The Pragmatic Yogi

The Positive Side of Pain

noreply@blogger.com (Lisa B. Minn) — Thu, 26 Jul 2012 10:00:00 +0000

Not long ago I was taking prenatal yoga class and it occurred to me that I just might actually enjoy pain. It was one of those days when my mind was spinning a mile a minute. I was trying to study for my statistics class earlier in the day and I had so much trouble concentrating and staying focused. When I got to yoga my mind was wandering, noticing all the external goings on around me. Then we got to the ‘practice being in pain’ part of the class. In this case that meant holding arms up and out to the sides until they burn and feel like they weigh 100 pounds each. I found myself dropping so deeply into my focus on breathing that I practically fell asleep! That 2 or 3 minutes was the most grounded I felt all day. My monkey mind returned as soon as we moved on to less challenging poses. Even the restorative Queen’s pose wasn’t as relaxing to me as the ‘hold your arms up until they feel like they’re going to fall off’ pose.

I also really like doing the Thai Goddess pose, another way to practice breathing through pain. I don’t know that this makes me a masochist but it does make me realize that there are benefits to embracing pain. There is probably a similar psychological mechanism at play when participating in athletic events that hurt. I don’t particularly like running but I do like running races. I like that feeling when things get uncomfortable and I have to just hunker down and find a rhythm in order to keep going. I do like mountain biking and xc skiing and I love the challenge of climbing hills. The lungs and thighs may burn but the mind is focused and breath is all there is. The after effects of these kind of athletic challenges is pretty great too. There is a high that I’m sure is some kind of endorphin-based warm and fuzzy feeling.

I will soon become acquainted with what is said to be one of the most painful experiences possible. I can’t say with confidence that I will enjoy the pain of childbirth but I’m beginning to think that it just might be an experience that comes with benefits (aside from a brand new baby!). Two minutes in a painful pose is a lot different from 12 hours of sustained challenge but I expect the resulting high will also be a lot more amazing than just cresting a hill or crossing a finish line. Hopefully I will find out this week...

Asana Analysis: Thai Goddess

noreply@blogger.com (Lisa B. Minn) — Fri, 20 Jul 2012 22:47:00 +0000

This pose is mostly taught in prenatal yoga classes as a means to teach breathing and relaxation in the midst of discomfort. But it also has value for many non-pregnant men and women and I often teach it in my regular yoga classes and to certain physical therapy patients. There are two main benefits of this pose. The first is mental, when used as method for teaching relaxation. The second is physical as it is a great pose for improving flexibility and range of motion (ROM) of the feet.

Muscles Stretched: Flexor digitorum longus, flexor hallicus longus, intrinsic muscles including flexor digitorum brevis, flexor hallicus brevis, plantar interossei. It can also stretch the plantar fascia, Achilles tendon and other tendons and ligaments of the foot.

Points of Body Awareness:
*Be sure that the soles of the feet are vertical so that the weight is distributed evenly across the balls of the feet.
*Are you sitting upright or leaning forward in an effort to get away from the discomfort?
*Is the spine in neutral alignment: shoulders directly over hips, ears over shoulders?
*Are the buttock muscles gripping? Are the shoulders elevated? Is there tension in your brow? Be sure to let go of all unnecessary muscle tension.
*Drop the chin slightly to calm the nervous system and decrease the flight-or-fight instinct.
*Take long, slow breaths. Breath down through your toes. Exhale through the nose in a smooth and calm manner.
*Try to hold the pose for at least 30 seconds. Repeat 2-3 times. For women preparing for labor, try to hold for up to two minutes which is the maximum length of a contraction.

To Modify:
*If unable to sit upright on the heels, try placing a bolster or folded blanket between the hips and heels.
*For a less intense stretch of the feet, start in quadraped (hands and knees) with the toes curled under. Then, keeping the hands on the floor, sit back onto the heels. Gradually shift more weight from the hands into the feet.

