Ask the Teacher is an recommendation column that connects Yoga Journal members straight with our group of knowledgeable yoga lecturers. Every different week, we’ll reply a query from our readers. Submit your questions right here, or drop us a line at asktheteacher@yogajournal.com.

Are there any particular precautions it is advisable to take when you have a pacemaker?

—Deborah in Clearwater, Fla.

For this query, we turned to our contributor Carol Krucoff for steerage. A yoga therapist and co-director of the Integrative Yoga for Seniors trainer coaching at Duke University’s Integrative Medicine Center, she’s nationally recognized for her work with seniors, so we figured she might have handled a pacemaker or two.

As it seems, the topic is actually near her coronary heart (pun supposed): Some time again, Krucoff wrote a bit for YJ about her expertise with open coronary heart surgical procedure to appropriate a malformed valve. Her husband, Mitchell Krucoff, MD, is a heart specialist and a member of the college for her trainer coaching. Carol Krucoff was a wealth of data about yoga and coronary heart situations.

“An vital consideration isn’t just having the pacemaker itself, however why you might have the pacemaker,” Krucoff says.

“The pacemaker is a tool that’s implanted in your physique to assist your coronary heart beat appropriately,” she explains. It’s adjusted on your specific wants and it solely works when it’s wanted. If your coronary heart beats too slowly (brachycardia), the pacemaker kicks in to ensure your coronary heart charge doesn’t go too low. It will help individuals who have sorts of dysrhythmia (irregular heartbeat) or who’re experiencing coronary heart failure.  Your physician can greatest clarify what bodily exercise it’s best to or shouldn’t do, relying in your situation.

Practice with Ease

That stated, Krucoff says a pacemaker itself could be very small and can seemingly not intervene with many yoga poses and practices.

Right after the pacemaker is implanted and till you’re cleared for train, your physician might advise you to keep away from strenuous exercise and to not carry your left arm above shoulder peak. That eliminates complicated, energetic poses and/or people who require raised arms. “Once the machine is admittedly safe within the physique—after a interval of six weeks or two months or so—it actually normally doesn’t get in the way in which of your apply,” she says.

She says some individuals might really feel and even see a little bit bump below their pores and skin the place the placemaker is implanted. That might make poses that require you to lie in your stomach uncomfortable.

Balance poses may be difficult for individuals who are likely to have a low coronary heart charge or who take coronary heart drugs that trigger dizziness. “It’s vital to apply close to a assist—a wall,  a chair, or one thing steady in case it’s wanted for stability,” she says.

Keep Your Heart Lifted

Depending on the guts situation, inversions could also be unwise, she says. Someone with coronary heart failure might are likely to get edema or swelling of their legs and ankles as a result of the guts isn’t pumping blood and fluids effectively. “When you do an inversion—even a seemingly mild inversion like Legs Up the Wall—that will trigger a column of fluid to run down the legs and overwhelm an already compromised coronary heart,” she says.

That doesn’t imply you possibly can’t apply yoga. Instead of placing your legs at a 90-degree angle in Legs Up the Wall, for it’s possible you’ll relaxation them on a chair or on a pillow. Or strive Lazy Boy Pose, a modification Krucoff developed together with her Relax into Yoga for Seniors co-author and educating companion Kimberly Carson as a part of their Integrative Yoga for Seniors Professional Training.

In this “recliner chair” variation, reasonably than lie flat on the ground, elevate the higher physique right into a reclined place with a bolster on a block. Then elevate the legs with one other bolster or pillow. “Now the pinnacle is above the guts and any extra fluid that comes down the legs goes to the pelvic space, and never overwhelm the guts,” she explains.

Know Your Intention

While yoga is commonly touted as mild and fully benign, even seemingly innocent practices might be dangerous for individuals with cardiovascular problems, relying in your coronary heart situation.

Krucoff advises towards sturdy pranayama practices, for instance.  “There is such a connection between the respiratory system and the cardiovascular system that after we do excessive respiratory practices—say a Kapalabhati or Bhastrika—that will put an excessive amount of strain on the intrathoracic chamber,” she says. “That simply could also be an excessive amount of stress on the guts.”

Even holding your breath could also be problematic when you have hypertension or a coronary heart situation. Instead, apply pranayama methods that maintain the breath flowing and cozy, she says. A delicate suspension of the breath after exhalation could also be effective, she says. Avoid breath retention after inhalation.

“It’s at all times an vital query, whether or not you’re a trainer or a practitioner, to ask your self, Why am I doing this?” she says. You can nearly at all times discover a technique to obtain the intention of a pose and cut back the dangers by working towards a modification, utilizing props, or attempting a gentler variation.

Got a query about alignment in a sure yoga pose? Want to higher perceive a side of yoga philosophy? Need recommendation on easy methods to method a difficult state of affairs in your class? Submit your questions right here or electronic mail us at asktheteacher@yogajournal.com, and we might reply it in an upcoming column.