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Month: November 2016

Meditations for Weight Loss – Interview for YogaGlo

Hundreds of medical studies have shown the spectacular health benefits of meditation. Now Tiffany Cruikshank, founder of Yoga Medicine, puts that scientific research to good, practical use. Her 21-day program incorporates easy-to-use, targeted meditations for weight loss. This program optimizes metabolism and improves body image by tapping into the hidden strength of the mind. We learn a whole new way to lose weight, and it takes just a few minutes a day.

Yogi meditating in Lotus pose. Learn about meditations for weight loss, and how meditation can improve body image and boost metabolism

Each day of the plan in Meditate Your Weight helps you explore and release what’s weighing you down physically, emotionally, and mentally. Discover the mental blocks, thoughts, habits, and behaviors that stand in your way. Learn to target these blocks to make it easier to think more clearly, make better choices, improve body image, and maximize metabolism. As you lighten up on the inside, you’ll lighten up on the outside.

Click here to read the full article on YogaGlo’s blog.

Yin Yoga: 10 Reasons You’re Not Too Busy

Think you don’t have time for yoga during the holidays—much less 3-minute pose holds? Yoga Medicine teacher Shannon Stephens makes a case for why yin yoga may be the best practice for your busiest times.
Yogi holding a yin yoga pose.

As a full-time yoga instructor with a demanding schedule that has me running between classes and private sessions most of the day, my personal yin practice has become essential to recharge and give back to my body, mind, and spirit. Yin is an introspective practice that offers a chance to turn inward and nurture the calm, quiet center that is innate in all of us. It is a practice in stillness, patience, and non-reactivity. Through yin yoga, we become adept at self-care. We become better listeners with practice tuning in; we become wiser as we get to know ourselves from the inside out, and we become more curious about the world through the exploration of our own inner worlds.

To practice yin is to relinquish control—such a novel and therapeutic concept in our modern-day lives. On the surface, the yin practice might appear uneventful. But if you are able to tune in, you will encounter some pretty fascinating events occurring in the layers beneath the skin.

Not convinced? Dig deeper into 10 nourishing qualities and therapeutic benefits I’ve encountered both with my students and through my own practice of this form of medicine like no other.

1. The yin practice can help the body restore range of motion.

With a healthy range of motion, layers of connective tissue must allow muscles to glide over each other. But injury, habitual posture in daily life, and aging, among other factors, can bind these connective tissues together, creating so-called adhesions and restricting that movement between the sliding surfaces of the muscles. Like a traffic jam, adhesions block the flow of nutrients and energy through the body, causing pain and limiting mobility. However, holding poses that gently lengthen the muscles and fascia can help break up adhesions. Also, applying mild stress to joints and connective tissues can increase their range of motion.

2. Yin yoga revitalizes the tissues of the body.

Our body’s tissues can be revived by a good long soak the same way that an old, stiff sponge can. As you hold a yin pose, the subtle release that takes you deeper into the pose is the tissues lengthening, hydrating, and becoming more pliable. If you pay close attention, you can sense the tissues being stretched, squeezed, twisted, and compressed. A yin practice can leave you feeling as though you’ve had a massage.

3. Yin offers a unique opportunity to cultivate gratitude for the body.

The simplicity of a yin practice allows us to return to our bodies and to see clearly just how remarkable we really are. Journeying into the deeper layers of ourselves, we tune into our inner workings, connecting to respiratory and circulatory functions, internal organs, and sensations within the muscles and joints. This heightened awareness of the physiological processes of the body ultimately moves us closer to santosha, or contentment.

4. The yin practice forces us to slow down.

Yin poses’ long holds offer a chance to marinate in stillness. When you allow yourself to stay present and experience the near-imperceptible shifts that occur while holding a yin posture, time opens up. Deadlines, commitments, pressing matters, and to-do lists fade to the background, leaving tremendous space for rest and renewal.

5. Yin yoga teaches self-compassion.

The ability to tend to all facets of ourselves (physical, mental, emotional, and spiritual) is fundamental to our wellbeing. The yin practice provides an opportunity to observe, nurture, soothe, and calm ourselves. The act of carefully taking a posture and tending to your body’s unique set of needs for the duration of the hold is a form of self-care and lovingkindness.

6. The long hold times of a yin practice offer the chance to sit with our emotions.

Our bodies store emotions, and it’s not uncommon for sensitive thoughts, feelings, and memories to surface while practicing any form of yoga. Yin teaches us how to be gentle, patient, and nonreactive. When emotions bubble to the surface, the conditions are safe.

7. Yin yoga can help us become more resilient to stress. 

Holding a pose for several minutes can provoke anxiety. But when we approach it with tenderness, the body acclimates. Surrender is a common theme in yin yoga, and giving up the need to control a situation is a lesson that we can carry with us into our day-to-day lives. The ability to adapt to the ups and downs of life and to manage change with grace can lessen our predisposition to stress.

8. Yin yoga can help us tap into the parasympathetic nervous system.

Diaphragmatic breathing, or belly breathing, is a powerful way to trigger the parasympathetic nervous system. You may have heard some of the reasons activating the parasympathetic nervous system is beneficial (stress, tension, blood pressure, sleep, digestion, immune function, hormones, etc)—and that most of us don’t do it often enough. Instead, we spend our days locked in sympathetic nervous system overdrive, constantly being pulled from one overly important deadline to another. Belly breathing can be a quick and easy way to change this.

