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The Ins and Outs of Yoga and Scoliosis

By Sara Lindberg for Healthline.

When looking for ways to manage scoliosis, many people turn to physical activity. One form of movement that’s gained a lot of followers in the scoliosis community is yoga.

Scoliosis, which causes a sideways curve of the spine, is often associated with children and adolescents, but people of all ages have this disorder. And the spine, like the rest of our bodies, can change over time.

Physical activity, such as a regular yoga practice, is one form of treatment your doctor may recommend to help you deal with the challenges and pain that accompany scoliosis.

That said, there are some things to consider before you flow into a yoga sequence. Here are some tips and moves to get you started.

Why Yoga is Beneficial for Scoliosis

Yoga can be very helpful for those with scoliosis, particularly given the combination of flexibility and core stabilization needed to perform yoga poses properly, according to Sami Ahmed, DPT, a physical therapist at The Centers for Advanced Orthopaedics.

 

Stretch and Strengthen the Sides of the Body

When practicing yoga, Ahmed says parts of the body are stretched, and others are forced to contract by performing various movement patterns that require a sustained hold of a certain position. This often results in increased mobility of the thoracic spine.

Decrease Pain and Stiffness

“When looking at the spine, especially for those with scoliosis, we think about two concepts regarding its stability: form and force closure,” says Ahmed.

By strengthening the force closure, which is made up of muscles and connective tissue that keep the spine in proper alignment, Ahmed says you can often see a decrease in pain and improvement in overall function.

Physical activity, such as yoga, can help foster the maintenance of a neutral spine or improve the overall alignment.

Maintain or Improve Spinal Position

In fact, one study of 25 patients with scoliosis found that those who performed the Side Plank pose saw improvement in the primary scoliotic curve of the spine (measured as the Cobb angle).

To show improvement, participants practiced the yoga pose for 90 seconds, on an average of 6 days per week, for a little over 6 months.

Potential Benefits of Yoga for Scoliosis
  • stretch areas tightened by spinal curvature
  • strengthen weakened areas affected by the spine’s position
  • strengthen the core overall
  • pain management
  • improve mobility and flexibility
  • maintain or improve spinal position

Introducing Yoga

 

Know Your Scoliosis Type

If you’re interested in trying yoga to reduce pain and correct your curve, Elise Browning Miller, a senior certified Iyengar yoga teacher (CIYT) with an MA in therapeutic recreation, says you first need to understand what your pattern of scoliosis is.

“In other words, they need to picture which way their curve goes from behind and understand the rotation as well because if they don’t know their curve, they won’t understand how to do the poses to correct the curve,” she says.

Begin with Conscious Breathing

When Miller works with students who have scoliosis, she first focuses on yoga breathing with simple poses to bring the breath into the compressed areas, where breathing is compromised.

“If there is the gnawing tightness on the side or sides of the back where the scoliosis laterally and rotationally goes, then stretching that area can relieve the discomfort,” she adds.

“The approach should both involve reducing pain as well as correcting the scoliosis,” says Miller. That said, she does point out that the most important thing is to reduce the pain or discomfort and to keep the curve from getting worse, which can be done with the right approach to yoga.

Accept That Moves Can Be Different for Right and Left Sides

Jenni Tarma, a Yoga Medicine® Therapeutic Specialist, says that when using yoga to help manage scoliosis, you should remember that the distribution of tension in the surrounding tissues has become uneven due to the curvature of the spine.

“More specifically, the tissues on the concave side of the curve are shorter and tighter, whereas those on the convex side are in a continually lengthened position, and most likely weaker,” she says.

Stretch or Strengthen Where It’s Needed

Ideally, Tarma says the goal is to reestablish some balance and try to get things more symmetrical with:

  • targeted stretching on the concave or shortened side
  • strengthening on the convex or lengthened side
Skip the Pose, Any Pose

She also reminds students that since there might be significant limitations with range of motion, you should feel comfortable and empowered to skip poses that aren’t feasible or productive. It’s always important to work within your own capacity.

Give the Instructor a Heads-Up

It’s common for instructors to move around during a yoga class and make adjustments to a person’s pose.

“Hands-on adjustments in classes aren’t necessarily off the table,” says Tarma, “but I would definitely recommend making the instructor aware of the specifics before class and absolutely letting them know if you’d prefer not to be adjusted for any reason.”

Practicing Yoga with Scoliosis

As to the method of yoga, Miller prefers Iyengar because it focuses on alignment and postural awareness strengthening, as well as flexibility.
 
“It is a therapeutic approach, and also, mind-consciousness is key to this system (meditation in action) where you stay in the pose long enough to adjust for your scoliosis,” she adds.
 

Yoga Poses for Scoliosis

Yoga poses that Miller recommends for scoliosis include:

  • Half Forward Bend (Ardha Uttanasana)
  • Downward-Facing Dog (Adho Mukha Svanasna) with a belt around a door for traction to lengthen the spine
  • Locust Pose (Salabhasana)
  • Bridge Pose (Setu Bandha)
  • Side Plank (Vasisthasana)
  • Side-Reclining Leg Lift (Anantasana)
  • Mountain Pose (Tadasana)

Other Stretching Exercises for Scoliosis

 

Use Bolsters, Rollers, or Other Accessories to Stretch

Miller adds that supported back opening, such as lying over a bolster, and corrective breathing, such as lying on your side where the apex of the scoliosis curve is, can be beneficial. It opens up the breathing and corrects the curve.

Practice Your Posture

Postural awareness is also key, and Miller says she teaches it between the standing poses, such as in Mountain pose.

Try Gentle Spinal Twists and Side Bends

Simple movements like spinal rotation and side bends can also be very helpful in addressing the imbalance. However, Tarma says that due to the asymmetry, these movements will be noticeably more challenging on one side than the other.

“The goal is to train a better range of motion and function on the weaker side. For example, if twisting to the right is more challenging, that’s the side we would focus on,” she says. You can do twists and side bends in a simple seated posture, either on the floor or in a chair.

Strengthen Your Core

That said, Tarma does point out that at least some of the work should be active, meaning you’re using the core and back muscles to execute the movement, as opposed to using your hands or arms to leverage yourself into the position. “Long-term results require more active strengthening to shift the spine into a more neutral position,” she adds.

Work Towards a Balance, Not Symmetry

And while perfect symmetry may not be attainable or even necessary, Tarma says that working toward it can help mitigate discomfort and improve overall function.

Tech Neck? Try These Three Simple Techniques to Relieve that Nagging Neck and Shoulder Pain

Do-It-Yourself myofascial release to reduce pain, restore flexibility, hydrate tissues, and re-establish healthy movement to relieve common pain-causing tension.

Do you suffer from pain in your shoulders and neck? Maybe it’s the result of working at your desk, driving a car, picking up kids or perhaps you hold tension in this region of the body when you are feeling stressed. Whatever the reason, nagging pain in the shoulders and neck can be exhausting. The good news is, there are some simple self massage techniques you can do any time to relieve this aching pain.

