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Month: June 2018

Eastern and Western Medicine Meet with Yoga Medicine

Tiffany Cruikshank, LAc, MAOM, E-RYT for Retreat Guru‘s featured teacher series. Tiffany discusses the meeting of Eastern and Western medicine, why she loves yoga, and how Yoga Medicine came to be.

Bridging Eastern and Western healing: with Tiffany Cruikshank

Why do you practice yoga? Do you come to the practice to help heal an injury, support spinal health, or perhaps, release some stress? Maybe yoga is your spiritual practice, and the physical benefits are an afterthought. A fusion of all these things?

For Tiffany Cruikshank, founder of Yoga Medicine®, the magic of yoga — and what had her create a yoga school — is an appreciation for how yoga can support the whole person. We spoke with her about how her approach fuses Eastern and Western medicine. Learn why this might just be the future of yoga as a healing modality.

Chinese Medicine & Healing

“I think the beauty of both, yoga and Chinese medicine is looking at who this person is,” she says. “I love teaching our teachers… not, ‘here’s this pose for headaches’ or ‘here’s this pose for hypertension’, but really understanding: who is this person? And, what is it that unlocks the mystery of their health journey?

It’s not necessarily that I can just look at someone and know. It’s not a magical thing. Truly it’s not a clear-cut approach but really learning how to understand the human being, both from a physiological standpoint and an anatomical standpoint. What makes sense to me is the Chinese medicine context as well. Because for me, that’s where it starts to tie in the whole person. It starts to bring together the psychological aspects, the physical aspects, and the physiological aspects.”

What Does it Mean to be Healthy

Her experience forms the philosophical foundation for her Yoga Medicine® approach to movement and health. It’s not about creating a one-size-fits-all program, Tiffany says, but answering a broader question: what does it mean to be healthy.

“I think there is a healthy concurrent to enjoying your exercise, but there’s always the sense that we have to beat ourselves up to be healthy and I really believe to be healthy is about supporting your body’s natural capacities. Yes, we get lazy and at times have to push ourselves to get out and do something, but it doesn’t necessarily mean we have to beat ourselves up. I’m not saying there’s no place for intensive intervals and things like that, I think there’s a place for everything.

For me, [it’s about] questioning what it means to be healthy and where these ideas come from… What drives it… and how that feeds my priorities. I think the beauty of yoga is the lifestyle that it creates, the mindfulness that it creates for us to look at and examine and take ownership of our health, of our lives. And as I get older, for me it’s also just recognizing that you only have so much time in this world, you only have so much time in this life. How should we use that time? For some people that might be running, and for others that might be with their families or doing yoga.

You know, the beauty of yoga is that it can fit seamlessly into that. It can just be a few minutes of meditation, it can just be a few minutes a day, and be something that really supports everything else that you’re doing. I think that’s why it has caught on fire all around the world.”

Merging East with West

Interested in herbalism from the young age of 14, Tiffany now has a breadth of training that bridges both classical Eastern medicine, in the forms of yoga and acupuncture and oriental medicine, with Western medicine in the form of rigorous anatomy, physiology, and kinesiology. She dreamed of playing professional tennis. Because of this, sports medicine drew her interest in school. This created a foundation to be the link between the traditional practices of yoga and oriental medicine. Tiffany explains that doctors and practitioners are wanting to increase the inclusion of yoga in their work.

“I feel that a lot of the desire for doctors wanting to use it is there, they just really don’t know how to. And fair enough, the reality as a healthcare provider is if you refer your patient to go to yoga, you might get in a lot of trouble because they can end up in an Ashtanga class, they might end up in a Yin Yoga class or anything in between, all of which could be fantastic, any one of those could be the cure to all their problems – or potentially not. Because it could potentially make things worse.” And this is where Tiffany and her school are raising the bar on teacher trainings. Although she doesn’t believe yoga teachers are meant to be diagnosing students’ ailments or injuries, she does believe her students can be prepared to better interact with the medical world.

Engaging the Medical Community

“My purpose was really just to train teachers on a deeper level, to be a resource of teachers to serve the medical providers. My school, Yoga Medicine® is not a style of yoga but a school that trains teachers to think for themselves and apply the appropriate style and techniques for the individual. I really believe that there’s a place for every style of yoga out there. It’s just knowing how and when to use them and in what context it would be most helpful for people. Especially if you are talking about people who are injured or sick for whatever reason.”

If that means she can get medical professionals into her training, whether to gain perspective for themselves or to learn how to better use yoga in their practices, she’s thrilled. “For doctors, I think it’s changed a lot. Nowadays it’s not uncommon for us to see in a training of 70 people that 20 of them are healthcare providers of some sort. From surgeons to anaesthesiologists to radiologists, and obviously, there’s been physiotherapists coming into the yoga world for a while, massage therapists, but the doctors I think is a new thing, at least for me in the past few years. Surgeons and doctors who are already set up in the medical world, in hospitals, are wanting to come in and learn how to teach yoga in those facilities, which is crazy.”

