Friday Q A Chair Yoga

Q: My daughter just came from a retreat with Dr. Bell in Montana and suggested I contact you regarding some chair poses. I'm 77 years old and am in good physical health, but have never been involved with yoga.  Can you point me in a direction if indeed you do have chair poses as included somewhere on your website?

A:  Thank you for your question. Turns out we have nine different posts listed in our table of contents on this topic.  Click here to see a short sequence on our site. As with any yoga sequence, you may want to do easier versions of some of the poses, for instance, the seated backbend and forward bend pictured might be too deep for a new practitioner to do safely, so only take yourself part way in those directions.  Also, know that in addition to doing poses seated on the chair, you can also use a chair for support while you are standing. Find a chair that has a back that is tall enough so you can place your hand on it while you stand behind it. This will allow you to explore some of the standing poses by using your hands on the back of the chair to help you with your balance. If you get stronger and more confident in some of these poses, you can also wean yourself off the chair as a support.

You might also consider getting a book on chair yoga or a book that includes chair yoga practices. Although there are many such books on the market, here is a short list of books that I have in my own library and can recommend:

1. Yoga For Osteoporosis by Loren Fishman, MD and Ellen Saltonstall
2. The Healing Path of Yoga by Nischala Joy Devi
3. Recovery Yoga by Sam Dworkis

Some of the chair poses you will find in these books would be great for someone just starting out with yoga; others might be too advanced.  Usually your common sense will tell you which ones to avoid.  I am sharing a picture I took of the Sun Salutation in a chair from The Healing Path of Yoga as an example of how you might move through a series of shapes with the support of your chair.

In addition to books, there are a lot of free yoga videos online at youtube.com. But I recommend you watch the videos from start to finish without doing the practice to make sure it all looks safe and doable for you at this point in time. Sometimes the quality of those freebies is not so great, so look at a few before deciding which one to practice with.

Finally, make sure you also look around your community for a chair yoga class. They are becoming more and more common, especially at the YMCA and senior centers or places that cater to an older clientele. And learning in person from a teacher is one of the best ways to get started with your practice.

The nice thing about chair yoga is you can get away with doing it with out too many props. All you really need is a sturdy folding metal chair. Other chairs without arms can work nicely, too, as long as they are sturdy. I am sure in some books you will come across poses that employ other props, like firm wool or cotton blankets, yoga blocks or belts.  And these things can be helpful, but if the thought of getting all that extra stuff is daunting and gets in the way of you trying some yoga in a chair, just forget about them for now, and explore what you and your chair can do, just the two of you. One other consideration: it is nice to have your chair not sliding around on the floor, so get one with those plastic sticky caps on the bottom of the legs, or have the chair in a carpeted room where the legs will dig into the carpet as you move on the chair, or if you have a yoga sticky mat, place the chair on your yoga mat. 

And no matter where you end up getting your chair yoga information from, keep in mind that the basic skills of mindfulness and attention to your breath and your body will need to be applied to the work you do in the chair. If you have any present difficulties with arthritis or osteoporosis, two extremely common issues in those over 65, consider reading our posts on those topics. Then, as you prepare to do some yoga, you can be mindful of which movements to be more careful with.

Have fun and let me know how your yoga practice is coming along!

—Baxter

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Dizziness and Yoga

by Baxter

Looking Up in Jersey City by Brad Gibson

I recently heard from an old friend who lives up near Glacier National Park (must be quiet up there, what with the park closed—come on Mr. Boehner!). She was wondering what to do about recurring vertigo and yoga. And she is certainly not alone! I know so many people with vertigo, or dizziness, and once it kicks in, doing yoga can be a challenge. 

Because there are many possible causes of “vertigo” or “dizziness,” I’m going to write today about one of the most common causes, known as benign (paroxysmal) positional vertigo. It’s benign because usually there is not a life-threatening underlying cause for this kind of dizziness. The exception is if the dizziness is causing someone to fall, which we have discussed (especially in relationship to osteoporosis) in other posts. It’s paroxysmal because it comes on suddenly. It is positional in that the mild to intense spells of dizziness seem to be triggered by body or head position or movement. Common complaints I've heard are that rolling over in bed brought on the dizziness (and can cause it if done in that direction again) or simply turning the head in a particular way can stimulate dizziness. Dizziness spells can have an intense period that does not last more than a few minutes, but can have a lingering general feeling of dizziness and wobbliness. And although dizziness is the primary complaint, other symptoms can include: the feeling that you or your surroundings is spinning, unsteadiness, loss of balance, blurred vision when dizzy, nausea or vomiting. So although you are not likely to get into serious trouble, BPV can certainly be disruptive to your everyday activities.

In fact, I have known more than a few friends and students who have to modify their activities of daily living for a few days until their symptoms settle down. And because the risk of falls and injury is real, I often recommend that you modify your yoga practice until the symptoms begin to more fully resolve. You can do floor practices on your back (unless that is a trigger), do seated poses on the floor or a chair, and if you are going to do standing work, do the poses with your back to a wall and avoid holding poses very long. Inversions can be tricky, as they could also aggravate BPV symptoms, so either do easier versions of them, such as Legs Up the Wall (Viparita Karani) and Chair Shoulderstand, or leave them out entirely until you are feeling better. Try your restorative poses with your head slightly elevated. See how you feel right after each pose and after a short sequence to determine if they are helpful and/or safe to continue to practice.

Western medicine often utilizes medications that help lessen the symptoms of dizziness or nausea (if you get that, too), and also sometimes recommends a manual adjustment technique called the Epley maneuver. A doctor or physical therapist does this with you lying supine on an exam table with your head held by the practitioner, who quickly extends your head and rotates to one side, then the other.  Often, one or two times with the maneuver can help to resolve your symptoms. The theory behind it is that crystals normally found in the inner ear can become dislodged from their normal location and block flow of fluid that helps with normal balance. The maneuver is thought to dislodge the crystals and let the inner ear fluid flow normally. You can see it done here:

There are also some versions of this that you can administer to yourself, and we've heard good feedback from people who've tried it. And I suppose it is conceivable that movements of the neck in certain yoga poses, like Trikonasana (Triangle pose) or Ardha Matseyendrasana (Half King of the Fishes twist) could have a similar effect, but no one has studied them to date. In fact, I’d recommend seeing your doc first thing for three reasons:

• to make sure there is not a more worrisome cause for your dizziness
• because BPV can come back from time to time and it is good to know what your options for treatment are
• because the doctor could perform the Epley maneuver, which may possibly resolve your problem quickly

Then there is the occasional student who will note the onset of dizziness during an asana class. This has happened very infrequently in my experience, but it does happen. I usually have the student immediately sit down on the floor with their back to the wall for support for a few minutes. If their symptoms resolve completely, I’ll invite them to gently try a few more poses, if the sequence is not full of balance poses or inversions, and see how they do. If they seem to have BPV, they need to sit out the rest of class. I have worked with these students at times to develop an individualized approach to their public classes so they can avoid movements that trigger their vertigo and can allow them to continue to enjoy most of their regular practice. Hope that helps way up there in Glacier and anywhere you find yourself!

To learn more about benign positional vertigo, visit mayoclinic.com.

