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Month: September 2018

When Your Doctor Recommends Yoga

 for Yoga Medicine® discusses the concept of a yoga prescription – or a doctor recommendation that you start yoga. Learn about some of the benefits, and how to maximize the chance of success.

Yoga Prescription: When Your Doctor Recommends Yoga

The benefits of yoga are starting to overwhelm the Western medical community in such a way that more and more doctors are prescribing yoga. Studies are emerging with positive and beneficial results from a regular yoga practice. Not only for physical health but also mental health.

A study by the Yoga Journal found that “the health care world’s increased acceptance of yoga therapy is partly due to a significant body of clinical research. This research documents yoga’s proven benefits for a range of health conditions, including back pain, anxiety, depression, and insomnia…” [1]

While there are many reasons why yoga is gaining traction, a key oversight that seems to be unaddressed is what actually constitutes “yoga” as it encompasses numerous interpretations, especially for those who have never practiced or are new to a yoga practice. As a yoga teacher, I can’t count the number of times I’ve heard misconceptions such as, “yoga is just stretching” or “yoga is great for relaxing”. While both of these statements contain some validity, there are many realms to yoga, including power yoga, inversions, strength-focused and flow-focused practices. Because of this, doctors are prescribing yoga almost blindly, and unfortunately, if the patient is unaware of different styles of yoga, this prescription could have the potential to be more detrimental than beneficial.

Let’s talk about how you can ensure that a yoga prescription will produce a positive result.

1. Do your research.

As I stated earlier, there are many different forms of yoga. Here are some prevalent styles of yoga to help you decide what would be the best option for you in your studio research.

Hatha:

Hatha is the physical practice of yoga, also called asana. Its postures are meant to create alignment and balance within the body. There can be beginner and advanced Hatha classes.

Vinyasa:

Vinyasa is a set of movements initiated by the breath and created to help flow from one sequence to another. It can be found in all levels of classes and can be non-heated or heated. (Shoulder injuries should be cautious with this type of practice, and most likely, avoid.)

Ashtanga:

Ashtanga incorporates vinyasa in a physically demanding practice that merges the breath and body. It can vary from beginner to advanced. (Shoulder injuries should be cautious with this type of practice, and most likely, avoid.)

Bikram:

Bikram is a form of Hatha and consists of a set of 26 postures done twice each in a heated room that can get up to 108 degrees, plus humidity.

Power Yoga:

Power yoga has stormed across the yoga world. It often involves ashtanga and/or vinyasa and can often be heated. Many relate to this style as showing up for a hot, sweaty, high-energy, strength and conditioning class that also contains some aspects of stretching and cool-down. This type of class is not recommended if you’re dealing with an injury. This style is more geared towards the students who is wanting to get in shape, build muscle, and advance in the postures.

Yin Yoga:

Yin yoga is a gentle form of yoga that involves holding stretches for a longer amount of time. This can be highly beneficial for those dealing with injuries, however, make sure you find a teacher who knows how to offer pose modifications if you are new or injured.

Restorative Yoga:

The teacher will instruct you into a gentle pose that usually requires no muscle activation and very little stretch. This type of yoga can often be very healing for someone dealing with an injury or stress as it allows the body to slow down and recover.

Beginner Yoga:

I highly recommend this style for those who are new to yoga, especially if you’re dealing with an injury. These classes allow you the chance to learn the poses correctly, more gently, and in a space with other beginners. It’s often less intimidating.

     Side note: If you see “Level 1” and “Level 2/3” class descriptions, Level 1 can be beginner or can be more of an intermediate flow. It will depend on that particular studio. Level 2/3 is typically an advanced class for those looking to grow their practice into an advanced state.

2. Look for teachers who are qualified.

When I look back at my first couple years of teaching, I almost feel embarrassed from some of the cues I gave and the way I instructed students into poses. Teachers grow not only through actual teaching experience, but also through advanced trainings that focus on specific injuries and anatomy within the yoga practice.

Look up your instructor before you take their class. Often, there will be a quick bio on the website of the studio. Some instructors may also have their own websites and social media profiles. Make sure to check for these factors:

Certification: A 200-hour certification is the standard certification for instructors. A 500-hour is more advanced and requires much more training and hopefully, instructing experience.

Experience: How many years have they been teaching? What classes do they normally teach? Do they have any specialties?