PT Notes:
Thai Goddess pose is contraindicated for those with acute injuries of foot, ankle or knee. But modified versions may be helpful for those with chronic or post-acute problems associated with decreased ROM or tightness of the plantar fascia. I have found that Thai Goddess is often a great pose for runners with limited extension ROM of 1st MTP. Runners need at least 70 degrees for good gait mechanics and when they lack that amount, they often end up with Achilles tendonitis, knee pain or even lower back pain.

Yoga for Runners

noreply@blogger.com (Lisa B. Minn) — Tue, 26 Jun 2012 17:41:00 +0000

My last post was about how to prevent running injuries. Yoga is definitely a useful tool for incorporating prevention strategies. Yoga obviously can be a form of stretching but it can also be an effective way to strengthen the body. By practicing breathing and meditation, runners may find that they are more connected to their bodies and may recognize tweaks early on and adjust their training programs before outright injury can set in. Vinyasa (or flow) yoga can be a good cross training activity and restorative yoga is the perfect activity for rest days. Scheduling rest days into a training schedule is an essential part of injury prevention. A restorative yoga practice is extremely beneficial for runners, especially after long, hard runs to facilitate the body’s need for rebuilding and rejuvenation.

Here are some common running-related injuries and yoga poses that may be helpful in preventing those injuries:

Iliotibial Band (ITB) Syndrome - This is a very common injury for marathon runners. It can be associated with tightness of the ITB, over-pronation of the foot and weakness of hip abductor muscles.

Standing Forward Fold/Utanasana variation with crossed legs - This pose will stretch the ITB along with hamstrings.

Tree Pose/Vrkasana - When done well, this pose is excellent for increasing strength and awareness of the hip abductors as well as the foot and ankle muscles.

Piriformis Syndrome - This often occurs in runners with significant tightness of the hip and low back muscles, over-pronation of the foot or weakness of the gluteals.

All of the following are good stretches for the hip muscles including the piriformis, gluteals and small external rotators:

Sage Twist/Marichasana

Pigeon/Eka Pada Rajakapotasana

Cow’s Face/Gomukhasana

Bridge/Setu Bhandasana variation with single leg. This is a good pose for strengthening the gluteals and oblique muscles of the trunk.

Patellofemoral Pain Syndrome (PFPS) - This is a very common injury among runners and may be related to quadricep weakness (especially the vastus medialis), weakness of the hip abductors and external rotators or tightness of the ITB, quadriceps and/or hamstrings.

Chair/Utkatasana variation with strap for isometric abduction and external rotation - This pose is excellent for strengthening the quadriceps and gluteals as well as improving awareness of biomechanics and alignment of the knees, hips and ankles.

Triangle/Trikonasana - strengthens the quadriceps and intrinsic foot muscles, stretches the hamstrings.

Half moon/Ardha Chandrasana - This pose offers all the benefits of triangle plus even more strengthening of the hip abductors and external rotators.

Medial Tibial Stress Syndrome/Shin Splints and Plantar Fascitis - These conditions are often associated with tightness of the gastrocnemius muscle and Achilles tendon, over-pronation or high/rigid arches.

Down Dog/Adho Mukha Svanasana - This classic pose is great for stretching the gastrocnemius and Achilles tendons. A dynamic version where you pedal the feet by dropping one heel at a time is particularly nice for working the ankles and calves.

Standing Hand-BigToe Pose/Utthita Hasta Padangusthasana - This is a challenging balance pose that requires good flexibility of the calves and hamstrings as well as much action in the muscles of the foot and ankle. Be sure to do this pose with a neutral foot position (outer heel in line with pinky toe, weight equally distributed, arch slightly lifted). Use a strap if the hamstrings are tight.

Thai Goddess Pose- This pose involves sitting on the heels with the toes curled under. It is an intense stretch of the plantar fascia and also of the big toe. It may not be appropriate for those with acute plantar fascitis but it is an excellent stretch for those with chronic foot or leg pain who lack range of motion in the first metatarsalphalangeal joint. Runners need at least 70 degrees of extension in order to have good gait mechanics. I have seen many runners with various injuries who improved dramatically as they gain motion in their big toes. Thai Goddess is usually taught in prenatal yoga classes as a practice in relaxing during intense sensations (i.e. labor contrations) but runners can also benefit from this mental practice of relaxing in the midst of discomfort.