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Yoga for Hiccups

by Baxter

Water Glass by Jean-Baptise-Simeon Chardin

 A short while back I shared with you a list of common minor problems that yoga can help with. If I did not state it then, that list was not meant to be a complete by any means. In fact, as soon as I finished the list, I started getting emails and suggestions in class about problems I had not included. One of those was the common and quite annoying problem of hiccups. In all likelihood, all of us have had at least one bout, if not 50, of hiccups in our lifetimes. And although they usually resolve within a few minutes, for some of us they can linger on for longer periods of time, for hours or even days. They can range for mild to violent in intensity. And for a rare few, hiccups can be a chronic, disruptive event that can start to erode their quality of life, by affecting eating, sleeping, speech, and even wound healing after surgery.

According to the Mayo Clinic, hiccups are:

"involuntary contractions of the diaphragm — the muscle that separates your chest from your abdomen and plays an important role in breathing. Each contraction is followed by a sudden closure of your vocal cords, which produces the characteristic "hic" sound. Hiccups may result from a large meal, alcoholic beverages or sudden excitement. In some cases, hiccups may be a sign of an underlying medical condition.”

So, if you have hiccups that last for more than 48 hours, I recommend you get evaluated by your doctor to rule out more serious causes of hiccups. Common hiccups that last less than 48 hours have the following triggers:

• Drinking carbonated beverages
• Drinking too much alcohol
• Eating too much
• Excitement or emotional stress
• Sudden temperature changes
• Swallowing air with chewing gum or sucking on candy

More serious causes of hiccups can include nerve irritation to the vagus or phrenic nerves (a common cause of this is gastroesophageal reflux), central nervous system damage (as in stroke, MS, or traumatic brain injury, to name few causes), and metabolic disorders and drugs (like alcoholism, diabetes, or steroids). The risk factors for both short and long-term hiccups that yoga could address include: stress, anxiety, and emotional excitement.


Today, I’m interested in addressing those with the less serious forms of hiccups, or those who have longer bouts of hiccups but who have ruled out a more serious underlying cause.

Personally, I’ve noticed that I have at least one fairly predictable trigger for getting a bout of hiccups: spicy food! This is a bit of problem, as I like to eat spicy foods, but really don’t enjoy the negative possibility of a bout of hiccups, thank you very much! Since I will go ahead and indulge in the hot stuff at least a few times a week, I have had plenty of practice over the years trying the commonly suggested techniques of trying to short circuit the hiccups: drinking a glass of water backwards, holding my breath for a certain amount of time, doing a standing forward bend, having someone try to scare me, and so on, with very limited effect. However, once I started practicing yoga and became more aware of my breath and my ability to control the breath (see Pranayama: A Powerful Key to Your Nervous System), I started experimenting with that when I would get the hiccups. The theory on what causes hiccups is a presumed rhythmic spasm of the big breathing muscle, the diaphragm. So my theory on relieving that spasm was trying a balancing breath or calming breath pattern to see what would happen, especially as it can influence the vagus nerve. Turns out for me, if I can slow my breath down to a 2 second inhale, followed by a 2 second exhale, followed by a gentle 1 second pause, I can usually resolve the hiccups in 3-4 breath cycles! Pretty nifty!

But I also wondered if there has been any research on yoga for hiccups, so I did a web search. Unfortunately, no formal studies have been done to date. However, I did come across two other yoga posts by yoga bloggers who had found two other techniques that seemed to help. These, of course, are merely anecdotal, but are simple enough that you could give them a spin if you find yourself uncomfortable during your next bout of hiccups. The first, in Dakini's How to cure hiccups with yoga, is to utilize the lower belly lock, known as Uddiyana Bandha, when hiccupping. Lola Rephann suggested practicing engaging the lower belly muscles in towards the spine and scooping the muscles up towards the diaphragm on your exhale, and releasing the lock on your inhale, doing it a few times so you are practiced when you actually start hiccupping. She theorized that the pressure upwards toward the spasming diaphragm might help to relax the diaphragm and release the spasm. She also would hold the breath out for a few beats at the end of the exhale with the lock in place. 

In the second post, Cure for Hiccups, Kris found engaging the chin lock, Jalandhara Bandha, helpful in short-circuiting her bouts of hiccups. Sitting or standing in good postural alignment, tip your chin towards the sternum and hold it there in place for several rounds of breath. This person’s theory is that Jalandhara Bandha stimulates the vagal nerve, which could relax the diaphragm and relieve the spasms that way.

Finally, I came across an article Has science solved the mystery of the hiccup? in the Guardian that reports on a case of woman with intractable hiccups who responded to learning “measured breaths” as a biofeedback technique that worked quite effectively in stopping her debilitating hiccups—sounds like pranayama to me! Pass the hot sauce, please!

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Lets Learn About Yoga and Pranayama!

Hello everybody!

Certainly a great warm Sunday and I am sure many of you must have dozed a bit longer! But there are people who have gotten up as usual and have had their great morning work out. Good going guys! Today my mind is particularly carried towards spiritual exercise; and Yoga and Pranayama top the list among these exercises. Just read a marvelous piece of article regarding the same by Nunuram and so posting it for you people. Let's know about Yoga and Pranayama basics--

Yoga evolved in ancient India more than 4000 years back. The word "Yoga" originates from the Sanskrit language and means, to join or integrate, or simply union. The meaning of Yoga is union of the body, mind and spirit with truth. Yoga encompasses the physical, mental, emotional, and spiritual aspects of life. The benefits of Yoga breathing exercises (pranayama),Yoga postures or poses (asanas), and meditation (dhyana) are really, really immense.

In spite of all its greatness and goodness though, Yoga was never practised on a large scale in India in the sense that the common people were not in its ambit. It is only in the last decade or so that Yoga has spread among the masses, thanks to Yoga Gurus like Baba Ramdev and literally tens of millions of people in India and elsewhere are coming within its fold and benefiting from it in a very real sense. You just speak with anyone who practices yoga and they will quickly extol an endless list of its benefits and sing its praise. Housewives, businessmen, sportspeople, teenagers and the aged are all practising a variety of yoga asanas (postures), dhyana (meditation) and pranayama (breathing exercises). For many, yoga becomes a way of life - often giving a more spiritual side to their lives.

The modern world scenario with its stressful life and cut-throat competition is providing a very fertile ground for the growth and spread of Yoga. Medical practitioners always questioned the efficacy of Yoga, but now it is being prescribed even by doctors for health ailments and illnesses, as a stress reliever and to complement other fitness programs. There are numerous documented cases of yoga relieving or curing serious illnesses such as Parkinson's disease, multiple sclerosis, heart disease, and respiratory illnesses like asthma, diabetes, bloodpressure, etc.

The sphere of Yoga is very big. However, for the common man practising Yoga, the problem is of shortage of time because of which he cannot go into all aspects of Yoga. So two aspects become very important for him for good health, physical fitness, flexibility and mental relaxation, viz namely asanas (physical exercise) and pranayama (breathing exercises). Here, I will concentrate on Pranayama.

As you all know, oxygen is the supreme necessity for our bodies and without it we cannot survive perhaps even for a couple of minutes. There is almost unlimited oxygen all around us. But we do not know how to get its benefits fully as we never utilize our full lung capacity. Consequently our body is sort of starved of oxygen. Pranayama is a technique to govern the breathing process. Breathing is normally an unconscious process. Through Pranayama, a person learns to consciously govern the breath to bring harmony into the body, mind and spirit. Regular breathing exercises tremendously increase the capacity to inhale and absorb life-giving oxygen. The capacity of the lungs even during unconscious breathing increases. There are four breathing exercises which are particularly helpful :

1)BHASTRIKA PRANAYAMA : In this you repeatedly breathe in to the full capacity of your lungs and then breathe out completely. Should be done for minm. 2minutes ; maxm is 5 minutesHelps heart, lungs, brain, nervous system, and in migraine, depression, paralysis, etc.