Crazy amazing, in our opinion.

Neuroplasticity and the Importance of Self-Care

 for Yoga Medicine® discusses neuroplasticity, how it contributes to health, and how self care takes advantage of the power of the brain.

Neuroplasticity and Self-Care

What we practice on the mat has a huge impact on our muscles and joints, but what about our self-talk? What is the impact of a 60-minute practice on the storyline running in our heads throughout the other 23 hours of each day? Just like life, practice can be filled with preferences and opinions that cycle back into our personal critiques that we carry off the mat. We can become grounded in likes and dislikes of postures, styles, body parts and even breathing techniques. What happens when we get anchored in places that negatively affect our conversation with our own bodies or abilities?

Negative self talk can be likened to inflammation on the brain. We have the capacity to trigger or elevate our stress response in the body. Our adrenals are responsible for the production of the stress hormones, cortisol and adrenaline; but the adrenals are reacting to the mental patterns or environmental triggers. The adrenals are not acting independently, we have a huge impact on their stress or ease. Makes sense right? We can be doing all the things – have a regular practice, go to classes, teach lovely sequences – but are we checking the underlying inflammation and stress levels in our bodies? Are we stuck in patterns that are winding up our fight or flight mode, as we are trying to find some ease in the day?

Teach Lovely Sequences

That’s right, I said teach lovely sequences, because yoga teachers do not get a free pass here. As teachers, we too can be incredibly hard on ourselves as we simultaneously craft a body positive environment for our students or clients. This can especially be true for a new teacher who is trying to find a unique voice and style, which can create anxiety and stress. Students and teachers alike can focus practice on perfection way more than on ease.

The first yama is ahimsa or nonviolence, to do no harm. Practicing kindness to ourselves, our abilities, our bodies is the subtle side of ahimsa. In this mindset, we get to rewire our stress response with new language, a new foundation of support for ourselves. When we choose self care as a motivation, it transforms our practice and make room for easeful pathways in the brain.

Let’s face it, most of us didn’t find yoga because everything was awesome in our lives. We found the practice for it’s ability to change us, to change our attitudes, our focus, our ability to chill out in a stressful time. This is the beauty of neuroplasticity, the brain’s ability to form and reorganize synaptic connections in response to learning, injury, and general life experiences. We are able to adjust our response and reorganize our thoughts and reactions around fresh connections in the brain. We can change patterns and belief systems and our bodies through yoga.

A Practice to Try

#1 – Write it out.

Name your mindset and describe it. Maybe it is about a challenge, task at hand or emotional response you are experiencing.

#2 – Call out the evidence.

Mindsets and self talk are molded with the evidence we collect. We gather to prop it up, to make the mindset stronger and stronger. For example, when we have a mindset that we are connected to all living beings, we see the world through that lens. We collect the evidence in our lives to support connectivity. We may be more likely to see similarities with others, to find compassion for another person’s difficult time. Connectivity, as a mindset, changes the way we interact with the world.

#3 – Ask yourself if there is another pathway to explore or a route – a PATTERN INTERRUPT.

This is where we can collect and mine for different evidence to support a new groove in our brain. We get the opportunity to soften the edges of what seemed so solid and try on a new conversation. We have all experienced times of loneliness, when we may feel like the only person on the planet who gets it. And many of us have experienced a pattern interrupt when we remember our connectivity, we remember that we are in this together, we wake up to the possibility of support.

#4 – Be willing.

Letting go of the conversation that we hold so dear can sometimes feel like a white knuckled death grip. It can feel like unknown territory … because it is. It is the beginning and we have to try it out like a new outfit and it may take a while before it becomes a favorite. But everyday we can choose to be willing to try.

#5 – There is plenty.

Remind yourself that there is plenty – of time, of possibilities, of perspectives, of ways to be in relationship with yourself. The relationship we craft with ourselves, is the longest one we will ever have. There is a vast depth to our ability to care for ourselves, to let our yoga practice facilitate a wild release of what may be stagnating our potential. There is plenty of room to be kinder to ourselves and reap the benefits.

Yoga Guided Me Through My Brother’s Suicide

Erica Jung for Yoga Journal on how yoga helped her grieve the loss of her brother after his suicide. Learn how to use yoga to help you cope emotionally with difficult times.

Utilize Your Community

7 Strategies for Healthy Hamstrings

Rachel Land for Yoga International. Senior Yoga Medicine teacher Rachel Land offers her top 7 tips for relieving tension in your hamstrings and keeping them happy, healthy, and strong.

