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Therapeu(c contribu(on of Iyengar yoga in
physiotherapy

©marcmichnowski	-	marctecartm@gmail.com	-	@marc_michnowski	-	@soignezvousenpra:quantleyoga		 1
Medical	gymnas.cs	and	physical	exercises	are	tools	used	in	
physiotherapy.	
Aims	:	
Strengthen,	maintain,	restore	the	func:onal	abili:es	of	the	body	when	
it	has	been	trauma:zed	or	simply	undergoes	the	ac:on	of	:me.	
In	the	West	=>	therapeu:c	means	to	bring	pa:ents	to	a	normal	and	
op:mal	physical	form.	
	
	
	
©marcmichnowski	-	marctecartm@gmail.com	-	@marc_michnowski	-	@soignezvousenpra:quantleyoga		 2
The	philosophical	texts	of	ancient	India	indicate	that	the	prac:ce	of	
yoga	postures	(Āsana)	is	a	means	available	to	humans	to:	
-  Stay	healthy.	
-  Have	a	strong,	agile	and	stable	body,	more	resistant	to	diseases.		
-  Have	a	disciplined	mind,	available	and	controlled.	
	
Like	Kung-Fu,	Tai-chi-chuan	or	Qi	gong	
in	tradi:onal	Chinese	medicine,	yoga	postures	
are	the	physical	part	of	tradi:onal	Indian		
medicine	(Ayurveda).	
©marcmichnowski	-	marctecartm@gmail.com	-	@marc_michnowski	-	@soignezvousenpra:quantleyoga		 3
©marcmichnowski	-	marctecartm@gmail.com	-	@marc_michnowski	-	@soignezvousenpra:quantleyoga		 4	
	
The	prac:ces	of	yoga	postures	and	those	of	medical	gymnas:cs	or	physical	
exercises	have	the	same	objec:ves.	
	
	
	
	
	
	
	
	
Even	if	yoga	seems	more	spiritual…	
=>	Is	this	the	reason	why	yoga	is	s.ll	li9le	used	by	physiotherapists	???
What	does	the	story	tell	us	about	the	two	
techniques?	
©marcmichnowski	-	marctecartm@gmail.com	-	@marc_michnowski	-	@soignezvousenpra:quantleyoga		 5
The	earliest	traces	of	yoga	date	back	to	1800	BC	and	are	found	in	the	
Mahābhārata	(sacred	book	of	India)	wri^en	around	400	BC.	
The	dei:es	of	Hindu	mythology	told	the	people	that	they	must	live	in	
accordance	with	the	laws	that	govern	the	world	(Dharma).	
	
Only	solu:on	for	this:	apply	the	(yoga)	method!	
	
When	death	comes,	an	individual	record		
of	acts	of	life	(Karma)	would	be	trained	and	
presented	to	God,	to	enable	him	to	decide		
on	the	future	incarna:on.	
©marcmichnowski	-	marctecartm@gmail.com	-	@marc_michnowski	-	@soignezvousenpra:quantleyoga		 6
In	300	BC,	Patanjali's	Yoga	Sutras	(philosophical	text	of	yoga)	describes	
the	yoga	method	and	its	8	pillars.	
	
The	5th	deals	with	the	prac:ce	of	postures	(āsana)	:	
	
To	have	a	good	behaviour,	stability	and	a	flexibility	of	the	body.	
For	training	to	have	strength	in	the	work.	
To	be	more	resistant	to	diseases.	
To	discipline	the	body	for	an	available	mind.	
To	have	be^er	control	of	emo:ons.	
©marcmichnowski	-	marctecartm@gmail.com	-	@marc_michnowski	-	@soignezvousenpra:quantleyoga		 7
Western	gymnas:cs	seems	more	recent:	
(600	BC)	=>	Greek	"gymnos":	exercises	of	maintenance,	relaxa:on	and	
warm-up	of	the	body	before	the	prac:ce	of	wrestling	and	athle:cs	
under	Ancient	Greek.	
	
(400	BC)=>	Under	Ancient	Rome	we	find	traces	of	Medical	Gymnas:cs	
under	the	Metho:c	Era.	
	