2)KAPALBHATI PRANAYAMA: In this breathing exercise, you exhale completely and with force while pulling in your abdomen.Inhaling is done in a normal manner. Should be repeated 30 times, maxm 10 minutes. Helps in diabetes, constipation, gastric problems, hepatitis B, obesity, cholesterol, asthma, snoring and even in cancer and AIDS.

3)ANULOM VILOM PRANAYAMA: This pranayama is slightly more complicated but the benefits are enormous. (a) Close your right nasal orifice with your thumb and breathe in deeply with your left nose. (b) Now open the right nose, close the left nose with middle and ring fingers, and breathe out completely with your right nose. (c) Next, breathe in deeply with the right nose, close the right nose with your thumb, and breathe out completely with the left nose. Start again with (a), then move onto (b) then (c).
Repeat for at least 10 minutes.
Helps in heart, high blood pressure, heart blockages, arthritis, migraine, depression, neural system, paralysis, asthma, sinus, allergy, Parkinson's disease, etc

4)BHRAMARI PRANAYAMA: Here you close your ears with thumbs, keep index fingers on your forehead and rest three fingers should cover both eyes. Breathe in deeply and then breathe out through the nose while making a humming sound like a honey bee. Should be done seven to ten times.
It helps in cases of tension, hypertension, high blood pressure, heart, heart blockages, paralysis, migraine pain, etc. It also improves concentration and confidence. Now let us summarize the benefits that accrue if a person does Pranayama every morning (or evening) for a period of 20 to 25 minutes

It increases lung capacity and improves breathing efficiency,It improves circulation, helps normalize blood pressure and improves cardiovascular efficiency,It boosts the immune system and enhances immunity,It increases energy levels and gives a lot of positive energy,It strengthens and tones the nervous system,It combats anxiety and depression and improves sleep,It improves digestion and excretory functions,It provides massage to the internal organs, stimulates the glands and enhances endocrine functions,
It normalizes body weight and provides great conditioning for weight loss,and lastly it improves skin tone and complexion.

Friday Q A Marijuana and Yoga

Q: With the legalization of marijuana in the news I thought it would be a good time to bring up the question of marijuana use during yoga practice. I find that if I smoke after work that I suddenly become much more aware of my body and that I am more motivated to do poses to counteract what my body has gone through throughout my working day (I am a housekeeper). Also, when I want to commit to a good lengthy home-practice session, using marijuana has facilitated holding my intention that I set before practice throughout the entire practice, and has ultimately aided in making breakthroughs in my yoga practice. I don't like to smoke everyday in my personal life, nor every time that I do yoga. What are the ramifications for an older person who uses marijuana? Are there opinions in the yoga community regarding spiritual and physical ramifications of marijuana use?

I am not looking for a reason or an excuse to use marijuana. I am simply trying to gather informed opinions on its pluses and/or minuses and make appropriate choices for my future.

A: Baxter and I wondered whether we should even answer this question—it seemed somewhat controversial—but here we are on a Friday and this is the only question that came in this week, so what the heck. So we talked it over in person, and Baxter said that he does not really have any knowledge or expertise in this matter (and he’s the yoga teacher/doctor). He suggested that as there is a lot of scientific information about the long-term use of marijuana—apart from the yoga practice issue—you should search out that information on your own to answer your question about the ramifications for an older person who uses marijuana.

As far as the yoga community goes, I know you can find modern yoga teachers in both camps, some for and some against the use of marijuana or other mind-altering drugs during practice. I’ve certainly known both types, myself (my lips are sealed!). In a way it might depend on why you’re practicing yoga. If you are practicing to quiet the “fluctuations of the mind,” which is how the Yoga Sutras defines “yoga,” then using a mind-altering substance would seem counterproductive. In fact, for the ancient yogis, purity of the body was a very important aspect of achieving enlightenment. (Original hatha yoga included a great many cleansing practices, such as shoving a strip of cloth down your—oh, never mind.) However, if you’re practicing yoga asana as a form of exercise, maybe this is not such an issue. My one concern is that it is possible that practicing while you are high might cause you to be less mindful and injure yourself—for example, would you practice drunk?—but I have no proof of that. Mainly, to be honest, your question reminds me of the questions in the New York Times “The Ethicist” column. People usually write in to The Ethicist when they have qualms about something.

If anyone else wants to weigh on it this issue, please do! Baxter says he hopes you will.

—Nina

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Techniques for Strength Building with Yoga

by Nina

Bob Kubik, Age 79

As you might have been able to tell, Baxter and I have been delving into the topic of strength building lately (see Strength Building: How Long to Hold Poses and Static versus Dynamic Poses). And now I’m excited to announce that after a couple of weeks of research, discussion, and debate, we’ve finally come up with a basic set of guidelines for how you can use your yoga practice for strength building! So I thought I’d share them today. 

All poses, except restorative poses, are weight bearing (even if you’re bearing weight on some body part besides your feet), and all active poses require muscle contraction in some form, so any active yoga pose will strengthen both your bones and muscles. A well-rounded active yoga practice that includes a good mix of standing poses, backbends, twists, and forward bends will provide all-around muscle and bone strength building. But if you’d like to focus on strengthening a particular area, for example, if you have knee arthritis and want to work on leg strength, you can choose the corresponding categories to emphasize in your practice. 

Poses for Leg and Hip Strength. Any poses where you stand on one or both legs, especially with one or both knees bent, are strengthening for legs and hips. Also strengthening for hips and legs are poses where you lift your leg or legs away from the ground, for example, in Locust pose (Salabasana) or Boat pose (Navasana).

Poses for Arm and Shoulder Strength. Any pose where you bear weight on hands or forearms will strengthen your arms and shoulders. (To strengthen your wrists, you need to bear weigh on your hands.) Also strengthening for arms and shoulders are any poses where you lift your arms away from the floor, either out to the sides (Warrior 2), overhead (Warrior 1), forward or behind your back (Locust pose).

Poses for Core Strength. Any poses where you lift your leg or legs away from the floor, such as Hunting Dog pose, Locust pose, and Boat pose. Any poses where you tip your torso to the front, side, or back, such as Triangle pose, Half Standing Forward Bend, or Standing Backbend. And any pose where you lift your hips away from the floor, such as Plank pose, Side Plank pose, and Upward Plank pose. 

Poses for Back and Spinal Strength. Both standing and seated twists help strengthen spinal bones and the muscles of your back that support your spine. Standing, prone, and reclined backbends will strengthen overall back muscles.

How Long to Hold the Poses

For muscle strength in static poses, you can either work on muscle strength or endurance. To work on muscle strength alone, hold the pose at least 8 to 10 seconds and consider repeating the pose several times. To work on endurance, hold the pose as long as you safely can, gradually working up to longer and longer holds. For bone strength in static poses, we recommend holding the pose for 30 seconds or more. 

If you’re too weak or fatigued to stay in a pose for the recommended timings, hold the pose for as long as you safely can and then come out. Gradually over the next several weeks work your way up to longer and longer holds. 

For muscle strength in dynamic poses, you can either move in and out of the pose with your breath or hold the full pose within the vinyasa for at least 8 to 10 seconds to enhance strength building. For bone strength in dynamic poses, based on what we know about weight-bearing movement, such as walking and running, we recommend practicing poses dynamically for bone strength in sets of six repetitions.