Myofascial Release (MFR) is a massage technique that works with both the muscles and fascia. Myo refers to the muscles, while fascia refers to the connective tissue and fascia. MFR can be very simple but it’s also incredibly complex. The goal of myofascial release is to reduce pain, restore flexibility, hydrate tissues, re-establish healthy movement between the myo-fascia and allow for free passage of signals through the connective tissue system.

What is Fascia?

The fascial web is one continuous interconnected system of connective tissue that exists from head to toe without any interruption. In quite recent history, connective tissue was believed to be a ‘space filler’ and was cut away in a cadaver. However, in more recent years its relevance has become increasingly important as body worker and the medical community are realizing its vital role in creating support, providing separation, protection, hydration and communication for the body. 

Some Fundamentals

When coming to practice MFR, there are some fundamentals to consider:

  • Avoid bone: you won’t cause damage to the bone but it will just feel uncomfortable.
  • Avoid areas of acute injury/ inflammation/ swelling. If you have an area of acute pain, work around that region softly rather than irritating even more.
  • Change the position of the ball if you feel numbness, tingling, shooting or sharp pain. 
  • Less is more: the aim of MFR is to reduce pain and deep seated tension. If applying pressure on the massage balls is causing you to tense up more and screw your face up (!) then ease off as there’s every chance that you’ll be causing more tension rather than less, making the practice counter productive.

Neck Release on a Block

Good For: releasing tension in the sub-occipital muscles at the base of the skull, which work hard all day holding the head up right.

Props: 1 block and a blanket

Lie supine on the ground with both knees bent and your feet on the floor. Lift your head and place the block on its medium height. The bottom edge of the block should be pressing into the base of the skull (approximately where the hair line is). Allow your head to be really heavy on the block. Very slowly, start to move your head from right to left (as if you were shaking your head to say ‘no’). Make sure that as your do this you are keeping your head really heavy on the block. When you find a point of tension that you can work with, pause for a couple of breaths at the spot. Allow the weight of your head and gravity sink down into the block, releasing deep seated tension at the base of the skull. When you feel even on both sides, move the block to one side to lie the back of your head on the ground. If you suffer from headaches or find that the block alone is too intense, place the blanket over the block to reduce the intensity.

Corners of the Neck

Good For: Releasing tension in two common trigger points for the upper portion of the Trapezius muscles. This is a common area of the body that people tend to hold onto stress.

Props: 2 tennis balls/massage balls, blanket and a block

Lie on your back and use your right hand to place the ball at the left ‘corner of the neck’ and use your left hand to place the ball on the right side. This might already feel tender for some people, in which case stay as you are. If you would like to apply more pressure onto the balls, lift and place your hips on the block. If you would still like to apply more pressure onto the balls, raise your arms up above your head so the backs of your hands are resting on the ground behind you. Stay here for about one minute and breathe deeply. Just as before, you can place a blanket over the balls to reduce the intensity.

Between the Shoulder Blades

Good For: Releasing tension in space in between the shoulder blades, the Rhomboid muscles. This tends to be a common area of tightness and tension, especially for people who sit for a large portion of the day.

Props: 2 tennis balls/massage balls, pillow and a blanket

Lie on your back and bend both knees so your feet are on the ground. Use your right hand to place the ball between the left shoulder blade and the spine and use your left hand to place the ball on the right side. At this point, you may like to lie your head on a pillow. Bring your arms out in a ‘T’ position, with the palms of your hands turned up toward the ceiling. If this is already tender, stay as you are and breath deeply. You can also bring your arms across your body as if you were giving yourself a hug. When you find a point that you can work with, stay there and breath. After about one minute, remove the balls and lie flat on your back.

The 18 Best Yoga Poses for Beginners

By Timothy Burgin for Yoga Basics.

If you are new to yoga, you might feel overwhelmed with how to safely and adequately perform all of the yoga poses. We have over 120 different yoga exercises listed in our asana index–fortunately, you don’t need to learn them all when you are just starting yoga. There are a handful of foundational yoga poses that share common alignment and muscular actions with all of the other poses. Even though there are hundreds of asanas, most yoga classes repeat the same primary ones. Becoming familiar with these fundamental poses will be essential for you to learn so you can feel comfortable going to a yoga class or can be safe practicing on your own at home.

We reached out to eleven yoga experts to get their recommendations for the most essential yoga poses that beginners should start with learning. We also asked them for their tips and advice on how beginners should approach these asanas and how to modify the poses to make them approachable for newbies. We recommend that you follow the link to the yoga pose instruction page to see the step-by-step instructions on how to perform each pose. If you are brand new to yoga, take your time to absorb all of this info, and always listen to your body and alter the posture to best suit your body’s level of ability, strength, and flexibility.

1. Cat and Cow (Marjaiasana / Bitilasana)

One of the most essential and easiest yoga poses for a beginner to learn is cat pose and cow pose. Yoga Instructor Brooke Nicole Smith explains that “this sequence connects movement with breath, moves through both flexion and extension of the spine, and allows the practitioner to experience stillness at the apex of each movement, as well as in a neutral spine position between the movements.”

“The key benefits are improved awareness and depth of breath as well as heightened awareness and control of spinal, shoulder, and pelvic position/movement. In other words, this pose helps new yoga practitioners experience the connection between the spine, shoulders, pelvis, and breath. These small movements and connections facilitate the understanding of alignment in so many other poses (e.g. understanding internal and external rotation of the hips makes more sense in the context of how the pelvis connects to the spine). This pose makes me feel deeply connected to and present in my body. When I practice it, my awareness goes directly into my body. My mind quiets. The sensations of my breath, my movement, and my body capture my full attention. I experience peace.”

“This movement and action of the spine is found in many other yoga poses, so it is considered a foundational pose for beginners to understand and master. If you have wrist discomfort or pain, you can use fists or place your forearms on a bolster or blocks. This spinal movement exercise can also be practiced in a seated or standing position.”

2. Easy Pose (Sukasana)

The classic seated pose with legs crossed and a straight spine isn’t always easy to do. Most yoga classes will start off in Easy pose, so it is essential to know how to make this beginner pose as comfortable as possible. As Yoga Teacher and Yoga Therapist Donna F. Brown tells us, “Easy pose is often difficult to do as most people do not know how to sit still for even 5 minutes in our chaotic, fast-moving society! This pose helps beginning students to establish a seated foundation for their practice, is a common pose for learning the art of meditation, and encourages lengthening and proper alignment of the spine. Sukasana also is very calming for the mind and body, and enables concentration.” To make Easy pose easy, try sitting up on a cushion, folded blankets, or even a yoga block. If your knees feel achy, support them with blankets or blocks.

3. Mountain Pose (Tadasana)

The foundation of all standing poses is Mountain pose. Laura Finch, founder of Yogakali.com, believes that “Tadasana is the most crucial yoga pose for beginner yogis as well as for yoga teachers who work with entry-level students. Before diving into more intricate yoga poses, both students and teachers have to analyze the foundation. From the anatomical point of view, Tadasana is the basic posture that carries a pool of information about where our mind and body are at the moment. What’s more, Tadasana reveals the uniqueness of each and every body, creating the opportunity for creativity instead of blindly forcing our bodies into the “perfect” shape we’ve seen on Instagram.”

