Q: Quick question, Baxter. Every morning when I wake up and come down, I stop at the middle landing, grab two post on both sides of the staircase and take a deep breath and slowly start bending back and I stay that way for about 20 seconds or less till I start getting a slight dizziness/rush/ kinda thing and then I do the "cow" pose (reverse). And I feel so fresh after that...now while doing this am I doing something that could be not right in course of time and I should stop doing that...does it sound like a kundalini rush or just a good work out for the back? I do need to know if you please. I am sixty five years old and do not wish to hurt myself in any manner that would make me bed bound. So please advise. Appreciate that. Thanx
A: Dear Stair Cat-Cower,
What a fascinating question! I am curious as to how long you have been doing this little morning ritual cat/cow standing on your staircase. Has the dizziness ever been so severe that you felt you might pass out? I suspect not, as I cannot imagine you would continue to practice this half way down the stairs, as a fall from that place could be quite injurious!
As to what is going on, that is anyone’s guess without more information and without personally examining you to make sure you don’t have any underlying conditions that would be worrisome, such as high blood pressure or cervical disc disease. The fact that it is somewhat mild sensation that leaves you feeling refreshed seems a good sign. However, if you have any concerns of doing something detrimental for your health, I’d get a general check up and mention the symptoms to your primary care doctor. It might be worth requesting some plain x-rays of your neck to look for any obvious reason to not be tipping your head backwards first thing the morning.
As to the question of “kundalini” energy, this is usually discussed in the setting of pranayama breath practices and deep meditations, although there are anecdotal accounts of kundalini energy activation via asana practices. However, once released, that sort of energy is usually described as having a more constant and continuous effect on the inner sensations of the body, as compared to your short and brief rush of feeling. It would be interesting to hear where you are getting this inner feeling? Is it in a particular location or does it run a particular course? These could be clues to the underlying precipitating cause of the sensations. If you have not done so, you might also have a private consultation with the most experienced teacher in your area to get their slant on what it happening for you. In the meantime, I’d recommend doing this at the bottom of the staircase, and make sure there is a soft landing in front of you in case the dizziness gets worse! And thanks for your intriguing question!
Namaste, Baxter
Friday, August 31, 2012
Thursday, August 30, 2012
Caloric Restriction and Longevity
by Nina and Brad
You may have noticed that we’ve been talking about yoga for healthy eating this week (see Yoga for Healthy Eating) without defining what “healthy eating” entails. To be honest, we’ve intentionally been avoiding getting too specific about dietary recommendations because there is so much controversy these days about what a healthy diet is. However, one thing we can now say with confidence is that the best diet for healthy aging does not mean starving yourself. In today’s New York Times, the results of a 25 year study at National Institutes of Health on caloric restriction was announced, disproving the somewhat popular theory that a low-calorie diet will prolong our life span. See Severe Diet Doesn’t Prolong Life, at Least in Monkeys.
Since we just happen to have a bona fide scientist who studies aging on our staff, we decided to ask him to weigh in. Here’s what Prof. Bradford Gibson (aka Brad) has to say about this news and about caloric restriction in general:
"The data demonstrating that caloric restriction (CR) increasing longevity is impressive, at least for yeast, worms and flies. It was generally thought that this link between CR and longevity was evolutionarily conserved in mammals as well, as evidence from several mouse and rat studies seemed to indicate. (However, even the mouse data has come under scrutiny as the CR effect does not seem to work nearly as well in when these studies are carried out on mice with more diverse genetic backgrounds, you know, like the ones in your attic as opposed to the inbred lab strains.)
"The primate studies, however, have been obviously more problematic to carry out, considering the cost and time required to get the results can be 20 years or more. This, of course, has not discouraged some people, including some very prominent scientist, to adopt this seriously restrictive diet by choice. Personally, I thought they were nuts to do so; but the field of aging research has always attracted extreme positions and is littered with false or exceedingly thin claims and snake oil salesmen, despite the general field of aging research becoming more mainstream. So what have we learned? Hypothesis fail. Experimental designs are flawed. Things are more complicated than we thought. And I can assert that my own small number of encounters of people on the CR diet suggest that they don't look so good, i.e., pale, gaunt, and a bit listless. So enjoy your meal, wine and chocolate, and maybe the field of aging research will move on to a more interesting and scientifically compelling hypothesis to spend our NIH dollars on."
You may have noticed that we’ve been talking about yoga for healthy eating this week (see Yoga for Healthy Eating) without defining what “healthy eating” entails. To be honest, we’ve intentionally been avoiding getting too specific about dietary recommendations because there is so much controversy these days about what a healthy diet is. However, one thing we can now say with confidence is that the best diet for healthy aging does not mean starving yourself. In today’s New York Times, the results of a 25 year study at National Institutes of Health on caloric restriction was announced, disproving the somewhat popular theory that a low-calorie diet will prolong our life span. See Severe Diet Doesn’t Prolong Life, at Least in Monkeys.
 |
| Photo from National Institutes of Health |
"The data demonstrating that caloric restriction (CR) increasing longevity is impressive, at least for yeast, worms and flies. It was generally thought that this link between CR and longevity was evolutionarily conserved in mammals as well, as evidence from several mouse and rat studies seemed to indicate. (However, even the mouse data has come under scrutiny as the CR effect does not seem to work nearly as well in when these studies are carried out on mice with more diverse genetic backgrounds, you know, like the ones in your attic as opposed to the inbred lab strains.)
"The primate studies, however, have been obviously more problematic to carry out, considering the cost and time required to get the results can be 20 years or more. This, of course, has not discouraged some people, including some very prominent scientist, to adopt this seriously restrictive diet by choice. Personally, I thought they were nuts to do so; but the field of aging research has always attracted extreme positions and is littered with false or exceedingly thin claims and snake oil salesmen, despite the general field of aging research becoming more mainstream. So what have we learned? Hypothesis fail. Experimental designs are flawed. Things are more complicated than we thought. And I can assert that my own small number of encounters of people on the CR diet suggest that they don't look so good, i.e., pale, gaunt, and a bit listless. So enjoy your meal, wine and chocolate, and maybe the field of aging research will move on to a more interesting and scientifically compelling hypothesis to spend our NIH dollars on."
Wednesday, August 29, 2012
Reasons for Doing Yoga
by Nina
Yesterday in his post Yoga for Healthy Eating, Baxter wrote about a study that showed that obesity in modern societies was not caused by our sedentary lifestyle but instead by our eating habits. But the fact is, our current culture is a very sedentary one, and if weight loss isn’t a good reason for exercising, there are many, other important reasons, including both physical and mental health. If you’ve been reading our blog for any amount of time, you’ll surely have noticed that we’re strongly encouraging exercise in the form of yoga asanas as one of the most important strategies for fostering for healthy aging.
By chance on the same day Jane Brody of the New York Times addressed the issue of motivation for exercise (see Changing Our Tune on Exercise) by saying that the usual reasons experts give for encouraging us to exercise, including a desire to lose weight or improve your figure, to keep heart disease, cancer or type 2 diabetes at bay, to lower your blood pressure or cholesterol, to protect your bones, and to live to a healthy old age, turn out not to be good motivators for people. Instead it is the short-term benefits of feelings of well-being and happiness that keep us exercising:
Now research by psychologists strongly suggests it’s time to stop thinking of future health, weight loss and body image as motivators for exercise. Instead, these experts recommend a strategy marketers use to sell products: portray physical activity as a way to enhance current well-being and happiness.
Doesn’t that sound like one of the real purposes of yoga? Many years ago, my then teacher Rodney Yee, asked me why I did yoga, and struggling to find the right (and truthful) words, I could only come up with the following:
It makes my life better.
I went on to say that I almost always felt better after taking a yoga class or practicing at home on my own. And that is what kept me coming back to my mat day after day. Of course, I’m delighted that the practice I’ve chosen will have most likely provide many significant long-term benefits for me (and I can already see that I’m aging well compared to more sedentary people my current age), but in the meantime, I’ll be practicing today because, well, it makes my life better. Jane Brody put it this way in her article:
I walk three miles daily, or bike ten miles and swim three-quarters of a mile. If you ask me why, weight control may be my first answer, followed by a desire to live long and well. But that’s not what gets me out of bed before dawn to join friends on a morning walk and then bike to the Y for my swim.
It’s how these activities make me feel: more energized, less stressed, more productive, more engaged and, yes, happier — better able to smell the roses and cope with the inevitable frustrations of daily life.
For more information, see the original study Brody references, The role of motives in exercise participation.
Yesterday in his post Yoga for Healthy Eating, Baxter wrote about a study that showed that obesity in modern societies was not caused by our sedentary lifestyle but instead by our eating habits. But the fact is, our current culture is a very sedentary one, and if weight loss isn’t a good reason for exercising, there are many, other important reasons, including both physical and mental health. If you’ve been reading our blog for any amount of time, you’ll surely have noticed that we’re strongly encouraging exercise in the form of yoga asanas as one of the most important strategies for fostering for healthy aging.
By chance on the same day Jane Brody of the New York Times addressed the issue of motivation for exercise (see Changing Our Tune on Exercise) by saying that the usual reasons experts give for encouraging us to exercise, including a desire to lose weight or improve your figure, to keep heart disease, cancer or type 2 diabetes at bay, to lower your blood pressure or cholesterol, to protect your bones, and to live to a healthy old age, turn out not to be good motivators for people. Instead it is the short-term benefits of feelings of well-being and happiness that keep us exercising:
Now research by psychologists strongly suggests it’s time to stop thinking of future health, weight loss and body image as motivators for exercise. Instead, these experts recommend a strategy marketers use to sell products: portray physical activity as a way to enhance current well-being and happiness.
 |
| Bees Sipping Nectar by Michele Macartney-Filgate |
It makes my life better.
I went on to say that I almost always felt better after taking a yoga class or practicing at home on my own. And that is what kept me coming back to my mat day after day. Of course, I’m delighted that the practice I’ve chosen will have most likely provide many significant long-term benefits for me (and I can already see that I’m aging well compared to more sedentary people my current age), but in the meantime, I’ll be practicing today because, well, it makes my life better. Jane Brody put it this way in her article:
I walk three miles daily, or bike ten miles and swim three-quarters of a mile. If you ask me why, weight control may be my first answer, followed by a desire to live long and well. But that’s not what gets me out of bed before dawn to join friends on a morning walk and then bike to the Y for my swim.
It’s how these activities make me feel: more energized, less stressed, more productive, more engaged and, yes, happier — better able to smell the roses and cope with the inevitable frustrations of daily life.
For more information, see the original study Brody references, The role of motives in exercise participation.
Tuesday, August 28, 2012
Yoga for Healthy Eating
by Baxter
Nina and I have recently been talking about yoga’s potential benefit on developing healthy eating habits. Healthy eating habits are vitally important because, after all, the modern adage that you are what you eat seems more and more true as time goes on. What you eat can make you feel bad and can make you sick, as exemplified by such conditions as gluten and dairy sensitivities. It may even lead to diseases such as diabetes and heart disease that can shorten your life span.
Sometimes we hear folks claim that it is our relative modern inactivity that is to blame for the trend towards more and more obesity in this country and in the developed world. Often called the Hunter-Gatherer myth, it goes something like this: modern health problems like diabetes and heart disease are a result of our modern way of life being radically different from the hunter-gatherer environments in which our bodies evolved. Intrigued by such claims, Herman Pontzer, an assistant professor of anthropology at Hunter College, and his colleagues, set out to see if they could shed some light on this question (see Hunter-Gatherer Energetics and Human Obesity). They wondered if hunter-gatherer societies, due to their more active lifestyles, burned more calories in the course of their day than their developed counterparts in the big city. That could account for the lower rates of obesity and heart disease and the like. They turned to the Hazda people of eastern Africa, one of the few remaining hunter-gatherer societies on the planet. They measured the daily energy expenditure among the Hadza people of Tanzania to see if these people, whose daily life is so similar to that of our distant ancestors, expend more energy than we do in a given day. And guess what? They don’t. In fact, it is about the same amount as the modern couch potato. Even though they did not look at other side of the formula, the daily calorie intake of the Hadza, they came up with the following conclusion:
“All of this means that if we want to end obesity, we need to focus on our diet and reduce the number of calories we eat, particularly the sugars our primate brains have evolved to love. We’re getting fat because we eat too much, not because we’re sedentary. Physical activity is very important for maintaining physical and mental health, but we aren’t going to Jazzercise our way out of the obesity epidemic.”
If we shift focus onto the original question that I am interested in, how can yoga help my student’s develop healthy eating habits, from this study and lots of other evidence out there to support Mr. Ponzer’s assertion, I want yoga to influence how much we are eating. And since more physical activity does not appear to be the key factor here (meaning more asana or more vigorous asana is not necessarily the answer) I return, once again, to the benefit of practicing the quality of mindfulness that is so central to most styles yoga practices that include more than just asana. So much eating of high calorie, low nutritional value food happens via a mindless habit. Our yoga practice can begin to bring into clearer view the food choices and quantities of food we are taking in. It requires some specific focuses and goals, such as noticing the difference between actual hunger versus emotionally stimulated eating habits.
It might involve the practice of eating slowly and mindfully, so as to not bypass the body’s natural signals from the brain that tell us when we are satisfied by our meal, versus eating fast and stopping when we feel full (or over-full, as is often the case). And perhaps doing a brief meditation to check in with how the body responds to the ingestion of those sodas and desserts that we crave, but often leave us feeling tired and depleted after the initial sugar high wears off, might start to shed light on their real effects. Once established in this mindful approach to eating and being, students often report making healthy changes in what and how much they eat. And they are able to tell a distinct difference in how they feel. They feel better, more even in their daily energy needs, less sleepy after lunch, more rested in the morning. So before you start foraging or hunting for you daily sustenance, try the easier route! Get more mindful about your eating habits!