How Often to Do the Poses

Muscles need a day of rest between exercise sessions when you are working on strength building. So generally you shouldn’t exercise the same muscle group on consecutive days. However, you can do muscle strength-building yoga poses every day if you focus on different areas of your body on each day, for example, alternating between upper body, lower body and core strength. Or, you can alternate strength building practice days with gentle stretching restorative yoga, or sessions of breath work and/or meditation. If you are practicing for bone strength, follow the same recommendations.

Other Tips

Balancing Your Practice. To balance your strength building, make sure your practice includes poses of all the basic types: standing poses, backbends, forward bends, and twists, as long as they are safe for you. Of course you don’t need to do all these basic types within a single practice; just try to get to them sometime each week. Also, try to include poses where you bear weight on your hands as well as sitting bones, shins, and so on, such as Downward-Facing Dog pose, Side Plank pose, Hunting Dog pose, and Boat pose.

Stretching. Because your body’s response to stretching and strengthening is similar in promoting muscle growth, poses that you might think of as “just stretching” actually also enhance strength (see Just Stretching is Not Just Stretching). So when practicing for flexibility you’ll be increasing strength. You can enhance your strength building in a stretch (and improve the stretch) by adding in muscle activation for stretching as described in Why and How to Activate Your Muscles in Yoga Poses.

Muscle Activation for Strengthening. Although a weight-bearing pose on its own will strengthen bones that are actually bearing your weight, if you consciously contract the muscles holding you up by firming them toward the bones, you will enhance the bone strengthening effects of the pose. For example, if you’re standing in Tree pose (Vrksasana), firming your leg muscles will enhance bone building in the standing leg. 

For strengthening muscles, you can strengthen more than just the obviously active muscles by consciously contracting other muscles as you work in the pose. For example, in Downward-Facing Dog pose (Adho Mukha Svanasana), firm all your arm muscles and shoulder muscles toward the bone. When you want to strengthen your hip area, in a standing pose, for example, you can slowly engage the muscles all around your hip joints, while ensuring that this action does not pull you out of good alignment. 

To achieve these benefits, contract your muscles gently rather than strongly. Strongly contracting a muscle noticeably shortens the muscle, which seems to prevent you from moving as freely in the pose. On the other hand, gently firming a muscle toward the bone provides muscular support without interfering as much with movement. If you’re not used to working this way, it may take some practice. Take it in two steps: 

1. Consciously relax the muscle, allowing it to lengthen. 
2. Gently firm the muscle toward the bone. 

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Shari Ser Joins Yoga for Healthy Aging

Through the Forest
by Michele Macartney-Filgate

We're pleased to announce that Shari Ser, a physical therapist and Iyengar-style yoga teacher, has joined the staff here at Yoga for Healthy Aging. She'll be posting regularly, and will be available to answer questions on a weekly basis. To begin, we've asked her to tell us all a little about her background in physical therapy and yoga. —Nina

Before I trained to be a physical therapist, I had a degree from SUNY Buffalo in Women's Studies/Labor History/American Studies—really useful, no? But it was circa 1978, and I was very involved in the food coop scene, eating healthy, growing your own food, collective households, communes—the personal was the political. I traveled for two years in Asia and ended up in London at a whole foods bakery. So it was either go into nutritional sciences and get married in England for citizenship or come back to the US and go to Physical Therapy school. I was always interested in taking care of your body, women’s health and alternatives, and thought PT would be a venue where I could be covert. Ironically, how wrong I was, because at the time PT's were some of the most conservative individuals I ever met. PT school was grueling and there are no words to describe how hard it was, but maybe that is where the yoga came in because it was a place I could be and not be judged, and just explore with my teacher the boundaries of my physical body.

I started practicing yoga in 1980. I was involved with San Francisco Zen Center at the time and someone suggested I check out this class nearby led by Roger Cole. I did and just continued practicing. I liked it and it made me feel good but it wasn't like “love at first sight.” Roger eventually moved on but he directed me to Judith Lasater's class at the Iyengar institute and she became my main teacher after that. At that point I was in Physical Therapy school at University of California, San Francisco, and it was nice to be studying with a teacher who “spoke my language.”

I studied with Judith from 1980-1987 till we moved to the East Bay. I was on bed rest for my first pregnancy on IV tocolytics from week #24-36 and Judith would visit periodically. She gave me Geeta Iyengar’s woman's yoga book (Yoga: A Gem for Women). During that time of bed rest, I would do yoga in my mind and had a whole bed routine that I did on my side—out of bed only to pee. Talk about weakness when you are finally allowed up! I had four days of late pregnancy till I gave birth to my daughter but wasn’t allowed to go back to yoga till I wasn't bleeding. That took another six weeks. Judith was very solicitous and kind to me in class when I came back. Then ego took over and I had to progress to her more advanced 3-5 class, and I just had to be able to do handstand!

So then I was in the level 3-5 class and met Donna Farhi. I was also informally taking some of the advanced studies' classes at the Iyengar Institute. We moved and then I found Donald Moyer through Judith. I assisted Donna and Roger at a class they taught at the Institute with my infant daughter in tow (when she began to crawl it wasn't a possibility any more). I also took a body work training that Donna co-taught. Why did I stick with yoga? It just became my time where I could leave my responsibilities of being a mom and working, and have my own time. Going to class was the only thing I did for myself at that time because trying to find time to practice was almost impossible (working full time with an infant).

One pregnancy down, a move to the East Bay and my realization that unless I committed to yoga more formally no one would “take me seriously,” so I enrolled in the Berkeley Yoga Room's Advanced Studies Program. I didn't quite know how to bridge physical therapy with yoga, though at the time I was working in outpatient orthopedics and was doing a lot of back care rehabilitation and taking a lot of continuing education classes for different manual therapy skills. Yoga was something I did in another life. After another pregnancy and another bed rest, I finished the program in 1999. I began teaching at the Berkeley Yoga Room soon after that.

I continued to work in outpatient orthopedics but yoga was creeping into my clinical practice. I changed into home health to allow me the flexibility of raising two children and working. I slowly began to add “more yoga” into the guise of therapeutic exercise. You have to be careful with some people in how you talk to them because not everyone is open to things they don’t understand. I still don't call what I do yoga in the home care setting—it is still “therapeutic exercise” or “Home Exercise Program”—but there is more attention to breathing, awareness and responsibility in health choices.

What I have learned from being a physical therapist is not from my education per se but learning to listen to my patients as they share their lives with me. In home health I am a guest in their homes and I have to learn to be respectful. My agenda and their agendas may not be the same. I currently have a 94-year old retired astronomy professor who sustained a fall in his home and broke his arm and foot. When I first met him he was very persnickety and didn’t want to do anything I said until I changed the wording and it was “what would you like to do today?” or “would it be alright with you if we did....” Once he was given permission to say no and he knew I would respect it, he began to trust me and work with me to regain his mobility and to work with his fear of falling again. That to me is the most valuable lesson I learned is to respect the word “no.”

