Featured Sequence: Mini Restorative Practice for Digestion (or just relaxation)

by Baxter and Nina

Baxter’s been thinking a lot about digestion lately because he’s going to be teaching a workshop on yoga for digestion this Saturday, June 2, at Fourth Street Yoga in Berkeley, CA (see 4th Street Yoga for details). And he’s observed that a lovely underlying principle for working with digestive issues is that no matter what’s going on, all digestive issues respond to restorative poses. Remember, the opposite of the Fight, Flight or Freeze response is the Rest and Digest response (also known as the Relaxation response—see Relaxation Reponse and Yoga for information). So with that in mind, today we’re presenting a mini restorative practice consisting of three of Baxter’s favorite restorative poses, which you can use to help with digestive problems as well as other problems caused by stress, such as insomnia, fatigue, and anxiety.

1.    Reclined Cobbler’s Pose, from 10 to 20 minutes. Set a timer so you don’t fall asleep in the pose.

You will notice from the photograph that we’re using quite a few official yoga props (including a block under the bolster to prop the bolster at an angle). Don’t let this prevent you from trying it! If you don't have bolsters and blocks, look around your house to see what else you can use; try cushions from your couch, folded blankets, beach towels, and so on. Just make sure you’re completely physically comfortable in the pose.

One of the important parts of completing digestion is good elimination. In addition to physical relaxation, which this pose provides, gravity is also helpful for good elimination. As you can see from the photo, Reclined Cobbler’s pose creates a gradual slope from your head to your hips. Therefore, it’s possible that this pose can help with problems such as constipation and sluggish elimination. One of our favorite teachers, Patricia Walden, suggests that this pose may increase blood flow to your organs, as well as cool your digestive fire.

2.    Supported Child’s Pose, for 3 to 5 minutes. Turn your head to the other side when you’re half way through.

Make sure your bolster (or folded blankets, stacked pillows or couch cushion) is pulled in against your pubic bone so your belly actually rests on the prop. If necessary, turn the bolster on its edge or add folded blankets on top of the bolster to make sure your belly is fully supported.

As you can see from the photo, Child’s pose is a forward bend of your belly toward your thighs. Because the bolster is pressing against your belly, it’s possible this posture will have a stimulating effect on your digestive system and your abdominal organs. Patricia Walden suggests that this pose can relieve constipation, gas, and bloating.

3.    Legs Up the Wall pose, from 10 to 15 minutes. Come out if your legs fall asleep.

We’re showing two versions of the pose, one with just a folded blanket and the other using a bolster with a folded blanket underneath it and a second folded blanket under the spine. Try both versions to see which one is more comfortable for you. If they are equally comfortable, try the higher version, as this may enhance your relaxation.

This pose is a slight inversion (more so on the bolster than on the blanket). Therefore, it could have any even more profound quieting effect on your nervous system than the first two poses. Also because your hips are higher than your heart, there is a mild reversal of the effects of gravity, which could quiet an over-stimulated system in people who have, for example, IBS or chronic diarrhea. Patricia Walden says this is an excellent pose of nausea and diarrhea. However, if you have a history of gerd or chronic heartburn, take care with this pose, and come out if makes your symptoms worse.

Day to Night: Yoga for Better Sleep

by Nina

This morning I was talking with Bonnie Maeda, RN and Shari Ser, PT about the workshop we’re going to be teaching on yoga for sleep disorders at the Berkeley Yoga Room, Saturday, June 16, from 2 to 5 (see here for registration information). When I described my 24-hour approach to practicing yoga for better sleep to them, they were very enthusiastic. So I'm going to share it with you today.

Yes, yoga in general is relaxing, but some poses are more relaxing than others while some poses and practices are actually quite stimulating. So if you’re having trouble sleeping, I recommend you plan out your day regarding which poses you do when. I mean, if you’ve been suffering from insomnia, you wouldn’t drink a double espresso right before bed, would you? Standing poses, backbends and vinyasa flows can be almost as stimulating, so a strong practice including those poses done just before bed can keep you awake (trust me, I've tried it). But those poses help keep you strong and flexible, as well as reducing stress by releasing physical tension from your body, so you wouldn’t want to eliminate those poses entirely from your practice. On the other hand, there are relaxing practices you can do right in bed either before sleep or in the middle of the night that will help you fall asleep more quickly and sleep more deeply.

Buddha in My Garden by Michele Macartney-Filgate

Here's how to plan out your day:

Day Time
Getting exercise is important for improving your sleep. So during the day, walk, run, swim, cycle, or do a strong yoga practice that includes forceful, stimulating poses, including standing poses, backbends, twists, and/or Sun Salutations and vinyasa flows.

Early Evening
After work or in the early evening, if you’re up for practicing, it’s best to do poses and practices that calm your nervous system, such as forward bends, inverted poses, and restorative yoga. Meditation, Relaxation pose with a mental focus, and yoga nidra (yogic sleep) are also good stress reducers. If you want to use a guided relaxation, see the Relaxation Tracks tab on at the top of the blog. From this point on it’s best to avoid the simulating poses and practices.

Before Bed
Turn off the TV early or put your book down, and take some time before you get into bed for conscious relaxation. Switching your nervous system from fight or flight to relaxation mode before getting into bed will help you fall asleep more quickly and sleep more deeply. Supported inverted poses, such as Legs Up the Wall pose, Easy Inverted pose (see here), and Bridge pose with straight legs, will calm your nervous system. Some people also like to meditate or practice seated breath awareness before getting into bed.

In Bed
For people suffering from insomnia, just getting into bed can trigger a new bout of stress. If you find your thoughts are racing and you are worrying about falling asleep, you can practice a body scan (Relaxation pose with a mental focus), where you conscious relax various parts of your body. Or you can work with your breath, either practicing general breath awareness or any form of pranayama that lengthens or emphasizes the exhalation. Practicing conscious relaxation before falling asleep will help you sleep more deeply. See my post Yoga You Can Do In Bed for more information on yoga you can do before falling asleep.

In the Middle of the Night
All of us insomniacs are familiar with the terrible moment in the middle of the night when we realize we’re wide awake and the possibility of returning to sleep feels hopeless. However, the worst thing you can do is lie there worrying about not falling back to sleep. Instead, return to the same practices you do before falling asleep, such as Relaxation pose with a mental focus, breath awareness, or extending the exhalation. Although it takes some discipline to focus on these practices (for some reason, worrying seems so much easier in the middle of the night), many people, including me, find that 10 to 20 minutes of practice allows us to fall back into a deep sleep.

