Yoga and Hip Dysplasia

by Baxter

I received an email just the other day from a colleague in Colorado who was about to meet with a new private yoga client and was looking for some guidance. The woman coming in had apparently been diagnosed with hip dysplasia around the time of delivering a baby. Even without any more information than that, I could guess that the affected hip is the left one, as statistics for this unique hip condition bear that out. And it is eight times more likely to show up in women than men.

Usually, this is a condition that is diagnosed around the time of birth in babies.  When I was involved in my family practice, I’d go in the morning after a baby was delivered to our practice and one of the routine examination techniques was to check the hips of the newborn for a clunking shift in one or both hips when performing a certain movement of the femur bones. From there, if the test was positive, follow up ultrasound or X-rays was done to confirm the diagnosis. The screening done around birth, however, is not perfect, especially when the hip changes are small and that is why the student in question was not diagnosed until adulthood.

Femur Bone

The term “dysplasia” refers to abnormal development of the place where the femur bone (thigh bone) meets the pelvis bone. It can be either the head of the femur bone or, more commonly, the acetabulum (the rounded, concave receptive part of the pelvic bone) that does not develop normally. This abnormal development leads to an increased chance for the hip joint to mildly or more dramatically shift or even dislocate. This can lead in turn to abnormal walking, limping, shifts in the pelvic alignment and other undesirable changes, including pain. When caught in infancy, there are treatments that can help stabilize or treat the condition to increase the chances of more normal development of the joint as the child ages. Untreated milder forms of hip dysplasia can lead to early development of arthritis in the hip joint. And the opposite hip, if unaffected initially, can start to have it’s own problems as it has to pick up the slack for the misaligned dysplastic joint.

According to one source, all treatment aims to delay the onset of arthritis, but no treatment is fully successful in avoiding it. But despite this seemingly dire prediction, it is worth working via yoga or physical therapy to preserve or improve function of the hip.  I’d always recommend checking in with the student’s orthopedic doctor and/or their physical therapist to get a sense of the degree of change in the joint, and any precautions they recommend. Since subluxation (shifting of the bones out of normal alignment) and dislocation are possibilities, using caution when doing deeper internal and external rotation, and deep forward bending of the joint would be wise. The approach I’d take would be to work on strengthening and stabilizing the hip area via both weight-bearing standing poses (such as Mountain Pose, Triangle pose, Warrior 1 and 2 poses, and Extended Side Angle pose, with appropriate modifications and/or propping) and non-weight-bearing poses (such as Reclined Leg Stretch  and our Dynamic Reclined Hip Stretches).

Dynamic Reclined Hip Stretch Position 2

If there is already some arthritis and pain, I’d treat this situation like any arthritis condition, recommending initially practicing more non-weight-bearing asana variations, including reclining on the floor or using a chair for the standing poses, and progressing to weight-bearing if pain has diminished and strength is improving.  Also, remember that preserving range of motion of the joint is important, so taking the joint through all of it’s movement possibilities, keeping the above cautions in mind, will also help keep the joint healthier over time. I will be curious to see how things progress with my colleague’s work. Maybe we’ll get a report back down the road that I can share with you! 

How to be a Yoga Student

by Nina

The Student by Pablo Picasso

I recently wrote about the responsibility that a yoga teacher has (or should have) to respect his or her students (see When to Fire Your Yoga Teacher). But like every relationship, the teacher-student relationship is one that goes both ways. All of us here at Yoga for Healthy Aging are both yoga teachers and yoga students. No matter how much or for how long we’ve taught, we also still take public classes from valued teachers we highly respect. So we have a pretty good idea of how to conduct ourselves on both sides of the equation. And, frankly, I’ve recently heard some disturbing stories about student behavior, including a student who seriously injured himself after ignoring his teacher’s warnings. So I decided it was time to write a little something about how to be a yoga student.

After giving it some thought (and talking with one of my teacher friends), I’ve come up with the following guidelines. If you have some suggestions for guidelines you think I’ve overlooked, please comment on this post or send me an email, and I’ll update the list in a future post

1. Tell your teacher before class about any injuries, medical problems, or other issues that might affect your performance during class. See What Your Yoga Teacher Really Wants to Know for details about what kind of info your teacher needs to keep you safe.
2. Make an effort to show up on time to class. All your yoga classes are planned with appropriate warm-up or opening poses, and missing the beginning of class can affect your ability to do the rest of the sequence. Besides, it’s just good manners!
3. Pay attention to your teacher’s instructions. We all have wandering minds—the kids, the job, your date tonight, the phone call from your mom yesterday, dinner-ooh-yes—but concentrating as best as possible on being present in your class will not only help you stay safe (which is a priority for your teacher), but you’ll also learn more. In addition, staying present will make your yoga session more effective at reducing stress levels as you get a break from your everyday worries.
4. If your teacher asks you not to do something because he or she is concerned for your safety, don’t do it, even if you feel confident that it won’t be a problem for you. Just. Don’t. Do. It. Okay? Your teacher may be wrong, but he or she is trying to look out for everyone in the class.
5. If your teacher asks you to do something that you don’t usually do and don’t particularly want to do—use a particular prop, change your alignment, try a new pose, and so on—go ahead and try it, just this time. You might learn something new, and you can do whatever you want later in your home practice. The only exception to this is if you feel your teacher is asking something that will put you at risk for injury or other harm, or something that you are absolutely too frightened to try. In this case, briefly explain why you can’t do it, and ask for an alternative.
6. Rest if you need to (see Resting Between Poses). Stop if you are in pain (see When to Stop Practicing Yoga). Looking after yourself is a great favor to both your teacher and yourself.
7. Don’t flirt with your teacher, ask your teacher on a date, or make inappropriate personal remarks (you know what I mean). Good yoga teachers don’t have romantic relationships with their students, and overstepping the boundaries they are trying to maintain only makes them—and other people in the class—uncomfortable. (I hate to have to bring this up, but, really, I’ve heard some disconcerting things over the years....)
8. After class, give your teacher occasional feedback about what you found helpful, what you found confusing, or what didn’t work for you (very politely, of course!). All of us teachers want to continue to learn and, hopefully, improve, and getting occasional feedback is very valuable. So don’t be shy!

Friday Q&A: Yoga and Pacemakers

Q: I am a yoga practitioner and a teacher of active classes, and have been for 20 years. I am 64. Four years ago, I had a pacemaker put in to correct sick sinus syndrome, which is to say I began randomly fainting because my heart hesitated too long between beats - for no identifiable reason. All other aspects of my heart health and general health are excellent. I returned to my asana practice slowly as I learned to keep space between the collarbone and first rib where the wire is inserted in the subclavanian artery so as not to damage or wear it out prematurely. Having been certified in Anusara, I exaggerated the action of 'shoulder loop', keeping my side body long and my inner body bright. I have not found any other practitioners or therapists, nor have I found any teacher or doctor other than Dr. Carrie Demers who would even address this. Dr. Deemers suggested nadi sodana and agni sara as ways to vitalize the first chakra energy and therefore increase energy upward.

Does anyone on your team have insight or suggestions? I can't be the only yogi with a pacemaker, can I? My aim is to lessen the amount of times my body turns to this back-up device and to put off the eventual need for replacement of the battery and/or wires - which has to be down for everyone sooner or later.

A: This is an intriguing question. To date, there are no specific studies looking at sick sinus syndrome and yoga to help guide us. And none of our staff are cardiac medical specialists, so we are not able to give the kind of specific, scientifically grounded advice our reader may be seeking. The steps the writer has already taken to keep space between the collar bone and first rib appear to be anatomically sound and may indeed lead to keeping the pacemaker in working order longer than poor postural habits might do. General attention to Mountain pose and other upright poses that encourage a broad, open upper chest region could help this work with the Anusara chest loop.

Because the sick sinus syndrome is not very common, I have included a brief definition found on the Mayo Clinic website:

 “Sick sinus syndrome is the name for a group of heart rhythm problems (arrhythmias) in which the sinus node — the heart's natural pacemaker — doesn't work properly.” 

See the Mayo website here for further information.