I suppose that is where I am now. I think that bad things do happen to people who do all the right things; people die too early when they aren't ready, and it still hurts. What I try to do now is give people tools that they can use or not, but allowing them the information by which to make their choices. I do a lot of education about health and how one is part of the team, and a lot of encouragement for people to learn how to talk to their physicians. As to aging: what can I say? It is happening to all of us and I am just like the next person who doesn’t like the limitations that my body is starting to exhibit. I continue to push the envelop so to speak, but am mindful of injury more now than when I was younger, partly because it takes so much longer to heal as we age and prevention is the best path. It isn’t easy to acknowledge one’s limitations but maybe that is the new definition of aging. —Shari

Bringing Yoga to Her Community An Interview with Muriel Zimmerman

by Nina

Starting this blog with Brad and Baxter was the beginning of an adventure. Naturally we hoped there was an audience for our information on yoga and aging, but we didn’t think too much about who those people would be. Now, just over a year later, we find that we have readers not just all over our country, but also all over the world. And the information we’ve been providing has not only influenced the way people have been practicing and teaching but has inspired a couple of people to start yoga classes in their community. I have to say that hearing about new community classes  touched me more than just any of the other feedback we’ve received about our blog.

Recently I had the opportunity to meet one of those people, Muriel Zimmerman, in person, and when she shared with me some of the details about the yoga class she had started in her community, I just knew I had to interview her.

Nina: Can you tell us something about yourself and your job?

Muriel: I have been the Executive Director of the Children and Family Center of Northwest Missouri for ten years. The Children and Family Center of Northwest Missouri serves victims of domestic violence and sexual assault. We provided 4065 direct services (crisis management, case management, court advocacy, shelter, hot line and support groups) to 636 females, males and children this past year). Prior to that I was the Adult/Community Education Coordinator for the Maryville RII School District for eighteen years. For me, life is a balance between physical, emotional and spiritual. I’ve love all parts of my life—being a caregiver, patient advocate, work, being a parent, and facilitating support groups, teaching a variety of classes—while trying to balance taking care of myself.

I’d always been physically active, but hated to “exercise” and never seemed to find the time to take care of “me.” For eighteen years, work days often went from 8 a.m. until 10 p.m. with an hour break early evening to be home for dinner with the children. Being an emotional eater, meds from cancer treatments, hating cold weather and exercise resulted in a forty-pound weight gain. I have a library of self-help books, yoga tapes, etc. And I avidly believe in “lifelong learning.” I don’t even want to think about how many times I’ve journalled a “healthy me” program, involving keeping a daily food record, taking time for my spiritual journey, planning an exercise program, weighing myself. I’ve even taught nutrition classes. And when I haven’t felt successful, I’ve gradually given up.

But approximately seventeen years ago, I found a yoga teacher who taught classes one night a week. And I was “hooked” on yoga and all it had to offer. I was flexible and gradually found I was gaining more upper body strength, flexibility, and reducing stress. I found a good yoga routine and put it to music for a twenty-minute routine that I could do at home. I even have a chair yoga tape that shows movements for slow, medium, and advanced. But it sits on my shelf. Going to the gym and doing yoga in a class works for me. I think it has to do with the fact that I’m “missed” if I am not there, and I need some social interaction as one of the “vital needs” in my life.

Nina: What inspired you to start a yoga class?

Muriel: As an Adult Education Coordinator, I had the option to develop any community education classes for all ages I wanted to. A lot of my friends were complaining that they had no upper body strength, no balance or flexibility, fell often, were stressed, and problems they blamed on aging.  Their vocabulary focused on the words “could”, “should,” “would”, “but” or “if”.  WRONG.  I didn’t think this had to happen. I went to the Community Center and talked to staff about the number of individuals in the community who were “rehabbing,” needed or had knee replacements or hip replacements, or were overweight, had health issues, and other numerous “excuses” or “reasons” why they could not exercise. I knew from my previous health issues that those issues would only get worse. We had a choice: to have a quality life or not. We needed a safe, nurturing place to explore yoga with well-qualified instructors who would teach, monitor, explain and encourage us

Nina: What is the yoga class like?

Muriel: I think individuals are more apt to try something new if they know it will meet some basic need in their lives. Our chair yoga class is informal. It is currently taught on Wednesday and Fridays at 10:00-10:45 a.m., which is the same time and location that Senior Circuit Training is taught. That, itself, reduces stress for adults. There are lots of windows on the south side of the classroom. We sit with our backs to the window and the lights off, soft music, fans turned down and folding chairs with plenty of space between us. We are mostly older adults. We feel safe and nurtured in a small class (twelve maximum).

The instructor always tells us to do things at our own pace. At the beginning of each class she suggests that we might set our intention for the class: to breathe easily, to reduce stress, to strength, to become more flexible, to balance. This will be different on different days. What does our body tell us today? We are learning to be aware of our bodies.  She encourages us to put aside all the multitasking thoughts we have and focus on the moment, to be mindful and come back to our breath when our minds start to wander.

She always has a quote posted on a small white board at the front of the room stating the benefits of yoga or thought for the day.  She talks a lot about working with adults in nursing homes; as we do different stretches she tells us how that movement will benefit us (such as, the benefits of lying down flat on a bed to nap rather than sitting on our spine in a recliner chair with our feet propped up and our backs curved). She keeps reminding us to breathe easily. She always shows alternate movements and reminds us of small movements we can do at home.

We always start with a sitting routine. About half way through she will give us the option of doing the Warrior and other positions either sitting or standing behind the chair (using the chair for balance).  She tries to challenge us within our abilities. We always work on balance and strengthening and upper body and lower body movements. We find that some of these same movements are in the senior circuit classes, especially the relaxation movements at the end of class. It all works together. At the end of each class has enough time for relaxation that we all seem calm, relaxed, and peaceful. She always stays around for a few minutes after class so we can ask individual questions or comment on the class.

Nina: Is there anything else you’d like to tell our readers?

Muriel: We all have choices to a healthy lifestyle—how we spend our time, our talents and our money. We have our addictions (like chocolate, playing free cell on my laptop propped up in a recliner chair, etc.), our excuses, our priorities, our habits and routines. I just need to keep saying to myself, “don’t be judgmental or critical of myself and definitely not of others,” take it a step and a day at a time, determine what my vital needs are for a healthy life, and give myself a pat on the back when I take advantage of opportunities to improve my health.

The benefits of yoga for me? I’ve strengthened the muscles around the torn ligaments and my core. I no longer wear leg braces. My balance has improved. I’ve lost 25 pounds. I can “transfer” more easily (get out of bed and stand up straight without pain), go on walks without first thinking how far I might be able to walk and will I have the energy or strength to get back home. I’m finally starting to focus on “me” and feel I’m as important as anyone I care for.  I’m learning to understand my body, accept my strengths and weaknesses, keep a positive attitude and not feel guilty when I take time for yoga and myself. I feel more confident, have more energy, and definitely feel better about myself. I look forward to checking out this blog and learning how to age gracefully and enjoy each moment of my life. I just hope my story helps someone make the decision to explore the options of yoga and what life has to offer.

Muriel Zimmerman has always lived in the Midwest, and has worked as a teacher, Adult Education Coordinator, and is Executive Director of a domestic violence center, and active community volunteer. Her favorite pastimes are her perennial flower beds, spending time with family and friends, traveling, and being “Granma.” She is transitioning into retirement.