Nina and I have recently been talking about yoga’s potential benefit on developing healthy eating habits. Healthy eating habits are vitally important because, after all, the modern adage that you are what you eat seems more and more true as time goes on. What you eat can make you feel bad and can make you sick, as exemplified by such conditions as gluten and dairy sensitivities. It may even lead to diseases such as diabetes and heart disease that can shorten your life span.
Sometimes we hear folks claim that it is our relative modern inactivity that is to blame for the trend towards more and more obesity in this country and in the developed world. Often called the Hunter-Gatherer myth, it goes something like this: modern health problems like diabetes and heart disease are a result of our modern way of life being radically different from the hunter-gatherer environments in which our bodies evolved. Intrigued by such claims, Herman Pontzer, an assistant professor of anthropology at Hunter College, and his colleagues, set out to see if they could shed some light on this question (see Hunter-Gatherer Energetics and Human Obesity). They wondered if hunter-gatherer societies, due to their more active lifestyles, burned more calories in the course of their day than their developed counterparts in the big city. That could account for the lower rates of obesity and heart disease and the like. They turned to the Hazda people of eastern Africa, one of the few remaining hunter-gatherer societies on the planet. They measured the daily energy expenditure among the Hadza people of Tanzania to see if these people, whose daily life is so similar to that of our distant ancestors, expend more energy than we do in a given day. And guess what? They don’t. In fact, it is about the same amount as the modern couch potato. Even though they did not look at other side of the formula, the daily calorie intake of the Hadza, they came up with the following conclusion:
“All of this means that if we want to end obesity, we need to focus on our diet and reduce the number of calories we eat, particularly the sugars our primate brains have evolved to love. We’re getting fat because we eat too much, not because we’re sedentary. Physical activity is very important for maintaining physical and mental health, but we aren’t going to Jazzercise our way out of the obesity epidemic.”
If we shift focus onto the original question that I am interested in, how can yoga help my student’s develop healthy eating habits, from this study and lots of other evidence out there to support Mr. Ponzer’s assertion, I want yoga to influence how much we are eating. And since more physical activity does not appear to be the key factor here (meaning more asana or more vigorous asana is not necessarily the answer) I return, once again, to the benefit of practicing the quality of mindfulness that is so central to most styles yoga practices that include more than just asana. So much eating of high calorie, low nutritional value food happens via a mindless habit. Our yoga practice can begin to bring into clearer view the food choices and quantities of food we are taking in. It requires some specific focuses and goals, such as noticing the difference between actual hunger versus emotionally stimulated eating habits.
 |
| Ripening Grapes by Nina Zolotow |
Monday, August 27, 2012
Georg Feuerstein, 1947-2012
by Nina
Just the other day in my post Why You Should Study Yoga Philosophy I wrote about how much I valued the work of yoga scholar Dr. Georg Feuerstein. Then yesterday I learned that he died on August 25. Even though I never met him, I consider him to be one of my most important teachers, so I wanted to take a moment to honor him.
It was always the work of Dr. Feuerstein that I turned to (and will continue to turn to) when I wanted answers to questions I had about yoga history and when I wanted a very literal translation—one in which I could see the relationship between the original Sanskrit and the English—of a yoga scripture. I felt I could always rely on him for a relatively unbaised perspective. But the most important single lesson I learned from him is this one:
“Yoga is like an ancient river with countless rapids, eddies, loops, tributaries, and backwaters, extending over a vast, colourful terrain of many different habitats. So, when we speak of Yoga, we speak of a multitude of paths and orientations with contrasting theoretical frameworks and occasionally incompatible goals.” —Georg Feuerstein, Ph.D.
Dr. Feuerstein’s wife, Brenda L. Feuerstein, announced his death on Facebook this way:
It is with great sadness that I announce that my husband and spiritual partner, Georg Feuerstein, Ph.D., left his body on August 25, 2012 at 9:10 PM.
At this time, I would like to request prayers from the worldwide community for Georg's transition through the afterlife states and for a swift rebirth.
In lieu of flowers and gifts, Georg had requested a scholarship fund be set up to enable incarcerated people the opportunity to participate in our distance learning courses. More information about the fund will be available this week.
 |
| Doorways by Nina Zolotow |
It was always the work of Dr. Feuerstein that I turned to (and will continue to turn to) when I wanted answers to questions I had about yoga history and when I wanted a very literal translation—one in which I could see the relationship between the original Sanskrit and the English—of a yoga scripture. I felt I could always rely on him for a relatively unbaised perspective. But the most important single lesson I learned from him is this one:
“Yoga is like an ancient river with countless rapids, eddies, loops, tributaries, and backwaters, extending over a vast, colourful terrain of many different habitats. So, when we speak of Yoga, we speak of a multitude of paths and orientations with contrasting theoretical frameworks and occasionally incompatible goals.” —Georg Feuerstein, Ph.D.
Dr. Feuerstein’s wife, Brenda L. Feuerstein, announced his death on Facebook this way:
It is with great sadness that I announce that my husband and spiritual partner, Georg Feuerstein, Ph.D., left his body on August 25, 2012 at 9:10 PM.
At this time, I would like to request prayers from the worldwide community for Georg's transition through the afterlife states and for a swift rebirth.
In lieu of flowers and gifts, Georg had requested a scholarship fund be set up to enable incarcerated people the opportunity to participate in our distance learning courses. More information about the fund will be available this week.
Friday, August 24, 2012
Friday Q&A: Post-Surgery Scar Tissue
Q: Hi good folks. Several years ago I had emergency surgery for diverticulitus (I was 44, now 48). Afterward I lived with a colostomy bag for six months and then had a colon resection. During the second surgery it was discovered that I had extensive scar tissue. I am assuming that there is even more scar tissue now resulting from the second surgery. Since then I have experienced some occasional intense short blasts of pain when doing asanas (parsvottanasana and prasarita padottanasan in particular). I know I have to be careful of causing hernias and have worked to increase abdominal strength. I have two questions: What about the forward bends is causing the pain and how do I correct myself to prevent the pain? Will stretching (twists and backbends) aggravate the creation of scar tissue or can it help to keep my abdominal area more supple? Thank you in advance for any information and/or advice you can provide.
A: Thanks for writing in! Your question is challenging for several reasons. The most obvious one is that without a longer interview about your recent and past history and without an actual physical exam, it is really hard to know what is the source of your abdominal pain. As we have advised students in the past, make sure to get a good check up soon with your surgeon and family MD if you have not do so yet. Secondly, you could assume, and maybe rightly so, that your pain is coming from scar tissue that formed as part of the healing process from your two surgeries. It would be helpful to know if you had similar pains between the two surgeries, or only since the second one, when you have been able, I would imagine, to be more physically active. But—and the big but—there could be a completely different source of your pain that is as yet undiagnosed! Ergo the need to see your docs for a check up to rule out some other source of abdominal pain.
Finally, I am not sure, but must assume, that the abundant scar tissue seen during the second surgery may have been a result of a ruptured diverticuli, that ruptured into your abdominal cavity. This could explain the need for a temporary colostomy bag. When you have a rupture of this sort, the contents of your large intestines, stool, can escape into the belly cavity. This can result in an infection and inflammation situation in the belly, often treated with strong antibiotics. A side effect of such a situation is that the tissues of the belly can end up sticking to one another and adhesions (like the word adhesive) form between these tissues, and they are often referred to as “scar tissue.” Sometimes these adhesions don’t cause any trouble, sometimes they cause pain or pulling, and in rare instances, they could block to gut and cause a serious back up.
I would also assume that during the second surgery, they probably cleaned up the scarred areas while they re-connected the two ends of your large intestine. If everything was clean and no infection happened after the second surgery, you could expect little or no new scar tissue or adhesions. This is good news, and your assumption about more scar tissue after the second surgery may not be true.
But even with an uncomplicated surgery, healing tissue forms a scar as part of healing process and this is an expected and normal situation. However, the areas of scar on the surface of the body and even inside the body could lead to some tightness and restriction of movement in the affected area. I know this first hand, as I had a double groin hernia repair about ten years ago, and after the initial pain subsided, I definitely had tightness and mild discomfort for months if not a year afterwards. A patient yoga practice gradually got me back to a full experience of yoga.
Backing up a moment, clean wounds seal up pretty fast, with in a few weeks, but they continue to get stronger for a while longer, at least six weeks. In fact, a common warning after surgery is to limit activity for about six weeks after surgery to give the body enough to form a strong scar. Usually, after that, you can gradually resume your pre-surgery activity.
So if we assume you have been to the doctor and have a clean bill of health, how do you approach the pain you are having? If it is exclusively happening in forward bends, is it in all forward bends, or only the two standing ones you mention above? The fact that it happens in forward bends makes me suspicious that the action of “compressing” the abdominal contents is the trigger for the pain, especially if twists and backbends don’t cause pain. If the source of the pain is fascia or connective tissue in the belly, you can cautiously and safely do backbends and twists as a way of releasing some of that tension, which could lead to lessening of pain on forward bends.
If you love forward bends and want to keep them in your practice, consider tipping from the hip joints and avoid rounding the spine and don’t bring the lower belly in contact with your thighs. In other words, stay a little higher up in the forward bends and see if you can avoid triggering the pain. You can still feel a nice stretch in the back of the legs and torso with this modified way of doing forward bends. Also, for seated forward bends like Upavista Konasana (Wide Angle Forward Bend), where the legs are wide apart and the belly is not so compressed, I’d hope you would have less chance of triggering pain, even though the standing version was a trigger. You will have to do some experimenting in your home practice and have an experienced teacher observe you in your forward bends to begin to get more details on what poses seem good to do and others that might be best avoided. If I have a pose that I avoid because it triggers pain, I like to have one that I can substitute in when I am in a public class and don’t want to miss out.
Hope these thoughts are helpful in you yoga explorations!
—Baxter
A: Thanks for writing in! Your question is challenging for several reasons. The most obvious one is that without a longer interview about your recent and past history and without an actual physical exam, it is really hard to know what is the source of your abdominal pain. As we have advised students in the past, make sure to get a good check up soon with your surgeon and family MD if you have not do so yet. Secondly, you could assume, and maybe rightly so, that your pain is coming from scar tissue that formed as part of the healing process from your two surgeries. It would be helpful to know if you had similar pains between the two surgeries, or only since the second one, when you have been able, I would imagine, to be more physically active. But—and the big but—there could be a completely different source of your pain that is as yet undiagnosed! Ergo the need to see your docs for a check up to rule out some other source of abdominal pain.
Finally, I am not sure, but must assume, that the abundant scar tissue seen during the second surgery may have been a result of a ruptured diverticuli, that ruptured into your abdominal cavity. This could explain the need for a temporary colostomy bag. When you have a rupture of this sort, the contents of your large intestines, stool, can escape into the belly cavity. This can result in an infection and inflammation situation in the belly, often treated with strong antibiotics. A side effect of such a situation is that the tissues of the belly can end up sticking to one another and adhesions (like the word adhesive) form between these tissues, and they are often referred to as “scar tissue.” Sometimes these adhesions don’t cause any trouble, sometimes they cause pain or pulling, and in rare instances, they could block to gut and cause a serious back up.
I would also assume that during the second surgery, they probably cleaned up the scarred areas while they re-connected the two ends of your large intestine. If everything was clean and no infection happened after the second surgery, you could expect little or no new scar tissue or adhesions. This is good news, and your assumption about more scar tissue after the second surgery may not be true.
But even with an uncomplicated surgery, healing tissue forms a scar as part of healing process and this is an expected and normal situation. However, the areas of scar on the surface of the body and even inside the body could lead to some tightness and restriction of movement in the affected area. I know this first hand, as I had a double groin hernia repair about ten years ago, and after the initial pain subsided, I definitely had tightness and mild discomfort for months if not a year afterwards. A patient yoga practice gradually got me back to a full experience of yoga.
Backing up a moment, clean wounds seal up pretty fast, with in a few weeks, but they continue to get stronger for a while longer, at least six weeks. In fact, a common warning after surgery is to limit activity for about six weeks after surgery to give the body enough to form a strong scar. Usually, after that, you can gradually resume your pre-surgery activity.
So if we assume you have been to the doctor and have a clean bill of health, how do you approach the pain you are having? If it is exclusively happening in forward bends, is it in all forward bends, or only the two standing ones you mention above? The fact that it happens in forward bends makes me suspicious that the action of “compressing” the abdominal contents is the trigger for the pain, especially if twists and backbends don’t cause pain. If the source of the pain is fascia or connective tissue in the belly, you can cautiously and safely do backbends and twists as a way of releasing some of that tension, which could lead to lessening of pain on forward bends.
If you love forward bends and want to keep them in your practice, consider tipping from the hip joints and avoid rounding the spine and don’t bring the lower belly in contact with your thighs. In other words, stay a little higher up in the forward bends and see if you can avoid triggering the pain. You can still feel a nice stretch in the back of the legs and torso with this modified way of doing forward bends. Also, for seated forward bends like Upavista Konasana (Wide Angle Forward Bend), where the legs are wide apart and the belly is not so compressed, I’d hope you would have less chance of triggering pain, even though the standing version was a trigger. You will have to do some experimenting in your home practice and have an experienced teacher observe you in your forward bends to begin to get more details on what poses seem good to do and others that might be best avoided. If I have a pose that I avoid because it triggers pain, I like to have one that I can substitute in when I am in a public class and don’t want to miss out.
