Friday Q&A: Propping for Relaxation Pose (Savasana)

Q: I have been wondering something about Savasana: Aside from the fact that Savasana has not been all that great for me due to low back/SI joint issues which are lately resolving, I find that my knees feel like they hyperextend in the relaxed state with gravity's pull. Would that alone be reason to always place a support under my knees, or not necessarily? Additional information: I developed the habit of sleeping with pillows under my knees probably 15 years ago at the recommendation of a physical therapist I was seeing at the time for neck problems. Lately my back & SI problems are greatly improved so now I am noticing the feeling of knee hyperextension more as I try to back off of over-reliance on knee support during Savasana. Engaging the quads to ease that seems counterproductive to Savasana. I feel fine with props. I just don't want to overuse them if that would set me up for some imbalance elsewhere.

Thank you so much for your time and dedication to the mission of educating us!

A: I have studied with the foremost expert (in my mind and others) on restorative yoga, Judith Lasater, and her teaching as I interpret is that a restorative pose should feel WONDERFUL when you are in it. The aim of Savasana is deep relaxation, and sometimes we have to work a little to get the pose perfect. So if you need to prop your knees or arms, support your head or low back, or whatever, then that is what you need to do for YOUR Savasana to be inviting and nourishing. There is no one way to do any yoga pose, and that is the gift of yoga which is to find out what works for you.

Please allow yourself to explore and experiment in how you position yourself for the utmost ease and enjoyment. Yoga is not “one size fits all.”

Happy journey.

—Shari

Featured Pose: Warrior 1 for Upper Body Strength

by Baxter and Nina

Warrior 1 is the second pose in our upper body strengthening series because, like Warrior 2, Warrior 1 is an accessible pose that is very strengthening for your arms and upper body. Even though you don’t bear weight on your hands or arms, the Warrior 1 arm position entails resisting gravity. Because the arm position is different than Warrior 2, this pose strengthens different muscles, including those that raise your arms forward and up overhead, and all of the small muscles inside the joint that help you stabilize your arms in that position. In addition, because you are taking your arms through the range of motion in forward flexion (forward and up), this pose also helps increase flexibility in the shoulder joint.

Furthermore, as your upper back and chest move into a slight backbend (extension) in Warrior 1, your back muscles are also strengthened, including the muscles around your shoulder blades, your trapezius and serratus anterior, and all the muscles that line your back spine. These are important muscles for keeping your spine healthy and for maintaining good posture. Good posture is essential for healthy aging because it helps keep your spine healthy, supports your respiratory system, and keeps you more mobile.

This pose is accessible even if you have something going on in your shoulders that is challenging because you can control how far you raise your arms. You don’t need to bear weight on your hands, so if you have wrist or hand problems still can do it. And, of course, an added benefit is the pose is very strengthening for the legs as well as the upper body!

Warrior 1 can be challenging to hold (and balance in) for long periods of time, so if you’d like to focus on your upper body rather than your lower body, you can work with your back heel against the wall or try having your feet slightly closer together.

Because we’re focusing on upper body strength for next several weeks, we’re going to give you three different ways to strengthen your body with Warrior 1. Version 1 is the traditional pose, and Versions 2 and 3 use props to help strengthen different muscles in your arms, shoulders and upper body..

Instructions: Starting in Tadasana, step your feet about three feet apart and place your hands on your hips. Spin your right foot out 90 degrees. Then lift your back heel, pivot on the ball of your foot, and spin your back heel back about four or five inches. Next, rotate your hips and chest in the same as your right foot. Don’t force your hips to square with the wall you are facing. Instead, allow your left hip to turn slightly toward your back leg, but square your head and your torso ,from the navel on up,  with your front foot. Maintain a straight strong back leg throughout.

Now, release your arms to your sides and turn your palms to face each other. Keeping your palms facing each other, inhale your arms forward and up. If your shoulders are tight, don’t worry about your arms being exactly vertical. But do keep your arms parallel—don’t try to bring your hands together. On your next exhale, bend your front knee so it is directly over your ankle joint. Do not lean forward or back, but keep your torso directly over your pelvis.

As you breathe in the pose, encourage your outer shoulder blades to lift with your arms, while keeping the upper inner corners of your shoulder blade moving down your back (so the sides of your neck are relaxed and long). Keep your arms active and bring your awareness to your elbows, making sure they are not bent, and reach through both sides of your elbow joints. Stay in the pose for 30 seconds and gradually work up to longer periods of time.

To come out of the pose, inhale and straighten your front leg. Then exhale and release your arms to your sides. Pivoting on the balls of your feet, bring your feet back to neutral as your turn your head and torso to face the long end of your mat.

As you come up, check your back, neck and shoulders for any pain. If you experience pain, reduce the time or change the foot position or not force your arms as high or keep them in a V position if your shoulders are good. Preparing for the other side.

Version 2: With a Block

This version activates the muscles on the inner edges of your arms and increases the activity of your pectoralis muscles so you strengthen more muscles than when you do the pose without the block. Start with the lightest block or prop you have. When pose becomes easier with practice, you can use a heavier prop.

Start by holding the block and follow the instructions for the traditional version of Warrior 1. Before you raise your arms forward and up, place the block between your hands on the widest side. Keeping your arms straight, press firmly into the block with your hands without bending your wrists or hands. As you inhale, take your arms forward and over head, and as you exhale, bend the front knee. If you have tight shoulders you may not be able to bring your arms to vertical, so take them to a comfortable height.

Version 3: With a Strap

This version activates the muscles on the outer surfaces of yours arms and some of your side chest muscles that get extra strengthening.

Before you begin, make a loop with your strap that is sized so when put your arms through and  push your arms against the strap, your arms are kept parallel. Place the strap about two inches below your elbows on the fat part of your forearms (you’ll may have to experiment to find the right position for your head). Note from Nina: yes, yes, I realize the photograph shows the strap just above the elbows, but that seems to work for Baxter. I definitely need the strap higher toward my hands, as otherwise my head gets trapped.

Follow the instructions for the traditional version of Warrior 1. As you raise your arms forward and up, press outward against the strap on your arms as you also focus your awareness on keeping your elbows straight.

Cautions: If you have high blood pressure or cardiovascular problems, we recommend that you do not to stay in the pose for long periods of time. Try doing the pose dynamically instead, moving in and out of the pose with your breath (see Warrior 1 and Warrior 2 Dynamic Vinyasas), which will still strengthen your arms and upper body. When you use the block or strap, honor any sensations of pain in your shoulder joint. Keep the sides of your neck relaxed, and modify your arm position to see if that makes the pain subside. If pain persists, come out of the pose, and ask a teacher to check your alignment.

Meditation and Healthy Eating

by Nina

My friend Elizabeth told me that before I knew her she weighed 205 pounds, but that she was able to lose weight and keep it off by changing her eating habits. From my observations of people close to me who have weight problems and from what I’ve read, I understood how unusual this was. So I asked Elizabeth to share her story with us. Okay, fine, I admit it! I have an agenda. Because I know from our previous conversations that Elizabeth has a regular meditation practice as well as a regular yoga practice, and that she credits both with helping her stay focused on maintaining her healthy eating habits.

Cake and Photo by Brad Gibson (yeah, he bakes, too)

I also happen to be reading The Willpower Instinct by Kelley McGonigal, Ph.D. because I want to learn more about how to help people change their eating habits. That’s because, as I'm sure most of you know by now, maintaining a healthy weight and eating more nourishing foods is vital for healthy aging. And sure enough, in one of the early chapters in Dr. McGonigal’s book she tells us that one of the best ways to strengthen your self control (and don’t we all need that to help us resist the daily food temptations we’re exposed to, I mean, my own daughter is pastry chef!) is to meditate.

Here is what she says:

“Neuroscientists have discovered that when you ask the brain to meditate, it gets better not just at meditating, but at a wide range of self-control skills, including attention, focus, stress management, impulse control, and self awareness. People who meditate regularly aren’t just better at these things. Over time, their brains become finely tuned willpower machines. Regular meditators have more gray matter in the prefrontal cortex, as well as regions of the brain that support self-awareness."

