If Yoga Is No Longer the Center of Wellness Culture, What Comes Next for Yoga Therapy?

A perspective on optimization culture, movement trends, and why yoga therapy may need to become more—not less—distinct from the fitness industry.

Recently, The Atlantic published Rheana Murray’s essay, “What Happened to Yoga?” Murray begins with an almost provocative declaration from a former yoga teacher: “Yoga is dead.”

Of course, yoga is not dead.

People continue to practice yoga in studios, homes, hospitals, schools, workplaces, airports, community centers, and online. Yet Murray identifies something worth noting: yoga may no longer occupy the cultural position it once held within American wellness.

Pilates is booming. Strength training has become increasingly visible, particularly for women. Sculpt classes, heated fitness, wearable technology, biohacking, and data-driven approaches to health compete for consumers’ attention. Studios that once primarily offered yoga are diversifying their schedules to meet changing demand. Murray describes a wellness culture that has increasingly shifted from seeking inner peace toward pursuing measurable optimization.

I found myself reading the article not only as a longtime movement professional, but as a yoga therapist.

And I kept thinking:

This may not be a crisis for yoga. It may be an opportunity for yoga therapy to clarify what it actually is. For example, when clients or healthcare professionals ask about yoga therapy, I often use a simple elevator pitch: "Yoga therapy is a personalized, collaborative approach that draws from yoga's tools to support individual health and wellbeing, especially when someone is managing a specific health challenge." I might clarify further by saying, "Unlike a group yoga class, yoga therapy starts with your unique needs and goals, and integrates assessment, education, movement, breath, and mindfulness to serve you as a whole person. It's distinct from fitness or general wellness because it's tailored, evidence-informed, and designed to complement other care." These clear explanations help people understand how yoga therapy stands apart and what it can offer.

When Yoga Becomes a Workout

There is nothing inherently wrong with exercise.

Strength matters. Cardiovascular fitness matters. Bone health matters. Mobility matters. And people are allowed to choose movement simply because it feels good, makes them sweat, builds muscle, creates community, or is fun.

I have spent much of my professional life in movement spaces. I understand the appeal of a class where everyone moves together, follows a rhythm, works hard, and leaves feeling like something has been accomplished.

These environments create a kind of movement entrainment: the music, instructor, sequencing, cadence, group energy, and repetition carry us together through an experience.

That can be powerful.

But it is not the same thing as yoga therapy.

Yoga therapy is not simply slower yoga. It is not a yoga class modified for someone with a diagnosis. And it is not the clinical-sounding version of a fitness service. Rather, yoga therapy is a personalized, relationship-centered process designed to support a person’s health, healing, and well-being through the specific tools and principles of yoga an embodied philosophy. Yoga therapists work collaboratively with clients to assess needs, identify goals, and select evidence-informed practices—movement, breathing, mindfulness, education—that honor each person’s unique experiences and circumstances.

The work begins somewhere else.

It begins with listening.

What is happening in this person’s life?

What matters to them?

What are they experiencing physically, physiologically, emotionally, socially, and perhaps existentially?

What helps?

What aggravates?

What resources are already available to them?

What is within my scope to address, and when should another healthcare professional be involved?

Then comes assessment, education, collaborative goal setting, clinical reasoning, selecting and adapting practices, observing the response, reassessing, and, when appropriate, communicating with other members of a healthcare team. For those unfamiliar with the process, a typical client journey in yoga therapy often begins with an initial intake and thorough assessment, where the therapist listens to the person's story, health background, and goals. Together, therapist and client identify priorities and set meaningful objectives for their work. Each session generally includes discussion, education, guided movement, breath or mindfulness practices tailored to the client's needs, and time to reflect on what was noticed or learned. After each session, the therapist adjusts the approach based on feedback and progress, maintains documentation, and, if applicable, collaborates with other providers. This step-by-step, personalized workflow keeps therapy responsive, collaborative, and aligned with the person's changing situation.

Sometimes the result is movement.

Sometimes it is breath.

Sometimes it is rest, meditation, inquiry, or education.

Sometimes it is helping a person recognize that what they need today is different from what they needed six months ago.

That process is considerably less flashy than a neon-lit workout.

I have occasionally joked that what I do is boring.