See Runner'sWorld.com for a nice sequence of restorative stretches for runners.
Image from Zen Girl in the City

Run Healthy, Run Well

noreply@blogger.com (Lisa B. Minn) — Thu, 24 May 2012 10:30:00 +0000

My husband recently began training for his first 10K run and I’m sure that he is not alone in gearing up for summer runs and races. Many people get motivated to start running when the weather warms up and the days get longer. Running can be an ideal way to exercise, especially since all it requires is a good pair of shoes. The benefits of running include weight management, improved cardiovascular health, stress relief and stronger bones. According to Erin Hughes, MSPT, there are 30 million runners in the U.S. however 50% of those runners will have some kind of running-related injury each year. Not surprisingly, new runners have the highest rate of injury and most of their injuries occurred in the lower leg. Marathon runners have a lower rate of injury overall but when they do get injured, the injuries are most frequently involve the knees. With such a high incidence of injury one might consider running a ‘dangerous’ sport. However for a healthy person the benefits likely outweigh the risks. Luckily there are several common sense strategies one can use to prevent injuries.

Always wear good, supportive shoes. Different feet have different needs so make sure to get the right shoe. A person with stiff feet and rigid arches needs more cushioning. A person with floppy feet who over-pronates (some pronation is normal and essential for good gait mechanics) needs more arch support. And everyone should replace their shoes after running 300 - 500 miles or every 6 months.

Training regimens should progress slowly. It is estimated that more than half of all running related injuries are due to training too hard and fast. Running more than 40 miles per week is associated with a higher incidence of injury. Only increase mileage by 10% or less each week. And be prudent with adding increased intensity, in the form of speed drills and/or hill running, to your training program.

New runners or those recovering from an injury would be wise to start with a run/walk program. Start with a brisk walk to warm up. Then jog for 2 -10 minutes, depending on level of conditioning or the sensitivity of the previously injured body part. Walk for 1 minute then do another interval of jogging or running. Continue this pattern for 20-30 minutes the first time out. Increase the duration of intervals and/or total length of workout by no more than 10% per week.

Make sure to schedule cross training and rest days each week. The number one predictor of injury is the presence of a previous injury. Many running injuries require at least 4 weeks of rest to fully recover, much longer for injuries such as stress fractures. Cross training and rest will help to prevent that first injury and adequate rest after a minor injury will help to keep it at bay. Good options for cross training include swimming, water running, cycling, cross country skiing, hiking and walking.

Do not neglect stretching and strengthening of the legs and torso. Over the years, I have heard many runners say that they only do upper body strengthening because they believe that the act of running is enough strengthening for the legs. The problem with that thinking is that only some muscle groups are strengthened and only in a specific way. The vast majority of runners who end up in physical therapy have significant weakness of the lateral muscles of the hip, especially the gluteus medius. This weakness contributes to poor gait mechanics and is associated with injuries of the hip, knee and back. Make sure to stretch after every run and do some strengthening exercises 2-3 times per week.

Yoga is certainly a useful tool for incorporating some of these prevention strategies. Next time I will share some details on why yoga is good for runners and how it can help to prevent injuries.

The information in this post is based on Erin Hughes' continuing education course, "Running Injuries" which will soon be available to health and fitness professionals at DSW Fitness.

Return to Yoga

noreply@blogger.com (Lisa B. Minn) — Thu, 26 Apr 2012 11:00:00 +0000

I have a new article targeted toward practicing PTs on the website, PutMeBackTogether.com called When is it Safe to Return to Yoga Class? Here's a condensed version:

There are more than 15 million people in America who practice yoga according to a 2008 Yoga Journal study. It’s likely that that number is even higher now, four years later. It’s inevitable that a physical therapist working in an outpatient clinic will face the question, “When can I go back to yoga class?” or “Is taking yoga a good idea for me?”