Some practitioners I know do soothing poses in the middle of the night, such as supported forward beds (in bed with pillows) or even Legs Up the Wall pose. You can try this if seems appealing; just make sure you move slowly, stay warm, and keep the lights as low as possible. You could even play a guided relaxation track at this point. Again, see my post Yoga You Can Do In Bed for more information.

Morning
Good morning! I hope you slept better last night. Now, if you feel like gently stimulating your nervous system by moving with your breath, doing a few standing poses, or even doing a full yoga practice, go for it!

Probability, Aging and a Pain in the Neck....

by Brad

It seems appropriate to discuss "probability" as I wait in my seat for takeoff on my flight to Vancouver on a sunny day in San Francisco in mid-may.  First probability calculation: what’s the likelihood that it will be sunny in Vancouver, a city a thousand miles north but also on the Pacific Coast? Better than the average expectation, but probably not by much given the low correlation between weather in the Pacific Northwest with that of the Bay Area, especially in late spring and summer.

Vancouver's Chinese Garden in the Rain by Nina Zolotow

I’m not sure how many calculations of this type most people make in a day, but I tend to think this way a lot (probability calculation #2: am I an outlier in this regard, say in the 5% fringe, or is this more common that I imagine?).  The reason to bring up probability with respect to aging is that most people don’t think about probabilities and randomness in looking at their future health—or their present state for that matter—and how it might change, for better or worse.  Or more to the point, how do changes you make right now influence your health, both in the near term as well as 10 or 20 years out (probability calculation #3: I expect to live say another 25 years or so to about 85, but 90 or so seems considerably more uncertain, even with a exercise, yoga and a good diet). 

Several months ago I was aghast to read a letter to the editor in the New York Times from a woman who couldn’t understand why she unable to get pregnant in her late thirties since she had been taken care of herself, had been eating well, and practiced yoga daily.  She apparently believed that her (good) behavior would insure health and fertility through her thirities.  Probability calculation #4: what is the likelihood that a woman in her late thirities can get pregnant relatively easily, and how much is this is improved if she's in relatively good health? I suspect the answer is that the improvement is small, despite what one might expect. This is just one of thousands of puzzling, fascinating, and at times callous probabilities that govern our lives in a world governed by processes that are themselves inherently random. Try as we might to make rational decisions that we believe will influence our present and future selves in predictable ways, this is clearly not the full story. 

The birth of modern quantum physics over one hundred years ago taught us that even the most basic particles that make up our universe—electrons, protons, light, etc.—are governed by rules that are probabilistic.  Einstein’s famous lament that “God doesn’t play dice with universe” was a last stand against the onslaught of quantum weirdness and other concepts that now dominate our thinking on the physical laws of the universe.  But biology is also subject to these same probabilities, such as the underlying molecular principles of random DNA mutations in evolutionary theory.  Biological aging also has many random elements, or stochastic processes. Indeed, some theorists have resisted any notion of programmed aging or defined biological process of aging per se, and rather believe that aging is inherently driven by the sum of hundred and thousands of random events every second that ultimately contribute to the overall aging process. As Yogi Berra once said, “If you see a fork in the road, take it.”

So as I sit in my airplane seat waiting for this trip to start, I also feel the pain in my neck that hasn’t gone away after a 23-day stretch of 10-12 hour days in front of computer working on grants and papers.  Oddly, I’ve done this many times before in my academic career, but hadn’t any neck pain that didn’t take more than a day or two go away. But I’m 59 now, and this time is different.  Probability calculation #6: if I just ignore this and take some ibuprophen for a few days, will it go away on its own?  As it turned out, no such luck….  It had seemed a reasonable bet since I had done nothing I hadn’t done many time before in the last 30 years.  But of course I hadn’t factored in the "aging" component in this calculation, or the probability that this behavior was now going to come at a price.  So now I’m looking at how I can change my yoga practice to help alleviate this new and unwanted development.  Calculation #7: what’s the chance that if I spend 20-30 minutes a day in a few key poses (Downward-Facing Dog with a wall, Standing Forward Bend, a passive backbend over a rolled blanket ) that my neck pain will improve or, better yet, heal completely?  I’ll let you know in a few weeks.

And one last thing, the weather in Vancouver was beautiful when we arrived, but was followed by five days of overcast skies and intermittent rain. It was a great trip.

Friday Q&A: Which Forward Bends Are Safe?

Q: Nina's post earlier this week on how to get comfortable in forward bends was very informative (see Getting Comfortable in Forward Bends). But I was wondering whether both versions shown in the photos--the one with the rounded back and the one with the neutral spine--are safe for everyone.

A: Forward bends always need to be approached with awareness, caution and respect, especially for people with acute low back injuries or chronic low back conditions. People with herniated discs, facet irritation, or degenerative joint conditions in their spines may find that too much bending forward will increase their pain.

Several leg muscles attach to your pelvis and tight leg muscles can restrict the movement of your pelvis, which needs to be able to roll over the top of your hip joints. If your leg muscles are tight, sometimes sitting on a folded blanket can allow you to get the proper movement of your pelvis. However, if you have very tight hamstrings and don't have the ability to keep the natural curve in your low back as you bend forward, then the version with the bolster under your thighs may still be problematic.

Rounded Back Version: Could Be Problematic

In addition, there are some people with conditions for which forward bends are contraindicated, meaning that the risk is greater than the benefit. This includes individuals with severe osteoporosis as well as individuals who may have had vertebral compression fractures in the past. For them the neutral spine version with the chair or bench may be safe, but, again, be sure to  proceed with caution.

Neutral Spine Version: Proceed With Caution

In general, cultivating flexibility in your hip rotators and hamstrings can help you achieve a neutral spine in your forward bends, which will help keep your lower back safe.

—Shari

Featured Pose: Standing Cow-Face Pose

by Baxter and Nina

This versatile pose from our office yoga series uses just the arm positions from the full Cow-Face pose, which is typically done in a seated position. Because the pose works your two arms differently, it’s almost like two poses in one, taking your shoulders and arms through much of their range of motion. With your top arm, you reach up and overhead, spinning your upper arm bone outward and deeply bending your elbow joint. With your bottom arm, you reach down and back behind you, spinning your upper arm bone inward as you bend at the elbow joint. As it works your arms, this pose also stretches and strengthens your shoulder blades, upper back and neck.