Hope these thoughts are helpful in you yoga explorations!
—Baxter
Thursday, August 23, 2012
Featured Sequence: Chair Yoga Mini Sequence
.by Baxter and Nina
How much yoga can you do without getting out of your chair? Well, it turns out quite a lot! In fact, today’s mini sequence is a well-rounded practice that includes backbends, forward bends, a twist, a hip opener, and a relaxation pose, all of which can be done at your desk or at the airport. The entire sequence is accessible to almost everyone, including people who find it difficult to get up and down from the floor or who cannot stand.
1. Chair Cat Pose for six rounds (with six breaths). This seated version of Cat pose is a great way to counteract the tendency to round forward when you sit in front of your computer, laptop, or tablet, or commute in your car. For those who tend to assume a head forward position, this pose returns your head to a healthier alignment over your shoulders. And moving back and forth between arching and rounding your spine strengthens the muscles that support your head in a more even way. For all of us, moving your spine back and forth between flexion (rounded) and extension (arched) helps keep your spine healthy by providing nourishment to the bones and disks.
Because you move rhythmically with your breath in this pose, you take in more oxygen, which has a positive effect on your respiratory system and can help if you get winded easily. In addition, moving with your breath is a stimulating, which may perk you up when you are feeling sluggish and can help you focus your concentration. It’s a good way to kick start your practice when you are feeling fatigued or depressed. After you start gently moving in this pose, you may feel ready for some larger movements.
For instructions and cautions, see: Seated Cat-Cow Pose
2. Chair Twist for one minute. This pose releases back muscles that are stiff or sore from sitting at a desk or from traveling, or from everyday activities that stress the back, such as gardening and painting, and increases the rotational mobility in your spine. Twisting also helps nourish the spine—movement of the spine helps maintain the health of the discs—and also strengthens the bones themselves as your back muscles pull on the bony insertions of the spine. This pose also strengthens the oblique muscles of your core (and we could all use a little of that). Traditional yoga teachers recommend twists for the health of your internal organs, improving circulation to and function of the abdominal organs, although no studies have been conducted to confirm this. And finally, for many of us, twists can release physical and emotional tension, providing relief from stress.
For instructions and cautions, see: Chair Twist.
3. Chair Seated Forward Bend/Hip Opener for one to two minutes. This simple pose is another good antidote to sitting upright in your chair. An excellent hip opener, this forward bend counteracts the tightness of your hips that you develop from sitting with your legs straight in front of you, helping you to maintain mobility in your hip joints. The release in your hips can feel wonderful, and you may also feel a good stretch in your lower back and inner thighs. The pose also helps stretch and wake up your arms as you press them toward the floor. By changing your relationship to gravity, this pose helps release tension you’re holding in your back, neck, and head. This can be particularly helpful if you’ve spent hours in front of your computer screen or driving, and your neck is stiff or even painful. The partial inversion also stimulates your circulatory system and can re-enliven you if you’re feeling sluggish, stimulates your circulatory system.
For instructions and cautions, see: Chair Seated Forward Bend.
4. Chair Backbend for 12 to 16 breaths. This simple chair backbend is the perfect antidote to the typical postural habits of slumping forward that we develop from sitting all day at our desks, in cars, and airplanes, and from the many everyday activities where we are bending forward, such as gardening or washing dishes. The basic back-bending shape re-establishes the natural curve of your lower back, correctly aligning your spine in its natural curves, which helps to keep your back healthy. The backbend also lengthens the front of your body, allowing many of us to breath in with greater ease. It helps release stress from your upper body, especially the upper chest. And while stretching the front of your body, the pose strengthens your back body muscles, which tend to be overstretched and weak if they are ignored. Because backbends in general tend to be uplifting, you may even find this pose helps encourage a more positive mood as you take deep inhalations and exhalations.
For instructions and cautions, see: Chair Backbend.
5. Supported Forward Bend for one to ten minutes. The simple supported forward bend is a safe forward bend for almost everyone. Because you’re bending your legs at the knees, you’re reducing the tension on your hamstrings and therefore allowing your pelvis to have more flexibility at your hip joints. In addition, because you’re resting your arms and head on a chair or desk and you’re not hanging in space, your lower back muscles can release more completely and relax more deeply. (Some of the seated forward bends with straight legs can aggravate lower back pain or disc problems because they pull so strongly on your back muscles and encourage the discs to move toward a posterior position, and you can sometimes over-strain your ligaments when you overdo.)
This forward bend can provide you a quiet moment in your busy day, and allows you to access the deep rest of conscious relaxation without lying on the floor, especially if you focus on your breath while you are in the pose. In addition, folding forward creates a feeling of safety and comfort for many people. And supporting your head enhances the soothing quality of the forward bend, so the Chair Forward Bend may even have a quieting effect on your mind and your emotions, cooling negative emotions such as anger and anxiety.
For instructions and cautions, see: Chair Supported Forward Bend.
How much yoga can you do without getting out of your chair? Well, it turns out quite a lot! In fact, today’s mini sequence is a well-rounded practice that includes backbends, forward bends, a twist, a hip opener, and a relaxation pose, all of which can be done at your desk or at the airport. The entire sequence is accessible to almost everyone, including people who find it difficult to get up and down from the floor or who cannot stand.
1. Chair Cat Pose for six rounds (with six breaths). This seated version of Cat pose is a great way to counteract the tendency to round forward when you sit in front of your computer, laptop, or tablet, or commute in your car. For those who tend to assume a head forward position, this pose returns your head to a healthier alignment over your shoulders. And moving back and forth between arching and rounding your spine strengthens the muscles that support your head in a more even way. For all of us, moving your spine back and forth between flexion (rounded) and extension (arched) helps keep your spine healthy by providing nourishment to the bones and disks.
Because you move rhythmically with your breath in this pose, you take in more oxygen, which has a positive effect on your respiratory system and can help if you get winded easily. In addition, moving with your breath is a stimulating, which may perk you up when you are feeling sluggish and can help you focus your concentration. It’s a good way to kick start your practice when you are feeling fatigued or depressed. After you start gently moving in this pose, you may feel ready for some larger movements.
2. Chair Twist for one minute. This pose releases back muscles that are stiff or sore from sitting at a desk or from traveling, or from everyday activities that stress the back, such as gardening and painting, and increases the rotational mobility in your spine. Twisting also helps nourish the spine—movement of the spine helps maintain the health of the discs—and also strengthens the bones themselves as your back muscles pull on the bony insertions of the spine. This pose also strengthens the oblique muscles of your core (and we could all use a little of that). Traditional yoga teachers recommend twists for the health of your internal organs, improving circulation to and function of the abdominal organs, although no studies have been conducted to confirm this. And finally, for many of us, twists can release physical and emotional tension, providing relief from stress.
3. Chair Seated Forward Bend/Hip Opener for one to two minutes. This simple pose is another good antidote to sitting upright in your chair. An excellent hip opener, this forward bend counteracts the tightness of your hips that you develop from sitting with your legs straight in front of you, helping you to maintain mobility in your hip joints. The release in your hips can feel wonderful, and you may also feel a good stretch in your lower back and inner thighs. The pose also helps stretch and wake up your arms as you press them toward the floor. By changing your relationship to gravity, this pose helps release tension you’re holding in your back, neck, and head. This can be particularly helpful if you’ve spent hours in front of your computer screen or driving, and your neck is stiff or even painful. The partial inversion also stimulates your circulatory system and can re-enliven you if you’re feeling sluggish, stimulates your circulatory system.
4. Chair Backbend for 12 to 16 breaths. This simple chair backbend is the perfect antidote to the typical postural habits of slumping forward that we develop from sitting all day at our desks, in cars, and airplanes, and from the many everyday activities where we are bending forward, such as gardening or washing dishes. The basic back-bending shape re-establishes the natural curve of your lower back, correctly aligning your spine in its natural curves, which helps to keep your back healthy. The backbend also lengthens the front of your body, allowing many of us to breath in with greater ease. It helps release stress from your upper body, especially the upper chest. And while stretching the front of your body, the pose strengthens your back body muscles, which tend to be overstretched and weak if they are ignored. Because backbends in general tend to be uplifting, you may even find this pose helps encourage a more positive mood as you take deep inhalations and exhalations.
5. Supported Forward Bend for one to ten minutes. The simple supported forward bend is a safe forward bend for almost everyone. Because you’re bending your legs at the knees, you’re reducing the tension on your hamstrings and therefore allowing your pelvis to have more flexibility at your hip joints. In addition, because you’re resting your arms and head on a chair or desk and you’re not hanging in space, your lower back muscles can release more completely and relax more deeply. (Some of the seated forward bends with straight legs can aggravate lower back pain or disc problems because they pull so strongly on your back muscles and encourage the discs to move toward a posterior position, and you can sometimes over-strain your ligaments when you overdo.)
This forward bend can provide you a quiet moment in your busy day, and allows you to access the deep rest of conscious relaxation without lying on the floor, especially if you focus on your breath while you are in the pose. In addition, folding forward creates a feeling of safety and comfort for many people. And supporting your head enhances the soothing quality of the forward bend, so the Chair Forward Bend may even have a quieting effect on your mind and your emotions, cooling negative emotions such as anger and anxiety.
Wednesday, August 22, 2012
Why You Should Study Yoga Philosophy
by Nina
Baxter’s post yesterday (see Does Home Practice Make You Healthier?) was packed full of interesting tidbits, wasn’t it? But one of the most striking comments for me was this one about yoga philosophy:
Notably, frequency of philosophy study was the yoga practice variable that most often predicted health. In addition, more frequent philosophy study also contributed to a lower BMI and higher odds of being a vegetarian. And this sometimes equated to only reading philosophy once a week.
Now I’ve been saying for some time, both to students and on this blog, that I felt yoga philosophy was one of yoga’s valuable tools for cultivating equanimity (see Acceptance, Active Engagement and the Bhagavad Gita and other posts on yoga philosophy). So it was wonderful to hear that this recent study offered some evidence to back me up! And I thought today I’d say a little bit about why I think yoga philosophy is so beneficial, and also mention a few ways for you to get started with yoga philosophy, if you have not already done so.
In general I think that yoga philosophy helps us cultivate equanimity because it provides an alternative way of thinking about our lives. Every day in our society we’re bombarded with advertising that tells us that in order to be happy, we must buy more and achieve more. That’s just due to the nature of capitalism, as, of course, various companies and individuals wanting to make money need to persuade us to be unhappy with our current situation and urge us to improve ourselves by buying their products and/or services. And striving for material success also seems to be built into our culture Unfortunately, for most of us, this pressure leaves us feeling continually unhappy and stressed out, caught in an endless cycle desire and dissatisfaction. What yoga philosophy does is remind us that there is another way thinking about our lives, and provides us with a different goal we can aim for: equanimity. The following quote from the Bhagavad Gita describes the yogi who has achieved equanimity.
He who hates no light, nor busy activity, nor even darkness, when they are near, neither longs for them when they are far.
Who unperturbed by changing conditions sits apart and watches and says “the powers of nature go round”, and remains firm and shakes not.
Who dwells in his inner self, and is the same in pleasure and pain; to whom gold or stones or earth are one, and what is pleasing or displeasing leave him in peace; who is beyond both praise and blame, and whose mind is steady and quiet.
Who is the same in honor or disgrace, and has the same love for enemies or friends.
Although it is obviously a lifelong quest to achieve the state of equanimity described above, I’ve found that it is very beneficial when I notice dissatisfaction taking over, to step back and at least remind myself there is a different point of view. Then I can begin to let go. And obviously the people interviewed in the study Baxter discussed found similar benefits.
So, if I have convinced you to start exploring yoga philosophy, where should you start? The two most frequently read yoga scriptures these days are the Yoga Sutras and the Bhagavad Gita, and these books are a great place to begin. As they are very different from each other (and, indeed, their messages are very different as well), I thought I’d briefly describe them to you.
The Yoga Sutras is likely the most commonly cited scripture these days (though this probably was not true in the past). Composed in 150-200 C.E. by Patanjali, who may or may not have been a single person, the Yoga Sutras is a short, concise work of aphorisms. It is very intellectual and abstract as opposed to Bhagavad Gita, and while some people find it too dry and abstract. I myself find it a brilliant work on psychology and the nature of the mind. The Yoga Sutras is often considered by some to be the climax of a long development of yogic technology, and Patanjali’s school has come to be considered the authoritative system of the yoga tradition referred to as “classical yoga.”
There are many different translations, some with detailed commentaries, others with little or no explanation. I suggest you peruse several different versions to find the best one for you to start with. Being something of a nerd on the topic, I find myself using several different translations on a regular basis, including:
Light on the Yoga Sutras by BKS Iyengar, with Iyengar’s commentary
Barbara Stoler Miller’s translation
The Yoga Sutras of Patanjali by Edwin F. Bryant
Desikachar’s very loose translation in The Heart of Yoga
Georg Fuerstein’s very literal translation in The Yoga Tradition
The Bhagavad Gita is one section of a much longer work, the dramatic epic poem the Mahabharata, written in approximately 500 to 400 BCE. The Gita tells the story of Arjuna, the most distinguished warrior in the Pandava army, as he stops and surveys his adversaries in the Kavara army. The Kavaras are power-hungry corrupt rulers who had usurped the throne. The peace-leaving Pandavas, on the other hand, have the welfare to the people at heart. So this is considered a moral war. Arjuna sees among the opposing forces many with whom the Pandavas have no quarrel, including highly esteemed teachers and elders. He tells Krishna, his charioteer and great friend, he is determined not to fight. His scruples center on the imagined personal consequences of his fighting: his guilt for the decimation of his people. Krishna speaks with him about yoga—the Gita is their dialogue—until he is once more resolved to fight. Some people Krishna’s advice to Arjuna to go into battle disturbing, but Mohandas K. Ghandi, who called the Gita his “mother,” considered the war to be a metaphor for the battle within our souls.
