Savasana (Corpse Pose) Variations

by Nina

In my post last week on Savasana (see here), I promised that I would do a follow-up post that shows alternative positions you can take if lying flat on your back in uncomfortable or even if you just want to rest in a position that’s a bit cushier and self indulgent.

The first Savasana variation is the simple addition of support under your head, a position that is good for people who are tight in the shoulders or chest and find it hard to rest their heads comfortably on the ground. Most people benefit from a bit of support under their heads, so check it out. Just make sure the support under your head is firm (not soft) and that your shoulders are touching the ground (not the support). Ideally in Savasana, your chin should be pointing slighting down toward your chest (not tipping back away from it).

Savasana with Head Support

The second of Savasana variation provides support behind your knees, a position that is good for people who have lower back problems or who simply want to rest their backs comfortably on the ground. Use a bolster (as shown below) or a rolled blanket behind your knees.

Savasana with Knee Support

The third variation of Savasana uses a chair to support your calves, which provides excellent rest for your lower back. It also creates a sight inversion (your legs are higher than your torso), which will help enhance your ability to relax (inverted poses is a topic I will address in a future post). Make sure that your legs drop comfortably onto the chair seat (if you are tall, you might have to stack blankets on the chair to make the surface high enough). If you can’t get your legs through the back of the chair, try turning the chair sideways instead.

Savasana with Legs on a Chair

The fourth and fifth variations are restorative versions of Savasana, with support under your torso and head. One version uses a bolster under your torso, and the other a stack of two folded blankets. This may be easier for you than lying flat on the floor or even deliciously comfy, and can help you breathe more freely in the pose as the support helps open your chest. When you do either of these versions, make sure that you sit on the floor (not on the bolster or blankets) before you lay back. The support should be under your torso, but not under your buttocks (a typical mistake I see beginners make!).

Restorative Savasana (Bolster Supporting Torso)

Restorative Savasana (Blankets Supporting Torso)

The sixth version is a side-lying Savasana, which is good for anyone who, for medical or other reasons, cannot lie on their backs (as well as for pregnant women). Notice there is support under your head, between your legs and between your arms—super comfy! You can use folded blankets or pillows, or any combination of the two.

Side-Lying Savasana

 The  last version is Crocodile pose (Makrasana), which is helpful for people who feel anxious or vulnerable lying on their backs and need the comfort of having their front bodies protected. If this pose is hard on your lower back, trying placing a folded blanket under your lower belly (below your navel) so your lower back doesn’t arch as deeply.

Crocodile Pose (Makrasana)

That’s it for now, but feel free to come up with your own variations to these basic versions or to use a version you learned in class or from a book. If you’re not comfortable in the pose, you won’t be able to relax, so take the time to set yourself up with whatever props you like. You can even get creative. I used to teach yoga in a room that had couches in it (don’t ask), and had my students do a pose I called “Legs on the Couch,” which was a variation of Savasana with legs on a chair. My students, who were busy graduate students or mothers of young children, absolutely loved it.(By the way, if you don’t have a yoga bolster, I recommend going ahead and splurging on one. You’ll be amazed at how much use and enjoyment you’ll get from it for years to come.)

Friday Q&A: What is Yoga Nidra?

 

Q: What is yoga nidra (yogic sleep)?

A: Well, this is a good question. A straight up translation is “the sleep of the yogi,” however, done correctly, one does not enter fully into sleep, but is guided by a teacher on a journey while resting in a restorative version of Savasana. I love this practice, as it can lead to a profound conscious rest (that means, again, you are not sleeping!) that has many physiologic, mental and emotional benefits.  Because you are listening and following the voice of a teacher while resting anywhere from 20-45 minutes, your mind is gently occupied and does not tend to revert to its typical habits of remembering, anticipating or judging. This provides a mental respite for your mind, and your body tends to more quickly shift into the rest and digest part of the nervous system, even faster than in normal sleep. Yoga nidra is being used to treat PTSD in vets returning from Iraq and Afghanistan, so the potential effect on anxiety, fear and worry seems obvious.

You can practice yoga nidra is the physical presence of the teacher who is guiding you (in a class or workshop) or on your own using a recording of your favorite teacher. And I hope to record a version of yoga nidra for your listening pleasure in the next few weeks. Nina will fill you in on yoga nidra’s modern roots, which may surprise some of you who have been told it is an “ancient “practice.” — Baxter

A: Yoga nidra was developed by Swami Sivananda Saraswati in the early twentieth century (based on the teachings of his guru, Swami Sivananda). Yes, the twentieth century. He wrote, “I came across many important but little known practices, which interested me greatly. After practicing them myself, I decided to construct a new system called yoga nidra which would incorporate the essence of these practices without having complicated ritualistic drawbacks.” He says the yoga nidra practice was inspired by the tantric practice of nyasa, but nyasa was performed in a sitting posture and involved the use of specific mantras which were “placed” in different parts of the body.

Swami Sivananda Saraswati’s disciple Swami Satyananda Saraswati describes the yoga nidra practice in great detail in his book Yoga Nidra. Swami The form of practice taught by Swami Satyananda includes eight stages: Internalisation, Sankalpa, Rotation of Consciousness, Breath Awareness, Manifestation of Opposites, Creative Visualization, Sankalpa and Externalisation. Contemporary teachers, such as our very own Baxter Bell, often create their own versions of yoga nidra.

So yoga nidra is not ancient after all! But that doesn’t mean it’s not a very powerful practice. Much of the yoga that we know and love was actually developed by a few brilliant Indian yogis during the early twentieth century (Desikachar, Iyengar, Jois, etc.), a very exciting and fruitful time in the long history of yoga.