7 Strategies for Healthy Hamstrings

5 Steps to Release The Erector Spinae & Balance Organ Function

Erica Yeary for Yoga Medicine® shares some key information on what the erector spinae is, what it does, and how to treat it.

5 Steps to Release The Erector Spinae & Balance Organ Function

The more time I spend studying the anatomy of the human body, the more I am fascinated I am. Both the function of individual systems and how the systems are intricately interconnected are astounding.  To dive into both, we are going to look specifically at the function of the erector spinae muscles, how they connect with other systems in Traditional Chinese Medicine, and how to use myofascial release (MFR) techniques to address issues throughout the body.
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Erector Spinae

First, let’s get to know the function of the erector spinae muscles.  The erector spinae is a group of muscles that extend on each side of the spinal column from the skull to the thoracolumbar fascia in the pelvic region.  The three muscles, from medial to lateral, are the spinalis, logissimus, and iliocostalis.  These are powerful, movement-oriented muscles that create bilateral extension of the spine and unilateral rotation and/or lateral flexion.  Without the strength of the erectors, we would not be able to stand up straight. While strength in this muscle is imperative, many people can have overly tight erector spinae muscles and present with lower cross syndrome, which is a condition where the lumbar spine is overly curved with an anterior pelvic tilt and hyperlordosis.  As a result, many people could benefit from utilizing MFR techniques on this group of muscles.  But what if you feel along the sides of your spine and the muscles don’t feel tight or tender?  You could still benefit from MFR because of the interconnected communication between these muscles and other systems of the body. Much like our physical hips are related to our “emotional junk drawer”, the erector muscles are more than just physical movers of the spine.  Specific points along the erectors are direct links to major systems of the body, as explained in Traditional Chinese Medicine.  The following steps explain how to use tennis balls or MFR balls to not only release the muscles themselves, but also aid in the function of specific internal organs.  As a general rule of thumb, stay at each step between 30 seconds and 2 minutes for the full effects to settle in.
Copyright Yoga Medicine®

Step 1

Place two balls that are touching at the center of your mat. Lay down on your back on top of the balls so that they are on either side of the spine (not on top of the spine itself) at the level of the top of your shoulder blade or T1.  The knees can be bent or straight.  If the intensity is too much, place a blanket on top of the balls and then lay on top of the blanket.  Feel free to move the arms in a manner that is appropriate for you, which could include giving yourself a hug or just letting the arms fall to the sides.  This location is known as the UB11 acu-point and it relates to the lungs by spreading and descending Lung Qi in Traditional Chinese Medicine.  Stimulating this location can help with coughing or an inability to connect with your breath.

Step 2

Roll the balls down the back until they are at the level of the bottom of the shoulder blade at T7 on either side of the spine.  Relax the shoulders down on the ground.  Stimulating this location, known as UB17, can invigorate the blood to aid in any blood or cardiovascular related conditions because it is the converging point of blood.

Step 3

Roll the balls down just a little further to T9.  If you wear a bra, this is about the level of the horizontal bra strap across the back.  Continue to let the entire body be heavy down on the ground with the balls on either side of the spine.  This location would be particularly important to address if you consume alcohol on a regular basis because UB18 acu-point is related to the liver and gallbladder.

Step 4

Remain on your back as you roll the balls further down the spine to the base of the ribcage at T11 and T12.  This is slightly below the level of the belly button.  Continue to breathe deeply and relax the muscles in contact with the balls.  For increased intensity, you may bring the knees in toward the chest slowly.  Known as the UB20 acu-point, stimulating this location can help with bloating, diarrhea, vomiting, and any spleen conditions because it is related to the spleen and stomach.

Step 5

The final MFR location is at start of the lumbar curve of the spine at L2.  Make sure the balls are still touching and on either side of the spine.  This location, the UB23, is known to strengthen and balance the kidneys. After 30 seconds to 2 minutes, remove the balls and lay flat on the ground to reflect on any changes you feel.

Quick Tips for MFR

Always look for an area that you can calmly breathe and relax in without pain, sharp and/or shooting sensations.  Avoid nerves, bones (in this instance, especially the spine!), visible swelling or bruising, and broken skin.  Always consult healthcare provider first as this is not meant to replace medical care.

What is the Interstitium REALLY all about?

Michelle Dickey for Yoga Medicine® on what the interstitium is, what it does, how it can affect your yoga practice, and how to keep it healthy.

The Interstitium: Breaking Down the Mystery

What is all this talk about our “new human organ”? Did scientists really NOT know about an entire organ in the body? You might have heard that a new human organ has been discovered. On March 28, 2018, scientists named the new organ the “Interstitium”. Upon first reading this, my instant reaction was to wonder how scientists could possibly discover a new organ. We’re all aware of our heart, lungs, stomach, kidneys, etc. being organs, so how is it that one got overlooked?