And the good news is that it doesn’t take a lifetime of meditation to change the brain. Here’s another quote from The Willpower Instinct:

"One study found that just three hours of meditation practice led to improved attention and self control. The new meditators had increased neural connections between regions of the brain important for staying focused, ignoring distractions, and controlling impulses. Another study found that eight weeks of daily meditation practice led to increased self-awareness in everyday life, as well as increased gray matter in corresponding areas of the brain.

"It may seem incredible that incredible that our brains can reshape themselves so quickly, but meditation increases blood flow to the prefrontal cortex, in much the same way that lifting weights increases blood flow to your muscles The brain appears to adapt to exercise in the same way that muscles do, getting both bigger and faster in order to get better at what you ask of it."

I don’t know about you, but I find these results fascinating. Because while self control is important for healthy eating, it’s also helpful for many other ways of fostering of healthy aging, whether it is something you need to stop doing, such as smoking, or something you need to start, like exercising.

But enough about science! Let’s hear what Elizabeth says about putting theory into practice:

Nina: Can you tell us something about why you needed to change your eating habits?

Elizabeth: I was overweight (205 lbs) and unhealthy at 32. I also had Crohn's disease. The change started when I moved to California in 1999. Eventually, I lost 50 lbs and have kept it off for 12 years.

Nina: What changes were you able to make that led to the weight loss and helped you maintain it?

Elizabeth: I started by making small, realistic changes that I knew would be easy to maintain. For dietary changes, I started with milk. I went from regular to 2%, then 1%. If I had fat-I tried to make it a healthy one such as avocado or olive oil. I also created a cookbook of my favorite recipes, and revamped them so they are still flavorful but healthy. I'm a genius at the 30-minute healthy dinner. My favorite is Cuban Black Bean soup. I try to always make time in my day for exercise. If I couldn't go to the gym, I would make a point of taking the stairs or walking on my lunch break. I also changed my perspective by viewing eating healthy and exercising as a way to do something positive for myself, not something to dread. I have a nice variety of yoga and exercise DVDs at home, which is also very convenient.

Nina: What is your meditation practice like and how do you think it helps you maintain healthy eating habits?

Elizabeth: I practice Transcendental Meditation, which is typically done twice daily, for 20 minutes. I meditate in the morning—I feel it's a great start to my day. It helps me to get the rest and focus that I need. It also manages stress and helps me to be checked in with what's going on in my life. I'm more likely to defer my unhealthy snacks once I've checked in with myself.

Nina: What you said about meditation helping you get focus is very interesting. Kelly McGonigal says, “Meditation is not about getting rid of your thoughts; it’s learning not to get so lost in them you forget what your goal is.” So meditation is supposed to help you stay “focused” on your goals.

I know that you also practice yoga asana. Has this helped with you maintain healthy eating habits? If so, how?

Elizabeth: Yoga has been wonderful in many ways. I am more relaxed, have less back pain, and I am more aware of how I'm feeling. For example, for most of the time, when I'm hungry, I'm actually dehydrated or have low potassium. I'll have a glass of water and a banana and I'm fine. Yoga helps me to be quiet through an uncomfortable situation (there are many of those in my practice!). I've learned to just pay attention to my breath and it usually moves me through a situation feeling very safe and grounded.

Nina: What you just said is so important! I think self-awareness is vital for healthy eating. You need to learn, as you said, when you’re just dehydrated rather than hungry, when you’re full and should stop eating, and which foods make feel good rather than just tasting good. And the relationship between stress management and healthy eating is so key that you’ve given me an idea for a future post. Thank you so much, Lizzy!

Yoga for Agility

by Baxter

This past weekend, Nina and I taught our first official “Yoga for Healthy Aging” workshop together in Castro Valley, CA, just a short 25 minute jaunt from Oakland.  As we were preparing for the session, we discussed some essential skills or benefits that regular asana, pranayama and meditation practice can lead to for those of us concerned with aging well. Some of the more obvious benefits include improved flexibility and mobility of muscles and joints, improved strength and improved balance. But another result that requires a combination of the previous three benefits is improved agility. And although I will be referring to mainly physical agility, experience also points to improved mental agility as a bi-product of regular practice as well.

If you search “agility” on Google, most of the first hits are about our favorite four-legged friends, dogs (down, you cat lovers!).

Agile Mugsy Pretending to be Baxter

It turns out there are actual courses you can enroll your dog in to improve his or her agility! In many ways, our yoga practice does the same for us two legged creatures! So get yourself enrolled soon if you are not already. 

So, what does “agility” entail? Well, in addition to flexibility, mobility, strength and balance, wikipedia expounds nicely on these and a few more components:

“Agility or nimbleness is the ability to change the body's position efficiently, and requires the integration of isolated movement skills using a combination of balance, coordination, speed, reflexes, strength and endurance. Agility is the ability to change the direction of the body in an efficient and effective manner and to achieve this you require a combination of: balance - the ability to maintain equilibrium when stationary or moving (i.e. not to fall over) through the coordinated actions of our sensory functions (eyes, ears and the proprioceptive organs in our joints); static balance - the ability to retain the centre of mass above the base of support in a stationary position; dynamic balance - the ability to maintain balance with body movement; speed - the ability to move all or part of the body quickly; strength - the ability of a muscle or muscle group to overcome a resistance; and lastly, co-ordination - the ability to control the movement of the body in co-operation with the body's sensory functions (e.g. catching a ball [ball, hand and eye co-ordination])”

What warms the cockles of my heart (what ever those are!) when I read this definition is how wonderfully a balanced yoga practice supports our ability to improve agility. We’ve referred to proprioceptors in past posts, and how mindful awareness of information coming from the joints to the brain allows us to master yoga postures, and improves our ability to know where we are in space and how fast we are moving. And with a good mix of held and dynamic yoga practices, we are cultivating balance and reducing the chance of falls, which, as many of you may know, are a leading cause of morbidity (increased chance of disease) and mortality (death) in the elderly. And by learning new sequences of postures, especially dynamic ones, as in vinyasa practices, your co-ordination is challenged and improved. I often like to make small changes in flow sequences like sun and moon salutes to continue to challenge students to be attentive and as a way of assessing the mental and physical nimbleness in making quick changes in a safe and effective way. And whether this translates into being able to quickly navigate a crowd or maintain your stationary balance on the crowded commuter train, agility means having one more beneficial tool to live a full life. And yoga delivers it! 

Ready to try? You might do the following:

1. Work daily on a few basic balancing poses, such as Tree, Half Moon, Warrior 3.
2. When doing Sun Salutes at home, change your foot placement an inch or so as you step forward and back, and try to be precise at landing on your new mark.
3. Look at your mix of static poses and dynamic sequences, and add in what is lacking of one or the other. 

Until next time, zip, zip, zip…I’m outa’ here! (By the way, turns out cockles are small, edible saltwater clams!  And allusion, no doubt, to the valves in our heart.)

Active vs. Passive Yoga Practice

by Shari

August Flowers by Nina Zolotow

I have been thinking a lot about this topic and how I vary my own practice daily. Common sense would dictate that when you feel energetic you do an energetic practice and when you feel tired or exhausted a restorative or passive asana practice would be appropriate, but it isn’t as clear cut as that. There is this small impediment and it is called your conscious mind.

Now many different disciplines, schools of thought and medical approaches call “your conscious mind” by different names. But I call it that pesky unrelenting little voice in my head that is constantly directing me nonstop. I have noticed though that my pesky little voice has changed from my teens now into my 50’s because of its attention to unending details. What dictated my days then is very different from now. But let me reassure you that my own personal aging process has changed its focus but not its insistence.