The result of a natural pacemaker that does not work properly can be a slower heart rate, a faster heart rate, long pauses in heart rhythm, or a combination of these variations.  Once the condition is treated and artificial pacemaker is put in place, these variations become less dangerous.

Although I could not find specifics on the effects of stress for sick sinus syndrome, stress can definitely have a negative effect on general heart health. Yoga has been found to be helpful with other heart conditions, even though sick sinus syndrome has not been yet studied. And because yoga techniques can help lower stress responses in regular practitioners, simply doing a balanced practice several times a day, if approved by your cardiologist, could be of overall help for your heart health. In addition, practices that are deeply relaxing for the body and mind, such as restorative practice and guided meditations like yoga nidra would also be helpful.

Caution should be practiced with pranayama techniques in which the breath is held at the beginning or end of an inhale or exhale, as these could either stimulate the heart rate to drop too low or surge too high.  In particular, if one takes a full breath in and then retains or holds it for a number of seconds, it could cause a sudden drop in heart rate if not performed properly. In the medical world, this is known as a Valsalva maneuver.  And although it is used in medical settings to treat abnormally fast heart rates and even as a diagnostic tool, a pranayama practitioner would not necessarily want to invoke this response unawares. 

Balanced alternate nostril breathing, nadi shodhana, without retention, would therefore  likely be neutral in effect on the heart, and therefore safe to practice. Agni sara, since it involves breath retention at the end of an exhale, could be a bit more tricky. I’d recommend finding a pranayama teacher with many years of experience to work with more closely to support a regular heart rate. Please keep us posted on practices you find helpful down the road!

—Baxter

Practicing Yoga Off the Mat

by Nina 

Rock Close Up by Brad Gibson

This sutra prescribes a kind of mindfulness or mental cultivation off the mat, so to speak, that is, in day-to-day affairs outside of the context of citta-vritti-nirodha-type meditation. Cultivating the higher qualities of sattva is a continuous and constant requirement of the yogic path and spills over into all aspects of life’s affairs and social interactions. It speaks to the fact that yoga need not be perceived as a world-renouncing tradition but is perfectly compatible with engaged and benevolent social action in the world. —Edwin Bryant

In my home practice, I’ve worked on some pretty challenging yoga poses in my day (dropping from headstand into a backbend, for example), but the most challenging yoga practice I’ve ever attempted is something I’ve taken up lately, off the mat. In fact, it’s the practice recommended by the yoga sutra that Edwin Bryant was referring to in the above quote:

Yoga Sutra 1.33. By cultivating an attitude of friendship toward those who are happy, compassion toward those in distress, joy toward those who are virtuous, and equanimity toward those who are nonvirtuous, lucidity arises in the mind. —trans. by Edwin Bryant

In classical yoga, the intent of this practice is for cultivating the peace of mind (“lucidity arises in the mind”) that is a necessary prerequisite for achieving the union with the divine that is yoga. However, I’m adopting this practice (or trying to, anyway) for other reasons as well. One of my main reasons is to help me maintain good relationships as I age. (I want the richness of life that comes with that, not just the health benefits....)

In talking with some of my older friends, I’ve been noticing that many of them seem to be getting fed up with each other. They talk about this one being angry all the time or that one being lonely due to his or her own bad behavior in the past. And I can’t help but feel a little more compassion might go a long way to preserving these long-time friendships. It’s something Brad and I have been discussing, and we have agreed to try to cultivate more compassion for those in distress (as well as all that other stuff in the sutra 1.33) for the benefit of all our relationships in the long run.

I have to confess practice is very difficult for me, however. I tend to very judgmental, probably because that’s how I was raised. My parents were very snobbish—although that’s a word they wouldn’t use themselves—about people who didn’t share their values and tastes. I wonder now if that was a result of them both being the children of immigrants, and the hard times they had as children fitting in to the American mainstream. It’s not the stereotypical story—they were artistic types who taught me to disdain people who had a lot of money but no taste—but it’s still a story of people who used their judgments of others as a shield for their feelings of insecurity. I also tend to be very envious of other people’s successes (rather than happy for them). I don’t know if this was also a family pattern—I do know my father suffered from feelings of failure because he never lived up the expectations that he and others had for him when he was a young art prodigy—but it’s something I’ve observed about myself time and time again. And all these samskaras  (thought patterns) run very deep.

So how am I beginning my practice of this challenging form of yoga? For now, I’m starting with mindfulness in my thoughts and feelings about others. And when I catch myself moving toward (or leaping to) judgment, I remind myself that there is another attitude I can take: compassion. As Stephen Cope says in Yoga and the Quest for the True Self:

I have said that samskaras are like ruts in a road, and that as the ruts deepen through repetition, it becomes inevitable that the car will slide into them unawares. Any intentional effort to restrain the car from slipping into the rut is called tapas.

Tapas requires a particular kind of attention—precisely the kind required when driving on a rutted road. We need to be awake. We need to be concentrated in order to avoid the edges of the ruts. And sometimes we need to pull the car wheels—with considerable effort—out of the ridges in the road.

Many Right Ways To Do A Pose and a Few Wrong Ones

by Timothy

Branches and Roots by Brad Gibson

I got involved in a conversation the other day with Nina after class with our teacher Donald Moyer. Another student was wondering about the “correct” way to do forward bends. She’d just read an article in Yoga Journal by a highly respected teacher who said that the only correct way to do forward bends was with a concave lower back, that is, maintaining a normal inward curve of the lumbar spine. Although Donald sometimes prepares for forward bends like Uttanasana by doing the pose with a concave lower back, in the final pose, he suggests we allow a nice, even rounding of the spine, that is, completely reversing the lumbar curve.

Inherent in the student’s question is the notion that there is only one correct way, that everybody in all circumstances, should do any pose. The reality is that it always depends. What are you trying to achieve? What poses have preceded it and what do you plan to do after it in your practice? Are there contraindications you need to consider? Are there quirks in your anatomy or injuries you need to work around?

We could do this analysis for any pose but, since we’re on the topic, let’s stick with forward bends.

There are times when it is definitely not a good idea to fully round the spine. If you have a herniated lumbar disc, for example, rounding is generally contraindicated. When you round forward, the front surfaces of adjacent lumbar vertebrae come together which tends to push the disc material toward the back of the body, near where nerves exit the spine. This rounding the lower back could lead to nerve compression and sciatic pain.

For a similar reason, rounding the back in forward bends is generally not recommended for those with osteoporosis. Compression fractures of the spine happen when the front surface of one vertebra collapses under pressure from a neighbor. But forward bends done with a concave lower back can actually be therapeutic for those with thinning bones, and were part of the routine Dr. Loren Fishman used in his ground-breaking research (still ongoing for those interested in enrolling in the study) that is documenting yoga’s powerful ability to increase bone mineral density.

For those who lack such contraindications, rounding the spine the way Donald teaches may lead to deeper relaxation and more quieting of the nervous system. When looking at students from an Ayurvedic standpoint, long holds of rounded forward bends can be deeply calming to the vata dosha (the imbalance often tied to stress and over-activity). Long holds of such forward bends are part of yin yoga, and can be a wonderful way to open tight hips, for example, to prepare the body to sit comfortably for long periods of time in mediation.

So my way of thinking is that there is more than one correct way to do forward bends, all depending on the overall situation and what you are trying to accomplish. But that said, there are also certainly wrong ways to do poses. In my mind, any way of doing a pose that unduly increases the risk of injury, or which puts the joints or other bodily tissues in compromised positions is wrong. In forward bends, one common incorrect method is to bend from the waist rather than hinging from the hips. Although not all yoga teachers would agree, I also advise against any knee locking in the poses.

Of course, this just begins to describe all the thinking on forward bends found among different yoga teachers. Some people sit up on folded blankets or other props, which allows them to get more forward tipping of the pelvis, but not everyone needs to do this. Some people hold their toes, some hold a strap looped around the soles of their feet, and some place their hands alongside their legs. Ultimately, good teachers learn to look at students, ask them questions and determine a reasonable approach.

To me the final arbiter of whether a yoga technique is right or wrong is the breath. If you’re able to do the pose and the breath can remain smooth, deep and even, more than likely you're doing it a right way (though probably not the right way).

