A Note from Larry
and Richard

The doctor of the future will give no medicine,
but will interest his patient in the care of the human frame,
in diet and in the cause and prevention of disease.

—Thomas A. Edison

Yoga has dramatically changed both our lives. We wrote this book because we wanted to help you restore your health, relieve your pain, and feel better through Yoga therapy. As a Yoga therapist and a medical doctor, we have different backgrounds and lead very diverse lives. Yet both of us have experienced such powerful effects from Yoga that we have committed ourselves to sharing this extraordinary healing tool with others. We believe Yoga is one of the most effective ways to treat your body and mind simultaneously, reducing stress and increasing flexibility, muscle strength, concentration, and a general sense of well-being. We want to spread the news that Yoga is not only effective for overall health, it can also be used in a targeted manner, with specially designed postures and routines, to manage and even cure specific physical disorders.

As part of his medical practice, Dr. Richard Usatine teaches the basics of Yoga to patients suffering from ailments as varied as back pain, anxiety, and asthma. He refers many patients to Yoga therapy for healing of their painful and injured bodies. Dr. Larry Payne is a Yoga teacher and therapist working each week with hundreds of people, in classes and in one-on-one therapy sessions, to improve their health.

A few words about our backgrounds before we met will help you understand how we both became so passionate about Yoga.

RICHARD'S STORY

I took my first Yoga class when I was in college and was wary because I thought I'd be spending a lot of time sitting in the lotus position, a popular image back in the 1970s. I was relieved to find that the postures of Yoga are many and varied—and they feel great. I saw how Yoga could help me increase my flexibility and learn to relax both my mind and my body. Since then, I have used Yoga intermittently with other physical activities, including swimming, cycling, squash, and tennis.

After medical school, I completed my family medicine residency at the University of California at Los Angeles (UCLA) and then practiced full-time at the Venice Family Clinic. From the beginning, I took a holistic approach to treating patients. I listened to their stories, made house calls, and developed strong relationships with the patients and their communities. Meanwhile, the medical students and residents I was training at the clinic learned the value of caring for the whole person, taking into account their physical, mental, and emotional needs.

In 1989, I returned to UCLA to co-direct the family medicine training program for interns and residents. Influenced by holistic ideas in the works of Bernie Siegel, Joan Borysenko, and John Sarno, I began to teach mind–body medicine to residents. The idea was to get young doctors to promote an overall healthy lifestyle to their patients. Meanwhile, furthering my study of Yoga gave me an opportunity to learn more about the mind–body connection and the value of Yoga in my own life. One instance of this was when I was able to use Yoga to heal a skiing injury to my knee. I began referring my own patients to Yoga for various conditions, both physical and stress related, and I constantly received positive feedback on Yoga's effects.

In 1990, I began teaching doctors how to help their patients quit smoking through abdominal breathing, the same Yoga breathing I had learned many years before. Patients were able to cope with the stress and anxiety of quitting their addiction, and we had quite a success rate! This was just one of the countless medically sound uses I have found for Yoga in my years as a family physician and a teacher.

LARRY'S STORY

In 1978, I was an advertising sales executive living in Los Angeles and working for a major New York–based women's magazine. The money was great, and the perks were even better. I drove a fancy company car, had a generous expense account, and enjoyed my work. But, as the advertising business became more competitive, the pressure intensified and I became totally overwhelmed. Eventually, I developed high blood pressure and a serious back problem. For the next two years, my job-related stress continued while doctors tried to fix my back. Orthopedic specialists, physical therapists, and prescription drugs all failed to bring relief. The only options left were surgery, more drugs, or learn to live with it.

Then a dear friend virtually dragged me (not quite kicking and screaming; I was willing to try anything) to a Yoga class. I remember being embarrassed, thinking I couldn't possibly do those strange postures the right way. My muscles were tight, and I was wired from the stress of my job. Fortunately, the teacher was compassionate and wise. She instructed me in the postures and the Yoga breathing, advising me not to be competitive or to push myself too hard. At the end of the class, she led us in a guided relaxation for about ten minutes. I couldn't believe it. The pain in my back disappeared for the first time in two years. The relief lasted several hours, and I had this unfamiliar feeling of being relaxed and happy. It was a life-changing experience, and I was eager to share it with everyone around me.

I began to pursue the Yoga path seriously, first attending a Yoga and health retreat founded by Dr. Evarts Loomis, father of holistic medicine in America. Then I took a one-year sabbatical to study Yoga. My sojourn led me to eleven countries and eventually to India, the birthplace of Yoga. There I trained as a Yoga teacher and had the fortune to study with many of India's foremost Yoga masters, including my teacher of twenty years, T. K. V Desikachar.

