Yoga for Anaesthetists | Association of Anaesthetists
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Yoga for Anaesthetists

Tips for getting started

  • Yoga is NOT about how you look or how flexible you are (although it can help us be more flexible). The principal aim is reconnecting our mind with our bodies, and there are many benefits to this, not least to our mental health. 
  • Find a teacher you like. There are so many types of yoga and styles of teaching. Experiment until you find one that clicks. Some might be too structured. Others could feel too ‘new age’. Others could feel amazing. Ask for recommendations and find one that works. 
  • Focus on the benefits. Whilst many people do enjoy the physicality, for others, it’s the sense of calm and headspace.
  • Like most exercise, we often don’t know what we like until we try it. Why not give it a go and see what you think?
  • If in-person classes are not appealing or possible, now, more than ever, there are online offerings. It can be helpful to find a local teacher and access their online live classes, where they can offer a personal connection and tips during and after the streamed class. There is also much recorded content, for example on YouTube.

Benefits to anaesthetists:

I’ve become passionate about how yoga can make a difference to our everyday lives:

  • Self-awareness. How often do you stop and notice how you are feeling in body and mind? It can be all too easy to work continuously in healthcare roles. Being conscious of how you are feeling gives you more power to make changes.
  • Mindset. Many people, particularly high achievers, are self-critical, which can be motivational but can also be a source of pain. Yoga encourages acceptance and compassion towards ourselves and others; a mindset that can reduce our stress levels. 
  • Movement. Yoga offers systematic movement sequencing that gives a great deal of self-awareness about our bodies. It teaches where we are tight, and where we lack strength. Continued practice can bring positive changes to our physical wellbeing. 
  • Mindfulness. Yoga is all about being in the moment - increasing our ability to focus.
  • Self-care. Most of us know what works for wellbeing, but how many of us actually do these things enough? If we can schedule a weekly yoga class into the calendar, at least we make 60-90 minutes a week for our self-care.
  • Relaxation. Yoga gives us space to relax, to switch off our sympathetic stress response and switch on our parasympathetic nervous system. If nothing else, who in the healthcare system doesn’t need a well-deserved break?

Tips for fitting yoga into everyday life:

Whilst not all of us can fit a yoga class in every week, there are ways we can bring more yoga to everyday life:

  • The power of the pause – it can feel like a cliché, but stopping to take a deep breath can give us that microbreak to refocus.
  • Reconnecting our minds to the here and now – in a crisis, our minds can feel overwhelmed. Yoga techniques can bring our minds to the present and help us refocus. 
  • Movement – while we might be stuck in a small space at times, we can still move to help re-energise ourselves. Some seated or standing stretches can help both our physical and mental wellbeing. 
  • Purpose – if we’re getting stuck in the politics or details, reminding ourselves of the purpose of our work can feel powerful. 
  • Gratitude – a strand from yoga and positive psychology – reminding ourselves of something we’re grateful for, however small, can trigger a big mindset shift. Whether it was that cup of tea, a smile from a stranger, or a ray of sunlight shining into a dark room, being grateful for the small things can help us get through the big things. 
  • Compassion – if we’re noticing anger at ourselves or others, bringing a sense of compassion to the situation can help (unless it’s helpful to be angry for a particular reason).
  • Mini-relaxations – if we’re feeling our stress levels are high, try a short breath-based relaxation exercise. How about breathing in for the count of four and out for the count of four?

Yoga for Anaesthetists

Introduction – Robert Self

‘Yoga in centuries past was a mystic wonderland in which the practices differed from our own in ways that ranged from the mundane to the almost unimaginable.’ William J Broad [1].

Until about two years ago, I viewed yoga as an obscure ‘new age’ cult, and would have laughed at the suggestion of going to a yoga class. It didn’t seem to be something for a man in his late forties, but rather something for athletic celebrities pictured in magazines. My first yoga class happened entirely by accident while on a walking holiday in the Lake District. One of the walkers also happened to be a yoga teacher, and led a class after a long walk. Perhaps it was the scenery and amazing weather, but I came away from the class with a remarkable feeling of wellbeing that was difficult to explain. I decided to give yoga a try, and have been a regular ever since. To date, I have always left a yoga class feeling better than when I arrived.

Throughout COVID-19, I have found a daily yoga practice (even just five minutes) to be a calm place during stormy times. Although missing face to face classes, YouTube and live Zoom classes have been surprisingly good. During lockdown, many of us discovered and enjoyed free yoga resources such as ‘Yoga with Adriene’ [2] – led by Adriene Mishler and her dog, Benji. I believe that some of the benefits of yoga are transferable from the mat into the operating theatre, in particular the breathing practices.

In the rest of this article, I have asked my co-authors to share some pointers for getting started with yoga, and how this may fit into the busy lives of anaesthetists. On a personal note, I would like to thank the amazing teachers at Triyoga, with special mention to Serena Davis and teachers running the NHS online classes during lockdown. Finally, a big thank you to the yoga teacher and walker who started my accidental introduction to yoga.

An individual and departmental perspective – Katherine Horner

“Yoga allows you to find an inner peace that is not ruffled and riled by the endless stresses and struggles of life.” BKS Iyengar

I have practiced yoga regularly for the past five years. I’ve stuck with it because I think it’s one of the most holistic forms of exercise there is. Yoga relaxes the mind whilst simultaneously improving strength, flexibility, balance and aerobic capacity. Yoga works on every muscle of the body from the flexor digitorum brevis to frontalis - all without any expensive equipment, just comfortable clothing and a mat.

