“I’d love to try yoga, but…”
In almost two decades of teaching yoga in medical settings, we’ve heard this wistful phrase from countless people who have mistakenly assumed that yoga isn’t for them.
“I’m not flexible enough,” they shrug sadly. Or they concede, “I can’t sit on the floor,” or “I’m too old, too heavy, too stiff.”
We’re quick to assure them that yoga is not just for twentysomethings in spandex. Despite the common misconception that you must be able to twist yourself into a pretzel or stand on your head, there’s only one thing you need to do to practice yoga and reap its many benefits. You don’t have to touch your toes, sit cross-legged, or even get out of bed.
The only thing you need to be able to do to practice yoga is breathe.
And the potential rewards are vast. This ancient discipline has long been recognized as a path to inner peace and as an excellent way to boost strength, balance, and flexibility. Modern research indicates that yoga offers a host of physiological and psychological benefits, including reducing heart rate and blood pressure, relieving anxiety and depression, and easing back pain.1 While yoga research is in its infancy, numerous studies are examining its therapeutic effects on a broad array of ailments, including heart failure, arthritis, chronic pain, cancer, and Parkinson’s disease.2 Evidence suggests that yoga not only improves health-related quality of life but also enhances walking and balance, muscle strength, cardiovascular health, and sleep,3 and it may even improve lung function.4
But not all yoga classes are alike, and it’s unfortunately common to find people who say that the supposedly healing practice of yoga caused them pain. As teachers specializing in yoga for potentially vulnerable populations, we often hear stories about people having a negative experience in a yoga class—frequently because the class was too difficult for the participant or taught by an inexperienced or poorly trained instructor. Yoga’s booming popularity has resulted in a broad array of offerings, including hybrids such as yoga on an exercise ball, as well as classes taught by instructors whose training consists of a weekend yoga workshop. Even yoga instructors who are adequately trained to teach able, fit students typically have a limited understanding of the important safety considerations that Western medicine recognizes as vital when working with “mature” bodies and people with health issues.
Having the extraordinary opportunity to teach yoga at one of the country’s leading academic medical centers has helped us recognize the critical need to integrate evidence-based guidelines from modern medical science with the profound wisdom of the ancient yogic tradition. During the past decade we have worked with top medical experts in varied fields—including pain management, cardiology, physical therapy, oncology, pulmonary rehabilitation, exercise physiology, and geriatrics—to develop a safe and effective yoga practice for older adults and people with medical conditions.
We call our approach “Relax into Yoga” because our work with people at midlife and beyond has highlighted the essential need to develop awareness, ease, and a compassionate relationship with the body. In a culture committed to doing, striving, and pushing, Relax into Yoga cultivates the critical counterbalance of undoing, of slowing down, of savoring the moment and knowing more fully what life is presenting right now .
Too often, people are hypercritical of themselves or even at war with their own bodies—saying they “hate” parts of themselves that carry excess weight, feel a little creaky, or experience pain. They might struggle and complain about a “bad” knee or “bum” back, an attitude that can create excess tension and exacerbate pain.
We emphasize learning to treat yourself with kindness, let go of judgment, and to love yourself as you are. Slowing down and paying attention—not only to the physical body but also to emotional and mental reactions—helps calm the nervous system while cultivating strength and flexibility. Making peace with your body—even those places that are “challenged”—can relieve the suffering caused by resistance to the experience you are already having. And rather than working toward complex postures that might be eye-catching on a magazine cover, we focus on poses designed to help people function better in daily life activities, such as walking along a narrow street, carrying groceries, and getting into and out of a car.
Our Relax into Yoga program cultivates the critical counterbalance of undoing, of slowing down, of savoring the moment and knowing more fully what life is presenting right now .
We’ve had the privilege of teaching yoga to countless older adults—ranging from competitive athletes to couch potatoes—as well as those facing serious illness such as cancer, heart failure, and lung disease. Many of our students tell us that yoga has made a profound difference in their health, relieving pain, boosting mood, and enhancing sleep. We hear numerous examples of how yoga has improved their quality of life, from being able to get down on the floor to play with grandchildren, to restoring the ability to play tennis or golf, to being better able to manage stressful events. And we’ve seen some dramatic effects of the practice, including students who’ve been able to cut back or eliminate medications, rely less on the use of a cane, and learn to breathe—rather than scream—through a pain crisis.
