On a recent Thursday night, a group of barefoot people are moving through a yoga practice at Bend Yoga’s studio in downtown Pittsburgh.
It’s a yoga class for people with traumatic brain injuries or post-traumatic stress disorder — or both. Among them is Chris Ohleger, who said yoga has benefited him in ways no other treatments or therapies have.
"Different medicines and even some physical therapy felt more like work and less like healing, less like fixing anything," he said. "It was more difficult to maintain, and it didn’t feel like as complete and as wholesome as this feels and as motivating as this feels."
Millions of Americans have a traumatic brain injuries. The injuries are difficult to live with and expensive to treat. Even with treatment, there is no actual cure — those with a TBI just learn ways to work around their injury. One way to alleviate the ailments of TBI may be through yoga.
Ohleger, a 29-year-old Army veteran, sustained injuries from blasts while serving in Iraq. A few months ago, some friends started talking up a yoga class they’d been going to at the Wounded Warrior Project's Pittsburgh office. After a lot of urging, he agreed to go. Then he told his wife Audrey.
"When he told me he was going to yoga I said, 'Are you kidding?" she said laughing. "Because it’s the last place I thought I would see him go."
Teaching that series of Wounded Warriors classes was yoga instructor Janna Leyde. She said initially there was some resistance from her students.
"To teach a Wounded Warrior class, you’re a little bit of a different yoga teacher than to say come into my studio and just teach regular students," Leyde said. "You gotta hang with them and just play their game."
Leyde’s Wounded Warrior class eventually ended, but by its conclusion, the response from her students was positive.
"They would tell me they were sleeping better, not falling on their face if they closed their eyes and they were like, is it the yoga?" Leyde said. "And I would say, 'It might be!'"
That prompted her to start a new class at Bend Yoga, opening it to all people with brain injuries.
For Leyde, though, working with those who have traumatic brain injuries started closer to home.
When she was a teenager, Leyde’s father John sustained a traumatic brain injury in a car accident. His frontal lobe, which affects things like executive function, was impaired.
His injury changed both of their lives.
"To see him, he is normal, he looks normal, but he couldn’t balance a bank account, he couldn’t hold a job, he just couldn’t do all of those things because of the injury in his brain, and so it was a very challenging way to grow up with that kind of a father," she said. "It was a lot of role reversal within a family."
Years later, practicing yoga regularly helped her deal with the emotions she had suppressed around her father’s injury. Eventually, she became a yoga teacher. And then on visits to her parent’s home in rural Mercer County, she started teaching her father some basic yoga poses she thought might help him.
"I thought maybe because it had helped me so much it would help my father with some of the things that his therapies and the things he had been working at for 17 years ... help him realize he has a brain injury and work with the deficits he has, to help him, you know, react better emotionally, behaviorally, cognitively," Leyde said. "I thought maybe let's give yoga a shot, can’t hurt."
Her father John says while he didn’t resist yoga at first, he didn’t have expectations for it either.
"I thought it was something mystical," he said. "I thought it was something druggies did. I was wrong."
Now a few years into a regular yoga practice, both father and daughter say its helped him.
"I think there is a disconnection between my physical and my mental. And yoga is reestablishing my physical and my mental because when I do it I have to think about what I’m doing," he said.
Janna Leyde said they see changes. Her father's balance and memory are better, and he initiates his own tasks.
When Leyde was starting to teach her father yoga she broke down a sun salutation: some forward bends, some backward bends, some balancing poses.
"It was a big challenge at first," she said. "Our first practice was like 2, 2 and a half hours, I was exhausted mentally. He was exhausted physically. And we kept at it."
TBI affects everything from the way you act to the way you move. Falls, accidents, sports are some of the most common causes, and increasingly, soldiers are returning from Iraq and Afghanistan with TBI. Every injury is different, making each one difficult to treat.
When Janna Leyde went looking for books that would give her some pointers, she couldn’t find any.
"You go into a bookstore or Amazon these days and you look up yoga for and you can find yoga for cancer survivors, yoga for domestic abuse, yoga for depression, yoga for sciatica, anything and I didn’t ever find yoga for brain injury," she said.
So she decided to write one herself.
The world of TBI and yoga is small but growing.
Dr. John Rigg is the director of the Traumatic Brain Injury Clinic at the Dwight D. Eisenhower Army Medical Center, a hospital and treatment center for active duty soldiers in Fort Gordon, Georgia. He works with soldiers who’ve been exposed to IED, rocket, propellant grenade, bomb blasts in Afghanistan and Iraq.
"They’ll come into our program and they’ll see medical doctors, they’ll see behavioral health specialists to deal with mood, physical, occupational, speech therapists to deal with cognitive issues, recreational therapists to help them integrate back into society," Rigg said. "If they’re not responding to that, they get involved in a three-week long in-patient program, and during that program they get exposed to five or six yoga classes over the course of a couple weeks."
Rigg described the effect of the injury compounded with stress as a toxic combination.
"What happens is that primitive animal instinct, which is located in the subcortical brain, becomes hyper-aroused, which serves the soldier very well in combat," he said. "Well, when he returns home to the United States, the cortical brain, the intelligent human brain understands that a geographical shift has occurred. But the subcortical brain doesn’t understand geography and stays hyper-aroused. Their muscles are tightened up and the significant muscle tension in the backs of the head and necks creates tension headaches which then can trigger a migraine-type headache."
They started teaching yoga to the soldiers four years ago, and it took off. Now they have a full-time yoga teacher — a Department of Defense employee — working with the soldiers. Yoga, Rigg said, is in many cases, a good alternative to psychotropics.
"Medication is not like a finely tuned hyper-bullet to the part of the brain that makes hyper-arousal tame," he said.
Rigg said that almost immediately as soon as the soldiers start taking classes, they see results: better sleep, relaxed neck muscles, a more positive outlook.
And after a few years, and about 400 soldiers who have taken the classes at his base alone, it’s become a sort of catalyst for change.
"There are people who have really gotten a lot out of it, and even for people who haven’t followed up with it, it's been a great introduction as to how to use the body movement as a healing force," Rigg said. "I think it's been enlightening factor even for people who don’t continue in yoga to see that they can use breath and physical movement to actually change the way they feel."
There hasn’t been much research on yoga and TBI. A couple years ago, researchers at the University of San Francisco and Harvard published a paper on the respiratory, physical and psychological benefits of breath-focused yoga for adults with severe traumatic brain injury.
It’s easier to measure things like breath than it is to measure things like empathy. But those who have been taking the classes say it's changed them, and even if they don’t fully understand what it is about the yoga that has.
Back in Pittsburgh, when the Wounded Warrior class ended, Army veteran Chris Ohleger started feeling some of the old effects returning.
"And I noticed then having stopped doing it for a month, I noticed the difference, not so much when I started for the first couple sessions, any sustained change, but I really noticed when I was no longer doing it and more tension coming back, more anxiety and more stress coming back," he said. "I just didn’t have that regular release and regular rehabilitation of doing the yoga."
So Ohleger is back at Janna Leyde’s class at Bend Yoga. He plans to continue going as often as he can.