As with the Yoga Sutras, there are many different translations of the Bhagavad Gita, and I recommend that you search for a translation that speaks to you. Translation can make such a difference; I’ve seen the same definition of yoga translated in these different ways:
yoga is equanimity
yoga is balance
yoga is evenness of mind
I really enjoy both the simple, very accessible translation by Stephen Mitchell as well as the more vivid and dramatic one by Juan Mascaro. And I always turn to Georg Feuerstein when I want a translation that while awkward is as close as possible to the original Sanskrit.
Although these two scriptures are just the tip of the yoga philosophy iceberg, I promise you that these two very different books are rich with insights, and you can read them over and over. And I assure you that if you find just one helpful message or concept, it will be worth your time and effort. If reading these works by yourself is too daunting, consider finding a friend or two to read and discuss the books with (I did that for many years with one of my dearest long-time yoga friends).
Baxter’s post yesterday (see Does Home Practice Make You Healthier?) was packed full of interesting tidbits, wasn’t it? But one of the most striking comments for me was this one about yoga philosophy:
Notably, frequency of philosophy study was the yoga practice variable that most often predicted health. In addition, more frequent philosophy study also contributed to a lower BMI and higher odds of being a vegetarian. And this sometimes equated to only reading philosophy once a week.
Now I’ve been saying for some time, both to students and on this blog, that I felt yoga philosophy was one of yoga’s valuable tools for cultivating equanimity (see Acceptance, Active Engagement and the Bhagavad Gita and other posts on yoga philosophy). So it was wonderful to hear that this recent study offered some evidence to back me up! And I thought today I’d say a little bit about why I think yoga philosophy is so beneficial, and also mention a few ways for you to get started with yoga philosophy, if you have not already done so.
In general I think that yoga philosophy helps us cultivate equanimity because it provides an alternative way of thinking about our lives. Every day in our society we’re bombarded with advertising that tells us that in order to be happy, we must buy more and achieve more. That’s just due to the nature of capitalism, as, of course, various companies and individuals wanting to make money need to persuade us to be unhappy with our current situation and urge us to improve ourselves by buying their products and/or services. And striving for material success also seems to be built into our culture Unfortunately, for most of us, this pressure leaves us feeling continually unhappy and stressed out, caught in an endless cycle desire and dissatisfaction. What yoga philosophy does is remind us that there is another way thinking about our lives, and provides us with a different goal we can aim for: equanimity. The following quote from the Bhagavad Gita describes the yogi who has achieved equanimity.
He who hates no light, nor busy activity, nor even darkness, when they are near, neither longs for them when they are far.
Who unperturbed by changing conditions sits apart and watches and says “the powers of nature go round”, and remains firm and shakes not.
Who dwells in his inner self, and is the same in pleasure and pain; to whom gold or stones or earth are one, and what is pleasing or displeasing leave him in peace; who is beyond both praise and blame, and whose mind is steady and quiet.
Who is the same in honor or disgrace, and has the same love for enemies or friends.
Although it is obviously a lifelong quest to achieve the state of equanimity described above, I’ve found that it is very beneficial when I notice dissatisfaction taking over, to step back and at least remind myself there is a different point of view. Then I can begin to let go. And obviously the people interviewed in the study Baxter discussed found similar benefits.
 |
| Arctic Sun by Michele Macartney-Filgate |
The Yoga Sutras is likely the most commonly cited scripture these days (though this probably was not true in the past). Composed in 150-200 C.E. by Patanjali, who may or may not have been a single person, the Yoga Sutras is a short, concise work of aphorisms. It is very intellectual and abstract as opposed to Bhagavad Gita, and while some people find it too dry and abstract. I myself find it a brilliant work on psychology and the nature of the mind. The Yoga Sutras is often considered by some to be the climax of a long development of yogic technology, and Patanjali’s school has come to be considered the authoritative system of the yoga tradition referred to as “classical yoga.”
There are many different translations, some with detailed commentaries, others with little or no explanation. I suggest you peruse several different versions to find the best one for you to start with. Being something of a nerd on the topic, I find myself using several different translations on a regular basis, including:
Light on the Yoga Sutras by BKS Iyengar, with Iyengar’s commentary
Barbara Stoler Miller’s translation
The Yoga Sutras of Patanjali by Edwin F. Bryant
Desikachar’s very loose translation in The Heart of Yoga
Georg Fuerstein’s very literal translation in The Yoga Tradition
The Bhagavad Gita is one section of a much longer work, the dramatic epic poem the Mahabharata, written in approximately 500 to 400 BCE. The Gita tells the story of Arjuna, the most distinguished warrior in the Pandava army, as he stops and surveys his adversaries in the Kavara army. The Kavaras are power-hungry corrupt rulers who had usurped the throne. The peace-leaving Pandavas, on the other hand, have the welfare to the people at heart. So this is considered a moral war. Arjuna sees among the opposing forces many with whom the Pandavas have no quarrel, including highly esteemed teachers and elders. He tells Krishna, his charioteer and great friend, he is determined not to fight. His scruples center on the imagined personal consequences of his fighting: his guilt for the decimation of his people. Krishna speaks with him about yoga—the Gita is their dialogue—until he is once more resolved to fight. Some people Krishna’s advice to Arjuna to go into battle disturbing, but Mohandas K. Ghandi, who called the Gita his “mother,” considered the war to be a metaphor for the battle within our souls.
As with the Yoga Sutras, there are many different translations of the Bhagavad Gita, and I recommend that you search for a translation that speaks to you. Translation can make such a difference; I’ve seen the same definition of yoga translated in these different ways:
yoga is equanimity
yoga is balance
yoga is evenness of mind
I really enjoy both the simple, very accessible translation by Stephen Mitchell as well as the more vivid and dramatic one by Juan Mascaro. And I always turn to Georg Feuerstein when I want a translation that while awkward is as close as possible to the original Sanskrit.
Although these two scriptures are just the tip of the yoga philosophy iceberg, I promise you that these two very different books are rich with insights, and you can read them over and over. And I assure you that if you find just one helpful message or concept, it will be worth your time and effort. If reading these works by yourself is too daunting, consider finding a friend or two to read and discuss the books with (I did that for many years with one of my dearest long-time yoga friends).
Tuesday, August 21, 2012
Does Home Yoga Practice Make You Healthier?
by Baxter
Over the years, as I have worked with individuals on a variety of health issues using yoga as a therapeutic tool, I have observed that those who do a regular home practice (usually two to four times a week) have more dramatic and sustained improvement in their health. There are always other factors that come into play, but in general, if they do their work regularly, they feel better and function better over time. This has been especially true for the students who have chronic pain conditions. But can what I have observed informally be applied more broadly to our general population of yoga practitioners? And what if you are generally healthy? Does yoga give you an advantage over other things? Well, a new study seems to say yes to that and a few other propositions about yoga’s benefits.
In a recent study entitled “Frequency of Yoga Practice Predicts Health: Results of a National Survey of Yoga Practitioners,”the authors out of the University of Maryland School of Nursing and the National Institutes of Health Clinical Center looked at the positive health benefits of yoga, not simply the therapeutic benefits of yoga for those with illness and injury. Their stated purpose was to examine the relationship between yoga practice and health by evaluating such things as subjective well-being, diet, BMI, smoking, alcohol/caffeine consumption, sleep, fatigue, social support, mindfulness, and physical activity. They chose the tool of a survey, administered to practitioners of a specific style of yoga with a strict standardization of teaching that would likely contribute to consistent instruction, Iyengar Yoga, which could lead to a more valid set of results. Out of a pool of over 18,000 potential students at fifteen Iyengar schools in the US, they sent out a cross-sectional, anonymous internet survey to 4307 randomly selected students. They received back 1045 (24.3%) surveys completed and ready for analysis.
When they evaluated their data, they found that home practice had the greatest predictive positive effect on health. Frequency of home practice favorably predicted the following: mindfulness, subjective well-being, BMI, fruit and vegetable consumption, vegetarian status, sleep, and fatigue. They also found that the different components of yoga practice also had some influence: “Each component of yoga practice (different categories of physical poses, breath work, meditation, philosophy study) predicted at least 1 health outcome.”
Finally, they concluded, “Home practice of yoga predicted health better than years of practice or class frequency. Different physical poses and yoga techniques may have unique health benefits.” This so wonderfully echoed something I probably say once a week in class: “I love that you come to yoga class once a week with me, but if you want to get the real benefits of yoga, you need to practice on your own a few times a week.” And, of course, Patanjali in the Yoga Sutra says the same thing when he states that you will achieve your goals when you practice regularly over a long period of time!
To recap what the authors were looking at, I quote their study once again:
“The objective of this study is to better understand the interrelationship between yoga practice and health. Specifically, the study addressed the contributions of yoga practice in general (years of practice, classes per month, and/or days per month of home practice) and practice of specific components of yoga practice (physical poses, breath work, meditation, and/or philosophy study) to these aspects of health. It is important to study the unique contributions of the individual components of yoga practice because some aspects of yoga practice may be more effective than others in improving specific health outcomes such as body weight, sleep, and mental health.”
I couldn’t agree more! As I work with individuals, I am always considering which component practices would best serve the unique circumstances an individual is working with in designing a home practice for them.
When reading the fine print, a few notable specific observations popped out at me, specifically related to the study of yoga philosophy. Notably, frequency of philosophy study was the yoga practice variable that most often predicted health. In addition, more frequent philosophy study also contributed to a lower BMI and higher odds of being a vegetarian. And this sometimes equated to only reading philosophy once a week.
When they looked at categories of poses, “vigorous poses remained an independent predictor of BMI and sleep quality, for every additional day per week of vigorous pose practice, BMI decreased .21 of a point, and sleep disturbance improved .26 of a point.” And doing gentle poses more often correlated to a greater chance of eating vegetarian diet and drinking less alcohol. In regards to fatigue, it seemed that for older practitioners, even a small amount of yoga had a positive effect on fatigue levels and sleep disturbances.
And since so many of us are concerned about eating in a healthy way as we age, “more frequent practice of gentle poses, including supine restorative poses and relaxation pose (Savasana), were associated with three aspects of health that deal with feeding behaviors or cravings: higher fruit and vegetable consumption, higher rates of vegetarianism, and lower alcohol consumption.”
When the question of how does yoga achieve these impressive results, the authors mention a theory on how yoga decreases stress: “It has been postulated that yoga impacts the Hypothalamic-Pituitary-Adrenal (HPA) axis and the Sympathetic Nervous System (SNS) response to stress, possibly via direct vagal stimulation.” In other words, yoga may have some impact on the endocrine and autonomic nervous systems that results in lowered stress reactions in the body. We have alluded to this mechanism of action in past blog posts, and although this study does not look at the biochemistry of those surveyed, this theory still seems plausible as an underlying explanation for yoga’s benefits.
I need to go back to the philosophy findings. The authors go on to note that all those who had regular philosophy study were also practicing a lot of yoga in general. They concluded,” Thus, any relationship between philosophy study and health may reflect the relationship of frequency and intensity of yoga practice to health. This provides more evidence that an intense practice involving all aspects of yoga practice may be more beneficial to health than a less intense practice that includes only one or two aspects of yoga practice, such as just practicing the physical poses or breath work.” Darn! I can’t just sit around and read about yoga and expect good health! But we all kind of know that already from our personal experience, don’t we?
So, does yoga lead to good health? Well, this study does not actually prove this. It infers that may be the case, but it does not conclude that yoga causes good health. It may seem like semantics, but it simply means more work needs to be done to show causality between practicing yoga and good health.
Like all studies, there were some blind spots. Some of the limitations of the study included: studying only to Iyengar yoga practitioners in the USA; anonymous online surveys have the potential for lots of inaccurate data; the response rate of 27% was low; most of the subjects were predominantly white, female, and highly educated, so diversity was not represented; and this kind of study allows one to draw inferences, but do not allow one to conclude that yoga actually impacts health.
Despite these limitations, yoga still looks like a good bet to help improve your overall health. It seems you don’t necessarily need to practice for years to get benefits, but the more you incorporate it into your daily life, the more likely you are to see the predicted positives come true for you.
Over the years, as I have worked with individuals on a variety of health issues using yoga as a therapeutic tool, I have observed that those who do a regular home practice (usually two to four times a week) have more dramatic and sustained improvement in their health. There are always other factors that come into play, but in general, if they do their work regularly, they feel better and function better over time. This has been especially true for the students who have chronic pain conditions. But can what I have observed informally be applied more broadly to our general population of yoga practitioners? And what if you are generally healthy? Does yoga give you an advantage over other things? Well, a new study seems to say yes to that and a few other propositions about yoga’s benefits.