Pay close attention while breathing from the abdomen and in no time you will notice a significant shift. It may feel like a wave of relaxation washes over the body. The deepest layers of the belly soften, the forehead tingles, and the brain relaxes. It’s as if the whole body takes a prolonged sigh. As you move deeper into the yin practice, the breath slows down significantly drawing you deeper and deeper into this parasympathetic, or relaxation, mode. This is where the internal organs get a chance to catch up on their to-do list (digest, eliminate toxins, heal, repair).

9. The stillness of a yin practice primes us for meditation.

Meditation is not necessarily something you have to find; sometimes it finds you. The yin practice sets us up to tap into the meditation bandwidth. We rarely see who we really are because the cloud of thoughts and distractions block the view. When we create opportunities for physical stillness in a yin practice, we also create the perfect conditions for the brain to become clear. In these precious moments, we are able to see our true selves.

10. Yin yoga cultivates balance.

Your own health and wellbeing is a balancing act. If you look at the yin/yang symbol you will see that the white and black forms are in perfect balance. Many of us live very active (yang) lifestyles and leave little or no time to foster the quiet, introspective side. Over time this can be physically, mentally, and emotionally draining. Through the yin practice, we can restore equilibrium and feel whole.

About Our Expert

Shannon Stephens is currently working toward a 500-hour advanced training with Yoga Medicine. She teaches a diverse range of classes and has received training in Chinese Medicine, Thai yoga bodywork, myofascial release, yin yoga, and meditation. Shannon is a full-time yoga teacher in Oklahoma City. She teaches both group and private classes and co-owns Routed Connection, a small business that specializes in international yoga retreats. Learn more at shannonstephensyoga.com.

Click here to view the original article on Yoga Journal online.

Bridging Yoga Medicine & Western Medicine: Part IV

Part 4: Healthcare Providers as Clients

This is the fourth installment in a series of articles for yoga teachers on ideas for networking and sharing yoga practice with the healthcare community in your locale.

  • In Part 1, we explored defining the types of patients you can best help and using Evidence-Based Medicine (EBM) to validate the ways in which you can support them.
  • In Part 2, we looked at ways to align your services within today’s healthcare world of patient-centered care and quality improvement.
  • Part 3 discussed awareness of self in relationship with yoga teacher colleagues and how being an industry expert can serve you and future clients. In this segment, we will investigate another potential way of approaching networking with medicine – recognizing healthcare providers as an additional community that can benefit from healing.

Doctor Heal Thyself

Chances are when you meet with the medical director of a healthcare facility and/or healthcare providers in a clinic you hope to get involved with, like many other people out there, they may not know much about yoga’s potential beyond group exercise. A large part of your time will be spent educating them. Perhaps you will use talking points you put together after reflecting upon earlier articles in this series.

Meet healthcare professionals where they are at. By using language familiar to them, you will be able to draw their cognitive interest with ease. Another crucial part of outreach to consider is experiential – simultaneously drawing them in physically, emotionally, and maybe (dare I even say it?) spiritually.

There could not be a more suitable time to reach out in this way to physicians. In the United States, the healthcare workforce is experiencing work-related stress and burnout in, what even the US Surgeon General considers, alarming proportions.

Stress and Burnout in Medicine

Defining Burnout

Characterized by: (1) emotional exhaustion, or a loss of enthusiasm for work; along with (2) feelings of cynicism or depersonalization; and (3) a decreased sense of personal accomplishment at work. Physicians and other members of the healthcare team, including medical trainees, often experience burnout as a result of continued job-related stress.

In the United States, more than half of physicians may be experiencing professional burnout. A 2014 Mayo Clinic study in partnership with the American Medical Association revealed 54% of surveyed physicians reported at least one key indicator of burnout. This is an increase from 46% in 20111. Although burnout affects physicians in all specialties of medicine, those on the front lines of care including emergency medicine, internal medicine, and family medicine, are at greater risk. 2

Burnout amongst physicians during residency, an inherently stressful period of medical training, is perhaps even more prevalent. Surveys among residency programs from various specialties across the US report burnout to affect up to 60% of trainees.3

Physicians are not alone in their experiences. Amongst nurses, 34% of hospital nurses and 37% of nursing home nurses report burnout, while 22% working in other settings are affected as well.4

The Consequences

The consequences of burnout in the healthcare workforce are multi-dimensional. Personally, the increased distress can contribute to stress-related health concerns and unhealthy coping behaviors, such as substance abuse.3 Depressive symptoms, as well as professional burnout, are strongly correlated with suicidal ideation amongst doctors.3,5

The culture of medicine can begin to take a toll as enthusiasm in work decreases and cynicism increases, affecting professionalism and healthcare team morale. The impacts of burnout can even drive some practitioners to leave their careers altogether.3

Implications for patient care are also present as burnout has been associated with suboptimal quality of care and medical errors.3 Distress has also been reported to create poorer relationships with patients, as emotional exhaustion and depersonalization are inversely correlated with the ability to provide empathy.3,6

Risk Factors

Though it is a blend of external and internal factors that contribute to the perfect storm where burnout in medicine can arise, studies suggest institutional characteristics are significant determinants of burnout.3

Professional and environmental characteristics like workload, Electronic Health Record (EHR) tasks, work-hours, patient volumes, relationships with colleagues, autonomy, and dissatisfaction with supervisors and organizational leadership are all contributors.3,7 When work hours are decreased, a phenomenon called “work compression” takes over where physicians are expected to complete the same amount of administrative work while providing high-quality compassionate patient care in a shortened period of time.1,3 Personally, conflicts in relationships, work/life balance, illness, and financial debt from educational loans are additional stressors leading to burnout.3

Today’s physicians find their souls in battle, caught between the demands of growing healthcare systems along with insurance companies, in conflict with their innate desire to truly connect with their patients in meaningful ways, building compassion and trust into the heart of the care they provide.