In simple English, yoga nidra is a practice where you lie in some version of Savasana (Corpse pose) and allow a teacher, who is following a format devised by Swami Sivananda Saraswati, to guide you into a state of conscious relaxation that is referred to as “yogic sleep.” It doesn’t feel like being asleep and it doesn’t feel like being awake—trust me, I’ve tried it.

— Nina

What is a Yoga Practice?

by Brad

A year or so ago I was talking with a colleague about a genomics study he was planning that was going to look at exercise and aging. Previously, he and his colleagues had shown that resistance exercise training had a significant effect on the genes that were transcribed in muscle tissue, and that the older people undergoing this training had gene transcription profiles that resembled much younger people. This time around they were planning a more nuanced study and would look at several exercise regimens, including yoga. I remembered asking him what type of yoga practice they planned to use, and was met with a slightly confused look. He wasn’t sure, but thought it was a “standard practice” involving some stretching and aerobic components. When I inquired further about whether it was Iyengar style or one of those high-energy aerobic practices (like Ashtanga Vinyasa), I realized that our discussion had reached a dead end. He had no idea what I was talking about.

Photo from Yoga: The Poetry of the Body by Yee and Zolotow

So when I ran across another article today on Yoga for Back Pain that was mentioned in the Science Times section of this weeks NY Times (see here), I decided to take a little closer look at what the actual practice was. I also looked back at the Ornish and Blackburn study I discussed a couple weeks ago (see here), as well as a few other studies I had run across. I was interested in seeing how well the practice was described and whether it made in sense.

I was surprised to find that the most high profile of these studies, the 2008 Ornish and Blackburn study (see here), had the least detail. What they described as yoga for stress management consisted of “gentle yoga-based stretching, breathing, meditation, imagery, and progressive relaxation techniques 60 min/day, 6 days/week”. In contrast, a study published this summer by Dr. Fishman on osteoporosis and yoga (see here ) was considerably more comprehensive, listing all 10 yoga poses by both Anglicized and Indian names, e.g., “Upward and Downward Dog poses (Adho Mukha Svanasana and Urdhva Mukha Svanasana),” as well providing an appendix of 13 figures illustrating each poses. It should be pointed out that the lead author of this study was extremely familiar with yoga, having practiced it in India for three before attending medical school.

Another group that was fairly thorough in their description was Sherman et al. which just appeared on-line a couple days ago (see here) in their study of chronic low back pain, where they describe a viniyoga practice consisting of 5-11 poses (with pictorial diagrams referenced from earlier 2005 paper by this same group (see here). Interestingly, these authors also provided the credential for the teachers as “instructors with at least 500 hours of viniyoga training, 5 years of teaching experience, and familiarity with the selected postures and who were briefed by our yoga consultant.” This paper also gave a defense of their yoga style (viniyoga), as “a therapeutically oriented style of yoga that emphasizes safety and is relatively easy to learn.” 

Iyengar-style yoga was used in another study examining stress and inflammation by Kiecolt-Glaser, et al (see here) because it ”emphasizes the use of props to help students achieve precise postures safely and comfortably according to their particular body types and need”. In this latter study, the 12 poses and timing of each were well described and was constant, and apparently selected “based on their purported relationship to immune function and/or restorative effects.”

Obviously not everyone is going to agree with what is a good or best yoga practice for stress, back pain, osteoporosis or whatever. But what is clear is that these studies need to provide a through description of the regimen (time, poses, teacher qualifications) and their overall rationale, so that if someone wanted to reproduce this study or compare it with another, they shouldn’t be in the dark as to what the yoga practice was. In the end, it’s you who is going to have to decide on what to believe, as the standards for comparing these practices, pose sequences, and yoga styles are confusing at best. Maybe Nina and Baxter can comment on this, as I’m not an expert.

Come On, Stand Up, Get Outta that Chair!

by Baxter

While waiting to put in my order at a café yesterday, I observed a toddler’s delight in sitting down between the café’s coffee bar and a foot rest pole about 12 inches off the floor, then standing right back up and grabbing her mom’s pant leg. She then repeated the process maybe 10 more times, with a huge smile on her face the whole time.

 Standing Baby (from Wikimedia)

I couldn’t help but contrast this with an elderly yoga student I had worked with years before whose main difficulty was in getting up out of a chair without help.

One can only wonder at what happens between the joyful discovery and repetition of the movement of a toddler and the decline that leads to trouble with such an everyday transition as standing up from sitting in a chair. The factors are many, from general physical weakness, loss of balance integration and proprioception (your body’s ability to know where it is in space, where it is moving and how fast), to multiple possible medical problems.

A regular hatha yoga practice may help you avoid this incapacity entirely. But if you do develop some difficulty in getting out of a chair, yoga could help retrain your muscles and improve your proprioception, allowing you greater ease in accomplishing this essential daily transition. 

With a regular hatha yoga practice that includes standing poses, you are both strengthening and stretching your body. But maybe more importantly, you are utilizing the nerve receptors for balance and kinesthetic sense, called proprioceptors, in a very active, conscious way. My theory is that this ability is down-regulated through disuse, but can be reactivated with yoga asana practice, or trained for the first time if your body just has been sedentary most of your life. This translates into greater ease in shifting your weight from a sitting position onto your feet and up through your legs to rise up gracefully out of your chair and out into life.   

In addition, older students are reluctant to get down on the floor, as they have observed that it is getting harder to get back up. Mindful work with yoga could lead to this transition becoming easier also, for the same reasons stated above, although it may take a little longer to achieve due to the increased challenges against gravity.

 

Stay tuned for the featured pose of the week, Powerful pose (Utkatasana), which is a key pose for the sit-to-stand transition. Update: You can see it here.

