Can Evidence-Informed Practice & Yoga Philosophy Co-Exist? What Do They Have to Do With Your Pelvic Floor?
By: Nataliya Zlotnikov, HBSc, MSc
By: Nataliya Zlotnikov, HBSc, MSc
Hi there, thanks for stopping by!
As the title of this blog suggests, today we will be discussing yoga.
Can evidence-informed practice and yoga philosophy co-exist? Should you be teaching and cueing Kegels as much as you do? The answers to these and other burning questions are discussed below.
Today's blog is based on two distinct but related courses, Yoga and Science in Pain Care Chapter 2: Current Research in Yoga and Pain and PhysioYoga and the Pelvic Floor.
First, we will present a brief history of evidence-based medicine and how it relates to yoga, and then jump into some current trends in yoga, providing you with some clinical applications for pelvic health.
Let's jump right in.
Evidence-Informed Practice & Yoga Timeline
Evidence-informed practice (EIP) or evidence-based medicine (EBM) is something that we all use in our practices today; anything else would be unacceptable.
What you may not know though, is that as late as 2009, only half of medical schools were teaching EBM. That's just 12 years ago!
When did Yoga originate? Well, there is evidence that yoga dates back to 2700 BCE (Government of India Ministry of External Affairs), predating EIP by a few good years.
Can We Research Yoga From a Modern Medicalized Lens?
This difference in time begs the question, can we research yoga from a modern medicalized lens?
What do you think?
Some people believe we cannot study yoga from this perspective as doing so would disregard the complexity, tradition, and philosophy of thousands of years of yoga.
Steffany Moonaz, PhD, C-IAYT, author of the second chapter of Yoga and Science in Pain Care, and presenter of Chapter/Week 2 of our 15-part book club webinar series, Yoga and Science in Pain Care Chapter 2: Current Research in Yoga and Pain, takes a slightly different perspective.
EIP Aligns With Yoga Philosophy and Is Not Counter to It!
Steffany believes that it is important to look at the places where evidence-informed practice and yoga philosophy intersect.
The ways that we engage in EIP actually do incorporate some key elements of yoga philosophy!
In the figure below, EIP and Yoga Philosophy, from Steffany's presentation, we can see that the Samkhya Yoga Philosophy concepts on the left, align in interesting ways with the three elements of evidence-informed practice on the right.
They may not be directly correlated or overlap perfectly, but, they all use elements of each other.
In This Course, Steffany Discusses the Following Themes:
- History of evidence-informed practice
- Yoga research progression
- Trajectory of yoga research
- Yoga for neck pain
- Yoga for chronic low back pain
- Yoga dosing and analysis
- Neurological and abdominal pain
- Yoga and arthritis
- Future directions
You also have a chance to check out the remaining live webinars of the Book Club Series as they are still happening all the way through to November 2021! It's your chance to ask the authors and editors your questions.
Of course, the webinars are all recorded and will be available as courses if you cannot make any of our webinar times.
If you'd like to know a little more about the book and complete webinar series, take a look at our blog, Yoga and Science in Pain Care: Can We Do Better for Those in Pain?
Yoga in Today’s World
Let's switch our gears a little bit.
As clinicians, we know the many reasons why evidence-based practice is essential. It allows us to standardize dosing, generate objective and standardized clinical protocols, improve patient outcomes, increase safety, and more.
We also now have evidence supporting the vast health benefits of yoga, many of which were likely just as present over 4000 years ago, long before Canadian physician Gordon Guyatt ever coined the term evidence-based medicine.
So let's check in with what is happening with yoga in parts of our world today, both in and outside of clinical practice.
Current Trends in Yoga
The current trend is that the general population is looking to yoga not just for overall health and wellness anymore, but for specific health concerns and/or rehabilitation.
Now, more than ever before, healthcare practitioners around the world are integrating yoga into their healthcare practices and recommending it to their clients.
Who Is Using Yoga Clinically?
Yoga is not limited to studio or fitness settings anymore. It's also being offered as Yoga Therapy in a wide and diverse range of healthcare settings.
In 2015, a collaborative study by the International Association of Yoga Therapists (IAYT) and Maryland University of Integrative Health surveyed a few hundred yoga therapist members of the IAYT asking them to describe the setting where they work. Below are the results of this survey.
As you can see, yoga therapists are being employed in a wide range of settings.
Now That We Are Caught Up
Now that we're caught up on the intersectionality of evidence-informed practice and yoga philosophy, and understand that yoga is being used much more widely today in a diverse range of healthcare settings, we can discuss Shelly Prosko's course, PhysioYoga and the Pelvic Floor, a little more.
In this course, Shelly ties in evidence-based medicine with years of clinical physiotherapy and yoga therapy experience.
The techniques offered in the course are intended for immediate use in a physiotherapy clinic or yoga therapy setting.
