Yoga in Clinical Practice

by Yvonne Hart, MS, NBC-HWC

I often encourage my patients to initiate or sustain a yoga practice and you should consider it as well (if you don't regularly recommend it already).

Yoga is having its moment in healthcare, and for good reason. It's no longer a niche activity relegated to hippies and hyper-flexible social media influencers. Yoga is science-backed, accessible, and adaptable for a wide range of people and conditions. As a healthcare practitioner (HCP), I often encourage yoga in my clinical practice not just because it's "good for you," but because it provides a powerful tool for addressing physical and mental health.

But recommending yoga to patients isn’t without its challenges. Many individuals feel intimidated, unmotivated, or downright skeptical. In this article, we’ll delve into why yoga deserves a spot in your toolkit as a practitioner, how to navigate common patient barriers, and when yoga might not be the best recommendation.

The Case for Yoga in Healthcare

Yoga combines three pillars of holistic health: movement, breathwork, and mindfulness. These elements make it a versatile intervention for a broad spectrum of conditions.

Physical Benefits

• Chronic Pain: Studies show that yoga can reduce pain in conditions like low back pain, osteoarthritis, and fibromyalgia.[1] It achieves this by improving flexibility, strength, and body awareness.
• Cardiovascular Health: Yoga has been shown to reduce blood pressure, improve BMI and hemoglobin A1c, along with significant improvement in lipid profiles, including LDL cholesterol, likely due to its ability to lower stress and promote physical activity.[2]
• Balance and Mobility: A 12-week randomized controlled trial involving participants with a mean age of 68 demonstrated that yoga can improve proprioception and reduce fall risk among older adults.[3]

Mental Health Benefits

• Anxiety and Depression: Mindfulness and breathing techniques practiced in yoga stimulate the parasympathetic nervous system, which helps reduce anxiety and promote emotional resilience.[4] Trauma-sensitive yoga has shown promise in helping patients process and regulate emotions while fostering a sense of safety and comfort within their bodies.[5]

Preventive Benefits

An 8-week yoga practice has been shown to reduce inflammation by decreasing tumor necrosis factor (TNF) gene methylation, lowering TNF production, and disrupting inflammatory pathways.[6][7] Yoga also normalizes gene transcripts for DNA repair, upregulates telomerase and sirtuins to slow cellular aging, and can calm an overactive sympathetic nervous system with its analgesic effects and support cardiac vagal tone. [7][8]

Understanding Patient Barriers to Yoga

Even when patients understand the benefits of yoga, many hesitate to try it. Here's what they might say—and how you can respond.

Barrier 1: I’m not flexible enough to do yoga.

Patients often assume they need to twist into pretzels to participate. This myth can deter individuals who could benefit most, such as those with limited mobility or chronic pain.

Practitioner Response:
Yoga isn’t about touching your toes; it’s about what you learn on the way down. Chair yoga or gentle yoga classes are perfect for beginners or those with limited flexibility. I even recommend online options to try in the comfort of the patient’s own home.

Barrier 2: I don’t have time.

Modern schedules leave little room for an hour-long yoga session, and this barrier is often voiced with a mix of frustration and guilt.

Practitioner Response:
Even 5–10 minutes of yoga a day can make a big difference. Let’s start with something manageable, like a short morning stretch or a calming bedtime routine. There are great apps and online videos with quick practices designed for busy people. Search "quick yoga” in your favorite search engine.

Barrier 3: Yoga classes are expensive.

Patients may perceive yoga as a luxury, with expensive studio memberships or private lessons.

Practitioner Response:
Yoga doesn’t have to cost a dime. Many community centers offer free or low-cost classes, and there are excellent online resources available for free. Let’s work together to find something that fits your budget.

Barrier 4: I feel self-conscious in a yoga class.

Patients with body image concerns or anxiety about group settings may shy away from public yoga classes.

Practitioner Response:

You don’t have to attend a group class to practice yoga. Home-based yoga is a great option, and I can help you find beginner-friendly resources. If you’re open to it, private classes with an experienced instructor can also help build confidence.

Addressing Contraindications and Modifications

While yoga is beneficial for most, it’s not universally appropriate. Understanding contraindications and how to modify poses is essential.

When Yoga May Not Be Recommended:

• Acute Injuries: Patients with recent fractures, severe joint instability, or soft-tissue injuries should avoid yoga until medical cleared for this purpose.
• Severe Cardiovascular Conditions: Certain poses, especially inversions, can strain the cardiovascular system. Patients with uncontrolled hypertension or advanced heart disease should be medically cleared with the stated objective of performing yoga.
• High-Risk Pregnancy: While prenatal yoga is generally safe, some poses may be contraindicated, particularly in the third trimester.

Modifications to Consider:

• Arthritis: Gentle, joint-friendly yoga styles like restorative yoga can help. Encourage the use of props like bolsters and blocks.
• Obesity: Larger-bodied patients may benefit from chair yoga or accessible practices designed to meet them where they are.
• Trauma History: Trauma-informed yoga avoids triggering poses or language, emphasizing safety and personal agency.

How to Integrate Yoga into Primary Care

Screen for Interest and Readiness:
Ask open-ended questions like, "If I suggested yoga for you, what would you think about that?" or "What do you think about incorporating movement and mindfulness into your routine?" This second option purposefully avoids using the work “yoga” and bypasses certain preconceived notions a patient may have about the practice.

Provide Specific Recommendations:
Tailor your advice to the patient’s needs, condition, and lifestyle. For example:

• Chronic pain? -Suggest gentle yoga.
• Anxiety? -Recommend mindfulness-based yoga with a focus on breathwork.
• Mobility issues? -Offer chair yoga or physical therapy-informed practices.

Leverage Technology:
Introduce patients to trusted apps (e.g., Down Dog, Yoga for Beginners) or YouTube channels (e.g., Yoga with Adriene).

Collaborate with Local Resources:
Build relationships with local yoga instructors or studios that offer beginner-friendly or therapeutic classes.

Normalize Experimentation:
Encourage patients to try different styles, such as Hatha, Restorative, or Yin yoga, until they find one that resonates.

Conclusion: A Bold Leap Toward Better Health

Recommending yoga in clinical practice isn’t just hopping on the latest wellness bandwagon—it’s a science-backed, versatile powerhouse that can revolutionize health from the inside out. As healthcare practitioners, we have a unique opportunity (and duty) to introduce patients to tools that build physical strength, emotional resilience, and holistic well-being.

By tackling common misconceptions with compassion and practical solutions, we can show patients that yoga isn’t reserved for human pretzels or zen gurus—it’s for everyone. In doing so, we’re not just improving their balance, strength, and peace; we’re opening the door to a healthier, more empowered life.

Yvonne Hart, MS, NBC-HWC is the founder of NuVida Wellness, focusing on empowering clients through evidence-based strategies in lifestyle modification, chronic disease management, and holistic wellness. She is a board-certified health and wellness coach and clinical nutrition applied scientist with a background in biology and over a decade of entrepreneurial experience. Yvonne completed her health and wellness coaching training at Duke Integrative Medicine and earned her Master of Science in Clinical Nutrition from Sonoran University of Health Sciences.