SAVASANA (CORPSE POSE)

by Nina

Of all the hundreds (or thousands?) of yoga poses, there is a single pose that has been called the best antidote to the stresses of western civilization. And anyone can do the pose, regardless of age, physical condition, or yoga experience, because all it requires is the ability to lie down and be still. This is Savasana (Corpse pose). And while  Savasana is often taught as the last pose in yoga class, you can do it on its own, at any time you need. All that’s required is a firm surface to lie on and 10 to 20 minutes, and you’ve got a surprisingly effective anti-stress medicine that has absolutely no side effects and if you become addicted, well, that’s a good thing.

Now you may be wondering, how can just lying down on your bedroom floor trigger the relaxation response? And how is this position that you take all the time in bed, on the grass under a blue sky, or on the warm sand of a beach qualify as a yoga pose?

Savasana triggers the relaxation response (see here) because you bring your attention to your body and your mind while you lie on the floor instead of just daydreaming or spacing out. And it qualifies as a yoga pose, because to practice Savasana properly, you:

• align your body

• remain still
• use a mental focus
• maintain your awareness as you come out of the pose

Here are details about these four aspects of Savasana:

Alignment. The first thing to do when you lie down in Savasana is to arrange your body—and that means every single part of you, including your arms, your legs, your torso and even your head—in a neutral position. This neutral position ensures you’re as comfortable as possible so you can relax completely without physical distractions (like having your legs go to sleep or getting a crick in your neck).

Lie down on your back on a firm surface, with your spine in its healthy, natural curves. If your head isn’t comfortable resting flat on the floor, place a folded blanket or firm pillow underneath it (but keep your shoulders touching the floor). Make sure you are dressed warmly; if necessary cover yourself with a blanket.

Place your legs eight to ten inches apart, turn your arms out so your palms face up and your hands are six to eight inches from the body, and position your head perfectly between your two shoulders, with your eyes about equal distance from the ceiling. None of us are completely symmetrical, but you can adjust your body so it’s as symmetrical as possible and the weight is even on both sides of your body. Now your alignment is close to what medical books call “anatomical neutral,” the position your body naturally assumes when no muscles are being activated. And when you are in this neutral position, you can begin to relax your body completely.

When your body is entirely supported by the floor, you no longer need to contract your muscles to hold yourself upright (or partly upright). You can simply let your body to completely drop with the force of gravity, so all your muscles can soften and melt, releasing their hold. 

For those of you who find you can’t lie comfortably in the classic position, don’t worry. You can use props to make yourself more comfortable (for example, if you are having back problems, you can rest your calves on the seat of a chair) and you can even lie in a different position (for example, if you are pregnant, you can lie on your side or if you’re anxious you can lie on your belly). I’ll describe these alternate versions in a future post.

Stillness. After positioning your body so you're aligned as symmetrically as possible, make a commitment to remain still. When your body becomes motionless, external stimulation is reduced to a minimum, allowing your nervous system to cool down and your mind to quiet. Normally when you rest on your bed or couch, you shift around unconsciously, fidgeting or wiggling around to find a more comfortable position. You probably even change from one position to another when you’re sleeping (if you’ve ever shared a bed with someone else, you know what we mean). In Savasana, keeping your body still allows you to relax completely because there is no need to contract of any muscles at all except those needed to breathe. In fact, we’re so used to contracting our muscles, even when resting, it may take some time for you to let go completely.

After you have stilled your body, you’ll continue to receive messages from your ears, nose, tongue, skin, and eyes. Even in a quiet room, there’s still a lot to hear, smell, taste, and feel, and you’ll continue to perceive the light (or lack of it) in the room even with your eyes closed. All these sensory impressions send stimulating messages to your brain. So after quieting your body, consciously relax your sense organs, letting your tongue rest on the floor of your mouth, allowing your eyes to soften back toward your skull and gazing with closed eyes under your cheekbones, and withdraw your awareness from the rest of your senses. With the withdrawal of your senses, your physical relaxation will increase.

Out onto Mary's Lake by Brad Gibson

Focus for the Mind. If your thoughts are busying while you're in Savasana—whether you're trying to decide if you should watch Law and Order to CSI: Miami tonight or considering something more momentous—you won't be able to relax completely or trigger the relaxation response. So after you've aligned and quieted your body, turn your awareness inward. Typically the focus for your mind in Savasana is your breath, the gradual relaxation of specific parts of your body (sometimes called a body scan), or a peaceful image (for example, you might imagine your mind is the surface of a lake whose ripples are slowly subsiding). Rather than simply letting your thoughts wander as they would if you were lying on the grass in your backyard, intentionally keep your mind focused on your object of choice. When you notice your attention wandering, gently return it to that object. For example, if your breath is your focus for your practice, continue to watch your breath for the entire practice, and each time you notice your mind wandering, gently bring it back to your breath again.

Maintaining a mental focus is how you stay alert in the pose, allowing you to reap the benefits of conscious relaxation, rather than simply falling asleep. It helps you stay aware in the pose by keeping your mind anchored in your body, rather than drifting off into fantasy. And it helps you stay present in the pose by keeping your thoughts in the moment, rather than dwelling in the past or racing into the future. 

When you abide in the present moment you naturally become more aware of your own thoughts. As an impartial witness to your own experience, observe each thought as it passes through your mind without becoming involved in any of the storylines.  Alert and aware, serene and detached, watch your thoughts—what’s on TV, should I cook ratatouille or paella, did I remember to feed the goldfish—as they come and go, come and go. There will be time for all that later. Then, like a pond that has been stirred up with a stick, allow your mind to settle down gradually until the waters are serene and clear.