Thoracic Outlet Syndrome and Yoga

by Baxter

For many of you out there, Thoracic Outlet Syndrome, abbreviated TOS, is one you may not have heard of. Yet, it arises most commonly in people who have been in traumatic accidents, typically in car accidents, or who do repetitive jobs, such as computer work at a non-ergonomic workstation, so that is potentially a lot of people. In addition to the two causes mentioned already, there are other less common causes of Thoracic Outlet Syndrome, like the presence of an extra small rib that can compress nerves and blood vessels near the lower side of the neck.  Regardless of the underlying cause, folks who develop Thoracic Outlet Syndrome often complain of a host of symptoms, which can include, but are not limited to, numbness and pain in the affected side of the neck, that is, in the arm, front chest and neck. There can also be weakness in that arm or hand. Symptoms often come and go, and in some situations can be positional in nature, only arising when the affected side arm is lifted and held overhead for a little while. 

What’s happening under the skin, so to speak, is that any of a number of structures could be getting compressed that should not be. More specifically, the cervical nerves that come out of your spine and come together to form the brachial plexus, (a kind of super highway interchange of different nerves from the cervical spine before heading down into the arm) can be pushed on by muscles and/or bones and lead to the symptoms described above. The same fate can befall the subclavian artery, the large blood vessel from the heart that feeds the arms, as it moves through the area of the side neck, under the collar bone, and out into the upper arm. 

A commonly cited aggravator of this condition is poor posture, which we have mentioned in many other contexts as contributing to other body pain conditions, and for which yoga is such a great antidote. In fact, most people diagnosed with Thoracic Outlet Syndrome will first be referred to physical therapy for postural re-alignment and stretches to open up the area of the neck and upper chest in order to create more space around the brachial plexus and arteries and veins to lessen or eliminate the symptoms associated with the condition. One muscle group that is often implicated in compressing the nerves and blood vessels is the scalenes, specifically the anterior and medial bodies of this three-muscle trio.

Muscles of the Neck

It would be worth your while to review an anatomy book if you are interested in understanding these muscles, which movements they normally create, and how one might stretch them to relieve tension on our delicate nerves and arteries.

Yoga could be a great adjunct to this healing process, since many of our sequences and poses address this area of the body nicely. Even simple warm up exercises like shoulder rolls, where you bring your shoulders forward, then up, then back and down, can start to improve this area immensely. I start class with this kind of attention to the upper chest quite often. Basic attention to Mountain pose and supported reclining backbends would be good starting places as well. And there are a few postures that directly affect the scalenes, such as the head positions in Bharadvajrasana seated twist in which you rotate and then side-bend the neck.

Conversely, since folks with Thoracic Outlet Syndrome often get symptoms when their arms are held overhead, some caution must be used when doing yoga poses with the arms ups, like Warrior I pose, for instance, especially if you intend to hold the pose for a while. I would not be surprised that a few people out there may have become aware of their positional symptoms after starting yoga due to the demands of the poses on the arms. (Yoga would not “cause” Thoracic Outlet Syndrome, but could alert you to its presence in such positions as Mountain pose with arms overhead, Urdhva Hastasana.) If such postures do bring on pain or numbness, it might be more prudent to experiment with dynamic versions of such poses, moving the arms up and down with the breath to see if the dynamic action precipitates symptoms. If not, you could continue to practice this way or even add in short holds as long as no symptoms arise. 

By moving and liberating held tension in this area, ultimately you may be able to relieve the compression that is underlying the Thoracic Outlet Syndrome. In fact, most patients with this diagnosis find some improvement with modalities like physical therapy and, I suspect, yoga as well, and very few have to resort to surgical intervention to find relief. 

Satya: The Truth About Lies and Healthy Aging

by Ram

Sun Through the Clouds by Brad Gibson

In the Sadhana Pada of the Yoga Sutras by Patanjali we are introduced to the yamas that serve as moral, ethical and societal guidelines for a harmonious living. The five positive guidelines help us to behave and relate to our surroundings and environment and to achieve oneness with it. Patanjali considered the yamas as universal vows and preached that they be practiced on all levels: by way of thoughts, actions, and words. Thus, the yamas serve as prized guides to lead a conscious, honest and ethical life. Satya, meaning truth, is one of the five yamas in the yoga sutras. Verse 2.36 defines satya as:

satya pratisthayam kriya phala ashrayatvam

Being well grounded/established (pratisthayam) in truthfulness (satya), the fruits (phala) of actions (kriya) naturally result (ashrayatvam) according to the will of the Yogi. —translation by Swami Jnaneshvara

Satya is also defined in Sanskrit as “sate hitam satyam,” which translates to “The path to truth is ultimate truth itself.” Thus, one who is always truthful in actions, speech, and thoughts, his or her will is naturally fulfilled since such behavior allows a natural flow of goodness or positive feelings. Truth is considered divine and should be spoken to maintain righteousness (dharma in Sanskrit). Truth connotes purity and is superior to silence. If we start living in truth, we may not have to tell lies at all at any point of time. Truth keeps us free from all kinds of emotional turmoil.

Telling the truth significantly improves a person’s mental and physical health, and has a positive impact on health and longevity, according to a “Science of Honesty” study presented at the American Psychological Association’s 120th Annual Convention. Anita Kelly and LiJuan Wang of Notre Dame recruited a group of 110 people from 18 to 71 years old, and told them that once a week for ten weeks they’d have to come in and, in a lie detector machine, report how many times in the previous week they had lied. Approximately half the participants were instructed to stop telling both major and minor lies for the duration of the 10-week study. The other half served as a control group that received no special instructions about lying. Both groups came to the laboratory weekly to complete health and relationship measures and to take a polygraph test assessing the number of major and white lies they had told during that week.

The results were astounding. Participants across both groups who lied less in a given week reported their physical health and mental health to be significantly better that week. Participants in the no-lie group reported improvements in their relationships, less trouble sleeping, less tension, fewer headaches, and fewer sore throats. Telling three fewer minor lies a week translated to four fewer mental health complaints, and three fewer physical complaints. According to the authors of the study when you are honest, you feel good about it and life gets better. Associated with this, there is less stress and fewer physical and mental problems.

Research on how lying affects health is scant, but lying is thought to trigger the release of stress hormones, increasing heart rate and blood pressure. Stress reduces the number of your body’s infection-fighting white blood cells, and over the years, could contribute to lower-back pain, tension headaches, a rapid heartbeat, menstrual problems, and even infertility. Moreover, research has linked telling lies to an increased risk of cancer, increased risk of obesity, anxiety, depression, addiction, gambling, poor work satisfaction, and poor relationships (see The Prevalence of Lying in America: Three Studies of Self-Reported Lies. According to these studies, lying and its negative effects are a two-sided problem: liars create physical and emotional problems for themselves and people with these underlying problems are more likely to lie. Lies not only imprison an individual, but the more we lie, the harder we have to work to protect those lies from being discovered. As a result, all the physical, mental and emotional energies are diverted into protecting those lies, and we live in constant fear that can lead to chronic stress, health problems and unhealthy aging

One method that has been suggested for cutting back on lies and telling the truth is to surround yourself with like-minded, honest folks who will encourage you to be a truthful person. There’s an adage “Truth hurts for a little while, but lies hurt forever.” So tell the truth and protect yourself from the insidious damage of chronic stress, as it will help you live healthier and even longer lives.

Satyameva Jayate
(Truth Alone Triumphs)

Friday Q&A: Peel Method in Bridge and Other Poses

Q: Is the Peel Method (flexion) for Bridge pose also contraindicated for students with spinal osteoporosis?

