address my questions. (Please see Rich's full bio included at the end of this piece!)

Today I present to you the much-anticipated second half of our Q&A. Between these two installments, I feel that this is a very valuable and fascinating offering for yoga teachers who are interested in becoming more evidence-based in their teaching. I hope that you enjoy, and don't hesitate to share your comments and thoughts below!

 

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YOGA & BREATHING Q&A WITH RICH SEVERIN PT, DPT, PHD(C), CCS - PART 2 OF 2

 

QUESTION 4: Is there an alignment relationship between the rib cage and the pelvis (or between the diaphragm and the pelvic floor) that ensures optimal physiological function in the body? We often hear in the yoga & movement worlds that it’s important that the diaphragm be "stacked above" the pelvic floor so that these two structures can move in concert during breathing. If the rib cage and pelvis are habitually aligned in such a way that these two structures are not “stacked”, can this result in pain (especially around the spine and pelvis) and/or dysfunction in the body?

ANSWER: Everyone’s anatomy is unique. Everyone’s anatomy is slightly asymmetrical. Everyone’s. Our bodies respond and make adaptations to stresses over time as well. The ability to respond and adapt/remodel while preserving physiological function is how we’ve survived as a species for thousands of years.

The ability to respond and adapt/remodel while preserving physiological function is how we’ve survived as a species for thousands of years.
— Rich Severin

Now that’s not to say that sudden or gross changes to posture can’t result in problems. It can and most of that has to do with exposing the body to stresses and loads exceeding its capacity or without enough time to make adaptions. It’s also not to say that just because someone has a slight deviation from our socially constructed (and not biologically constructed) ideal posture they will have pain or dysfunction. So no I’m not certain that I would agree with that statement or line of thinking.

 

QUESTION 5: Is there a known causal relationship between specific patterns of breathing (for example habitual “belly breathing”) and specific core conditions such as pelvic organ prolapse and diastasis recti?

ANSWER: Like I mentioned above there’s a lot of things that go into disease and dysfunction. I wouldn’t ascribe one mechanism to any disease or dysfunction. There is some research suggesting that individuals with COPD might have a higher risk for urinary incontinence and pelvic floor dysfunction but that’s at the extremes of respiratory muscle dysfunction. I don’t think most people in yoga are at that level of disease. However if one were to bear down long enough and they had pelvic floor weakness/laxity I could reasonably see a prolapse develop. However even in that example it’s not a one to one relationship. I would caution against making that sort of relationship. 

 

QUESTION 6: In yoga class, we are always taught to breathe in and out through our nose rather than through our mouth. I can see how cultivating nasal breathing during yoga might slow the breath down and could therefore offer a meditative benefit to one’s practice. But are there significant physiological benefits to breathing through the nose instead of the mouth in a yoga practice - and in daily life in general?

ANSWER: Most people will generally breathe through their nose. Even those who use their mouth to breathe often still breath through their nose too. Nasal breathing is reflexive and as long as nasal airway resistance doesn’t get too high (like when you have a cold or congested nose), the lips maintain their seal and the tongue maintains contact with the back of the mouth cavity, you will breathe through your nose. Nasal breathing is innate and it allows us to warm, humidify and clean the air we breathe before it gets down to our lungs.

Nasal breathing is innate and it allows us to warm, humidify and clean the air we breathe before it gets down to our lungs.
— Rich Severin

The research is a bit limited and conflicting regarding whether mouth breathing or nasal only breathing is more efficient. Some studies demonstrate that nasal breathing is more energy efficient during exercise, however some have shown that there is no difference. Oral breathing definitely tends to dehydrate your oral passages and could make talking more challenging. 

 

QUESTION 7: If someone desired to change their habitual way of breathing (i.e. breathe more into their rib cage and less into their abdomen, for example), how easily can she/he re-set the way that their autonomic nervous system controls their ~20,000 breaths per day?