Coming Out. Stay in the pose for at least 10 minutes (it takes 7 or 8 minutes to trigger the relaxation response). When you are ready to come out, take a couple of deep soft breaths, then slowly bend your knees and place the soles of your feet on the ground. Next, slowly turn over onto your right side and rest there for a couple of breaths. Then slowly use your hands to push yourself up to a seated position, allowing your head to release downward until you are completely upright. Finally, when you are seated upright, slowly lift your head. (And, yes, do it all slowly.)

FRIDAY Q&A: DOES YOGA MAKE YOU FAT?

Very Salty Water by Brad Gibson

Q: I have a student, a 55 year old male, who has been practicing twice a week regularly for about four months. He recently commented that he has gained weight. How does yoga relate to metabolism? The classes he takes are general hatha style.

A: Thanks for writing in about your student who complains of weight gain despite two yoga sessions a week. Right off the bat, it is unlikely that two sessions a week would have a sustained effect in improving his metabolic rate. Any form of exercise, and here we will say that yoga asana is his exercise, would likely need to be aerobic in nature and done at least every other day, for at least 30 minutes, to affect his metabolism. Likewise, it is unlikely that amount of yoga would lower the metabolism, resulting in weight gain.

I’d also like to respond in general to the issue of yoga and metabolism. If nothing else, Maureen Dowd’s strange “editorial” two weeks ago in the New York Times claiming that yoga makes you fat (see here) raises intriguing questions regarding the effects of regular yoga practice on weight loss or gain that unfortunately won’t be answered until Broad’s book is released in February of next year. The piece will likely boost early orders of her colleagues book, but it casts yoga in the middle of our wonky relationship to “weight” in this country. From my experience as a yoga instructor for more than a dozen years now, I’ve never once heard a student complain that their yoga practice had contributed to weight gain. And on occasion, I’ve been told just the opposite. Of course we don’t know what style of yoga those folks in the alluded to study were practicing, nor for how long and how frequently they practiced. But nothing in Ms. Dowd’s article would lead me to contemplate not practicing yoga. And keep in mind that poor health can sometimes be accompanied by weight loss, and for those individuals, gaining back weight via yoga would be considered a very welcome benefit of a regular practice. So until February, I still confidently prescribe yoga! —Baxter Bell

A: Maureen Dowd set the yoga world abuzz two weeks ago with her editorial that quoted from a not-yet published book by William Broad:

“For decades, teachers of yoga have hailed the discipline as a great way to shed pounds,” Broad writes. “But it turns out that yoga works so well at reducing the body’s metabolic rate that—all things being equal—people who take up the practice will burn fewer calories, prompting them to gain weight and deposit new layers of fat. And for better or worse, scientists have found that the individuals most skilled at lowering their metabolisms are women.” See here for full article. 

So who are these nameless scientists? And can we see the original studies, please? Our own staff scientist, Dr. Brad Gibson, said skeptically that he wonders if any of this is true. And he promises that when the book comes out, he’ll review the original studies to see what, if any, conclusions he can draw from them. In the meantime, if you read his post from last week on science, aging and yoga (see here), you’ll understand why most of the scientific studies on yoga do not really merit conclusions that are as definitive as the one that Ms. Dowd cites. Our advice for now:

1.    Get out your saltshaker.

2.     Shake vigorously.

—Nina Zolotow

FEATURED POSE: WARRIOR 2

by Baxter and Nina

This week’s featured pose is one of Baxter’s favorite poses for osteoporosis (see here). In addition to building bone strength, Warrior 2 strengthens your arm and leg muscles. This pose also improves your balance and stretches your inner thighs. The variations we describe below make it accessible to almost everyone (it can even be done on a chair).

Baxter prescribes Warrior 2 for:

• osteoporosis
• balance problems
• anxiety (it burns off excess energy and is “grounding”)

Warrior 2 Pose (from Moving Toward Balance)

General Instructions:Step your feet wide apart (about the length of your legs). Turn your right foot out about 90 degrees and your left foot in slightly, so the toes of your back foot line up with the long edge of your yoga mat. Inhale and extend your arms out to your sides. Then exhale and bend your right knee toward 90 degrees (but not further), making sure your right knee is aligned with your middle right toe. If it’s comfortable for you, turn your head to gaze over your right hand. Repeat the pose on your left side.

Recommended Timing:30 seconds (8 breaths) for beginners, working up to 1 minute (12 to 16 breaths)

Some helpful variations:

1. To build arm strength, leave your arms up while changing from the right side to the left.

2. If you have balance problems, practice with your back to a wall, with the hip of your front leg touching the wall. If balance is a serious concern, you can touch your hands to the wall as you bend your knee and while you stay in the pose.

3. If you are generally weak or tight in the hips, practice the pose with your back heel touching the wall. This is also useful to get a clear sense of the straightness of your back leg.

Cautions: If you have knee problems, don’t bend your front knee quite as deeply. Make sure it stops just shy of being over the front ankle. In addition, standing with your feet a bit closer than the 4 to 4 1/2 feet apart that is usually recommended can also help. And if your knee is acutely painful, you could sit on a chair with your front thigh supported by the chair seat to take all weight off your front knee.

Warrior 2, with feet closer, knee less bent (from Moving Toward Balance)

Conscious Relaxation vs. Sleep

by Nina

Did you ever wake up in the middle of the night with your heart racing, short of breath, mouth dry, and thoughts racing? Maybe you just had a nightmare. Or maybe your mind was spinning, worrying about some difficulty at home or at work, or even about a disaster somewhere else in the world. Then you know intuitively that sleep is not necessarily “relaxing.”
 