A: If the peel method you are referring to is the technique Baxter's described in his post To Peel or Not To Peel of slowly rounding the spine into flexion, then the short answer is yes, this version of the pose is contraindicated for students with spinal osteoporosis. Students with spinal osteoporosis should not generally move their spines into a flexed (rounded) position one vertebrae at a time. But I have to qualify this statement. If you are flexing vertebra by vertebra while standing as if you are going into Standing Forward Bend (Uttanasana) this would definitely be contraindicated, because the force generated through the vertebral bodies will be very high. However, if you are talking about the movement of going into Bridge pose as Baxter described, then the answer might be “maybe.” In Bridge pose, gravitational forces through the vertebral bodies are less because the load is not vertical loading. However, if the muscular contractions to round the vertebra are very strong and maybe propulsive then this would potentially cause load forces greater than the vertebral bodies can sustain (see info on Wolfe's law in the post What is Osteopenia?). So how do you know how much force is transmitted through the vertebral body? Unfortunately, you can’t really tell. So my general recommendation for all people with osteoporosis is to stay on the safe side and avoid all flexed asana positions, including the flexed position of the spine created by Peel Method of entering and exiting Bridge pose. I hope this helps!

—Shari

Writing to Us

by Nina

The Love Letter by Johannes Vermee

All of us here at Yoga for Healthy Aging (Baxter, Brad, Nina, Shari, Ram, Timothy and Bridget) love hearing from you! Getting feedback from you about our posts helps keep us inspired and provides us with interesting topics to address that we might not have come up with on our own. And, of course, we love fan mail!

One way you can contact us is by leaving a comment on any post (even an old one). See the "How to Comment" tab at the top of the page if you are confused about how to leave a comment. You can be sure your comment will be seen! I, Nina, read all the comments as they come in, save all the questions in a file so we can address them in the future, and forward comments of interest to the authors of the respective post to ensure they read them. However, comments are seen by the general public and you may wish to send us a private message.

To send us a private message, use the "Contact Us" tab at the top of the page. The email address you will be using is mine, so I, Nina, receive all the messages. Again, I read through all of the messages and if there is a question, I store it in a file so we can address it in the future and forward any messages of interest to the author of the respective post. And, of course, all the authors read the messages that I forward to them.

Although the messages you email to me are private, I assume any yoga questions you have can be used for the Friday Q&A (although I always remove the name of the person who asked the question) or as the basis for a new blog post. However, if you state in your message that you want the contents to remain completely private, I will respect that. So you can feel comfortable sending something personal.

The one thing I cannot promise is that any of us will conduct a private correspondence with you. I say this because once in a while we receive messages with personal questions or concerns that request a personal reply. To be honest, it’s really an issue of time. All of us have other kinds of work we’re doing (such as full-time jobs or busy teaching schedules!) so taking the time to write a single person about his or her personal yoga concerns is time away from working on the blog itself. This just doesn’t make sense because all the writers for this blog are unpaid—it’s a labor of love for all of us—so we need to focus our free time on providing high-quality content for the general public. Also, as I put it to Baxter when he received a detailed request for advice regarding a reader’s physical problems, the writer would essentially be getting free private coaching, which is obviously not something we can offer to hundreds or thousands (our following is growing!) of people. I sincerely hope you understand and keep this in mind when you write to us. Again, I do promise to read all your messages, and if you write to a particular person, I’ll make sure that he or she reads your message as well.

Namaste.

Mixed Feelings About Yoga Poses

by Nina

Crying Girl by Roy Lichtenstein

When I first started practicing yoga at home, I had no idea how to sequence poses. I mean, I had a basic idea that there was a warm up pose or two, then some standing poses, and then some seated poses (or backbends). But within those larger categories, I didn’t really know how to put the poses in order. So for my standing poses, what I would do—ssshh! true confession!—is alternate between poses that were difficult for me (I had some intuition that I should practice them so they would become easier for me—befriending them, you might say) and “treat” poses, the poses I always looked forward to and enjoyed doing. So there I was telling myself, okay, if you do a pose that’s hard for you (let’s say Extended Side Angle pose), then you get a little reward by doing a pose you really enjoy (let’s say Triangle pose).

These days, having completed a three-year teacher training program, not to mention having more than 20 years of practice under my belt, I know a lot more about how to sequence poses. However, I still find that I have a similar mix of feelings about the poses I practice. Various thoughts go through my mind as I move to the next one (or, if I’m in class, when my teacher announces the next one) from "uh-oh, not this one", to "oh, boy, my favorite!" As my practice has matured and my body has changed (there’s that bit of arthritis in my right hip), some of my attitudes toward particular poses have evolved, but there are still some poses I love, some I feel neutral about, and some that, well, are just not my favorites. Then, because our minds are a little quirky sometimes, I have other thoughts, too. One of the thoughts I often catch myself having always amuses me, and it goes something like “Whoa, I haven’t done that pose in so long it’s going to be so—wait—I think I actually did it yesterday!” Then I smile and think, “What’s that about?”

I’m telling you all of this because yesterday in her post When to Stop Practicing Yoga, Shari made reference to the “flurry of self-judgments and criticisms” we experience when doing yoga poses:

Each time we move into a yoga pose there are a flurry of self-judgments and criticisms—”Oh no, not this pose again, I can’t ever do this, I hate this…”—the internal psychological dialogue can be unending. It takes a lot of mental discipline to quiet the mind to be fully in the asana. But then the actual physical body starts its own chorus of complaints—“This is making my knee hurt, or my back or my shoulder.” The mind can and does ignore a lot of this noise, “strong arming” the body into submission. But that cranky joint knows when to strike back and it often does. So, when should we listen to the body over the noise of the mind?

I don’t know about you, but this experience that Shari describes is one that I have had before. And I think she was writing this in the spirit of compassion for those who are struggling with chronic pain or fear of movement. However, I think it’s important to emphasize that there probably isn’t a flurry of self-judgments of and criticisms every time we move into every pose. Sometimes there is contentment and pleasure, maybe even joy. Some days practice is easier than it is on other days. And whether it’s a challenging pose like Headstand or a delicious restorative pose like Reclined Cobbler’s pose, just about everyone has some poses that they enjoy—and maybe even love—doing on a regular basis. And in my home practice, I still make sure to include some of my "treat" poses in every sequence that I do. In fact, it’s my love of the asana practice and the pleasure it brings me that has kept me for practicing for all these years. (Sometimes—another confession—I have so much fun during my practice, I dance around a little between the poses.)

So if you’re having negative thoughts about a pose, know you’re not alone. Be compassionate with yourself when you catch yourself doing it and try to be present in the pose. And, as Shari recommended, listen to your body to see if it’s trying to tell you something important. But also take the time to notice your positive thoughts and the enjoyment you take in certain poses (or maybe, at times, in all the poses). This will not only teach you about your mental habits but you’ll be learning about your particular body type and emotional temperament. It might even provide you with the information you need to make some of the poses you find difficult—and, trust me, everyone finds some poses difficult, though the particular poses people find difficult differ widely—easier and more enjoyable to practice.

When to Stop Practicing Yoga

by Shari

Swan at Rest by Brad Gibson

Sometimes we do things that we think are healthy or beneficial for us, but which are actually not. Even practice of yoga, whether at home or in a class, can occasionally be problematic. Have you ever gone to a class feeling a “bit off” and then walked away from the class feeling drained or in actual pain? Or, have you ever gone to a class feeling a “bit creaky” but hope that the “kinks” will work themselves out, but instead of feeling in less pain, you are in more pain after class? I don’t think this is a situation that only I have experienced in my over 30 years of practice! And I have begun to think of this topic as a means of exploring self-empowerment and non-judgment.

So, why do we continue to participate when we know we should stop? All of my fellow bloggers have addressed this issue in slightly different ways, whether it is in our approach to eating, sleeping, or basic life stressors.

I think we can explore this idea on a psychological /emotional level or on a gross physical level. I will start this discussion with the gross physical level of the body. First off, the practice of asana is not just a physical body moving through space following the commands of our central nervous system. Each time we move into a yoga pose there can be a flurry of self-judgments and criticisms—”Oh no, not this pose again, I can’t ever do this, I hate this…”—the internal psychological dialogue can be unending. It takes a lot of mental discipline to quiet the mind to be fully in the asana. But then the actual physical body can start its own chorus of complaints—“This is making my knee hurt, or my back or my shoulder.” The mind can and does ignore a lot of this noise, “strong arming” the body into submission. But that cranky joint knows when to strike back and it often does. So, when should we listen to the body over the noise of the mind?