(131-200	BC)	=>	Galien	develops	it	for	
	purposes	educa:onal,	military,	sports	
	and	medical.	
©marcmichnowski	-	marctecartm@gmail.com	-	@marc_michnowski	-	@soignezvousenpra:quantleyoga		 8
The history of Asana prac(ce and gymnas(cs seems to follow
that of the discovery of anatomy!
In	orient:	
Āyurvedas:	(sacred	Hindu	book),	3000	years	old,	
Described	bones,	tendons,	fascia,	joints,	nerves	...	
Late	discovery	because	Hessler	translated	it	in	1844.	
	
In	Occident	:	
It	will	be	necessary	to	wait	for	Hippocrate	(5th	BC)		
and	Galien	(2nd)	to	see	appearing	
the	first	trea:es	of	anatomy.	
	
©marcmichnowski	-	marctecartm@gmail.com	-	@marc_michnowski	-	@soignezvousenpra:quantleyoga		 9
How	yoga	and	gymnas:cs	evolve	over	:me?	
In	India,	foreigners	see	yoga	as	a	ritual,	they	are	not	interested	in	it	and	
aim	only	at	the	invasion	of	the	territories.	
	
Yoga	con:nues	to	be	passed	on	from	genera:on	to	genera:on.	
	
In	the	17th	century,	Catholics	discovered	Hinduism	and	yoga	with	the	
arrival	of	Bri:sh	explorers.	
First	considered	as	contor:onist	gymnas:cs,	physical	and	spiritual	yoga	
is	taken	into	account	aoer	reading	ancient	texts.	
Westerners	will	even	ask	the	Yogi	Masters	to	use	it	to	train	their	armies.	
©marcmichnowski	-	marctecartm@gmail.com	-	@marc_michnowski	-	@soignezvousenpra:quantleyoga		 10
Medical	gymnas:cs	also	crosses	:me	and	different	currents.	
	
In	the	Middle	Ages:	the	interest	of	the	body	is	not	a	priority.	
	
During	the	Renaissance:	body	care	appears	more	important	and	
gymnas:cs	finds	4	axes:	
	
-	Pedagogical	=>	man	is	physical,	moral	and	intellectual	en:ty.	
-	Military	 			=>	man	must	be	strong	to	serve	be^er.	
-	Spor:ve							=>	man	must	be	compe::ve.	
-	Medical							=>	man	must	maintain	a	good	health.	
	 ©marcmichnowski	-	marctecartm@gmail.com	-	@marc_michnowski	-	@soignezvousenpra:quantleyoga		 11
1850	=>	Big	changes	for	yoga	and	medical	gymnas:cs!	
	
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In	India,	yoga	evolves	and	is	divided	into	two	parts:	
-Rāja	yoga	or	Ashtanga	yoga=>	spiritual	part.	
-Hatha	yoga	(effort	yoga)	=>	physical	part	
	
	
	
1900	=>	Ashrams	(both	spiritual	centers	and	hospitals)	appear.		
Prac:ce	places	for	medita:on	and	postures	to	treat	pathologies.	
Become	schools	that	train	yoga	teachers	(guru).	
They	will	travel	around	the	world	to	introduce	and	train	other	teachers.	
	
©marcmichnowski	-	marctecartm@gmail.com	-	@marc_michnowski	-	@soignezvousenpra:quantleyoga		 13
In	the	West,	tradi:onal,	chemical	medicine	has	li^le	success.	
Bonese^ers	and	healers	gain	importance.	
Massage,	chiroprac:c,	osteopathy,	gymnas:cs	are	mainly	provided	by	
non-doctors.	
Doctors	forbid	these	techniques	by	chan:ng	the	illegal	exercise.	
They	create	very	quickly	the	physical	medicine.	
Sweden:	Ling	-	Norstrom	
France	:	Lagrange	-	Mesnard	
Australie:	Kenny	
	
©marcmichnowski	-	marctecartm@gmail.com	-	@marc_michnowski	-	@soignezvousenpra:quantleyoga		 14
The	first	world	war	imposes	the	increase	of	the	number	of	act	of	
physical	medicine.	
	
Soldiers	must	be	treated	to	return	to	combat	or	to	reduce	the	amount	
of	disability	premium.	
	
Pilates	creates	his	techniques	by	caring	for	prisoners	of	war	in	England.	
	
In	France,	in	1946	the	physiotherapy	is	prac:ced	by	specialized	nurses	
and	teachers	of	sports	under	the	control	of	doctors.	
©marcmichnowski	-	marctecartm@gmail.com	-	@marc_michnowski	-	@soignezvousenpra:quantleyoga		 15
Medical	gymnas:cs	is	then	influenced	by	German,	Bri:sh,	Swedish	and	
Spanish.	
Based	on	5	basic	postures	(lying	-	sirng	–	kneeling	-	standing	and	
suspended	to	a	chinning	bar).	
	