Earlier this year, the NYT Magazine caused quite a stir when they published an article entitled “How Yoga Can Wreck Your Body”. Given the popular hysteria that resulted from this article, PTs may feel more obliged than ever to make sure our patients are not putting themselves at risk by doing yoga. Here are some basic criteria you can use to help you guide your patient to a safe return to a community-based yoga class.

Always recommend that your patient start with a gentle or beginner level class even if they are not a beginner.
Make sure your patient has full and painless range of motion in their affected joint.
There is a psychological element of participating in a class that stokes a natural tendency to compete with other students or to want to perform well for the teacher.
Forge a relationship with one or more teachers in your community who you can trust.
Your patient should demonstrate independence with awareness of proper alignment and neuromuscular control of the involved body part.

Consult The Pragmatic Yogi!

Contrary to the NYT Magazine’s article, yoga will not wreck the body when done in a mindful, conscientious and non-competitive manner. The collaboration of health care professionals and yoga instructors can further the chance that yoga will be a healthy, healing experience rather than an ego-driven, contortionist sport that is indeed risky business.

Asana Analysis: Chatarunga Dandasana / Four Limb Staff Pose

noreply@blogger.com (Lisa B. Minn) — Thu, 22 Mar 2012 10:46:00 +0000

This pose is one that is often taken for granted. In sun salutations, chaturanga (I often refer to it as ‘hover’ pose) is usually a brief transition between plank and up-dog. Most people don’t spend a lot of time holding this pose so they often don’t spend much time thinking about it either. But chaturanga has the potential to injure the shoulder if not done correctly so it is incredibly important to master for anyone who practices vinyasa or flow yoga.

Muscles Strengthened: Triceps, pectorals, serratus anterior, abdominals, gluteals, quadriceps, errector spinae (cervical spine)

Points of Body Awareness:
*Be sure that your upper arms are drawing in close to your ribs with your elbows pointing back toward your heels, instead of winging out to the sides.
*Are the shoulders collapsing forward? This is one of the most important aspects of alignment to be aware of in this pose. People often drop their shoulders forward, which places a lot of stress on the passive restraints of the anterior shoulder (ligaments and tendons).
*The upper arm bone (humerus) should be parallel to the floor, with the elbow and humeral head in alignment.
*Feel the muscles around the shoulder blades and across the center of the back support the alignment of the shoulders. The tops of the shoulders and neck muscles should feel relatively relaxed and lengthened.
*The spine is in neutral alignment, with a small inward curve of the lumbar spine, a small outward curve in the thoracic spine and and small inward curve of the neck.
*Be sure that you are not letting the pelvis drop too low and just sagging in the pose. Also be aware if you are compensating by holding the pelvis up too high, above the level of the shoulders and knees.
*The belly button draws in toward the spine, the inner thighs engage and the heels reach back. These actions will all help to support neutral spine and to reduce excessive strain in the shoulders and neck.
*Fix your gaze on a spot on the floor that is 6-10 inches in front of you.
*Be sure that you can maintain a deep, slow and steady breath. Hold for 5-10 breath cycles.

To Modify:
This pose is quite difficult to perform correctly however, like Plank pose, it is easy to vary the amount of weight being held by the arms and to progress step-wise. For minimal weight-bearing, begin at a wall. You can then progress to holding the pose at a table top or seat of a chair, then on the floor with the knees down.

Another option for practicing this pose is to loop a strap around the upper arms. The strap should be just wide enough so that when your elbows are bend and chest lowered, the strap holds the upper arms in close to the ribs. You will also be able to rest the chest across the strap. This results in a somewhat passive version of chaturanga but it is useful for training the body to recognize good alignment with the elbows in and shoulders back. It is also a good place to practice fully engaging the abdominal and leg muscles and to help train the breath and gaze.

