Restorative Yoga

Iyengar and the use of props

B.K.S. Iyengar was born on December 14, 1918, in Bellur, India, began studying yoga at 15 and was sent by his teacher T. Krishnamacharya to teach in Pune in 1937, according to the Iyengar Yoga association of the United States. The same page credits him with the innovative creation and use of props, such as blocks, belts, blankets and chairs, which it says let people at all stages of health perform asanas more easily. It gives 1956 as the year he first taught in the United States, in Ann Arbor, Michigan.

The sources reviewed do not document when supported, relaxation-oriented sequences were first set apart from the rest of Iyengar's system. They also do not trace the practice to a dated text. The trial team that ran the PRYSMS study described its protocol as based on Iyengar-style restorative yoga, which shows that researchers link the style to his tradition, but that description is not a history of its development.

Judith Hanson Lasater and the United States

In a published interview, Judith Hanson Lasater says she studied extensively with Iyengar and that he introduced her to props, which she calls a radical idea in the United States in 1974. She recounts that her first restorative class was improvised when a storm cut the lights during a class she was teaching on the Canadian plains, and that she had students lie over bolsters. The interview presents these as her own recollections, and it was written for a yoga education site, not a scholarly journal.

The same interview dates a friend's suggestion that she write about restorative yoga to 1993 and names the resulting book as Relax and Renew, but it does not give a publisher or publication year. Her definition, quoted there, is the use of props to support the body in positions of comfort and ease to facilitate health and relaxation. The interview is the only source reviewed for her role, so the extent to which her teaching shaped the style elsewhere is not established here.

How the name is used

Yoga Alliance lists a category it calls gentle yoga, which it describes as focused on support and relaxation, often using aids such as blocks, and notes that the category is also sometimes called restorative and sometimes yin yoga. That usage shows that the names are not applied consistently by teachers or organizations. Trials add further variation: a breast cancer trial described its restorative classes as based on the Integral Yoga tradition and combining postures, breathing and deep relaxation, while a cancer survivor trial described them as emphasizing the contemplative and relaxation components of yoga.

Restorative yoga and Yin Yoga

Yin Yoga is covered on its own Machipedia page, Yin Yoga. A Swedish trial describes it as a calmer, more meditative form of yoga that uses seated and lying postures held for three to five minutes with deep breathing. A yin yoga history page says Paul Grilley popularized the practice but did not invent it, and credits Sarah Powers, in a footnote, with coining the term in common use. By contrast, the PRYSMS restorative protocol held supported poses for 10 to 15 minutes with props such as a bolster, blankets and an eye pillow.

The sources reviewed do not set out a formal comparison of the two styles, and none contrasts them directly. The difference described here comes from how separate studies and pages describe each one. The overlap in common usage is reflected in Yoga Alliance grouping them under one heading.

Restorative yoga and yoga therapy

Yoga therapy is described on the Machipedia page Yoga Therapy, and restorative classes are one format that may be used within it. The sources opened for this page do not define the boundary between a restorative class and yoga therapy, and they do not show how often teachers use the terms interchangeably. The trials reviewed describe supervised group classes taught by yoga instructors, with home practice added in several, and none describes an individualized therapeutic assessment.

Session structure in published trials

The PRYSMS protocol centered on five supported poses: supported reclining, a forward bend with the head on a chair, a baby bridge, reclining with the legs on a chair, and a final relaxation pose. Participants used a mat, bolster, blankets, towels, a belt and an eye pillow, held each pose for 10 to 15 minutes in quiet, dim conditions with minimal talking, and received no breathing, mantra or meditation instruction. Classes were 90 minutes long, twice weekly for 12 weeks, then less often.

A Japanese crossover trial used a 1-hour guided session with supported bound-angle pose, supported bridge, supported child's pose, a reclining twist over a bolster and legs-up-the-wall, followed by home practice of 5 to 15 minutes at least three times a week. A cancer survivor trial used resting postures lying on the back, lying on the stomach and seated, in 60-minute classes ending with 5 minutes of relaxation. These designs show that session length, hold time and the inclusion of breathing or meditation differ between studies.

Related Machipedia practices

The breast cancer trial added centering and meditation of about 15 minutes, breathing and a principle of ahimsa, under which participants were told not to take any pose that caused discomfort. Related practices with their own Machipedia pages include Yoga, Meditation, Pranayama, Nidra Yoga, Guided Imagery and Iyengar Yoga, and some teachers combine them with supported poses. The trials reviewed here do not show which combinations are common outside research settings.