In 2017, I was lucky enough to take part in Yoga Medicine’s cadaver lab where we dissected untreated cadavers. Untreated means that the body is not preserved with formaldehyde nor had the body been previously deconstructed. Throughout this dissection, Master Dissector Todd Garcia would name the various tissues that we were handling and moving through. This included all the organs. Not once in this dissection, did the trainer stop and hold up anything and say “this is a thing without a name,” and then move on. So, it baffled me when I saw the headline about discovering a new organ. Especially because my hands had been in a cadaver, learning about all the different components within the human body.

What is it?

The newly discovered interstitium is defined as “a contiguous fluid-filled space existing between the skin and the body organs, including muscles and the circulatory system.” [1] That means that this organ covers the whole body from head to toe and is underneath our skin but before our body organs. Our skin isn’t that thick; it’s about the thickness of a few pieces of paper. Somehow this new organ lies under that single piece of paper before the muscles? That seems pretty crazy.

Now it becomes a little easier to see why this organ was hiding from us for so long. With the more common organs such as the heart and lungs, etc, we have a large mass of body tissue that is palpable. These more common organs are able to be seen right away within the body as they have their own individual texture and feel to them that differentiates them from the other body tissue surrounding them.

Where is it?

But this interstitium, it’s the king of hide-and-seek. In a cadaver, peel off the skin, first layer of adipose, and fascia, and you’re left looking at, what appears to be, the beginning of the silvery layer of deep fascia that covers the muscles. At least that’s what was previously thought.

In the video link below [2], you can watch as Fascial Researcher Gil Hedley dissects various parts of the body and finds in each area that between the skin and the muscles and organs of the body, there is this layer that is extremely difficult to see unless you know to look for it. Watch as Gil Hedley expertly dissects through this “fuzzy layer” or “perifascia” and shows that this isn’t just a slimy goop of boogers hanging out on top of things, but it’s a very fine layer of collagen and elastin that has rebound properties and tensity.

This tiny, tiny layer of fuzz, is so thin it’s transparent. This is the “new” organ that is finally coming out into the open. The layer is tricky though because when exposed to the elements, it hardens and turns brown and doesn’t seem to be of any true importance. This hardened layer was thought to be a densely-packed stack of connective tissue, lacking moisture. It wasn’t until a team of researchers, using a new in vivo microscope technique called confocal laser endomicroscopy, discovered this layer while investigating a patient’s bile duct for cancer. They found that within this fuzzy layer are microscopic subcompartments of interstitial fluid (aka lymph fluid) that wrap around the entire body and connect into the lymphatic system. The lymphatic system connection that the interstitium has could be a key player in cancer metastasis [3].

Just like the other organs in our body, there are ways to keep this newly defined interstitium healthy and strong so it can continue to act as a shock absorber (because of the rebound properties) and help protect you from damage.

How to Keep It Healthy

1. Yoga:

Taking part in a yoga class works many different areas of the body from the cardiovascular system to the muscular system and everything in between. To focus in on the interstitium during your practice, pay attention to longer holds of poses and work into a gentle “bounce and recoil” within these holds.

For example if you’re in low lunge, pretend your back leg is a rubber band and deepen your stretch to your body’s most comfortable depth and then let your body rebound naturally to the natural lunge stance. Try not to control the rebound but let the body’s natural elasticity bring you back to the starting pose – thus working the elastic properties of the interstitium.

2. Myofascial Release Techniques (MFR):

MFR is a great way to work the interstitium as well as multiple fascial lines throughout the body. As an example, while standing, take a tennis ball or lacrosse ball and place it underneath the middle of your foot. Then, roll the ball from the base of the heel to the toes in a straight line. Next move the ball to the outer side of your same foot and repeat rolling in a straight line from heel to toes.

Move the ball to the inner side of the foot and repeat once more from heel to toes. After you’ve rolled the middle, outer, and inner sides of the foot, go back to a spot that felt it needed more work, place the ball under that spot and set your heel down. Wrap and unwrap your toes around the ball. Repeat on as many spots as needed then switch and repeat on other foot. This can be done throughout the entire body in a variety of ways and will reduce and eliminate restrictions.

3. Water:

Drinking water will help keep the moisture and elastic properties of your fascia, including the interstitium. Try to get at least eight – 8 oz. glasses of water each day to help keep your body and interstitium at peak function.