“Tadasana is perfect for beginners and accessible to the majority of able-bodied yoga students. Opening a yoga class with Tadasana is a perfect moment to detect what’s “broken” and set an intention for the yoga practice. From reflecting on our emotional well-being, and hinting previous injuries to revealing adverse lifestyle patterns, the way we stand is the best indicator of what we need to focus on in our yoga practice today. I find Tadasana to be extremely grounding and soothing. I treat it as a sort of standing Savasana, a chance to connect with the breath, center, and scan the body and feelings.”

Mountain is also a pose that Donna F. Brown deems essential to the beginner. She notes that “standing still and maintaining good alignment can be difficult for most people. When you are in Tadasana, every muscle group in your body is utilized to hold you erect. The dynamics of the pose begins in the grounding of the feet to establish balance, and the energy travels from the feet up the legs and thighs and spreads to the entire body. The hips and abdominal muscles are engaged, and this helps to properly align the spine. The shoulders are relaxed, and the head is centered directly over the spine. This pose creates a sense of steadiness, power, and strength, and thus, the name, Mountain pose.”

If you’re struggling with feeling stable in this pose, try to have your feet wider apart. You can also practice the asana against a wall for extra support and to help you properly align your spine in the posture.

4. Downward Facing Dog (Adho Mukha Svanasana)

One of the most practiced poses in a yoga class is Downward Facing Dog. This pose is often used as a transition between poses and can eventually become a great place to catch your breath in a fast-flowing class. Kelly Clifton Turner, Director of Education of YogaSix, tells us that this pose “can be challenging, but the fastest way for me to feel better in my body is to move into Down Dog for 5-10 rounds of breath. It decompresses the spine, all the way up through the neck, letting the head hang heavy. It lengthens the hamstrings, which is a great counter for those who either sit a ton or are super active (think marathon runners and cyclists, whose hamstrings are always firing). It opens the chest, allowing for easy and smooth breath. It is both grounding and energizing, and will leave people feeling better in their body with just a minute or two of practice. Place one block under each hand (at the lowest height). This helps release pressure from the shoulder girdle, which allows you to focus on maximizing the length in your spine.”

Adho Mukha Svanasana is also one of Donna F. Brown’s favorite poses. She tells us, “This pose strengthens, tones and energizes the entire body! It also is an inversion pose that improves circulation to the brain, head, and neck, and strengthens the shoulders and arms, and legs. Many students lean too much on their hands and need to focus more on centering their body weight back toward the legs and up toward the hips.”

5. Cobra Pose (Bhujangasana)

The most foundational and commonly practiced backbend in yoga is Cobra pose. Yoga Medicine® instructor Rachel Land, advises us to “think of Cobra as the antidote to a slumped posture. All backbends broaden the collarbones and lift the sternum, opening up space for better breathing and even digestion. Because the backbend in Cobra is against the downward push of gravity, it is particularly helpful in awakening back body muscles that commonly weaken when we sit a lot, as most of us do in modern life.”

“Backbends feature regularly in yoga asana practice, but deep backbends are challenging for many of us, especially for newer students. This pose encourages us to practice three actions required to make deeper backbends more accessible:

  • Posterior pelvic tilt: lifting the lower belly or lengthening the tail creates more space in the low back and lengthens commonly tight muscles on the fronts of the hips.
  • Deep abdominal engagement: cinching around the waist even as the skin over the belly lengthens can help transfer the sensation of the backbend away from the lumbar spine to the targeted areas of the chest and upper back.
  • Scapula retraction: squeezing the shoulder blades back toward the spine helps to lift and open the chest, creating the heart-opening benefits of the pose.”

“We sometimes confuse pose depth with pose quality, but it’s not necessary for a backbend to be deep in order for it to be beneficial. So rather than aiming to lift your chest as high as possible, practice the three actions outlined above to open your heart and lengthen your hip flexors without creating any compression in your low back. Some students feel best with their legs together, some with legs hip-width apart, and some with the legs wider; be willing to experiment to see what feels best for you. Finally, looking down or forward rather than looking up can also help you focus the sensation on your chest rather than your neck.”

6. Crescent Lunge Pose (Utthita Ashwa Sanchalanasana)

Part of a traditional sun salutation, Crescent Lunge is also the foundational yoga pose needed to build up the necessary strength and proper alignment to perform the Warrior lunge poses. Tom Johnson, Yoga Teacher with Enjoy Community Wellness, describes Crescent Lunge as “an important pose which builds heat and strength in the body, preparing the body for more complex poses. Crescent Lunge uses and integrates muscles of the entire body (legs, core, arms), lengthening and strengthening the upper and lower body. It builds balancing capability and prepares the student for Warrior I pose.”

“Crescent Lunge is an awesome pose to counteract the negative effects of a sedentary lifestyle as it opens up the chest, core, and hips in precisely the opposite direction from sitting. Crescent Lunge lengthens and tones the arms, legs, hip flexors, foot, and toes; and strengthens the legs, hips, and butt. Crescent Lunge is a strong and powerful pose for the mind and body. It encourages beginners to practice the power of concentration and gives them an opportunity to own and fully occupy space on the mat. This is a common pose to warm-up the big muscles and joints of the body to prepare for more challenging postures.”

“This pose is commonly entered into from Downward Facing Dog with the back leg straight, which is challenging for both beginners and experienced practitioners. So, the beginner may want to drop into a neutral table-top (on hands and knees), place one foot forward between the hands, then lift the back knee and straighten the back leg. What’s most important is to establish a strong base by planting the heel of the front foot underneath the knee, creating a 90-degree angle at the front knee. This may require “helping” the front foot into place by taking a couple of steps forward to get the knee over the heel. Beginners may also want to keep the back knee down on the mat and focus on building the base in the front leg.”

7. Triangle Pose (Utthita Trikonasana)

Understanding how to align the arms, legs, shoulders, and hips in multiple directions is a key teaching of Triangle pose. This foundational pose is much trickier than it looks, so approach this posture with patience and persistence. Certified yoga expert Mackenzie Shier notes that “Triangle is a great posture with a lot of benefits while being accessible for most people regardless of yoga experience. This pose strengthens the legs, obliques, core, and back while stretching the hamstrings and calves as well as the groin muscles and chest. A common pitfall in this posture is allowing the ego to drive the lower hand all the way to the floor and allowing the body to come forward in order to do so, thus losing many of the great benefits of the posture as well as possibly putting the lumbar spine in jeopardy. A great way to avoid this is by either turning the palm up, so there isn’t weight in the lower arm or even by practicing this posture against the wall. If practicing against a wall, go down only as far as the back remains fully on the wall. It may feel more difficult, but it helps to ensure proper alignment and opening of the chest.”

“Triangle is one of the first poses taught to beginners and practiced in more advanced classes too,” notes Tom Johnson. “It’s a playful way to make shapes with the body while grounding down into the earth and opening the body. It helps build balance and is a preparatory pose for more advanced postures like Half Moon Pose (Ardha Chandrasana). Done with a strong base and proper alignment, the student will feel strong, balanced, and open.”

“As a beginner, focus more on creating a strong base with the legs and seeking length and alignment in the spine. Don’t worry about reaching the hand to the floor–use a block to bring the floor up to you, so you keep a solid alignment of the spine. Also, wedging the back foot against a wall can help create a strong base from which to extend the spine.”