Protective Factors

Although many of the institutional factors described above are beyond individual control, there are personal behaviors that have been shown to be protective against burnout. These include: (1) seeking and giving social support (2) engagement in activities that help to create meaning both at work and at home; and (3) health-promoting behaviors, particularly sleep hygiene and stress management.3,8

In a study I helped to conduct at the University of Buffalo in Buffalo, NY, resident physicians who reported no regular engagement in personal emotional and/or spiritual practices to support wellbeing were two times more likely to be emotionally exhausted when compared to residents who reported engagement.   Similarly, those who reported no physical activity were almost three times more likely to be emotionally exhausted when compared to medical residents who reported 150+ minutes of at least moderate intensity physical activity per week.9

Solutions: A Role for Mindfulness and Yoga in Healthcare Provider Self-Care

The wide range of factors impacting healthcare worker burnout warrants solutions that effect change at multiple levels – from broader systemic, institutional layers through professional and personal dimensions. A recent meta-analysis reveals that both individual-based and organizational strategies can lead to equally meaningful reductions in healthcare provider burnout.10

While administrators work on vital structural changes, interventions to nurture personal wellness can further support provider health and resilience. Of particular interest to yoga professionals is the role mindfulness programs have been playing to increase physicians’ awareness of burnout in its early stages and temper its effects. By encouraging engagement in self-care activities and creating meaning in the workplace, mindfulness-based programs can provide an evidence-based means for healing healthcare provider burnout.8,10

Mindfulness trainings for healthcare professionals can include meditation and yoga to develop greater self-awareness, cognitive behavioral strategies to lower reactivity in stressful situations, mindful communication to strengthen interpersonal relationships, reflection, and discussion. Participation in a twelve-month program utilizing these elements resulted in significant reductions of burnout and mood disturbances while increasing mindfulness and empathy amongst primary care physicians both in the short and long term.11

Abbreviated interventions have also been successful as evidenced by a 2013 study utilizing a weekend immersion on mindfulness followed by two evening sessions, web support, and a commitment by participants to engage in 10-20 minutes of mindful home practice. This pilot trial with primary care clinicians resulted in reductions in burnout, depression, anxiety, and stress sustained over nine months of follow-up.12 

How Can Yoga Professionals Get Involved?

With provider wellness finally getting some much-needed attention, the healthcare system is looking for ways to bring joy and meaning back into the practice of medicine. Given the potential for mindfulness practices to support resiliency in the healthcare workforce 7,8,10-13, now is a great time for yoga professionals to get involved. By serving this community, you could potentially help to heal burnout at a personal level while simultaneously exposing medical professionals to the healing potential of yoga, perhaps encouraging them to consider referring more patients to the practice as well.

Here are just a few starting ideas on how you may get involved:

  • Offer after-hours group classes and/or privates for healthcare professionals focused on self-care practices that enhance self-compassion and mindfulness.
  • Contact a clinic, hospital, or a local managed care organization about providing a workshop on mindful movement and meditation as a professional development activity for employees. Topics to include could be:
    • Brief history and philosophy of yoga, meditation, pranayama.
    • Overview of the physiological and psychological benefits of practices.
    • Restorative and Yin yoga – benefits and contraindications.
    • Meditation and mindfulness exercises for enhancing moment-to-moment awareness and identification of unhelpful thought patterns.
    • Using self-care practices to enhance gratitude, empathy, compassion, and resilience in the workplace and at home.
  • Partner with existing physician wellbeing programs or local physicians to integrate yoga into their offerings
  • Medical trainees can benefit from these programs. Consider contacting local medical, nursing, and physician assistant training programs as well as Graduate Medical Education (GME) departments to provide programs for students and faculty.

If you are a healthcare professional interested in learning more about evidence-based mindfulness programs tailored to physicians, please see the Mindful Practice website for further information. 

Potential Barriers

Please note the physician community can often be quick to site the laundry list of organizational and structural changes that contribute to burnout while resisting the potential for learning new personal practices. There are strong feelings amongst doctors about the need for resiliency training, and they are not entirely wrong. Doctors likely do have a strong reserve of coping skills that have helped them succeed thus far, but resilience is not just about bouncing back.

Resilience is about maintaining personal health AND being able to adapt, change, and grow. Self-care must be nurtured to help us flourish in this way. It is not one thing versus another, internal versus external characteristics; several factors contribute to physician wellness. Hence, it is advised to partner individual-based interventions with the organization level changes.13

I often remind physicians I have worked with that organizational changes, though very effective, can often take a long time to implement. While we keep advocating for the necessary shifts in healthcare, mindfulness and self-care practices are things we can do right now to impact personal wellness in this moment. If it can make us happier, and doesn’t have to take too much time, why not give it a chance?