Now both Nina and Baxter have very eloquently talked in past posts about meditation, stress reduction, and anxiety management. What I am talking about is different. It is the need or compulsion to be in motion from the time that I wake up till the time I go to bed. I am not the type of person that can “do nothing.” My husband is very good at this activity and often can’t understand why I can’t “just sit down and rest.” This inability to stop motion gets translated too often into my daily asana practice. It is not a frenetic obsession with activity but the time-honored adage: “you don’t rest until all your work is done.” This mind set is very pre-industrial agrarian age when farm work was never done because there always was something more.

But in our computer age with so many technological tools to assist us the busy work really doesn’t stop unless you make yourself stop. It is the same with housework or caring for your family. There never is an end to the work that must be done unless it is your mindset that sets the limit.

So how does one set time aside for a daily practice and then decide what your practice should consist of? It is like do you eat dessert first or dinner? Complicate that with one’s own personality type, the type of yoga that you practice, and your time limitations. If you only have five minutes should you do a quick, one-time abbreviated sun salutation or should it be a Viparita Karani (Legs Up the Wall Pose?) Active vs. Passive. What to pick?

Now here is where the self-introspection comes in and the ability to look critically but without judgment at yourself. What do you feel like doing? Now that is also a very revolutionary question. Our days are filled with doing stuff that we really may not want to do but have to for many various reasons. But when we roll out our mat and give ourselves the gift to make this decision it is very powerful.

There are so many “shoulds” now associated with yoga. Do we do yoga for an external goal? Or is it internally driven? How do we learn to know what we need or what we want? I have learned through my many years of practice that sometimes the decision isn’t obvious and you have to search a little to find the solution.

When I start my practice, I will usually lie on my mat on my back with my knees bent and eyes closed for several breaths as I just check into how I feel that day. I tend to do my practice in the morning (after a 35-minute aerobic treadmill walk and shower), so that is my stiffer time of day even after my own warm up. I might have a vague thought that “oh it is forward bends this week” but that isn’t what I focus on.

I try to listen to how my hips are feeling, or my low back or shoulders, and so on. It always starts on the physical plane. As I start my warm ups (I tend to do a 30-minute practice), I generally try to target those areas in my own body that may be chronically stiff. After my warm up I always do some standing poses. Standing poses can be made challenging by either moving through them quickly or more methodically when one is paying attention to the orchestration of movement. Observing one’s body unfold into and out of an asana is not only mentally engaging but it is a period of immense gratitude.

Then I move onto the main focus of the practice. Is it to be a pose that I love to do, or is it a pose that I struggle to attempt? How hard do I want to work? Is it okay to not want to work? Those are questions that always arise for me in my daily practice. Sometimes if I am sick or getting sick or recovering from some type of cold or flu, it is plainly obvious that a restorative practice is what I need because I literally don’t have the energy or stamina to be vigorous. But it is the other times that are frankly more challenging. I don’t want my yoga practice to fall into the “shoulds” because then I lose the nurturance of the practice.

When I go to a yoga class and the teacher directs my practice it is very different from when I am at home directing my own practice. I don’t have the external guidance of the teacher, but instead I have my own monkey mind that guides me and I have to learn how to acknowledge it but also be a bit firm with. Through the usage of breathing (simple pranayama), I have learned to create my own stress reduction response and I have learned to do it in under five minutes!

The gift of yoga isn’t the complicated poses that I can never accomplish but the ability to work within my own body with the time that I have available. In my practice I try to combine both active and passive asana depending on the day, the room temperature and my own energy level. It is never repetitive and it is always amazing the simple things that you perceive when you give yourself the opportunity to do so.

Friday Q&A: Watching TV While Doing Yoga

Q: Is it possible to distinguish which benefits of hatha yoga arise from (just) the physical activity and which from the practice of paying attention to one’s body in the pose? For example, what if one does a sequence of poses while, say, watching television and not paying much attention to the pose? I would think that would still help develop strength, flexibility and balance.

A: First of all, congratulations for starting—or thinking about starting—a home practice. Practicing a home is the best way to create the yoga practice that’s best for you, rather than just hoping your teacher will happen to give you the right class.

And, believe it or not, you’re not the first person we know who wonders about doing yoga in front of a TV. When I wrote the section on motivating yourself to practice in the book Moving Toward Balance, I interviewed yoga teacher Jason Crandell because I knew that he started his own home practice while watching The Simpsons. Here’s what he said:

Every day for a long, long time, I would get out of the warehouse and get home and watch “The Simpsons,” the 6:00 and 6:30 episodes. So I bartered with myself that for the 6:00 to 7:00 period, I would, no matter what, five days a week, lay my yoga mat out in front of the TV and do as much yoga as I could. It seemed like a perfect trade, and it didn’t seem like it was at cross purposes—it didn’t seem like it was ironic or even funny—it just seemed like it was a reasonable thing to do And it worked beautifully. And then basically what happened was that I started to become more interested in what my body was doing in that period and “The Simpsons” actually became more of a distraction. It was a natural evolution that I turned it off after a few months.

So, yes, you absolutely will still get the benefits of developing strength, flexibility, and balance if you practice in front of TV. As Shari Ser says, “Any movement is better than no movement.”

That being said, you will be missing out on some of yoga’s important benefits:

1. Stress reduction. TV is distracting, not relaxing. If you practice while watching the news or drama, your stress response may be triggered by things you see or hear.
2. Mindfulness. Not paying attention to your body as you practice will prevent you from learning about what works for you and what doesn’t, and you won’t reap the benefits of the asana practice as a moving meditation.

So here’s what I suggest. Try practicing in front of the TV until your habit, like Jason’s, becomes established, and then experiment with turning it off. If practicing in silence is difficult, try playing relaxing music instead. The right kind of music is less distracting and less stimulating for the nervous system, so you’ll be able to be more engaged in your practice and more relaxed as well. (And if you haven’t thought of it yet, perhaps you could try practicing with music now, instead of the TV and see how that goes.)

P. S. There is nothing from The Simpsons on youtube so I went with one of my favorite TV show openings (I  love the song by Massive Attack). I briefly considered including the credits for "True Blood," which is probably my all time favorite opening, but was worried it would be too racy for some people. 

—Nina

Featured Pose: Warrior 2 for Upper Body Strength

by Baxter and Nina

Warrior 2 is the first pose in our upper body strengthening series because it is a very easy and accessible pose that is very strengthening for your arms and upper body. Even though you don’t bear weight on your hands or arms, the arm position entails resisting gravity. This strengthens the muscles that lift your arms to your sides and all of the small muscles inside the joint that help you stabilize your arms at the shoulder joint, including the deltoid and supraspinatus, which are important for maintaining the health of those joints. In addition the pose provides equal strengthening of both your upper back, around the shoulder blades, and your chest, around the collar bones, as you build strength in your upper trapezius. And of course an added benefit is that this  pose is very strengthening for the legs as well as the upper body!

This pose is accessible even if you have something going on in your shoulders that is challenging because it doesn’t require full range of motion in the shoulder joints. And you don’t need to bear weight on your hands, so if you have wrist or hand problems you can still can do the pose.

Because we’re focusing on upper body strength for next several weeks, we’re going to give you three different ways to strengthen your body with Warrior 2. Version 1 is the traditional pose, and Versions 2 and 3 use a slightly different arm position.

Instructions: Starting in Tadasana, step your feet wide apart. Turn your right foot out 90 degrees, then, pivoting on the ball of your back foot, shift your left heel back an inch or two to your left so the foot is slightly turned in.

Next, inhale and raise your arms up so they are parallel to the floor, with your palms facing down toward the floor. Keep your shoulder blades relaxed and moving down your back (not sliding up toward your ears) as you raise your arms. Then, on an exhalation, bend your right knee directly over your right ankle while keeping your torso centered over your pelvis (not leaning over your front leg). Allow your hips to rotate slightly toward your right knee but rotate your chest away from your right knee so your chest faces directly forward. Finally, allow your head and neck to turn so you gaze over your right hand.

Once you are in the pose, use your eyes to check both arms to make sure they are in an even line with the tops of your shoulders, that they are neither too high or low, and that they are parallel with the floor.