Well, that was it for advertising. When I returned to Los Angeles in 1981, I retired from the advertising world, became a full-time Yoga teacher, and founded the Samata Yoga Center. For the past two decades, I have worked to bring Yoga and Yoga therapy into the mainstream as a legitimate and respected health-care alternative.

OUR COLLABORATION

The two of us first met in 1997. A year earlier, Richard had been a passenger in an auto accident, and shortly afterward, the nagging low back pain began. Months later when the pain hadn't disappeared, he finally went for medical attention. The orthopedic doctors performed x-rays, computed tomography (CT) scans, magnetic resonance imaging (MRI), and even a bone scan, but they found nothing structural to explain the pain. Eventually, he was referred to Larry for Yoga therapy. At that first appointment, Larry took a history and assessed Richard's posture, flexibility, and gait. Larry developed a Yoga program specifically for Richard, and within a few short weeks Richard was essentially pain free and feeling completely well for the first time in more than a year. To this day, Richard uses the program Larry developed to keep his back flexible and healthy. (In Chapter 8, you will find a similar program, called Yoga for the Back.)

As we continued to work together, we began to discuss how valuable it would be for medical students to be exposed to Yoga, both for their own well-being and to provide them with a technique for their patients. Together, we created an elective class in Yoga and Yoga therapy at the UCLA School of Medicine. In an innovative alliance of Western medicine and ancient Eastern philosophies, the course became an immediate success, and in 1998 it became a regular part of the school's elective curriculum—a first for a U.S. medical school. Larry teaches the theories of Yoga for one hour and leads the students in practicing Yoga for a second hour. Yoga now helps these students manage their stress and exposes them to Yoga as a beneficial therapy for their own future patients. It was exciting to observe a student from our first Yoga class teaching a patient how to use Yoga breathing and postures to overcome his back pain.

YOGA: NO PAIN, ALL GAIN

As most people know by now, there are vast quantities of scientific evidence showing that exercise enhances your health and prevents illness. The benefits of physical activity are cumulative, so that small amounts of time spent exercising on a regular and long-term basis will add up to big rewards. According to the Centers for Disease Control and Prevention (CDC), exercise:

Yoga provides all of the benefits of exercise and more. The Yoga postures involve stretching to maintain and enhance flexibility. Many poses are a form of isometric strengthening exercise, which involve the contraction of muscles without moving the joint. In other words, you're working very hard to remain motionless. This technique, which strengthens muscles without putting too much stress on the joint, is often used in physical therapy for the rehabilitation of injured joints. Other Yoga poses involve movement, which is always done slowly and with focus. Because Yoga is safe and gentle, it can be enjoyed late into life, when normal aging causes many of us to lose flexibility and strength, making us more susceptible to injury.

But Yoga is more than just the physical movements and postures. The central element is Yoga breathing, which we encourage you to practice before you begin trying the routines. Yoga breathing simply means using various techniques to breathe in a slow and focused manner, which calms your mind and relaxes your body. More than twenty-five years ago Herbert Benson, a Harvard physician, researched the physiology of what he called our “relaxation response.” He found that high blood pressure could be reduced with abdominal breathing and simple meditation. The relaxation breathing stimulates the parasympathetic nervous system, which is responsible for telling our bodies to relax. The vagus nerve is a part of this system; and when it is stimulated, it reduces the heart rate and the intensity of the heart pump, thereby lowering blood pressure. Although he did not specifically use Yoga techniques, the slow and measured breathing that went with the meditation he taught was identical to Yoga breathing. That does not mean that all people with high blood pressure can be treated exclusively with this type of breathing and the relaxation response. But Dr. Benson found that this was sufficient therapy for some patients and was beneficial for those patients who still needed medication. The benefits of Yoga breathing are numerous, and we'll go into them in detail in Chapter 5 and provide you with instructions and exercises.

There is overwhelming scientific evidence that the severity of many medical problems increases with stress. For example, virtually all types of pain worsen when a person is under great stress. We feel pain when our body sends pain messages to the brain through the spinal cord. When the brain is performing optimally, it sends blocking signals down the spinal cord, which decrease the transmission of pain to the central nervous system. When the brain is under stress, it appears that these blocking signals don't work as well so we experience pain more intensely. Stress can also exacerbate high blood pressure and lead to a heart attack. Yoga has the wonderful benefit of reducing stress through the relaxation response, plus it offers all the advantages of exercise.

Like all forms of exercise, Yoga should be performed only to your capacity. There are always exceptions; but if you are older, you should not expect to be as flexible and strong as younger people. It is essential that when you initially practice Yoga, you avoid pushing yourself beyond your limit. You cannot “muscle” your way into Yoga. Injuries occur when you try to force your body to do something your body is not prepared to do. Advocates of no pain–no gain will find no supporters here. The sensible, noncompetitive, and individualistic approach to Yoga should bring you nothing but increased flexibility, strength, and improved health— no matter where you start.