Gratitude and A Request for Sharing

Thank you to Tiffany and Yoga Medicine for giving me the opportunity to share my thoughts and experiences with our community. I would love to hear more from all of you! What are strategies that have worked for you when reaching out to the medical community? Have you provided programs for healthcare professionals? What have been your experiences?

Please email me at rashmi.bismark@gmail.com to share your thoughts, comments, and questions. I plan to put together our Yoga Medicine Community’s tips into another follow-up article – so please contact me soon! Thanks again, and hope some pieces of this series have been helpful to you. Looking forward to hearing your ideas. Namaste.

References:

  1. Shanafelt T, et al. Changes in Burnout and Satisfaction With Work-Life Balance in Physicians and the General US Working Population Between 2011 and 2014. Mayo Clin Proc. 2016 Feb;91(2):276.
  2. Shanafelt T, et al. Burnout and Satisfaction With Work-Life Balance Among Physicians Relative to the General US Population. Arch Inten Med. 2012; 172(18):1377-1385.
  3. Dyrbye L and Shanafelt T. A narrative review on burnout experienced by medical students and residents. Med Educ.2016 Jan;50(1):132-49
  4. McHugh MD et al. Nurses’ widespread job dissatisfaction, burnout, and frustration with health benefits signal problems for patient care. Health Affairs. 2011;30(2):202-210.
  5. Andrew LB. Medscape: Physician Suicide. Oct 2016. http://emedicine.medscape.com/article/806779-overview#showall . Accessed Oct 26, 2016.
  6. Thomas MR, Dyrbye LN, et al. How do distress and wellbeing relate to medical student empathy? A multi-center study. J Gen Intern Med.2007 Feb;22(2):177-83.
  7. Bodenheimer T and Sinsky C. From triple to quadruple aim: care of the patient requires care of the provider. Ann Fam Med.2014 Nov-Dec;12(6):573-6
  8. Epstein RM and Krasner MS. Physician resilience: what it means, why it matters, and how to promote it. Acad Med. 2013 Mar;88(3):301-3.
  9. Ahmad I, Bismark RS, Evans TB et al. Burnout and Health Promoting Behaviors Among Medical Residents in Buffalo, NY. American College of Graduate Medical Education Annual Conference, February 2013.
  10. West CP et al. Interventions to prevent and reduce physician burnout: a systematic review and meta-analysis. Lancet. 2016 Sep 28. Epub ahead of print.
  11. Krasner MS, Epstein RM et al. Association of an educational program in mindful communication with burnout, empathy, and attitudes among primary care physicians. 2009 Sep 23;302(12):1284-93.
  12. Fortney L, et al. Abbreviated Mindfulness Intervention for Job Satisfaction, Quality of Life, and Compassion in Primary Care Clinicians. Ann Fam Med. 2013 Sep; 11(5): 412–420
  13. Epstein RM and Privitera MR. Doing something about physician burnout. Lancet. 2016 Sept 28. Epub ahead of print.

Bridging Yoga Medicine & Western Medicine: Part III

Part 3: Partnering from Within: Your Community Yoga Network

This is the third of a four-part series of articles for yoga teachers on networking within the medical community. In the first installment, we explored defining the types of patients you can best help and using Evidence-Based Medicine (EBM) to validate the ways in which you can support them. In the second, we looked at ways to align your services within today’s healthcare world of patient-centered care and quality improvement. Now we will delve into further alignment, this time exploring yourself in a relationship with your greatest asset – yoga colleagues teaching and working in your community.

Recognizing Strengths While Bringing Awareness to Ahamkara

In the eagerness to bridge yoga with the medical community in your locale, it is very important to carry mindful self-awareness with you. As yoga teachers within a broader network of skillful yoga providers, we must each recognize our unique strengths within the practice of yoga while creating familiarity with the strengths of those around us.

Though we may like to think we can help everyone, yoga teaches us to always be aware of our ahamkara (ego) and its sophisticated tendency to influence our actions.

Back in the summer between my undergraduate and medical school training, I interned with my university’s medical humanities department, working with a local massage therapist interested in building a network of complementary and alternative medicine (CAM) providers. At the time, the first integrative health clinics set our city abuzz. The concept was creative and unique for its time – a center for health promotion and self-care supported by complementary wellness providers poised to partner with individual medical providers.

Unfortunately, the clinic did not stay open for very long. Positioned as a stand-alone center, practitioners primarily referred patients to other practitioners within the clinic. Many CAM providers felt the center underutilized the city’s rich CAM community, which may have contributed to the center’s fate.

Ask yourself, what are your true drives for wanting to partner with neighboring medical providers?

For most all of us, the answer to this question is not simply to increase our number of clients. More likely, it is the drive within us to share the beauty of yoga and help others to heal which drives us to reach out to the healthcare world. With this commitment to service at the forefront, aligning yourself with peers in your community becomes a much more meaningful task.

Yoga Industry Expert

By networking with other yoga teachers and yoga therapists in your community, you can add value to the services you may potentially provide within healthcare. As you become an “industry expert” in your vicinity, you can position yourself to be a key liaison between the medical and yoga communities.

Taking on new client referrals from medical clinics can become as important as becoming the point person for referrals to others in the community. In this way, even if a medical clinic is not quite ready to take you on as an employee, they can be confident in your skills as a primary practitioner to refer patients to, whether it is for care or for triage to another skilled yoga teacher or therapist with different expertise.