Because your purpose in doing Warrior 2 this time is to develop strength in your upper body, you should keep your arms out to your sides for a decent amount of time. Start with 30 seconds and work your way up to 1 to 2 minutes over time, gradually building up endurance. Of course if you’re very fatigued or shaking, come out earlier. Notice that the longer you hold your arms up, the more you unconsciously will slide your shoulder blades up toward your ears. If this happens, consciously move relax your shoulder blades back down your back.

To come out of the pose, exhale and release your arms. Then straight your knee, turn your feet to a parallel position, and switch to the other side:

Version 2: Palms turned up

Because of the external rotation in your shoulder joint required to turn your palms up, this variation allows you to strengthen areas that aren’t strengthened with the first version With your palms up you activate a different portion of your deltoid muscles (front portion) and other muscles deeper in your shoulder joint. You could do Version 2 of the pose immediately after doing Version 1 or you could alternate different arm positions on different days. activates a different portion of your deltoid muscles and activates other muscles deeper in the shoulder joint.

For this version, follow the instructions for Version 1. When it comes time to raise your arms, start by spinning from your upper arms to turn your palms to face front. Then as your raise your arms, keep spinning form your upper arms to turn your palms up toward the ceiling.

Version 3: Holding blocks

This version strengthens the same muscles as version 2, but provides increased strength building because you are holding a weight. You can use yoga blocks, same-weight books, or even bags of rice or beans. However, we recommend building up your strength practicing Versions 1 and 2 before trying Versions 3. We also recommend that you start off with lightest weight possible, such as foam blocks, and work up to heavier weights over time, such as cork or wooden blocks.

For this version, start by holding the props and then follow the instructions for Version 1. As you lift your arms, rotate your upper arm bones so as you arms come out to the sides, the blocks are resting on your upturned palms.

Because of the additional weight, you may feel the additional work, and you may need to reduce the time you stay in the pose! If you become fatigued or shaky, release your arms. Gradually, over time, increase your time in the pose to up to 2 minutes.

Cautions: In general, Warrior 2 is a very safe pose. However, if you experience pain in your shoulder joints or neck, come out of the pose and get some advice from a yoga teacher about your alignment. If you have a history of rotator cuff injury or dislocated shoulder, approach the pose carefully, especially Version 3.

One Year Anniversary!

by Nina

It’s our one-year anniversary today! Celebrate with us by listening to one of my favorite songs by Flogging Molly (I love the video, too). I’ve always thought the chorus for this song, “Ah but don't, don't sink the boat/That you built, you built to keep afloat,” works perfectly as a theme for this blog. That, and the ending to the song:

A ripe old age,
A ripe old age,
A ripe old age,
Just doing the best I can!

We’ve come a long way in our first year. There have been 248 posts, covering a wide range of topics from asana practice to aging theories to medical conditions to philosophy. We started taking our own photos and even made our first video (see here). And we’ve gained two new regular contributors, Timothy McCall, MD and Shari Ser, Physical Therapist.

We have a lot of exciting plans for the coming year, including an in-depth series on upper body strength and more on healthy eating. But really our favorite thing to do is to address the issues that concern you, our readers. So please keep your questions and requests coming! You can ask a question or request a topic for any of us to write about either by commenting on any post (including this one) or by emailing me by clicking the contact us tab at the top of the page.

“Tomorrow smells of less decay
The flowers quick just bloom and fray
Be thankful, that's all you can” —Flogging Molly

Yoga for Healthy Eating, Part 2

by Baxter

Today, as I was driving to the Farmers Market in Berkeley to enjoy my weekly ritual of buying local grown and produced fruits, veggies and animal protein, I happened to catch a bit of the show “Your Health and Fitness” on KPFA. The host posited the assertion that “health” bestows on each of us the opportunity to live a full life. I gotta say, I loved the simplicity of this notion, and all that it really implies. Then I got home to read the following comment on my recent post regarding yoga for healthy eating, full of more wisdom born out of personal experience. It came from an old friend and colleague of mine, and with her permission, I share it with you now:

“Hey Baxter,

Kudos on taking on such a complicated subject! I have a few ideas I think are worth adding to the discussion on mindfulness and healthy eating, and when I say "ideas", I really mean personal opinions I've formed along the journey of nurturing my personal health.

The first idea that really drives my weight management is focusing on eating more good food rather less bad food. "Eat less" is very common advice, but when we set out attempting to do this, what happens is, we end up eating meals that are less than we need to feel satisfied, and then, when we are inevitably hungry in an hour or two, we reach for a convenient snack. This snack is rarely nutritious, and does two things; it keeps us from our goal of losing weight and gives us a sense that we are inept in managing our food. This second part is often the killer. When people ask me for advice about weight loss, I always say the same thing; "EAT MORE VEGGIES". If you add a large serving of vegetables to lunch and dinner, you will not be hungry in between meals. And these vegetables are of tremendous value to your long term health. Your body will shift naturally a healthier size. Eat more, not less.

Also, I believe that living in the modern world means being absolutely inundated with information about dieting, and most of this information is not helpful. Find a plan that works for your lifestyle and stick to it. I've used the same food plan through two terms of weight loss (one in my early thirties & one after my daughter was born), and I generally use the same plan for maintenance today. Find a plan that works for your lifestyle and stick to it.

Lastly, I think exercise is vital to weight maintenance, not because it assists in weight loss (I've actually found it to hinder my weight loss), but because it helps with stress reduction and confidence in the long run. Stress is perhaps the most important factor in why we eat and why we fail at weight loss. When we find exercise that we enjoy and we can integrate into our lifestyle, we have a useful tool in managing our long-term health through stress reduction. Secondarily, we gain in the process an enjoyment of our bodies that is necessary to continue on a path of nurturing self -care. Exercise we enjoy makes us feel good. Feeling good helps us to want to continue on the journey.

Hope this is helpful to the greater discussion.

Amelia”

Yes, Amelia, I think this is very helpful to the greater discussion around healthy eating. Implied in Amelia’s approach is, as I see it, the idea that a longer vision goal is being set by each of us as we decide to make healthy changes in our eating habits. It seems prudent, as an example, that if my goal is weight loss for me to sit and consider what my expectations are when my goal is reached: do I expect to feel better physically, emotionally or mentally? Do I expect a present health problem to resolve itself secondary to my weight loss goal being met? Is there an expectation of an underlying happiness that will arise? In all likelihood, quiet contemplation around this goal of “weight loss” will reveal these sorts of underlying hopes and expectations that could ultimately be more important than any number on the scale.

The practices of yoga, starting with pranayama as a beginning method to quiet the normal mental chatter and give the busy portion of the mind a rest, can be quiet helpful in this process of introspection.  From there, dharana and dhyana, one-pointed concentration practice and continual meditation practice, will refine and sharpen the ability to be receptive to these deeper goals. One of the qualities that is always mentioned in either succeeding or failing at these sorts of attempted changes is the presence of “will power.”  And according to Stanford psychologist, author and yoga teacher Kelly McGonigal, scientists now consider will power to be like a muscle, versus something you either have or don’t have. We all have the muscle, and you can strengthen it with practice. And yoga is a discipline that teaches us about practice, or abhyasa, as one of the main tools for succeeding in meeting our highest goals. 

So to recap Amelia’s wisdom:

• Eat enough good food (VEGGIES!) to satisfy your energy needs and satisfy you hunger.
• Find a plan that works for your lifestyle and stick to it, ie practice it everyday!
• Don’t underestimate the value of exercise as a stress reducing and confidence-inspiring tool (a strong asana practice could be part of that I’d think!), as stress is a huge trigger for unhealthy eating.  And exercise makes us feel good, which has a positive feedback on motivation.

Keep those comments coming! We love ‘em!

Yoga for People with Medical Conditions

by Shari and Nina

Carol Krucoff’s post last week Yoga May Be the Best Activity for the Elderly inspired me to interview Shari Ser about the Yoga for Health class at the Berkeley Yoga Room that she and Bonnie Maeda, RN teach on a weekly basis. This class is special because it’s for seniors with medical conditions as well as general aging dysfunction, and current students include those bilateral total knee replacement, severe osteoporosis, coronary artery bypass graft and other heart issues, stroke, vertigo related conditions, severe arthritis, fibromyalgia, and several hip fractures.

