As a student in Prema Yoga Institute’s Yoga Therapy Certification program, I had the privilege of undergoing a 50 hour training in Functional Anatomy under the tutelage of Erin Moon, a certified yoga therapist and Prema graduate, and director and co-creator of the World Spine Care Yoga Project.

World Spine Care created the Global Spine Care Initiative (GSCI) in 2018 as a community project, to “reduce the global burden of disease and disability by bringing together leading healthcare providers, scientists, specialists, government agencies, and other stakeholders to transform the delivery of spine care.”

I recently had the opportunity to sit down with Erin and ask her some questions about her work as a yoga therapist in general and the Project in particular in advance of World Spine Day, which will mark its eighth year of official celebration on October 16th. What follows are excerpts from that conversation.

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PYI: What originally drew you to yoga therapy?

EM: It was a natural progression as the term came into greater recognition and regulation within the modern yoga community. I was grandfathered into IAYT partially because, like so many collogues, I had been and continue to work with every client with deep care and the approach of the holistic health paradigm that the ancient practices and philosophies of yoga provide. I felt it was important, as I furthered my education, to dive deeper into the intersection of the allopathic and holistic approaches to health and healing. As it does for so many others, the desire to deepen my training arose from personal trauma and the old adage “teacher heal thyself.”

PYI: While studying at PYI, what was your favorite module?

EM: I loved Yoga in Healthcare. In my 300hr training, before Prema, I focused on yoga and healing and then narrowed my focus to yoga and stress, specifically the neurobiology of stress. Yogic practices, I believe, work with stress in a very special way and provide our greatest opportunity for intervention through many, many tools. So getting a chance to learn from soma-psychotherapists, physicians and physical therapists who are also yoga therapists about what they have learned clinically was astoundingly enlightening.

PYI: When did you first begin to focus on spinal care?

EM: In 2015 I met the Clinical Director of World Spine Care (WSC), Geoff Outerbridge, at an adult sleep-away camp called Camp Good Life Project and we realized that we had a lot to talk about. He was developing an idea for a community Project for WSC that needed a teacher of yoga teachers with a strong anatomy and therapeutics background who happened to also have international volunteer experience (the flagship clinic is in Botswana, so being culturally aware and sensitive was very important). That is when I became the co-director/creator (along with my co-creator Barrie Risman and, since 2017, Jesal Parikh and Letizzia Wastavino) and particularly interested in Spine Care. However, the Yoga Project (YP) is not solely focused on Spine Care but also more generally on all musculoskeletal care, pain management, and active and preventative self-care.

PYI: Please tell us about the World Spine Care YOGA Project.

EM: I think the best way to start is with our mission and vision:

Mission

We are focused on building community capacity for low mobility populations by sharing the practices of Yoga as tools for management and prevention of musculoskeletal pain.

Vision

To globally inspire self-directed, self-led and self-sustaining communities, who experience low mobility, to use the practices of Yoga for active and preventative self-care and pain management.

We began in 2016 when Barrie Risman and I first rolled out the program in the flagship clinic in Shoshong (a village) and Mahalapye (a town) in Botswana. That first time, we worked with two different groups: one with higher mobility and one with lower mobility. We’ve since learned that the more mature group with lower mobility, who themselves benefited from the protocol, are the group that has kept the program going. They are also living in an area with a tighter community spirit. Because the Yoga Project is a community-oriented program, we learned, over time, how fundamental that tightly knit community is to the success of the program. They have taught us a lot and we have since gone back and offered level two of our protocol with more standing postures and breath and mindfulness.

Overall, this is how we function:

We work only with populations who have asked for a preventative/active self-care and pain management modal.
We work in our respective home countries and in global communities where World Spine Care has an existing presence with potential for expansion beyond WSC clinical modal into interested and supportive communities.
We train people who are interested in using the benefits of the Yoga Project protocol to contribute to their community and themselves.
We adapt to the individual needs of the communities we are working with; cultural norms and practices are incorporated into the program, i.e. dance, song, physical appropriateness of postures, posture names, etc.
We are a secular program, meaning that we are open to the beliefs of all the communities we serve and happily encourage worship where appropriate, but we do not come in with any religious overlay or agenda. We also teach that the history of the practice’s roots come from India and that there are many more practices, not included in the Yoga Project protocol, that can be explored individually.
We adapt the Yoga Project protocol as new information about mobility, physiology and psychology is made available to us through research.
We offer practices of mindfulness based upon research concerning mindfulness-based stress reduction and the 3000 years of Yogic practices for pain and stress management.
We offer practices of breath based upon vagal nerve research, etc., and the 3000 years of Yogic practices for pain and stress management.
We offer poses that explore stable, long-term, functional range of motion for lower mobility populations. We encourage adapting to offer low too no pain- movements to those experiencing pain.
We offer multiple levels of trainings as is appropriate for different levels of mobility and pain. Currently our offerings include: a level one training with a larger percentage of chair supported postures and a level two training with more standing postures and greater physical challenge.
We also offer our programs to MD, PT, OT and chiropractors as well as trained yoga instructors as continuing education to better serve their communities and patients.
We are an online resource for low mobility and pain populations world wide for at-home practice and capacity-building, using the practices of Mindfulness, Breath and Posture.