The pose is actually quite physically challenging, so it’s a good pose to turn to when you’re feeling lethargic or restless. Because it releases muscular tension from your shoulders, neck, and back, it’s a perfect antidote to sitting in front of a keyboard or holding onto a steering wheel.

The standing version is very compact so you can do it in small space, like at the back of an airplane. However, you can also do the pose seated on a chair or in seated on the floor in Seated Crossed-Legs position, Hero pose, or the classic Cow-Face pose leg position.

Baxter prescribes this pose for:

• general stiffness and tightness in your shoulders
• stiffness in your upper back, especially if you have kyphosis of the spine (Dowager’s Hump)
• improving inner and outer rotation of your arm bones (you could use it, carefully, to address rotator cuff immobility)
• discomfort in your middle or upper back
• preparation for inversions like Forearm Balance (Pincamayurasana) and backbends

Instructions: If you know can't clasp hands in this pose (or suspect you might not be able to), find a yoga strap, belt, tie, or even a towel and place it over your left shoulder. Then, start by standing Mountain pose. First bring your right arm into position by taking it back behind you. Turn your arm in, bend your elbow, and place your forearm across your middle back with your palm facing away from you. Try to locate the end of your strap and hold onto it lightly. If it’s helpful, you can take your other hand and use it to encourage your right arm further in toward the midline of your body and further up the channel of your spine.

Next, bring you left arm into position by swinging it forward and up overhead. Turn your left hand toward the wall behind you, bend your elbow and drop your fingertips down toward your left shoulder blade. A few of you will be able to bring your two hands together, gently clasping your fingertips. The rest of us mere mortals can grab onto the top of the strap with your left hand, and carefully work both hands closer to each other along the strap. When you start to feel an increasing sensation on your arms, stop so you don’t over do it. Be aware of the tendency of your elbows to swing out away from the sides of your body, and if necessary firm your elbows back toward the sides of your body.

Stay in the pose 30 seconds to two minutes. Remember to breathe, staying as relaxed as possible. As you release out of the pose, be very careful as you bring your bottom arm out, moving slowly and mindfully. After you release your arms out of the pose, relax both arms for a few seconds, perhaps shaking and jiggling them before you go do the second side. Then repeat the pose on the other side. If you’ve never done this pose before, realize that there may be a huge difference between your two sides because you use your left and right arms so differently in your everyday lives.

Cautions: If you have any pain in your shoulder joint, back up until you are pain free. Be especially aware of pain in your bottom arm, as the upper arm area can get pinched. If the pose causes too discomfort for your bottom arm, just do the top arm part of the exercise. Then, for your bottom arms, you can hold both elbows behind your back (coming soon!).

The Digestion System and Yoga

by Baxter 

Over the last 2 years, I have had the good fortune to act as faculty for the Niroga Institute’s Yoga Therapy Program in Berkeley, CA. As part of my teaching duties, I was asked to present and teach the group about yoga and the digestive system. This is a fairly daunting task, as the digestive system is a complex system that interconnects with our conscious mind, the unconscious portions of our nervous system via the autonomic systems sympathetic and parasympathetic systems (which we have discussed here on more than one occasion), and our immune and endocrine systems.  Despite the enormity of the task, I came to be reminded of a wonderful fact about the digestive system: it has its own nervous system, called the enteric nervous system (ENS). Upon further investigation, I discovered that this system has a lot to do with helping to move food through the small and large intestines, affecting the fluid absorption from the gut, as well as local blood flow in the gut. The ENS is sometimes referred to as an independent gut brain, which seems quite cool. But this is not quite accurate, for while it does have an independent influence on the many gut activities, it interfaces profoundly with the autonomic nervous system and conscious mind as well.

In some ways, this is good news. As we have seen before when discussing yoga and stress, if we can influence the autonomic nervous system and shift the patterns of excess sympathetic stimulation to balanced stimulation, including appropriate amounts of parasympathetic stimulation, we can allow for the body to have adequate amounts of rest and replenishment.  In fact one lay term for the parasympathetic system is the “rest and digest response!"

Human Digestive System

When we engage in a balanced yoga practice that includes active poses, resting poses, breath awareness and relaxation, an interesting thing happens: our digestive system often works more efficiently with less unwelcome symptoms (I’ll leave that to your own experience and imagination to figure out what those are!). So, although the digestive system itself is complex, our yoga practices quite elegantly can interface and support the best possible digestion, via our effect on the conscious mind and the background autonomic nervous system.

More specifically, consider restorative practices and yoga nidra when you know you are under lots of stress that could over-activate your sympathetic nervous system (your fight or flight response). If you’re in the Bay Area and would like to learn more about yoga and the digestive system, consider joining me on June 2^nd at 4^th Street Yoga in Berkeley, CA. See http://www.4thstreetyoga.com/workshops.html for information. 

Getting Comfortable in Forward Bends

by Nina

I have always known that seated forward bends are considered quieting poses, but it wasn't until I interviewed Shari (see Talking About Baroreceptors and Yoga) about baroreceptors that I discovered that forward bends are quieting for the same reason that inverted poses are calming: pressure on the baroreceptors causes your body to lower your blood pressure and reduce your stress hormones. No wonder three minutes in a forward bend seems to turn off the noise in my head and put me in a relaxed, almost dreamy state. But this got me curious because you're not exactly upside down in a forward bend, so I asked Baxter if he knew why forward bends had the same effect as inversions (I'm like that about yoga, I always want to know why!). Here's what he said:

Regarding the beneficial effect of seated forward folds on lowering blood pressure, I would hypothesize that the fold brings enough pressure onto the abdominal area to place pressure on the main blood vessel in the belly, the abdominal aorta. If this caused a temporary narrowing in the vessel, this could create a back pressure up to the baroreceptors in the neck and aortic arch. This would have the same effect as inversions.

By now you may be reading this and thinking, "That's fine for you to say, but I hate forward bends.  Just the thought of doing them makes me feel cranky, not relaxed." Yes, I realize that I'm one of the lucky few who is flexible enough to be comfortable in forward bends. And I do know that a large number of people, especially those with tight hamstrings, are, shall we say, quite the opposite of comfortable in forward bends. For those people, discomfort in the pose pretty much negates the soothing effects because being physically uncomfortable tends to irritate the nervous system.

But does that mean you have to miss out entirely on the blissful feeling I've just described? Definitely not! Because in today's post I'm going to present two different ways to prop your forward bends to take remove the yuck and bring on the bliss.