Nina: Why did you two decide to start your Yoga for Health class?

Shari: We started this class because we wanted a safe venue to offer to seniors who couldn't participate in a regular gentle yoga class or a Yoga for Seniors class due to individual medical conditions that might make it more challenging for them to safely participate. We intentionally organized the class so there would always be two trained teachers present at all times. One teacher primarily teaches and the supporting teacher assists students who might need modifications other than the way the pose was being taught.

Nina: How is yoga helpful for people with medical conditions?

Shari: Yoga is helpful for all that ails you! It builds strength, stamina, and balance. It also builds confidence and the mental equanimity that you can face anything. The fact that yoga is portable and can be done anywhere is also extremely attractive. You can do yoga in bed, sitting in a chair, driving in a car. Your mat doesn't have to be confined to a physical space but your practice situation can truly be anywhere.

The ability to face any critical illness is aided by stress reduction techniques that Baxter, Timothy and Nina have addressed in previous posts. Being able to monitor your breathing allows you the mental clarity to think things through in a more methodical and calm manner. Learning to find your own focus point whether it is learning how to stand on your toes or dealing with obtuse health insurance adjusters when contesting a claims bill is equally important. I can't overemphasize the importance of the relaxation response when living with chronic health issues.

Furthermore, for so many people their preconceived notions of what they can or can't do is astonishing. People very often tend to underestimate their abilities because no one has ever taken the time to help them break down a series of movements into bite size pieces that they can and do hungrily consume. The look of joy and astonishment on a student's face when they can successfully participate in class continues to be both Bonnie's and my guiding light in our teaching!

But people who are living with chronic medical conditions apart from general aging do present particular unique challenges for the yoga teacher. You literally are thinking on your feet at all times during class because modifications need to be individualized and often times that may precipitate a lot of prop hauling to get the asana just right for the student to begin to reap the healing benefits. An extra set of hands or two is invaluable!

Nina: I love the idea that you help people learn they are capable of more than they think—that's good for the spirit as well as the body. So, what are your classes like?

Shari: All of our classes work on the entire body as well as encouraging a practice space that feels safe and nurturing. It is our circle of practice that invites the student to join us. Also, we try to adequately challenge the students within their abilities. So every class has a balance component with lots of strengthening. We work a lot on developing core stability with flexibility in our shoulders, hips, spine, knees and ankles. Working on upper body as well as lower body strength is also critically important. We also talk about the carryover in their own lives, like being able to turn their heads when they are changing lanes if they still drive, reaching for the item overhead in their kitchen, or as mundane as being able to tie their own shoes.

Nina: I think we'd all agree that helping people stay independent as they age is absolutely invaluable! What should people with medical conditions consider when they look for and/or start to take a yoga class, or start practicing on their own at home?

Shari: Certain medical conditions may warrant formal physician clearance for participation in a yoga class. Our personal opinion is all recent surgeries need official clearance. Other than that it is the teacher's responsibility to keep the student safe but it is equally important that you, as a student, pay attention to how you are feeling during class and to inform the teacher if you notice any sudden changes in yourself during class.

We also think as a student you should ask the prospective teacher specifically what their training is, are they experienced with dealing with your medical condition and can you stop as needed during the class. Also can you decline to participate in an activity that you do not feel ready to do? This is an important question because it tells you how adaptable the teacher will be if special circumstances arise during class.

You should also consider the size of the class. We think a class needs to be small, with no more than 10-12 with two teachers, because this type of population needs close monitoring and frequent rest and hydration breaks. Lastly, the class needs to be fun! Joking and having people share with each other builds a sense of community among the students.

Friday Q&A: Yoga for Healthy Aging Workshops

Q: Do Nina and Baxter ever teach workshops on yoga for healthy aging together?

A: Why, I thought you’d never ask. Because it just so happens we’re going to be teaching a workshop on yoga for healthy aging together for the first time ever this month!  On Sunday, September 23, 1:00 – 4:00 pm, we’ll be teaching a Yoga for Healthy Aging workshop at Yoga in the Middle in Castro Valley, California. Come celebrate the one year anniversary of our blog by learning in person about some of the many things we’ve been blogging about! To register, go to: yogainthemiddle.com.

Yoga for Healthy Aging

with Baxter Bell, MD & Nina Zolotow

Sunday, September 23 1:00-4:00pm

$45 pre-registered by 9/16 Click on “Workshops” to register

We hope there will be more workshops like these in the future. But if you'd like to take a workshop from Baxter by himself, click the Workshops and Retreats tab at the top of the page. He's scheduled to teach some Yoga for Healthy Aging workshops throughout the country in the coming year.
—Nina

Upcoming Featured Poses: Upper Body Strength and Flexibility!

by Nina (with Baxter)

Baxter and I have been excitedly planning (and photographing) the next group of poses we’re going to feature on our blog. Inspired by the popularity of my post Building Upper Body Strength the Easy Way, we decided to focus on the upper body for the next several months. We’ll be presenting several basic, easily accessible poses, all with several modifications, that will help you both build your upper body strength while you increase flexibility in your arms, shoulders, chest, and upper back.

Before getting started with the individual poses, we thought we’d take a moment to say something about why upper body strength and flexibility is so important for healthy aging.

With our current shift to more sedentary work styles, for many of us, our upper bodies are typically underused. Because we’re no longer carrying, lifting, and reaching on a regular basis, our upper bodies are not at their optimal levels of strength and function. And even those of us who exercise regularly by walking, running, or cycling, can become imbalanced due to neglecting our upper bodies.

I think that it’s important to most if not all of us that we maintain our independence as we age. For the elderly, upper body weakness has a significant effect on everyday activities, including the most basic ones, such as getting out of a chair, taking care of your home, and carrying your groceries. We also need to work on upper body flexibility, as people who are tight in upper back, shoulder and chest areas can have difficulty taking items off shelves or even dressing themselves.

Working your upper body also helps optimize your circulatory system, keep the connective tissue around your nerves mobile, and facilitate communication between your upper body and your brain, all of which will contribute to keeping your body healthier as you age.  

So stay tuned! Hmmm, what is Baxter doing with that block?

Yoga Solutions for Anxiety

by Nina

In the last few of weeks, two different women I know told me they were having panic attacks. As their life circumstances were very different as were their symptoms, the private lessons I gave them ended up being very different as well. That’s the beauty of yoga (and the private lesson), which allows you to customize your solutions to a particular person’s needs and concerns. But before I started to write about my yoga solutions for anxiety, I felt some background about anxiety and how yoga helps would be useful. So I asked Baxter to write a general post about the topic, which we put up on the blog yesterday (see 9/11 Anxiety and Yoga). 

Now that you know something about how yoga helps with anxiety, I’ll tell you what I explained to both women about the basic strategy for combating anxiety and panic attacks. For each of them, we needed to come up with two things:

1. One or more techniques for heading off an anxiety or panic attack when it occurs. This is a short-term goal that can help you deal with your current condition more effectively.
2. A regular yoga practice to pacify the nervous system. Since anxiety and panic attacks are related to chronic stress, practicing some form of relaxation on a regular basis can help prevent the anxiety and/or panic attacks from occurring in the first place.

In the first case, the woman’s mother had recently died, after she had been at her mother’s bedside in the hospital for weeks. Her panic attack had come in the middle of the night, when she was alone in bed. After some experimenting, we decided together that the best technique for heading off a full-blown panic attack would be a breath practice where she consciously extended her exhalation. Although even just breath awareness can help with a panic attack or anxiety, having a specific exercise to do helped her focus more on her breath instead of just “watching” it. The good news is that she later reported back to me:

“The breathing has totally helped me, and it even helped me during the day when I was starting to freak out at a restaurant!”