Key Take-Aways from Parts 1-3:

  1. Define the community of patients you can best serve.
  2. Build support with the help of EBM to validate the ways in which you can help them.
  3. Understand how yoga can align with quality improvement trends in healthcare including patient-centered care, self-management, and cost-reduction.
  4. Nurture relationships with yoga teachers and therapists in your community as you become an industry expert, able to both teach and effectively bridge medical providers with the appropriate yoga care for their patients.

Join me for the next and final installment of this series where we will discuss one more approach to networking within healthcare – self-care for medical providers themselves. Healer, heal thyself.

Bridging Yoga Medicine & Western Medicine: Part II

Part 2: Positioning Yourself in Healthcare

This is the second of a four-part series of articles for yoga teachers on networking within the medical community. In the first installment we explored defining the types of patients you can best help and using Evidence-Based Medicine (EBM) to validate the ways in which you can support them. Although medically trained ears may find that information intriguing, they may not be able to picture how your services can fit in to their practice. Sometimes it can be helpful to explain how you and your yoga services can align with the overarching goals of today’s healthcare world.

HEALTHCARE TRENDS

Patient Centered Care

In addition to providing care that is safe, effective, timely, efficient, and equitable, in 2001, the Institute of Medicine (IOM) included patient-centered as one of the six aims of healthcare quality in the United States for the 21st Century. The IOM defined this key element of high-quality care as “care that is respectful of and responsive to individual patient preferences, needs, and values and [ensures] that patient values guide all clinical decisions 1.”

Since then, the concept of patient-centered care has taken a prime role as health care institutions, medical providers, community health planners, insurance companies, and hospital administrators have all made this quality indicator a priority. To this end, new models of medical care have been evolving, including the Patient-Centered Medical Home or Primary Care Medical Home (PCMH)2.

A PCMH provides a team-based, comprehensive and coordinated approach to meet the healthcare needs of each patient as a whole person.   The core team may include physicians, nurses, pharmacists, nutritionists, mental health professionals, and more who work together with patients and their families to optimize health.

It can be easy to see how yoga can align with these concepts of patient-centered, whole-person care. Bringing together physical activity with psychosocial well-being, yoga can provide a supportive care measure that fits into patient-centered ideals of comprehensive wellness and prevention. The US Veterans Affairs (VA) even features yoga as patient-centered whole health approach 3.

Additionally, as a Yoga Medicine-trained teacher, you have the knowledge and vocabulary to be an essential team player in the healthcare team. Dr. Stephen Dahmer MD, a family medicine physician in Manhattan, cites “soft style, anatomical knowledge, ability to spot red flags (and ability to effectively communicate this with medical providers) and overall compassion,” as key qualities one of his medical practices looked for when working with yoga teachers.

Self-Management

A large part of patient-centered care is also inviting patients take a more active role in their personal health care. Medical homes, clinics, community organizations, and even insurance companies have started to employ health coaches and/or provide group classes for patients on self-management and self-care. They teach patients how to manage their illnesses and make lifestyle changes to support their health. A classic example is the Dean Ornish Program for Reversing Health Disease, an intensive cardiac rehab class developed by Dr. Dean Ornish, MD, incorporating yoga, meditation, plant-based diet, exercise, and social support to alter patient risk profiles after heart attacks.

Yoga can be a creative add-on to existing self-care programs or may even be integrated in new, novel ways to support patients. Dr. Dahmer worked together with health coaches, who were also trained yoga teachers, at one of his offices to develop an innovative group program for his patients. “We started a class, called Body Lab, where I co-led with a yoga teacher – incorporating yoga, physical exam, anatomy, self-care – all in a group session, “ shares Dr. Dahmer.

Reducing Healthcare Costs

In addition to quality improvement, self-management, and patient-centered care, another broader goal of today’s healthcare is managing skyrocketing costs and reducing burden on the healthcare system as a whole. Fortunately, support is beginning to amount for mind body practices as potential ways to cut medical costs.

In October 2015, a retrospective study by researchers at Harvard showed that amongst a group of over 4000 patients who participated in Harvard mind body programs incorporating yoga and meditation, total healthcare utilization decreased by 43% one year after participation in the programs. In subgroup analyses, high utilizers of healthcare within the intervention group were 25% more likely to significantly reduce healthcare utilization when compared to high utilizers within the control group of over 13,000 patients from Boston-area health-care facilities 4.

Because studies like this one are observing broad statistical links, they cannot prove that mind body modalities were the sole contributor to reductions in healthcare demand. Regardless, this study offers hope and the possibility that safe and inexpensive interventions like yoga and meditation may help to control rising healthcare costs. That is music to any healthcare administrator’s ears, and another way to align your practice with broader healthcare ideals and trends.

Join me in my next installment of this series where we will explore further ways of positioning yourself as an ideal partner in wellness with the medical world.

References:

  1. Institute of Medicine (IOM). Crossing the Quality Chasm: A New Health System for the 21st Century. Washington, D.C.: National Academy Press; 2001.
  2. US Department of Health and Human Services. Defining the PCMH. https://www.pcmh.ahrq.gov/page/defining-pcmh
  3. US Department of Veterans Affairs. VA Patient Centered Care: A Life-Changing Solution. http://www.va.gov/PATIENTCENTEREDCARE/features/A_Life_Changing_Solution.asp
  4. Stahl JE et al. Relaxation Response and Resiliency Training and Its effect on Healthcare Utilization. PLoS ONE 10(10): e0140212. Oct 2015.