I often tell my students that it is extremely important to understand our own physical as well as mental limitations and to respect them. Pushing beyond one’s actual abilities does lead to injuries (see Baxter's post Getting Clearer on Yoga and Risk of Injury). So when and how do we improve our abilities without causing injury or damage? We have to know when to stop!

With that in mind, here is a list of physical warning signs that would be important to acknowledge:

1. Pain progression in both intensity and location. A back pain that is located centrally in your spine that starts to spread outward or downward is a warning sign to stop that activity. Another warning sign is when the area of pain totally changes location from back (spine) to arm or leg.
2. Pain intensity. Pain is usually quantified on a 0-10 point scale where 0= no pain and 10 is excruciating intense pain. Any pain that moves from negligible, like a 3, to a 6-7, is not something you want to encourage. 
3. Loss of sensation in a limb, an increase of numbness, a tingling, or burning that doesn’t stop once the position is changed.
4. Increase in a sense of “unease.” You don’t know why this activity is making your nervous, unsettled or agitated, but it would be wise to stop the activity and ask your teacher afterwards.
5. Any sensation of dizziness, nausea, double vision. These are not symptoms that are a healthy benefit from asana.
6. Any signs or symptoms of heart racing or feeling that your heart beat feels irregular.
7. Physical exhaustion. Instead of feeling better as the class progresses, you start to feel more and more exhausted.
8. Mental exhaustion.

If any of these events occur during a class it would be wise to stop and sit leaning against a wall. Sometimes closing your eyes or going to get a drink of water will be helpful. Other times just stopping and lying down in Savasana will work. Finally, there may be times actually leaving the class is necessary. If this occurs, quietly get up and leave the room. Your teacher may or may not come to talk with you. If he or she does approach you, briefly let the teacher know what is going on with you. If you are concerned about discussing medical issues in front of the class, only discuss what you feel comfortable with. Then, especially if this is a regular class that you attend, consider contacting the teacher afterward to give him or her the complete information. Having complete information about your condition will help your teacher do a better job of making your next experience in class a good one.

For information about what you might want to tell your teacher before a class, see What Your Yoga Teacher Really Wants to Know.

Finding the Right Yoga Teacher: Tips for Third Agers

by Andrea Gilats, Ph.D., R.Y.T. (guest poster)

In my yoga teaching practice, I regularly work with people who have had negative experiences in yoga classes geared for younger bodies. The names of these classes tell the story—Power Flow, Yoga Blast, Yoga Sculpt, Hot Flow—you get the idea.

What do these students tell me about their experiences? “I thought I was going to die,” “I was counting the minutes until it was over,” and, most frequently, “Get me out of here!” I’ve come to call these yoga seekers “refugees” because they often come to my Third Age Yoga classes as a haven of last resort. 

Like most of my students who are experiencing aging-related changes and challenges, “refugees” want to learn or reconnect with yoga, but most yoga studios don’t serve them well. And that’s a shame when you consider that there are 76 million baby boomers in the United States who want to stay healthy and vital as they age. We need our society’s fastest growing demographic segment—adults 55 and over—to be self-sufficient, contributing members of our communities well into their 70s, 80s, and beyond.

As we get older, our bodies become more unique and less alike. That’s because we carry our physical and emotional histories in them. And whether it’s because of a chronic condition like osteoporosis, a touch or more of arthritis, too many years of too much sitting at a desk, a joint replacement, or surviving through cancer, we need approaches to yoga that respect our growing individuality so that we can stay safe in our practice and fully enjoy the benefits of yoga.

Don’t get me wrong. Most people in their 50s, 60s, and 70s—what some aging experts call the “Third Age”—are a far cry from needing the chair yoga classes offered in senior centers, but we do need classes that offer body-sensitive, age-appropriate yoga instruction and practice. In that spirit, I hope you’ll consider the following tips as you choose yoga teachers and classes.

Look for a teacher who has experience with older students. This may be someone who is older and more life-experienced herself or a younger teacher who is especially sensitive to each student as an individual.

Notice how your teacher treats her or his students. Is the teacher respectful and compassionate toward each person? Is she patient without unduly disrupting the continuity of the class? Is she fully present? Does she fully engage your attention? As Ram Dass said in his classic book, “Be here now.” That goes for all of us!

Look for a teacher who actually teaches. Rather than someone who simply leads a group through a series of lockstep movements, choose a teacher who demonstrates before inviting you to engage the poses, who thoughtfully tries to answer your questions, and who offers optional and alternative approaches to poses, rather than one “correct” version.

Look for classes in which the teacher can see and pay attention to each student. This is a basic safety precaution, and yet—probably for financial reasons—many yoga classes are just too big. Make sure you have enough room to bring your arms straight out to your sides, and make sure you can see your teacher, especially her feet and knees. If necessary, leave your mat to watch your teacher demonstrate.

Find a class in which you can comfortably keep up with the teacher. Yoga is a journey through your comfort zone, so think first about how you feel in each pose. Are you reasonably comfortable while enjoying a healthy challenge? Or are you counting the seconds until your teacher releases you from your torture? Is your breathing steady? Or do you feel stressed or panicked? Stay with movements and positions that feel like they’re doing you some good, but feel good while you’re doing them. You’re in the wrong class if you don’t feel good while practicing and can’t keep up with the teacher.

Take a short rest during class if you need to. Don’t worry if you can’t keep in step every moment, even in a class in which the pace and rhythm feel right to you. For example, I serve students who are living with chronic lung conditions, so I try to observe their breathing and offer them chances to catch their breath when needed. Just feeling free to hit the pause button for a few moments during class can transform a negative yoga experience into a positive one.

Don’t ever let a teacher touch you without your permission. I learned this from Judith Hanson Lasater, a renowned yoga teacher. And guess what? I’ve found that if I stand right next to my student, and we move together into and out of a pose, that person grasps the essence of the pose more quickly and deeply than if I had tried—however gently—to prod her body into a position that may not have been available to her at that time.

Stay with a teacher who stresses healthy postural alignment. One of the most important benefits of practicing yoga as we age is reclaiming healthy postural habits. Good posture —the natural, stable alignment of our bones—is a key to feeling comfortable and steady in yoga poses. So try not to become impatient when learning techniques for finding healthy posture; they not only help on the mat, but are immediately helpful in our lives off the mat.

And finally, don’t worry if you can’t find all these suggestions wrapped up into a perfect teacher/class package! If you connect with your teacher and feel comfortable with your fellow students, you will probably have a physically beneficial, life-enhancing yoga experience to which you’ll want to return week after week.

Andrea (Andy) Gilats, Ph.D., R.Y.T., is an educator, writer, and certified yoga instructor. She specializes in working with people seeking a body-sensitive, age-appropriate approach to practice. She calls her approach Third Age Yoga  (www.thirdageyoga.net) as a welcome mat to all of us in the Third Age, a sustained era of life beyond midlife but before true old age, in which active engagement and personal fulfillment take center stage. As a writer, Andy has published a variety of articles on wellness and positive aging, and she is the author of Life Slices, a lushly illustrated card deck that invites us to contemplate eight timeless life themes and 52 pathways toward creating a life of purpose and meaning.

Friday Q&A: Working with Cat and Mountain Poses

Q: So glad to see dialogue about osteoporosis and yoga! Very topical for so many of us. Thank you. What about the cat pose in cat/cow sequence? Possible modification in focusing more on rounding the fanny end of the spine, rather than the shoulders? Best poses for back extensor strengthening? Anything that reinforces Tadasana?

A: Thanks for your questions regarding different approaches to yoga poses. I always start by asking myself what is my underlying purpose of goal in doing this pose?  Am I doing it simply as part of a well balanced practice, to both stretch and strengthen as much of the body as I can? Or am I using the pose as a preparation for a more challenging pose later in a given sequence or practice?  Given those possibilities, there are many different and equally valid variations on a theme of a given pose that I might play with.

