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When OTs Wore White Shoes

Yoga as OT Practice

Published January 27, 2014 11:01 AM by Debra Karplus
Performing heavy lifting at home without bending at the knees was simply stupid, given the decades of experience I have as an occupational therapist. As a result, the soreness in my lower back ranged in intensity throughout each day and I awoke each morning with inflammation in my hip, ad much overall stiffness, making getting out of bed a huge challenge. Despite a new mattress, good walking shoes that were custom fitted to my feet that cost more than my usual twenty dollars from the discount store, and a change in sleeping position and in sitting position, the discomfort did not really go away or even get better. The chiropractor diagnosed it as lumbago, which is pain in the lumbar region of the back.  My physician identified it as bursitis, inflamed bursa, and he recommended a variety of lower extremity stretching exercises that he found on the Internet.

By coincidence, I noticed an online promotion for a one week free trial membership at one of our local fitness centers. I perused the schedule of exercise classes and saw that a variety of instructors taught yoga classes, different types of yoga, several times daily. I had done yoga from time to time in the past, or "practiced yoga" as the experts say. But apparently I hadn't stuck with it or ever given it enough time and continuity to do its magic.

When doing yoga, accommodations can be made for an ailing body.

As I experimented with different yoga classes, I observed that each class began with the instructor asking in anyone had any "problem areas." Even though these were classes for people of all ages, not only senior citizen yogis, it seemed that the majority of the people in the yoga classes had back trouble, hip problems, shoulder issues, arthritis or some other acute or chronic body challenges. A few of the people in the class were able to do chair yoga and still benefit greatly from regularly participating in the class.

The instructors who are specially trained in yoga techniques were always knowledgeable and were able to offer ways to modify each position so as to facilitate stretching without causing any damage or pain. I was impressed!  And after only a week of daily yoga classes, I could see that the type of stretching and breathing done in yoga was just what my injured back and hip needed.

Yoga can help our patients of all ages with many physical disabilities.

I have been doing yoga for about a year now, and though I am not as clumsy as I was initially, I am still not as graceful as many of the other men and women in the class. But, as I have thought about my success with yoga, stretching, and the improvement in my lower back, I have considered how helpful yoga could be when used as a treatment modality with our patients, either individually or in small groups, in most any clinical setting. Even patients who use a wheelchair can do many of the yoga positions and stretches and achieve great benefits from the activity. Take a look at some of the goals you have set for your patients and consider how incorporating yoga into their therapy program can help achieve these goals.

It's likely that your patients in a physical rehab setting have goals related to increasing range of motion, strength, muscle tone, coordination and flexibility, and balance. Observe or participate in a yoga class at your local gym and imagine how some of the people on your current caseload might do a modified version of these exercises. It should become obvious that there is much in yoga that could help our patients achieve optimal health and well-being.

Sensory-motor deficits can be assisted by the practice of yoga.

For children and adults with motor planning issues, yoga can be the answer. Consider the child in school who has difficulty with left-right discrimination or the stroke patient at the long term care facility who has trouble crossing the midline of the body. These and many other areas of sensory- motor functioning, such as position-in-space and praxis skills can be helped via the practice of yoga. And yoga can help with following directions, concentration and attention to task, sequencing skills and memory, too, for both kids and grownups.

Breathing and relaxation and meditation are the cornerstones of yoga and can be beneficial to most any patient, young or old in most any clinical setting.

It's the controlled, deep breathing component of yoga that makes it different from other forms of exercise, such as Pilates or aerobics or even dance such as ballet. For people with respiratory problems such as asthma, emphysema and coronary obstructive pulmonary disease (COPD), yoga may help open airways and prevent shallow breathing, and allow better circulation of oxygen. Yoga may also help reduce the anxiety that often accompanies these respiratory conditions. Consequently, patients in psychiatric settings may also benefit from yoga for many of the same reasons.

So, how can an occupational therapist learn how to integrate yoga into treatment planning for physical, sensory-motor and psychiatric ailments?

To the best of my knowledge, learning to instruct in yoga is not specifically part of any occupational therapy professional program at the Master's Degree level, though I would be pleased to discover that I am incorrect about this. If you do a web search, you will discover that there are a relatively small number of occupational therapists in private practice, mostly providing services to a pediatric population who utilize yoga; some of these practitioners present workshops on therapeutic yoga to clinicians. 

There are training programs around the country for people who want to become Registered Yoga Teachers. These problems are not at all specific to occupational therapy; they are available to the general public. Number of hours of training ranges from two hundred to five hundred depending on level of training desired; cost is approximately three thousand dollars.

For the occupational therapist who is a yoga novice, components of a yoga practice can be incorporated into a therapy session, such as deep breathing, or some of the less complicated postures for stretching and balance. Review some of your patient care plans. Assess how yoga can help your clients have a more optimal quality of life.

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Thanks for your comments on the article I wrote, Sharon.  Keep the posts coming!

Debra Karplus February 11, 2014 6:56 PM

Hi Debra, I am a COTA/L, practicing in the public school setting,

I have used Yoga movements in my sessions. Also the PT's that work in the same schools have used Yoga. It is great for aiding in transitions, attention, body awarness, balance etc. I enjoyed your article.

Sharon February 11, 2014 4:33 PM

Thanks for commenting on my article, Debbie.

When I don't go to yoga class, I feel the difference.

Debra January 27, 2014 9:01 PM

Debra,  totally agree.  It is a great tonic for the body!


Debbie Shapiro January 27, 2014 8:14 PM
mclean VA

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