8. Plank Pose (Kumbhakasana)

Many yoga newbies struggle with having the necessary upper body strength to protect the wrists from strain and to further advance in the practice. Plank pose provides this foundational strength. As Rachel Land notes, “Several key yoga poses require us to bear our weight on our hands, something that most of us don’t often do in daily life. It can be difficult at first, so plank helps us adapt to weight-bearing on the hands without the flexibility required by poses like downward-facing dog (adho mukha svanasana), or the upper body strength required by low push-up (chaturanga dandasana), inversions or arm balances.”

“There’s no doubt plank pose is difficult, but I love the feeling that every part of my body has to work in order to hold the position. Staying in plank pose, even when it is difficult, creates a sense of personal power that is a major part of what draws me to my yoga mat. As well as helping us adjust to weight-bearing on our hands, plank pose helps us stoke the internal fire or motivation that the ancient yogis called “tapas”: hold a plank for just a few breaths and you’ll soon feel the heat build in your chest, arms, core, and legs.”

“Even experienced students find plank pose difficult, so modifications can be helpful for all of us. If you’re building up to feeling strong in plank pose, lowering your knees to the mat will reduce the effort required to hold the pose with good alignment. On days where your wrists are bothered by weight-bearing, you can prop the heels of your palms on a folded blanket or mat, or take plank pose on elbows and forearms instead. Finally, try squeezing a block between your thighs to help you recruit leg strength.”

9. Child’s Pose (Balasana)

One of the most important poses for anyone new to yoga to learn is Child’s Pose, explains Heather Dressler, owner of BodyLift Fitness. “This pose is accessible for most, and it’s a position those practicing yoga can always go to when they are feeling overwhelmed, stressed, or when they have the need to calm their body down. It’s also a good pose to move your body into when you are faced with a pose during your yoga class that you can’t physically or mentally practice at that time. When we get stressed out, often, our response is to bring our hands to our foreheads. Bringing your forehead to the mat in Child’s Pose automatically calms the parasympathetic nervous system, relieving stress, anxiety, and fatigue. If your forehead doesn’t reach the mat during Child’s Pose, you can grab a block and place it between the forehead and the mat to assist. You can also place a block behind the knees to lessen the bend and lift yourself off of your heels. Child’s Pose has extra benefits, including massaging the internal organs and opening the lower back, hips, shins, and quads. If you walk your hands forward, you can also add opening to the armpit area and the chest to the list.”

10. Corpse Pose (Shavasana)

Stress reduction is one of the top reasons people begin practicing yoga, and Corpse pose is the best yoga pose to teach one how to relax. While the name sounds a bit morbid, the goal of this asana is to let go of everything that you possibly can. While it might look like naptime, it is crucial not to fall asleep in this pose. Learning to relax in Shavasana will allow you to more easily and quickly relax into the other yoga poses, which will allow you to further reduce stress and tension in your body.

Registered Yoga Teacher Lucile Hernandez Rodriguez believes that “Shavasana is a perfect way of introducing meditation in a beginners’ class. Meditation can sometimes seem not accessible enough to beginners, especially if they are not used to seating for long periods of time and can feel discomfort when doing so. Laying down solves this issue as it allows for a total release of the body.”

“For some people lying down flat on your back might hurt. You can try modifying this pose by putting a bolster under your knees. If you have back issues, put your feet as wide as the mat, knees together for a constructive resting feeling. This pose should be all about relaxation, and you shouldn’t feel any tension in your body. When you are in the pose, bring a light focus to your breath. If you notice that your thoughts are running wild, don’t judge them and just come back to your breath.”

11. Warrior 1 (Virabhadrasana I)

There are several asanas that embody the strength and power and fearlessness, and Warrior 1 is the foundation for these empowering standing poses. “This is an energizing pose that strengthens the legs, ankles, arms, and back while stretching the hips and torso,” notes Mackenzie Shier. “It’s also great for improving balance and stability. If the full variation of the posture isn’t appropriate or accessible for your body, you can always lift the back heel to reduce pressure on the ankle and hips or even lower to the back knee. There are a wide variety of options to reduce tension in the chest, shoulders, and neck. If this is an issue, try separating the hands or even bending the elbows into cactus arms while continuing to lift the torso.”

If you need to make this pose a bit easier, have less bend in the knee. You can take a break by straightening the leg and then bending it back into position. Make sure the bent knee is pointing directly at the middle toe, to make sure you do not put excess strain on the knee joint.

12. Warrior 2 (Virabhadrasana II)

Of all of the leg lunging poses, Warrior 2 is one of the most essential for beginners to learn. Reverse Warrior and Warrior Angle both rely on the same alignment in the legs and hips as this pose. “The standing poses are a major part of yoga asana practice,” explains Rachel Land. “They create a platform through which to embody the dynamic balance between strength and softness. Warrior 2 is a relatively accessible way for beginners to explore these opposing forces—pairing a sturdy standing base with an open and expansive chest. Warrior 2 teaches us to build strength, stability, and endurance, especially in the lower body, without closing off the hips or chest; this can have flow-on benefits to our posture, and connect us to our feet in a way that boosts our stability in all standing positions.”

“Like all Warrior poses, the posture creates a feeling of strength, power, and focus. The open, side-facing nature of Warrior 2 reminds us to balance that strength with softness by relaxing the face, releasing the sides of the neck, and allowing our collarbones to broaden. Though a foundational pose, Warrior 2 still requires significant strength and range of motion. Try moving your feet closer together to reduce the load on your legs. You might also find that turning your back foot and hip slightly toward the front of your mat (rather than toward the side of your mat) makes it a little easier to keep your front knee tracking over your front ankle. If your shoulders fatigue, bring your hands to your hips or into prayer position (anjali mudra).”

13. Tree Pose (Vriksasana)

Of the many balancing poses in yoga, Tree pose is the most common and best suited for the beginner. Registered Yoga Instructor Annette Goubeaux describes Tree pose as a “simple, foundational pose that is physically challenging for the hips, balance, ankles, and feet. It will make you feel strong and grounded even if held for a few breaths. As a strengthening posture, it helps you for all other balances in yoga and is a wonderful transition posture to move smoothly from pose to pose with strength and focus.”

“The practice of this posture can change daily based emotional factors such as how much sleep you’ve had, type of day, interactions with others, so it is important to tune into your emotional body and simply notice, and never judge. Emotionally it can help curb anxiety and stress and is a great way to slow down when you are feeling overwhelmed. From a mental standpoint, it can help create more confidence and raise your self-esteem as you stand tall and proud, which is why this is one of my favorite beginning yoga postures. Although it can start off challenging, students often find they can mark progress easily as they master this posture and grow stronger.”

“Tree pose builds strength in the core for more advanced yoga postures later, and as a strengthening posture, it helps you for all other balances in yoga and is a wonderful transition posture to move smoothly from pose to pose with strength and focus. This asana also helps to open the hips which will help to counteract tight hips that we often get from spending time sitting at a desk, while watching TV or while driving a car. It is also a great standing posture for beginners to work on to learn to connect to their breath, gain focus and clarity and keep the body balanced on one foot. This posture also teaches the student to connect with themselves as it is difficult to let your mind wander while in a balancing posture. To make this asana easier for a beginner, you can try varying foot positions such as heel to your inner calf, a block, or inner thigh.”