To Challenge:
Chaturanga is an advanced pose. To challenge this pose really means to refine it so that the alignment becomes automatic and that one is able to move in and out of the pose with good control. An advanced practice also requires improved endurance of the posture so that form doesn’t degrade with fatigue which is likely to happen after many sun salutations at the end of a 90 minute class.

With block

PT Notes:
The traditional version of Hover pose is contraindicated for those with acute upper extremity injuries including rotator cuff tears/repairs, dislocations, subluxations, SLAP lesions, fractures, degenerative joint disease, and carpal tunnel syndrome. However modified versions of hover pose may be very useful when instructed by a qualified therapist once patients are cleared for weight bearing through the upper extremities.

This is a posture I often evaluate and teach to high level patients who intend to return to community-based yoga classes. This pose can be good for those who have had shoulder injuries as well as problems with the cervical spine because, when done correctly, requires a lot of scapular stabilization as well as good postural awareness.You can start working on some fundamentals of the pose relatively early in rehab, as soon as they are appropriate for closed-chain work. Begin working on awareness of GHJ positioning and scapular control and stability. It is critically important that the patient avoids anterior positioning of the humeral head, especially if they have history of anterior dislocation or subluxation. Gradually increase weight bearing, as described in Modifications (from wall to table top to knees, etc.). Once a patient demonstrates mastery of static alignment in full weight bearing, make sure that they demonstrate good dynamic control. They must show that they are able to move from plank to hover, then from hover to updog in order to be independent with traditional sun salutations at home or in a class.

Here are some good links to websites that cover chaturanga dandasana in more detail:
Yoga.iSport.com
YogaJournal.com
DailyBandha.com

Prenatal Yoga, Fast and Free

noreply@blogger.com (Lisa B. Minn) — Thu, 01 Mar 2012 11:46:00 +0000

Last week, I talked about taking and teaching prenatal yoga in a class setting. (Pros of Prenatal Yoga) Of course practicing prenatal yoga at home offers benefits that going to a class can't offer. Like any home practice, at-home prenatal practice will allow you to follow your intuition as to what your body/mind needs and craves. It gives you privacy to work with postures that you may find embarrassing or you may inhibited about doing in a group. You can spend as much or as little time as you need. And it's free!

Whether or not you spend time practicing prenatal postures at home, one thing everyone can do is to pick one or two affirmations to practice every day. This will help to connect you to the experience of your pregnancy to to increase your confidence in the process. You can choose a new one each day or find one that you really resonate with and stick to that every day. Here are a few suggestions:

About you:
I am healthy, strong and ready to bring my child into the world.
My heart is open and ready to love my child.
I am a capable and competent parent.
I am the best mom I can be.

About your baby:
Baby, you have a perfect soul and a perfect heart.
You have the world in your hands.
You are a treasure, a gift beyond all measure.
You are filled with love, peace and contentment.
Finally... I had to steal this one from The Help:
“You is kind, you is smart, you is important.”

Related Posts:
Yoga for Women
PT for Mothers-to-Be.
Asana Analysis: Queen's Pose

Image from About.com, where you can find more ideas about pregnancy affirmations.

SUP'ing in Sausalito

noreply@blogger.com (Lisa B. Minn) — Tue, 28 Feb 2012 18:18:00 +0000

If you haven't tried stand-up paddle board (SUP) yoga yet, you're missing out on a fun and effective mind/body experience. Hopefully this segment from CNN will convince you that it is not as scary as it looks, especially if you are using a big, stable board. Classes have been going all winter long in Sausalito with Leigh Claxton at Sea Trek. But this winter has been a mild one all over the country so hopefully there will be a paddle board yoga class starting up somewhere near you.

Related posts:
Go For The Flow, about the unique benefits of SUP yoga. Includes links to SUP yoga classes throughout the country.

Cultivating a Calm Mind in Rough Waters, about the crazy October day the above video was filmed.