Yoga for Neuropsychiatric Disorders

by Ram

The Shady Side of the Mountain by Brad Gibson

"The demand for clinically efficacious, safe, patient acceptable, and cost-effective forms of treatment for mental illness is growing. Several studies have demonstrated benefit from yoga in specific psychiatric symptoms and a general sense of well-being." —Balasubramaniam, et al

Among the vedic sciences, Ayurveda is considered the healing side of yoga, and yoga the spiritual side of Ayurveda. Both these sciences are considered as two sides of the same coin, as they emphasize a complete approach to the well-being of the body, the mind, and the spirit. Both yoga and Ayurveda describe the disease process as taking its roots first in the mind. If we fail to recognize the disease process in the mind and continue to make wrong choices, the disease overflows into the physical body as specific symptoms. Thus, symptoms are simply the body’s voice communicating that we are living out of harmony. When we live out of harmony we suffer. When we change our life to bring greater harmony, our bodies reflect this change and there is less suffering.

Turn to yoga philosophy and one of the main tenets in the Yoga Sutras is:

Yogas chitta vritii nirodhah

yoga =union, to join; chitta = mutable thoughts of the mind-field; vritti = mental fluctuations/ modifications, nirodhah = coordination, regulation, channeling.

Swami Jnaneshvara translates this as: Yoga is the control (nirodhah, regulation, channeling, mastery, integration, coordination, stilling, quieting, setting aside) of the mutable thoughts/modifications (gross and subtle thought patterns) of the mind field. In other words, when you achieve a union of the body, mind and spirit, all mental fluctuations and turbulence cease.

Dissect this tenet in more simple terms and this is the message: human being as a whole is a combination of body, mind and spirit, with physical, mental (psychological) and spiritual dimensions. When we just think of ourselves as a physical body and lose our connection with the mind and spirit, we become susceptible to mental and physical diseases. If this theory is hard to follow, understand that we share a close relationship with our environment, the world around us. If an individual is living in harmony with the environment, optimum health is possible. However, the further out of harmony an individual is living, the less likely it is that they will reach their full life potential in either length or quality of life. Healing is the process of returning to harmony by becoming one with our environment. Once back in harmony, the body and the mind have no reason to communicate symptoms. The body is at ease; the mind attains peace.

Mention the mind-body relationship to a scientist or a medical doctor and you will immediately notice their discomfort as this relationship lacks sufficient scientific backing. In addition, I have noticed that the general public is less likely to embrace some of these theories and alternative therapeutic interventions unless they have been proved by science. At one of the national Ayurveda/Yoga conferences, I had suggested some yoga modalities for ADHD patients but since I could not provide a scientific rationale, my suggestions were met with skepticism.  So does it surprise me now when a review published in the journal, Frontiers in Psychiatry titled Yoga on our minds: a systematic review of yoga for neuropsychiatric disorders by Balasubramaniam, et al describes yoga to be “highly promising” as a complimentary care to medication for psychiatric disorders (the authors examined the literature for a gamut of psychiatric illness) but without the negative side effects that come with pills? Not in the least. Because all psychiatric disorders have a mind component, a mind-body integrative program, such as yoga, can definitely assist people in their pursuit of peace and calmness, and bring greater wholeness and integration in their lives.

Unfortunately, if you just mention this 5000-year-old ancient practice as a standalone solution, you will have skeptics. Bring in statistics, scientific methodology and other modern applications, however, and people will start believing you.

"There is emerging evidence from randomized trials to support popular beliefs about yoga for depression, sleep disorders, and as an augmentation therapy. Limitations of literature include inability to do double-blind studies, multiplicity of comparisons within small studies, and lack of replication. Biomarker and neuroimaging studies, those comparing yoga with standard pharmaco- and psychotherapies, and studies of long-term efficacy are needed to fully translate the promise of yoga for enhancing mental health."—Balasubramaniam, et al

But whatever it takes, the mind-body connection definitely needs to be considered seriously!

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Techniques for Managing Pain with Yoga

by Baxter and Nina

Beams of Light by Melina Meza

This post recommends techniques for helping you manage acute and/or chronic pain. Although the causes of acute and chronic pain differ, depending on your condition on a given day, you can use similar techniques to reduce your pain.

Start by considering your pain levels both today and, if you are suffering from chronic pain, over time. By reviewing your pain levels through the course of a day, week, or month, you will begin to see patterns. To do this, you might find it useful to assign a rating to your pain and keep a journal of pain levels that you can periodically review. To get a better picture of how pain is affecting your entire being, you could also note your stress levels and your predominate mood. You can then use all this information to guide you to practice differently on different days. 

For chronic pain, on high pain days, start or stay with gentle poses, relaxing breath practices, and meditation. If your pain is very severe, focus on relaxation and breath practices, and maybe imagine the poses. And on low pain days, try carefully increasing the intensity of your practice.

For acute pain, if your pain is tolerable, this is a good time to practice asanas, which will increase oxygen flow to brain and muscle tissues, and release held tension from the muscles. But if your pain is severe, you should focus solely on relaxation and breath practices. 

For everyone, practicing stress management on a regular basis is very beneficial, as reducing stress levels can lower pain levels. We will compare and contrast some of the techniques below. 

How Often to Practice. For chronic pain, it is important to have rest days, where you are practice only restorative or extremely gentle poses, or skip the asana portion of your practice entirely. So we recommend that you practice more actively 3 to 4 times a week, and at least do breath practices and meditation on your resting days, if possible. 

For acute pain, follow a similar schedule. Because acute pain will ideally resolve more quickly, as your pain subsides and your functioning returns to normal, you can gradually increase your practice days to 5-6 days a week. 

Balanced Practice. We recommend that your active practice be a well-rounded one, including yoga poses from all the basic groups (as long as they are appropriate for you unique pain situation), in both dynamic and static variations. In addition to your poses, try to include breath work, resting poses, and mediation. Because down-regulating your sympathetic nervous system is so beneficial for pain management, we recommend that at least 25 percent of your practice be devoted to breath work, restorative poses and/or meditation.

For both types of pain, always begin your asana practice with gentle poses. Start with simple movements that improve breathing, such as Cat-Cow pose, seated or standing side-bends, and arm range-of-motion actions. Then, if you are feeling up to it, add in more active asana, dynamic or static, such as Arms Overhead pose, Warrior 1 and 2 poses, Downward-Facing Dog pose, and Locust pose, and any other basic poses that work well for your particular condition. Finish up with one or more relaxing restorative poses, such as Easy Inverted pose, Legs Up the Wall pose, Supported Child’s pose, or Supported Relaxation pose. 

Dynamic Poses. Use dynamic poses either to create a balanced practice or to address a particular area where you have pain. When you first try a dynamic pose that may stimulate the area of your pain, move slowly and mindfully in and out of the pose. If this movement stimulates pain, modify it so you come up to the edge of pain without fully triggering your pain response. When you find a way to practice that feels safe, you can move at a pace that feels good to you, be it slower or slightly faster.

Static Poses. Use static poses to stretch areas that are stiff and tight, and, if you have chronic pain, that may have developed limited mobility as a result of pain. Focus on the particular flexibility poses that will gently stretch your tight areas. For example, if you have low back pain and are tight in the backs of your legs, Reclined Leg Stretch could be a good choice. 

Also use static poses to strengthen muscles that have been become weak due to lack of use. For example, chronic low back pain often results in weakness for the lower back muscles. Focus on strength building poses that will gradually build strength in your weak areas, For example, for weak lower back muscles, choose poses that builds back strength, such as Locust pose, to regain lost strength.

As you work with both flexibility and strength building, practice mindfully and note if these poses also begin to reduce pain levels. If they do reduce pain levels, continue practicing the poses and gradually add in other similar poses. However, if they don’t reduce your pain levels, try reducing the time in each pose or consult with an experienced teacher to help you re-organize your practice choices.