Let’s look at the Cat position in Cat/Cow. We are allowing the spine to round toward the ceiling, bringing all of the vertebral joints into forward flexion direction, and retroverting the pelvic bones over the thigh bones. If we were standing in Mountain pose, this would be the action we typically call “tucking the pelvis under.” It is not the ideal shape for the pelvis and lumbar area in standing position, but you could do or demonstrate this standing before doing Cat/Cow to set up an understanding of the extremes of the range of motion you are looking for in each part of Cat/Cow.  Likewise, you could do the same from lying on your back and doing pelvic rock and roll in constructive rest. Another way to emphasize the Cat could be to ask the student to bring more attention to drawing the lowest part of the abdominal muscles up toward the sacrum on an exhale, while pointing the tailbone down more actively. With students who are not able to find this, I will ask permission to assist in moving the pelvis into the desired position. What I sometimes discover is that their hip rotators are extremely tight and they are already working at their maximum. Give them time and repetitions to gradually open this area more.

As for poses that strengthen the back body extensor muscles that promote extension or back bending of the spine and torso, I use easy backbends, such as accessible poses like Cow pose in Cat/Cow, Locust and Cobra (low, middle and high), Warrior 1 and 3, gradually moving towards more challenging back bending poses, like Bow and Upward Facing bow. I usually warm up the muscles by doing a dynamic series, such as with Locust from the starting position on the belly, inhaling into Locust, exhaling back to the starting position, repeated six times. Then, I would try to hold the pose for a while, say six breath cycles. In general, a good balanced yoga practice that includes some backbends will strengthen these muscles nicely.

In order to reinforce the Tadasana position (Mountain pose), it really depends on what aspects of the pose you are looking to bring attention to. One thing that I find very helpful is the leg action of “grounding” into the feet. This can be confusing to beginners, but is quickly remedied by having them lie on their backs near a wall, knees very slightly bent, and then have them push the soles of the feet evenly into the baseboard or lowest part of the wall their feet are touching. Have them push the heel and ball of the foot evenly into the wall while noting the feeling of the leg muscles contracting to create this action. Then get them up and have them recreate that feeling standing.

Finding the natural lift of the spine is trickier, but I have a little skull lifting adjustment I do with them that quickly helps them re-align the spine. I will try to get some photos of that, as it is easier to see than describe.

Hope these ideas are helpful as you play with Cat/Cow, back strengthening and Mountain Pose!

—Baxter

Meditation: A Bench Press for the Brain?

by Nina

Two recent articles in the NY Times suggest that practicing meditation may increase our cognitive abilities. The first article, How Meditation Might Boost Your Test Scores, discussed a study published last month in the journal Psychological Science  by University of California, Santa Barbara researchers. The UCSB researchers found that after a group of undergraduates went through a two-week intensive mindfulness training program, their mind-wandering decreased and their working memory capacity improved. They also performed better on a GRE reading comprehension test. Students in the control group had no similar improvement.

Granted, this study was on young adults, but increasing memory capacity in general sounds real good to me! Richard J. Davidson, a professor of psychology and psychiatry at the University of Wisconsin-Madison, who has studied brain function in long-term and novice mindful meditators, explained it this way, “You can improve the signal-to-noise ratio by reducing the noise. Decreasing mind-wandering is doing just that.”

The second NY Times article, In Sitting Still, a Bench Press for the Brain, discussed the many possible benefits of meditation in older people, citing several different studies. One study that intrigued me was The unique brain anatomy of meditation practitioners: alterations in cortical gyrification published in the Frontiers in Human Neuroscience journal in February, which looked at the extent to which meditation may affect neuroplasticity (the brain’s ability to make physiological changes) Previous studies found that the brains of long-term meditators had increased amounts of gray matter—believed to be involved in processing information and white matter—believed to be the “wiring” of the brain’s communication system.

In the recent University of California, Los Angeles study, M.R.I. scans were used to measure the features of the subject’s brains and compare them to a control group of non-meditators. The meditators had a median age of 51 and had all been practicing meditation of various types for an average of 20 years. The oldest subject was 71 and the longest practitioner had been meditating regularly for 46 years. The study concluded that “the degree of cortical gyrification appeared to increase as the number of years practicing meditation increased.” The Times quotes the lead scientist of the study:

“We used to believe that when you were born, your brain would grow and reach a peak in the early 20s and then start shrinking,” Dr. Luders said. “It was thought there was nothing we could do to change that.”

Now it appears that we can! Although this study does not provide conclusive proof that meditation caused the brain adaptations or that the increased folds meant improved cognitive performance for these older adults, the results were certainly intriguing and I’m sure there will be more research in this area to come.

I don’t know about you, but keeping my cognitive abilities in good shape as I age is pretty high on my priority list! And these two articles at least give me some hope that there is something that I can actually do about it—something completely free, with no dangerous side effects, mind you.

Santosha, Smiling and Longevity

by Ram

In my previous article regarding santosha, Santosha: Happiness and Longevity, I mentioned that discontentment and unhappiness arise when we get caught up in the materialistic world. If we are happy with our lifestyle and what we currently have, it will help us in the journey to absolute truth and the highest realization.

Santosha Anuttamah Sukha Labhah

From an attitude of contentment/true happiness (santosha), mental comfort, joy, and satisfaction (anuttamah sukha) are obtained. —Yoga Sutras, translated by Swami Jnaneshvara.

This observation was supported by a scientific study that showed that people who are contented are not only healthier but they may also live longer (see Santosha: Happiness and Longevity).

There are several ways of expressing santosha or happiness. One visible way of showing that you are happy and contented is through a SMILE. Smiles can be warm, beautiful, welcoming, cute, innocent, charming or heart melting. A smile of any kind has the same positive effect: it brightens up the people surrounding the smiling person. Smile and notice that the people around smile with you. The world changes based on a person's perception and outlook, and having a smile on the face not only reveals the radiance of the person smiling but it also makes the individual a pleasurable person to be around.

A person with a smile not only mitigates the suffering around but also boosts up someone else's existence, even if it is for a fleeting moment. People tend to trust and cooperate more with individuals who sport a smile. Moreover, smiling is infectious; a smiling individual lightens up the room, change the moods of others, brings happiness along and attracts more people. Several scientific studies suggest that people who smile a lot are not only happy and contented, they are also more stable, happier in their marriages, have better cognitive skills and interpersonal skills. And now there’s an additional benefit that comes with a smile: it adds years to your life.

A study by researchers at Wayne State University concludes that a smile has an impact on aging and life expectancy. The wider you grin and the deeper you smile, the more likely you are to have a healthy aging and longer existence. For the study the researchers analyzed 230 pictures of major league baseball players who began their careers in professional baseball before 1950. The photos were enlarged and a rating of their smile intensity (big smile, partial smile, no smile) was noted. Researchers then ranked the players according to their smiles and laughter lines (length of the creases). The players smile ratings were compared with data from deaths that occurred from 2006 through 2009. The conclusions from the study:

1. Players with big smiles (n=23) lived an average 79.9 years.
2. Players with partial smiles (n=64) lived an average of 75 years. 
3. Players with no smiles (n=63) lived an average of 72 years. 

The above results did not change when the researchers also corrected for other factors associated with longevity. Furthermore, the researchers also noted that the benefits did not extend to players who put out a false smile but only those who looked truly happy had the extra life expectancy.

One may wonder how the act of opening the lips wide and bringing on a smile triggers all of the above-mentioned benefits including longer lifespan? Studies have shown that a simple smile triggers several positive changes in the body. Smiling helps to boost the immune system, which provides resistance from many diseases. Smiling relieves stress, lowers blood pressure, triggers the release of endogenous pain killers and changes the mood attitude for the better, all of which help in graceful aging.

So how about bringing santosha in the form of a wide smile in your own lives as well? Smile as much as you can, even if you are not on camera!

Healthy Bones for Men and Women Alike

by Baxter

Upon reviewing our blog this morning on the topic of thinning of the bones or osteoporosis, and its precursor osteopenia, I found we had discussed the condition quite a few times, with some posts looking at the very technical aspects of diagnosis, Wolff’s law and other helpful concepts (see What is Osteopenia? And How Can Yoga Help?). However, my motivation for investigating the topic one more time arose out of preparing for a Teacher Training workshop I led over the weekend in Berkeley.  I was teaching to a group of 18 yoga teachers attending a post-graduate program in yoga therapy at the Niroga Institute. Over the course of the weekend, we covered topics ranging from basic skeletal anatomy to diseases and illnesses like arthritis, scoliosis and osteoporosis. And in preparing for the seminar, I purchased Yoga for Osteoporosis by Loren Fishman, MD and Ellen Saltonstall, and read, with great interest, the first several chapters that lead into their recommendations of yoga poses for osteoporosis.