Bridging Yoga Medicine & Western Medicine: Part I

YogaMedicine-trained practitioners are particularly well suited to partner and work efficiently with Western medical providers because they are a community of yoga teachers trained to understand the function and dysfunction of the human body. Most likely, as a Yoga Medicine teacher, you are already well connected to your local wellness and supportive health practitioners. Developing relationships with the medical community, however, can often be a bit more challenging.

I personally know the hurdles, being a physician who has been finding ways to bridge my holistic health interests with the medical world for almost two decades. From the skeptic looks to closed-minded views, doctors can seem to be an intimidating bunch, but there are always those who are willing to open their perspectives to complementary ways of serving patients.

This is the first of a four-part series of articles on ideas for approaching networking with medical providers in your locale.

Part 1: WHO You Serve and HOW Your Skills Benefit Them

When thinking about where to even begin with the healthcare networking process, it can be very helpful to develop a deep understanding of the populations you serve.

If You Already Have a Target Demographic

Perhaps you may have already developed your own niche of clientele, a group of individuals you really enjoy working with. Maybe their common link has to do with social demographic characteristics, like children from low-resource neighbourhoods, female college athletes, or elderly nursing home communities. These social determinants help you to have a greater understanding of their potential health risks and conditions. Your yoga practice may be particularly tailored for them.

Alternatively, perhaps your practice is tailored to support individuals with specific health conditions such as scoliosis, addictions, or obesity. In this case, you may serve a diverse community of clients who share a common experience of illness.

In either scenario, you have likely developed keen expertise on the issues impacting the health of these populations, providing you with great insight to help tailor group classes and individual one-to-one sessions. As you consider where to start reaching out to medical providers, this understanding can help you to target healthcare practices that serve your niche communities. Maybe you will begin with a local community health center that serves inner-city youth or nearby pediatric clinics. Maybe you will reach out to Planned Parenthood centers or focus your outreach on OB/GYN practices.

If You Need to Pick a Target Demographic

If you happen to be a yoga teacher working with a wide variety of clients and/or perhaps are not bound to a particular niche, consider taking some time to research large medical practices you may want to reach out to in your community. Develop an understanding of the populations they serve. If practices do not have such information on their websites, consider giving them a call to find out a bit about their demographics. Otherwise, in the United States, you can often find a lot of health-related statistics about your region from your local county’s health department website. Community Health Assessments (like this one), conducted by each county across the country, are often published and include community-specific health improvement goals.   These reports can give you an overview of social characteristics and predominant health conditions influencing your potential client base.

Evidence Based Medicine

Once you have a well-developed understanding of the populations you may serve, it can be very helpful to familiarize yourself with the Evidence-Based Medicine (EBM) research on benefits of yoga, meditation, and mind-body modalities for the specific communities you work with. Familiarizing yourself with this support can help you to “make your case” when speaking with members of the medical community. Even being able to just cite 1-2 key studies that highlight benefits can often get uninterested ears perking.

The increasing popularity of yoga over the past three decades has ignited the scientific medical community’s interest in researching the benefits of yoga for health. You have likely been exposed to several studies supporting the use of yoga throughout your training with Yoga Medicine. Though the scientific literature base on yoga has been steadily growing, the quality and rigor of research studies have been mixed. Fortunately, there are resources that can help you sift through it all, including research compilation books that evaluate the data to date.

Dr. Gurjeet Birdee, MD, MPH, a physician-scientist and yoga therapist at Vanderbilt University suggests the new book, The Principles and Practice of Yoga in Health Care, edited by Sat Bir Singh Khalsa PhD, et al. “Yoga therapists and teachers often ask me about the evidence of yoga for specific conditions so they can cite the literature to clients and healthcare professionals such as physicians, “ says Dr. Birdee. He feels this book can be effectively used to find such references to support and validate clinical yoga practices. Chapters include overviews of conditions, surveys of literature, clinical considerations and insights from practicing yoga therapists and teachers.

Beginning to Craft Your “Elevator Pitch”

Using the information gathered above, you can start to artfully create your “elevator pitch” of sorts. Knowing your target communities, the health conditions they face, contributing factors, and EBM support for yoga in their healing journey, you can begin to tell the story of WHO you can serve and HOW your skills will help them nurture their health.

Join me in next installment of this series as we explore more approaches to support Yoga Medicine teachers looking to segue into the medical world. Namaste.

A Flexible Life: Amy Sedgwick

Living without a roadmap, finding fulfillment and other lessons from physician and yoga instructor Amy Sedgwick.

Amy has just returned from a weeklong yoga training. “I’ve been pursuing this 500-hour teacher certification for some time,” she says between sips of tea. She’s sitting at her kitchen island and her dark hair is up in a loose ponytail. Around her, signs of family life point toward the everyday chaos of getting two young daughters out the door in time for school. The previous night, she worked a long shift at InterMed, where she is an emergency physician, yet she seems rested. It must be from all the yoga.

Or perhaps it’s just her inner reserves of strength.