For long-term relaxation, we experimented with some supported poses. In the end the one that suited her best was Legs Up the Wall pose, a supported inversion that triggers the relaxation response. Since she was very active already with ballet lessons and wasn’t a regular yoga practitioner, we decided that starting with a mini practice of this one pose for 10 to 20 minutes a day would be the best approach for her.

In the second case, the woman had recently moved to the Bay Area, away from family and friends, to go to graduate school and had already tended in the past to suffer from anxiety. Her panic attacks came in the daytime, when she was fully awake and getting ready to face her day in her new home. I also taught her the same breathing techniques of simple breath awareness and extending the exhalation but she didn’t seem interested in doing breath work. She was hyper and restless and wanted to do asana! And the thought of sitting still to meditate or lying down to practice breath awareness or yoga nidra made her feel even more anxious.

So for this woman, we decided the best strategy would be to do a very strong asana practice in the morning to head off the anxiety and to prepare herself for relaxation by tiring her out a little. I recommended sun salutations and standing poses possibly followed by forward bends (which some people find calming), but suggested that she stay away from backbends. Although backbends can be uplifting they also tend to energize you, and if you’re anxious and hyper that can be too much. Then I urged her to practice either a supported inversion or meditation at the end of her practice to pacify her nervous system. After trying every single supported inversion (see Inverted Poses), it turned out that the one that felt most comfortable and relaxing to her was a Supported Bridge pose with straight legs. I recommended that she practice this pose at the end of her practice from 10 to 20 minutes to pacify her nervous system.

As you can see from these two cases, yoga solutions for anxiety can greatly vary, depending on the person’s particular situation, yoga experience, and personal preferences. But as Baxter mentioned yesterday, there are three different possibilities for treating anxiety: pranayama, meditation, and asana. You can use them in any combination that works for you, and hopefully you’ll soon be able to reap both short-term and long-term benefits

Note that although a guided Savasana or yoga nidra can be tremendously helpful for anxiety (yoga nidra in particular has been very successful for treating veterans with PTSD), neither woman seemed inclined to try these practices. Having suffered from anxiety myself, I could understand that just the thought of lying down for a long period of time while you are awake is intolerable. However, if anyone out there is suffering for anxiety and wants to try either of these practices, click on the Audio Tracks tab at the top of the page to find Baxter’s relaxation tracks.

9/11 Anxiety and Yoga

by Baxter

Some years ago, when Nina and I were working on a series of yoga classes for stress management, I read the book The Relaxation Response by Dr. Herbert Benson, and an interesting finding from the work he did has stuck with me. He noted that his blood pressure patients who meditated regularly not only saw improvements in their blood pressure readings, but they also had certain substances in the blood stream that increased or decreased.  One of those substances was lactate, or lactic acid, which is a byproduct of cells using sugar or glucose for fuel. It had already been noted back in the 60s that folks with anxiety disorders often had elevated levels of lactate in their bloodstream compared to individuals without anxiety. Since meditation seemed to lower lactate levels, it seemed like a great potential treatment.

More recently, an article in Scientific American looked at lactate and other markers in the body that could account for why some folks develop panic disorders, an extreme form of anxiety. Studies done in the last two years point to the pH in the brain as a possible causative factor in the experience of fear, and by extension, anxiety. It seems a more acidic pH in the brain is associated with more active trigger of the fear centers in the brain. In fact, there are receptors at individual synapses, the spaces between to nerve cells, that respond to elevated levels of acid. In the area of the brain strongly associated with the emotion of fear, the amygdala, this increase in local pH can trigger fear responses.

They also noted that carbon dioxide levels, when increased in the blood stream and the brain, lead to greater acidity. And other studies have demonstrated that patients with panic disorders are more likely to have an event if they inhale a higher concentration of CO2, compared to non-anxious individuals. These researchers also addressed the lactic acid phenomena that Dr. Benson noted years before: patients with panic disorder tend to generate excess lactic acid in their brains. We all generate lactic acid in our brains as sugars are burned as fuel, but in people with panic attacks, even normal mental activity to lead to an accumulation of lactic acid in the brain.

So if an increase in pH in the brain could be a trigger for anxiety and panic attacks, either due to a real or simply a perceived danger, whether due to CO2 build up or lactic acid build up in certain areas of the brain, how could yoga diffuse this situation? Well, way back in the 60s it was already observed that the “relaxation response” that arose from simple meditation practice could lower the pH in the blood stream. This might indicate that it could be lowered in the brain, too. So I’d give high marks to establishing a regular meditation practice, even if only for ten minutes at a time. Secondly, certain pranayama practices could theoretically lower blood CO2 levels slowly and gradually, especially those that favor a longer exhale over inhale ratio.  hat sounds like it would be worth a trial as well. And finally, the authors of the study noted that: “one of the many beneficial effects of aerobic exercise training (like running or cycling) is that metabolically active tissues (including the brain) become more efficient at consuming–removing—lactic acid.”  And although not all yoga asana practices are aerobic, some are to a certain degree. So, physiologically, your asana practice, especially if it is more vigorous, could be the third prong in your yoga tools approach to anxiety, panic attacks and fear.

Here is a link to the 2010 SA article here so you can get more details on the work I’ve alluded to: scientificamerican.com. And may you and yours be safe and anxiety free this 9/11 anniversary. 

Yoga May Be the Best Activity for the Elderly

by Carol Krucoff, E-RYT 500

Inviting elderly people to try yoga can be challenging, since many harbor the common misconception that you must be young and fit—or at least able to get down and up from the floor—to practice. That’s why I always tell prospective students: If you can breathe, you can do yoga.

Now, a new study suggests that for older adults—even frail elders in their 80s and 90s—yoga offers substantial health benefits and may be the best form of physical activity.  Writing in the Journal of Alternative and Complementary Medicine, geriatrician Neela K. Patel, MD, MPH, CMD, and colleagues at the University of Texas Health Science Center at San Antonio, performed a meta-analysis of 18 randomized control trials of yoga for people over age 60 and compared the results with those from other exercise programs for seniors (see here). Her conclusion: 

“Yoga may be superior to conventional physical-activity interventions in elderly people.”

I recently had a lovely interview with Dr. Patel; it was very exciting to see research that supports what we teach! According to Dr. Patel, many health problems facing seniors can be directly influenced by yoga:

“Yoga not only improves health-related quality of life, but also enhances walking and balance, muscle strength, cardiovascular health, blood pressure, sleep and functioning of other systems. Yoga may also have psychosocial benefits through prevention and control of common health and emotional problems linked with aging.”

All four aspects of exercise, as outlined by the National Institute on Aging—strength, endurance, flexibility and balance—can be improved through an appropriate yoga practice, Dr. Patel told me, adding that the ability to individualize the practice and its social nature may also benefit seniors. But the most important aspect, she says, may be yoga’s impact on enhancing seniors’ ability to perform activities of daily living and maintain independence.

“Having the leg strength to get up and down from the bed to go to the toilet, and the arm strength to open a door, can make a tremendous difference in an older adult’s life,” she says. “And yoga goes beyond physical health, to help relieve anxiety and calm the mind, which is also critical.”

Dr. Patel has observed the impact of yoga practice on older adults first hand, as her husband, Sreedhara Akkihebbalu, teaches classes to elderly residents of an independent living community and a nursing home—ages 75 to 102. Perceived benefits among those students in independent living include improved gait and balance, deceased pain, decreased need for medications, improved sleep, less anxiety and depression and increased mobility. She notes:

“For the oldest old, the breathing practice can be particularly beneficial. Yoga shows great potential for improving quality of life in even the frailest of older adults."

Carol Krucoff, E-RYT 500, is co-director of the Therapeutic Yoga for Seniors teacher training offered at Duke Integrative Medicine and the Kripalu Center for Yoga and Health, and co-creator of the new DVD, “Relax into Yoga for Seniors,” available at pranamaya.com.  She is author of several books including Healing Yoga for Neck and Shoulder Pain.  Visit her websites:  yoga4seniors.com and healingmoves.com.

