Yoga Teacher Training Forum

Namaskar, Dear Ones

The following is a conversation regarding safe Hatha or Vinyasa Yoga practice for those of us who have blood clots. Any doctor, or anyone who has blood clots, please feel free to add any information, or present an opposing opinion. It is important that we share our findings, even if we do not agree.

OM Shanti,

Paul

Question: I do have a question for you, and it's kind of a biggie. Here is the background: In early September I developed a subclavian-axillary blood clot. I felt a tiny "ping" during warrior 1 during a class, perhaps from too-vigorous shoulderblade wrapping, and I had been painting ceilings for three days prior. I woke up with a swollen arm. Subsequent tests revealed some minor genetic inclination toward clotting. I have been on anticoagulants (coumadin) since then and will be for six months.

A recent ultrasound revealed the auxiliary clot was gone, the sub-clavian clot was well on its way, and I had good flow throughout the region. The clot stabilizes after a couple of weeks and there is almost zero danger of a pulmonary embolism. They also did the ultrasound with my arm lifted overhead and determined there was no compression of the vein. Prior to that, I had been told to avoid any arms-overhead movements or arms-straight-back (requiring a LOT of modification to my practice) just in case it compressed the sub-clavian vein.

With this discovery, the doctor (who is somewhat familiar with yoga - none of my family M.D.s have been) gave me the OK to return to my usual yoga practice. I asked whether there was any reason I should not invert (Google searches had turned up some suggestion of this, and I knew as a teacher that certain related circulation issues were prohibitive of inversions) and he said he didn't know of any, as I was inverted every time I bent over to pick something up. The resources I've found that list clots as a contraindication never seem to say why.

I see a hematologist in another city next week to determine what, if any, long-term treatment I need. I have some minor swelling in the arm still, but I think returning to vinyasa practice has made that better and not worse. All of my doctors have recommended exercise, including for the arm, to help heal. Still, I'm very concerned about this happening again. None of my fellow yoga teachers have been able to provide any information on clots/propensity to clot and any specific yoga postures. Any information you have would be incredibly helpful. I have added prior postures back in one by one since the doc's OK, including headstand, forearm stand, and urdhva dhanurasana. The only one I haven't attempted is handstand.

Also, since I developed this clot, it seems other people who have had similar problems have been coming out of the woodwork (though it's always in the legs - the location of mine is very rare, and even more so because it was spontaneous and not related to an underlying disease like cancer or to insertion of a catheter). I hope to be able to advise students in the future who may have had a similar problem.

I understand that you can't give specific medical advice - I would like to present information to the specialist next week from a qualified yoga perspective so he can evaluate it for my specific case and advise me. I appreciate any insight you may have.

Answer: Thank God they found it, and have you on Coumadin. I'm surprised that no web sites have gone into this one, but let's look at body mechanics, and in this case a comparison to plumbing.

If you had a clogged pipe in your house and turned the house upside down for a while, the clog would find its way to the highest pipe in your house. Therefore, gravity would send a blood clot toward your brain if you hold inversions long enough.

Worst possible scenario is a stroke. Even though you are taking a good anti-coagulant, it's not worth the risk. Sorry to say, I would advise against inversions until a Dr. gives you the o.k. Take it easy and be patient.

Last Response: A doctor has already given me the OK, but I'm just being extra cautious. Wise not to take chances, as you said.

What remains of the clot is very stable - it essentially becomes part of the wall of the vein and then breaks down slowly. I have no doubt years of yoga helped save my life. The clot was completely occlusive behind the clavicle, but I had such fantastic collateral blood flow that even the swelling was minimal. Years of pranayama, etc., no doubt!