DEAR MAYO CLINIC >> I have always been fairly flexible, so I have never felt compelled to include yoga in my fitness routine. Typically, I just walk and maybe do some weights for strength training. I was talking to a friend who said her physical therapist recommended yoga as part of a well-rounded workout routine. What is the benefit of yoga? Should I add it to my routine or stick with what I'm doing?

ANSWER >> Yoga is a wonderful form of exercise that provides benefits that walking or strength training don't provide. In Eastern cultures, yoga is not seen as exercise, but rather "a moving meditation." In the Western world, many people know power yoga or vinyasa yoga, which are classified as exercise.

Regardless of the type of yoga, when practiced mindfully, there are many advantages for the body, mind and soul. Yoga can provide three primary benefits that a typical gym routine may not provide.

Benefit 1: Yoga improves the function of the nervous system. Since yoga is based on breathing, parts of the nervous system are affected when exhales are lengthened and breath is controlled. This is cued throughout particular yoga sequences. Specifically, yoga can help lower the fight-or-flight response and improve the body's "rest-and-digest" response.

Practicing slow, controlled breathing stimulates the body's vagus nerve, which takes information about the current state of relaxation and relays it to the rest of the body, including the brain. One area affected when the vagal nerve is stimulated is the parasympathic nervous system, which controls the body's rest and digestion functions. The mindful breathing practiced in yoga increases the activity of the parasympathic nervous system. As a result, yoga lowers the heart rate, improves digestion and quality of sleep, and strengthens the immune system. Another benefit is an improved stress level.

Benefit 2: Yoga can improve joint range of motion. The difference between flexibility and active range of motion is important. Think of flexibility as how much a muscle can be passively stretched. In contrast, range of motion is how much muscles can be used to control a joint's movement.

It is not uncommon these days for people to report neck and back pain, and poor range of motion in their thoracic spine due to constant sitting, typing on computers and looking down at cellphones. Yoga is excellent in improving thoracic range of motion because many poses involve extending the body through the rib cage and using strength to hold these postures.

Yoga incorporates all four motions of the spine: flexion, extension, rotation and side-bending. Therefore, yoga can prevent stiffness and disuse that also can occur with age. Being able to control the available range of motion in joints is crucial to good posture and decreasing the risk of injury.

Benefit 3: Yoga improves dynamic balance, decreasing the risk of falling. Think of balance like a muscle. By working hard at different exercises, balance can improve. This is similar to improved strength by lifting weights.

Balance is a complex system, requiring three parts: the sensation of the foot on the ground, or proprioception; vision; and the inner ear, or vestibular system. These three parts tell the brain where the head is in space. These three components work together to control both static and dynamic balance. Yoga trains the proprioception and visual systems to improve balance. Depending on the pose, cues are sent to focus, for instance, on the foot rooted to the ground. By concentrating in an attempt to maintain contact, the big toe, little toe and heel form a tripod of sorts, which in turn helps focus the proprioception portion of balance.

In yoga, you may hear the term "drishti," which refers to obtaining a focused gaze or focus in the mind. The concept comes into play as people aim to hold a pose with their eyes closed. Certain poses become more challenging with eyes closed, which improves the visual part of balance.

Also, moving back and forth between poses without fully touching a limb to the ground can increase the ability to dynamically move and not lose balance. Over time, this will reduce the risk of falling while walking on uneven ground or turning quickly.

While it may be hard to add one more thing to your busy life routine, incorporating yoga into your workout routine can benefit your stress level, mobility and balance in ways that may not be achieved from a regular gym routine.

Lauren Hubbard, D.P.T., Physical Therapy, Mayo Clinic, Jacksonville, Florida

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