	
	
	
	
From	them,	sta:c	and	dynamic	examina:ons	
are	carried	out	and	exercises	are	proposed	to	
correct	the	defects.	
	
©marcmichnowski	-	marctecartm@gmail.com	-	@marc_michnowski	-	@soignezvousenpra:quantleyoga		 16
1970:	Fitness	methods	explode	in	the	United	States	and	Europe	
=>Cooper	(Aerobics)	or	Jane	Fonda	(Workout)	
Ephemeral	methods	follow	one	another	
=>	step,	body	pump,	body	balance,	body	combat,	body	aEack	
	
Yoga	also	a^racts	a	lot	of	followers	because	the	West	is	looking	for	
spirituality	in	a	mode	based	on	technical	progress	and	economic	profit.	
Yoga	prac:ce	remains	tradi:onal	(Ashtanga,	Hatha)	but	is	popularized	
thanks	to	The	Beatles,	The	Rolling	Stones,	S.ng	then	Madonna	...	
	
Pilates	and	Swedish	gymnas:c	are	also	gaining	popularity	
©marcmichnowski	-	marctecartm@gmail.com	-	@marc_michnowski	-	@soignezvousenpra:quantleyoga		 17
©marcmichnowski	-	marctecartm@gmail.com	-	@marc_michnowski	-	@soignezvousenpra:quantleyoga		 18
Yoga	does	not	resist	muta:on	either.	
Postures,	breathing,	medita:on	are	not	enough,	the	prac:ce	must	be	
entertaining!	
Vinyasa	flow,	yoga	Bikram,	power	yoga,	yoga	for	dogs(doga),	yoga	
goats,	nude	yoga,	yoga	beers	...	200	names	are	counted	today.	
©marcmichnowski	-	marctecartm@gmail.com	-	@marc_michnowski	-	@soignezvousenpra:quantleyoga		 19
.	
©marcmichnowski	-	marctecartm@gmail.com	-	@marc_michnowski	-	@soignezvousenpra:quantleyoga		 20
However,	there	has	recently	been	a	return	to	basics	in	prac:ces.	
Like	the	organic	with	the	food!	
	
Fitness	=>	Cross	fit	(mix	of	weightlioing	and	gymnas:cs)		
			=>	Hiit	(interval	training	exercises	with	body	weight)	
	
Yoga:	=>	Hatha,	Ashtanga	are	Tradi:onal	
	=>	Yin	(Chinese	meridians)		
	=>	Kundalini	(medita:ve)	
	=>	Iyengar	(Therapeu:c)	
	
©marcmichnowski	-	marctecartm@gmail.com	-	@marc_michnowski	-	@soignezvousenpra:quantleyoga		 21
Fortunately,	medical	gymnas:c	exercises	have	also	evolved.	
Gone	are	the	wire	cages,	ropes,	sandbag	weights,	sheaves.	
The	physiotherapy	rooms	now	look	like	a	real	small	gym.	
The	material	is	some:mes	even	more	modern,	even	if	there	are	s:ll	
unstable	pla^ers	and	wooden	s:cks.	
There	are	expensive	installa:ons	(balance	plasorm,	virtual	system,	
isokine:c	devices)	that	make	the	rehabilita:on	more	comfortable,	fun	
and	entertaining.	
	
	
	
©marcmichnowski	-	marctecartm@gmail.com	-	@marc_michnowski	-	@soignezvousenpra:quantleyoga		 22
©marcmichnowski	-	marctecartm@gmail.com	-	@marc_michnowski	-	@soignezvousenpra:quantleyoga		 23
Whatever	the	ac:vity	and	the	material	used,	the	required	exercises	
must	be	performed	with	the	greatest	accuracy	for	an	op:mal	result	
especially	if	they	have	a	therapeu:c	or	preven:ve	purpose.	
	
Otherwise	they	will	be	ineffec:ve	or	pathogenic	quickly	or	on	a	short	
term	basis.	
	
©marcmichnowski	-	marctecartm@gmail.com	-	@marc_michnowski	-	@soignezvousenpra:quantleyoga		 24
In	physiotherapy	as	in	yoga	prac:ce,	it	is	common	to	see	achievements	
of	exercises	or	postures	without	worry	of	correct	alignment	of	skeletal	
parts.	
	