PYI: We understand that you train teachers in Botswana. Have the Botswana teachers found specific spinal needs in their communities?

EM: They themselves are dealing with a host of different spinal and musculoskeletal issues, pain and bio-psycho-social factors. We do not encourage or have time to specifically train our teachers to work with each different type of malady. Every issue they see and we have seen is multifactorial. The program is focused on keeping people mindfully active and offering stress management tools to help with pain management. Also, because we include such things as good biomechanics for getting in and out of a chair, seated posture work, etc., we are offering day-to-day applications of mindful movement. Basically, instead of working with individual conditions, we focus on mindfulness and svadyaya (self-reflection) as tools for choosing and working with movement that “feels good”.

Statistically, the most affected populations with chronic (long-lasting) pain due to musculoskeletal and specific spinal issues are women over 50 in developing nations, due to a host of reasons ranging from access to good health care options and self-care education to highly labor-oriented lifestyles (though that is never to say that someone who sits all day at work will suffer less pain). It is always a complicated mix of elements that includes: which musculoskeletal issues and pain issues arise as well as the bio-psycho-social factors in any given population, so I want to be careful about being too reductive.

That being said, here is a little bit from WSC website to help:

The Global Burden of Disease report was published in Lancet in December 2012 (Murray et al, Vos et al, 2012). In this report, the following information regarding spinal conditions was reported:

• Low back pain is the leading cause of disability.

• Neck pain is the fourth leading cause of disability.

• Low back pain and neck pain affect 1 billion people worldwide.

• Spinal pain contributes more to the global burden of disease (including death and disability) than: HIV, diabetes, malaria, stroke, Alzheimer’s disease, breast and lung cancer combined, traffic injuries, and lower respiratory infections.

PYI: In the recent past in America, yoga has been mostly available and marketed to a more privileged group of students. How do you suggest we work to diversify to provide yoga for all?

EM: Well, this really is the question! It certainly is on my mind all the time. I cannot propose to have the answer, though, because for me, I feel it is time to really listen, to ask questions and get curious, to listen again and then listen again and then to stand beside rather than in front of the voices that are rising in our community about intersectionality and inclusion. Perhaps through this process things will change: through good, true allyship.

The question I pose to any yoga business is this: what face, body, ability and/or sexual identity are you representing in your teaching staff and in your advertisements? How are you creating a sangha that feels safe and accessible to all the bodies you hope to serve in your community? Who is in your community? Have you asked what they want? If it is not a visible shift, I don’t think a shift can actually happen. If it is not a fundamental values shift, I don’t think a shift can happen.

PYI: Do you have any advice for therapeutic yoga teachers wishing to start their own not-for-profit initiative?

EM: Ask questions, listen and go slowly. Do not think you know what a community needs because something has served you or “the research says” or “the tradition says”. Listen to what people are actually asking for: what their bodies and hearts and minds are asking for. Be open to learning and adapting. Ask, observe, adapt and then ask again!

PYI: How can we donate to your initiative?

EM: On this page you can specifically donate to the Yoga Project. You can find us on Facebook and Instagram @worldspinecareyogaproject, where we offer pain management tools and active self care from our protocol.

If you are an MD, PT or YT and want to do a Work-A-Day for WSCYP on the 16th in honor or World Spine day, follow this link.

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It was truly an honor to spend time with Erin and learn about her important and groundbreaking work incorporating yoga therapy into the work of the World Spine Care—the PYI community extends its thanks and appreciation to her and the healthcare professionals and dedicated communities with whom she works. We look forward to offering you more interviews and insight on the exciting work being done by our students and graduates in the coming months.

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An Interview with Erin Moon, PYI Graduate and Director/Co-Creator of the World Spine Care Yoga Project