Contact: If you are still unsure if a teacher is the right fit for you, feel free to contact either the teacher directly or the studio. If you feel comfortable with the initial contact, you’ll most likely feel more comfortable in person.

3. Practice in a studio.

Don’t get me wrong, the access to online yoga is wonderful and makes establishing a consistent practice more financially accessible. However, if you’re dealing with a specific injury or an area in need of help, or if you’re a beginner or you need to focus specifically on proper alignment, I would highly recommend going into a studio. Using the above information, it would be helpful to find a teacher with experience and knowledge in the specific area you’re dealing with, and practice under the guidance of that instructor. This can help ensure safety within your practice and your body. If you don’t feel comfortable practicing in a group setting, most instructors offer private sessions. While that can be a little harder on the wallet, it allows for an invaluable one-on-one experience.

4. Practice with the mindset of non-judgment.

“Mindfulness is defined as the nonjudgmental focus of one’s attention on the experience that occurs in the present moment,” says a recent study done on the benefits of practicing mindfulness and non-judgement within athletics and performance of the athletes. 2 This study found that that “mindful-ness and acceptance approaches may be particularly effective for performance enhancement” and that this awareness actually helped the athletes “manage their activation state more efficiently”. I can only imagine and believe that this would be true within a yoga practice as well. Yoga is centered around the idea of mindfulness. Can you imagine coming to your yoga practice with a mindset of non-judgement? The healing benefits both physically and mentally could be extremely effective.

I may be slightly biased, but I truly believe yoga is for everyone and you will experience physical and mental benefits when you find the right style, teacher, and mindset. Above all, listen to your doctor’s advice, but do your research as well in order to assure that you receive healthy instruction and the proper class for YOU.

Here’s to getting healthy through yoga and continuing to merge yoga and medicine.

***

References:

1. Enfield, Susan. Why More Western Doctors are Now Prescribing Yoga. Yoga Journal, 2016.

2. Marjorie Bernier, Emilie Thienot, Romain Codron, Jean F. Fournier. Mindfulness and Acceptance Approaches in Sport Performance. Journal of Clinical Sports Psychology, Human Kinetics, 2009, 320, 329.

27 Mind-Blowing Inversions From Rockstar Yogis

By MindBodyGreen.

Here at MBG we love yoga and we love going upside down! We know how difficult it can be to achieve your first inversion pose, and how great it can feel when you finally get the strength, grace, and confidence to balance in a headstand.

So we reached out to some of the best yogis in the world to find out why they love inversions and asked them to share some of their favorites.

We hope you are as amazed by the responses as we are!

Sit back, relax, and be amazed at what the human body can do! And perhaps get inspired to go upside down yourself!

Elena Brower

Pose: Handstand.
Location: On a seamless in my home for Chapter 5 in my book, Art of Attention
Why I love going upside down: I love handstands because it took so long to learn HOW. I have a lot of respect for the dynamics and difficulty of inversions in general. Our bodies love being upside down, and it feels like a new lease on life every time.

Gigi Yogini

Pose: Headstand.
Location: Flatiron building, New York City. Photo by Fluid Frame. 
Why I love going upside down: Headstand helps you calm your mind, even amid chaotic circumstances. It’s considered the king of all asana for good reason and should be practiced every day.

Noelle Beaugureau

Pose: Handstand with Splits variation.
Location: The photo was taken by amazing friend and photographer Kristin Burns out in the desert on a dry lake bed.
Why I love going upside down: It reminds me of the strength and calm that yoga provides. I love this picture because I had such a fun time on this shoot with Kristin, the ground was so hot, I could only stand or balance on it with my hands for a few seconds. We were out on the dry lake bed all alone and it was such a beautiful experience to be in the desert and connect to that intense vortex of energy in that is out there.

Tiffany Cruikshank

Pose: Lotus handstand variation.
Location: Washington DC with the amazing Drew Xeron Photography.
Why I love going upside down: I love the playfulness of inversions and their ability to empower us to take the difficult and often scary steps we need to take in our lives.
***

Check out the rest of the 27 Mind-Blowing Inversions From Rockstar Yogis – click here!

Concussion Recovery: Yoga for the “Invisible” Injury

Daya Alexander Grant, Ph.D., M.S. for Yoga Medicine® shares some information on concussions – the most common head injury. Learn how yoga can benefit concussion recovery and how to practice safely as you heal.