There were several points that jumped out at me that I feel are worthy of repeating or, in some cases, sharing for the first time on these pages. First off, there is the perception that I believe still exists among the general population that osteoporosis is primarily a problem for women, and so men immediately tune out when the topic comes up. I’d recommend you tune back in, fellas! The following statistics are compelling for me as a man to start addressing prevention of osteoporosis in my own life:

While it is impressive that one in two women over 50 have an osteoporosis-related fracture, it is still quite impressive that one in four men over 50 will also experience an osteoporosis-related fracture.  More men over 50 will sustain a hip fracture due to osteoporosis than will develop prostate cancer (this was shocking to me!)  How come this is not being announced all over the country! And the mortality rate in the first year after a hip fracture is 25%! That’s right, one in four adults who sustain a hip fracture will be dead and gone within the 12 months that follow the break.

So, it is now clear to me that this condition is of equal concern for both men and women and has profound and serious consequences once it develops. The typical recommendation, still found on all of your standard info outlets, is for patients with osteoporosis or at risk for osteoporosis to do weight-bearing, impact exercise ( like walking and running) to stimulate bone growth.  The trouble with this, as Nina notes in her evaluation of the Fishman early protocol for osteoporosis (Friday Q&A: Is Loren Fishmans Osteoporosis Sequence Safe?), is that this approach can actually worsen other conditions we often have as we get older, like osteoarthritis.

But the great news that I shared with my aspiring yoga therapists is that low-impact practices like yoga asana may be as effective as older, mainstream recommended practices, like walking, hiking, aerobics and such, with less chance of worsening conditions like arthritis. The research data that shows that we can stimulate new bone growth along lines of stress by holding poses for between 8-72 seconds is, for me, the pivotal nuance to add to the yoga practice you are already doing. Because of this, I have been working recently with holding postures for 30-60 seconds, depending on the physical demands of a given pose (for example, holding Downward-Facing Dog for 60 seconds while holding Hand to Foot pose (Hasta Padangustasana), a much more demanding pose on many levels, for 30 seconds).

Remember that engaging opposing muscle groups while doing the pose increases the stimulation of the underlying bone cells that make new bone. So, in Downward-Facing Dog I consciously engage the muscles around all the joints I can think of: wrists joints (the third most commonly fractured joint in osteoporosis), elbows, shoulders, hips (the second most commonly fractured joint in osteoporosis and the one with the gravest consequences), knees and ankles. And because the vertebrae of the spine are the number one area of fracture in osteoporosis and often lead to chronic, debilitating pain, I have been adding in accessible back bends, like Locust pose, low Cobra pose and Bridge pose, which engage the extensor spinae muscles that attach along the entire length of the spine, and therefore each vertebrae, and holding these poses for 30-60 seconds.

Fishman also notes that while the mainstream medical community has often warned about twisting actions for osteoporosis, as they could lead to vertebral fractures, he and Saltonstall have continued to include simple, basic twists, like seated Sukhasana twist, in their protocols. He believes they may actually be stimulating vertebral bone strength. And the main caution in doing yoga if you already have osteoporosis or osteopenia (precursor to osteoporosis) is avoiding or modifying deep forward bends, which can increase your chances of vertebral fractures.

So, the take home messages for my trainees and all of you:

• Osteoporosis affects both men and women as we age, and it is easier to prevent than it is treat it, so get your yoga going, especially you fellas!
• A well-balanced yoga practice, done on the feet or hands or both, is a “simple, silent, inexpensive, and impact-free (for those with arthritis) way of applying force…” to build bone. 
• Holding your poses for 30-60 seconds is the key adaptation in transforming any yoga asana practice into a bone-building practice, even for your limbs that may not be bearing weight (such as your arms in Warrior 2, for example).
• If you already have a diagnosis of osteoporosis or osteopenia, minimize or avoid forward folding poses.

Live long and have strong bones!

Ssshh! Falling Asleep the Way You Like To

by Nina

"The shoe that fits one person pinches another; there is no recipe for living that suits all cases." Carl Jung

I've had more than one person ask me the same question about my post recommending practicing breath awareness or pranayama in bed for insomnia (see Yoga for Better Sleep: Workshop and Tip). The question had to do with the position you should take while you are practicing in bed:
Was wondering whether this breath practice was to relax you enough so that you can then turn over and fall asleep or to fall asleep while doing this practice? If you are to fall asleep while doing the practice and you happen to be someone who cannot fall asleep laying on your back, do you then do the practice in the position that you fall asleep in?

The simple answer is: it's up to you! The description I provided of practicing on your back with your hands on your belly just happens to be the way I do it, at least most of the time. It was never meant as a prescription.

Although breath awareness and pranayama are typically taught either in seated positions or supine positions (on the back), in this case your aim—the opposite of that for a formal breath practice—is to fall asleep. So you will need to experiment to see what works best for you. Maybe you'll practice on your back until you feel ready to turn over and fall asleep. Or maybe you'll practice in your typical sleeping position and fall asleep while practicing. As it happens, I've also been taught to practice pranayama in supported Child's pose, feeling my breath in my back body, so practicing in a prone position (face down) even turns out to be legit!

Supported Child's Pose

Or, if you practice on your back, you might, to your own surprise, find yourself drifting off to sleep in that position, maybe even turning over in your sleep. (To be honest, I'm pretty sure I've done all these things, at one time or another.) And what works one night (or one month) may not work at another time, for any number of reasons, including physical ones, such as having a cold or a physical problem that requires a change in your sleep position.

The point is: Ssshh! It's dark, no one is looking, and you can do whatever you want! 

Friday Q&A: Pranayama on an Airplane

Q: I have a question for your esteemed teachers on Pranayama: I do a lot of air travel: Internal (within US) and international. My international trips involve a minimum of 10-12 hrs of continuous travel. Flying at an altitude of more than 30,000 feet and with the air pressure being so low outside, we are breathing in compressed air inside the plane. Is it safe to do Pranayama inside the plane on long flight duration since the air is primarily re-circulated?

A: I have had the good fortune to travel to Estes Park, Colorado on a number of occasions to teach or study at an annual yoga conference there. Many of the classes held there include breathing practices or pranayama. The altitude at Estes Park just happens to be 7552 feet above sea level. I had no problems, personally, adjusting to the altitude and participating fully in my classes. In the history of yoga, there are many stories of yogis doing their training in the mountains of India, Nepal and Tibet, at high altitudes. My reason for mentioning these facts is that a pressurized, temperature controlled modern jet plane creates an atmospheric pressure of somewhere between 5 to 8000 feet above sea level, not unlike my elevation while studying in Colorado. This means that the percentage of oxygen in the air inside the plane is the same as it would be in Estes Park. So, from a purely atmospheric pressure standpoint, pranayama could safely be practiced on your flight.

Regarding the safety of the air you breathe on planes, I found this online article by an airline pilot illuminating and reassuring in regards to both the amount of fresh air and re-circulated air (50:50 mix in most cases) and the high quality filters that are used on modern jets, considered hospital quality (To read the pilot’s full post, see Cabin Air Quality. And if you want to understand how pressurized cabins in airplanes developed, here’s a great article for Air and Space Magazine online that will give you all the details: How Things Work: Cabin Pressure) In fact, when I posed this question to my colleague Richard Rosen, author of two books on pranayama, he pointed out that the air quality in a plane is a lot better than the hot, polluted air in Pune, India, home of the Iyengar family.

