Is Yin Yoga appropriate for someone with significant health challenges?

Is Yin Yoga the same as Restorative Yoga, or is Restorative Yoga the same as Yin Yoga? There are three correct answers to this question: yes! no! and maybe! This question has many relatives:

  • “I have osteoporosis; should I do Yin Yoga?”
  • “My doctor told me to come to your class because I have sciatica – is that ok?”
  • “I have a rod in my back;
  • “I have had a hip replacement;
  • “I have spondylolisthesis;
  • “I had a vasectomy; can I do Yin Yoga?”

What should we say to people asking these questions?

Let’s begin by defining our terms for clarity: Restorative Yoga is a form of practice directed towards students who are injured, stressed or ill, who need a very gentle practice and who are looking to regain the quality of life that they used to have, but have lost. It involves the use of props (sometimes lots of props) to allow the body to feel totally supported, to allow the body to relax and release; long holds of these gentle postures, postures often selected to address specific challenges; and deep mental and visceral relaxation. This does sound very ‘yin-like’ compared to the ‘yang-like’ Hatha yoga practices that include dynamic movements, muscular engagement, active breath-work or energizing music. And it is ‘yin’ in this respect, but is it Yin Yoga?

Yin Yoga, as a style of yoga popularized by Paul Grilley and Sarah Powers, is not intended to be Restorative Yoga: it encompasses long held, static stresses of the deep connective tissues allowing them to be remodeled. It may include props and it does include long holds and mindfully reducing stress but it is not intended to heal broken bodies in the way that Restorative Yoga does. Now all Hatha yogas can help heal broken bodies but we can think of the main intention of Yin Yoga to be maintaining or improving the current state of health to optimal levels. In short, and it is always dangerous to make short dogmatic definitions but here goes, Restorative Yoga takes an unhealthy body and brings it (hopefully) back to normal, while Yin Yoga takes a normal healthy body and brings it up to optimum. So you see – it is a question of degree.

In an arguably average sized Yin Yoga class, say fifteen to thirty students, the teacher is going to focus on the average condition of the majority of students: catering to the extremes is rarely a successful strategy for teaching yoga – if you offer poses that only the most advanced student can do you risk boring or possibly injuring everyone else; however, if you make sure the poses are safe enough and easy enough for everyone to be able to do you risk boring the majority. If the teacher is experienced perhaps she can layer the class into several levels to offer something for 90% of the class, but no teacher in one class can offer something for every possible health condition. Choices and trade-offs have to be made. This means that in a normal class, one that does not have lots of students who have had back surgery, knee operations, are eight months pregnant, suffering arthritis, cancer, aids, etc., the teacher will offer a Yin Yoga practice that will meet most people’s needs.

In a Restorative Class generally the size of the class is much smaller, perhaps four to twelve students, which allows the teacher to get to know the health and injury status of each student and thus tailor the poses and options for each individual. The whole class will be quieter and more relaxed than other styles of yoga class.

Now, what to do when a student shows up in a Yin Yoga class with a specific and challenging condition that is outside the norm for the other students? She may have been told to come to your class because ‘Yin Yoga is Restorative Yoga.’ Do you refuse her entrance? Do you allow her in but bring down the level of the class and deprive your regular students of the challenge they need? Do you try to teach normally but keep fretting about how this one student is doing, and end up so distracted that you offer little value to anyone? These are tough choices! Let’s put this question on hold for a moment and consider one other question: is Yin Yoga even appropriate for someone with significant health challenges?

When the intention of a yoga practice is to achieve optimal health a question has to be asked as to how deep to stress the body. The answer is is found in the Goldilocks’ curve: if too little stress is applied the tissues atrophy. If too much stress is applied the tissues degenerate. For some students the intention is not optimal health but rather optimal performance: they will want to push the poses to the maximum of their physical and emotional limits. This may be appropriate for dancers, gymnasts and athletes whose jobs require maximum performance, but they should be aware that their choice comes at a cost: maximum performance is obtained at the expense of optimal health. Talk to any retired dancer, gymnast or athlete and you may find some of the most broken bodies around.

All tissues need stress! This fact is one that confuses the discussion of using yoga as therapy. A student who suffers osteoporosis in her lumbar spine may have been told to not stress her lower back at all, to make sure she doesn’t break her spine. This advice is offered with the best of intentions but it may not be the best of advice because if there is absolutely no stress on the spine, the tissues will continue to atrophy. But clearly, too much stress will degenerate the bones leading to worse problems. So what to do? In these cases it is best to think of the Goldilocks’ curve as becoming narrower and shifted to the left.

Notice this second graph: the area of safe stress is very tiny and there is a smaller margin of error between too little and too much. The point is – all tissues need stress but with injury or illness the proper amount of that stress falls into a very narrow band. It is easy to go too far and hurt the student but it is equally too easy to say, “don’t do anything,” which also hurts the student. The student coming to a Yin Yoga class may be totally justified in wanting to take your class. A Restorative Class may not work for them: it may be too gentle, they may only have one area that needs care but the rest of their body wants a regular workout, or they do want to work into the damaged connective tissues and can only get that in a Yin Yoga class.

So we are back to our basic question: is Yin Yoga the same as Restorative Yoga? The answer is – “No!” Restorative Yoga is a very gentle practice that does not try to stress the tissues deeply and does not take the student outside her normal comfort zone. Yin Yoga is simple, but simple does not mean easy: it will challenge the student and will deeply stress the tissues. But the answer is also – “Yes!” Yin Yoga, when applied carefully and conscientiously can apply an appropriate Goldilocks level of stress to damaged tissues and help them recover. The key word is appropriate: how do you know when the stress is appropriate? Short of wearing X-ray glasses and having a portable MRI handy, you cannot be absolutely sure, but what you can do is teach the student how to pay attention to her edge. This is the answer you need to give to the student who shows up unexpectedly at the beginning of your class claiming that Yin Yoga will be good for her severe spinal stenosis: “Pay Attention! Practice mindfully!”

Teach the student how to feel what is going on: this is not easy and takes time and practice. Advise her to go very slowly and very gently into each pose, feeling all the sensations occurring in detail. Describe to her what is inappropriate sensation: pain! Unfortunately, she may answer that she always feels pain, in which case tell her to look for any increase in pain or changes in its quality. Caveat your class: this is not Restorative Yoga and it may not be appropriate for her; you are not a doctor; but if she promises to take it really easy, do all the modifications that you will suggest and come out of the poses whenever it gets even a little bit challenging, then you will let her try the class. Unfortunately, and there is no way around this, you will have to keep checking on her and offering appropriate options that fit her situation: that’s part of the bargain you have made when you accepted her into your class. (If you are not prepared to, or are unable to do this, don’t let her in the class!) Also, don’t let her slip away with the crowd after shavasana: talk to her again after class; check in with her, see how she feels, and spend a bit more time explaining the ideal Goldilocks position for her.

Finally, ask her to pay attention to how she feels over the next 48 hours: sometimes the changes for good or ill do not show up right away. She needs to keep paying attention to what is happening within and then try to correlate any changes to what she has been doing. That is also part of living and practicing yoga mindfully. Maybe you both will discover that Yin Yoga can be Restorative Yoga!

(Back to Newsletter #13)