Simply put, when I attend yoga classes regularly, I feel better. I feel freedom in my daily movements, have better posture, better sleep, a more relaxed and even approach to life and sudden awkward twists and turns at work don’t pull any muscles (we’ve all had to intubate a patient on the floor, or turn awkwardly to reach the anaesthetic machine in a less than ideal position).

Yoga is often described as a ‘moving meditation’. Both movement and meditation now have a strong evidence base for improving health. Yoga also improves balance. Our ability to balance declines significantly as we age, and a fall will land a lot of us in hospital or be our pre-terminal event when we’re older. There is always a strong emphasis on breathing during a yoga class. This is because smooth, regular, deep breathing stimulates the vagal nerve and parasympathetic nervous system. One of the aims in yoga is to keep your breath smooth and your face relaxed, whilst the body is challenged with postures of varying complexity. Of course, the ultimate aim is for yoga to translate unconsciously into daily life, training you to remain calm, with smooth and even breathing, despite the stresses, strains and indeed crises around you.

I would say that yoga is attractive to ‘over-achieving’ medics because it is easy to track progress. Postures that were once impossible become easy as flexibility and strength improve. Furthermore, there is always another challenge, even for the most experienced practitioner. Again, the real achievement is when yoga practice translates into daily life. An elderly woman once told me how yoga had enabled her to put on her socks for the first time in a decade.

Yoga is an incredibly useful tool for promoting and maintaining wellbeing amongst anaesthetists and theatre staff. As a trainee at Northwick Park Hospital, I arranged for the day surgery recovery unit, which was not used overnight, to become a temporary yoga studio once a week from 7.00 - 7.45 A.M. with a visiting teacher. Although most trusts offer exercise classes, they often don’t fit well with the operating theatre schedule. It was useful to have a class that allowed us to practice within the theatre complex, and then go straight off to assess our patients for the day.

More recently, during the COVID-19 pandemic, I set up regular yoga classes for our department via Zoom, which worked really well (Figure 1). The benefit of a Zoom yoga class is that it gives the sense of practising together, whilst allowing privacy and social distancing. Colleagues often say “hello” and “goodbye” at the start and end of each class, but turn their cameras off whilst practising, allowing them to retain their dignity! Additionally, the live Zoom class was recorded and could be replayed during the week, or accessed by those who missed the class due to an overrunning list. A word of caution: I would say that a mixed ability yoga class via Zoom requires a highly experienced teacher to keep everyone safe from injury. Our teacher, Leandra Ashton, targeted the classes specifically to the needs of anaesthetists, and has so far focused on shoulders, neck, upper back, arms and wrists, alongside relaxation (Yoga with Leandra; on Facebook or leandra@flyingcloudtheatre.com).

Illustrated ad for yoga with Leandra

As I finish writing this article, the words of a very famous yoga teacher BKS Iyengar from Pune, India, come to me “Words cannot convey the value of yoga – it has to be experienced” and so all there is left to say is, why not give yoga a try yourself?

say-ommm-01

View from a yoga teacher – Cathy Bailey

I had the idea for Office Om over ten years ago. I was in a senior role in the Civil Service. Keen to exceed targets, there were never enough hours in the day. I drove home each day feeling anxious and grumpy, with headaches and pain in my neck, shoulders and wrists. My employer gave me new equipment, but it didn’t make a difference. Meanwhile, I was feeling great in a yoga class for 90 minutes each week. It was suggested I stretched more at my desk and I discovered desk yoga – the idea for Office Om was born.

I had been training as a counsellor in the background, and when I subsequently trained as a yoga teacher, I was struck by the overlap between the two. There is so much in modern day psychology and wellbeing theory that can be seen in yoga texts from thousands of years ago.

There are so many misconceptions that are a huge block to people trying yoga. There is a belief, strengthened by all the social media-fuelled images of people doing gymnastics on the beach in bikinis, that yoga is something for the young, slim and beautiful. Yoga can be seen as about the physical form; something that makes us flexible. It can be seen as an egobased exercise for the ‘avocado on toast’ generation. However, this is not really yoga. Yoga in essence is the union of our mind and body – a way of living that calms the fluctuations of the mind. Whether they would use these words or not, yoga is a huge pillar of many people’s mental health strategy.


Robert Self 
Elected Member, Association of Anaesthetists 
Consultant Anaesthetist 
The Royal Marsden NHS Foundation Trust

Katherine Horner 
Consultant Anaesthetist and Wellbeing Lead 
St George’s University Hospitals NHS Foundation Trust

Cathy Bailey 
Yoga Teacher 
Founder of Office Om www.officeom.com

Twitter: @bobself_London@doctorkatieh@CathyOfficeOm

References 

  1. Broad WJ. Science of yoga: the risks and the rewards. New York: Simon and Schuster, 2012. 
  2. Guardian online. Yoga With Adriene: how the YouTube star won lockdown, 2020. https://www.theguardian.com/lifeandstyle/2020/ apr/30/yoga-with-adriene-how-the-youtube-star-won-lockdown (accessed 9/9/2020).

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