Yoga for the “Invisible” Injury

“Are there any injuries I should know about?”

Most yoga teachers begin class with some form of this question. The goal is to become aware of any current physical limitations that a student may be experiencing. This is so that the teacher can make the asana practice accessible by offering the appropriate modifications to protect the injury.

Unfortunately, head injuries are rarely acknowledged – either by the teacher or by the student. Most teachers are not very knowledgeable about concussions, and students recovering from one often remain silent since it can be difficult to articulate their symptoms.

With the heightened awareness of concussions in recent years and the benefits of yoga being touted to a larger audience, it is valuable for yoga teachers to learn about this particular injury.

What You Should Know About Concussions

A concussion is defined as a mild traumatic brain injury, but it hardly feels mild for the person experiencing it. Upwards of 3.8 million concussions occur in the U.S. annually1, with the most common causes being sports-related incidents, falls, motor vehicle accidents, and blast injuries (among veterans). A recent study showed that 1 in 5 teenagers reported having at least one concussion2. Every brain is unique and each concussion manifests differently, but common symptoms include headaches, dizziness, insomnia, mood changes (e.g. irritability, sadness, nervousness), sensitivity to light and sound, difficulty with balance, concentration, and memory, and generally feeling like you’re “in a fog”.

Cognitive dysfunction after concussions is due to transient cellular damage, but not destruction. 80-90% of concussion symptoms typically resolve within 7-10 days, although this tends to take longer with younger people and for those who have had multiple concussions. It is important to note that even after symptoms dissipate, the brain may still have microstructural damage which can cause a resurgence of symptoms in stressful or taxing situations. While most students who attend a yoga class will be outside of the acute injury phase, they still may be dealing with repercussions of the injury.

Benefits of Yoga for Concussion

Yoga means “to yoke” or “to unite” the body, mind, and spirit. That intention is precisely what people who have had concussions are seeking. Furthermore, a gentle yoga practice can offer cognitive, physical, and emotional improvements for someone healing from a concussion.

The general consensus in the neurotrauma community is that prolonged restrictions after brain injury (e.g. sitting in a dark room with no sounds) are actually detrimental to recovery. Instead, doctors now advise patients to avoid strenuous physical or mental activities for the initial 24-48 hours after a concussion. After that period, the patient will follow a gradual and personalized return-to-play protocol. The goal is prompt re-engagement in social and physical activities that do not worsen symptoms or put the brain at risk for another injury.

Yoga is an effective way to improve quality of life and reduce symptoms after a concussion. In a recent study that I co-authored, adults with traumatic brain injury (TBI), including concussions, participated in an 8-week pilot yoga program. At the end, participants reported improvements in quality of life and self-perception, as well as a reduction in negative emotions3. The empirical research on yoga for concussions is in its infancy, but several studies focusing on TBI as a whole have demonstrated the benefit of yoga and meditation on information processing and mental fatigue4, attention5, strength and endurance6, and memory7.

Tips for Working with Yogis who are Recovering from a Concussion

As yoga teachers, we can implement three simple practices to encourage a welcoming and healing environment for anyone dealing with a concussion.

Hold Space

  • Create a safe and peaceful environment where the student can be exactly who they are on that day. Some days, it’s hard to leave your house with a concussion. The world is overwhelming and the simplest tasks can be exhausting. Attending a yoga class may be the one activity they do that day. So it is important to make it a positive and supportive space as much as possible.

Emphasize the Breath

  • We’ve all experienced the benefits of a deep breath. But sometimes it’s easy to forget how powerful that tool is amidst the chaos of daily life. Anyone with a concussion will benefit from conscious breathing – specifically, slow, deep ujjayi breaths. Not only will the breath bring their mind in to the present moment and benefit them physiologically during practice, but it will also help them deal with the overstimulation and intense emotions they’re experiencing off the mat.

Keep it Simple

  • A concussed brain processes information slower, since the myelin (insulation around the neurons’ axons), which is responsible for fast signal transmission, is damaged. Therefore, it’s important to keep instruction to a minimum. Too many words are difficult for anyone to follow, especially someone who has had a brain injury. While alignment is always important, choose your cues mindfully so as not to distract from the goal of helping your students turn their attention inward.