The first way is to place a round bolster or a very thick blanket roll behind the thigh of your straight leg or behind both legs if you are doing Paschimottanasana (as shown in the photo below). With the bolster behind your thigh, you knee or knees will be bent and supported.

Bend from your hips to come into the forward bend and then slowly round your back into a gentle curve. Baxter is someone who has very tight hamstrings and normally doesn't enjoy forward bends, but just look how comfy he looks in these photographs!

Stay in the pose at least three minutes (I've found it takes that long for the pose to work its magic). Whhen you are ready to come out of the pose, come out very slowly, rolling up to an upright position.

And if that propping doesn't work for you, I've got another trick up my sleeve. In the second version of a supported forward bend, you use a bench or chair on which to rest your arms and head. Position the chair over your straight leg (or legs), far enough away so you can keep your spine long and straight when you come into the forward bend. If the bench or chair isn't high enough for you to easily reach, add folded blankets or towels to increase the height. To come into the pose, bend from your hip joints, keeping your spine straight and long (in this version you do not round your back). Place your folded arms on the chair or bench, and rest your head on your hands. If possible, catch your forehead skin on your hands and tug it gently down toward your eyebrows.

Again, stay in the pose at least three minutes. When you are ready to come out of the pose, come out very slowly, using your hands to press yourself into an upright position.

I often teach this second version of the pose, and I'm always so pleased to see almost everyone in the class come out of the pose with a calm, relaxed expression on their faces! I'd love to hear how it feels to you!

For cautions for these forward bends (and forward bends in general), see Which Forward Bends Are Safe?

Workhops of Interest: Baxter's Summer Workhops!

Baxter Bell has some very cool workshops this summer. For further information or to register, please follow the links to the appropriate web sites. He hopes to meet some of you in person soon!

June 2nd, 2012, 2-5pm
Yoga for Digestion, taught by Baxter Bell, MD
4th Street Yoga, Berkeley, CA

4thstreetyoga.com 

June 9,  2012, 2-5 pm
Healthy Knees! taught by Baxter Bell, MD
Mountain Yoga, Oakland, CA
mountainyoga.com 

July 14th, 2012, 12:30-3:30pm
Yoga Philosophy: The Sutras, taught by Baxter Bell, MD
Bodyworks Yoga, Petaluma, CA
bodyworksyoga.com 

June 30 - July 6, 2012, 2012
The Music of Yoga, the Yoga of Music, taught by Baxter Bell, MD and Mark Stanton Welch
Feathered Pipe Ranch, Montana
http://featheredpipe.com/the-music-of-yoga-the-yoga-of-music/ 

August 4 and 5, 2012
Yoga and the Endocrine System, taught by Baxter Bell, MD
Niroga Institute, Berkeley, CA
All weekend for Yoga Teachers, Sunday 2-5pm Workshop for Community Members
www.niroga.org 

August 24 - 26, 2012
Yoga for Healthy Living, taught by Baxter Bell, MD
River Rock Yoga, Ocean Springs, MS
RiverRockYoga.com

Friday Q&A: When to Go to the Doctor

Q: Well, my right knee has bothered me for about three years, which is my fault as I really pushed too hard on the "perfect" lotus position. And now, about 6 months ago my right hip has really been hurting and stiff and I'm wondering is this arthritis?

I purchased the book you recommended by Sandy Blaine, Yoga for Healthy Knees. I figured I would give about 6 months try with the knee poses she recommends and if I'm still in trouble, go to a knee specialist. However, I do have a question about my knee. On page 21, she states, "ligaments once torn or stretched out of shape, do not heal." That statement got my attention. I wondered if I had TORN a ligament in my knee? Perhaps I'm being foolish and need to have the doctor look at it and at least go from there. What would you say to this? I'm just afraid of these doctors as 1/2 the people my age seem to be having knee surgery. I often wonder if it is really that necessary?

A: This is the kind of question all of us here at Yoga for Healthy Aging hear frequently from students, friends, colleagues, etc. And basically the answer we give is always the same: go to the doctor for a diagnosis! It is only when you have a proper diagnosis that we can help you with some yoga recommendations. Now, your doctor may make some recommendations based on the diagnosis that you don’t like or don’t agree with (such as surgery), but you don’t have to follow them. But only a trained professional (not a yoga teacher) can tell you whether your guesses about what is wrong with you are accurate. (For example, a friend of mine who was having back pain discovered after going to the doctor that she had gallstones!)

After discussing this with Baxter, I, Nina, decided to answer this question because my own experience is so relevant. For years I had ongoing problems with my right hip, but one day I woke up and my whole right hip kind of froze up! So I called my doctor and my doctor referred me to an orthopedist. The orthopedist asked me to get an X-ray before my visit, and when I walked into my appointment, he told me bluntly, “You have arthritis at the back of your hip joint. And you’re headed for a hip replacement. Could be months, could be years. Meanwhile, nothing you do could make it better, and nothing you do could make it worse.” Well, you can imagine my shock! As a yoga teacher, I knew from the X-ray and the tests he did on me, that I did indeed have arthritis. But I also knew how wrong he was with his single recommendation (hip replacement). I understood that I could definitely make my hip worse by not exercising, and while I probably couldn’t make it better, I could possibly postpone the need for a replacement by keeping my joint as healthy and mobile as possible. And keeping my joint as healthy and mobile as possible became my new goal. (For further information on this, see Yoga for Osteoarthritis.)

Here’s what I did after my appointment (that is, after I nicely told my referring doctor how arrogant and uninformed I thought the orthopedist was, and that I never wanted to see him again, thank you very much): I went to see a physical therapist (who understands yoga), and he helped me unfreeze my hip and regain some mobility. Then, with his guidance, I adapted my regular yoga practice to include hip openers to keep the blood flowing to my hip joint. I later had some chiropractic adjustments as well because I wondered if my scoliosis wasn’t contributing to the problem. So using my doctor’s diagnosis of my condition, I was able to put together my own treatment plan. And guess what? Five years later, I have to say, I’m actually—and I wasn’t even hoping for this—seeing even more improvement in my mobility.

My wish for you is that you can find a nicer, more knowledgeable doctor than I did. But the point is, even if you don’t, the information you get from the diagnosis itself is invaluable. Only when you have a real diagnosis can you make an informed decision about the next step to take. And only when you have a real diagnosis can your local yoga teacher help you figure out how to use yoga to ameliorate your condition.