And, truthfully, that may be one reason some people choose not to work with me.

I am not trying to entertain someone for an hour. I do feel having someone's undivided attention (1:1) for an hour has value. Many of my medically adjacent movement professionals do not get to spend an hour of experiential movement with their patients. I’m grateful that I do;  perhaps you find value in that too.

I am trying to understand my clients.

The Value of “Boring”

Movement professionals face tremendous cultural pressure to create an experience.

Make it harder.

Make it hotter.

Make it faster.

Make it beautiful enough to film.

Give people a burn they can feel, metrics they can measure, or an accomplishment they can post.

Clinical work often moves in the opposite direction.

It asks us to slow down enough to notice.

It asks whether more is actually better.

It asks what happens after the session, not merely during it.

It asks whether an intervention is appropriate for this particular person, in this particular body, with this particular history and health context.

Evidence-informed care is rarely glamorous.

Neither is documentation.

Neither is reviewing research, recognizing red flags, staying within scope, communicating with another provider, modifying an intervention because the client’s health has changed, or deciding that the most responsible action is to refer someone elsewhere.

Yet these are precisely the behaviors that help transform a service from generalized wellness into professional therapeutic care.

So perhaps “boring” deserves a second look.

Boring can mean careful.

Boring can mean individualized.

Boring can mean the practitioner pays more attention to the person in front of them than to performing expertise in front of them.

Why I Use the Term Medically Adjacent

This is one reason I increasingly describe my work as medically adjacent.

Yoga therapy does not need to become medicine to work responsibly alongside medicine.

I am not diagnosing disease. I am not replacing physicians, physical therapists, mental-health professionals, dietitians, nurses, or other licensed healthcare providers.

I am also not simply teaching a generalized yoga or Pilates class and assuming that because yoga/Pilates is beneficial, the same approach is appropriate for everyone.

Medically adjacent practice occupies an important middle space.

It means understanding health conditions well enough to work responsibly within one’s scope.

It means recognizing contraindications, precautions, and red flags.

It means understanding the language of healthcare sufficiently to communicate across disciplines without pretending to belong to a profession we do not.

It means being able to explain why we selected an intervention, what outcome we are observing, when something should be modified, and when collaboration or referral is warranted. Good documentation supports this process. For example, after a session, I might briefly note the client's stated goal, the specific practices we used (such as breathwork for anxiety management), any observations about their response, and our shared plan for next steps. Clear, concise records help track progress over time, inform future sessions, and ensure effective communication with other healthcare providers when appropriate.

It also means preserving something healthcare itself can sometimes struggle to provide: time to explore the lived experience of illness.

A person is more than a diagnosis.

They are also living in relationship with that diagnosis—with their body, family, work, identity, fear, hope, meaning, function, and future.

Yoga therapy has something important to contribute there.

From Optimization to Relationship

One of the most interesting observations in Murray’s article is the tension between yoga and contemporary optimization culture.

Modern wellness increasingly gives us numbers.

Steps.

Sleep scores.

Heart-rate variability.

Glucose curves.

Calories.

Zones.

Recovery scores.

Body composition.

These tools can provide useful information. But information is not the same as wisdom, and measurement is not automatically synonymous with health.

At some point, the pursuit of optimization can become another demand placed on a human being.

Yoga offers another possibility.

Not: How can I perfect this body?

But: How can I develop a different relationship with this body?

Not: How can I eliminate every uncomfortable sensation?

But: What is this experience communicating, and how might I respond skillfully?

Not: How do I continuously improve myself?

But perhaps: What would living well look like from here?

That distinction matters especially in yoga therapy.

Many of the people who seek therapeutic care are not trying to become optimized versions of themselves. They may be living with cancer, persistent pain, neurological disease, disability, aging, caregiving demands, grief, anxiety, sleep disruption, or the long-term effects of medical treatment.

The promise that every body can continually become stronger, thinner, younger, faster, or more efficient is neither realistic nor particularly compassionate.

Sometimes health means adaptation.

Sometimes it means maintaining function.

Sometimes it means finding agency within circumstances we cannot entirely change.

Sometimes it means learning that quality of life is not the consolation prize we receive when optimization fails.

It is the point.

Yoga Therapy Cannot Depend on Yoga Being Cool.

