For the opportunity to reflect on this article and earn CE/CME credits, see the instructions below.
Yoga is a particularly powerful form of physical activity that can be embodied within a polyvagal informed routine to contribute towards health, wellbeing, and sustainable high performance.
In the pursuit of health, wellbeing, and sustainable high performance within the polyvagal informed paradigm of the Practice of the Healthcare Athlete, an important strategy to implement within our daily routines is movement and physical activity. These skills can be used to recognize our physiological state as well as to shift our state. It is not necessarily only high intensity physical exertion, but also lower energy movements and activities which are effective. Yoga is a particularly significant practice within the broader category of movement and physical activity.
I am very excited to present this article written by Brendan Meany, a Doctor of Sport and Performance Psychology, researcher, writer, educator, and coach. His recent work focuses on implementing high-performance skills in medicine, psychological research and publishing, leadership and culture development, and optimizing human potential. Dr. Meany is an avid yoga practitioner and teaches yoga to all ages and ability levels in person and online. You can find his free live and recorded yoga sessions at www.UpDocYoga.com. I encourage you to check out his work!
Yoga is an ancient top-down and bottom-up regulatory practice that unifies the body and mind. The secular (Western) version of yoga incorporates three main components: breathing (pranayama), asanas (poses), and meditation/attentional focus. Combining these elements, yoga has been found, among many other benefits, to regulate the autonomic nervous system and, in particular, the vagus nerve, manage psychophysiological states, and train resilience.
Although many reasons exist for practicing yoga, homeostatic maintenance is crucial for optimal functioning. Being your best requires clear thoughts, flexible cognition/movement, and unincumbered connections to surroundings. When people shed mental and physical tension, they can approach old and new situations without baggage, preconceived notions, or suppositions. Imagine going to the airport without luggage, security checkpoints, or a designated departure time- traveling would be a much more enjoyable experience! Yoga improves a person’s baseline functioning through priming for daily challenges. Instead of struggling against adverse stimuli, yoga teaches operating more fluidly by decoupling from stressful internal thoughts, judgments, self-talk, and external stimuli. Creating agnostic connections with provocations allows a person to react thoughtfully and move forward, preventing stagnation and training resilience.
Respiration and heart rate, specifically heart rate variability (temporal variance between beats), have been found to correlate with different vagal complexes on the polyvagal ladder. Ventral vagal activation is associated with deep diaphragmatic breathing that comes from the lower abdomen and slows the heart rate. The sympathetic state, quite the opposite, is generally fast upper chest breathing that uses the shoulders and trapezius to lift the sternum, accelerating oxygen intake and pulse. Breathing and heart rate slow in the dorsal vagal state, but so does blood pressure. This phenomenon essentially deprives the organism of oxygen, contributing to the freeze phase of the vagal ladder.
A core concept of yoga is pranayama- using the breath to manipulate autonomic functions. Managing this involuntary mechanism directly is a challenging task. Yoga influences the breath circuitously by putting the body through poses at certain speeds that facilitate automatic physiological and psychological responses. During a session, the practitioner will generally adopt a breathing pattern that coincides with the style of chosen yoga: vinyasa, hatha, or yin. Yogic breathing is often associated with long, deep inhales and slow, methodical exhales, which reengage the ventral vagal circuits with neural elements of the heart, lungs, limbic system, and cortex. Balanced breathing patterns that oxygenate, calm, and maintain homeostasis such as: 4-4 breathing- symmetrical duration of inhales with exhale; box breathing- inhale 4 sec, hold 4 sec, exhale 4 sec, hold 4 sec; ujjayi breathing (ocean breath)- regular inhale and long drawn out audible exhale; send messages through vagal fibers to the central nervous system that positively influence cognition, emotion, perception, behavior, and somatic expression. These styles of breathing associated with hatha or yin yoga can maintain ventral vagal activation or relax a person in sympathetic states.
Faster-paced syncing of movements with respiration, vinyasa necessitates a slightly quicker style of breathing. Like the popular Wim Hof Method of Breathing (holotropic), swift and shallow inhales, followed by short exhales, can also shift someone out of apathy and improve mood. Because vinyasa is more cardiovascularly intensive, this type of yoga could mobilize someone out of a dorsal vagal state, initially into a sympathetic state and then towards a ventral vagal state. As the speed of breathing increases, neromodulators, blood pressure, and heart rate instinctively mobilize the body and engage the mind mimicking a strenuous situation. Although using sympathetic-like properties, the attention to one’s breathing during a yoga session manages the reparatory rate syncing autonomic functions while also inducing a present, calm, and controlled state.