In a recent study entitled “Frequency of Yoga Practice Predicts Health: Results of a National Survey of Yoga Practitioners,”the authors out of the University of Maryland School of Nursing and the National Institutes of Health Clinical Center looked at the positive health benefits of yoga, not simply the therapeutic benefits of yoga for those with illness and injury. Their stated purpose was to examine the relationship between yoga practice and health by evaluating such things as subjective well-being, diet, BMI, smoking, alcohol/caffeine consumption, sleep, fatigue, social support, mindfulness, and physical activity. They chose the tool of a survey, administered to practitioners of a specific style of yoga with a strict standardization of teaching that would likely contribute to consistent instruction, Iyengar Yoga, which could lead to a more valid set of results. Out of a pool of over 18,000 potential students at fifteen Iyengar schools in the US, they sent out a cross-sectional, anonymous internet survey to 4307 randomly selected students. They received back 1045 (24.3%) surveys completed and ready for analysis.
 |
| Backyard Wild Flowers by Brad Gibson |
Finally, they concluded, “Home practice of yoga predicted health better than years of practice or class frequency. Different physical poses and yoga techniques may have unique health benefits.” This so wonderfully echoed something I probably say once a week in class: “I love that you come to yoga class once a week with me, but if you want to get the real benefits of yoga, you need to practice on your own a few times a week.” And, of course, Patanjali in the Yoga Sutra says the same thing when he states that you will achieve your goals when you practice regularly over a long period of time!
To recap what the authors were looking at, I quote their study once again:
“The objective of this study is to better understand the interrelationship between yoga practice and health. Specifically, the study addressed the contributions of yoga practice in general (years of practice, classes per month, and/or days per month of home practice) and practice of specific components of yoga practice (physical poses, breath work, meditation, and/or philosophy study) to these aspects of health. It is important to study the unique contributions of the individual components of yoga practice because some aspects of yoga practice may be more effective than others in improving specific health outcomes such as body weight, sleep, and mental health.”
I couldn’t agree more! As I work with individuals, I am always considering which component practices would best serve the unique circumstances an individual is working with in designing a home practice for them.
When reading the fine print, a few notable specific observations popped out at me, specifically related to the study of yoga philosophy. Notably, frequency of philosophy study was the yoga practice variable that most often predicted health. In addition, more frequent philosophy study also contributed to a lower BMI and higher odds of being a vegetarian. And this sometimes equated to only reading philosophy once a week.
When they looked at categories of poses, “vigorous poses remained an independent predictor of BMI and sleep quality, for every additional day per week of vigorous pose practice, BMI decreased .21 of a point, and sleep disturbance improved .26 of a point.” And doing gentle poses more often correlated to a greater chance of eating vegetarian diet and drinking less alcohol. In regards to fatigue, it seemed that for older practitioners, even a small amount of yoga had a positive effect on fatigue levels and sleep disturbances.
And since so many of us are concerned about eating in a healthy way as we age, “more frequent practice of gentle poses, including supine restorative poses and relaxation pose (Savasana), were associated with three aspects of health that deal with feeding behaviors or cravings: higher fruit and vegetable consumption, higher rates of vegetarianism, and lower alcohol consumption.”
When the question of how does yoga achieve these impressive results, the authors mention a theory on how yoga decreases stress: “It has been postulated that yoga impacts the Hypothalamic-Pituitary-Adrenal (HPA) axis and the Sympathetic Nervous System (SNS) response to stress, possibly via direct vagal stimulation.” In other words, yoga may have some impact on the endocrine and autonomic nervous systems that results in lowered stress reactions in the body. We have alluded to this mechanism of action in past blog posts, and although this study does not look at the biochemistry of those surveyed, this theory still seems plausible as an underlying explanation for yoga’s benefits.
I need to go back to the philosophy findings. The authors go on to note that all those who had regular philosophy study were also practicing a lot of yoga in general. They concluded,” Thus, any relationship between philosophy study and health may reflect the relationship of frequency and intensity of yoga practice to health. This provides more evidence that an intense practice involving all aspects of yoga practice may be more beneficial to health than a less intense practice that includes only one or two aspects of yoga practice, such as just practicing the physical poses or breath work.” Darn! I can’t just sit around and read about yoga and expect good health! But we all kind of know that already from our personal experience, don’t we?
So, does yoga lead to good health? Well, this study does not actually prove this. It infers that may be the case, but it does not conclude that yoga causes good health. It may seem like semantics, but it simply means more work needs to be done to show causality between practicing yoga and good health.
Like all studies, there were some blind spots. Some of the limitations of the study included: studying only to Iyengar yoga practitioners in the USA; anonymous online surveys have the potential for lots of inaccurate data; the response rate of 27% was low; most of the subjects were predominantly white, female, and highly educated, so diversity was not represented; and this kind of study allows one to draw inferences, but do not allow one to conclude that yoga actually impacts health.
Despite these limitations, yoga still looks like a good bet to help improve your overall health. It seems you don’t necessarily need to practice for years to get benefits, but the more you incorporate it into your daily life, the more likely you are to see the predicted positives come true for you.
Monday, August 20, 2012
Balance and Safety
by Shari
A lot of my students tell me that they have balance issues and want to improve their balance with yoga practice. There is no unifying factor on why these students have balance issues. Some are due to injuries with surgical repairs (ankle fractures or other bone fractures, joint replacements of the hips or knees, spinal surgeries). Some are due to soft tissue injuries of muscle, tendons or ligaments. Some are due to brain injuries, such as strokes, multiple sclerosis, or Parkinsons Disease. Some are due to coordination issues, visual issues, inner ear issues. Some are part of medication side effects. I think you are getting the picture. So how does the yoga student and teacher address their own or their student’s balance issues?
I don’t specifically ask people if they have balance issues but instead I observe how they are in class. Then I am very free with using the wall as my favorite prop! I LOVE THE WALL! I can face it with the front of my body, I can have it behind me or I can be perpendicular to it. It depends on what I am working on at that particular time and the needs of my students. If there is a “yoga horse” in the place that you practice then it can be an even better love affair! I use the wall to allow me not to be afraid. Fear of falling can occur in all ages of students. Falling when you are younger is a lot less injurious than when you are in your 50’s and 60’s. Young bones “bounce” but older bones shatter. There are many reasons for this but the simplest can be attributed to osteoporosis and how we fall. Certain body parts are more prone to breaking than others and the surfaces that we fall on also contribute to fracture risks.
The other unfortunate thing is that as we age we are less efficient in making new bone through the “remodeling process.” Bone is living tissue and it is constantly being formed and remodeled throughout our lifetime but like all parts of aging things get less efficient and slower (sigh). So falling in yoga class or during practice is not good for anyone’s health or confidence. For standing poses for some students, I may use a combination of the wall and a chair, having them use both to assist in their balance as they are learning poses and then later on for them to increase their endurance when holding a pose. I think of blocks more as making poses accessible but not as a tool to safeguard from falling because they are too small and unstable themselves. If I have someone in class who is very unsteady I might place them in a corner so they have three points of stability (feet, side and then with a chair).
You may remember from a previous post Nina and I did way back when she interviewed me on balance (see Aging and Balance), we talked about balance receptors being found in hands and feet in large number. Being barefoot in class is really an important component of balance, and whenever possible I encourage my students to be barefoot if possible. Sometimes usage of a sticky mat isn’t as optimal as not using one (it may be easier to balance directly on the floor), so you have to decide what works best for you. Learning how to feel the intrinsic muscles in your feet (which Baxter has been so eloquent on in his recent posts on feet) and hands WILL affect balance in standing poses and some inversions.
Also, remembering to use your eyes in yoga class is also going to affect your balance (again see Aging and Balance about vestibular reflexes). Focusing on a fixed object as you move into and out of one-legged poses helps with stability. Keeping your head in neutral and not compressing your upper cervical spine into hyperextension (thrusting your chin forward) will also improve your balance (there are balance receptors at the base of your skull).
Other factors that affects our balance and safety are our individual levels of flexibility, strength and endurance. Being able to access a pose requires a certain degree of flexibility as well as alignment. When we try to do poses we aren’t ready for, we almost certainly will fall (think Headstand, arm balances, and Shoulderstands). These are truly advanced poses and take years to safely prepare to do them. Fatigue and endurance are factors in balance because we are unable to access the required muscular strength to perform an asana when we fatigue.
Lastly anticipation is also a factor in how balanced you are. The mental mindset “I always fall in Ardha Chandrasana when I do it on my left” pre-programs those pesky neural circuits into anticipating that you are going to fall so they aren’t going to be able to prevent it. Now I am not saying to disregard past experience or history it just that always doing the pose so that you fall isn’t a way to learn how NOT to fall in it. Learning to sense your balance changes within a safe context is extremely important as we try to improve our balance.
Balance like strength and flexibility is not static but improves with practice and time. I have a current student with me who began yoga because his wife told him to. He is a retired physician and told me when he started that he had cerebellar problems and couldn’t balance. Well he was correct the first year. He is now going on his second year with me and is now starting to do Ardha Chandrasana with just one foot at the wall. He can also now balance on each foot when he does tree pose (not very long but the time isn’t the issue but that he is starting to be able to do it). When I recently mentioned to him that his balance is improving he agreed and said, “I didn’t think it ever would and I am as surprised as you by it.”
I am truly humbled by the body’s ability to transform. That's one of the things that gets me onto my mat daily!
A lot of my students tell me that they have balance issues and want to improve their balance with yoga practice. There is no unifying factor on why these students have balance issues. Some are due to injuries with surgical repairs (ankle fractures or other bone fractures, joint replacements of the hips or knees, spinal surgeries). Some are due to soft tissue injuries of muscle, tendons or ligaments. Some are due to brain injuries, such as strokes, multiple sclerosis, or Parkinsons Disease. Some are due to coordination issues, visual issues, inner ear issues. Some are part of medication side effects. I think you are getting the picture. So how does the yoga student and teacher address their own or their student’s balance issues?
I don’t specifically ask people if they have balance issues but instead I observe how they are in class. Then I am very free with using the wall as my favorite prop! I LOVE THE WALL! I can face it with the front of my body, I can have it behind me or I can be perpendicular to it. It depends on what I am working on at that particular time and the needs of my students. If there is a “yoga horse” in the place that you practice then it can be an even better love affair! I use the wall to allow me not to be afraid. Fear of falling can occur in all ages of students. Falling when you are younger is a lot less injurious than when you are in your 50’s and 60’s. Young bones “bounce” but older bones shatter. There are many reasons for this but the simplest can be attributed to osteoporosis and how we fall. Certain body parts are more prone to breaking than others and the surfaces that we fall on also contribute to fracture risks.
 |
| Bones of the Right Leg |
You may remember from a previous post Nina and I did way back when she interviewed me on balance (see Aging and Balance), we talked about balance receptors being found in hands and feet in large number. Being barefoot in class is really an important component of balance, and whenever possible I encourage my students to be barefoot if possible. Sometimes usage of a sticky mat isn’t as optimal as not using one (it may be easier to balance directly on the floor), so you have to decide what works best for you. Learning how to feel the intrinsic muscles in your feet (which Baxter has been so eloquent on in his recent posts on feet) and hands WILL affect balance in standing poses and some inversions.
Also, remembering to use your eyes in yoga class is also going to affect your balance (again see Aging and Balance about vestibular reflexes). Focusing on a fixed object as you move into and out of one-legged poses helps with stability. Keeping your head in neutral and not compressing your upper cervical spine into hyperextension (thrusting your chin forward) will also improve your balance (there are balance receptors at the base of your skull).
Other factors that affects our balance and safety are our individual levels of flexibility, strength and endurance. Being able to access a pose requires a certain degree of flexibility as well as alignment. When we try to do poses we aren’t ready for, we almost certainly will fall (think Headstand, arm balances, and Shoulderstands). These are truly advanced poses and take years to safely prepare to do them. Fatigue and endurance are factors in balance because we are unable to access the required muscular strength to perform an asana when we fatigue.
Lastly anticipation is also a factor in how balanced you are. The mental mindset “I always fall in Ardha Chandrasana when I do it on my left” pre-programs those pesky neural circuits into anticipating that you are going to fall so they aren’t going to be able to prevent it. Now I am not saying to disregard past experience or history it just that always doing the pose so that you fall isn’t a way to learn how NOT to fall in it. Learning to sense your balance changes within a safe context is extremely important as we try to improve our balance.
Balance like strength and flexibility is not static but improves with practice and time. I have a current student with me who began yoga because his wife told him to. He is a retired physician and told me when he started that he had cerebellar problems and couldn’t balance. Well he was correct the first year. He is now going on his second year with me and is now starting to do Ardha Chandrasana with just one foot at the wall. He can also now balance on each foot when he does tree pose (not very long but the time isn’t the issue but that he is starting to be able to do it). When I recently mentioned to him that his balance is improving he agreed and said, “I didn’t think it ever would and I am as surprised as you by it.”
I am truly humbled by the body’s ability to transform. That's one of the things that gets me onto my mat daily!
Friday, August 17, 2012
Friday Q&A: Plantar Fascitis
Q: I have a question about flat feet and Morton's toe. I'm a 57 YO man who walks a lot and I have both. I always have difficulty balancing on one foot—tree, eagle pose, etc., and have recently had a bout with Plantar Fasciitis showing up in my left heel. No fun. I was at a yoga class yesterday and some poses felt good, others hurt. When I left the class, I literally limped home and iced it for 1/2 hr. then heat, then rest. I had acupuncture at Quan Yin this morning for it and bought new, sturdy shoes and heel pads. It feels a little better today. Can you suggest any asana or other treatment I can do at home that may help speed the healing process and prevent future trouble?