This may be one of the most important implications of our profession in the current cultural moment.

For many years, yoga therapy benefited from yoga’s enormous cultural visibility.

People already knew the word yoga. Healthcare systems already offered yoga classes. Research on yoga expanded. Patients asked about it. Integrative-health programs included it.

But familiarity can also obscure important distinctions.

If yoga therapy is understood merely as “yoga for people with health problems,” then the profession remains tethered to the fortunes of the commercial yoga marketplace.

If yoga classes decline in popularity, yoga therapy appears to decline with them.

That is why professionalization matters.

The future of yoga therapy cannot rest solely on yoga's popularity.

It must rest on the quality of yoga therapists.

On educational rigor.

Clinical competency.

Ethical practice.

Clear scope.

Evidence-informed decision-making.

Therapeutic relationships.

Appropriate assessment.

Documentation.

Interprofessional communication.

Referral pathways.

Meaningful outcomes.

And the ability to explain clearly what we contribute to collaborative care. For example, when speaking with healthcare professionals or patients, a yoga therapist might say: "As a yoga therapist, my role is to integrate individualized movement, breath, and mindfulness practices to support clients' health goals in collaboration with the broader care team. I help clients manage symptoms, improve self-regulation, and enhance their quality of life, while ensuring every approach is aligned with clinical guidance and personal needs." An accessible talking point like this can help yoga therapists advocate effectively for their unique contribution within healthcare teams.

The Method Is Not the Lens

This distinction also shapes the way I work in my own practice.

My professional toolbox includes both yoga and classical Pilates techniques, along with movement education, breath practices, interoceptive awareness, meditation, and other strategies that may support a client's goals. I’ve spent 20+ years building my toolbox, and I've learned many techniques from my mentors over the decades.

But the tools are not the framework.

Yoga therapy is the lens through which I see the whole person, make clinical decisions, and determine how—or whether—a particular tool belongs in the plan of care.

That means I do not begin with, “Which yoga practice should I teach?” or “Which Pilates exercise should I prescribe?”

I begin with the person.

What are they experiencing? What matters to them? What are we noticing together? What supports function, agency, participation, and quality of life? What does the evidence suggest? What is appropriate within my scope? And what can we adapt as their needs change?

Sometimes a classical Pilates exercise may be exactly the right movement strategy.

An asana, breathing practice, meditation, or contemplative inquiry may be more appropriate.

Sometimes the best intervention is education.

And sometimes the most skillful clinical decision is to do less.

The modality can change.

The therapeutic lens remains.

That distinction matters in my work at ISM.Health. I don't ask clients to fit themselves into a predetermined method. I draw from the methods I have spent decades studying and practicing. At the same time, yoga therapy provides the clinical and philosophical framework for understanding how those tools might serve the individual in front of me. When I work with a client, I begin by listening carefully to their story, needs, and goals, and then use assessment and collaboration to determine which approaches or methods will be most supportive. For example, if someone is experiencing persistent pain, I might prioritize breathwork and gentle movement first, while with another client facing fatigue, restorative postures or guided relaxation may be more appropriate. I consider factors like health status, functional needs, personal preferences, and evidence behind each practice before integrating any method. Throughout this process, I adapt what we do based on a client's feedback and progress, so each session remains both individualized and relevant.

Perhaps “Boring” Is Where the Future Begins

The future of yoga therapy may look decidedly less glamorous than the wellness industry surrounding us.

I am comfortable with that.

The future of yoga therapy may not be found by making yoga more competitive with Pilates, sculpt, strength training, biohacking, or whatever comes next.

Our task may be entirely different.

To become exceptionally good at helping human beings live well in the bodies and circumstances they actually have.

If that is boring, I am increasingly convinced that boring may be exactly where the interesting work begins.

Inspiration

This perspective was inspired by Rheana Murray’s exploration of yoga’s changing cultural position in the United States and the broader shift toward fitness, optimization, and performance-oriented wellness. The reflections and conclusions presented here are my own and extend the conversation specifically into the developing profession of yoga therapy.

Reference

Murray, R. (2026, August 31). What happened to yoga? The Atlantic. https://www.theatlantic.com/culture/2026/08/yoga-america-culture-decline/688461/