Amy Sedgwick Flexible Life

About Amy Sedgwick

amy-sedgwickIn addition to practicing emergency medicine, Amy owns a yoga studio, Riverbend Yoga, in Yarmouth, Maine tto provide a space for people to learn how to affect their own health and resilience from within.  The community at Riverbend has grown immensely. She has found many of her medical colleagues refer their patients to Riverbend as well as gravitate to the practice with her. This has become a very fulfilling path and continues to inspire Amy as she seeks more knowledge and understanding of how we human beings can optimize well being and affect positive change in our communities.

Amy attended Wellesley College and earned a B.A. in Economics. She then spent several years working in New York City for an investment bank.  After realizing that she was much more suited to taking care of people, she went on to earn a M.D. at the University of Vermont College of Medicine.  From there completed she Emergency Medicine residency at Maine Medical Center where she continues to work.  Amy has also worked at InterMed, P.A. taking care of patients across the spectrum. Amy completed her 200-hr Vinyasa Yoga training under Jacqui Bonwell have pursued further yoga training with Josh Summers, Johnny Gillespie, Karin Gurtner and Tom Myers.

She feels so fortunate to now be in the midst of completing a 500-hr certification with Tiffany Cruikshank. Tiffany continues to inspire her quest for a deeper understanding of this beautiful practice.  Amy has two sweet daughters, Alexis (9) and Gabrielle (7)and a wonderful husband, Peter. Amy has competed in over 30 marathons and several Ironman and 1/2 Ironman races. She finds some of her best moments simply walking in the woods.

Click here to read the full article

By Katy Kelleher. Photos by Lauryn Hottinger

Beginner Yoga for a Strong Core and Flat Belly

By Rachel Land for DYI Active.
If you’re anything like me, the idea of doing abdominal crunches for toned abs and a flat belly is enough to send you running away from the gym. Fortunately, you don’t have to do crunches to have a strong core… Here are 4 beginner yoga poses that anyone can do for a strong core and flat belly!

Using yoga for a flat belly! Here’s how:

Learning how to engage the deeper muscles that support the trunk, hips, and even shoulders allows you to co-ordinate the power of the lower body with the agility of the upper body. Using your core this way, especially while you’re moving, creates functional stability in everything you do – from sports, to lifting up your kids, working in the garden, or walking safely on icy or slippery ground.

Here are four simple core stability exercises you can do at home, with no equipment other than your own body. If you’re new to exercise, or have back, shoulder or wrist injuries, do check with your doctor or physical therapist to ensure these exercises are safe for you.

1. Knee Lifts

Rachel Land Knee Lifts
This simple exercise connects you to your deepest abdominal muscle, which wraps around the waist and supports the lower back. Think of it as your corset muscle.
Lie on your back with your feet on the floor and your knees bent at 90-degrees. Place the heels of your palms onto your front hipbones, thumbs toward your navel and fingers toward your pubic bone. Imagine tying a string around your waist, and feel how the belly becomes flat and firm as you hug all four sides of your waist into the midline. You can keep your hands here, or relax them by your sides.
Maintaining this set up, lift your right foot off the floor, keeping the same 90-degree angle at the knee. Swap feet in mid-air, keeping your belly flat and firm, and your hips as still as possible. Repeat 10 times per leg, then return both feet to the floor. Windshield wipe your knees side to side to rest, then repeat.
Need to back off?
If you feel your lower back pulling away from the floor, or your belly bulging, bring the first foot back to the floor before lifting the second one. You could also press your palms down to the floor beside you for extra support.
Want to amp it up?
Next time, start with both feet lifted, knees stacked over hips with a 90-degree bend in your knees. Keeping the same angle in the right knee, touch the toes to the floor. Swap legs in mid-air, still keeping your belly flat, your hips steady, and your breathing relaxed.

2. Walking BridgeRachel Land Walking Bridge

This exercise builds on the waist activation we created above, adding stability work for your hips.

Lie on your back with your knees bent. Set your feet hip-width apart, close to your buttocks. Re-create the feeling of “hugging in” around your waist, then lift your hips until you have a straight line between shoulders and knees. Rather than clenching your buttocks, lengthen your sit bones towards the backs of your knees. You might even feel your buttocks with your hands to ensure they aren’t gripping your lower back.

Maintaining this alignment, slowly hover your right foot just above the floor, keeping your hips as still as possible. Swap sides, slowly walking the feet while aiming to keep your hips from rocking side to side. Repeat 10 times per side, before settling both feet and your hips back down onto the floor. Hug your knees into your chest for a rest, then repeat.

Need to back off?
If you can’t keep your hips stable, try lifting to tiptoes, one foot at a time, rather than lifting your foot entirely off the floor.

Want to amp it up?
Next time, try the exercise with your support foot on tiptoes. This decreases the amount of surface area on the floor, making it more challenging for you to retain your balance.

3. Bird Dog Flow Rachel Land Bird Dog Flow

Here we continue to engage waist and stabilize the hips, and add some work for the small, deep muscles that stabilize your shoulders.

Set up on all fours, wrists under shoulders and knees a little narrower than your hips. Feel your shoulders and hips parallel to the floor, firm your belly and narrow your waist. Extend your right leg straight out behind you, lengthening your tail and spinning your inner thigh towards the ceiling to keep your hips square. Press into your right hand to lift your ribcage away from the floor and send your right shoulder down your back to lengthen your neck. Then reach your left arm forward, extending hand away from foot. Return back to all fours to swap. Continue flowing from side to side, extending opposite arm and leg, keeping your shoulders and hips as steady as you can. Complete 10 times per side, before returning to all fours. Stretch your hips back to your heels to rest in Childs Pose, then repeat.