14. Bridge Pose (Setu Bandha Sarvangasana)

One of the most common asanas to practice at the end of a yoga practice is Bridge pose. Tom Johnson likes Bridge pose for its accessibility and versatility. He tells us that “it can be either a calming posture or an energizing one, depending on how the pose is executed. It’s also a great preparatory pose for the more complex Wheel (Urdhva Dhanurasana ) and Shoulderstand (Salamba Sarvangasana) postures.”

“Bridge Pose is a nice, grounding pose that creates flexibility in the thoracic spine, strengthens the back, legs, and glutes and opens the hips and shoulders. It’s an excellent counter-pose to the position many people assume during the day as they’re hunched over a computer or steering wheel. Bridge Pose is often performed after a vigorous flow sequence, so it helps to slow down the heart rate, calm the mind and ease anxiety. It’s a posture that opens up the shoulders and heart center, allowing students to feel more compassion for the self and others.”

“A beginner may want to enter into this posture using blocks as support. Initially, the beginner can use them by placing one block underneath the back at the base of the shoulder blades, which helps to open the heart center. The second block is placed under the head at the second-highest level to support the head. The beginner can keep the legs bent or straighten the legs and let the full weight of the body be supported by the blocks.”

15. Four-Limbed Staff Pose (Chaturanga Dandasana)

If you go to a popular vinyasa or flow yoga class, you will need to know how to properly move into a Four-Limbed Staff pose. Chaturanga is a part of the Ashtanga yoga Sun Salutation but can be substituted with knees-chin-chest posture if it is too challenging. This yogi pushup movement is one of the most difficult to have the correct alignment of all of the basic yoga poses, especially for new students.

Kelly Clifton Turner believes that “the most common misalignment in the classic yoga push up transition, often known as Chaturanga is rushing through and letting gravity do all the work. Instead of flopping down low, s-l-o-w it down. Move with control. Keep your upper arms hugging in towards the ribs as you hinge the elbow joints back towards your hips. Stop when the shoulders are either at or over the elbow line, avoiding the “stripper dip,” which can wreak havoc on your rotator cuffs. Knees can always be on the ground to support this mindful transition without sacrificing form.”

16. Wide-Legged Standing Forward Bend (Prasarita Padottanasana)

Many people are afraid to go to a yoga class because they think they are too inflexible, especially in the hamstrings, to do the practice. The Wide-Legged Standing Forward Bend pose is a perfect hamstring stretch for these beginners as it allows a gentle stretch in the backs of the legs to promote flexibility. Mar Soraparu, Partner at BIAN, believes that “the wide-legged standing forward bend is one of the most effective and approachable poses, in my opinion for any yoga practitioner to put to practice. This pose can be modified or advanced quite simply with simple shifts and opens the entire body with the added benefit of a slight inversion.”

“As you embark on your yoga journey there is naturally some anxiety around starting a new practice which is why the added benefit of having your head below your heart in this pose, allowing for extra blood flow to the brain, supports easing into your practice with a sense of serenity and confidence when you are just getting started. For a beginner specifically, this pose serves as an introductory point to opening some of the major muscle groups all at once in a safe and effective way. For those who feel that they do not have any flexibility, rest assured that with the use of blocks, bending of the knees, and adjusting the positioning of the feet to a wider stance, you are able to experience the benefits of this pose.”

“The lower back, hips, hamstrings, groin, and calves are the primary muscles being stretched; however as you ease into the pose, you may feel a release in the neck and entire spine as gravity gently pulls you downward and slightly forward. Additionally, the ankles, knees, and quadriceps are strengthened as you engage these areas to stabilize. The light inversion element is incredibly beneficial to calm the nervous system which can relieve anxiety, stress, fatigue, and many other unpleasant emotional states as fresh-blood flow circulates through the body and into the brain.”

“This pose not only is excellent for your physical being but is incredibly effective in the interconnectedness of the mind and body. I always feel the narrative of my mind slow to a steadier pace as soon as I begin this pose. The longer I hold, the more my body releases and my mind finds clarity.”

17. Bound Angle Pose (Baddha Konasana)

One of the most accessible poses to increase flexibility in the hips is Bound Angle pose. Kelly Clifton Turner believes “this pose is great for beginners, as it is a pose that can easily be modified to fit the individual. This pose has many benefits – a few include stretching the inner thighs and knees, as well as enhancing overall circulation in the body.” If the pose is too deep of a stretch, you can modify by sitting up on a cushion or blankets, sliding the feet further forward, or by placing yoga blocks under the knees.

Turner also suggests that beginners practice this pose in the reclined variation. “Angle and support the torso up on a couple of blocks or (better yet!) a bolster. Draw the soles of the feet together and allow the knees to drape wide. If there is any strain on the inner groin, slide blocks, blankets or bolsters under the knees to give the body permission to truly relax. Rest one hand on the belly, connecting with the rise and fall of breath, and the other hand at the heart, feeling the steady drumming of the amazing organ that supports you every second of every day. Stay for five to ten minutes (or longer!) and connect with a sense of gratitude and love towards yourself.”

18. Fish Pose (Matsyasana)

If you have poor posture and tend to hunch forward then you will love how Fish pose opens up your chest and helps to realign your spine. This back-bending pose is an excellent gentle, and soothing stretch for beginners. Lucile Hernandez Rodriguez tells us that “this pose will greatly help you in beginning your yoga practice as it will bring you the shoulder mobility you need for other poses such as downward-facing dog.”

“Most beginners have tight shoulders from being hunched at a computer all day. If that’s your case, fish pose will bring a feeling of release and gently open your body. You will find a backbend in your thoracic spine and stretch the whole front of the body, including your throat, chest, and abs. I personally love this pose as it allows me to totally let go of tensions after working on my computer. I also love the soothing and energizing feeling that comes with slowly opening your chest while breathing deeply.”

“To make this pose easy, try rolling a blanket, placing it under your shoulder blades and laying down on it. If this is too much for you, unroll the blanket a bit until it is fully comfortable! Make sure there is no tension in your shoulders or neck and that you feel at ease breathing in this position.”

Practice Tips for Yoga Beginners

Even though this list of poses for beginners is small, it is still a lot of information to digest at once. It is highly recommend that you begin to explore these poses slowly and carefully to not be overwhelmed. The How to Start a Yoga Practice guide will give you the four basic steps to starting a yoga practice. The General Practice Guidelines covers all of the dos and don’ts to starting a successful yoga practice. Once you have looked through these two articles, continue reading the Yoga for Beginner’s section for further tips and advice.

How Yoga Is Helping Me Manage My Sciatica

By Fiona Tapp for Prevention.

Sciatica is a pain in the butt, literally. Since having a baby, I feel fire dancing down my back, into my backside, and tingling in my legs whenever I turn over just a little too quickly. Far from a temporary inconvenience, this condition seems intent on sticking around: My “baby” is now almost 4 years old, and he recently had to play nurse when I suffered an attack that left me on the floor unable to move. Luckily, he managed to follow my instructions to grab the remote control, a pillow, blanket, and the phone to call Daddy.