References:

  1. Wiig, H; Swartz, M. A (2012). “Interstitial fluid and lymph formation and transport: Physiological regulation and roles in inflammation and cancer”. Retrieved April 11, 2018 from Physiological Reviews https://www.physiology.org/doi/full/10.1152/physrev.00037.2011
  2. Hedley, Gil – Somanaut (2018, March 28). “Interstitium aka: Perifascia: Gil Hedley dissects “the fuzz” on camera.1” [Video File] Retrieved April 11, 2018 from Youtube https://www.youtube.com/watch?time_continue=407&v=gf_2TSnlagM
  3. Olena, Abby (2018). “Is the Interstitium Really a New Organ?”. Retrieved April 11, 2018 from The Scientist https://www.the-scientist.com/ articles.view/articleNo/52168/title/Is-the-Interstitium-Really-a-New-Organ

Increase Mobility: Stretch, Strengthen & Stabilize

Jessica Rasmussen-Williams for Yoga Medicine® shares two routines to strengthen and stretch your shoulders. Use these routines to increase mobility and range of motion.

Stretch, Strengthen & Stabilize Your Way Back into Mobility

Remember the days when hanging from a jungle gym, climbing trees and throwing a ball came as easy as reaching for your keyboard to check your email, picking up your phone to make a phone call or check in on social media?  In early childhood, our joints are at their maximum mobility and over time we build strength through exploration and curiosity.  For example, we slowly built the stability for load bearing on the shoulder joints through “tummy time”, learning to crawl and eventually the power to pull ourselves upright to resemble the humans around us. From there, we moved to jungle gyms, trees and fields for ball throwing. Without thought, we launched ourselves across the monkey bars, reached for the next branch to pull ourselves further up the trees and played catch with our friends for hours without waking up injured or sore.

During our early teenage years, playground antics, tree climbing and ball throwing gave way to sitting at a desk in middle school without an option for the ever popular recess.  Our physical priorities changed even more as we moved into high school and for some, made our way through college. As adults, many of us have unintentionally lost some of our physical curiosity and exploration as new priorities entered the game: computers and cell phones.

Posture & Lifestyle

While we begin to spend more hours of the day occupied with these computers and phones, our daily range of motion (ROM) that we practice begins to adapt to a new formation.  It’s easy to get caught up in the eye catching information that these devices are putting in front of us these days.  If we aren’t mindful, we can easily lose sight of the fact that we begin to round our shoulders and upper back as our head moves forward and drops to observe the luminous screen.  Our posture takes the hit from this decreased ROM as the muscles in the front of the shoulder and chest tighten and the back of the shoulder and upper back strain and weaken.  One day, we find ourselves feeling a bit rusty or even injured when we step back in time and attempt something outside of our new norm.

Joint Structure: A Brief Overview

The shoulder is made up of two joints, the glenohumeral and acromioclavical (AC) joints.  While they are both a synovial joint, meaning that they have a joint capsule and secrete synovial fluid for lubrication, the two move in a completely different manner.  The glenohumeral joint is a ball and socket joint which allows for movement of the humeral head in all directions in an ideally healthy ROM and stability.  The AC joint is a gliding joint which offers up very small gliding movements and allows for the movement of the scapula on the back of the rib cage.

While the structure of the two joints differ significantly, the stabilization of both is equally important.  The level of efficiency in the structure of the shoulder as a whole is negatively impacted when only one joint is stabilized.  There are 2 types of stability that come into action here, passive and active.

Passive and Active Stability

Passive stability is where we are unable to energetically control the cartilage, capsule, ligaments and bone structure.  Our skeletal structure and unique history of both healthy and injured joints limits our individual range of motion (ROM).

Active stability is where our mindful movement enters the playing field with muscles stretching and strengthening to keep the integrity of the joint and surrounding areas.  We are able to control our destiny in preventing injuries along with wear and tear on the joint if we are able to find a balance in tension.  The optimal joint positioning will make a world of difference in prevention, but how do we get there?  Unless there is a genetic disposition to degeneration or abnormal bone structure, the answer is tensegrity.

Tensegrity

Stedman’s Medical Dictionary for Health Professions and Nursing[1] defines tensegrity as a concept of muscular-skeletal relationships based on the work of architect Buckminster Fuller.  The concept refers to the forces of tension (provided by muscles, tendons, ligaments, and fascia) pulling on the structure (bones and joints) that help keep the body both stable and efficient in mass and movement.

The tensegrity system is responsible for managing tension and compression in the body.  In the case of the shoulder, the basics of this concept suggest the integrity of the tension determines the stability of the joints.  If there is a weakness on one side of the system, there will be increased tension distributed to other areas of the structure.  To find those areas of weakness, first look for the tension.  For example, notice your own posture.  If the shoulders and upper back are rounded forward, the tension will likely lie in the pectoral muscles and internal rotators, resulting a weakness or straining in the external rotators, scapular stabilizers and erectors.

To combat this common postural limitation, we will take a look at a few ways to stretch the areas of tension, strengthen the areas of weakness and find the stability necessary to restore healthy function in the shoulder.  In other words, we are looking for a community effect in the body.