While we originally targeted our Relax into Yoga classes for seniors, we’ve found that many younger people are also drawn to this approach to practice. Typically these are students facing health issues—such as PTSD, obesity, and chronic pain—who are worried about getting injured or feeling uncomfortable in a “regular” yoga class. It has become clear that our mindful, gentle approach—with a specific focus on safety and effectiveness—can appeal to anyone of any age.
In our wired, worried society, where more than one in five American adults takes at least one mental heath medication,5 learning to take an easy breath, to quiet your body and mind, and to connect with your innermost self can be a lifesaving skill. We invite you to relax into yoga—a breath-by-breath, step-by-step path to wholeness.
We are in the midst of one of the greatest sociological shifts in history: global aging. Sometimes called the “Silver Tsunami” or the “Age Wave,” this phenomenon of increased longevity among unprecedented numbers of people promises to dramatically transform our world. Seniors ages sixty-five and older comprise the fastest-growing sector of the U.S. population.6 This group is expected to more than double (from 8 percent of Americans to 20 percent) to more than eighty million by the year 2050.7 And there will be a huge jump in the “oldest old”—nearly 5 percent of Americans will be eighty-five and older in 2050, compared to just over 1 percent in 1994.8, 9
Like many people looking to boost their health, fitness, and peace of mind, older adults are increasingly drawn to yoga. Yoga is one of the most commonly used complementary health approaches in the nation, with participation nearly doubling from 5.1 percent of adults in 2002 to 9.5 percent in 2012.10 And a growing number of physicians are encouraging their patients to try yoga to relieve problems such as back pain, high blood pressure, and irritable bowel syndrome. Yet finding a yoga class that is appropriate for baby boomers and beyond can be a challenge.
Most yoga books and studios rely on postures geared to younger individuals—some of which pose potentially serious risks for mature bodies. For example, the popular Sun Salutation sequence includes straight-legged forward bends, a movement that can strain the back and that the National Osteoporosis Foundation advises people with compromised bone to avoid, as it increases the risk of vertebral fracture.11 People with osteoarthritis in their knees and/or hips often experience pain in postures that place body weight on an affected joint, such as deep squats or sitting cross-legged. And popular “hot yoga” studios that heat the room to temperatures as high as 104 degrees Fahrenheit may be problematic for people with heart disease, particularly those taking medications that can exaggerate the body’s response to heat.12
Today’s seniors are a very diverse group, including healthy and fit individuals able to run marathons, compete in masters athletic events, and even stand on their heads. However, much more common are those who fit the profile of an average seventy-five-year-old in America: someone who has three chronic conditions and uses five prescription drugs.13 Many of the medications taken for common conditions such as high blood pressure, pain, and depression can increase the risk of falling.14 Among people over sixty-five, falls are the number one cause of fractures, hospital admissions for trauma, loss of independence, and injury deaths.15 That’s why it’s essential to make sure your yoga practice is safe, appropriate, and effective. This includes beginners as well as experienced practitioners who want to adapt their practice to their changing bodies, hearts, and minds.
Yoga offers a host of physiological and psychological benefits, including reducing heart rate and blood pressure, relieving anxiety and depression, and easing back pain.
Along with a growing appreciation of yoga’s therapeutic benefits has come an increased recognition that, like any physical activity, yoga can cause injury. Triggered in part by a controversial 2012 New York Times Magazine cover story, “How Yoga Can Wreck Your Body,” is a burgeoning awareness that the supposedly healing practice of yoga may also cause harm.16 And, somewhat paradoxically, the very people who may have the most to gain from yoga—older adults and people with health challenges—may also have the most to lose.
When we first started teaching yoga at Duke University and the Durham VA Medical Center in the late 1990s, the idea that yoga was not just for youngsters who wanted to stand on their heads but might actually benefit people fifty and up, as well as those with serious illness, was brand new. This budding interest in yoga’s healing potential arose, in part, from a groundbreaking study published in 1990 in one of medicine’s top journals, the Lancet , suggesting that a yogic lifestyle may stop, slow, or even reverse the progression of heart disease.17
This was also a time when medical advances were triggering the new “longevity boom” by helping people recover from ailments that might have killed them just a generation ago. The development of clot-busting drugs, such as tPA, gave physicians a lifesaving tool to combat heart attack and stroke. Today, tens of thousands of Americans survive these events each year and go on to live active, full lives.18 Advances in oncology have made cancer—once a death sentence—now increasingly survivable, with more than 14 million Americans, most of whom are seniors, having experienced the cancer journey.19 Many people who have faced such serious health issues describe the experience as a turning point in their lives, prompting them to embrace healthy physical and emotional changes such as exercising and eating well. As a result, they become stronger and more resilient than ever before.
