High Blood Pressure and Inversions
The practice of Yoga poses (Hatha Yoga) offers tremendous health and wellness benefits, but certain health conditions require important modifications and omissions of specific asanas. High blood pressure is a serious health condition that generates many possible contraindications especially in Yoga postures that invert the head below the level of the heart.
High blood pressure (or hypertension) is the occurrence of abnormally high arterial blood pressure at resting state. High blood pressure can result from a variety of factors but is commonly associated with atherosclerosis (a common arterial disease in which raised areas degeneration and cholesterol deposits form on the inner surfaces of the arteries), poor dietary habits, lack of physical activity, and high proportions of body fat.
High blood pressure is a result of arteries having poor blood flow. This resistance to flow requires the heart to pump more vigorously in order to circulate the blood (oxygen and nutrients) to all the cells of the body. This extra effort placed on the heart has a wearing effect on heart tissues and places a greater amount of fluid pressure against the walls of blood vessels.
How Does High Blood Pressure Affect Yoga Poses?
When we invert the body such that the head is below the level of the heart, there is a tendency for blood to pool into the head. This pooling of blood into the head greatly increases when one also elevates the lower body and legs above the level of the head. When we do Yoga poses and other forms of exercise, there is an increased demand for oxygen by muscle cells.
The way that the body meets this increased demand for oxygen is by increasing heart rate and blood flow. So if we invert or place the head below heart-level during Yoga poses and other exercises, not only is there a pooling of blood in the head, there is elevated blood flow and pressure coming into the cranial region.
Normally, the body is adapted to handle blood pooling and mild pressure in cranial blood vessels. But if one already has elevated blood pressure at resting states, the sudden inversions in Yoga can add to the elevated blood pressure, thus generating pressure that is enough to damage delicate blood vessels in the brain. In severe cases, high blood pressure combined with inversions may cause blood vessels to hemorrhage.
Another area of awareness required, when high blood pressure is present, is the process of breathing. When one holds the breath while doing heavy exertion, blood pressure dramatically increases. This contraindicating effect is called the Valsava Maneuver. Many people are familiar with hearing fitness trainers saying “breath out” during the exertion stage of an exercise repetition.
Again, this breathing pattern not only keeps a steady flow of oxygen moving to the tissues but also has physiological benefits in preventing negative pressure occurring in heart and brain tissues. Therefore, when one has high blood pressure, holding the breath in Yoga poses or holding the breath in specific pranayama (breathing exercises) should be avoided.
If you have concerns about having high blood pressure, consult your physician. If you are diagnosed with high blood pressure, make certain you tell every Yoga teacher with whom you practice. Your Yoga teacher can then offer the appropriate modifications and variations in Yoga postures and pranayama.
Poses to Avoid When One Has High Blood Pressure
In simple terms, avoid Yoga poses that position the head below heart level especially when the practice or pose is vigorous. Here are examples of complete and partial inversions:
- Salamba Sarvangasana (Shoulder stand)
- Shirshasana (Head Stand)
- Adho Mukha Svanasana (Downward-facing Dog)
- Setu Bandhasana (Bridge or Spinal Lift pose)
- Uttanasana (Standing Forward Bend)
- Prasarita Padottanasana (Wide Leg Standing Forward Bend)
Having high blood pressure should not prevent one from doing Yoga. By understanding the degree of the health condition and by following the recommendations of physicians, one can still have a fulfilling Yoga practice with a wide range of Yoga poses.
About the Author
When Things Get Turned Upside Down: Yoga Inversions
You’re never more alive than when things get turned upside down.
::Malcolm Gladwell
Whether misjudging a headstand and crashing to the floor, fired from our job just when we thought we were up for a promotion or dumped after posting “in a relationship” on our social media status for all to see, nothing gets our attention like being confronted by the unexpected. Suddenly, we find ourselves in a surprising new landscape for which we weren’t prepared. We’re staring down change and wrestling with the fear that we might fall again.
The truth is we’re guaranteed to fall again…and again. Like crashing waves, challenges will crest and crumble whether we’re talking about our headstands or our lives. Personally I’ve fallen many times, certainly out of my headstand, but ultimately into a new headspace.
Inversions in Yoga
To me, inversions are a fantastic living laboratory where we can embrace and move beyond things like fear, expectation, and impatience. All at once upside down needs to become right side up, and we have to surrender our tight grip on what we think we can control. We feel tangible postural balance merge with something deeper.
Inversions are an amazing reminder that how we do one thing is how we do everything. They reveal to us that often things are not going to go as we’d planned, but they just might turn out even better that way.
Making the Leap
Starting a new job or relationship is like the leap of faith it takes to turn upside down in a handstand. Though initially our jump may resemble a first handstand in an unfortunate bra, revealing things we had not hoped for…we learn as we go. Frankly, sometimes the catalysts for our evolution are pretty tits-out, upside down. But, if we move through our raw initiation and prove to ourselves a little at a time that we can do it, before you know it, whatever we were attempting becomes an important part of our personal fabric.
When we try too desperately to control the things we can’t, we become tightly wound in lopsided ways that stunt our growth and leave us miserable.
If we litter our inversions or our lives with expectation, we pin ourselves underneath frustration and impatience, which, in turn, erode the courage and humility it takes to try again.
Outcomes Are Not Guaranteed
The bottom line is we can’t control a guaranteed outcome. Even Kino MacGregor and Doug Swenson have days when they can’t balance in their handstand (albeit annoyingly infrequently). And for all of us, life can feel out of control and out of balance sometimes when it comes to work, deadlines, responsibilities, Trader Joe’s Dark Chocolate Covered Almonds, time wasted down the rabbit hole of Facebook…you name it.
The Yoga Sutras
In Patanjali’s Yoga Sutras, abhyasa (perseverant practice) and vairagya (surrendering without expectation of a particular outcome) demand that we resist the trappings of instant gratification our modern society seems to promote. And Pattabhi Jois, the father of Ashtanga yoga, stated,
Do your practice and all is coming.
He didn’t say, “Do your practice and kurmasana (flipping your feet behind your head) is coming instantly.” Nor did he promise results like millions of dollars and six-pack abs. We have to allow incremental progress to eclipse our need to accomplish the finished product. As Ralph Waldo Emerson so famously put it,
Life is a journey not a destination.
What We Can Control
There is one thing we can control, however, and that’s the accountability and integrity with which we show up — on our mat, at our job, for ourselves and for one another. Abhyasa and vairagya ask us to see balance and progress not as a single handstand, but as a part of a larger personal pilgrimage (sadhana). When we look at things through a wider lens, we can see every wobble, challenge and fall as an opportunity to learn and grow. Each time we glean a little bit more wisdom to bring to our next inversion or adventure. And as we do, we start to see that we’re never more alive than when things get turned upside down.