Shelly aims to offer a theoretical and experiential integration of accessible and practical yoga methods and philosophy with evidence-informed practices to enhance overall pelvic floor health and wellness.
To Kegel or Not to Kegel?
Do you prescribe Kegels to your clients?
The answer to the question, to Kegel or not to Kegel, may not be as simple as we think.
Here is a snippet from Shelly Prosko's online healthcare course:
To take a look at the complete course, follow the yellow button below:
What Is Included in the Course:
- Anatomy of the pelvic floor and pelvic floor muscles
- Pelvic diaphragm roles
- Pelvic floor function and performance factors that may influence the function and performance of the pelvic floor
- To Kegel or not to Kegel?
- What about mula bandha?
- Over-recruited pelvic floor muscles: Why? So What?
- Yoga in pelvic health: Research, yoga in healthcare, yoga paths, 8 limbs
- Yamas and niyamas
- Pancha Maya Kosha Model
- Pelvic floor health issues: Four main categories accompanied by treatment ideas
- Case studies
- 21 patient exercises and 1 patient education that you can easily share with your patients on Embodia
That is one full and fascinating course!
If you currently feel that you do not have the time for such a thorough course but would still like to gain access to the video and audio practices from the practical component of PhysioYoga and the Pelvic Floor, the accompanying resource package is available to you as a standalone course.
You can gain access to the resource package by clicking here.
Too Tense? Relax With Supported Extended Child's Pose!
Many of our clients (maybe even ourselves) experience muscle tension, including pelvic floor muscle tension.
Let's wrap up today's discussion with a snippet of an exercise for you to try from Shelly Prosko's PhysioYoga and the Pelvic Floor course (and resource package) that can help support the relaxation of the pelvic floor muscles.
May you have a relaxed and peaceful day~
Date written: 10 June 2021
Last update: 22 June 2021
Marlysa is a physiotherapist and yoga therapist with over 15 years of experience working with people suffering with chronic pain conditions. She is an Assistant Professor in Yoga Therapy and Integrative Health Sciences at Maryland University of Integrative Health and holds an adjunct position at Emory University, where she teaches the integration of yoga and mindfulness into physical therapy practice in the DPT program. She is also the author of Understanding Yoga Therapy: Applied Philosophy and Science for Well-being and co-editor of Yoga and Science in Pain Care: Treating the Person in Pain as well as several peer-reviewed articles.
Marlysa has been involved in the professionalization of the field of yoga therapy through the educational standards committee of IAYT, which helped to define the competencies for the field, and in characterizing the yoga therapy workforce through research. Her research interests focus on defining the framework and explanatory model for yoga therapy based on philosophical and neurophysiological perspectives.
PT, MSc(RHBS), BA-BPHE, CIAYT, ERYT500
Neil Pearson is a physiotherapist, yoga therapist and Clinical Assistant Professor at University of British Columbia. He is founding chair of the Canadian Physiotherapy Pain Science Division, the first PT to receive the Canadian Pain Society's Excellence in Interprofessional Pain Education award, and a previous Director with Pain BC. He has received awards from Queen’s University and the Physiotherapy Association of British Columbia for his clinical work and teaching.
As a yoga therapist, Neil is certified with the International Association of Yoga Therapists, faculty in four yoga therapist training programs, and has trained over 2000 practitioners in the integration of pain science, pain care and yoga as therapy through his IAYT approved Pain Care Yoga certificate courses. Neil works for the Doctors of British Columbia developing and delivering Continuing Medical Education on pain management including yoga.
His recent accomplishments include lead contributor to Pain BC’s online Pain Foundations course and their Gentle Movement and Relaxation Series, and author/coeditor of the textbook, Yoga and Science in Pain Care. His patient education book, Understand Pain Live Well Again, published in 2007, has been translated to French and (written) Mandarin. His online pain care programs, First 5 Steps and Pain Care for Life are available at www.lifeisnow.ca, while www.paincareu.com is Neil’s pain care website.
PT, CPI, C-IAYT
Shelly is a physiotherapist, yoga therapist, educator and pioneer of PhysioYoga with over 20 years of experience integrating yoga into rehabilitation with a focus on helping people suffering from chronic or persistent pain, pelvic health conditions and professional burnout. She guest lectures at yoga and physiotherapy programs, presents at yoga therapy and medical conferences globally, provides mentorship to health providers, offers onsite and online continuing education courses for yoga and health professionals and is a Pain Care U Yoga Trainer. She maintains a clinical practice in Sylvan Lake, Canada and believes that cultivating meaningful connections, compassion and joy can be powerful contributors to recovery and well-being. Shelly is co-editor of the book Yoga and Science in Pain Care: Treating the Person in Pain.
Please visit www.physioyoga.ca to learn more