Need to back off?
If you are struggling with your balance, keep both hands on the floor and simply flow your legs from side to side.

Want to amp it up?
Next time, hover your support foot, reducing the surface area in contact with the floor so that you’re balancing just on your support knee and hand.

4. Side Plank Flow

Rachel Land Side plank flowThis exercise maintains core, hip and shoulder engagement while challenging the muscles of your side waist.

Lie on your right side, setting your elbow under your shoulder and your feet on top of each other. Extend your left arm to the ceiling, feeling your shoulders and hips stack, your belly firm and your waist narrow. Press down into your right elbow to draw your right side ribs away from the floor, and contract your right side waist to lift your hips high. Without allowing hips or shoulders to twist, or collapsing into your right shoulder, bring your hips down to hover just above the mat before raising them again. Do 5 hip lifts, then slowly lower to the floor to swap sides. Roll onto your back to rest, then repeat.

Need to back off?
If you are unable to maintain stability, bring your lower knee to the floor for some extra support.

Want to amp it up?
Next time, raise your top leg off your bottom leg, or try turning your body down toward the floor into a forearm plank to swap sides.

Wrap-Up
And there you have it beginner yoga for a strong core and flat belly! Without doing a single crunch, you’ve learned how to use the deep muscles of your core to stabilize your hips, spine, and shoulders even while you’re moving.

“As you continue your day, notice that you can use these same muscles to create a sense of stability in everything you do.”

Get more yoga poses for a flat belly and toned muscles here! Click here to visit the original article on DYIactive.com.

Rach-Headshot-06About the Author:

Rachel Land is a full-time yoga teacher in New Zealand and senior teacher with Yoga Medicine. Click here to learn more about Rachel and the Yoga Medicine team.

Prevent Deep Vein Thrombosis with 5 In-Flight Stretches

By Chelsea Peng for Marie Claire.

Spotify’s ads have been a mixed bag lately—hate the “Milkshake” phone plan one, love to listen to the Calvin Klein girl who somehow manages to speak with only enough air to flutter her vocal chords—but one of them brings up a good point: You are dying! We all are, because modern live demands that we sit, always.

Nothing reminds one of one’s looming mortality-by-dormant-butt more acutely than the long-haul flight (with layovers!), during which you can practically feel a deep vein thrombosis forming as you direct deeply negative vibes at your seat-mate, who’s insisted on keeping his reading light on EVEN THOUGH HE’S TOO FAST ASLEEP TO ACCEPT THE MINIATURE PRETZELS. You *could* be that person who crowds the aisles, but in this post-9/11 world, better to limit your bathroom trips. That doesn’t mean staying completely put, though—here, five not-embarrassing stretches to do at 30,000 feet, brought to you by Valerie Knopik (PhD, E-RYT), Director of Research at Yoga Medicine, and FitFusion trainer Andrea Orbeck.

1. Lower-Leg Extensions with Ankle Circles

Start with both feet flat on the floor. Lift your right foot off and extend the knee, reaching the right lower leg forward as far as your space allows. [Editor’s note: HAHAHAHAHA. But at least these celebrities know the hardship.] With your leg extended, flex and point the foot several times, then circle the ankle, both clockwise and counterclockwise. If you have the space, gently hug the right knee into your chest, clasping the hands around the shin, about 1–2 inches below the knee. Place the right foot back on the floor. Repeat with the left leg.

2. Figure-4 Stretch

Seated tall, place one heel across the opposite knee and push down on the bent knee. This will stretch the glute, which is a large muscle that tends to become very sedated when you’ve been seated for long periods of time.

3. Alternating Knee Pull-ins

Can be done seated, but standing will encourage more circulation. Hug your knee to your chest with both hands until you feel a stretch in the glutes and hamstrings. Alternate each side at least five times.

4. Quadricep Stretch

While you’re waiting in line for the lavatory/when everybody else is passed out because you’re weird like that, stretch your quads and hip flexors. Standing against a wall, bend one knee and pull the heel into the glutes. Hold for at least 20 seconds, alternating legs several times.

5. Foot Pumps

Start with both feet flat on the floor. Keeping your toes and the ball of the foot on the floor, lift your right heel. Then lower the right heel so the foot is flat again. Keeping the right heel and the ball of the right foot on the floor, lift all the toes. Repeat with the left foot. Continue for 5–10 repetitions.

Click here for the original article with Marie Claire.

Meditation: A New Type of Weight Loss Program

For decades, books have discussed the merits of losing weight and have offered weight loss program after weight loss program. From boosting your metabolism through exercise to radical diets and more. But very few have addressed self-talk, and whether this negative mental chatter is actually to blame for our extra weight.

Enter Tiffany Cruikshank’s latest book, Meditate Your Weight (Harmony Books, April 5, 2016), which offers no exercise regime – although she’d be qualified to do so as one of the leading yoga instructors in the world – nor eating plan.

Instead, she has you turn inward to acknowledge how your thoughts are affecting your body and your overall happiness. We all know that stress has negative effects on our body, but we often forget to take this one step further—if stress causes inflammation, depression, anxiety, and overeating, it also negatively affects our blood sugar levels, our dopamine levels and our overall chemical make-up.

By Melissa B. Williams for Healthy Lifestyles.

Click here to read the full article.

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