Am I ranting a bit? Well, yes. But that’s because I really want to get this message out there, not just to you, dear question asker, but also to everyone else who is listening!

—Nina

Featured Pose: Wrist Circles

by Baxter and Nina

Another very simple pose in our office yoga series, wrist circles move your wrists through their full range of motion Most of us use our hands in similar and limited movements over and over during the day. Moving your wrists through their full range of motion helps relieve fatigue in your hands and keeps your joints healthy, flexible and mobile. And we can all use some of that. Plus, you'll get to hum The Supremes (see “Instructions” below).

This pose works more than your wrists. As you rotate your wrists, you use the muscles of your forearms all the way up to your elbows. So these movements not only reduce tension in your forearms, but are also beneficial for your elbow joint. Baxter actually prescribes wrist circles for those of you with elbow issues, like tennis or golfer’s elbow.

This pose is super convenient—you don’t even have to leave your desk to do it. And you can do it several times a day if it feels good, even once every hour. For other wrist exercise, see Wrist Flossing for Wrist Care.

Baxter prescribes this pose for:

• carpal tunnel syndrome
• elbow issues like tennis or golfer's elbow
• arthritis of fingers, hands, wrists or arms
• fatigue in your hands or arms due to keyboard work, driving or any repetitive movements

Instructions:  Start by sitting with your knees parallel to each other, and your feet firmly on the floor, hips-distance apart. Stretch your arms out in front of you or rest your elbows on your knees. Next, draw your hands back with your palms facing forward in to a “Stop in the Name of Love!” position. From there, choose a direction and circle your wrists around into three to ten circles, drawing your fingers wide and back, which brings more stretch across the palm of your hand.

Repeat on the other side by circling in the opposite directions, for the same number of rounds.

Cautions: Generally this pose very safe. However, if you experience any pain in your hands or wrists, modify the circle to avoid the painful areas.

Blood Pressure: Talking about Baroreceptors and Yoga

by Shari and Nina 

Nina: Yesterday, Baxter gave us a little background on blood pressure (see So, what is blood pressure, anyway?). I thought today you could talk a bit more about the relationship between blood pressure and yoga.

Shari: First some more background! Of particular importance is the effect of our baroreceptors on blood pressure. Baroreceptors are stretch receptors that found in the major arteries, and they are activated when our arteries are over- or under-pressured by blood flow. This in turn changes our heart rate and arterial diameters. Baroreceptors are found abundantly in the carotid sinuses, the carotid arteries of the neck and the aortic arch of the heart.

Carotid Sinuses (Carotid Arteries of the Neck)

Aortic Arch of the Heart

When there is an increase in arterial pressure because of increased blood flow, vasodilation occurs and the heart rate will then drop. This causes a decrease in cardiac contraction and in turn causes a decrease in blood pressure.

Nina: For all of us overstressed folks, decreasing blood pressure is a good thing. And I’m betting yoga can help with this....

Shari: Absolutely. Research has shown that both forward bends and inversions affect the cardiac baroreceptors, ultimately causing a decrease in blood pressure and heart rate! Inversions and forward bends also increase baroreceptor sensitivity toward the fluid dynamic changes. So both forward bends and supported inversions are both recommended for reducing blood pressure.

Nina: That explains why both forward bends and supported inversions are considered calming poses. I certainly use both in my home practice for stress reduction. Do you have any favorite poses for lowering blood pressure?

Shari: I like supported Setubanda Sarvangasana (Bridge pose, with straight legs), perhaps with a head wrap. I also like Viparita Karani (Legs Up the Wall pose) with a head wrap. When the going gets rough, these are my “comfort poses.”

Nina: I also love Legs Up the Wall pose. And supported Child's pose is a good example of a forward bend that is very comforting—just thinking about it makes me relax. And we’ll definitely have to talk about the head wrap sometime soon!

So, what is blood pressure, anyway?

by Baxter

If you read yoga magazines or read online articles about yoga and your health, you often come across a warning to avoid this or modify that yoga asana if you suffer from high blood pressure or hypertension another term used for high blood pressure). But it turns out that there are a lot of differing opinions about how and what to change about a typical yoga practice if you have hypertension (HTN), and not a great deal of agreement on the best approach to take. However, before we get into that, I thought it would be helpful to discuss what blood pressure is, and how it is determined, as well as why HTN needs to be addressed either via lifestyle changes or medical intervention.

So, what is blood pressure? Well, it is a measurement we take—usually in your upper arm via a blood pressure cuff—that measures the pressure in the arteries of your arm. When you are sitting or standing with your arms at your sides, the place where blood pressure reading is taken is in line with your heart and its main artery, the thoracic aorta. Now we are measuring the pressure downstream in an artery in the arm, but it seems to correlate well with the pressures inside the heart and aorta. The top number of a blood pressure reading, called the systolic blood pressure, is the amount of pressure the blood in your arteries is exerting on the elastic, stretchy walls of the artery when the heart is at its maximum point of contraction. On average, it runs around 120mmHg’s of mercury in a normal healthy person. The bottom number, called the diastolic blood pressure, is the pressure at the time the heart is most relaxed between beats and is filling with more blood coming in from the body and lungs. A healthy average for that number is 80.  So, if your blood pressure, on average over the course of the day, is at 120/80 or below, it is said to be in the normal range.

Arctic Moon by Michele Macartney-Filgate

Via observations and studies, if your blood pressure averages 140/90 or above over the course of the day, you are said to have high blood pressure or hypertension. If you fall between 120/80 and 140/90, you are now said to have a condition called “pre-hypertension,” a no man’s land where it seems you are at a greater risk of developing HTN over time. More on HTN and why it’s important later.

Let’s go back to the concept of blood pressure for a few more moments. Your blood pressure is not a constant figure, but changes as your physical, mental and emotional activities change. It often goes up during exercise, stressful situations, and emotionally charged interactions, as well as varying with your body position of reclining, sitting or standing. It must vary dynamically to accommodate our changing situations throughout the day. Maintaining the proper blood pressure for our changing needs is a complex system that involves many of the body’s systems, including hormones, brain activity, and specialized receptors for pressure in the some of the biggest arteries in the body, called baroreceptors. As these various components of the blood pressure regulation interact, they result in dynamic fluid changes within the blood vessels and heart, via changing the blood flow in the vessels, the heart rate and the intensity of the contraction of the heart itself. Other organs also get involved, such as the kidneys, which are asked to help lower blood pressure at times by filtering out more water from the blood to decrease the overall amount of fluid in the system. Other parts of our nervous system can also influence the blood pressure readings. Your autonomic nervous system, composed of the two opposing and balancing parts, the sympathetic (Flight, Fight or Freeze response) and the parasympathetic (Rest and Digest response), can either increase or decrease your blood pressure, depending on how activated they are.