Yoga is designed to meet people exactly where they are on any given day. Let’s keep that in mind as we work with students who have had concussions, since every day is different. As yoga teachers, we have the honor of giving everyone the tools to re-connect their body, mind, and spirit – which, after a concussion, can feel like a daunting task.

***

References

Citation #1 Daneshvar DH, Nowinski CJ, McKee A, & Cantu RC (2011). The epidemiology of sport-related concussion. Clinics in Sports Medicine, 30(1): 1–17. DOI: http://doi.org/10.1016/j.csm.2010.08.006

Citation #2 Veliz P, McCabe SE, Eckner JT, Schulenberg JE (2017). Prevalence of concussion among US adolescents and correlated factors. JAMA, 318(12):1180–1182. DOI: 10.1001/jama.2017.9087

Citation #3 Donnelly KZ, Linnea K, Grant DA & Lichtenstein J (2017). The feasibility and impact of a yoga pilot programme on the quality-of-life of adults with acquired brain injury, Brain Injury, 31(2): 208-214. DOI: 10.1080/02699052.2016.1225988

Citation #4 Johansson B, Bjuhr H & Rönnbäck L (2012). Mindfulness-based stress reduction (MBSR) improves long-term mental fatigue after stroke or traumatic brain injury, Brain Injury, 26(13-14): 1621-1628. DOI: 10.3109/02699052.2012.700082

Citation #5 Cole MA, Muir JJ, Gans JJ, Shin LM, D’Esposito M, Harel BT, Schembri A (2015). Simultaneous treatment of neurocognitive and psychiatric symptoms in veterans with post-traumatic stress disorder and history of mild traumatic brain injury: A pilot study of mindfulness-based stress reduction, Military Medicine, 180(9): 956–963. DOI: https://doi.org/10.7205/MILMED-D-14-00581

Citation #6 Schmid AA, DeBaun-Sprague E, Gilles AM, Maguire JM, Mueller AL, Miller KK, Van Puymbroeck M, and Schalk N (2015). Yoga influences recovery during inpatient rehabilitation: A pilot study, International Journal of Yoga Therapy, 25(1): 141-152.

Citation #7 Azulay J, Smart CM, Mott T, Cicerone KD. A pilot study examining the effect of mindfulness-based stress reduction on symptoms of chronic mild traumatic brain injury/postconcussive syndrome. J Head Trauma Rehabil. 2013 Jul-Aug;28(4):323-31. DOI: 10.1097/HTR.0b013e318250ebda

Yoga for Better Posture: 4 Simple Poses

Louise Flanelly for Yoga Medicine® shares some info on posture, why you might have bad posture, what it’s doing to you, and how to fix it by using yoga for better posture.

Yoga for Better Posture

What is Posture?

Posture is the position in which you hold your body against gravity. Good posture means holding your body in such a way, that it places the least amount of stress on the muscles and ligaments of the body. The natural curves of the spine are maintained, and the bones and joints are in correct alignment.

Maintaining proper posture decreases stress on joints and ligaments. This eliminates muscular fatigue, allowing the muscles to be used more efficiently. Good posture also promotes an ease of breathing, as the lungs have more space to move.

What Affects our Posture?

Our posture can be affected on a physical level, through muscular tightness and weakness and also on an emotional level, such as during the ‘fight or flight’ response.

Posture and Our Emotions

Posture can tell a lot about a person. Have you ever seen someone walk into a room standing tall, with their shoulders back and a lift through their spine? Automatically you see this person as confident and healthy. Now compare this to somebody, who walks into a room with their shoulders slumped forward, a rounding of the upper back and the head protruding forward. You recognise this person as lacking confidence and maybe not so healthy!

When we feel scared or threatened, our natural tendency is to curl into that protective fetal position. In this ‘safe’ position the hips are slightly flexed and the shoulders roll forward. This gives that hunched over look that we so often see. Overtime this can lead to postural issues.

Posture on a Physical Level

On a physical level there are many contributing factors to poor posture. In modern society we have a sedentary culture characterized by desk jobs, long commutes, and time spent hunching over modern technological devices. Over time these repetitive actions cause tightness and tension within the body, effecting both the upper and lower body.