What teachers and sources describe

Lasater describes restorative yoga as the use of props to support the body in positions of comfort and ease, to facilitate health and relaxation, and treats relaxation and health as closely linked. The interview reviewed here states the aim in general terms and does not list conditions or outcomes. The page can only attribute these views; it does not treat them as established effects.

Populations studied in trials

Researchers have tested restorative yoga in women with breast cancer, in breast and ovarian cancer survivors, in adults with metabolic syndrome and in female nurses working night shifts. The outcomes examined include emotional well-being, fatigue, cognitive function, cortisol and perceived stress, blood glucose and job stress reactions. Studies of yoga in general, summarized by NCCIH, also cover sleep, and that agency states that studies suggest benefits for sleep, especially in older adults, without singling out the restorative style.

Stress and psychological outcomes

In a pilot trial of 44 women with breast cancer, 10 weekly 75-minute restorative classes were compared with a waitlist. Group differences favored yoga for mental health, depression, positive affect and spirituality, fatigue improved within the yoga group only, and sleep results were mostly nonsignificant. The authors cited small size, a waitlist control that did not match time and attention, and a mostly White, higher-income sample.

A crossover trial in 20 female night-shift nurses reported that stress-reaction scores fell from 65.7 to 56.1 after 4 weeks of home practice, compared with 64.1 after usual stress relief, with no change in blood pressure or pulse. The author noted the narrow sample, no blinding, unmonitored home practice and short duration. In the larger PRYSMS trial of 180 adults with metabolic syndrome, the comparator, low-impact stretching, produced lower waking cortisol at 6 months and lower perceived stress at 1 year, so the hypothesis favoring restorative yoga was not supported.

Metabolic and cognitive outcomes

In the companion trial of 180 underactive adults with metabolic syndrome, 135 completed the 48 weeks. Fasting glucose fell more with restorative yoga than with stretching at 12 months (0.35 versus 0.03 mmol/L), but no other metabolic difference was significant, and the stretching group had better quality of life. The authors called restorative yoga marginally better for fasting glucose only.

A pilot trial in 35 sedentary breast and ovarian cancer survivors compared restorative with vigorous yoga on cognitive tests. Fluid cognition was higher in the restorative group at week 24, which the authors called promising but in need of confirmation. The study had no usual-care arm, was set by convenience sample size and had a primary aim of feasibility and safety, so it cannot show that restorative yoga improves cognition.

Sleep, insomnia and the wider yoga literature

Searches of PubMed for restorative yoga combined with sleep, insomnia, trial and review terms returned no trial of restorative yoga aimed at an insomnia diagnosis among the records screened, and the one sleep outcome in the breast cancer trial above did not reach significance. NCCIH summarizes reviews of yoga overall, not restorative yoga specifically, as finding benefits for perceived stress and, in some studies, sleep, and calls the evidence for several conditions preliminary or low quality.

Adverse events in trials and reviews

The restorative trials that reported adverse events were small. The breast cancer trial reported none, the nurse trial reported none, and the cancer survivor trial reported mild to moderate pain in 2 of 20 restorative participants, compared with 6 of 15 in vigorous yoga. A 2015 meta-analysis of 94 yoga trials that reported adverse events found no difference from usual care or exercise, but only about 31 percent of identified trials reported them. A 2013 review of 76 case-report cases found musculoskeletal, nervous system and eye events, mostly linked to demanding practices, and does not mention restorative yoga.

Eye pressure, blood pressure, injury and pregnancy

NCCIH advises people with glaucoma, severe high blood pressure, balance problems, knee or hip injuries or lumbar spine disease to consult a health care provider and instructor about modifications. For pregnancy it advises a medical evaluation first and avoiding long periods of stillness or lying on the back, which is relevant because restorative poses are often held reclined for minutes. In a small observational study of 10 people with glaucoma and 10 without, legs-up-the-wall pose raised intraocular pressure significantly within a minute, although less than three other poses, and pressure returned close to baseline within two minutes; effects of longer holds were not tested.

NCCIH also says yoga should not be used as a reason to delay seeing a health care provider. The trials reviewed here were small and drew on specific groups, so they say little about people with acute injuries, recent surgery or unstable conditions.

Training and regulation

Yoga Alliance, a private registry, says its registered school credential lets graduates register as Registered Yoga Teachers, but the page opened does not state hour requirements and does not mention a restorative-specific credential. The Iyengar Yoga association of the United States says only certified teachers may describe their instruction as Iyengar Yoga. No statutory regulation or training standard specific to restorative yoga was found in the sources reviewed.