Pros of Prenatal Yoga

noreply@blogger.com (Lisa B. Minn) — Thu, 23 Feb 2012 21:16:00 +0000

If you are someone who practices yoga regularly, you may wonder what good a prenatal class would do. You might prefer to continue going to your regular yoga class for as long as you can, believing that prenatal yoga would feel too easy. Chances are, you will probably benefit from any type of yoga while you are pregnant but a prenatal class is going to give you an experience that is far beyond what you will encounter in a regular class. If you go to a regular class, you will likely improve your posture and your strength. You will have the opportunity to breathe more deeply and to achieve moments of deep relaxation. A prenatal class provides all of these things and more. In a prenatal class, many of the specific breathing techniques and postures are ones that you can actually use during your labor. A prenatal class will take extra care to prevent common pregnancy-related injuries. It will give you opportunities to connect to your baby and to meet other pregnant women. A prenatal class is a chance to let yourself be taken care of before the biggest adventure of your life!

If you are a yoga teacher teaching a group of pregnant women or even just one who comes to your regular class, here are 10 essential elements of prenatal yoga to keep in mind:

1. Include postures (e.g. spiraling movements like hip circles) that can be helpful for during labor and birthing.

2. Make sure students know about the effects of the hormone, relaxin and be aware of increased risk for injury to back, SIJ, wrists, etc.

3. Know that compression of the vena cava (the main vein that returns blood to the heart) will make lying flat on back impossible at some point in 2nd trimester.

4. Teach students how to minimize their risk of diastasis recti.

5. Have students learn to relax during intense sensations (For example, sit on the heels with the toes curled under. This is sometimes called 'Thai Goddess' pose.)

6. Use affirmative language which will help to decrease activity of the sympathetic nervous system (fight or flight) and increase confidence and parasympathetic tone (rest and digest).

7. Have students focus inward and connect to their babies.

8. Maintain ample space for Baby by providing cues for lengthening the spine and avoiding deep twists and rounding of the spine.

9. Teach students to respect their intuition for anything that does not feel right

10. Build a community and be a source of information and referrals.

Image from Yoga Workout HQ.

Anahata: The Heart Charkra

noreply@blogger.com (Lisa B. Minn) — Tue, 14 Feb 2012 19:10:00 +0000

Valentine’s day is a celebration of the heart. It is often considered a romantic holiday which is unfortunate because all kinds of love deserve to be celebrated. Our heart is the seat of love for our romantic partners as well as our families, friends, pets, community members, fellow human beings and first and foremost... ourselves. Our hearts must be healthy in order to feel and share all that love.

The heart is the seat of the 4th chakra or energy center of the body. It is a transitional chakra that may integrate the more physically-oriented 1st-3rd chakras and the the more spiritual 5th-7th chakras. A healthy heart chakra allows us to be open to connection and to recognize peaceful and harmonious feelings. It gives us the ability to have compassion, empathy and unconditional love for ourselves and others.

A heart energy that is blocked or deficient may be associated with loneliness, lack of empathy, or an inability to forgive. Physically it may manifest as slumped posture and a shallow breathing pattern. The long-term effects of such deficiencies may be associated with diseases of the lungs or immune system. The best therapy for blocked heart energy is working to improve relationships and to cultivate self-compassion. Yoga postures that help to stimulate and open the heart chakras include chest-openers, especially those that allow the heart to be higher than the head which can allow the mind to drop away and quiet our over-active thinking brain.
Crescent Pose
Camel/Ustrasana
Fish/Matsyasana
Bridge/Setu Bhandasana

Heart chakras can also be over-stimulated which may lead to feelings of jealously or co-dependency and could manifest as high blood pressure and eventually heart disease . Picture an angry or aggressive person with a puffed out chest, what western medicine has described as a typical Type-A personality. Calming, quieting postures such as forward bends are best in this case.
Child’s/Balasana
Seated Forward Fold/Pachimottanasana

On this Valentine's Day, make a commitment your own heart. Celebrate self-care and compassion. Practice forgiveness and empathy. And wait until tomorrow to take advantage of the sales on flowers and chocolate.

For more information about chakras see Yoga Journal and Chakra Healing.