Stretch

Roll up a portion of your yoga mat so it is about 3-4 inches thick.  Find a comfortable place to lay down on the rolled part of the mat along the length of the spine with the back of the hips on the floor and the head resting on the roll.

Bend the knees so the soles of your feet are on the floor a little further than hip distance apart.

Then let the knees fall together to touch, or place a block between the thighs as a resting place for the legs.

Take the arms out in a T position with the palms facing up for a few rounds of breath.

If this feels like too much already, remove the mat and come flat on your back. Regardless of which option you have chosen for yourself, bend the elbows into a goal post shape with the palms facing the ceiling.  Stay here for a few breaths to check in with how the body responds to this shape.

Feel the broadening of the rib cage with each inhale as that expansion stretches the pec major and minor in the front of the chest.

Find a heaviness across the front of the chest and outer edges of the shoulders with each exhale as you soften and allow the back of the rib cage and arms to get heavier on the roll and floor.

If you would like a little more, keeping the elbows at the 90 degree angle and start to glide the arms overhead until the fingers touch.

If at any point the arms raise up off of the floor, simply glide the arms back toward your starting point until the entire arm comes back in contact with the floor.  Once you’re there, come back to the breath to expand on your inhale and settle into the heaviness of the exhale.

Strengthen

Find your way to tabletop on your mat with the wrist crease directly below the head of the shoulder, a micro-bend in the elbows (to avoid a hyperextension in the joint), knees directly below the hips and gaze at the floor. From here we will work to strengthen the scapular stabilizers along the side of the rib cage (serratus anterior) and in between the shoulder blades themselves (rhomboids).

First, on your exhale, press firmly into the mat as you lift the chest away from the floor.

Maintain length in the spine without rounding in the upper back by pressing forward through the crown of the head and occipital bone at the base of the skull.  Find the shoulder blades wrapping themselves to the outer edge of the ribcage and imagine pressing the hands slightly forward and toward one another while keeping the shoulder head hugging into the socket of the joint itself.  The hands themselves won’t actually move with this action, although, the head of the humorous will stabilize into the joint.  Hold this position for three breaths.

On your next inhale, keep the same position in the arm, lower the chest and squeeze the shoulder blades back behind you.

Shoulder heads are softening away from the ears and hugging into the joint.  Again, look for the length along midline by hugging the belly away from the floor to keep from extending the spine.  Hold here for three breaths to check in with how that feels.

Finally, when you are ready, start to move on your breath.

Exhale to press into the palms, lift the chest away from the floor. Inhale to lower the chest, squeeze the shoulder blades back behind you.  Move back and forth on your breath through 10 rounds of each.  When you’ve completed those 10 rounds, make your way back to child’s pose to rest with the arms extended overhead.  Repeat 3 times and see where you feel strong and even where you feel a bit of weakness.

To ramp up the intensity, feel free to walk the knees back to a modified plank or come into full plank.

This will increase the load of weight bearing in the shoulder.  If you find that you are straining or losing the ability to be stable, simply back off by staying in table top until you find the strength to move to the next level.  There is strengthening to be found in all options, you may just need to increase or decrease the number of repetitions to find the right combination that works for you on that particular day.

Conclusion

Now that you have a couple of tools for stretching and strengthening, work to consistently incorporate them into your personal practice.  Pairing these simple, yet powerful exercises with a mindfulness of your posture and time spent with your computer will bring you the stability you need along with an increased accessibility to your natural mobility that makes way for movement without injury.

Footnotes

[1] Stedman, Thomas Lathrop (2012), Stedman’s Medical Dictionary for Health Professions and Nursing 7th Edition, New York, NY: Stegman

Surgery Recovery: A Surgeon’s Advice to Yogis Facing an Operation

Dr. Ryland Stucke for Yoga Medicine® shares some advice for any yogis who will be undergoing surgery or those who are already recovering from surgery.

A Surgeon’s Advice to Yogis Facing an Operation or Recovering from Surgery

On average, every person will undergo six surgical procedures during their lifetime, and the need for surgery is on the rise [1]. If you’re facing an operation, or recently had one, you probably have many questions about what you should or shouldn’t do, and when you can return to your usual yoga routine. Common sense goes a long way, and your surgeon can give you specific information. However, with some basic information, you can speed your recovery and reduce complications.

Prehabilitation

We all know about the idea of rehabilitation after surgery, but prehabilitation is preparing your body to better handle a major trauma, like surgery. New research has demonstrated that patients can, and SHOULD, actively participate in their recovery starting before they have their operation. Prehabilitation (prehab) helps avoid deconditioning and can lead to better outcomes and a faster recovery [2,3]! The key is thirty minutes of moderate intensity exercise every day to the point that you break a sweat. Your asana practice is a great way to combat the upcoming effects of surgery and lying in bed as you recover. Gentle twists and upper back openers are excellent poses to incorporate.