In fact, thanks largely to progress in medicine, the human life span has almost doubled in the last century . As recently as 1900, the average life expectancy in the United States was 47.20 In 2012, that number jumped to an all-time high of 78.8 years: 81.2 for females and 76.4 for males.21 And in some other countries people live even longer: 87 years for women in Japan and 81.2 years for men in Iceland.22 Throughout the world, more people are living to more advanced ages than ever before—and with a very broad range of functional capacities and needs.
The popular saying “sixty is the new forty” reflects this reality. In our grandparents’ day, life expectancy was about sixty years.23 But today, someone celebrating a sixtieth birthday can expect to live two decades or more, with the potential for making this chapter of life truly the golden years. And as a holistic discipline that touches body, mind, and spirit, yoga can be a profound and transformative practice during this precious time.
Our competitive culture promotes a crazy-busy mentality in which we’re taught to give 110 percent, push ourselves to achieve, and always be “in it to win it.” Many people—including athletes and soldiers—are even encouraged to “sacrifice their bodies” by training themselves to ignore sensations of discomfort and pain.
Yoga offers powerful tools to help offset this disconnected, forceful, frenetic mind-set by inviting us to pause, listen deeply, and be present for whatever is arising—physically, mentally, and spiritually—in each moment. We are reminded to be grateful for the gift of breath and to connect with our deepest, truest selves.
Yet for many people, shifting gears away from the Western striving and pushing mind-set is often extremely challenging. Lifetime habits of body and mind can make it difficult to ease up, relax, and embrace the yogic attitude of finding an appropriate balance between effort and surrender. Most of us are very good at doing but struggle with the very thing we need most: undoing.
That’s why it’s essential to recognize that yoga involves not just what you do but also how you do it. So if you’re showing off for spectators while you perform postures (or watching TV or mentally checking items off your to-do list) the experience is likely to be quite different than if you were practicing these same poses mindfully, with a nonjudgmental attitude of self-discovery, as you tune in to the various dimensions of your inner experience (for example, sensations, thoughts, feelings, energy). Our Relax into Yoga program is designed to help you cultivate a new and/or deeper awareness through yoga postures, breathing, meditation, and principles.
Despite the common misconception that yoga is primarily a form of exercise, this ancient discipline is actually a practice of awareness designed to quiet your mind and help you connect with your innermost self. Much more than a workout, yoga is a powerful form of mind-body medicine that approaches health in a holistic manner, honoring the interplay of our physical, emotional, and spiritual well-being. At its heart, yoga is a comprehensive system for transformation and freedom from suffering.
Awareness is a central component of yoga and is integral to all aspects of the practice:
We emphasize learning to treat yourself with kindness, let go of judgment, and to love yourself as you are.
In the ancient teachings of yoga, love is considered a central defining virtue of the human experience. To reflect this, we have created specific principles to cultivate a loving approach to every aspect of your practice. This includes how you move into and out of the postures, the quality of your relationship to thoughts and feelings, and your receptivity to energies, sensations, and spirit.
These principles were published in a journal article we wrote with several Duke colleagues that outlines essential considerations involved in teaching yoga to seniors.24 We have adapted them here to be relevant to students of any age or ability level who are interested in our heart-centered mindful approach to the full dimension of the yoga experience—physical, mental, emotional, and spiritual. (We’ve also written a teacher’s guide that further expands on the Carson-Krucoff principles for those interested in teaching yoga to older adults. Visit http://www.newharbinger.com/33643 to download it.)
This aligns with the yogic principle of ahimsa , or “nonviolence.” It applies to more than just physical violence, as it also relates to emotional harm from unkind words or behaviors. If you’ve ever complained about a “bad” knee or called a part of your body “ugly,” this is a kind of violence against yourself. Learning to love yourself, even those parts that are challenged or less than ideal, is central to yoga practice. Avoid violence in your movements as well as in your thoughts, words, and deeds.
