The practice of yoga is beneficial for individuals who suffer from vestibular disorders. To gain a deeper understanding of how valuable it can be, it is important to learn what the vestibular system is, what functions it serves, and what happens when it is not working properly. This article provides basic information on the vestibular system, describes the significance of yoga practice for vestibular patients, and provides tips and techniques to help guide vestibular patients through participating in the practice of yoga.
The vestibular system is composed of the inner ear and part of the brain (cerebellum). It is an intricate structure that works in conjunction with the visual and the musculoskeletal systems to provide balance and stability. The brain requires and processes sensory information from all three systems in order to provide motor output. The results of an efficiently functioning balance system are:
1. Stabilization of vision when the head is moving.
2. Maintenance of head position in space.
3. Ability to provide postural adjustments while the body is moving.
4. Ability to sustain upright posture.
When there is a conflict of sensory information provided to the brain, the resulting output contributes to vestibular disorders. As a result, individuals may experience a variety of symptoms such as dizziness, postural imbalance, motion impairment, vertigo (spinning), lack of focus, brain fog, altered perception of movement, and falls. This impacts one’s physical function, emotional well being, and ultimately one’s quality of life. Sufferers tend to avoid certain movement and activities, move in different ways to compensate for symptoms, move stiffly and tighten up, become increasingly sedentary, develop a fear of movement, avoid social activities, avoid community activities, avoid walking in crowded areas, and may become anxious or depressed.
The practice of yoga provides substantial physical and mental health benefits to vestibular patients. Yoga has been shown to help people regain balance, decrease dizziness, decrease stiffness, improve mobility, improve coordination, improve focus, decrease stress, decrease fear of movement, and decrease anxiety. Yoga can help individuals return to day-to-day activities, regain confidence with movement, return to social activities, and improve overall quality of life. This can be achieved through performing physical postures (asana), breathing techniques (pranayama), and/or meditation (dhyana).
Yoga practice is individualized as everybody is different. This makes it a great option for a vestibular patient at almost any point in their treatment or recovery. It does not rely soley on the physical aspect, and can be very gentle and relaxing. For example, if an individual has difficulty moving, their practice may be appropriate to focus on breathwork or meditation versus the physical postures. Below are descriptions and benefits of all three:
- Asana: Yoga postures improve balance, strength, and flexibility. Performing postures regularly and with full awareness will deepen the mind-body connection. An individual is able to become aware of the signals the body is sending to the brain so that they can be interpreted accurately. Adjustments can then be made to enhance physical comfort. A calmer body will promote a calmer mind. For individuals who have difficulty getting into postures, simply performing and maintaining one posture will provide benefits. The key is to stay present, allow the body to move gently, without much resistance, and then to ease further into postures when able. Asanas can be performed in different positions and tailored to the need of the vestibular patient.
- Pranayama: Breath is vital and supports any experience an individual has, physically and mentally. It controls the function of the nervous system and all of the cells in the body. Controlling one’s breath will allow an individual to dampen part of their nervous system for the purposes of decreasing heart rate and blood pressure, balancing hormones, boosting immunity, aiding in digestive issues, decreasing anxiety, and helping with depression. All of these things are important and many come into play with one who is experiencing symptoms from a vestibular disorder. There are a variety of breathing techniques utilized in yoga practice that are gentle and effective.
- Dhyana: The purpose of meditation is to cultivate awareness. It allows one to observe their thoughts, feelings, and emotions without judgement and without the need to immediately react. An unsettled mind communicates this to the body, which in turn may cause physical chaos. Meditation helps calm the nervous system to help vestibular patients remain centered when dealing with a wide array of symptoms. There are many forms of meditation, such as being still in a particular posture, walking in nature, repeating a mantra, chanting, and sound.
Approaching yoga as a vestibular patient can feel overwhelmingly scary, with the fear of losing balance, feeling dizzy, and not being able to keep up with the class. Emma Rodgers, co author of this article offers tips and techniques that she has developed throughout her years as a yoga teacher and vestibular patient:
Preparing for your first class:
- Trying some classes at home on YouTube is a good way to increase your confidence with yoga while being in your comfort zone before trying in-person classes.
- Look at the class title and description before attending the class. Choose class descriptions that mention “slow flow” or “gentle yoga.” Styles of yoga such as Yin Yoga or Restorative Yoga will also be slower and gentler.
- Inquire in your local area if anyone is offering Chair Yoga. This is a style of yoga that provides support and stability using a chair as a prop. It is often geared towards those with dizziness or balance issues.
- Try to opt for a shorter class initially – 45-minute classes are common.
- Talk to the teacher first or reach out to the studio ahead of the class. Have a chat to them about your condition and how it affects you. They will likely be able to offer words of encouragement or tips for your practice.
- Don’t go to class on a full stomach, but make sure you’re feeling good by having a small snack prior to arriving to avoid any additional dizziness.
- Wear clothes you feel comfortable to move around in (this doesn’t have to be expensive yoga gear!).
- Take water for during the class and a snack afterwards in case you need it.
- It’s okay if you’re a total yoga newbie. Everyone has to start somewhere!
During the class:
- Expect to feel wobbly and not-quite-right during the class. Yoga is challenging. It is training your balance system to recognize wobbles as normal. (Non-vestibular patients may also be wobbling around too! It’s very normal in yoga.)
- Go barefoot – this will give you a better grip on the mat and allow you to feel more grounded.
- Yoga teachers will often instruct you to open or close your eyes. This may be triggering for you one way or the other. Take the option that feels best for you or take a soft gaze instead (eyes partially open).
- Widen your stance where needed in different poses, particularly standing poses, as this creates a more stable base and therefore will make you less wobbly.
- Focus on moving slowly and mindfully during the class rather than rushing to do difficult poses. Yoga isn’t competitive.
- You can stop and pause at ANY time to let yourself settle and join back in when you’re ready. Good yoga teachers will encourage people to take breaks where needed.
- Modified, supportive options of poses are available. Yoga teachers will often share these options for you to try (if not, ask about them).
- Use a pillow or blanket under your head when lying flat if this position is difficult for you.
- Focus your thoughts on your body feeling strong and capable throughout the class.
- Finally, know that it may feel hard at first, but over time it will feel easier and you’ll become stronger, more confident, and begin noticing huge benefits!
Authors:
Emma Rodgers is a Yoga Teacher and Holistic Life Coach with Chronic Vestibular Migraine. Find her on Instagram @emmaleighyoga.
Denise Schneider is a physical therapist with a certification in Vestibular Rehabilitation and a yoga teacher. For PT related communications/information, she can be reached at [email protected] or doctorsofphysicaltherapy.com and for yoga related communications [email protected].
References:
- Chopra, D, Simon, D. The Seven Spiritual Laws of Yoga: A Practical Guide to Healing Body, Mind, and Spirit. Wiley and Sons, Inc. New Jersey; 2014.
- Gazbare, P et al. Effect of yogasanas versus gaze stability and habituation exercises on dizziness in vestibular dysfunction. Neurol India. 2021: 69(5): 1241-1246.
- Herdman, SJ, Clendaniel, RA. Eds. Vestibular Rehabilitation, 4e. McGraw Hill; 2014.
- Prado, E et al. Hatha yoga on body balance. Int J Yoga. Jul-Dec 2014; 7(2): 133-137.
- Sealy, A. Vestibular assessment: a practical approach. Occupational Medicine. 2014; 64:78-86.