Dr. Herbert Bensen, who originally discovered the relaxation response (see here for information), tells us that sleep, although necessary for our physical and emotional wellbeing, is a very different state than conscious relaxation. He identified the following four basic differences:

1. Dreams can actually cause stress through nightmares and anxiety dreams. During conscious relaxation on the other hand, your production of stress hormones gradually decreases, and other symptoms of stress, including both the physical and emotional sensations, subside.

2. During conscious relaxation, oxygen consumption decreases 10 to 20 percent during the first 3 minutes of practice while during sleep it decreases only 8 percent after about 4 or 5 hours. This reduced need for oxygen reflects the fact that during conscious relaxation your body is in rest and digest mode, not in stress mode where you are preparing to run or fight.

3.    During conscious relaxation, there is a marked decrease in blood lactate, a substance associated with anxiety attacks. Blood-lactate levels fall rapidly within the first 10 minutes of conscious relaxation, while sleep has no effect on blood-lactate levels. As you relax, your thoughts stop racing and your mind quiets while your body is resting and digesting.

4.    Alpha waves (slow brain waves) increase in intensity and frequency during conscious relaxation, but are not commonly found during sleep. Dr. Roger Cole, a sleep researcher and long-time yoga teacher, says that during rest or meditation our brain waves may slow to the alpha rhythm (8-12 cycles per second), during which we remain quietly aware of ourselves and our surroundings, without a lot of self-directed mental processing. Sometimes they may slow even further to the theta rhythm (4-7 cycles per second), during which we may get a “floating” feeling, dreamlike mental imagery, and withdrawal from the outside world. There is still much that is unknown about these unique states, but what is known is that regular practice of conscious relaxation helps foster ongoing feelings of serenity, contentment, and even happiness.

Now you can see why taking a nap or sleeping in on Sunday morning just won’t produce the same results as yoga. On the other hand, practicing conscious relaxation on a regular basis will not only provide you with immediate relief, it can also reduce your overall stress levels, so you can maintain your health and face the difficulties that life presents with greater equanimity. To be honest, I don’t practice conscious relaxation just because I’m hoping that it will reduce my chances of getting heart disease or having a stroke in the future (although that’s definitely a bonus), I do it because it makes my life better, right here, right now.

Naushon Meadow by Brad Gibson

Furthermore, as anti-intuitive as it might seem, relaxing while you are awake can even help you sleep better. When you are under great stress, it is difficult to fall asleep. Or, if you can fall asleep (because you are so tired) you often can’t stay asleep. To sleep well, your nervous system needs to be relaxed (if you are in a state of stress, you will be wakeful and alert, watching for danger) and your mind needs to be quiet (if your thoughts are racing, reviewing the past or worrying about the future, you will have a hard time settling down). But conscious relaxation, especially practiced before bed, will relax your nervous system and quiet your mind. And any of the methods I listed in my Monday post will produce these results. See here for further information.

POSES FOR OSTEOPOROSIS

by Baxter

As promised, today’s post will address a few of my recommendations for yoga for osteoporosis. As many of you know, OP is a very common condition that increases in incidence as we age. And before you fellas tune this out with the common misconception that OP is just a woman’s condition, it might surprise you to learn the following statistic from the Mayo Clinic: 1 in 8 men over the age of 50 will suffer an osteopenic fracture! And what are the most common fractures in men and women? The hips, spine and wrists are the areas most commonly affected.

The easiest lifestyle recommendation to have a positive impact on the progression of the condition is weight-bearing exercise. And although there are other forms of physical activity and exercise that fall in that category, all of yoga’s poses or asana fit the bill, and unlike walking, yoga actually requires that we bear weight on not just the feet, but the wrists and the spine as well, so in my estimation yoga is far superior to walking alone.

Three classic modern poses that are well known to most yogis are good examples of poses that are good for OP:

Warrior 2: I like this one because you are balancing on both feet, which is easier than on one foot, yet it is still a challenge for your balance receptors. And not only are you bearing weight, but if you do the pose for 1-2 minutes, you notice that you are also building strength and endurance in your legs and arms. (Later this week, we’ll talk about this Warrior 2 in detail. See here.)

Warrior 2 Pose from Moving Toward Balance

Downward-Facing Dog: Since all four of your limbs are in contact with the floor, balance is not much of an issue, but you are now bearing weight on your hands, wrists and arms as well as your legs. This will stimulate the bones of the upper extremities and could lead to increase density in these areas.

Downward-Facing Dog Pose from Moving Toward Balance

Tree Pose: For immediately obvious reasons, Tree pose will challenge your ability to remain balanced on one leg. The supporting leg must really work and be strong and stable to keep you upright, and the other leg’s hip gets a bit of opening from its position. And although this or any yoga pose will not eliminate the chance of a fall at some time in your future, more than one of my students has reported that after taking an unexpected spill, they felt their yoga practice prepared them to fall more gracefully and minimize the injury they sustained.

Tree Pose from Moving Toward Balance

Keep in mind that if you are young and/or without evidence of OP at this time, a regular practice could be preventative. If you have been diagnosed with osteopenia, the precursor to OP, it is possible that your regular practice could stabilize or even reverse the trend of thinning of the bones, at least according to a recent pilot study by Loren Fishman, MD. The same is true if you already have OP, but have not suffered fracture; but you will need to be a bit more cautious as you practice, and I’d recommend that you take class with an experienced teacher familiar with modifying the poses to fit your individual needs.

Even 10 minutes a day may be enough yoga asana to impact OP, so why not start today with these 3 poses?

THE RELAXATION RESPONSE AND YOGA

by Nina

Last week I wrote about the stress response, and how dangerous chronic stress is for your physical and emotional wellbeing (and possibly your longevity). So at this point you might be wondering: wouldn’t it be nice if there were an easy way for you to switch off your stress? I mean, something quicker and less expensive than a month in Tahiti or a week in a spa.