The lower body

Prolonged sitting means the hip flexors are contracting for long periods of time. This causes tightness of the hip flexors: rectus femoris and psoas major. Hours of sitting also contributes to weakness of the hip extensors, mainly gluteus maximus. These imbalances in the hip musculature, can contribute to lower back discomfort and limit mobility in the hip joint.

The upper body

Rounding of the upper back and protruding forward of the head, from prolonged computer/tablet/phone use, draws the shoulders forwards and closes off the chest. Subsequently, this causes tightness in the pectoral muscles of the chest. In contrast, these actions cause an over-stretching and weakness in the upper back muscles: trapezius and the rhomboids.

Impact of Poor Posture

All these issues, can overtime lead to restricted movement in the upper back, chest and hips. This results in over-stretched muscles of the upper back, tightness across the chest, decreased lung capacity, lower back issues and tightness in the hips.

How can yoga help combat poor posture?

The emotional aspect

Firstly, to tackle the emotional causes of poor posture. Yoga teaches us mindfulness and breath awareness. Through mindfulness, we can learn to recognise the early signs of stress and tension building in the body. This awareness allows us to gain control over the muscles and release this muscular tension.

Learning to slow down the breath in times of stress we slow down the mind. This in turns activates our parasympathetic, our rest and digest nervous system. This action helps relax the large mobiliser muscles of the body as we no longer need that ‘fight or flight’ response.

The breath

We can use the breath to help relax the body and calm the mind. Practising the three-part yogic breath when you feel stressed or anxious can help calm the nervous system. The “three parts” of the breath involve the abdomen, diaphragm and chest.

To practise the three-part yogic breath, begin by inhaling deeply into the belly, then expanding the ribs and finally the chest. Reverse the flow of the breath on the exhale. Exhaling and feeling the chest, the ribs and finally the belly release as the air leaves the body. Repeat for at least five breaths.

The physical aspect

If you sit at a desk for hours each day, it is so important to try and take a break at least once an hour. Stretch, go for a walk, just get away from your desk. If you commute to work maybe you can get off a stop earlier so you can walk the remainder of the way.

You can also practise these 3 great yoga poses regularly to help improve your posture.

1. Reverse Namaste

Benefits:
Opens the pectoral muscles of the chest, counteracts the rounding forward of the shoulders. Also, a fantastic stretch for the wrists.

Pose instructions:
1: Bend the elbows out to the side of the waist and bring the hands behind the back.
2: Join the palms together.
3: Relax the shoulders away from the ears.

Modifications:
Repeat step 1 above. Instead of joining the palms, hold the opposite elbows.

2. Extended Side Angle

Benefits:
Strengthens and stretches the legs, stretches the groin, spine, chest and shoulders.

Pose instructions:
1: Begin in Warrior II pose with the heel of the front foot in line with the arch of the back foot.
2: Ground firmly into the outer edge of the back foot.
3: Bend the front arm and place the arm lightly on the thigh.
4: Spin the heart towards the sky and take the gaze up.

Modifications:
Repeat steps 1 and 2. Instead of placing the arm on the thigh, place the front hand on a block or alternatively onto the mat.

3. Camel

Benefits:
Stretches the hips flexors, shoulders and chest muscles. Strengthens the shoulders and back.

Pose instructions:
1: Come to a kneeling position, with the knees hip width apart and tops of the feet pressing down.
2: Place the palms of the hands on the lower back, fingertips pointing towards the head.
3: Begin to lift the chest towards the sky, keeping the chin tucked in towards the chest.
4: Press the hips forward maintaining a squeezing action between the legs.
5: Drop the right hand to the right heel and then the left hand to the left heel.
6: Keep the chin tucked towards the chest or if it feels ok for the neck, drop the head back.

Modifications:
Easier version: Repeat steps 1-4, stay with the hands on the lower back and don’t drop the hands to the heels.
Intermediate version: Place blocks either side of the feet. Repeat steps 1 – 4, drop the hands to the blocks.
Intermediate-advanced version: As per step 1, kneel upright with the knees hip width apart. Tuck the toes under so the balls of the feet press into the mat and continue steps 2-6.

Conclusion

Practicing these 3 poses regularly will help to counteract poor posture, by building strength in weakened postural muscles and stretching out tighter muscles.

Remember to walk with confidence, keep the breath relaxed and keep practising yoga, yoga and more yoga!

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