Meditation/Pranayama

Beyond the physical benefits of a prehab routine, practices lik meditation and pranayama before surgery will help you cope with the extra mental stress of surgery. Hospitalized patients experience an interruption in their usual routines including boredom, sleeplessness, pain, and frequent interruptions from medical staff. Meditation and pranayama help ease these stressors, and enhance the parasympathetic nervous system which aids in recovery. If you don’t have an active mediation practice, explore it before your operation. Mediation apps also can be helpful. You can also try a simple mantra based meditation using a phrase such as, “Balance and strength” or “I am whole”. Practicing chandra bheda (left sided nostril breathing) can help to counter the inflammation and heat produced by surgery. Additionally, nodi shodhana (alternate nostril breathing) is a great way to balance the body after a major stress.

Nutrition

No single diet plan has been shown to be the best, but a well-balanced diet with good sources of vitamins and minerals matters. Vegetarian and even vegan diets are safe around the time of surgery, but make sure to have adequate protein which is the fuel for rebuilding tissues after surgery. No matter what you eat, a well-balanced diet featuring healthy foods should be the focus.

Additionally, if you smoke, quit right now. Smoking significantly increases complications and impairs wound healing; quitting has huge positive benefits for recovery. Cut back on alcohol consumption, which can suppress the immune system. Instead, try drinking fresh vegetable juices or smoothies for additional micronutrients and an immunity boost.

Surgery Recovery After the Operation

Time to get moving! Regular activity after surgery is important. This helps strengthen the immune system, minimize complications, and speed recovery. Most surgeons will ask you to take a small walk the same day of your operation. You can start with meditation, pranayama, and gentle restorative poses in your hospital bed right away. Even simple movements such as circular movements of the ankle, arm, and neck will improve blood flow and jump-start the healing process. Listen to your body and gradually increase your level of activity as tolerated.

No surgeon can entirely erase the pain, so know that coping with some pain is part of the healing process.

Depending on the surgery you have, you may have a specific rehab routine prescribed to you. However, many operations don’t come with a handbook of rehabilitation exercises. If you are having abdominal surgery with a traditional open incision, you’ll want to be especially careful. No deep twisting, large backbends, or focused core work for at least 4 weeks. If you have laparoscopic or robotic surgery, you may be able to restart your full practice sooner but talk to your surgeon.

If you have joint or orthopedic surgery, your rehabilitation plan and exercises should be prescribed. Make sure you get clearance from your surgeon before you go back to a group class, especially if it’s a more strenuous style. Your yoga teacher is also a great resource for ideas about safe poses and modifications for specific sequences. You might consider putting your yoga teacher and doctor in touch to consult each other on your surgery and a safe exercise plan.

General Rules to Follow

  • If it hurts, don’t do it (a little soreness is OK, pain is not).
  • You’ll have some ups and downs, but should generally keep improving after surgery. If you’re not improving overall, this could be the first sign that something is wrong which means you should talk to your surgeon.
  • Don’t over exert yourself, but don’t be a slug. Now is NOT a good time to binge-watch Netflix. If you can’t do anything else, walking is great after an operation.
  • Nutrition matters…. a lot. Eating nutritious foods helps your body heal and improves your immune system as your body recovers.
  • Everyone’s recovery is different, and every form of activity or exercise has its own risks. Listen to your body and respect the healing process. Personalized advice from yoga instructors or medical professionals is a great way to ensure you’re on the right path. Always consult your surgeon if you have concerns about your recovery.

References:

  1. Lee PHU,GawandeAA. The number of surgical procedures in an American lifetime in 3 states. J Am Coll Surg. 2008;358:S75
  2. GillisC, LiC, LeeL, et al. Prehabilitation versus rehabilitation: a randomized control trial in patients undergoing colorectal resection for cancer. Anesthesiology. 2014;358:937-47
  3. Barberan-GarciaA,Ubré M,RocaJ, et al. Personalised prehabilitation in high-risk patients undergoing elective major abdominal surgery: a randomised blinded controlled trial. Annals of Surgery. 2017; [epub ahead of print].

How to Practice Hot Yoga Safely

Christina Heiser for A Sweat Life shares some safety tips for those looking to explore hot yoga for the first time.

How to Practice Hot Yoga Safely

How Trauma Can Impact Your Yoga Practice

Abbie Stutzer for Organic Authority discusses how yoga can be used to heal trauma for survivors. Learn some tips to make the process easier, and get started.

How Trauma Can Impact Your Yoga Practice

Yoga can strengthen a person’s body and calm their mind. However, the whole yoga practice—going to class, interacting with a teacher—can cause stress if a student has experienced trauma.