The	most	frequent	errors	are	found	during	balancing	exercises	on	one	
foot,	performed	for	example,	following	a	sprain	of	an	ar:cula:on	of	
the	lower	limbs.	
	
The	exercise	is	certainly	done	but	with	many	compensa:ons	of	the	
whole	body.	
	
	
	 ©marcmichnowski	-	marctecartm@gmail.com	-	@marc_michnowski	-	@soignezvousenpra:quantleyoga		 25
©marcmichnowski	-	marctecartm@gmail.com	-	@marc_michnowski	-	@soignezvousenpra:quantleyoga		 26
©marcmichnowski	-	marctecartm@gmail.com	-	@marc_michnowski	-	@soignezvousenpra:quantleyoga		 27
In	yoga:	
To	avoid	these	mistakes	and	for	a	purpose	of	care	Iyengar	creates	a	
method	that	uses	the	tradi:onal	postures	of	Hatha	yoga.	
	
This	orthopaedic	technique	seeks	the	voluntary	and	precise	alignment	
of	bone	parts	during	the	construc:on	of	yoga	postures.		
It	wants	to	train	the	spirit	to	just	ac:ons.	
	
It	takes	into	account	individual	innate	anatomical	varia:ons	and	only	
acts	on	the	shrinkage	of	the	:ssues	as	well	as	on	the	muscle	tone.	
	
	
©marcmichnowski	-	marctecartm@gmail.com	-	@marc_michnowski	-	@soignezvousenpra:quantleyoga		 28
Who	is	Iyengar?	
	
Bellur	Krishnamachar	Sundararaja	Iyengar(1918-2014)	was	a	student	of	
a	Guru	in	India.	
Aoer	two	years	of	study,	he	makes	him	understand	that	yoga	is	not	an	
art	in	his	reach.	
Iyengar	then	decides	to	be	his	own	master	and	work	on	his	own	body	
to	compose	his	technique.	
He	opened	an	ins:tute	in	India	in	1973,	a	second	in	2001.	He	receives	
and	trains	students	and	prac:ces	with	pa:ents	with	orthopaedic	
pathologies.	
There	are	Iyengar	Ins:tutes		all	around	the	world.	
©marcmichnowski	-	marctecartm@gmail.com	-	@marc_michnowski	-	@soignezvousenpra:quantleyoga		 29
In	medical	gymnas:cs,	the	corrected	standing	posi:on	is	used	to	
correct	axis	defects	in	the	spine,	pelvis	and	limbs.	
	
	
	
	
	
	
	
The	techniques	are	called	MÉZIÈRES,	RPG-SOUCHARD	or	BUSQUET.	
©marcmichnowski	-	marctecartm@gmail.com	-	@marc_michnowski	-	@soignezvousenpra:quantleyoga		 30
In	Iyengar	Yoga,	the	mountain	posture	(Tādāsana)	is	the	basic	posture.	
She	seeks	the	perfect	alignment	of	bone	parts	from	the	feet	to	the	
skull.	
It	seeks	to	rest	the	center	of	gravity	above	the	feet,	precisely	on	the	
keystone	arches	it	must	first	recreate	looking	for	a	perfect	ground	
support	
©marcmichnowski	-	marctecartm@gmail.com	-	@marc_michnowski	-	@soignezvousenpra:quantleyoga		 31
Let’s	take	a	closer	look	at	the	two	modes	of	execu:on	of	the	same	
corrected	standing	pose:	
	
	
From	here,	let’s	analyse	the	exercise	of	balancing	on	one	foot.	
	
©marcmichnowski	-	marctecartm@gmail.com	-	@marc_michnowski	-	@soignezvousenpra:quantleyoga		 32
©marcmichnowski	-	marctecartm@gmail.com	-	@marc_michnowski	-	@soignezvousenpra:quantleyoga		 33	
Corrected	standing	in	
medical	gymnas:c	:	
	
Few	instruc:ons	:	
	
-	Feet	together	
-	Knees	stretched	
-	Contracted	abs	
-	Shoulders	down	
-	Chin	returned	
	
=>	Climb	the	top	of	
the	skull
©marcmichnowski	-	marctecartm@gmail.com	-	@marc_michnowski	-	@soignezvousenpra:quantleyoga		 34
©marcmichnowski	-	marctecartm@gmail.com	-	@marc_michnowski	-	@soignezvousenpra:quantleyoga		 35	
Tādāsana	:	
Many	instruc:ons	:	
	