ANSWER: There’s a lot to unpack in this question. Without diving into too much respiratory physiology, the cadence and depth (pattern) of your breathing is automatically controlled by the respiratory control center in your brain stem. The pattern of breathing can be modified by various sensory inputs to activate different neural circuits of the respiratory control center to modify the pattern to match the stress, activity or condition the body is undergoing. The most notable and potent sensory input is the pH of your blood and concentration of carbon dioxide (CO2) which are monitored by nerves called chemoreceptors. When pH or CO2 gets too high or too low, breathing cadence and depth will respond instantaneously in order to maintain a cellular environment conducive to metabolic work to keep us alive. The body is incredibly efficient and effective at this process, and control of pH will always “win”. 

...the evidence that exists now does not suggest that we can change our pattern of breathing permanently due to the role breathing takes to keep us alive.
— Rich Severin

We can make temporary volitional changes to our breathing pattern. We can even temporarily stop breathing. However as I mentioned above the control of pH will always win. So while we can absolutely make these changes temporarily, the evidence that exists now does not suggest that we can change our pattern of breathing permanently due to the role breathing takes to keep us alive.

What many people might observe is that when one is stressed or in pain it usually results in hyperventilating or rapid breathing. This is due to our respiratory control center responding to the sensory and emotional inputs and thus selecting an according breathing pattern to match this “perceived threat”. By practicing slow breathing it may allow one to achieve a more relaxed state or distract themselves from pain or stress. If this relaxed state is achieved, the sensory input of a perceived threat has been absolved and different circuitry in the respiratory control center will be activated producing a more relaxed pattern of breathing. We’re finding that some of the circuitry used or involved in these breathing “programs” utilized might be hardwired. 

 

QUESTION 8: The term “breathing dysfunction” is a commonly-used label in the yoga & movement worlds these days. Do yoga and movement teachers with no concurrent medical training have the authority and expertise to identify and label breathing dysfunctions and disorders?

ANSWER: Breathing dysfunction is a bit of a nebulous term. We encounter this issue often in physical therapy practice too. Unfortunately this term is often used cavalierly and done without performing a reliable, valid and objective assessment of breathing performance such as spirometry (lung volumes), respiratory muscle performance, pulse oximetry or arterial blood gases, and markers of ventilatory efficiency during exercise.

Visual inspection and manual assessment of breathing function are very subjective and are not sufficient to determine if someone’s breathing is dysfunctional.
— Rich Severin

Visual inspection and manual assessment of breathing function are very subjective and are not sufficient to determine if someone’s breathing is dysfunctional. So unless those objective measures mentioned previously are being used I would strongly caution against labeling anyone’s breathing as dysfunctional; especially if they are walking and talking into your clinic or studio. Remember there are so many things involved with breathing and we generally do a pretty good job at it.

 

THANK YOU AGAIN TO RICH FOR HIS GENEROSITY IN SHARING HIS KNOWLEDGE AND INSIGHT WITH THE YOGA COMMUNITY. I HOPE YOU FOUND THIS INTERVIEW INFORMATIVE AND HELPFUL FOR YOUR YOGA PRACTICE & TEACHING! -JENNI


Rich Severin PT, DPT, PhD(c), CCS is a physical therapist and board certified cardiovascular and pulmonary clinical specialist. Currently he serves on faculty as a Clinical Assistant Professor at Baylor University in the Hybrid Doctor of Physical Therapy program and The University of Illinois at Chicago (UIC) Department of Physical Therapy as a Visiting Clinical Instructor. At UIC he also serves as the program coordinator for the Bariatric surgery rehabilitation program and is working on a PhD in rehabilitation science with a focus on cardio-respiratory physiology and obesity.  He earned his Doctor of Physical Therapy Degree from the University of Miami. He completed a cardiopulmonary residency at the William S Middleton VA Medical Center/University of Wisconsin-Madison and an orthopedic residency with a focus on clinical research at the UIC. He has made scholarly contributions and presented both nationally and internationally on topics relating to cardio-respiratory physiology and clinical practice. He is an active member of the America Physical Therapy Association (APTA), The American Physiological Society and several other professional and scientific societies. He serves on the board of directors for Cardiopulmonary Section of the APTA as the chair of the communications committee and as a member of the nominating committee. Dr. Severin is also a member of the APTA Cardiopulmonary Section Heart Failure Clinical Practice Guideline development team, the Specialization Academy of Content Experts, and the editorial board for Cardiopulmonary Physical Therapy Journal. Follow him on twitter @PTReviewer.