A: If you can remember way back to three weeks ago to our question of the week, (above) our reader had shared that he had a triple whammy going on in his feet: flat feet (see Flat Feet), Morton’s neuroma (see Morton's Neuroma) AND Plantar Fascitis! We have addressed the first two topics already, and now we now ready to look at what is commonly referred to as heel spurs. This is a bit of a misnomer, as only sometimes does an X-ray of the feet show spurring off the calcaneus bone, a bony deposit of calcium growing forward along the plantar fascia. We’ll come back to this and clarify what these things are in just a moment.
The plantar fascia is a sheet of connective tissue that stretches from the heel bone, the calcaneus, forward along the sole of the foot to the base of the toes. It assists the ligaments and the muscles of the foot in maintaining tension across the bottom of the foot to help maintain the arches of the feet. As connective tissue, it has strength, but does not stretch much before running the risk of tearing or becoming inflamed. And, unlike muscles, it does not contract and create active movement in the foot.
Plantar fascitis (PF) is inflammation of this thick tissue on the bottom of the foot. It almost always occurs where the tissue arises from the heel bone. There are many possible factors that contribute to its development but basically it occurs when the thick band of tissue on the bottom of the foot is overstretched or overused. This can be painful and make walking more difficult. In fact, no one goes to the doctor with this condition unless their foot is giving them pain! According to the NIH, you are more likely to get plantar fascitis if you have (or do) any of the following:
The diagnosis of PF is usually made based on your history and physical exam. There is usually a complaint of stiffness and pain on the sole of the foot near the heel. It is usually dull or sharp, worse on the first few steps in the morning, better with continued movement if is not super flared, and recurs if you have been sitting for a while and get up and walk again. It can also occur if you are standing for a while or climbing stairs, or after intense activity. One of my students whose PF is improving, notices some lingering pain when the affected foot is the back foot in Warrior 1 pose. We are modifying it for now by using a wedge under that heel in that pose to eliminate the pain. The pain associated with PF can develop slowly over time, or suddenly after intense activities. During your physical exam, the doctor will press on the sole of the foot, especially near the heel bone, and if this elicits pain, this is another piece of evidence pointing to PF. They will also note if you have flat feet or high arches, if there is any redness or swelling near the heel bone, or if any stiffness or tightness can be appreciated on the arch at the bottom of the foot. X-rays could be ordered, too.
One of the reasons students will sometimes come to me for yoga or acupuncture treatments is the long course of recovery or resolution of the symptoms of PF. It can take from two months to two years for this condition to resolve! The average is nine months, which in this day and age can feel like an eternity. And on rare occasions, the pain could persist beyond two years, and some folks opt for more invasive (can you say “surgery”?) treatment at that point. Here in the US, a typical treatment plan by your doc could include, ice, resting by not doing aggravating activities, anti-inflammatory meds, wearing an immobilizing splint at night and physical therapy stretches for the Achilles tendon and feet. Commons sense recommendations include wearing shoes that fit properly and have good arch support. In addition, heel cups for your shoes or other more sophisticated arch supports might be recommended. If things don’t improve, steroid shots and more invasive treatments might be added.
How might yoga help out? Well, in addition to what we have discussed in the last two weeks, resting poses, such as Legs up the Wall pose (Viparita Karani) and all the inversions that involve having your feet in the air could assist in resting the plantar fascia. Many of our modern poses could also assist in stretching the Achilles tendon and the feet, if done with mindfulness, so as to avoid aggravating your foot symptoms. Almost all of the standing poses could have possible benefits in this regard, and Malasana, Garland pose, which is a deep squat, could do double duty.
The opposite case could be made if the poses are aggravating the foot, in that you may need to do some creative propping to permit your practice to continue without worsening your symptoms. Doubling up your sticky matt for more cushioning can help, as can using a wedge under the ball of the front foot or heel of the back foot to minimize stretch during flared times. An example of a pose that puts a lot of pressure onto the front foot heel is Parsvottanasana (Pyramid pose). Here I would use the wedge under the ball or the front foot. As always, if you want yoga to be in the mix of your healing plan, work with a teacher with experience around PF for the greatest chance of success. We’ll leave the feet behind for now, and I look forward to your upcoming questions! Don’t be shy, ask this guy!
—Baxter
A: If you can remember way back to three weeks ago to our question of the week, (above) our reader had shared that he had a triple whammy going on in his feet: flat feet (see Flat Feet), Morton’s neuroma (see Morton's Neuroma) AND Plantar Fascitis! We have addressed the first two topics already, and now we now ready to look at what is commonly referred to as heel spurs. This is a bit of a misnomer, as only sometimes does an X-ray of the feet show spurring off the calcaneus bone, a bony deposit of calcium growing forward along the plantar fascia. We’ll come back to this and clarify what these things are in just a moment.
The plantar fascia is a sheet of connective tissue that stretches from the heel bone, the calcaneus, forward along the sole of the foot to the base of the toes. It assists the ligaments and the muscles of the foot in maintaining tension across the bottom of the foot to help maintain the arches of the feet. As connective tissue, it has strength, but does not stretch much before running the risk of tearing or becoming inflamed. And, unlike muscles, it does not contract and create active movement in the foot.
Plantar fascitis (PF) is inflammation of this thick tissue on the bottom of the foot. It almost always occurs where the tissue arises from the heel bone. There are many possible factors that contribute to its development but basically it occurs when the thick band of tissue on the bottom of the foot is overstretched or overused. This can be painful and make walking more difficult. In fact, no one goes to the doctor with this condition unless their foot is giving them pain! According to the NIH, you are more likely to get plantar fascitis if you have (or do) any of the following:
- foot arch problems, either flat feet (ding, ding) or high arches
- long-distance running, especially running downhill or on uneven surfaces (I have four students with PF and all of them are runners)
- sudden weight gain or obesity
- tight Achilles tendon (the tendon connecting the calf muscles to the heel)
- shoes with poor arch support or soft soles
The diagnosis of PF is usually made based on your history and physical exam. There is usually a complaint of stiffness and pain on the sole of the foot near the heel. It is usually dull or sharp, worse on the first few steps in the morning, better with continued movement if is not super flared, and recurs if you have been sitting for a while and get up and walk again. It can also occur if you are standing for a while or climbing stairs, or after intense activity. One of my students whose PF is improving, notices some lingering pain when the affected foot is the back foot in Warrior 1 pose. We are modifying it for now by using a wedge under that heel in that pose to eliminate the pain. The pain associated with PF can develop slowly over time, or suddenly after intense activities. During your physical exam, the doctor will press on the sole of the foot, especially near the heel bone, and if this elicits pain, this is another piece of evidence pointing to PF. They will also note if you have flat feet or high arches, if there is any redness or swelling near the heel bone, or if any stiffness or tightness can be appreciated on the arch at the bottom of the foot. X-rays could be ordered, too.
One of the reasons students will sometimes come to me for yoga or acupuncture treatments is the long course of recovery or resolution of the symptoms of PF. It can take from two months to two years for this condition to resolve! The average is nine months, which in this day and age can feel like an eternity. And on rare occasions, the pain could persist beyond two years, and some folks opt for more invasive (can you say “surgery”?) treatment at that point. Here in the US, a typical treatment plan by your doc could include, ice, resting by not doing aggravating activities, anti-inflammatory meds, wearing an immobilizing splint at night and physical therapy stretches for the Achilles tendon and feet. Commons sense recommendations include wearing shoes that fit properly and have good arch support. In addition, heel cups for your shoes or other more sophisticated arch supports might be recommended. If things don’t improve, steroid shots and more invasive treatments might be added.
How might yoga help out? Well, in addition to what we have discussed in the last two weeks, resting poses, such as Legs up the Wall pose (Viparita Karani) and all the inversions that involve having your feet in the air could assist in resting the plantar fascia. Many of our modern poses could also assist in stretching the Achilles tendon and the feet, if done with mindfulness, so as to avoid aggravating your foot symptoms. Almost all of the standing poses could have possible benefits in this regard, and Malasana, Garland pose, which is a deep squat, could do double duty.
The opposite case could be made if the poses are aggravating the foot, in that you may need to do some creative propping to permit your practice to continue without worsening your symptoms. Doubling up your sticky matt for more cushioning can help, as can using a wedge under the ball of the front foot or heel of the back foot to minimize stretch during flared times. An example of a pose that puts a lot of pressure onto the front foot heel is Parsvottanasana (Pyramid pose). Here I would use the wedge under the ball or the front foot. As always, if you want yoga to be in the mix of your healing plan, work with a teacher with experience around PF for the greatest chance of success. We’ll leave the feet behind for now, and I look forward to your upcoming questions! Don’t be shy, ask this guy!
—Baxter
Thursday, August 16, 2012
Featured Pose: Seated Cat-Cow Pose
by Baxter and Nina
This deceptively simple, gentle pose from our office yoga series brings mobility to your entire spine, allowing you to move your spine in two of the six important movement directions in which your spine can move, extension (back bending) and flexion (forward bending). Mobility in the spine is important for maintaining the health of your spine, and for your entire body since your spinal cord, which communicates with your entire body, moves through your spine. Although most people don’t think of having arthritis of the spine, but it is a significant problem (see Arthritis of the Spine) and moving your spine is the best medicine for arthritis in this area. The gentle spinal movements can even help relieve back pain.
The pose also benefits your hip sockets because your sitting bones move back and forward with your spine, bringing movement into your hip sockets, which can get stiff from sitting from long periods of time. And because you move with your breath in this pose, inhaling into the backbend and exhaling into the forward bend, it’s a good way to learn breath awareness and beginning pranayama.
Accessible to everyone who can sit up, the pose is also so gentle that almost everyone, in any condition to do it. You can do it in any type of chair, even in the car! (In fact, Baxter did it just yesterday, while he was stuck in a !@#$%! traffic jam coming back to the East Bay from San Francisco.)
Baxter prescribes this pose for:
As you inhale, start moving from your pelvis, rocking your hips forward so your weight comes more onto the front edge of your sitting bones. As you continue to inhale, gently lift your spine and lengthen into gentle backbend. Lift your breastbone forward and up and allow your head and neck to lengthen out and back, coming into the Cow backbend.
As you exhale, start moving from your pelvis, dropping your pelvis in the opposite direction, moving the back of your waist backward and rocking onto the back part of your sitting bones. As you continue to exhale, allow your middle back to move back as well and drop your chin toward your chest, coming into the Cat forward bend.
Repeat both the Cow and Cat positions, moving with your breath, allowing your inhalations and exhalations to be slightly longer than they are when you are taking a resting breath. Do the pose for a minimum of six rounds up to any number that feels good to you.
Cautions: Because these are mild, everyday movements, those pose is relatively safe. However, if you have been instructed by your doctor to avoid certain movements of your spine, for example, some people who have lumbar disk problems are warned about forward bending movements being potentially dangerous, you should try smaller movements at first and see what your body can handle. The same cautions apply to people who have significant injuries to their necks.
Note from Nina: Oopsie! I just realized we already wrote up this pose in April (see Chair Cat Pose). Naturally, that write up is different if you care to compare it with the new one. I think it's time for us to move onto an entirely new set of poses....
The pose also benefits your hip sockets because your sitting bones move back and forward with your spine, bringing movement into your hip sockets, which can get stiff from sitting from long periods of time. And because you move with your breath in this pose, inhaling into the backbend and exhaling into the forward bend, it’s a good way to learn breath awareness and beginning pranayama.
Accessible to everyone who can sit up, the pose is also so gentle that almost everyone, in any condition to do it. You can do it in any type of chair, even in the car! (In fact, Baxter did it just yesterday, while he was stuck in a !@#$%! traffic jam coming back to the East Bay from San Francisco.)
Baxter prescribes this pose for:
- low back pain or stiffness
- arthritis or stiffness of the hips
- arthritis of the spine
- held tension anywhere from hips to neck
- beginner’s experience of pranayama
- general stress reliever while sitting at your desk
- warming up for office yoga or any other physical activity
Cautions: Because these are mild, everyday movements, those pose is relatively safe. However, if you have been instructed by your doctor to avoid certain movements of your spine, for example, some people who have lumbar disk problems are warned about forward bending movements being potentially dangerous, you should try smaller movements at first and see what your body can handle. The same cautions apply to people who have significant injuries to their necks.
Note from Nina: Oopsie! I just realized we already wrote up this pose in April (see Chair Cat Pose). Naturally, that write up is different if you care to compare it with the new one. I think it's time for us to move onto an entirely new set of poses....
Wednesday, August 15, 2012
Yoga Injuries — Fact or Fiction Telesummit
Yoga Injuries – Facts and Fiction Telesummit
Saturday, August 25, 2012, 12 pm to 4 pm EDT; 9 am to 1 pm PDT
“Yoga is a wonderful, powerful practice, with the potential to change lives. It's our hope that this telesummit will not just help clear up misconceptions about yoga injuries, but also afford an opportunity for you to learn more about how to make the most of your own practice. And if you’re a yoga teacher, this is a great opportunity to study with leading national teachers and gain new insights into how you can ensure that your students get the best yoga experience—no matter what level or age.”
To register for the telesummit, go to http://yogauonline.com/yogaspirit/affiliate/9433/yoga-injuries-register.
In addition to Timothy’s session entitled “Yoga As Medicine – How to Get the Most Out of Your Yoga Practice No Matter What Your Age,” there will be seven other sessions from an outstanding lineup of teachers, including Roger Cole, Ph.D., Julie Gudmestad, P.T., Dr. Loren Fishman, and Judith Lasater, Ph.D., P.T., among others.
During the summit, you’ll be able to listen in via your computer to get all this information.
Here is the lineup:
Saturday, August 25, 12 pm EDT to 4 pm EDT/9 am PDT to 1 pm PDT)
Session 1. Roger Cole, Ph.D.
