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
4 Ways to Make Savasana Sweeter
At the end of yoga class, it’s often joked that Savasana is the most difficult pose of all. It didn’t take me long to realize that there may be some truth to this joke. Many beginners struggle with Savasana, either falling asleep or hanging on to their thoughts, forbidding clarity and relaxation to sink in.
One of the reasons I developed a commitment to yoga was the paltry $5 difference between signing up for only yoga classes and tacking on a full gym membership. I seldom went upstairs to the gym. Movement on the machines felt unnatural and I was intimidated by the bulky dudes in tight shirts. Meanwhile, I found the yoga classes soothing. I sweated out so many toxins and worked on my flexibility, but there was something that regularly happened in class that annoyed the sweet prana right out of me.
When it was time for the exquisitely long 15 minutes of well-deserved Savasana, some unknowns upstairs would start their heavy weightlifting routine. Loud thuds and trembling shock waves distracted my focus and raised feelings of anger and rage. I thought about going upstairs to complain, but I wasn’t inclined to start an argument with buff dudes who could kick my skinny ass.
I didn’t realize until my teacher training that this aggravation was allowing me to practice aparigraha, or non-attachment, by letting go of thoughts and emotions, either positive or negative. After about four months, those thuds sounded like a light knock on the door of my perception; I had learned to withdraw from my senses and my active mind.
Here are four ways to improve the Savasana experience, both in your personal practice and when you’re teaching class.
Learn and Practice Yoga Nidra
Yoga Nidra is a technique that guides students through various parts of their bodies. It works by increasing the awareness of sensations in the muscular, connective and nerve tissues by breathing into them to send a signal of relaxation.
If done right, one can feel the energy flow up and down through the chakras. Eventually, it’s possible to dissolve sensations from the body altogether. It’s like having a voice-guided eraser that slowly fades your body into the ether.
There are many Yoga Nidra meditation recordings out there, and some teachers like to guide their students through a session during Savasana. However, due to time limits at studios, it’s best to incorporate in a home practice to allow yourself the extra time.
Mystical Music or Silence
Traditionally, yoga was done without music, much less meditation. It wasn’t until yoga came to the West that teachers started to notice the addition of music adds more flow and rhythm to a class. In the end, it really comes down to the preference of the individual.
Being a “Cosmic DJ” is no easy feat. We often let our personal musical preferences filter into our sacred tracks, be it mantras, Kirtan, white sounds or Enya. I’ve had some teachers play great songs through class and then choose an awful track for Savasana that was distracting or too intense.
My recommendation is to experiment and find tracks that take you to another dimension. If you live in a quiet town or deep in the woods, these locations allow for moments of silence; work with that and get a little Tibetan bowl timer in case you drift too deeply.
Visualizations
One of the most powerful resources available to us is our imagination. I’ve found that using my imagination for visualizations has led me to profound and prolonged sessions of peace, quiet and rest. Here are three visualizations that help the mind let go.
The Big Blue Sky
Bring your awareness to the color blue, as if you were lying down on the earth looking up at the sky. Feel the warmth of the sun on your body and start to breathe in the fresh air. Any thought that passes through your mind, give it the shape of a big, fluffy cloud. If a thought is more negative, make the cloud more stormy and grey.
As you inhale, summon the power of the wind element, and as you exhale, watch how the clouds slowly drift away. Continue attaching thoughts to cloud shapes and breathe them away until nothing remains except blue bliss.
This visualization is a personal favorite inspired by Pema Chodron’s quote, “You are the sky, everything else is just the weather.”
The Ocean of Consciousness
Imagine you are sitting on a deserted beach in front of the crashing waves. Imagine that each wave is a thought or feeling. Let the wave slowly rise and fall as it crashes and dissolves in the sand.
As the breath deepens, so do the waves. Ask yourself, Where are these waves coming from? Their source is the depths of your mind. Imagine standing on the shores of your own consciousness, witnessing the waves arriving and dissolving. Realize you are not just the waves, but the whole ocean.
(This visualization works great with some ambient wave sounds.)
The Theater and the Ghost Light
Imagine that the mind is a stage, and your awareness is auditioning thoughts to see how well they perform. Some are funny, others are dramatic, and there’s the occasional poetic script read.
Imagine that your cue to let each thought go is a deep breath. As you start to slow your breath, you notice the stage lights are slowly fading out. The stage turns dark except for a white light that’s keeping the ghosts from the past and future away.
This light is your anchor to the present moment. It’s the light that shines within you and illuminates other beings with love, compassion and kindness. With every inhale, let these positive feelings sink in and watch how the light glimmers brighter and brighter.
Essential Oils
Last but not least, aromatherapy is an effective way to calm the mind and relax the body. A diffuser works like a charm to spread the scent through a whole room, but there’s nothing more powerful than rubbing a little dab of oil right on the third eye, the base of the neck and the temples. Some favorite essential oils for Savasana are lavender, bergamot, ylang ylang, rose, jasmine, melissa and geranium.