For acute pain with no history of chronic pain, practicing strengthening poses is less important, because it takes time for weakness to develop. However, if the acute pain becomes chronic, we recommend adding strengthening poses to your practice to help prevent weakness from developing.

Breath Practices. You can use any breath practice you find helpful. Generally, we recommend starting with calming breath practices, such as:

• gently lengthening both inhalation and exhalation
• 1:2 ratio breathing
• alternate nostril breath

When you reach a point where you are working on stress hardiness or active strength building practices, you could try adding in a few more stimulating practices, such as 2:1 ratio breathing or Kapala Bhati, as these practices can help energize your body and mind, contributing to your strength and endurance. 

Restorative Poses & Focused Relaxation. All forms of focused relaxation are helpful for reducing stress. However, if you are in acute or severe pain, you may find recorded guided versions are easier to focus on, as your mind will be more attentive to the recording than your own attempts at moving your focus away from pain. 

In general, start with a comfortable relaxation pose, from simple Savasana (Relaxation pose) to any form of supported Savasana, or any symmetrical restorative pose. Then practice any conscious relaxation technique that works for you, such as simple breath awareness, a body scan or guided imagery, or the rotation of consciousness portion of yoga nidra. 

Meditation. For both acute and chronic pain, you can practice any form of meditation, from simple breath awareness to more formal practices that cultivate feeling of kindness towards your self. We especially recommend meditating on an image in your mind that is calming and joyful or a color that is peaceful and pleasant, or using the formal Vipassana Metta meditation (Loving Kindness Meditation). To get a handle on how much of your mental energy is going to thinking about your pain versus other topics, you can try simply observing your thoughts. Experiment with these various different techniques to see what works best for you (see Yoga Meditation Techniques).

Imagining Asana. For those with chronic pain, on days when you don’t feel up to moving, imagining you are doing an asana actually prepares your body to move with greater ease and comfort when you are ready to move again. To prepare yourself to do this, you may want to rehearse this technique on a low pain day while you are actively practicing. For example, as you using whatever method you normally use to practice, whether using a sequence from a book, a video, or an audio recording, or creating your own sequence, after each pose, stop, close your eyes, and do the pose or mentally, as a way of memorizing it. Then, the next day, try out a short practice mentally. As you improve at this technique, you will be able to easily access the mental practice on the days you don’t feel up to moving.

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Stroke Yoga for Rehabilitation

by Ram

Sunflowers by Melina Meza

Your brain cannot function if it is deprived of oxygen even for a very short time. Without oxygen, brain cells start to die. A stroke occurs when a blood vessel carrying oxygen and nutrients to the brain is either ruptures (hemorrhage) or is blocked by a clot (ischemia). In either situation, portions of the brain do not receive much needed blood and oxygen, as a result of which the brain cells die (see Balance, Strokes, and Brain Health). If brain cells die or are damaged because of a stroke, symptoms occur in the parts of the body that this region of the brain controls. 

Symptoms of a stroke include but not limited to: failure to move one or more limbs on one side of the body, inability to understand conversation, difficulty formulating speech, numbness, postural instability and imbalance, and vision impairment. A stroke can cause severe brain damage, long-term disability, or even death. Prevention is the best remedy for people who are at risk. Interventions include a regular wholesome diet, physical exercise, avoiding smoking, and limiting alcohol use, among others.

Victims of stroke have to undergo several weeks or months of rehabilitation in order to return to normal daily living. The rehab process helps the victim restore and relearn lost skills arising from the brain damage. If the stroke victim is experiencing any severe disabilities, the rehabilitation process teaches them alternate ways to perform those tasks and to overcome those disabilities. According to most experts, a successful rehabilitation program is one that is carefully directed and well-focused, with emphasis on repetitive practice—all of which enables victims to regain their lost motor function and skill sets. Skills include ability to walk, use of hand movements, communication, speaking, bathing and dressing, among others. Victims also engage in physical exercises, including passive or active range of motion exercises to strengthen their limbs. Patients may progress from sitting up and being moved to standing, balancing, and walking, with or without assistance. Rehabilitation is an ongoing process until the victims are able to successfully carry out basic activities of daily living independently. Depending on the extent of stroke, this may take months or even several years. 

Stroke is a leading cause of disability in the United States. While 40% of stroke patients suffer from moderate functional impairment, 15% to 30% of victims are left with severe disability. Effective rehabilitation interventions initiated early on can boost the recovery process and lessen functional disability. Approximately, seven million people in the US suffer from the chronic effects of stroke and only 14% of these victims recover completely after one year of rehabilitation programs. Thus, there is a greater need to improve functional outcomes following stroke. Stroke victims need to engage in physical activities despite being very fearful. Can yoga be used in rehabilitation programs and be helpful to stroke victims in their recovery process? 

Apparently, yes! A recent study Yoga leads to multiple physical improvements after stroke, a pilot study. showed that yoga not only improves physical function, it also helps patients to overcome the fear of physical activity. The goal of the study was to assess the changes in physical function in people with chronic stroke after an eight-week yoga therapy program. The parameters measured included pain, strength, endurance and range of motion, as these are most affected after a stroke. A total of 47 people were enrolled in the study. All participants were older than 18 years of age, had completed all stroke inpatient and outpatient rehabilitation, and were able to stand without a device and follow directions. There were two groups in the study: the yoga group and the control group. The control group was actually a wait-listed group (n=10 people), who were offered yoga after completion of all assessments. The authors fail to mention if the people in the control group were on any medication or if they were doing some other physical activities.

Patients in the yoga group participated in group yoga therapy sessions with 10 people per group. Each yoga session was one hour long, and participants engaged in two yoga sessions per week for a total of eight weeks. The yoga session, which was taught by a certified yoga therapist, included sitting, standing, and supine hatha yoga poses and ended with meditation and relaxation. At the end of the eight-week period, the researchers noted that the yoga therapy group showed significant improvement in many aspects of physical function. Nearly all of the people in the yoga group described their pain levels as significantly reduced. Endurance had also significantly improved in the yoga group as they were able to walk farther in a six-minute walk test compared to the non-yoga group. Bilateral neck and hamstring range of motion and upper extremity strength significantly improved in the yoga group compared to non-yoga control group.

Thus, the research study clearly demonstrated that in just two sessions/week for an eight-week period (16 yoga classes) there were radical changes in several physical functional parameters in stroke victims, including pain, range of motion, endurance and strength, all of which correlated with improved functional outcomes. The researchers also speculate that in addition to improvements in the physical body, yoga may have also helped patients to develop more awareness that in turn led to a better recovery. Despite some limitations to this study (small sample size, an non-blinded trial, involvement of the main researcher with the yoga therapy group), yoga definitely appeared to have a positive impact on stroke victims by not only improving physical function, but also the quality of life. I guess you will agree with me that we cannot find a better, cheaper, more effective and environmentally friendly therapy for recovery after a stroke.

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Is Womens Flexibility a Liability in Yoga Sharis Response to William Broad Rerun

by Shari

The latest New York Times article from William Broad Women’s Flexibility is a Liability (in Yoga) sparked a conversation between Nina and me, both whom are long-term yoga practitioners who have grappled with orthopedic injuries. Broad states that he has recently learned that women are at higher risk of hip injuries in a yoga class because of their inherent flexibility compared to men. He quotes a single yoga teacher, Michaelle Edwards, saying that “women’s elasticity became a liability when extreme bends resulted in serious wear and tear on their hips. Over time the chronic stress could develop into agonizing pain and, in some cases, the need for urgent hip repairs.” He also says of arthritis researchers:

The investigators found that extreme leg motions could cause the hip bones to repeatedly strike each other, leading over time to damaged cartilage, inflammation, pain and crippling arthritis. They called it Femoroacetabular Impingement — or F.A.I., in medical shorthand. The name spoke to a recurrence in which the neck of the thigh bone (the femur) swung so close to the hip socket (the acetabulum) that it repeatedly struck the socket’s protruding rim.