Reporting or Narrative? Reflections on Yoga Injuries Facts and Fiction
Media debate on yoga injuries got you confused? Learn how to distinguish facts from fiction. In this talk, Roger Cole, an internationally recognized, Iyengar yoga teacher and a Stanford-educated scientist, takes an in-depth look at some of the more disturbing claims about yoga injuries. Roger evaluates the evidence, and clears up some of the most pervasive misinformation.
Roger Cole, Ph.D., is a certified Iyengar Yoga teacher, who has written extensively for Yoga Journal and numerous other yoga publications. Roger teaches yoga workshops internationally, and he has taught yoga as a healing art to physicians, physical therapists, and medical students. As a speaker on yoga safety to the American College of Sports Medicine, Roger was also quoted in the January 2012 New York Times article on yoga injuries.
Session 2. Dr. Timothy McCall
Yoga As Medicine – How to Get the Most Out of Your Yoga Practice No Matter What Your Age
In this informative talk, Dr. Timothy McCall, author of Yoga As Medicine, takes a closer look at just why yoga is so good for us, and explores its benefits for various types of health conditions. He discusses how to maximize the transformative potential of your yoga practice, and shares the most important factor to pay attention to in order to protect ourselves from injury.
Dr. Timothy McCall is board-certified in internal medicine, an award-winning writer, and a medical editor of Yoga Journal. Dr. McCall has studiedyoga with Patricia Walden and other leading yoga teachers since 1995. He is the author of two books including the acclaimed, Yoga as Medicine: The Yogic Prescription for Health and Healing, and has written numerous articles on the health benefits of yoga and yoga therapy.
Session 3. Ellen Saltonstall
Seven Keys to a Safe Yoga Practice
Are you working your intelligent edge in your yoga practice—or just plain pushing? In this talk, Ellen Saltonstall looks at the seven most important factors to ensure a safe yoga practice, no matter what your level of experience. She also gives an overview on the results of a survey of yoga injuries she and Dr. Loren Fishman conducted, and highlights the main conclusions from said survey.
Ellen Saltonstall has studied yoga for more than 30 years, and teaches workshops on yoga anatomy and the therapeutic applications of yoga both nationally and internationally. She is well known for her clarity and depth, and lauded for her enthusiasm in encouraging students of all levels to find their inner joy and freedom through yoga. Ellen is the co-author with Dr. Loren Fishman of Yoga for Arthritis and Yoga for Osteoporosis. She and Dr. Fishman frequently offer online courses on YogaUOnline.com.
Session 4. Julie Gudmestad, P.T.
Yoga and the American Body: It’s Not One Size Fits All
The typical American body has tight legs, tight hips, a weak back and a weak rotator cuff. Yoga can be a great way to help overcome these conditions, but if you (or your yoga students) suffer from any of them, it could also predispose to injury. In this important talk, IYengar teacher and physical therapist Julie Gudmestad shares key insights into what to look out for, and which precautions to take to avoid injury.
Julie Gudmestad, P.T. has been certified as an Iyengar Yoga teacher since 1988, and also works as a physical therapist specializing in chronic pain, sports injuries, and stress-related problems. She is a frequent presenter at Yoga Journal conferences and is best known for her "Anatomy of a Yogi" column, which was featured in Yoga Journal for seven years. In her teaching of yoga, Julie Gudmestad aims to make the healing powers of yoga accessible to people of all levels and abilities. It is her belief that yoga encourages a mindful state that can help people heal emotionally, spiritually, and physically.
Session 5. Dr. Loren Fishman
Pre-Existing Medical Condition? Yes, You Can Still Practice Yoga
Yes, you can still practice yoga if you have a pre-existing medical condition. There are no generalized contraindications, but certain yoga postures are contraindicated for certain medical conditions. In this talk, Dr. Fishman goes into what you need to ask your yoga teacher, and what your teacher should ask you, if you suffer from a pre-existing medical condition.
Dr. Loren Fishman is Medical Director of Manhattan Physical Medicine and Rehabilitation in New York City. He lived in India for a year and studied yoga with B.K.S. Iyengar and has practiced yoga since 1973. Dr. Fishman is the author of 7 books, including Yoga for Arthritis and Yoga for Osteoporosis with Ellen Saltonstall. He is recognized as a pioneer in the treatment of piriformis syndrome and rotator cuff tear, and has developed several non-surgical interventions using simple yoga postures for these conditions.
Session 6. Peggy Cappy
Yoga for People Over 50 - Practicing Yoga Safely the Rest of Your Life
You don’t need to be thin, young or a contortionist to do yoga. In this talk, Yoga for the Rest of Us, author Peggy Cappy discusses how yoga can be practiced safely by everyone, whether you are slightly out of shape, very out of shape, or recovering from an injury. Peggy emphasizaes to never underestimate the effectiveness of any modified pose, just because it looks easy.
Peggy Cappy is the creator of the PBS series “Yoga for the Rest of Us” and the founder of Gentle Stretch Yoga for seniors and for others who need a gentle and modified approach to yoga. Peggy has helpled people ages 50 and older retain or improve their energy and their flexibility in more ways than they ever dreamed possible through yoga, helping them experience greater comfort and ease in their body, mind, and spirit.
Session 7. Tias Little
Yoga as Alchemy—The Art of Teaching Yoga
Becoming an effective yoga teacher is not a simple charge, because yoga touches not just the body, but the entire body-mind, says Tias Little, co-founder of Prajna Yoga. In this talk, Tias will explore the multi-faceted challenges yoga teachers face, and will offer his views on the limitations of the current standards for yoga teacher training. What does it take to offer students the full transformative potential of yoga? How can yoga teacher grow to master the anatomical nuances of yoga postures for students of different skill levels? How can yoga teachers gain a deep, experiential understanding of the mind and all the nuances of the emotional body, as it relates to the practice of yoga asanas? Join Tias as he explores the teaching of yoga as an internal art, and offers his perspective on how yoga teachers can continue to deepen the well they draw from in their teaching.
Session 8. Judith Hanson Lasater, Ph.D., P.T.
Practicing Yoga - The Whole Picture: Practicing Yoga Won’t Hurt You, But It Might Well Save Your Life
In this inspiring talk, Judith Hanson Lasater takes a step back to look at the bigger picture: Yoga is much more than just the physical poses, although that’s often where we start. The fundamental lesson of yoga is to create a habit of self-awareness, self-listening, self-observing. And therein lies the deepest, most intangible benefits.
Judith Hanson Lasater has been a yoga teacher for more than 40 years. She holds a doctorate in East West Psychology, is a physical therapist and the author of eight books including Relax and Renew, 30 Essential Yoga Poses, Living Your Yoga, and Yoga Body: Anatomy Kinesiology, and Asana. Judith has been a leading presence in shaping how yoga is taught and credentialed in the US, and she is much loved for the depth of knowledge she embodies.
Tuesday, August 14, 2012
Diving Deeper into Prana
by Baxter
When I want to dive a little deeper into any yoga-related topic, I feel blessed to work with one of the smartest and well-studied yoga teachers in America today, Richard Rosen. Richard is the owner of the Piedmont Yoga Studio in Oakland, CA, as well as author of two books on pranayama (a word I will let him define in a moment) and a Shambhala audio series on pranayama, as well as a new book on the earliest yoga poses Original Yoga (see here to read the introduction). To experience Richard’s writing firsthand, in addition to getting one of his books, you can sign up to receive Piedmont Yoga Studio’s monthly email newsletter (see piedmontyoga.com/). He always includes a fascinating article on some aspect of yoga, which I always learn a lot from!
When I asked Richard if he had written anything specifically on prana, or energy, he immediately sent me a twelve-page word document on pranayama that contained some intriguing kernels of information about prana that I thought would complement our initial look at prana last week (see May the Prana be with You). If you read that post, you'll see that I was not too far off in my definition of prana last week if we look at how Richard frames it:
“Prana is not specifically the breath, but rather the “life force,” a subtle energy that pervades the universe and manifests, in one important way, as breath and breathing”
He mentions breathing here, because he is ultimately interested in prana’s relationship to the yogic practice of pranayama. There are a lot of definitions of pranayama floating around out there. If you take a public class, you might think it refers to simply watching or observing your breath. Or you might think it refers to one particular way of breathing, namely taking a longer in breath and out breath. If you have been a student of Pattabhi Jois’s Ashtanga yoga, you might equate pranayama to the Darth Vadar-like breath technique known as ujjayi breath. And you’d be partially correct, as all of these things are part of the branch of yoga practice known as pranayama.
But let’s step back for a moment and take a look at Richard’s definition of the word. We have his take on prana, but what about the second half of the term, ayama?
“Ayama means both “extension” and “restraint.” I think of pranayama as the conscious, intelligent cultivation and refinement of the life force through the medium of the breath.”
Because we in the west have such a love affair with yoga poses, that is, asana, we have come to equate yoga with asana. As Richard points out, “you might be surprised to learn that traditionally pranayama is considered the central practice of hatha yoga.” So if pranayama is the central practice of yoga, what kind of boon does it promise if we actually start to practice it regularly? Richard points out many documented (meaning they are mentioned in the source books on hatha yoga we have available to us) benefits that come from regular, consistent practice, done over a long time, including such things as stoking the digestive fire, appeasing thirst and hunger, opening the sinuses, curing may diseases and conditions, and purifying both the gross and subtle energy systems of the body. In addition, prana and the practice of pranayama are said to destroy illness and increase longevity. The ancient yogis were interested in this because it gave them more time to achieve their yogic goals.
Richard also points out some more benefits that we should eye with a bit of skepticism, such as making you look like you are sixteen, making you a second God of Love, and bestowing even more extraordinary mental and physical powers. For us regular “householders,” what can we realistically expect from a regular breath practice? This of course depends a bit on what you put into it! Richard states:
“It’s likely that you’ll become more aware of, and gain greater control over, your everyday breath. Why is this a benefit? It’s already well known and widely accepted that your breath and your mental states are closely related, that the former reflects and can be used, to a certain extent, to influence the latter…. With the instrument of your breath then, you can monitor and modulate you psychic “temperature” throughout the day, cooling yourself down when the mercury rises, and heating yourself up when it drops off.”
Both Richard and I have heard from students who claim their work with prana via breath has resulted in a more relaxed and energized life on and off the mat. And, finally, Richard concludes: “all this to say that your breathing will become less effortful and more efficient.” Realistically, the more efficient and responsive your respiratory system is, the better you are able to handle stress. The lower your stress levels, the more beneficial the effect of yoga on the aging process. It all seems to come full circle once again. From my vantage point, I love the fact that so many different techniques are available to us under the large umbrella of yoga to assist us as we age!
Next time we look at pranayama, I’ll share with you my favorite summer breath technique, so until then, do what you can to stay cool!
When I want to dive a little deeper into any yoga-related topic, I feel blessed to work with one of the smartest and well-studied yoga teachers in America today, Richard Rosen. Richard is the owner of the Piedmont Yoga Studio in Oakland, CA, as well as author of two books on pranayama (a word I will let him define in a moment) and a Shambhala audio series on pranayama, as well as a new book on the earliest yoga poses Original Yoga (see here to read the introduction). To experience Richard’s writing firsthand, in addition to getting one of his books, you can sign up to receive Piedmont Yoga Studio’s monthly email newsletter (see piedmontyoga.com/). He always includes a fascinating article on some aspect of yoga, which I always learn a lot from!
When I asked Richard if he had written anything specifically on prana, or energy, he immediately sent me a twelve-page word document on pranayama that contained some intriguing kernels of information about prana that I thought would complement our initial look at prana last week (see May the Prana be with You). If you read that post, you'll see that I was not too far off in my definition of prana last week if we look at how Richard frames it:
“Prana is not specifically the breath, but rather the “life force,” a subtle energy that pervades the universe and manifests, in one important way, as breath and breathing”
He mentions breathing here, because he is ultimately interested in prana’s relationship to the yogic practice of pranayama. There are a lot of definitions of pranayama floating around out there. If you take a public class, you might think it refers to simply watching or observing your breath. Or you might think it refers to one particular way of breathing, namely taking a longer in breath and out breath. If you have been a student of Pattabhi Jois’s Ashtanga yoga, you might equate pranayama to the Darth Vadar-like breath technique known as ujjayi breath. And you’d be partially correct, as all of these things are part of the branch of yoga practice known as pranayama.
 |
| View from First Bridge by Brad Gibson |
“Ayama means both “extension” and “restraint.” I think of pranayama as the conscious, intelligent cultivation and refinement of the life force through the medium of the breath.”
Because we in the west have such a love affair with yoga poses, that is, asana, we have come to equate yoga with asana. As Richard points out, “you might be surprised to learn that traditionally pranayama is considered the central practice of hatha yoga.” So if pranayama is the central practice of yoga, what kind of boon does it promise if we actually start to practice it regularly? Richard points out many documented (meaning they are mentioned in the source books on hatha yoga we have available to us) benefits that come from regular, consistent practice, done over a long time, including such things as stoking the digestive fire, appeasing thirst and hunger, opening the sinuses, curing may diseases and conditions, and purifying both the gross and subtle energy systems of the body. In addition, prana and the practice of pranayama are said to destroy illness and increase longevity. The ancient yogis were interested in this because it gave them more time to achieve their yogic goals.