Ancient Chinese Wisdom

noreply@blogger.com (Lisa B. Minn) — Mon, 23 Jan 2012 11:00:00 +0000

Today is Chinese New Year 2012, the year of the Dragon. To mark the occasion, I want to share a favorite story with you. This story is from ancient China (the days of Lao Tzu) but the moral is timeless. We often think that yoga and other spiritual pursuits teach us to 'live in the moment' but while it may be wise to avoid grasping to the past or fretting about the future, it is also important to understand that this moment in time is just that... a moment. It is only by understanding that every moment is a single thread in the fabric of our lives that we will achieve serenity in the midst of what may seem to be extreme highs or lows in life.

There was an old man in a village, very poor, but even kings were jealous of him because he had a beautiful white horse. Kings offered fabulous prices for the horse but the man would say, “This horse is not a horse to me, he is a person. And how can you sell a person, a friend?” The man was poor, but he never sold the horse. One morning he found that the horse was not in the stable. The whole village gathered and they said, “You foolish old man! We knew that someday the horse would be stolen. It would’ve been better to sell it. What a misfortune!” The old man said, “Don’t go so far as to say that. Simply say that the horse is not in the stable. This is the fact; everything else is a judgement. Whether it is a misfortune or blessing I don’t know, because this is just a fragment. Who knows what is going to follow it?”

People laughed at the old man. They had always known he was a little crazy. But after fifteen days, suddenly one night the horse returned. He had not been stolen, he had escaped into the wild. And not only that, he brought a dozen horses with him. Again the people gathered and they said, “Old man, you were right. This was not a misfortune, it has indeed proved to be a blessing.” The old man said, “Again you are going too far. Just say that the horse is back... who knows whether it is a blessing or not? It is only a fragment. You read a single word in a sentence how can you judge the whole book?” This time the people could not say much, but inside they knew he was wrong. Twelve beautiful horses had come.

The old man had a son who started to train the wold horses. Just a week later he fell from a horse and his legs were broken. The people gathered again and again they judged. They said, “Again you proved right! It was a misfortune. Your only son has lost the use of his legs and in your old age he was your only support. Now you are poorer than ever.” The old many said, “You are obsessed with judgement. Don’t go that far. Say only that my son has broken his legs. Nobody knows whether this is a misfortune or a blessing. Life comes in fragments and more is never given to you.”

It happened that after a few weeks the country went to war and all the young men of the town were forcibly taken for the military. Only the old man’s son was left, because he was crippled. The whole town was crying and weeping, because it was a losing fight and they knew most of the young people would never come back. They came to the old man and said, “You were right, old man - this proved a blessing. Maybe your son is crippled but he is still with you. Our sons are gone forever.” The old man said again, “you go on and on judging. Nobody knows! Only say this, that your sons have been forced to enter the army and my son has not. But only God, the total, knows whether it is a blessing or a misfortune!”

Judith Lasater: A Teachers’ Teacher

noreply@blogger.com (Lisa B. Minn) — Mon, 16 Jan 2012 11:00:00 +0000

One of my favorite teachers in the yoga world is Judith Hansen Lasater. In fact, the name of this blog is in part inspired by her. The first time I took a class with her, I was amazed by the no-nonsense and down-to-earth way she was able to communicate with each individual in class. She is an innovator and a rule breaker. (Down dog with a rounded spine?!!!) She is the queen of restorative yoga and is an advocate for bringing rest and renewal to the masses. She actually went to PT school to become a better yoga teacher. (How cool is that?!) She wrote an essay for a recent edition of the International Journal of Yoga Therapy in which she boiled down her teaching process into three simple steps:

Step 1: Connect to Myself
It is important to be aware of what is going on inside our own hearts and heads before beginning to teach. You may be feeling excited and happy or you may be feeling tired and irritable. Whatever you feel, just acknowledge it rather than try to “fix it” or change it in any way. Just being aware of your own emotions will allow you to connect to your students more easily.