Asanas (poses), the most easily identifiable element of yoga, is what much of the Western world associates with the ancient practice. Commonly deduced as just “stretching”, yoga’s physical (bottom-up) element reciprocally accentuates the top-down benefits. Moving through postures has been found to lessen physiological tension, increase muscular stability, facilitate optimal cognition, and adjust autonomic nervous system functions through bidirectional safety communications. Brain/body medicine hypothesizes that affective stress can manifest in the body and create neurophysiological stiffness- most commonly in the upper respiratory area, back, shoulders, and neck. When stressed, the body instinctively enacts the sympathetic states and uses those muscles to increase the rate of respiration. Acutely, our physiology has evolved this reaction for self-preservation and protection. Chronically, it can have debilitating effects on psychophysiological operations. Incorporating movement with targeted breathing can increase the depth of breath, strengthen the core and abdominal muscles related to diaphragmatic breathing, and train the body to lean into challenges non-reactively. Regularly experiencing incremental difficulty creates a new association with increased rigor- like flying private, humans can get used to anything.
Resilience is an adaptive response to stressful circumstances with psychophysiological reserves intact to “bounce back”. Usually, this skill develops with cumulative exposure to difficulty in supportive environments that encourage adaptation through learning. Sometimes resilience is learned through more extreme necessities like catastrophic life changes forcing modification. Yoga acts as an effective way to expand the boundaries of mind and body in a safe environment devoid of judgment, expectations, or comparison. This is both an interoceptive and exteroceptive exercise in self-regulation. Internally, during meditation and mindfulness/appropriate attentional focus, the yogi learns to separate themselves from thoughts, beliefs, and past/future events. Actually, over time, distance is created between themselves and any stimuli. Through consistent top-down training and thousands of repetitions decoupling, discarding, and redirecting attention, the person learns to engage their vagal break and live predominantly in a ventral vagal state. As polyvagal theory posits, this two-way communication of equilibrium plays off each other- psychological flexibility supports physical resilience and vice-versa. When someone is in a homeostatic state mentally, they are more apt to try physically challenging tasks.
Similar to the multitude of mental repetitions yoga provides, moving through the different postures teaches physical resilience by continually leaning into discomfort and using respiration to open the body. A common misconception is that yoga requires Gumby-like elasticity. In reality, many yoga postures are foundationally very simple. The self-guided exploration of difficulty is only brought upon the practitioner through exploring their capacities- not through competition or comparison to others. Physical resilience is developed by adopting a yoga practice that continually challenges the body and changes the practitioner’s relationship with difficult circumstances, not striving for achievement.
So why does this matter? Let’s be clear; yoga is not a panacea. Yoga cannot immediately fix traumas, difficult circumstances, or health-related complications. As an evolving practice, yoga aims to help people self-regulate their psychophysiological state to navigate the world most advantageously. The ability to maintain and recover homeostatic states will help a person function better and teach resilience in adapting to challenging environments. Regular yoga practice provides the time and space to develop those skills to improve functioning at a pace comfortable to the practitioner.
Consider how these skills and practices can be integrated into the daily routine of healthcare professionals. It is frequently possible to find a period of time to practice yoga, such as between surgical cases or during a short break between patients in clinic. These provide opportunities to engage in movement and physical activity that can result in the significant benefits described above.
The CE experience for this Blog Post / Article is powered by CMEfy – click here to reflect and earn credits: https://earnc.me/VLYMHY
This experience is powered by CMEfy – an AI-powered platform that directs learners along a pathway to capture reflections at the point of inspiration, point of care. Clinicians may earn CME/CE credit via ReflectCE, the accredited activity portal. Learn more at about.cmefy.com/cme-info.
Cahn, B. R., Goodman, M. S., Peterson, C. T., Maturi, R., & Mills, P. J. (2017). Yoga, Meditation and Mind-Body Health: Increased BDNF, Cortisol Awakening Response, and Altered Inflammatory Marker Expression after a 3-Month Yoga and Meditation Retreat. Frontiers in Human Neuroscience, 11. https://doi.org/10.3389/fnhum.2017.00315
Mocanu, E., Mohr, C., Pouyan, N., Thuillard, S., & Dan-Glauser, E. S. (2018). Reasons, Years and Frequency of Yoga Practice: Effect on Emotion Response Reactivity. Frontiers in Human Neuroscience, 12. https://doi.org/10.3389/fnhum.2018.00264
Schmalzl, L., Powers, C., & Henje Blom, E. (2015). Neurophysiological and neurocognitive mechanisms underlying the effects of yoga-based practices: towards a comprehensive theoretical framework. Frontiers in Human Neuroscience, 9. https://doi.org/10.3389/fnhum.2015.00235
Streeter, C. C., Gerbarg, P. L., Saper, R. B., Ciraulo, D. A., & Brown, R. P. (2012). Effects of yoga on the autonomic nervous system, gamma-aminobutyric-acid, and allostasis in epilepsy, depression, and post-traumatic stress disorder. Medical Hypotheses, 78(5), 571–579. https://doi.org/10.1016/j.mehy.2012.01.021
Sullivan, M. B., Erb, M., Schmalzl, L., Moonaz, S., Noggle Taylor, J., & Porges, S. W. (2018). Yoga Therapy and Polyvagal Theory: The Convergence of Traditional Wisdom and Contemporary Neuroscience for Self-Regulation and Resilience. Frontiers in Human Neuroscience, 12(67). https://doi.org/10.3389/fnhum.2018.00067