Well, it turns out there is. Remember, between stressful situations, your body needs to rest, recover, and acquire new energy. So your nervous system responds by:

• lowering your blood pressure
• reducing your heart rate, diverting blood back to the skin and gastrointestinal tract
• contracting your pupils and bronchioles
• stimulating your salivary gland secretion, accelerating digestion, and promoting normal movement of food through the gut

Dr. Herbert Benson coined the term “the relaxation response,” to describe this phenomenon, and he discusses it in detail in his book The Relaxation Response (which I highly recommend). I’ve also heard the term “rest and digest” to describe this state, when your body is recovering and restoring itself, and I find this is a helpful way to think about it, as the opposite of “fight or flight.”

Of course when you are stressed out, you can’t just tell yourself to relax. (I remember when I was suffering terribly from chronic stress, a therapist told me to “stop worrying.” I said, “Are you kidding?” and, duh, never went back.) But this is where yoga performs so brilliantly. Because, as Dr. Benson discovered, to trigger the relaxation response all that is required is:

1. A quiet environment

2. A focus for your mind, such as a sound, word, phrase, physical sensation (breath or body part), or fixed gaze at an object

3. Passive (non-judgmental) attitude

4. A comfortable position

5. 10 to 20 minutes

A Garden Path by Joan Webster

If this makes you immediately think of meditation, you’re right about that. But yoga has bunch of different options that you can use to trigger the relaxation response:

1. Meditation. See here for information on how to meditate.
2. Breath practices (pranayama). See here for information your nervous system and your breath.
3. Restorative poses with a focus for the mind (such as your breath or the relaxation of your muscles).
4. Corpse pose (Savasana) with a focus for the mind (such as your breath, the relaxation of your muscles, or peaceful imagery). See here for information.
5. Yoga nidra (yogic sleep), a long, structured form of Savasana. See here for information about yoga nidra and here for a mini version of yoga nidra that you can stream or download.

Eventually, after his initial studies, Dr. Benson removed two items from the list: a comfortable position and a quiet environment. He soon realized that a mind-body practice, such as the yoga asana practice, can be a “moving meditation,” as long as there is a focus for your mind (such as the physical sensations of your body in the pose) and a passive attitude (refraining from judging yourself in the pose, such as how you look or whether you’re doing it “right”). See "What is Mindfulness?"

Finally, studies by Dr. Roger Cole proved that inverted and semi-inverted poses, where your heart is higher than your head, trigger the relaxation response through the mechanisms that control your blood pressure. This is why supported inversions, such Legs Up the Wall pose and Easy Inverted Pose (legs on a chair), are so effective. I’ll write soon specifically on inversions and how they work (see "Just in Time for the Holidays: Inverted Poses").

And in weeks to come, we’ll provide further information about all seven of these options for triggering the relaxation response: meditation, breath practice, restorative yoga, Savasana, Yoga Nidra, mindful yoga practices, and inverted poses.

By now you may be saying to yourself that while these practices definitely seem like a bargain compared to vacations and spas (free to be exact), they seem like a bit of work. Can’t I just skip all this “practicing” stuff and get a bit of shuteye instead? Sorry, but it turns out the state of conscious relaxation you achieve by triggering the relaxation response is very different than sleep, and I’ll be discussing that difference in my next post (though, of course, a good night’s sleep is also important for your physical and emotional health). See here for a comparison between conscious relaxation and sleep.

What about turning on the TV or reading a good book? Activities, such as TV and reading, while good distractions, aren’t necessarily relaxing. Hey, suspense, though good for a plot, can be very stressful, and I not only cry at the movies, but sometimes during sad parts of a novel! I’m not saying you should never watch TV or read, just that these activities can’t take the place of the conscious relaxation that yoga provides. So as Baxter said last week, "Got 10 minutes?"

And now, dear readers, I’d like to ask you for your help. What are your favorite yoga stress management techniques? What do you find the most useful? And have I overlooked anything? Also, if you’d like to vote on which yoga stress management techniques you’d like to hear about first, let me know. Leave your answers in a comment to this post or email them to me (see Contact Us on the right side of the blog).

FRIDAY Q&A

Q: My 73 year old father's lumbar disks have compressed and are causing nerve problems which result in knee pain & effect his mobility. His western MD recommends surgery to fuse the disks but he is leery of this approach. Any recommendations on a more holistic approach?

A: Thanks for your question regarding your dad’s disc situation. Unfortunately, without the benefit of examining dad and his tests, it would irresponsible of me to offer any advice regarding his treatment at this time. That being said, disc compression is not the same issue as osteoporosis, although if your dad had a dexa scan or some other diagnostic test to screen for OP, he could have this in addition to his disc compressions.

Lumber disc compressions are quite common, and get more frequent as we age. Your dad’s symptoms seem to be affecting his daily activities, so yoga may or may not be right for him. A private session with a seasoned yoga instructor or yoga therapist might be a good first step in deciding if some yoga-based movement could help with his pain and mobility. In addition, a visit to a physiatrist, an MD who works to help rehab folks with such conditions and who is not a surgeon, might also be worth considering. Sure hope this information helps!

—Baxter

SCIENCE, AGING AND YOGA

By Brad

So I promised I would get back to the question of how one would use science to study the effects of yoga on aging. As a starting point, let’s look at one highly publicized study that appeared a few years ago in Lancet Oncology (see here).