Now that I’ve been initiated into the painful club of sciatica sufferers, I’ve become much more aware of just how prevalent it is: An estimated 40% of people will have sciatica pain at some point in their lives. 

What is Sciatica?

The sciatic nerve is the longest single nerve in the human body, and it runs all the way from the lower back down the back of each leg, says Dr Loren Fishman. While anyone can develop pain along this nerve for a variety of reasons (such as a slipped disc), it’s fairly common among women during and after pregnancy.

For starters, weight gain can place pressure on the fragile nerves of the spine, says orthopedic surgeon Dr. Alfred Bonati. The sciatic nerve can also become irritated during childbirth itself, especially during long labors, when women experience so-called back labor, or when the baby is in an abnormal position (such as breech), according to research from the European Spine Journal. After childbirth, many moms are left with weakened back and abdominal muscles, which can lead to more pain. Poor posture and hunching—pretty common among those who are breastfeeding and cradling their baby—makes the problem even worse.

My son’s labour lasted a grueling 48 hours and involved long stretches of excruciating back labor. Once I was home, I didn’t pay too much attention to any aches and pains that I was experiencing. I was too busy taking care of my baby; plus, the pain was intermittent: I could go weeks without any symptoms, and then one day I’d bend down too quickly or move a certain way and be in agony. Sometimes I’d even end up “frozen” and unable to move without help, which was pretty frightening.

Shortly after my son’s first birthday, it finally dawned on me that maybe this wasn’t normal.

Is Yoga the Best Rx?

I started to research treatment options and found that the latest guidelines show pain meds aren’t best for most patients with low-back pain—or at least that they shouldn’t be relied upon as a first-line defense. Heat, massage, stretching, and yoga seem to do the trick for many people. Meanwhile, a study found that the practice can alleviate sciatic pain, at least in the short-term.

I’ve always loved yoga and had followed a prenatal routine throughout my pregnancy, but since my son’s birth I had fallen out of the habit. I decided to try a few asanas and realized that any moves that helped me stretch my back or lie flat on the floor provided immediate relief.

After practicing on my own for a while, I decided it was time to talk to an expert. Tiffany Cruikshank, who works closely with doctors to create pain management plans involving yoga, confirmed that the practice can definitely ease lower back pain and help prevent flare-ups. To that end, she suggests the following moves, which release the tense muscles along the back and down the legs. Just be careful not to push yourself too far. “Find a comfortable position and soften into the pose,” says Cruikshank. “If you experience any nerve pain, back out of the pose until the pain is gone.”

Ardha Matsyendrāsana (Seated Twist)

Sit on the ground cross-legged. Keep your left leg on the floor and cross your right leg over it, placing your right foot flat on the floor. Place your right hand to the floor behind you and use your left arm to hold onto your right leg. Lengthen your spine to sit up straight. As you exhale slowly, begin to twist to your right until you feel a gentle stretch. Take a few deep breaths and hold for at least 30 seconds, or up to 2 minutes if it feels good. Release slowly and repeat on the other side.

Bird Dog

Start in a tabletop position with a flat back. Focus on drawing in your abdomen to support your back. Keep your spine and legs straight while you slowly extend one leg back behind you and the opposite arm forward. Elongate your body from heel to head as you take 3-5 deep breaths. Repeat on the other side.

Supta Padangusthasana (Supine Hamstring Pose)

Lie on your back, bend your right knee into your chest, and place a strap around the sole of your right foot. Slowly extend your leg until you feel a gentle stretch through the back of the leg while keeping your lower back relaxed. Hold for 30-60 seconds and repeat on the other side.

Since I returned to a regular yoga practice, my sciatica has gotten much better. Of course, yoga isn’t a cure-all: I also make an effort to walk a lot, get quality sleep and I use a posture trainer for 15 minutes every day. But now whenever I feel that familiar pain, I usually realize that it’s been a few days or even a week since I’ve done yoga, and I make an extra effort to get back to the mat. Yes, the stretching aspect is key, but yoga also forces me to slow down, breathe, and focus on my needs—which is all pretty important.

Understanding How Physical Changes That Accumulate With Age Impact The Practice Needs Of Older Students

By Ashley Bouzis for Yoga Medicine®.

“A human being would certainly not grow to be 70 or 80 years old if this longevity had no meaning for the species to which he belongs. The afternoon of human life must also have a significance of its own and cannot be merely a pitiful appendage to life’s morning.” — Carl Jung

According to the US Census Bureau, the number of Americans ages 65 and older is projected to nearly double from 52 million in 2018 to 95 million by 2060. With this, the 65-and-older age group’s share of the total population will rise from 16% to 23%. 1 We can anticipate this shift in population demographics will be reflected on the mats of yoga students. In fact, the 2016 Yoga in America Study reports that nearly 40% of practicing yogis are over the age of 50. 2 These older individuals are more likely to have previous injuries, mobility restrictions and alterations in neuromuscular function than their younger counterparts.

Following, we explore some of the changes that occur in the pelvis, spine, joint capsule and neurologic function throughout the lifespan and I outline some tips and tricks to keep in mind when working with older yogis to assist in creating a safe practice that honors their needs.

The Pelvis and Lumbar Spine

In older populations, we often find shortened, high-tone hip flexors, particularly in individuals who spend a significant amount of time in a hip-flexed seated position. With this hypertonicity and shortening of hip flexors, the pelvis is pulled into a tipped forward position and the lumbar portion of the spine assumes a hyperlordotic (swayback) curve. This orientation of the pelvis allows a fair amount of mobility but is not structurally ideal as it increases risk of disc rupture and pinching of neurovascular bundles as they exit the spinal column. Additionally, it may contribute to low back pain as the surrounding musculature attempts to bring the spine into alignment.

A posteriorly tilted pelvis (which can also be brought on by prolonged sitting) is generally accompanied by gluteal muscle clenching and/or abdominal gripping; compensatory changes that take over as the body attempts to accommodate for the center of gravity shift caused by the posterior tilt. To get a sense of what this feels like, stand and squeeze your glutes together as if trying to bring your pubic bone forward and up. At the same time, turn on your abdominals as though trying to bring your anterior lower ribs in contact with your anterior superior iliac spine (ASIS). Now try to move around. You’re pretty locked in, right? Imagine trying to do a sun salutation from that position! Not only does this position limit mobility, it can also result in pinching or compression of the sacroiliac (SI) joints; another known contributor to low back pain.

So, if we don’t want our pelvis tipping too far anteriorly or too far posteriorly, where on earth is it supposed to be? I’m guessing you’ve heard of the “neutral pelvis,” right? Well, that’s what we are aiming for, but with a few tweaks!

When finding “neutral pelvis,” many of us have been taught to cue students to direct the ASIS toward the front of the room or bring the pubic bone slightly up. The challenge with this cue is it doesn’t accommodate for the fact that each person has an individually specific pelvic angle that allows their spine and pelvis to align in a way that maximizes stability and shock absorption. For this reason, the cueing described above will create the correct position for some students, but place others outside of the most “functional” range of their pelvis.