As I researched this topic, the one fact that did jump out at me that could have an effect on the quality of your pranayama practice is the relative humidity of the air in a modern jet. It runs around 12%, which is equivalent or lower than the humidity in a desert setting, which is pretty darn dry! So, the one recommendation I would make regardless of whether you are practicing yogic breath techniques or just napping on the plane, is to drink more water than you might normally at home. This would be doubly true for longer flights. This way you will avoid the dehydrating effect of air travel and you will likely feel better physically when you land at your destination! Richard mentioned that caution should be used with any pranayama technique that you’d be careful with at home or if you were inexperienced. He mentioned bastrika, or bellow’s breath and kapalabhati, or skull brightening breath, as two he would suggest you avoid. Richard did suggest that the “best bet” for airplane breathing is the modern version of ujjayi (in the traditional version the right nostril is closed on exhale), with a “special focus on the exhale and then a pensive pause at the end of each exhale.” So, there you have it, some common sense advice and some expert suggestions from one of the experts on pranayama in this country. To learn more about yogic breathing, check out Richard’s two books on the topic:

The Yoga of Breath
Pranayama, Beyond the Fundamentals

When Pain is Persistent

"When pain is persistent or increased, then the action is wrong. Self-protection is also spiritual knowledge." —B.K.S. Iyengar from Sparks of Divinity

The Yoga Injuries Debate Continues! Telesummit with Dr. Baxter Bell and Dr. Timothy McCall

by Nina

Well, we might not agree with New York Times "science writer" William Broad about his stance on yoga injuries (see, for example, Dr. Timothy McCall's response and Dr. Ram Rao's response to his claims that yoga is "remarkably dangerous for men,") but he certainly has given us in the yoga world a lot to talk about!

One of our favorite MDs (Baxter)

So we’re very excited here at Yoga for Healthy Aging that two of our staff members, Dr. Baxter Bell and Dr. Timothy McCall, will be participating in a YogaUOnline telesummit Yoga Injuries—Fact or Fiction from April 10-14, 2013. Along with our two favorite MDs, the telesummit will also feature Judith Hanson Lasater, Dr. Loren Fishman, Roger Cole, Julie Gudmestad, and other expert teachers.

The other favorite MD (Timothy)

Eva Norlyk Smith, Ph.D., the managing editor of YogaUOnline, has this to say about why the debate about yoga injuries is important:

“Why is this debate worth some serious attention? Because Broad offers up some pretty strong claims about a practice otherwise known for its extensive health benefits. In his book and accompanying articles, William Broad argues that yoga comes with a more extensive and severe risk of injury than the yoga community has faced up to.

Leading members of the yoga community, on the other hand, have pointed out that Broad's writings -- while replete with implied connections -- offer no solid evidence to back up the serious claims. Others have pointed to the somewhat suspicious timing of Broad's enthusiastic drumming of the alarm, which coincides with first the hardcover, then the softcover publications of his book."

For a preview of the telesummit, you can check out the interview with Timothy that Eva Norlyk Smith, Ph.D., recently published on the Huffington Post The Yoga Injuries Debate: How 'Dangerous' Is Yoga, Really?

Voting With Your Feet: Avoiding Abusive Teachers

by Baxter

Another View of Clear Water by Nina Zolotow

After Nina posted yesterday about abusive yoga teachers (see When to Fire Your Yoga Teacher), we received a follow-up message from another reader who had a similar experience of being humiliated when she attended the workshop of a visiting teacher to her community. In her case, she voted with her feet and did not attend a follow-up visit by the same teacher this year, but instead chose to study with a local teacher, and loved her experience. 

In discussing the humiliating teacher’s behavior with her regular teacher, the student was told, “That’s how they do it in India.” Well, this may indeed be true, but does it make this kind of behavior acceptable? In my own experience of studying with many teachers over the past 19 years at workshops and conferences and retreats, I have come across my fair share of angry, condescending, overtly or subtly demeaning behavior by teachers from at least two different traditions. In fact, I  studied with a well-regarded teacher a few times before a more subtle way of demeaning students on a fairly regular basis made me decide to give up the class despite some "good" asana instructions I was learning.  I could not justify continuing to support that kind of treatment of me or my fellow students.

 I also heard stories about a teacher I came to respect about how he had been a bear to study with when he was younger and how he had mellowed out as he aged. I felt blessed to have missed his “abusive” period since I learned so much and witnessed compassionate behavior from him regularly. I did carry a background concern about whether the other side might re-surface at some point; fortunately, I never had to encounter that situation from this particular teacher.

I do feel that teachers who study in a “lineage” that permits or even subtly approves of this bullying, degrading treatment of students tend to be more likely to participate in such behavior and maybe are even drawn to it. I don’t want to get into some deep exploration of trauma and its long-term effects, as it is a complex topic and I am not an expert in it. But, as Nina pointed out yesterday, you can vote with your feet, and I myself have done so more than once over the years. And that old observation that a happy customer tells one person about their experience, but a dissatisfied one will tell ten certainly has played out for me. I am asked all the time for referrals to other teachers or recommendations for teachers to study with at conferences. If a student happens to ask about a teacher I have had a bad experience with, I will recommend someone else instead.  I do not always go into the why of it, but do on occasion share my specific experience if I know that my personal experience was also confirmed by other yoga friends of mine. The good news is that we have more and more choices all around the country—and even internationally—when it comes to yoga instructors. So, don’t settle for anything less than a good instructor who is also respectful and kind.  

When to Fire Your Yoga Teacher

by Nina

Clear Water by Nina Zolotow

Yet another famous yoga teacher has been in the news recently for improper conduct. A former student has sued Bikram Choudhury, accusing him of sexual harassment, discrimination and defamation (see Lawsuit Accuses Founder of Yoga Empire of Misconduct).

Well, I could go on about that, and the tendency toward sexual abuse that appears to be a serious risk for some high-profile male teachers, but actually I’d like to focus on something a little more mundane. Recently we at YFHA received an email from one of our readers saying that she, a very long-time student, had attended a class where the female teacher had humiliated her in front of the class by angrily correcting her pose (which she was adapting for her particular body type) telling her that she was doing it completely “wrong.” This experience made our correspondent very upset. So, you see, abuse by yoga teachers comes in many forms, including simple verbal abuse and even, so I’ve heard, physical abuse.

Our correspondent was still trying to decide how she should handle this—maybe she should be considering forgiveness?—and asked us to address some of the issues that this situation raised. Because our reader was so upset, I decided to respond immediately by writing directly to her. And it was actually pretty easy for me to respond, because I said what I always tell people in this situation: you should never study with a teacher who you don’t respect or who doesn’t respect you.

In this case, I recommended, talking with the teacher, if possible—since it was a one-time occurrence, maybe she was just having a bad day—and seeing if an apology was forthcoming. But if a confrontation was out of the question or if the teacher defended her behavior, I recommended simply leaving the class for good. After all, you are paying your teacher to help you. Why would you put up with mistreatment? And isn’t the only way to stop this kind of behavior to vote with your feet (and your wallet)?

The question is, why does this kind of behavior continue? Why aren’t these teachers shunned by everyone? This brings us back to the NY Times article on Bikram because it included a quote that I found very perceptive about why students of any school of yoga will put up with inappropriate behavior from their teachers.

“Vulnerability and devotion are big parts of the practice,” said Benjamin Lorr, the author of the memoir Hellbent: Obsession, Pain, and the Search for Something like Transcendence in Competitive Yoga. “Bikram creates this mentality that the outside is phony. There is no path but this path, and everything that happens in this path is just a part of your yoga, that you have to learn to be strong and get past it.”

I think this myth that “There is no path but this path, and everything that happens in this path is just part of your yoga” is cultivated by more than one school of yoga and maybe even by some teachers in all the schools. Students feel like they can’t leave the teacher because of their emotional investment in "the path," their financial investment in "the path," or because they’ve been encouraged to believe this is a “good” teacher to guide them on "the path." And it takes strength and courage to resist this ideology.

But can a teacher who is abusive or corrupt really have anything important to teach you?

So, please, don’t hesitate to fire a yoga teacher who is mistreating you in any way. And if your teacher isn’t mistreating you in particular, but you witness him or her mistreating other students, you might want to consider the same action. That is the only way we can bring about change. And, trust me, there are many wonderful teachers out there who know that being a “good” teacher means something different than being able to get you into challenging poses or giving you access to some particular “lineage” of yoga.