This work was collaboration between Elizabeth Blackburn, a prominent and highly respected biochemist at UCSF and recent Nobel Prize winner in Medicine, and Dean Ornish, a clinician at UCSF and well-known author of books and articles linking better nutrition to health and disease prevention, especially for coronary heart disease. The basic premise of their 2009 Lancet study was to examine whether relatively short-term lifestyle changes consisting of a low-fat diet, moderate exercise and yoga-based stress management could effect telomerase activity in circulating blood peripheral blood mononuclear cells (PBMCs) that are largely cells involved in immunity.

The authors enrolled 30 men with a pre-diagnosed low-risk for prostate cancer for a three-month regimen. They measured telomerase activity, an enzyme present in certain class of replicating cells that maintains the length of telomeres. Telomeres are repetitive stretches of DNA at the ends of chromosomes that protect the integrity of chromosomes, and with each cell division gets shorter. Telomere shortening has been shown to negatively affect a cells capacity to replicate and general maintenance. Telomere shortening has been suggested as a biomarker of aging, acting as a type of clock for cellular aging. This so-called “telomere theory of aging” has gone out a favor among some scientists in recent few years, and its role in aging is controversial. Nonetheless, the basic premise underlying this study is that higher telomerase activity will lead to longer telomere lengths, which will set back the aging clock a bit in some way, or at least lead to healthier immune cells.

 The author’s conclusions were as follows: “Comprehensive lifestyle changes significantly increase telomerase activity and consequently telomere maintenance capacity in human immune-system cells. Given this finding and the pilot nature of this study, we report these increases in telomerase activity as a significant association rather than inferring causation. Larger randomized controlled trials are warranted to confirm the findings of this study.”

Paris in the Rain by Brad Gibson

What they mean here is that the number of patients in the study was low (N=30 is very small for a study of this type, and only 24 of these could actually be followed up the multiple times needed over this three-month period for technical reasons), the patients were pre-selected as having a clinical diagnosis of possible “low-risk prostate cancer” (that is, not a random group and probably motivated for a positive outcome), and that the results can at best be interpreted as an association and not necessarily a cause of the three-month lifestyle change (that is, just because thus group showed an increase in their telomerase activity, it doesn’t mean it resulted from the lifestyle intervention, but it could be the result of any one of a number of variables that were unaccounted for during this period, sometimes referred to as “confounders”).

But larger randomized properly controlled trials are expensive to run, and without a serious backer—the government or a drug company—don’t expect to see a follow-up any time soon.  Just think about the large-scale trails of vitamin E that after many years and millions of dollars not only failed to establish a link but also showed a possible negative association. This is part in parcel of the tough love and art of large-scale clinical trials that are required if you want to prove something using rigorous scientific methods. 

So what did this study actually show? At minimum they showed what was needed for carrying out a larger study (power calculation) to actually determine a causal relationship. No mechanism was defined for why telomerase activity increased, although several were suggested (reduction in oxidative stress and inflammation, for example). Otherwise one shouldn’t draw too many conclusions from this study, especially since three independent variables were introduced (diet, exercise and yoga) and the study group was so small and biased. And one has to also keep in mind that the telomere length was not directly measured, as the authors themselves pointed out that telomere length changes would likely to be too small to measure in such a short time (three months). So I guess there’s another message to take home: some things take time.

Reports like these remind me of one of the reasons I have sympathy for the “N of 1” studies, that is, experimenting on yourself. Not real science, but you’ve got to try something. Take up yoga, improve your diet, have a walk everyday, and see what happens. 

AFTER THE RETREAT: OFFICE YOGA

by Baxter

During my just-completed Italy yoga retreat, we had the unique opportunity to practice hatha yoga twice a day for nine days. As you can imagine, one can cover a lot of ground in that amount of time. So one afternoon session, I shared a chair practice that Nina and I have taught over the years as part of our Yoga For Stress series. It is a sequence that I often encourage students to consider practicing at work, as all you need is a sturdy chair and a small section of a wall.  Well, the group really loved the session, and several students asked if there was a video of the practice they could refer to once that returned home to work and their regular schedule.

As Nina and I were talking about her post for this week on the effects of chronic stress on health and aging, it occurred to me that one of the biggest contributors to increased stress these days is mounting pressures placed on us in the work place. So my prescription this week to all of you readers out there is to consider adding a wee bit of chair/office yoga to your work day to help lower the stress levels. Read on for some suggestions to try and stay tuned for some video content from us on this topic soon!

Until we make our own office yoga video, we’re including a link to a video by Esther Ekhart. This video includes several of our favorite office yoga poses and is generally pretty good. However, please skip the neck rolls at the end, as these can overstrain your neck!

When you do the poses, try to keep your mind focused on your alignment and the physical sensations of being in the pose (rather than thinking about your work).

Suggested office yoga poses:

1. Right Angle at the wall, desk or chair (see Esther Ekhart video below)

2. Chair Backbend (see Esther Ekhart video below--try it with hands clasped behind your head)

3. Chair Twist (see Esther Ekhart video below) 

4. Chair Forward Bend or Wall Hang (see earlier post)

CHRONIC STRESS: AN INTRODUCTION

by Nina

An ongoing theme that we’ll be exploring in depth on this blog is the negative effects of chronic stress on long-term health and the need for stress management as an important aspect of healthy aging. So perhaps it’s a good time for me to define exactly what we mean by “chronic stress” and to let you know a little about why it is such a serious problem.

I learned about dangers of chronic stress the hard way. Back in the early nineties, I had a job as the documentation manager and lead technical writer at a software start-up company, while at the same time I was raising two children. As you might imagine, the pressure was intense as our small company struggled to meet our first deadline, the first test of the product by real customers (who needed my manuals to teach them how to use the product!). As the deadline approached and I started working overtime, I began having difficulty sleeping. I also started losing weight because the stress made me so feel nauseated that I lost my appetite. Eventually I was so anxious, exhausted and nauseated that even though I met my deadline (and the company went on to success), I couldn’t bounce back to normal health. It took a year and half of therapy, medication, and lifestyle changes to recover completely.