We reached out to a handful of yoga and medical professionals and asked them to explain how yoga is beneficial for many trauma survivors and detail how some survivors approach their yoga practice.

How Yoga Helps Heal Trauma

Yoga can serve as a healing tool for people who have experienced trauma. In general, a yoga practice teaches people how to remain present, slow down their breath, and become acquainted with their bodies, Diane Malaspina, PhD., Yoga Medicine® instructor, and psychologist says.

So, a yoga practice can help stimulate the part of a human’s nervous system that is related to calming, soothing, and healing the body, brain, and mind. “Through yoga, we learn skills that can help us regain a sense of ownership over our body and experience,” Malaspina explains.

In 2014, a study demonstrated that yoga is a useful adjunctive treatment for PTSD, Dr. Srini Pillay, Harvard trained practicing psychiatrist, adds. Basically, yoga can help survivors tolerate physical and sensory experiences associated with fear and helplessness. Yoga also can help survivors become more emotionally aware and manage their emotions more effectively. 

Yoga for Trauma Survivors 

Pillay says that trauma survivors may appreciate trauma-informed or trauma-sensitive yoga, or kundalini yoga. “Trauma-sensitive yoga utilizes a series of postures and breathing aimed at strengthening self-connection after a traumatic event,” Pillay explains. “[It] removes strongly suggestive language, deemphasizes posture intensity, and eliminates hands-on assists from the teacher.”

Pillay adds that trauma-sensitive yoga places emphasis on feeling. “Typically, the yoga focuses on four themes: experiencing the present moment, making choices, taking effective action, and creating rhythms.”

“Debriefing may not actually be helpful,” Pillay adds; “focusing on resilience is key.

Brigitte Gordon, doctor of nursing practice (DNP), board-certified psychiatric nurse practitioner, and past yoga teacher and practitioner, adds that the “best” type of yoga is different for everyone. 

“Some individuals want to sweat, work hard, and not have to think,” Gordon says. “For them, an Ashtanga, vinyasa, Iyengar, or Bikram class may be best. For those who desire a slower, softer more gentle class (if they’re feeling vulnerable) may benefit from a yin or restorative class.” 

Finding the Right Teacher 

Ideally, a trauma survivor should work with a yoga teacher who is sensitive to their needs, Dr. Christopher Willard, licensed psychotherapist, educational consultant, and author, says. Survivors also could benefit from working with a teacher who is versed in adapting practices, poses, and classes for people with PTSD. 

Willard adds that there are many therapists who have experience with trauma and yoga; many therapists are also yoga instructors. “These [people] can be a great resource, so ask your therapist if they teach or have recommendations,” Willard says. 

“An instructor that offers modifications to poses and the option to take a break as needed can create a supportive environment,” Malaspina reiterates. “Providing the option to decline hands-on adjustments and using language that invites students to explore sensation as an inquiry into the body and mind is also supportive.”

Arrive Early

Some survivors gain comfort by coming to class early. This allows the student to familiarize their self with the studio, bathroom, and exits. Arriving early also allows the student to place their mat in a place that makes them feel comfortable.

“If triggered during class, some students will feel good going into child’s pose or using mindful grounding techniques, such as focusing on what you see, hear, feel, and smell,” Gordon says. “Focusing on your senses can be greatly grounding.” 

Be Aware of Triggers

If possible, a trauma survivor should become aware of the postures and poses that may feel triggering.  For example, some students may feel stress when opening or closing their eyes. Also, breath-work and visualization could feel challenging. “The idea with yoga and therapy is always to move at your own speed,” Willard explains, “not pushing yourself out of your safety zone.”

Trauma survivors also could benefit from finding a class that allows students to discretely tell a teacher they don’t want hands-on adjustments. “Studios are now offering smooth stones that a student can place on the corner of their mat to let the teacher know they don’t want touch,” Gordon says.

Gordon adds that a studio with an inclusive website that shows pictures of students and teachers who “look like them” (size, shape, ethnicity, etc.) can induce calm. 

Also, remember that what may trigger someone else may empower another person. “Don’t get into comparing yourself,” Willard adds. “Go easy, check in with yourself, and your teacher and therapist as you go.”

After Class

If you start crying or feel emotion arising after class, allow your emotion to release. “Holding the emotion in creates more tension in the body and mind,” Malaspina explains. “Crying stimulates the cranial nerves which soothe the emotional center in our brain.”

Malaspina adds that it’s also common for students to cry during a yoga class. After class, if you still feel raw or filled with tension, take slow deep breaths. “Emphasize lengthening the exhale, which soothes the nervous system,” Malaspina says. 

And if your feelings are overwhelming, reach out to a mental health professional for additional support.

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