A few more thoughts on the general topic of blood pressure. Although we have defined the situation where blood pressure is elevated above the normal level and is considered potentially dangerous if left untreated, the opposite situation can also exist. That is, your blood pressure can be lower than normal, and this situation is called hypotension. Highly trained runners, especially long distance runners, can have blood pressures that average 100/60 or even lower and feel no worse for the wear. However, in other situations, hypotension can create symptoms that indicate it is not a normal adaptation to good aerobic fitness, such as lightheadedness, dizziness on standing and fainting. So next time, we will look at the conditions of hypertension and hypotension in more detail, and begin to discuss how yoga could fit into plan for better health for these students. Special thanks today to both Shari Ser and PubMed for their insights on blood pressure, as well as all my teachers back at UC College of Medicine in Ohio!

Got 20 Minutes?

 by Nina 

The first 20 minutes of moving around, if someone has been really sedentary, provide most of the health benefits. You get prolonged life, reduced disease risk — all of those things come in in the first 20 minutes of being active. —Gretchen Reynolds

Last week I heard Gretchen Reynolds, Health and Fitness writer for the New York Times, being interviewed by Terry Gross on Fresh Air (see here) about her new book The First 20 Minutes. She said the reason she wrote the book is that she wanted sedentary people to understand that with just 20 minutes of exercise you can obtain a whole host of health benefits.

Two-thirds of Americans get no exercise at all. If one of those people gets up and moves around for 20 minutes, they are going to get a huge number of health benefits, and everything beyond that 20 minutes is, to some degree, gravy.

This was exciting for me to hear because for many years, Baxter and I have been encouraging people to start practicing at home with 15 to 20 minute mini yoga practices. In our case we were just trying to be realistic about the busy schedules that most people have. And we also knew that when people consider practicing at home, the idea of doing a full-length practice can be intimidating and overwhelming. So when we used to teach special series classes together (such as Yoga for Stress and Yoga for Real Life), we always created handouts for our students that included the full-length sequence we taught as well as a “mini” version of the practice. And we've been including mini yoga practices our blog as well (see our mini low back care sequence and mini office yoga practice). Now we’re thrilled to learn that these short practices can make all the difference between the negative effects of sedentary lifestyle and the positive health benefits of moving around for 20 minutes a day. And that’s what yoga for healthy aging is all about. As Reynolds says, “If someone starts an exercise program and improves his fitness, even if he doesn’t lose an ounce, he will generally have a longer life and a much healthier life.”

Perfect Tulips by Nina Zolotow

So if you’re not already practicing yoga at home, consider taking a small step toward improving your health by committing to just 20 minutes day. Don’t know how to create a short yoga sequence? Simply take a longer sequence and modify it by removing some of the poses, leaving the remaining poses in the same order as they were in the original sequence. Or see my post Iyengar-Style Sequencing  and create your own sequence. You don’t need to over-think it! The benefits of starting to move for 20 minutes per day are so great, and if you listen to your body, you’ll soon learn how to create the sequences that are best for you.

The human body is a really excellent coach. If you listen to it, it will tell you if you’re going hard enough, if you’re going too hard. If it starts to hurt, then you back off. It should just feel good, because we really are built to move, and not moving is so unnatural. Just move, because it really can be so easy, and it really can change your life. —Gretchen Reynolds

For more about Gretchen Reynolds and her new book, see the NPR web site and the New York Times blog.

Workshops of Interest: Yoga as Medicine

Dr. Timothy McCall, author of Yoga as Medicine and soon-to-be contributor to Yoga for Healthy Aging, will be teaching a weeklong workshop on yoga as medicine at the Himalayan Institute, in Honesdale, PA on June 24 to 28. Timothy says that it's a beautiful, sattvic place, and June is a great time of year to be there.

Yoga as Medicine
Himalayan Institute, Honesdale, PA
Sunday, June 24 - Thursday, June 28, 2012

Physician, author, and yogi Dr. Timothy McCall invites you to discover or deepen your appreciation of the healing potential of yoga. Explore yoga's vast toolbox, including postures, breathing techniques, relaxation, chanting, visualization, meditation, and philosophical ideas, and learn how these tools can be adapted to meet everyone's needs—young or old, fit or unfit, healthy or seriously ill. Beyond relieving symptoms or even curing disease, yoga as medicine is a path to high-level physical, emotional, and spiritual well-being. Areas of focus will include:

- The ancient yogic formula for changing dysfunctional habits
- Anatomical principles that deepen yoga practice and make it safer
- The vital link between breath, nervous system, and mind
- Reconciling yoga and modern science
- The yogic approach to heart disease, insomnia, depression, infertility, and weight loss
- Practicing safely with various health challenges
- Ayurvedic insights that deepen yoga's therapeutic potential.

This week is an opportunity to cultivate yogic awareness to guide life decisions, and make medical care, both alternative and conventional, more effective.

To register, call 1-800-822-4547 or visit www.himalayaninstitute.org. See http://www.drmccall.com/  for more information about Dr. Timothy McCall.

Friday Q&A: Abdominal Separation

Q: As I work with yoga students who are mid 50's -60's I am learning about abdominal separation that in most cases occurred during their child bearing years. In women's classes we often explore how the breath informs the pelvic floor muscles and communicates with transverse abdominis, obliques & rectus.

What are other causes of abdominal separation or "split abdominals"? What do I need to consider in working with women (and men?) who have abdominal separation? What poses to gently explore and what to avoid now that they are grandparents?

A: This condition, known technically as diastasis recti, occurs in two groups: newborns and pregnant women.  It is a separation of the midline of the most superficial layer of the abdominals, the rectus abdominus, at the vertical line known as the linea alba. This can happen anywhere from the lower tip of the breast bone all the way down to the pubic bone. It is more common in women who have had several children over time.  It is most noticeable as a midline buldging that occurs when the pressure in the belly increases, such as when coughing, sneezing, laughing, or suddenly carrying something heavy. It could be mistaken for an abdominal hernia, although it can be a much longer than your typical hernia.