Wounded Bird by Brad Gibson

Feeling stressed is not always a bad thing, however. It’s your body’s normal response to perceived danger or extreme physical activity (often called the “fight or flight response”), which is vital in keeping you safe and active. When you encounter a stressful situation, whether it is a grizzly bear or a stack of tax forms, your body releases hormones (adrenaline and noradrenaline) to provide you with the energy and alertness needed to cope with the situation. And anyone who has almost been run over an SUV knows the feeling: heart racing, rapid breathing, gut clenching. This is because in stress mode, your nervous system stimulates your organs and mobilizes energy by:

• raising your blood pressure
• increasing your heart rate and the blood supply to your skeletal muscles (and away from your gut)
• dilating your pupils and bronchioles, providing improved vision and oxygenation
• generating needed energy by breaking down sugar and fat stores for immediate use

Between stressful situations, your body needs to rest, recover, and acquire new energy, so your nervous system responds by:

• lowering your blood pressure
• reducing your heart rate, diverting blood back to the skin and gastrointestinal tract
• contracting your pupils and your bronchioles for reduced oxygenation
• stimulating your salivary gland secretion, accelerating digestion, and promoting normal movement of food through the gut

But what if the stress is long term? When you almost get hit by a car, escape from a bear or finish your taxes, the incident is over quickly and you bounce back to normal soon after. But if the stress is ongoing or “chronic,” maybe because of continuing job pressures (like mine at the software company), marriage problems, health problems, and so on, your nervous system is continuously on the alert and this can overtax your body potentially causing:

• heart disease
• hypertension (high blood pressure)
• insomnia and/or fatigue
• digestive disorders
• headaches
• chronic anxiety or depression
• weakened immune system

(Hmm, I just counted, and it seems I developed almost half of those symptoms, rather impressive in a weird sort of way.)

Of course, these symptoms are not only unpleasant but will seriously compromise your long-term health if you can’t manage to bring them under control. In addition, several age-related diseases, such as Alzheimer’s, Parkinson’s, and Diabetes are exacerbated by stress, and some theories of aging itself (such as the telomere theory I discussed last week) propose stress as a factor in the aging process itself.

I hope you’re not getting too stressed out by reading all of this! I credit yoga with helping me stay well since that breakdown. And in the coming weeks, we’ll be offering many different alternatives for managing your stress even as you take on the many challenges that life has to offer.

FRIDAY Q&A

Q: Richard Rosen’s post on yoga and Parkinson’s Disease this week was very informative. Do you know of any ongoing yoga classes especially for people with Parkinson’s Disease?

A: For those of you in the San Francisco Bay Area, Piedmont Yoga Studio in Oakland, CA, has two weekly classes for anyone with PD or for caregivers, taught by Vickie Russell Bell.

Classes are held on Tuesdays 3:00 pm - 4:15 pm and Thursdays 1:30 pm - 2:45. Advance registration is required. Both the Tuesday and the Thursday classes are now full, but a waiting list has been started. For more information or to sign up for the waiting list, call (510) 658-8899 or send email to yoga@pdactive.org.

 Also, the PD Active blog has information about classes and support groups for people with PD. (PD Active is a group of Berkeley/Oakland-based people impacted by Parkinson’s disease who act to build and strengthen their local community through advocacy, dance classes and other activities.)

Readers: If you have information about PD yoga classes or resources that you’d like to share, please let us know, either in a comment or through email.

 Q: Which questions would you like to see us address in this weekly post?

A: We love hearing from you! So please ask us questions or add to any discussion, either in a comment on any post or through email.

STRESS, TELOMERES, AND AGING

by Nina

In his next post, Brad will be writing about one of the several competing theories about aging: Nobel Prize winner Dr. Elizabeth Blackburn’s theory of the relationship between aging and telomeres (the protective caps at the ends of our chromosomes). Dr. Blackburn believes that telomere length is an indicator of the age and vitality of a cell, and that psychological stress actually ages cells, which can be seen when telomere length is measured.

We thought you might be interested in Dr. Blackburn’s work because she is so convinced about the effects of stress on cellular aging that she is studying the effects of meditation and yoga on telomeres. So for those of you who would like to learn a bit about her work before Brad’s post, here is a little background information. As a start, you can find a brief interview with Dr. Blackburn here. If you’ve got an hour or so, you can listen to her lecture on “Chromosome Ends and Diseases of Aging” here.

Gaudi Mosaic by Brad Gibson

Throughout your life, your cells may reproduce many times to repair and strengthen their host organs, to grow or to fight disease, and the telomere at the end shrinks each time the cell divides and duplicates itself. A chemical called telomerase helps restore a portion of the telomere with each division, but after 10 to 50 divisions or so (the number varies by tissue type and health, and biologists still do not understand the system well), the telomere gets so short that the cell is no longer able to replicate. Because some cells or tissues in our body (skin, blood cells, etc.) continue to replicate and be replaced as we age, or to be repaired after injury, if the progenitor cells needed for these processes cannot replicate due to telomere shortening, this can contribute to the aging process and increase our susceptibility to disease. See here for a short article on this.

For several years, Dr. Blackburn has been conducting research on the relationship between stress and telomere length. According to her, there is so much evidence that psychological stress actually ages cells that she and her colleagues have been studying the effects of mindful meditation on telomere length. See here for a full academic paper entitled “Can meditation slow the rate of cellular aging?” I've read that as a result of these studies, Dr. Blackburn has taken up meditation as regular practice.

To be continued....