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Michael, 50, of Vancouver was well aware yoga can improve flexibility and fitness, but he was unprepared for the cathartic release of emotions he experienced during his first yoga therapy session.

As he lay on the floor while yoga therapist Danielle McDermott gently stretched his body, Michael, who had been suffering from anxiety attacks and paralyzing feelings of inadequacy at work, suddenly began twitching uncontrollably.

"I started to get this overwhelming feeling of shaking and trembling through my whole body," he said.

By manoeuvring his body into a series of poses while she asked about his feelings, Ms. McDermott had unplugged a stream of thoughts and fears that he'd been suppressing, said Michael, who asked that his full name not be used.

"I left that session after, feeling an incredible emotional release," he said. "Physically, I felt lighter. I felt like I was floating."

Yoga therapy - the use of yoga poses for physical and mental healing - is emerging as a complementary treatment to mainstream medicine for a wide range of ailments, from chronic pain and injuries, to depression and anxiety. Since 2004, membership in the U.S.-based trade group, the International Association of Yoga Therapists, has tripled to more than 2,100. Canadian membership in the IAYT has also nearly tripled, to about 130.

In the United States, yoga therapy is used to help patients who have undergone heart surgery reduce their stress and avoid repeat hospitalization, as well as to provide relief for returning Iraq veterans with post-traumatic stress disorder.

In Canada, a handful of health-care centres, such as southern Alberta's main cancer treatment centre, the Tom Baker Cancer Centre, are also offering yoga therapy to their patients.

But while medical professionals agree yoga can benefit health, physicians and yoga therapists alike say patients should proceed with caution as there are no standards for yoga therapy training.

Ms. McDermott, who is a Vancouver psychotherapist and certified yoga therapist, said the rationale behind yoga therapy is simple.

"Everything - every thought, every emotion we have - affects our body because it's all connected," she said. Constant stress and anxiety can manifest as chronic physiological conditions, she said.

"Yoga therapy is trying to release the emotional content of what they're experiencing while also releasing the physical constriction or tension," Ms. McDermott said.

Unlike regular yoga classes, yoga therapy is usually practised one-on-one or in small groups, and the poses are customized to each client. The style of yoga also varies from therapist to therapist.

Although it's classified as a CAM (complementary and alternative medicine) therapy, akin to massage and acupuncture, yoga therapy is still in its infancy.

John Kepner, the executive director of the IAYT, attributes its growth to a general rise in the popularity of yoga.

But the lack of standards for yoga therapy training remains a major challenge for the practice. Creating a credentialing system is difficult because there are so many different approaches to yoga, Mr. Kepner said.

Practised incorrectly, yoga can be harmful, said Dr. Taizoon Baxamusa, a spokesman for the American Academy of Orthopaedic Surgeons and assistant professor of orthopedic surgery at the University of Illinois, Chicago. He said he often sees patients who injure themselves practising yoga.

Novices sometimes push themselves too far, he said, while yoga instructors and therapists who aren't adequately trained can give "less than proper advice."

Dr. Baxamusa added that while studies show yoga therapy does help certain conditions, it's not commonly used as an isolated treatment.

"Where we may use yoga is in conjunction with formal occupational or physical therapy," he said.

Yoga therapy experts also stress that the practice is not meant to replace traditional medical care. Ms. McDermott noted it is not covered by provincial medical insurance in Canada.

"Yoga is primarily a liberation philosophy … a spiritual practice that also has health-care benefits," Mr. Kepner added.

In Norfolk, Virginia, retired vascular surgeon Dr. Dilip Sarkar says he knows firsthand the health benefits of yoga therapy.

Dr. Sarkar took up Ayurvedic yoga, practised within the traditional Hindu system of medicine, after a heart attack six years ago at the age of 52.

Since then, he said, his cardiovascular function has improved and he has reduced his use of pharmaceuticals. Dr. Sarkar is now training to become an Ayurvedic practitioner and prescribes yoga to people with cardiovascular illnesses.

At Calgary's Tom Baker Cancer Centre, yoga and meditation are used to reduce anxiety in patients while they undergo chemotherapy and other medical treatments, said Dr. Linda Carlson, a researcher and psychologist with the Alberta Cancer Board.

However, she said, yoga therapy is not well incorporated in the Canadian health-care system; only a few centres currently offer it.

Michael, the Vancouver resident who suffered from anxiety attacks, said his emotional issues are still a work in progress.

After about nine yoga therapy sessions and months of constant practice, he no longer feels as anxious when he attends meetings or interacts with people at work.

"I would say I'm 90 per cent through all of that," he said. "The critical thing that I realized is that if I do [continue to suppress feelings] I'm going to end up having, literally, constipation of my emotions."

Special to The Globe and Mail

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