I find the most accessible way to find a “functional” rather than “neutral” pelvis is to instruct students to bend their knees slightly and gently bounce up and down, taking note of where the pelvis naturally wants to lie. The slight bouncing relaxes the tightened hip and gluteal musculature helping to allow the pelvis to fall into its functional position. The sensation we want students to find is that which allows an equal balance of support on all sides of the low spine without feeling excessively elongated or pinched in any one area. Once students feel they’ve found this position, invite them to slowly back out of the knee bend towards a straight leg position while maintaining the pelvic angle. As they straighten their legs, they should find their core naturally activates. Many students will find their center of gravity shifts slightly backward so the hips line up more directly over the ankles – the start of a great Tadasana (Mountain Pose). While assuming this position, I find it useful to remind students to not allow the glutes to take over and to only straighten the legs as far as they are able without letting the pelvis fall out of the established functional position. Keeping a micro-bend at the knee often helps with this.

The Mid Spine

Next, let’s turn our eyes to structures further above the pelvis, notably the changes that accumulate in the mid and upper back as we age.

Over the course of a lifetime, the human body experiences an overall reduction in bone mass. In the spine, this results in a decline of mechanical strength and collapse of the anterior and central portions of the vertebra. As these changes accumulate, one may experience pain, loss of height, and loss of the normal curve of the thoracic spine resulting in a hump or kyphosis. These changes occur alongside weakening of the structural integrity of intervertebral discs, which provide cushioning between the vertebral bodies. When the structural integrity of the disc is compromised, disk rupture and herniation become more likely. Rupture or herniation of disc structures may compress motor and sensory nerves as they enter/exit the spinal canal. If structures are compressed enough, radicular (shooting) pain or decreased muscle strength may develop.

Because much of the reduction in bone mass (mechanical support) is beyond our control, we need to look to other ways of supporting the spine as we age. The primary muscles of support for the spine are those of the deep back and core. Assisting students in building awareness and activation of these muscle groups helps protect the integrity of the spine through muscular support as mechanical support declines.

In addition to standard reclined core activation exercises, moving the body through leaning exercises while standing can help students develop the muscle awareness necessary to keep the core active as they move. To do this, I start with functional pelvic position as above and then ask students to gently and slowly lean forward, to the side, and slightly back while being mindful to keep the core active and the glutes relaxed. Many students will find a tendency, particularly as they lean backward, to almost “crunch” which brings the pelvis and chest forward in an effort to offset the center of gravity. The goal is to avoid these types of compensatory movements by only leaning as far as one can while maintaining the normal curvatures of the spine.

Bhujangasana (cobra) in a chair can also be used to activate and strengthen the upper back muscles. From a seated position, invite students to place their hands behind their head or use a strap if bringing the hands together is uncomfortable. Keeping the pelvis and neck in neutral range, ask students to look upwards on the wall towards the ceiling while maintaining the focus on moving from the thoracic spine as opposed to the lumbar or cervical spine. To incorporate more opening of the chest, students may place their hands behind them on the chair or out to the side in a wing-like position. If adopting these variations, it is important not to arch the neck too far backward. Keeping a subtle tuck of the chin can help offset this tendency.

Changes to Range of Motion

Studies show that our bodies experience a decrease in range of motion of multiple joints as we age. 3 While the exact mechanism of this decline remains poorly understood, the leading theory is that with age, the connective tissues responsible for joint stability (tendons, ligaments, and the fibrous joint capsule) undergo naturally occurring declines in compliance leading to restriction of mobility. In addition to the loss of tissue compliance, decreased range of motion (ROM) is exacerbated by reductions in bone mass, painful arthritic changes, alterations in muscle strength and injuries that accumulate over a lifetime.

While impaired range of motion in any joint will contribute to pain and functional impairment, mobility of the hip and ankle joints warrant specific attention as they contribute most significantly to back pain, gait (walking) abnormalities, and risk of falling.

Kapotasana (Pigeon) and Virabhadrasana I (Warrior I) are both wonderful poses to address mobility of the hip. As floor work may not be accessible for all elderly students, both poses can easily be adapted to a chair.

In seated Warrior I, students are asked to sit sideways in a chair with the seat supporting one thigh and the same side buttock. The leg to the outer part of the chair is then slid around to the back and the leg straightened as much as is comfortable. Because the chair supports the weight in this pose, more focus is directed to the stretch of the hip flexor as opposed to building strength in the lower limbs. If one wants to play with building strength from this position, simply engage the muscles required to lift the thigh away from the chair.

For seated Pigeon, one ankle is placed on the opposite knee to achieve lengthening of the external rotators of the hip. If more intensity is desired, students may lean forward, taking note to lean from the pelvis and to avoid rounding the lower back.

Working on ankle mobility is also easily accessible from the seated position. Controlled articular rotation exercises (CARs) offer a way to increase both range of motion and strength of the muscles responsible for ankle dorsiflexion (the motion that clears the foot over the ground during walking) and plantar flexion (necessary for the push off phase of walking).

To perform an ankle CAR from a seated position, ask students to extend one leg until the back of the heel rests on the ground. From this position, slowly move the foot into maximum plantar flexion, then slowly rotate the foot in a circle reaching to the end of the available range in all planes. The benefit of this type of movement is that it moves the joint through its “usable” range of motion under muscular and neurological control which enhances length, strength and control as opposed to utilizing passive stretching which only lengthens tissues. CARs can be used for nearly every joint in the body. There are a number of online resources illustrating how to apply CARs movement to various joints.

Proprioception

Another known change with age is a decline in a sensory function known as proprioception (the joint-position sense we use for balance and knowing where our body parts are in space). Declines in this sense contribute significantly to fall risk. While many of the treatments proven to improve proprioception are outside of the scope of a yoga practice, “active movement training with visual input” is a technique that can be applied on the mat and has been found to be one of the most effective ways to train and improve proprioception. 4

To engage in active movement training, students are asked to identify a target on the ground or wall and to use their visual input to guide a given body part to touch the target. For example, you might ask students to start from a standing position with arms at their sides and identify a small, distinct area on the floor, maybe a crack or an area of unevenness in the texture. Once the area is identified, you invite them to reach an identified body part (i.e. the heel) to touch the area and then bring the heel back to its previous position. For students with visual impairments, the instructor can provide verbal feedback to assist in reaching the target. When utilizing targets on the floor, it is best to start with flat targets (i.e. a mark or piece of tape on the floor) and utilize elevated targets (i.e. a block) only if the student has adequate strength and balance.

The Mind and Soul

In late adulthood and beyond, individuals often define their lives by what they are contributing to the world and what legacy they will leave behind. Psychoanalyst Erik Erikson referred to the final stages of life as characterized by generativity versus stagnation and ego integrity versus despair.

During the mid-stages of late life (approximately age 40-65), individuals may find themselves reflecting on their sense of “needed-ness.” Relevant questions may include: Am I contributing enough? To whom do I matter? How can I improve the state of the world? If one does not perceive that they will leave a legacy in line with their values, they may feel a loss of inertia and purpose. Encouragement to reflect on the legacy one would like to leave and ponder ways of building that legacy can be welcome class themes for students at this stage.

