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Yoga Starts Inside

Updated: Sep 1, 2023

I often hear that doctors are telling folks to take up yoga because it’s considered a healthy and approachable exercise. Living in a pretty ‘yoga-literate’ part of the US, I would think that many doctors may also understand that there are many types of yoga. Overwhelmingly, yoga in the US is focused on postures only. It’s been over 10 years now since a controversial article in the New York Times regarding injuries. What has been learned about this since? We know that many people are still being sent into the all-levels classes in which teachers are increasingly totally posture-centric (āsana), eliminating any of the other “eight limb” practices such as meditation (dhyāna) or breathing exercises (prāṇāyāma). People may be doing practices that aren’t appropriate for people who are just coming out of an injury or for other reasons. They may also be missing out on the total benefits that are available from a more well-rounded practice.

One example of medical evidence that has shown the benefits of a "slightly more comprehensive" yoga practice is from Wu et al. from the Mayo Clinic. In a systematic review and meta-analysis of 49 controlled trials, reduction of blood pressure was shown to be moderately better than controls. These practices were done three times per week and included postures, breathwork and meditation. The authors went so far as to call yoga a viable alternative lifestyle option because the magnitude of the reductions was comparable to antihypertensive medications and can reduce the risk of cardiovascular disease by nearly 50%. This is great and encouraging information to hear and I hope that more people take up yoga, but I also hope that they are able to find yoga that is more comprehensive. The study takes into account three of the most popular forms of yoga in America, but there is even more to yoga than that!

One other aspect of yoga that is not often mentioned anymore, in public classes, let alone scientific research is the ethical dimension of yoga. The practice of ethics can be seen as a psycho-emotional-spiritual practice. Such internal work such as ahimsa (non-harming) and vairagya (non-attachment) are just as valuable. These ethical restraints are a major part of yoga traditions from many sources: Brahmanical/Hindu, Jain and Buddhist. The restraints are an important system that lays the groundwork for approaching your “physical” practices such as postures, breathwork and meditation in a way that risk is minimized. For example, paying attention to the sensation in your hip that may signal you are going too far is a way to practice ahimsa. Ahimsa is intended to be used in bodies and also speech and action, according to Jain tradition. I recently visited the Jain Center of Northern California for a field trip and took the above picture. The figures you see above are images of Jain gurus who Gandhi studied with. They have slender bodies not because they want to look good in their swimwear, but because they want to cause the least amount of harm by taking fewer resources from other beings. Of course, Gandhi is a famous example of ahimsa in body, speech and action, but if we dig deeper we can always find out more about *why* we do what we do. It is not always an easy or clear practice and that is why studying and practicing with a teacher and community is also helpful. This is another dimension of yoga that can be so helpful!

I love to read the research on yoga, but it is only one view on yoga. For example, studies that get funded don’t always look at the complete yoga system. In the modern age of science-based psychology, it may seem odd to practice psycho-spiritual-emotional in these traditional ways. But they are really timeless and worth a try. I encourage yoga students of today to seek out a more well-rounded practice, not just limited to posture, breathwork and meditation. There are great insights to be found in practicing ethical restraints, to contemplate other notions of reality and to chant to focus the mind. These are a just a a few example of practices that get missed in contemporary American yoga. If you'd like to get started on breaking out of the box, I’m here to help!


Wu, Y., Johnson, B. T., Acabchuk, R. L., Chen, S., Lewis, H. K., Livingston, J., Park, C. L., & Pescatello, L. S. (2019). Yoga as Antihypertensive Lifestyle Therapy: A Systematic Review and Meta-analysis. Mayo Clinic proceedings, 94(3), 432–446.

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