Friday Q&A: Knee Restrictions

Q: I have chondromalacia from an untreated sprained knee that I got 5 years, at 2 months post partum. Once I finally had it diagnosed, I needed nearly a year of physio for my knee to become 95% functional. So today, I cannot hyperflex, or sit on my knees, or go on all fours. Because I am very interested in practicing yoga now, I need to adapt several poses. Some impossible positions for me are the child's pose, the lotus, and anything stemming from those poses. I wonder if you have any advice to offer regarding adaptation as I follow videos and don't attend a formal yoga class. Many, many grateful thanks to you for your help!

A: Thanks for your very interesting question. Since chondromalacia of the knees is a fairly common condition, especially for younger women, I am excited to talk a bit about the condition and then share some general ways of modifying your poses to enjoy the bigger benefits of yoga while keeping that knee happy!

So let’s start off by defining chondromalacia, or what is also known as patellofemoral syndrome (PFS). The NIH website defines it as follows: “Chondromalacia of the patella —the softening and breakdown of the tissue (cartilage) on the underside of the kneecap (patella). The pain associated with this condition is often felt at the front of the knee or kneecap (patella).” Another common cause of pain in this area of the knee is runner’s knee or patellar tendonitis. Because chondromalacia involves actual breakdown of the healthy cartilage that lines the back surface of the knee cap, recovery times, as you have experienced, could be a lot longer than those for inflammation of the patellar tendon, which connects the quadraceps muscle to the front shin bone, via the knee cap.  Runner’s knee usually refers to the section of tendon between the patella and the tibia or anterior shinbone.

It is always helpful to have a sense of how this could come about. Normally, the kneecap sits in front of the lowest part of the upper leg bone, the remur bone, when you leg is straight at the knee joint. Once you bend or flex the knee to 90 degrees and beyond, the kneecap ends up in front of the bottom of the femur bone. The patella has a midline raised grove on its backside like the hull of a sail boat, and the bottom of the femur bone has a groove in it that the patella normally slides on, like a perfect channel for the bottom of the boat. Both surfaces of these bones are normally coated with smooth, slick, cushioning cartilage, so movement proceeds smoothly, silently and without much of any sensation. So how do things go wrong?  Again, according to the NIH:

“Anterior knee pain (such as PFS) begins when the kneecap does not move properly and rubs against the lower part of the thigh bone. This may occur because:

• The kneecap is in an abnormal position (also called poor alignment of the patellofemoral joint)
• There is tightness or weakness of the muscles on the front and back of your thigh
• You are doing too much activity that places extra stress on the kneecap (such as running, jumping or twisting, skiing, or playing soccer)
• You have flat feet”

Because deep bending of the knee joint brings the kneecap and the thighbone into close tighter proximity of one another, inflammation and pain can ensue when PFS is present. So, it is not surprising that you experience pain (I am assuming that is why you are avoiding these poses) in poses like Child’s pose, where not only are you deeply flexing the joint, but you are also putting your full body weight right over that knee. And Lotus involves not only deep flexion of the knee, but also a spinning outward of the shin bone in order to get your foot on you opposite thigh, adding another 3D challenge to an already sensitive joint.

In general, I’d recommend avoiding the deep fold of the knees in poses like Child’s pose and Hero pose (Virasana). One way to do Child’s pose is just flip it upside down, lying on your back, with your hands behind the knee joint to encourage a bit of space in the joint.  For Hero pose, a block on its highest height under your hips could relieve the intensity of the fold and allow for a modified version. Instead of Lotus pose, substitute Cobblers pose (Baddha Konasana), where you can keep your feet further away from your pubic bone and control how deep of a fold of your knees you can do without precipitating pain.

For straight leg standing poses, like Triangle, if it is the knee of the front leg where you experience pain if the knee hyper extends, then there are ways to train yourself to find more even alignment of the femur and lower leg bones, so you can still practice the standing poses with out aggravating your knee.  One use of props that some find helpful is to angle a block just behind your front shin so that it pushes up and forward against the back of your calf at just the point your knee would be going to far toward hyperextension.  It takes some playing around to find just the right spot for the block, but it can start to train your joint receptors to tell you where straight is. Once you know that spot or alignment, you can take the block away.

An experienced yoga teacher could also share many ways to modify poses so you could begin to feel more competent in caring for yourself with the basic yoga postures, and eventually could set the stage for you feeling safe to try a regular class. And always keep in mind that accomplishing challenging yoga poses is not really the goal of yoga, and that you always want to create a practice that serves your bigger goals, such as mental equanimity and clarity, while honoring the unique challenges that each of our body’s will continue to dish up.

—Baxter

Caloric Restriction: Comment and Response

by Nina and Brad

Brad’s post on caloric restriction (see Caloric Restriction and Longevity) prompted an interesting comment from Kathleen Summers MD PhD that I thought it worthwhile to share with you. Rather than having Brad respond in the comments section (I'm not sure how many of you actually read the comments), I asked him to reply to her comment at the end of this post. So have a look! This debate is a very good example of how little scientists currently understand about the aging process (a theme we return to periodically) and provides a hint of some of the many issues surrounding the controversy regarding the best diet for healthy aging.

Posted by Kathleen Summers MD PhD to YOGA FOR HEALTHY AGING

The biggest lesson here is that an excess of energy intake brings disease, disability, and early death. Restricting intake protects against cancer - and also diabetes, arthritis, and heart disease to some degree, although the numbers in the latest study didn't reach significance for the latter (potentially due to limited sample size). Teasing out just what the optimal amount of intake is takes time and research. And it's complicated - there's nutritional, environmental, mental/emotional health, and genetics among other factors playing a role.

The monkeys in both groups of the Wisconsin study ate more and weighed more than the NIH monkeys. The researchers used different sources for their proteins, fats, and carbs as well as a different approach to vitamin and mineral supplementation.

We have one primate study showing extended life span with calorie restriction and one not showing the same but yet other positive results. Let's not jump to absolute conclusions about what the latter study means.

Response from Brad Gibson PhD

Kathleen,

You make some good points, and I agree that this most recent NIA caloric restriction study needs to be considered within the context of other published work. There are undoubtedly many nuances in experimental design and interpretation that future experiments will need to address. That said, my major point is that the data for CR in primates is weak at best.  Many of my colleagues were very critical of the earlier Wisconsin study on two counts: the fact that they fed the control group a fairly high caloric diet and that they removed animals from their final analysis on the basis that they died from non age-related reasons. The removal of animals in the final statistical analysis was a very dubious call. And, as it was pointed out in the NYT article—and by many critics of the Wisconsin study—if those animals were included there was no difference in longevity between the two primate groups. Combined with other studies on more diverse genetic backgrounds in mice that show very mixed effects of CR, one really has to wonder how much traction the CR models has left in it, at least in mammals. Oddly, the data on other model organisms (flies, worms etc.) remain strong.  But one can only push these conserved evolutionary arguments so far.

While there may be benefits in a CR diet as you indicate (e.g., cancer and heart disease), one needs to make a distinction between a low calorie diet and caloric restriction. Many years ago a very prominent scientist in the field of aging who practiced the CR diet stated at the end of his seminar that "we scientists" needed to make a case to the public about the benefits of CR. I challenged him on this assertion, saying that American's relationship to food is so screwed up as it is, that to send a message that food is your enemy is not good advice. There is no evidence that CR in humans is beneficial. In contrast, there's plenty of evidence that a sound, balanced, healthy, low-to-moderate caloric diet (especially one that limits or avoid meat and dairy) is good for you. I suspect we are in agreement on that point.

I also agree that we are still far from drawing a final conclusion on the benefits of CR on human longevity. I was a bit flippant on this point in my last blog post. Guilty as charged. And there is little doubt that there will be more NIH studies examining CR and longevity in various mammalian and primate models as there is still compelling and interesting evidence that needs to be sorted when all animal models of CR and longevity are considered. However, I for one, will be placing my bets elsewhere.

