Talking With Your Doctor About Your Yoga Practice

How should you approach the topic of yoga with your doctor or other health care practitioner?

by Timothy B. McCall, M.D.

If I were to list everything I learned about yoga in medical school, I could stop right here. As far as I can recall it was never mentioned. Even with yoga’s growing popularity you still can't expect the average doctor to know much about it.

Does that mean you shouldn’t discuss your yoga practice with your physician? Not necessarily. The primary reason to talk to your doctor is safety. Although yoga has enormous potential to heal, not all of its practices are advisable for everyone.

If you’re young and generally in good health—and not pregnant--there’s probably not much you need to say. If you develop an acute injury, such as a strained back, a muscle pull, or a sore shoulder, you might ask your doctor if you should restrict your practice for a while, but this is also something a good yoga teacher should be able to help you with.

The older you are and the more chronic medical conditions you have, such as high blood pressure, diabetes or arthritis, the more important it is that you get your doctor's approval for your yoga practice. Your overall level of health and fitness is a pretty good predictor of which practices put you at risk of injury or other complications.

You should first mention how vigorous is your practice is. If you’re 45 or older and haven't been exercising regularly, you may want to get a stress test before beginning a Bikram or Power Yoga class since the intense cardiovascular workout could precipitate a heart attack. The more risk factors you have for heart disease—such as smoking, diabetes, high blood pressure, elevated cholesterol or a strong family history of premature heart attacks—and the stronger the practice you’re undertaking, the more important this becomes. If your practice is a gentle one like viniyoga, Integral or Svaroopa, such testing may not be necessary. If you've got a book that illustrates the postures you typically do, that could help you get the information across in the few minutes you're likely to get during an average doctor's appointment.

Your physician also will no doubt want to assess your practice in light of any medications you are taking. Blood thinners, for example, would make balancing postures that you might fall out of riskier since internal bleeding could result. Other medications, including blood pressure drugs, antihistamines and psychiatric medications can affect how quickly your blood pressure corrects itself when you stand up out of a forward bend or other posture.

Be sure to also mention any inversions you’ll be doing as these present particular concerns. For instance, if you've had neck problems, poses like Headstand, Shoulderstand, and Plow Pose may be problematic. Going upside down also raises pressure in the head. This can be risky—particularly if you’re holding the postures for a long time—if you have high blood pressure that isn’t well controlled, or if you suffer from eye problems. Anyone with diabetes, glaucoma, or elevated intraocular pressure, prior cataract surgery, problems with the retina, or who is strongly near-sighted should be first cleared by an eye doctor.

If you practice pranayama, the major medical concern is with breath retention, which may not be appropriate if you have heart disease, asthma or other lung conditions. Vigorous breathing practices like kapalabhati, literally skull-shining breath, or bhastrika, bellows breath, both which involve rapid breathing may not be advisable if you have heart or lung problems or are weak from any disease or its treatment. Even the chanting of long phrases may be too much if you find yourself gasping for the next breath.

Finally, If you’re using yoga to help treat a specific health condition, be sure to tell your doctor and mention any benefits you feel it brings. Not only can this help ensure you don't do anything dangerous, it may educate your doctor about yoga's therapeutic potential. If your doctor sees it’s helping you, he or she might be more inclined to suggest yoga to the next patient with a similar problem.

Dr. Timothy McCall is a board-certified specialist in internal medicine, Yoga Journal’s medical editor, and the author of Yoga as Medicine: The Yogic Prescription for Health and Healing (Bantam). He teaches yoga workshops in the United States and internationally.