Richard also points out some more benefits that we should eye with a bit of skepticism, such as making you look like you are sixteen, making you a second God of Love, and bestowing even more extraordinary mental and physical powers. For us regular “householders,” what can we realistically expect from a regular breath practice? This of course depends a bit on what you put into it! Richard states:
“It’s likely that you’ll become more aware of, and gain greater control over, your everyday breath. Why is this a benefit? It’s already well known and widely accepted that your breath and your mental states are closely related, that the former reflects and can be used, to a certain extent, to influence the latter…. With the instrument of your breath then, you can monitor and modulate you psychic “temperature” throughout the day, cooling yourself down when the mercury rises, and heating yourself up when it drops off.”
Both Richard and I have heard from students who claim their work with prana via breath has resulted in a more relaxed and energized life on and off the mat. And, finally, Richard concludes: “all this to say that your breathing will become less effortful and more efficient.” Realistically, the more efficient and responsive your respiratory system is, the better you are able to handle stress. The lower your stress levels, the more beneficial the effect of yoga on the aging process. It all seems to come full circle once again. From my vantage point, I love the fact that so many different techniques are available to us under the large umbrella of yoga to assist us as we age!
Next time we look at pranayama, I’ll share with you my favorite summer breath technique, so until then, do what you can to stay cool!
Monday, August 13, 2012
Frequently Asked Questions: Yoga and Aging
by Nina And Baxter
Recently Baxter and I helped Brad prep for an interview with More Magazine (we'll let you know when it comes out) about yoga and aging. The interviewer sent Brad a few very general questions, the kind that people who know little or nothing about yoga frequently ask. I thought you might be interested to hear our answers.
Q: How is yoga good for aging bodies?
A: The physical postures help improve the following:
The National Institutes of Health has sponsored several studies on the yoga and age-related conditions, including arthritis and osteoporosis as well as on cancer-related issues that point to definite benefits for influencing the aging process.
Finally, and perhaps most importantly, yoga’s mindfulness practices and philosophy help you develop equanimity, enabling you to face life’s vicissitudes with grace and composure.
Q: Since we are all aging all the time, how can we define specifically when yoga is beneficial for aging bodies and minds?
A: It is never too early to start reducing stress and improving your physical health, so whatever age you are today is the right age to begin.
It is also never too late to start. At any age, in any condition, there is always something you can do, whether it is poses in some form or another, breath practices, meditation, and/or cultivating equanimity through yoga philosophy.
Q: Are there specific poses or aspects of yoga that are beneficial for aging?
A: Very briefly:
A: No more than other activities that have a physical component! But it is important to look for a well-trained teacher, preferably someone who has undergone months if not years of training and who has some knowledge of anatomy, who can help you adapt the practice to your particular body and concerns.
It is also important to listen to your body. If a pose causes pain (rather than just a stretching sensation), you should always back off, regardless of what the rest of your class might be doing.
As Baxter says, “Yoga is a system designed to optimize our lives, regardless of how old we are.”
Recently Baxter and I helped Brad prep for an interview with More Magazine (we'll let you know when it comes out) about yoga and aging. The interviewer sent Brad a few very general questions, the kind that people who know little or nothing about yoga frequently ask. I thought you might be interested to hear our answers.
 |
| Latch on Weathered Door by Nina Zolotow |
A: The physical postures help improve the following:
- strength
- balance
- flexibility
- agility
- circulation
- heart disease
- hypertension (high blood pressure)
- insomnia and/or fatigue
- digestive disorders
- headaches
- chronic anxiety or depression
- weakened immune system
The National Institutes of Health has sponsored several studies on the yoga and age-related conditions, including arthritis and osteoporosis as well as on cancer-related issues that point to definite benefits for influencing the aging process.
Finally, and perhaps most importantly, yoga’s mindfulness practices and philosophy help you develop equanimity, enabling you to face life’s vicissitudes with grace and composure.
Q: Since we are all aging all the time, how can we define specifically when yoga is beneficial for aging bodies and minds?
A: It is never too early to start reducing stress and improving your physical health, so whatever age you are today is the right age to begin.
It is also never too late to start. At any age, in any condition, there is always something you can do, whether it is poses in some form or another, breath practices, meditation, and/or cultivating equanimity through yoga philosophy.
Q: Are there specific poses or aspects of yoga that are beneficial for aging?
A: Very briefly:
- Stress management techniques, including meditation, breath practices, and relaxation poses and methods.
- Standing poses for strength, balance, flexibility, and agility—all in one package! But all poses have their benefits.
- Meditation and yoga philosophy for cultivating equanimity in the face of life’s vicissitudes.
- Since everyone ages differently, yoga’s greatest strength is the wealth of possibilities it offers. Each person can do the practices that are most effective for him or her at a given time. A healthy 65 year old is going to be capable of doing a lot more challenging physical practices than someone of the same age with a chronic disease; however, in many traditions such as Iyengar and viniyoga, there are ways to adapt the practice for any condition by using props and modifications. Even people who cannot stand can get tremendous benefits from doing yoga from a chair.
- For age-related conditions, including arthritis and osteoporosis, as well cancer-related issues, different poses and practices are helpful for each of the conditions.
A: No more than other activities that have a physical component! But it is important to look for a well-trained teacher, preferably someone who has undergone months if not years of training and who has some knowledge of anatomy, who can help you adapt the practice to your particular body and concerns.
It is also important to listen to your body. If a pose causes pain (rather than just a stretching sensation), you should always back off, regardless of what the rest of your class might be doing.
As Baxter says, “Yoga is a system designed to optimize our lives, regardless of how old we are.”
Friday, August 10, 2012
Friday Q&A: Morton's Neuroma
Q: I have a question about flat feet and Morton's toe. I'm a 57 YO man who walks a lot and I have both. I always have difficulty balancing on one foot—tree, eagle pose, etc., and have recently had a bout with Plantar Fasciitis showing up in my left heel. No fun. I was at a yoga class yesterday and some poses felt good, others hurt. When I left the class, I literally limped home and iced it for 1/2 hr. then heat, then rest. I had acupuncture at Quan Yin this morning for it and bought new, sturdy shoes and heel pads. It feels a little better today. Can you suggest any asana or other treatment I can do at home that may help speed the healing process and prevent future trouble?
A: This question from last week was really a three-parter, and I covered flat feet with you all last week (see Friday Q&A: Flat Feet), so let’s turn to the second issue that came up for our student last week, Morton’s neuroma. It turns out this particular condition can cause pain in the ball of the foot, as we shall see below.
According to the Mayo Clinic, “Morton's neuroma is a painful condition that affects the ball of your foot, most commonly the area between your third and fourth toes. When it develops, it may feel as if you are standing on a pebble in your shoe or on a fold in your sock. Morton's neuroma involves a thickening of the tissue around one of the nerves leading to your toes. In some cases, Morton's neuroma causes a sharp, burning pain in the ball of your foot. Your toes also may sting, burn or feel numb. Morton's neuroma may occur in response to irritation, injury or pressure. Common treatments for Morton's neuroma include changing footwear or using arch supports. Sometimes corticosteroid injections or surgery may be necessary.”
Interestingly, there's no outward sign of this condition, such as a lump or swelling on top or bottom of the foot. Instead, any of the following symptoms could appear: a feeling as if you're standing on a pebble in your shoe, a burning pain in the ball of your foot that may radiate into your toes, or tingling or numbness in your toes. We don’t know what causes this problem to develop, but it is theorized that irritation, pressure or injury to one of the nerves that lead to your toes may be the culprit. High-heel shoes, high-impact sports or sports with tight fitting shoes (can you say sport rock climbing?) or the presence of other foot deformities are all considered risk factors for developing a Morton’s neuroma. I could hypothesize that our student’s flat feet may have put him at risk for developing one of these buggers, but I don’t know about other activities that he was doing when it showed up. Obviously, the first two risk factors are addressable with lifestyle changes and choices. Not so much the foot deformities.
If you go in for evaluation for foot pain on the ball of your foot, your doc will likely press around on the foot, especially between the third and fourth toes, to see if you are tender there or have a fullness that is not visible from the exterior. In addition, X-rays may be ordered to rule out a fracture as a cause for your pain, or an ultrasound may be used to look for the swelling of the nerve indicative of a neuroma. Typical western medical treatment usually starts with the least expensive and simplest approach. This could include over the counter arch supports and pads to take pressure off the neuroma. Your doc might go so far as to recommend you get special customized arch supports made for your shoes. Another fairly common treatment involves injection a steroid medication into the swollen area, as it is a strong anti-inflammatory medication. There are three other more extreme surgical approaches that are invasive and beyond the scope of this blog post. My hope is that you would not have to go to that extreme.
The folks at the Mayo Clinic do have some other ideas that could help, which are pretty common sense, too, like taking anti-inflammatory medications like aspirin or ibuprofen, as they can help with pain and swelling. Or try an ice massage. Regular ice massage may help reduce pain. If you have not already changed your footwear, what are you waiting for? Get rid of those heels and make sure the box of your shoes is wide enough! Finally, they suggest you give your foot a break. For a few weeks, reduce activities such as jogging, aerobic exercise or dancing that subject your feet to high impact.
How might yoga fit into this healing process? Well, I, and many of my students, have noted that regular asana practice leads to a slight widening of the feet. This may be because the practice is done with bare feet (no shoes!). Regardless, this additional space might translate into enough space between your metatarsals to relieve the pressure on the nerve and allow healing to take place. We also often encourage students to spread their toes wide, which could travel upstream a few inches and also provide some much-needed space in the front foot. Finally, a modified practice, done with the buttocks supported on a chair for standing pose variations, as an example, could keep much of your body active while allowing your feet to have less pressure on them. And, of course, a regular practice of inverted poses could relieve all of the blood pressure effects of normal upright walking and standing, giving your feet a real rest. I’d recommend Legs Up the Wall as a “must do” on a daily basis for healing and recovery.
Next time, we’ll look at heal spurs in the mix of the other things our student has going on. Until then, tread lightly!
A: This question from last week was really a three-parter, and I covered flat feet with you all last week (see Friday Q&A: Flat Feet), so let’s turn to the second issue that came up for our student last week, Morton’s neuroma. It turns out this particular condition can cause pain in the ball of the foot, as we shall see below.
According to the Mayo Clinic, “Morton's neuroma is a painful condition that affects the ball of your foot, most commonly the area between your third and fourth toes. When it develops, it may feel as if you are standing on a pebble in your shoe or on a fold in your sock. Morton's neuroma involves a thickening of the tissue around one of the nerves leading to your toes. In some cases, Morton's neuroma causes a sharp, burning pain in the ball of your foot. Your toes also may sting, burn or feel numb. Morton's neuroma may occur in response to irritation, injury or pressure. Common treatments for Morton's neuroma include changing footwear or using arch supports. Sometimes corticosteroid injections or surgery may be necessary.”
Interestingly, there's no outward sign of this condition, such as a lump or swelling on top or bottom of the foot. Instead, any of the following symptoms could appear: a feeling as if you're standing on a pebble in your shoe, a burning pain in the ball of your foot that may radiate into your toes, or tingling or numbness in your toes. We don’t know what causes this problem to develop, but it is theorized that irritation, pressure or injury to one of the nerves that lead to your toes may be the culprit. High-heel shoes, high-impact sports or sports with tight fitting shoes (can you say sport rock climbing?) or the presence of other foot deformities are all considered risk factors for developing a Morton’s neuroma. I could hypothesize that our student’s flat feet may have put him at risk for developing one of these buggers, but I don’t know about other activities that he was doing when it showed up. Obviously, the first two risk factors are addressable with lifestyle changes and choices. Not so much the foot deformities.
If you go in for evaluation for foot pain on the ball of your foot, your doc will likely press around on the foot, especially between the third and fourth toes, to see if you are tender there or have a fullness that is not visible from the exterior. In addition, X-rays may be ordered to rule out a fracture as a cause for your pain, or an ultrasound may be used to look for the swelling of the nerve indicative of a neuroma. Typical western medical treatment usually starts with the least expensive and simplest approach. This could include over the counter arch supports and pads to take pressure off the neuroma. Your doc might go so far as to recommend you get special customized arch supports made for your shoes. Another fairly common treatment involves injection a steroid medication into the swollen area, as it is a strong anti-inflammatory medication. There are three other more extreme surgical approaches that are invasive and beyond the scope of this blog post. My hope is that you would not have to go to that extreme.
The folks at the Mayo Clinic do have some other ideas that could help, which are pretty common sense, too, like taking anti-inflammatory medications like aspirin or ibuprofen, as they can help with pain and swelling. Or try an ice massage. Regular ice massage may help reduce pain. If you have not already changed your footwear, what are you waiting for? Get rid of those heels and make sure the box of your shoes is wide enough! Finally, they suggest you give your foot a break. For a few weeks, reduce activities such as jogging, aerobic exercise or dancing that subject your feet to high impact.
How might yoga fit into this healing process? Well, I, and many of my students, have noted that regular asana practice leads to a slight widening of the feet. This may be because the practice is done with bare feet (no shoes!). Regardless, this additional space might translate into enough space between your metatarsals to relieve the pressure on the nerve and allow healing to take place. We also often encourage students to spread their toes wide, which could travel upstream a few inches and also provide some much-needed space in the front foot. Finally, a modified practice, done with the buttocks supported on a chair for standing pose variations, as an example, could keep much of your body active while allowing your feet to have less pressure on them. And, of course, a regular practice of inverted poses could relieve all of the blood pressure effects of normal upright walking and standing, giving your feet a real rest. I’d recommend Legs Up the Wall as a “must do” on a daily basis for healing and recovery.
Next time, we’ll look at heal spurs in the mix of the other things our student has going on. Until then, tread lightly!
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