Cultivate this attitude of non-harming by not comparing yourself with anyone else, treating yourself kindly, and not forcing your body into painful positions. Avoid being competitive or judgmental.
A yoga pose should be “stable and comfortable,” according to The Yoga Sutras of Patanjali .25 Challenge yourself in each pose, but avoid strain. Don’t be lazy, but don’t be pushy, either. Find the middle ground between effort and surrender.
Rather than struggling to perform something you think you should be able to do, start where you are and build from there. If an entire pose is too challenging, try just one piece—for example, an arm or leg movement. Even just visualizing yourself making a movement has value.
Let go of ideas of how a pose should look. Focus instead on how a pose feels. Learn to discriminate between discomfort , which may be an inherent part of the growth process, and pain , which, in general, is to be avoided. Note: If you have chronic pain—meaning that you continually live with some amount of pain—it’s important not to let pain keep you from moving, because inactivity is likely to exacerbate your pain. But be sure you are doing appropriate postures and breathing practices, and avoid movements that increase your level of pain (see “Chronic Pain,” page 42).
Yoga recognizes that everyone carries a deep, inner wisdom. Learn to listen to this true teacher within, and remember that you are the authority on how you feel. While it can be wise to seek guidance from experts, consider them partners rather than bosses. Recognize that a good yoga teacher is not a drill sergeant but a guide, helping you explore what works best for you.
In the ancient teachings of yoga, love is considered a central defining virtue of the human experience.
Create a mind-set that celebrates what you can do. Rather than fixate on what’s wrong, consider viewing the situation through the lens of what’s right. Cultivate an awareness of your blessings. Approach your practice in a manner similar to a child released onto the playground for recess. Have fun moving your body, and enjoy your breath.
The ancient Chinese text, the Tao Te Ching, teaches that “whoever is soft and yielding is a disciple of life.”26 This is particularly important as the body loses resiliency with age. Avoid jerky, ballistic movements and rigid holdings. Instead, cultivate a fluid quality of movement.
Our choice of words holds great power in helping us learn not just what to do but also how to do it. We encourage you to use skillful language in your self-talk, so your inner dialogue is kind and compassionate as you move toward your own seat of stability and comfort. Invite and encourage yourself into the practice, rather than direct and demand, to better facilitate your own personal journey within.
It’s not uncommon to come to yoga looking for relief from a troublesome problem such as an achy back, heart disease, or arthritis pain. While yoga may help heal these issues, our approach doesn’t focus on the symptom or ailment itself but on the person who is experiencing it. This means that an appropriate yoga practice for one person with back pain may be quite different from the appropriate practice for someone else with a similar problem. Remember that yoga is designed to help you quiet your mind and connect with your true self. Easing physical and emotional distress may be essential to helping you find this union, but it is the experience of union itself that is at the heart of the practice. Ultimately, yoga invites us to take refuge in the simplicity of being, the beauty of presence itself.
Relax into Yoga for Seniors is divided into two parts:
In addition, we have created audio recordings that will guide you through the breathing, postures, and meditations. They are available for free download from our publisher’s website at http://www.newharbinger.com/33643. We encourage you to take advantage of this unique resource, since it can be very helpful to be talked through the poses step-by-step once you have reviewed the illustrations and descriptions. This can give you a more fluid practice, as it can be difficult to refer to the book while practicing. (For instructions on how to access the audio recordings, see “How to Get the Accessories for Your Book,” on page 229.)
Please read part 1, “Yoga for Healthy Aging,” all the way through. In part 2, “Relax into Yoga Practices,” spend a week with each chapter. Give yourself time to experience the postures and build the skills presented, such as balance, back strength, and flexibility. Avoid rushing. Make a commitment to give yourself the full six weeks to fully experience our Relax into Yoga program, and then feel free to establish your own program as you become confident in the practice.
May your yoga practice bring you closer and closer to a rich and intimate relationship with yourself and your precious life. Enjoy!
A note for yoga teachers: You may be reading this book as a yoga instructor interested in teaching yoga to older adults but unfamiliar with how to begin adjusting your instruction to safely and effectively work with this population. We’ve written a guide that will help you do just that: Adapt your teaching for senior students. Visit http://www.newharbinger.com/33643 to access and download our complimentary guide. For instructions on how to do this, see “How to Get the Accessories for Your Book,” on page 229.