Medical Yoga, or Medical Yoga Therapy, or Clinical Yoga Therapy, as it is sometimes referred to, is a blend of ‘modern science’ and classical ‘Hatha Yoga’.
From a Western point-of-view, the word "yoga" refers to the enhanced quality of attention one pays to whatever they're doing, regardless of the activity. Awareness, mindfulness, meditation, are all terms generally referring to this overall phenomena.
Assessment & Treatment of Therapeutic Needs
From modern science, diagnostic tests and imaging such as: Blood Tests, X-rays, M.R.I. scans etc. are used to get an objective measurement and/or picture of the underlying problem.
Homeopathic Interview
Taking the assessment / evaluation process to an even deeper level involves the "homeopathic interview." This is based on the idea that becoming more aware of one's own internal processes triggers a spontaneous, inhibitory function of the nervous system, which can reduce stress and tension in the body, as well as the mind. The objective of the yoga therapist, in this case, is to ask questions causing the client to internally reflect and pay attention to their internal states.
Modern neuroscience indicates that such "mindfulness" initiates internal processes that can attenuate, or otherwise modulate, the levels of tension and stress in the bodymind. Such phenomena have been described by neuroscience luminaries such as Dr. Dan Siegel of the MindSight Institute.
One might also use a "psycho-structural" approach, where a "history interview" is first performed, and then a postural evaluation.
Structural / Postural Assessment
At the purely physical / structural level, the positioning of the bones in relation to each other, and in relation to the field of gravity, tell the yoga therapist which muscles are most over-lengthened, or over-shortened. This knowledge tells the yoga therapist which muscles are most likely to be most in need of attention. A precisely targeted stretch to that muscle, or a group of muscles, performing more or less the same structural function, can Relax & Lengthen that muscle or muscle group. As that occurs, accumulated stress, and excess musculofascial tension, is reduced, taking potentially pathological stresses off other structures of the body.
Restorative Yoga Approach
After such an individualized medical diagnosis, selected Hatha Yoga Asana (postures or stretches) are prescribed but with modifications using specially designed props such as benches, bolsters, ropes, belts et.al..; although the use of props makes it a 'passive' therapy (in that it significantly reduces the 'active' mental actuation of and expansive awareness of body muscles, mandated while performing classical Yoga asanas), the use of props use enables patients to hold the posture for much longer — if being able to do it at all — than the unassisted classical Yoga asana.
The trade off is that, if the client or patient is dong a purely passive approach — fully assisted by various props versus more active postures — certain nerve centers and neuromuscular units are not engaged, depriving the client of certain profound benefits of bodymind integration. The trade off is the prop assisted stretching provides the opportunity to fully and deeply relax and "give in" to the posture or stretch. Ideally, to achieve the full range of potential benefit, the client alternately does both approaches.
A customized sequence of 3 to 5 Yoga Therapy asanas is generally required to achieve the desired therapeutic effect, sometimes more. A trained yoga therapist typically assists the patient by tying a few ropes or belts on the patient's body in ways that accomplish the desired stretch and restoration of alignment of the affected joint(s). This approach allows the client or patient to go into a totally passive state of relaxation, with no effort at all exerted, providing opportunities for total relaxation of all muscle and neurological inputs.
However, this can typically be learnt and done by most patients themselves, once they get acquainted with the methodology, and ideally further understand their therapeutic rationale. Such asana are modified with the intent of making them very easy, comfortable and SAFE for even the aged and infirm to do, because they are often done against the support of a wall and with the help of specially designed props like chairs, benches, bolsters, pillows, ropes, belts etc. A typical daily session lasts an hour or two.
Low Intensity Yoga Approach
Another approach, requiring NO use of ropes, belts or other external props what-so-ever, can be applied. These are postures or stretches targeting muscles determined by the postural evaluation. Not requiring ropes, belts or props increases client compliance as they do not use the excuse of not having the "correct" props or tools at hand. They only need a floor and their own body. OR, there are certain stretches they can do off the side of their bed.
Parasympthetic — Self-Healing — Activation
The greater degree of injury or trauma a client or patient has experienced, the more they need to focus on LOW-intensity asana or stretching. Low intensity activation of the nervous system is more likely to stimulate the parasympathetic nerve system, the locus of the internal healing, built-in functions of the body. Inversely, high intensity stretches activate the sympathetic nerve system, which in turn tends to reduced activity of the parasympathetic system, therefor reducing the potential self-healing benefits.
Today, Medical Yoga Therapy is being widely used — in applicable cases — as a drugless treatment of musculoskeletal conditions such as osteoarthritis of the knee, spondylosis of lower back or neck, frozen shoulder etc., as also of stress management and other physiological conditions such as Type 2 diabetes, bronchial/allergic asthma, etc.
There are dozens of centers in India delivering this kind of yoga therapy to patients and conducting classes for students to train as therapists too. Yet there are yoga therapists in America more than competent to perform such therapy with clients as well.