Why doesn’t yoga4cancer include Downward Facing Dog?

Downward Facing Dog is often considered a resting or transition pose between other poses. It is a mainstay of yoga for most lineages, practices and styles. Downward Facing Dog is a powerful pose for lengthening the back of the body and the spine. It also builds upper body strength and flexibility.

However, for those diagnosed with cancer, this pose can be uncomfortable and challenging – especially for people who are new to yoga and do not have flexible hamstrings or upper body strength.  It can also be anxiety-producing, largely because breast cancer patients and survivors are erroneously told that this pose places too much downward pressure on the arms and will cause Lymphedema. This claim is not accurate, but we feel it is important to understand the concerns of our students and mitigate anxiety.

A real threat is that this pose can cause discomfort due to the inverted positioning of the torso, which puts gravitational pressure on incision sites, especially abdominal body parts that are missing, tumors that are not removed, or breast implants.

However, the best reason to build a yoga practice without including downward facing dog applies to all cancer survivors: Downward Facing Dog is actually a half inversion and doesn’t maximize the body’s natural detoxification process. Even though the pelvis is raised above the heart, the lower half of the body remains in an almost vertical position, which means the flow of blood and lymph are not redirected, which happens in other inversions like headstands, or supported inversions like Supported Shoulderstand. Almost equally dividing the body, neither body half has the benefit of gravity to move body fluids towards the body center, which is critical to our major goal of creating and maximizing lymphatic flow to the thoracic duct. Furthermore, diaphragmatic breathing from this position can be more difficult and therefore compromised, neutralizing a significant benefit. Inversions are valuable to assist the flow of lymph and blood to detoxify the body’s Immune System when they are done supported, or in their full expression.

These are a few of the reasons why we do not recommend nor use Downward Facing Dog in the yoga4cancer Methodology. And we utilize other poses to be transition poses or gain the benefits of a Down Dog without the risk or anxiety (see options below). But this does not mean the pose should never be practiced. Yoga practitioners who do not feel anxious in this pose and who understand how to safely and effectively practice this pose with the proper strength and alignment can enjoy all the benefits of Downward Facing Dog. A yoga teacher who understands how to protect vulnerable body parts can teach this pose safely.


  • If you love Downward Facing Dog and feel that your student (s) can benefit from the pose, instruct students to use proper alignment. Build their strength slowly by holding for no more than five breaths in the beginning. “Puppy Down-Dog” can also be done by keeping the knees on the ground and using the forearms to carry more upper body weight.
  • Downward Facing Dog at the wall or from the back of a chair is also a great alternative with all the benefits and minimal risk. Please see the illustrations in our book, Yoga for Cancer.
  • Finally we encourage use of blocks to support active transitions as seen below.