Beyond the age of 65, individuals often begin to contemplate the mark they will leave on the world at the time of their death. Relevant questions at this time include: Did I do enough? Have I acted in ways that reflect my values? What regrets do I have? At this stage, it is quite normal to experience a sense of regret and despair over prior actions. In order to peacefully conclude this, it is helpful for individuals to accept that there are aspects of their life they find regrettable and also aspects they find pride and peace in. Acceptance of this dialectic may help individuals develop the “sense of coherence and wholeness” 5 that comes from the “acceptance of one’s one and only life cycle as something that had to be.” 6 At this stage, students may benefit from themes surrounding the acceptance and tolerance of emotions such as regret, an opportunity to reflect on what parts of their legacy bring them a sense of satisfaction and encouragement to resolve any relationship rifts they feel able to.

Conclusion

As teachers, we are given the opportunity to work with students of all demographics, including those whose bodies have seen them through the morning of life, into the afternoon and beyond. Understanding the changes that occur as the body and mind move through these stages allows us to create a safe, effective and respectful practice for yogis of advanced age.

REFERENCES
1) Projected Age Groups and Sex Composition of the Population: Main Projections Series for the United States, 2017-2060. U.S. Census Bureau, Population Division: Washington, DC.
2) Ipsos. (2016). “2016 Yoga In America Study.” Oct 7-16, 2015. Retrieved from: https://www.yogaalliance.org/Portals/0/2016%20Yoga%20in%20America%20Study%20RESULTS.pdf
3) Stathokostas, L., McDonald, M. W., Little, R. and Paterson, D.H. (2013). Flexibility of older adults aged 55–86 years and the influence of physical activity. Journal of Aging Research, 2013, 743843.
4) Aman, J.E., Elangovan, N., Yeh, I., Konczak, J. (2014). The Effectiveness of proprioceptive training for improving motor function: a systematic review. Frontiers In Human Neuroscience, 8(1075).
5) Erikson, E. (1982). The life cycle completed. New York, NY, US: W W Norton & Co.
6) Erikson, E. H. (1950). Childhood and society. New York, NY, US: W W Norton & Co.

Self Myofascial Release Practices for Better Backbends

Senior Yoga Medicine® teacher Rachel Land shares a simple sequence that can unlock common areas of resistance and make your backbends feel better.

A Sequence to Make Backbends Feel Better

Rectus Femoris

Tensor Fascia Latae

Iliacus

Psoas

How Does Supine Position Affect Health?

Dr. Monisha Bhanote, who is currently pursuing her 500-hour certification with Yoga Medicine®, discusses the affects and risks the supine position can have on your sleeping patterns and general health.

By Sara Lindberg for healthline.

The term “supine position” is one you may come across when looking up or discussing various exercise movements or sleep positions. While it may sound complicated, supine simply means “lying on the back or with the face upward,” like when you lie in bed on your back and look up at the ceiling.

Supine position in exercise practices

It’s common to be in the supine position when doing exercises for yoga and Pilates or various breathing and relaxation exercises.

Dr. Monisha Bhanote, MD, FASCP, FCAP, triple board-certified physician and Yoga Medicine® instructor, says there are a number of yoga poses that may include the supine position, including but not limited to:

  • Bridge Pose (Setu Bandha Sarvangasana)
  • Reclined Twist (Supta Matsyendrasana)
  • Fish Pose
  • Reclined Butterfly (Supta Baddha Konasana)
  • Reclined Pigeon
  • Happy Baby
  • Supine Extended Mountain Pose (Supta Utthita Tadasana)
  • Savasana

When practicing these positions, you can always modify by using blocks, bolsters, or blankets for comfort.

Additionally, many Pilates classes do exercises in the supine position. The starting pose in many Pilates floor exercises involves finding a neutral spine. When your body is in this position, your core and hips need to be strong and steady.

Finding neutral spine

  1. To find neutral spine, start by lying on your back in the supine position. With your knees bent, keep your feet flat on the floor.
  2. Take a deep breath in and let your body relax or press into the floor.
  3. As you exhale, use your abs to press your lower spine into the floor.
  4. Inhale to release. When your back raises off the floor, you will feel a gap or natural curve in your lower back. This is the neutral spine position.

Supine position and sleep

How you sleep can exacerbate existing health issues as well as increase neck and back pain. If you have no specific health issues related to sleep, then sleeping in the supine position shouldn’t be a problem. But there are some health and medical issues that can get worse if you sleep on your back.

Here are some of the more common issues associated with sleeping in the supine position.

Obstructive sleep apnea

According to a 2014 study, more than half of all people with obstructive sleep apnea (OSA) are classified as supine-related OSA. That’s because for people with OSA being in the supine position may lead to sleep-related breathing problems as their ability to increase lung volume and expand the chest may be compromised.

“This occurs as the diaphragm and abdominal organs may compress the adjacent lung as one shifts from standing to supine. Due to difficulty with sleep, this decreases the overall quality,” explains Bhanote.

Pregnancy

After about 24 weeks of pregnancy, Bhanote says sleeping in the supine position may cause some dizziness with breathing difficulty. You can get relief from this by lying on your left side or sitting in an upright position.

Gastroesophageal reflux disease (GERD)

GERD affects up to 20 percent of the American population. With this disorder, stomach acid flows back into the esophagus.

The supine sleeping position is not recommended for people with reflux, as the supine position allows for more acid to travel up the esophagus and remain there for longer times. This results in heartburn, and even coughing or choking, while trying to sleep.

Longstanding GERD can eventually lead to more severe conditions including bleeding ulcers and Barrett’s esophagus. Keeping the head of your bed elevated may relieve some discomfort.

Risks of the supine position

Many of the risks associated with being in the supine position are also associated with other conditions.

During pregnancy

If you’re pregnant and spend a lot of time lying on your back, there is a risk that the uterus can compress the inferior vena cava, a large vein that carries de-oxygenated blood from the lower body to the heart. If this happens during pregnancy, it can result in hypotension for the person who is pregnant and reduced blood flow to the fetus.

Being in the supine position while exercising during pregnancy is another concern. According to the American College of Obstetricians and Gynecologists, you should avoid being on your back as much as possible. When doing Pilates or yoga moves, modify the poses to accommodate less time on your back.

With a heart condition

Additionally, Dr. Jessalynn Adam, MD, a board-certified physician specializing in primary care sports medicine with Orthopedics and Joint Replacement at Mercy, says that individuals with congestive heart failure can have trouble breathing in the supine position, and therefore, should not lie flat.

With acid reflux or GERD

Just like GERD can affect your sleep, it can also trigger symptoms after you eat. “Lying flat after a large meal can contribute to acid reflux as it allows the stomach contents to reflux into the esophagus,” explains Adam.

If you have GERD, she recommends eating smaller meals and remain sitting upright for at least 30 minutes after eating. If you are planning on sleeping in the supine position, Adam suggests eating no closer than two hours before bed to avoid reflux when lying supine.

The takeaway

The supine position is one of the most common ways to rest and sleep. It’s also a popular position when performing certain exercises during a yoga or Pilates class.

If you have a health condition that worsens when in this position, it’s best to avoid it or minimize the amount of time you spend on your back.

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.
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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.

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