There are specific techniques that have been developed to help improve the condition short of doing a cosmetic surgery to tighten up the two sides of the rectus that move away from one another with abdominal separation. They are known as the Tuppler Technique exercise. One of them sounds a lot like Plank pose on the forearms, with lower belly engaged to the spine as in Uddiyana Bandha.  The other one I was able to find was basically Constructive Rest pose (lying on the back, with knees bent and soles of the feet on the floor) with the same abdominal action, drawing the upper and lower abdomen towards the spine and holding that position for about 30 seconds. It would seem, then, that yogic pranayama techniques of engaged bandhas, with Viloma holds, could be very beneficial. In addition, the Kriya technique of Nauli might also be of benefit.  This usually done standing in a slight forward fold, like Utkatasana, with the hands on the thighs, and actively drawing the abdominal wall and contents back toward the spine. Nauli is not a practice I do regularly, but you can ask a local teacher about it if you want to learn more.

Poses to avoid include any that increase intra abdominal pressure, such as deep forward bends, where you might not ordinarily think to draw belly back towards the spine, arm balances, such as Heron or Crow, and Boat pose (Navasana). Also, deep backbends, where you are lengthening the abdomen could result in widening of abdomen as well, could worsen things.

—Baxter

Featured Pose: Half Widespread Standing Forward Bend

by Baxter and Nina

This office yoga pose is one of the most active, allover poses in the series. The pose can help energize you and awaken your body and mind, while at the same time, it can be done in almost any attire and in a variety of settings. All you need is a chair or some other piece of furniture on which you can rest your fingertips.

This forward bend not only helps stretch your hamstring muscles but also helps stretch and strengthen your inner thigh muscles (adductors), which become stiff and weak from long hours at a desk or in a chair. The position of your legs in this pose takes your legs into their full range of abduction, which is beneficial for your hip joint and can help prepare you for seated poses such as Seated Crossed Legs pose, Cobbler’s pose, and son.

This pose has similar benefits your back and spine as Half Dog pose (see here), opening your shoulders and stretching your arms, back, hips and legs. By creating a slight backbend in your thoracic spine, the pose is an antidote to the rounded back that extended sitting can cause). Because this is a forward fold, this pose can be refreshing for your mind and body because your blood flows down toward your heart and head. As your chest opens in the pose, your inhalations tend to become deeper and longer, improving your breathing.

Baxter prescribes this pose for:

• hip tightness
• inner thigh weakness
• upper back stiffness, tightness or roundness (kyphosis)
• shoulder stiffness
• respiratory problems, inhale tends to be deeper and longer
• mental sluggishness
• fatigue (physical or mental)

Instructions: Start by standing in Mountain pose, about two to three feet away from the chair back. Step your feet about three to three and half feet apart, with your feet parallel to each other.

Now, pivoting from your hips, bend forward and bring your fingertips to the chair back. Align your head evenly between your arms, so your ears are in line with your arm bones. If the chair is too close to you (that is, if you can’t stretch your arms straight), gently push the chair away. (If you can move the chair or other furniture, step back far enough so your arms can straighten.)

Press evenly into your inner and outer feet. And as you lengthen forward from your hips through your arms, root back through your sitting bones toward the wall behind you. To strengthen your legs, create an isometric action by imagining that you are squeezing your legs toward each other (even though they are spread apart). As you stay in the pose, bring some attention to your breath, focusing on creating a slightly deeper inhalation and exhalation. Stay in the pose from 30 seconds to 2 minutes.

To come out of the pose, bend your knees slightly and pull the chair back toward you (or step toward the non-moveable furniture). On an inhalation, pivot from your hips to bring your torso back to vertical. Then step your feet back into Mountain Pose.

Cautions: If you have low back problems, be as careful with this forward bend as you are with all other forward bends. Keep your knees slightly bent at first to make sure the pose feels okay for your lower back. If you have weak ankles or a history of ankle sprains, to make sure your ankles are okay, start with your feet a bit closer together and gradually work your feet wider checking your ankles as you go. If you have stiff or tight shoulders, you may not be able to reach the chair with your torso parallel to the floor. In this case, use a prop that is higher than a chair, such as a kitchen counter, filing cabinet, or bureau, or add folded blankets to the chair back to create a more appropriate height for your shoulders.

Arthritis of the Spine, Part 2

by Nina

With Baxter’s blessing, I’d like to add my two cents to his post yesterday on Arthritis of the Spine. You see, he forgot to mention hanging upside down! Yes, there is a whole group of poses that can provide great relief to those of you with arthritis of the spine (as well as other types of back pain), where you hang upside down and allow gravity to lengthen your spinal muscles and create space between your vertebral discs. You can use these poses at any time for relief from back pain and to help maintain the health of your spine. You can also use them to lengthen your spine at the beginning of a yoga practice.

Caution: If you are experiencing acute pain and your muscles are contracting, before hanging in an inverted pose, it is a good idea to start by relaxing and releasing your muscles in supine or prone poses.

If you’ve ever been in an Iyengar studio that has wall ropes, you may have seen people hanging upside down on the ropes with their legs in Cobbler’s pose. If you don’t know what I’m talking about, you can take a look at this the first pose in this video:

Other yoga studios have a yoga horse that you can hang from. Most of us can tell intuitively, just by looking at these hanging poses, just how good our backs would feel in them (kind of like looking at a recipe and being able to tell how good the dish would taste). And both these hanging poses, along with other variations, are excellent options for you if you have access to the appropriate props. So definitely try them out sometime in your local yoga studio. But what if you do yoga somewhere that doesn’t have these special props? And what can you do when you’re on your own at home? 

One good possibility is doing Downward-Facing Dog pose with a strap and a doornob, as shown in the photo below (taken from Back Care Basics by Mary Pullig Schatz, M.D.). Having the strap support you in the pose takes the weight off your arms and shoulders so you can just relax in the pose and let gravity do its magic.

 

Here's how to do it:

1. Find a door with a knob that is sturdy enough to support your weight.
2. Take a rope or yoga strap and make it into a loop.
3. Open the door half way, and hook the loop over both sides of the doorknob.
4. Step inside the loop and place the strap or rope at the tops of your thighs, at the point where your hips bend when you bend forward.
5. Lean forward into the rope until it supports your weight, bend forward and place your hands on the floor.
6. Using your hands to stabilize yourself, walk your feet back into Downward-Facing Dog position, with one foot on each side of the door.