Recovering from Strokes with Yoga

by Baxter

I recently received an email from a recent graduate of a yoga teacher-training program who is looking for more guidance in how to work with her students who have suffered a stroke and are attempting to recover some of their lost function. She happened upon a piece I did for Yoga Journal Magazine a number of years back (see here) and found it useful, but wanted any additional advice I could provide. Seemed like a good topic to share with all of our readers here, so let’s start by defining stroke.

According to the Mayo Clinic: “A stroke occurs when the blood supply to part of your brain is interrupted or severely reduced, depriving brain tissue of oxygen and food. Within minutes, brain cells begin to die.” Stroke is considered a medical emergency that can result is severe disability and death, so it is one of those conditions that need immediate attention. And in the span of time since I began practicing medicine, some significant changes have taken place in the acute treatment of stroke that have gone a long way in improving one’s chances of a better outcome. In fact, in the last 15 years the risk of dying from a stroke has dropped significantly. Better care of the risk factors associated with stroke, such as high blood pressure and cholesterol and diabetes, may be playing a role in these improvements, too. However, getting to a hospital immediately if you suspect stroke is the number one thing to do once symptoms show up.

Once a person has had a stroke, there are innumerable changes that can occur, including trouble walking or even balancing easily on two feet, trouble speaking or understanding what others are saying, paralysis or numbness of the face, arm or leg on one side of the body, or trouble seeing in one or both eyes. There can be mild, moderate or severe mixes of these various deficits in stroke survivors.

Despite the huge changes that can arise for someone who has suffered a stroke, new understanding of how the brain works provide encouragement that what was once considered a largely unchangeable thing (the brain) is now known to be highly changeable. This concept is known as “neuroplasticity.” According to well-known writer and neurologist Oliver Sacks, M.D., neuroplasticity is “the brain’s capacity to create new pathways.” There are now NIH studies looking at the brain’s ability to learn and grow new neural pathways after damage that are quite encouraging. And since physical therapy is considered an essential treatment for post–stroke recovery, yoga asana can supplement this quite nicely.  And yoga may work because someone new to yoga is “learning” new patterns of movement, new skills of observation, as well as learning a new language, Sanskrit, and new verbal patterns, via memorizing yoga sutras and learning chants. So the brain is being maximally stimulated to lay down new neurons in many if not all of the areas that have been negatively impacted by the stroke.

Flowers in a Rock Crevice by Michele Macartney-Filgate

As I have previously recommended, modifying asana practice via doing reclining pose variations either in a bed or on the floor if the patient can easily transfer up and down is quite helpful in situations of extreme weakness or balance problems.  Another way to work if standing is still dicey is to do a chair-based practice, with one or more chairs available. A huge variety of poses can be done safely in this way, including clever modifications of sun salutations.  I’d direct you to several books for more ideas, including Nischala Joy Devi’s The Healing Path of Yoga, and Sam Dworkis’ Recovery Yoga. Although not specifically written for stroke recovery, many of the ideas presented could be nicely adapted for this setting. And for those with more ability to do standing work, the use of the wall for supporting various body parts while doing any number of standing poses could be the next step in progressing students towards more normal physical functioning.

In addition, as way of working with the cognitive loses that can result from stroke, working with mantra, chant and pranayama could be quite helpful for most students. Always start off with simple variations of these things. Encourage regular, repeated practice outside of class once the student has learned the new “pattern.”  It is really the participating in a discipline that may ultimately lead to the positive changes we would hope for our students who have had a stroke. Another modality that may help is certain “eye exercises” that have made their way into modern yoga classes. And although I don’t have a lot of personal experience with these, you could seek out a teacher well versed in such techniques to learn and share with your students.

In addition, due to the fatigue associated with stroke, as well as the mental-emotional stresses that arise, restorative practices and yoga nidra can play a wonderful role in supporting the work of the other tools of yoga you have already introduced to your students. And for teachers just starting out, you often have been given very limited exposure to working with students with special needs, such as stroke survivors. So, I highly encourage you to look for workshops and post-graduate therapeutic training opportunities to increase your skills and competence in working with these special folks. I may return to this topic in the future, but for now, this should give you some ideas to start working with right away. All the best in this very worthwhile endeavor!

Stress, Your Health, and Yoga

by Timothy

As I travel around the globe teaching workshops on yoga therapy—the use of yogic tools from postures to meditation to help people heal—I am struck by what an enormous problem stress-related illness is.  Everywhere I go, from ultra-modern cities like Stockholm where I've spent the last week, to less developed nations, people young and old are suffering the health consequences of their increasingly busy schedules and sometimes even busier minds.

Surprisingly, in this time of widespread tension, unrest and economic insecurity, most doctors still seem not to fully appreciate the deadly consequences of out-of-control stress or how much something like yoga can help. In medical school we were taught about the connection of stress to such health problems as duodenal ulcers, migraine headaches and irritable bowel syndrome. But scientific evidence is increasing indicating that stress can be a factor in life-threatening conditions from heart attacks to depression to hip fractures. Ironically, doctors may be among the most at-risk members of our society, due to their endemic stress and lack of understanding of simple non-drug tools like yoga that can fight it.

When scientists talk about the stress-response system, they are referring to a complex web of events that ramp the body up to deal with an acute crisis. The sympathetic nervous system—the so-called “fight or flight” system—kicks in, which among other things increases blood flow to the large muscles that help you defend yourself or run away from a physical threat. Stress hormones like adrenaline and cortisol are also released. In response, blood pressure and heart rate go up and breathing quickens. Blood sugar and other energy stores are mobilized to fuel whatever challenge you are about to face. In case you are injured, your blood begins to clot more easily. In crisis mode, the body shunts energy away from restorative functions like digestion and reproduction, mediated by the parasympathetic nervous system, which you can think of as the “rest and digest” system.

Arctic Landscape by Michele Macartney-Filgate

This built-in stress-response system is well-adapted to acute crises but can lead to all kinds of problems if it doesn’t gets switched off after the acute crisis passes. Blood clots increase the risk of a heart attack or a stroke, as does the high blood pressure and elevated blood lipids that stress contributes to. Elevated levels of cortisol are associated with everything from major depression to osteoporosis to overeating and weight gain (and the many problems that result from that). And while the immune system initially gets stronger during an acutely stressful event, it starts functioning less well if the stress goes on too long, raising the risk of serious infections and, as at least some evidence suggests, autoimmune diseases.

The problem is that the ancient human stress-response system isn’t so well adapted to mostly non-physical modern world stressors like work deadlines, traffic jams, and even abstract ideas about whether you are happy or fulfilled. If you repeatedly mull these problems over, the chemical and physical changes that were designed to deal with an acute threat to physical health—and which are then supposed to shut off when the threat is removed—remain activated. Such mental tape loops can thus turn abstract worries into concrete threats to health and even to life itself.

Yoga is arguably the best overall system of stress reduction ever invented. More and more evidence suggests the practice can help treat and prevent a wide range of health problems (for details see my web site). Beyond the harmful effects on the body, feeling stressed is a drag. It can make you feel anxious, preoccupied, full of dread.

Yoga can—sometimes within minutes—quiet down an overactive stress-response system. One of the great insights of the ancient yoga masters is that when you move and breathe with awareness, it calms your nervous system and slows down the tape loops in your mind. When your inner monologue slows, most people experience a sense of peace, relaxation and a feeling of being centered.

At first, this only happens when you are doing yoga and perhaps for a short time afterwards. But if you maintain a steady practice, more and more you become aware of and can tap into the tranquility you find in yoga throughout the rest of your day. Over time, you can actually make your nervous system less reactive to minor stressors, and less likely to get knocked off balance by life's inevitable ups and downs. You learn that you can be in a difficult situation, but nonetheless keep the breath slow and deep, and the mind both relaxed and attentive.

This sense of inner calm can make you feel more grateful for what you have, appreciate the beauty around you (which you otherwise might not have noticed) and help you realize that some of the stuff you're getting bent out of shape about may, ultimately, not be very important. And that may be one of the best stress reducers of all.