Combining yoga and physical therapy accelerates healing

NO SURGERY NEEDED: Hilary Drake, left, helps Doris Rettig heal her back with yoga therapy at Asheville Family Fitness. Photo by Kate Lundquist

The intersection of yoga and physical therapy is a relatively new field, but the combination is springing up around Asheville. While physical therapy directly addresses an injury for rehabilitation, yoga therapy can further the healing, say several local practitioners.

“There is a growing body of evidence to support yoga’s therapeutic application for a wide variety of health conditions,” says Libby Hinsley, manager of the yoga therapeutics program and certified physical therapist at Asheville Family Fitness. To offer clients a well-rounded, healing environment, she strives to integrate physical therapy and yoga therapy, noting that the practice’s staff training included sharing peer-reviewed articles on yoga’s benefits. “As [physical therapists], we always return to the importance of evidence-based practice, and with yoga therapy, that base of evidence is growing.”

Before teaching one-on-one and group sessions at Asheville Family Fitness, yoga therapist Hilary Drake completed a 300-hour yoga therapeutics program, led by Hinsley, at the Asheville Yoga Center. The training included field trips to various community locations where participants teach yoga to limited/impaired populations. To enhance the study of anatomy, it also involved a trip to the cadaver lab at the Western Carolina University physical therapy department. “The energy and work of the clinic at Asheville Family Fitness feels unique, and we are reaching a population not necessarily served by more traditional yoga studios,” says Drake, who owns Thrive Yoga Therapy.

At Asheville Family Fitness, she teaches one-on-one and group therapy sessions, including yoga in chairs and wheelchairs. “The classes and sessions … are fully accessible and modified to serve every body, every condition, every limitation and to open our patients and clients to a world of possibility in terms of coping with life’s challenges,” says Drake.

In 1978, Asheville Family Fitness client Doris Rettig had surgery to correct scoliosis via the insertion of a rod into her back — now considered an outdated technique. A few years ago, doctors recommended physical therapy and another surgery that would fully fuse her spine where the rod doesn’t reach, she says. To prevent another operation, Rettig signed up for physical therapy at Asheville Family Fitness and has participated in back-strengthening yoga therapy classes. Her doctor says she no longer needs surgery.

“Before I started all this,” says Rettig, “I was very depressed because of the pain and feeling limited, and I didn’t want to live on pain medicine. And since all this yoga, I am a new person: I am not in pain, I built up my muscles … and I feel good about my body,” she says.

“I thought I could never do these [yoga] poses or moves, but the more I come to class, the more I can move my body.”

A friend, Nancy V. (who prefers not to use her last name), joined Rettig for group yoga therapy at Asheville Family Fitness. Nancy sustained a disabling injury during a nursing accident 10 years ago and says of fellow participants in chair yoga, “We are tired of taking pain medications. We came to find cleaner ways to help lessen the pain and help strengthen the body without fear of reinjury. I had practiced regular floor yoga over 15 years ago but knew, with my shape and [the] injuries I have now, I couldn’t keep getting up and down off the floor without being completely embarrassed and in pain.”

Drake says, “There is a different mindset at [the center] around who yoga is for, and people who have found yoga here really get it. They are not trying to get their bodies into particular shapes, but rather they are hoping to find new coping mechanisms for chronic pain, stress, anxiety and injury rehab. People come in to talk about functional issues, but we know they are not sleeping well and they are stressed, anxious or depressed. But now yoga therapy offers a toolbox for coping and managing challenges that come along with pain.”

Ferris Fakhoury, owner of Anjali Hot Yatra and Physio Yoga Center, also combines yoga and physical therapy. A physical therapist since 1984, Fakhoury didn’t discover the benefits of the ancient practice until she was 45 years old, when she was introduced to heated vinyasa yoga. As a cyclist and runner, Fakhoury says, she was drawn to the benefits of stretching in the heat and, through vinyasa, began to understand she was tight in the body where her muscles were weak.

A graduate in the master’s program at UNC Chapel Hill in human movement science, Fakhoury combines her love of yoga and physical therapy through PhysioTherapy, which uses yoga philosophy, breathing techniques and postures as primary modalities of treatment. The focus is on self-empowerment and self-healing rather than a prescription approach related to a diagnosis, she says.

Fakhoury does use an intake form in the evaluation of a patient, but, she emphasizes, it’s not meant to be diagnostic. “I talk with clients about not only the physical aspect of life but also the psychological and stress level in their lives,” she says. “I watch them breathe, and we talk about the value of breath.”

Together, they develop a goal or multiple goals, similar to what certified yoga therapists would do. Fakhoury primarily uses a physical therapy approach to address what limitations and strengths a client has, but she also uses yoga postures to address each area of concern.

One client, a 56-year-old retired medical administrator who asked to remain anonymous, had been sitting in the same way for 30 years, with one leg crossed over the other and his shoulder crunched to his ear, to hold a phone. His body had become like a cast that allowed almost no movement, says Fakhoury. After several sessions, he began to understand that his pelvis could move separately from his back. He lost 20 pounds and was able to get back to his love of gardening.

Jason Scholder owns the Three Minute Egg, a Weaverville business that makes an egg-shaped yoga prop. He created the prop to stretch his back and believes that in order for the body to be healed, nerves must be pacified. Scholder has seen a crossover in practitioners who use his product, including physical therapists as well as yoga teachers. “One of the things that I would imagine yoga might address a bit more intensively than physical therapy is some of the other aspects of a trauma that either accompany the incident or the injured lifestyle,” he says.

Hundreds of physical therapists have bought Three Minute Eggs to integrate yoga into physical therapy, Scholder says. “In order to heal someone effectively on the physical level, it is important to also address any trauma that might be associated with the pain, and yoga is miraculously good at tapping into trauma.”

As an exhibitor at the Yoga Therapy Conference for the past few years, Scholder has encountered many physical therapists who are interested in integrating yoga into their practices. “One of the pieces physical therapists seem to be getting into is the mental calm yoga can provide,” he says. “Physical therapists have primarily been addressing the physical needs of the body. I think it is becoming more commonly believed that the two practices benefit one another.”

More Info

Asheville Family Fitness

Throughout January, Asheville Family Fitness will be running several yoga therapy workshops and information sessions.

Libby Hinsley

Hilary Drake

Ferris Fakhoury

Jason Scholder






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