Stay in the pose for several minutes, keeping your arms extended and your legs active. To come out of the pose, walk your feet forward out of Dog pose, then bend your knees and slowly roll up to standing.

Another possibility is lying on a table, with your legs on the table and your torso hanging off the edge, as shown in this photo (also taken from Back Care Basics by Mary Pullig Schatz, M.D.). For this one, you’ll need help from a partner. You will also need to do some experimenting to see whether the table is high enough for you to hang from without your arms touching the floor. If it isn’t, place a folded blanket or a stack of folded blankets on the surface of the table, as shown in the photo.

Here's how to do it:

1. Place a chair about one foot from the table, with the seat facing the table.
2. If you are not using blankets on the table, fold a sticky mat and place it over the edge of the table, to create a softer surface over which to bend.
3. Sit on the table and then use your arms to bring yourself to a side-lying position.
4. From your side-lying position, roll onto your belly and scoot yourself to the edge of the table.
5. Have your partner hold your thighs or calves as you hold onto the chair seat and gradually move your torso off the table until the tops of your thighs are supported by the edge of the table.
6. When you are in the full position, fold your arms overhead so you can hang comfortably (your head and arms should not be touching the floor). Stay in the pose for several minutes, as long as you are comfortable.

To come out of the pose, bring your hands to the floor to support you as your partner releases your legs and comes around to support the chair for you. Then, place your hands on the chair for support. Slide your legs toward the side edge of the table. Then slowly put one foot down on the floor, then the other. Use your hands on the table to help you come up.

Do let us know if you try any of these poses! We'd love to know if they provide you with any relief.

Arthritis of the Spine

by Baxter

Be it lower back, middle back, upper back or neck pain, not a day goes by when at least one student offers up his or her particular version of back pain. Due to the effects of time, age and stress on the spine, one of the underlying causes of back pain is arthritis of the spine. To be more specific, we usually refer to it as “osteoarthritis of the spine” to differentiate it from other types of arthritis that may be due to autoimmune conditions.  Sounds specific, maybe even helpful to have a label to attach to one’s problem, but what does “arthritis” refer to? Well, it is an “itis,” so there’s a clue. "Itis" usually implies some inflammatory process, you know, like tendonitis, where the tendon is inflamed.

In arthritis, it is the boney structures and their coverings, usually cartilage, that are involved. In a healthy joint, anywhere in the body, the ends of two bones that make up a joint are covered with a protective coating of connective tissue known as cartilage, which acts as both a cushion between the two bones, and as a smooth, slippery surface that can slide and glide as the bones move over one another during motion. Here’s where time, age, stress and other factors ruin a perfectly good system.  Over time, with the aging process (which can dry out and thin the cartilage independent of the other factors), and with certain movement patterns (especially unusual, misaligned ones) and repetitive use, especially with additional stress from gravity or carrying loads, the cartilage can fray and thin and outright wear away. This exposes bare bone, which is not that smooth and slippery, and leads to the “itis” or inflammatory process we feel as “arthritis” via the symptoms of stiffness, immobility and pain.

Whale Bone by Michele Macartney-Filgate

When talking about the spine specifically, the places where two spinal bones, or vertebrae, meet include the donut-like intervertebral discs (which I will refer to as discs from now on), which sit between two adjacent “bodies” of the vertebral bones, in vertical relationship, and the two posterior facet joints, right and left, whose smaller surfaces are covered by a thin coating of cartilage. The most common area for arthritis in the spine is in the lowest part of the lower back, or lumbar region, due to extra effects from gravity of holding up the belly, torso, head and arms. The next most common area is the neck area or cervical spine, likely due to its incredible mobility and relatively short intervertebral discs. The thoracic area or rib cage region of the spine is often affected when two other complicating factors are present: scoliosis, or curvature of the spine, and osteoporosis, or thinning of the bones. I’m sure there will be more on those topics at another time.

Coming back to the discs for a minute, all the cumulative factors mentioned above can cause these guys to lose their normal integrity, resulting in the discs losing water and drying out, which increases the risk of them breaking open or rupturing their tougher outer ring known as the annulus fibrosis (even sounds tough!) and extruding or pushing out their inner contents, which is the gel-like inner part, the nucleus pulposa, often compared to the jelly in a jelly-filled donut. The discs also lose some of their height, which normally helps to keep a healthy distance between two vertebrae. This can then result in the facets rubbing more closely together, the opening for nerves narrowing enough to start pinching on nerves, and other such difficulties! When that nucleus pulposus material is released into the spinal canal, which sits just back of the discs and where your spinal cord descends down from the brain to the tail bone, it causes a local flare of inflammation that can last a while. When the disc is losing height but does not rupture, we call that degenerative disc disease (a bit of a misnomer, as it may not be a disease per se, but more like a natural aging process of the disc). This alone can result in pain for some, and it can be found in adults starting in their thirties!

How’s yoga supposed to improve this arthritis situation of the spine? Well, those of you who have been in class with me lately have heard me use the phrase “the prime directive.”  Sounds a bit Star Trek-y doesn’t it?  But in this setting, it refers to the inner action of creating an even lift from the base of the body, either the tailbone or the sitting bones, up through the whole length of the spine to the crown of the head. This is technically known as axial extension, and, according to Leslie Kaminoff, it does create a longer spine, even as it slightly diminishes the amount of natural arch in each region of the spine. That is, it straightens the spine a bit, but not entirely.  And it requires some muscular effort, especially if you have not been practicing it. You can do this anywhere, anytime, and if you are doing it and paying attention to how it feels as well as, perhaps, how it affects your breath, and you remain connected to the action for a bit, you have a mini yoga practice under way. 

And then from there, you can take the spine through some gentle range of motions, via some easy, basic yoga poses, such as Cat/Cow pose, Child’s pose to low Cobra pose, Standing Side Bend (sometimes called New Moon pose), and gentle reclining or seated twists. As you do this, you are always assessing the effect on the area of your spine that is sensitive, modifying the intensity, range of motion or number of repetitions or length of holding to make it appropriate for you situation. I believe that a while back Shari mentioned that movement actually hydrates, nourishes and revitalizes the discs of the spine, so inactivity is not a great option, is it? (See Yoga for Osteoarthritis for an interview with Shari about arthritis.).  So let’s get moving, yogis!  Great to be back from spring break. More good stuff tomorrow! See Arthritis of the Spine, Part 2 for more poses you can do to find relief from back pain and to lengthen your spine.