I personally can’t stand sensationalism of any type and particularly sensationalism of the fear and scare tactics kind. When I first saw this article, I groaned inwardly. But I then proceeded to read it carefully, including the related links, and then went on to do some additional research of my own. After all that, my response is: maybe.

First of all, I, as a long-term yoga practitioner, am not sure what exactly he means. We all can be overly flexible in some areas of our bodies and conversely overly tight in other areas of our bodies. The biomechanical model of structure and function is a beautiful yin and yang interplay between forces that influence our bodies, and yes, can ultimately change our structure and function. Some changes may not be as beneficial as others so we need to be consciously selective and astute to observe what changes occur with function.

I also think, as in the past, Broad is careless in his citations of his evidence and is vague about these ER records of hip injuries. However, he does cite some orthopedists and one international study that do substantiate his observation that women who put their hips into extreme ranges of motion can injure their hips. Well, this is blatantly obvious to anyone who may be neurologically intact. When a joint is taken into an extreme position there is a pain response recognized by the central nervous system that warns the person to back off. Of course, if we choose to ignore the pain response, then is it the yoga that is causing the injury or is it the person who is foolishly not listening to the feedback their body is providing?

I also think that to address William Broad’s assertion that women are more flexible than men, we need a better working definition of (biomechanical) flexibility:

Flexibility is the range of motion in a joint or group of joints, or, the ability to move joints effectively. Flexibility is related to muscle strength. Flexibility is also the ability to move through a full range of motion.

Flexibility is a conscious movement that has an intricate feedback mechanism between the muscles and the nerves innervating the muscles and the joints and the central nervous system. There are significant protective mechanisms that prevent the individual from overstretching if they PAY ATTENTION to the sensation of pain rather than ignoring it.

So are women “inherently” more flexible than men? Well, it depends who you ask. But all sports attract a body type, and if yoga is considered a “sport” then there is a body type that is drawn to yoga. We all like to do things that are “easy” and for some flexible bodies yoga is “easy.” The rub here is that this isn’t “yoga” but athleticism masquerading as yoga!

So now let us look at his assertion that yoga is the root cause of “femoracetabular impingement”. The literature that I read, including one of his references, states that the subjective symptoms are deep anterior groin pain with associated intermittent catching and locking of the hip joint. In addition, there is a significant decrease in hip internal rotation. The morphology is that there is a breakdown of the hip labrum (how the head of the femur is connected into the cup of the pelvic acetabulum) and the articular surfaces of the femur and acetabulum. There is a structural change in how the head of the femur is sitting and facing, and movement of the hip will continue to tear the tissue structures with a loosening of the integrity of the hip joint. The problem is that a lot of individuals who have this condition are pain free, asymptomatic and don’t know they have it. The concern is that this condition may be a precursor to developing hip arthritis down the road. There are four types of femoracetabular impingement and one type is more common in women and one type more common in men!

Another article that I read stated that the condition is caused by internal rotation of the hip while in 90 degrees of hip flexion. Yes, this can be Uttanasana (Standing Forward Bend)! So is the problem the combination of these two movements? I don’t know, but does that mean you need to stop doing Uttanasana? I don’t think so unless it is causing pain. And, yes, there are some pretty extreme hip positions in yoga which only some of could do when we were younger (maybe can still do them now) but the bottom line is that we need to practice with intention and attention to form, function and our own bodies' abilities and not soldier on through the pain. Yoga, as we have mentioned time and time again, can be physically and mentally challenging, but is not supposed to hurt. So don’t be scared off again by a sensational journalist who claims he is a yogi.

In a future post I would like to present some of the inherent differences between male and female pelvis and hips that might also help to put into perspective the allegation of the differences between men and women.

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Yoga for Traveling

by Nina

Ram’s Monday post on airplane yoga made me remember some of the other great information we have on our blog that might interest anyone who is taking a long trip. Since we’re coming up on the holiday travel season, I thought it would be fun to write a single post that gives you an overview of those posts.

By the way, from my experience of doing yoga on airplanes as well as in airports, I can tell you that some people will look at you as if you’re weird but other people will be totally envious. Once when I was doing yoga with Rodney Yee in airport waiting area, a complete stranger asked if she could join us. It ended up being a very memorable practice for me—I can still remember the woman and most of the sequence we did—and it was probably a memorable practice for her as well. 

Seated Poses. We have a few other poses on the blog that Ram didn’t mention that you might like to try while you are stuck in your seat. See Ankle Circles and Chair Cat Pose. And although we show it standing, Eagle pose arms could be done just as well seated. See also Standing Shoulder Stretches for other ideas for shoulder stretches you could do sitting down.

Of course, you could also do the same poses in a train, bus or car (as a passenger, of course). 

Standing Poses. In addition to those mentioned by Ram, we have featured quite a few poses you can do standing in the back of the plane. Standing Shoulder Stretches and Opening Tight Shoulders show stretches you can do standing in tight spaces.

I’d like to mention two standing poses that we haven’t featured yet. A Standing Marichyasana (Standing Twist) would feel great on your back and neck. Start by standing about a foot from a wall, with your right side to the wall. Then twist to the right toward the wall, placing both hands on the wall at shoulder height, elbows bent and palms on the wall. Inhale as you lengthen your spine up. Exhale as you move deeper into the twist. Stay 30 seconds to a minute. Then repeat on the left side.

A modified Natarajasana (Dancer’s pose) would be an excellent way to stretch your tight quadriceps. This would be a good counter pose to the all forward bending of your hips from sitting (and a good counter pose to Ram’s Standing Knee to Chest pose). Stand about a foot from a wall, with your right side to the wall, and place your right hand on the wall, at about shoulder height, elbow bent. Then shift your weight onto your right leg and bend your left knee. Reach your left hand back and take hold of the your left foot, then move your left thigh so it is perpendicular with the floor (Tadasana position). If you are ready for more stretch, you can lift your hand to gently pull your left thigh into a backbend. Stay for 30 seconds or more. Repeat on the other side.

Sleeping. Of course, sleeping is also a good thing to do when you’re on a long flight. Baxter’s post on sleeping on an airplane recommends a supported sleeping position that will help you survive the trip without acquiring a crick in your neck or a pain in your back.

Airport Yoga. In addition to the flight itself, when you’re traveling, you do a lot of sitting around in waiting areas, either before your flight or waiting for a connection. With more space and free use of a chair, you have even more possibilities for doing yoga. Almost all our office yoga poses and sequences can be done in waiting areas while you are dressed in street clothes. See Mini Office Yoga Practice  and Chair Yoga Mini Practice.

Stretching Your Legs at this point should feel great. You can't lie on the ground to do Reclined Leg Stretch but you can do the exact same poses in a standing position. See Standing Leg Stretches.

Our blog has quite a number of “office yoga” entries, so use the Search function at the upper right corner of the home page to explore and be inspired. And if you have ideas you’d like to contribute, please share them in the comments section.

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