-  Feet	together		
-  Toes	up	
-  Toes	down	
-  Lengthen	feet	
-  Press	both	inside	and	
outside	feet	part	on	floor	
-  Shake	shins,	knees	and	
thighs	together	
	
-  Contracted	Quadriceps		
-  External	rota:ons	of	lower	
limbs	
-  Contracted	abs	
-  Sacrum	on	middle	of	feet	
-  Sternum	up	and	forward	
-  Roll	shoulder	back	and	down	
-  Climb	the	top	of	the	skull	
-  Breathe	
	
=>	Hold	posi:on	and	correct	all	
serngs	again.
©marcmichnowski	-	marctecartm@gmail.com	-	@marc_michnowski	-	@soignezvousenpra:quantleyoga		 36
©marcmichnowski	-	marctecartm@gmail.com	-	@marc_michnowski	-	@soignezvousenpra:quantleyoga		 37
©marcmichnowski	-	marctecartm@gmail.com	-	@marc_michnowski	-	@soignezvousenpra:quantleyoga		 38
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©marcmichnowski	-	marctecartm@gmail.com	-	@marc_michnowski	-	@soignezvousenpra:quantleyoga		 40
This	example	illustrates	perfectly	that	it	is	possible	to	perform	the	
same	gesture	with	more	or	les	complex.	
	
It’s	not	useful	to	rely	on	scien:fic	studies	to	conclude	that	the	exercise	
performed	according	to	the	Iyengar	method	is	more	demanding	and	
requires	a	large	number	of	muscular	contrac:ons	and	as	many	
propriocep:ve	circuits.		
	
The	results	obtained	on	the	organiza:on	of	the	body	and	the	quality	of	
the	equilibrium	also	seem	rather	indisputable.	
©marcmichnowski	-	marctecartm@gmail.com	-	@marc_michnowski	-	@soignezvousenpra:quantleyoga		 41
In	a	way	that	may	be	less	visual,	it	is	possible	to	do	the	same	
experiment	from	the	sirng	posi:on.	
	
©marcmichnowski	-	marctecartm@gmail.com	-	@marc_michnowski	-	@soignezvousenpra:quantleyoga		 42
©marcmichnowski	-	marctecartm@gmail.com	-	@marc_michnowski	-	@soignezvousenpra:quantleyoga		 43
©marcmichnowski	-	marctecartm@gmail.com	-	@marc_michnowski	-	@soignezvousenpra:quantleyoga		 44
Medical	gymnas:c	exercices	and	others	are	used	in	physiotherapy	
protocols	validated	by	studies.	
	
The	prac:ce	of	certain	yoga	postures	begins	to	be	used	for	therapeu:c	
purposes.	
On	PubMed,	we	can	find	a	number	of	studies	that	reference	the	
therapeu:c	benefits	of	Iyengar	yoga.	
	
They	do	not	yet	include	enough	pa:ent	certainly	because	they	are	not	
funded	by	hardware	manufacturers.	
©marcmichnowski	-	marctecartm@gmail.com	-	@marc_michnowski	-	@soignezvousenpra:quantleyoga		 45
A	large	number	of	simple	and	non-acroba:c	postures	can	be	easily	
used	according	to	the	Iyengar	construc:on	method.	
	
Well	chosen,	they	can	certainly	bring	a	lot	of	benefits	if	they	are	
incorporated	at	the	right	:me	in	the	physiotherapy	treatments.	
	
They	do	not	require	special	equipment	and	are	reproducible	by	
pa:ents	alone.	
©marcmichnowski	-	marctecartm@gmail.com	-	@marc_michnowski	-	@soignezvousenpra:quantleyoga		 46
I	hope	I	have	drawn	your	a^en:on	to	the	therapeu:c	interests	of	the	
Iyengar	yoga	method.	
I	wish	that	a	large	number	of	physiotherapist	are	interested	in	it,	
prac:ce	it	and	use	it	to	prac:ce	their	pa:ents	differently.	
	
Merci	
	
Namaste.	
©marcmichnowski	-	marctecartm@gmail.com	-	@marc_michnowski	-	@soignezvousenpra:quantleyoga		 47

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Therapeutic contribution of Iyengar yoga in physiotherapy