Step 2: Connect to the Student
Always ask the name of the student, if you don’t already know, whenever answering their question, providing adjustments or giving individual feedback. When a student or client asks a question, consider what might be prompting that question. Rephrase it in your own words to be sure that you fully understand their question.

Step 3: Teach the Asana
Without the connection to yourself and to your student, a lot of the content and meaning of what you teach may be lost. When we teach yoga we teach people so much more than just how to move. Judith states that this approach to teaching has “created a more fertile ground for self-awareness and healing in both the client and myself.”

Judith is a yoga teacher who became a physical therapist. That is why she has an excellent grasp on anatomy and biomechanics. I am a physical therapist who became a yoga teacher. That is why it is easy for me to default to thinking of my students and clients with a one-dimensional, anatomical point of view. It is teachers like Judith who help me to remember that healing is about more than achieving biomechanical milestones. Healing is often about the need to be heard and it's impossible to really hear someone when you are not connected.

What about you? Who or what inspires you to treat the whole patient?

You can read more about Judith, her publications and teacher training schedule at her website,

http://www.judithlasater.com/

Asana Analysis: Flying Warrior Pose

noreply@blogger.com (Lisa B. Minn) — Mon, 09 Jan 2012 22:27:00 +0000

Fly into the 2012 with this challenging and joyful pose. This is usually called Warrior III but I think it is such a fun pose that it deserves a fun name. The perfect Flying Warrior pose evokes a feeling of stability and power but at the same time should put a smile on your face. This is a challenging pose that requires much strength, flexibility and balance but there are several modifications available that make it accessible to almost any level of fitness. However there is a lot of room for error in this pose. When searching for images for this post, I saw a lot of pictures of people with hyper-extended knees and necks, sagging spines and shifted hips. So make sure to ask a teacher, therapist or experienced yogi friend for feedback about your alignment when working on the Flying Warrior.

Muscles Stretched: The hamstrings, gluteals and gastrocnemius of the standing leg.

Muscles Strengthened: Gluteus maximus, hamstrings and quadriceps of both legs. Gluteus medius, tensor fascia latae, and iliopsoas of the standing leg. Calf muscles and intrinsic foot muscles of the standing leg. Transvesus abdominis, obliques, errector spinae muscles. Deltoids, triceps.

Points of Body Awareness:
*Begin by establishing a strong high lunge pose.
*Pivot the torso forward as the front knee straitens and the rear leg lifts away from the ground.
*If your hamstrings are flexible, your torso and flying leg will be parallel to the floor.
*If your hamstrings are tight, your torso and flying leg will be angled to the floor but should form one continuous line.
*Is the pelvis level? Resist the urge to stack the hips or to shift the pelvis up on the flying side.
*What is the alignment of the standing foot? It should be in a neutral position with the toes pointing strait ahead, outer heel lined up with the pinky toe, the arch of the foot slightly lifted and the weight equally distributed among the ball of the big and little toes and the heel.
*Is the torso long and strait? Are you able to hold a neutral spine position?
*Is the flying leg strait and strong? Make sure that the knee cap points strait down toward the floor.
*The standing leg should also be strait and strong but be sure the the knee is not hyperextending.
*Attempt to hold the pose for 5 to 10 breaths.
*When you are ready to come back down, lower the flying leg slowly as you bend the front knee to return to a high lunge pose.
*Step forward to mountain pose and enjoy the sensation of coming back down to earth.

To Modify:
I strongly recommend that when first learning this pose, that you chose an alternate position for the arms rather than the classic overhead position. You can reach the arms out to sides (like an airplane) or reach back with the hands alongside the hips. When the arms are overhead, it is much more difficult to hold a neutral position of the pelvis due to the increased forces through the standing hip. By choosing a modified arm position, you can focus your attention on achieving an ideal alignment of the legs and torso and build up strength, endurance and balance.

For tight hamstrings, the torso will not be parallel to the floor but at an angle. This will allow you to work on strength and balance without over-stretching the hamstring or compensating for tight hamstrings by rounding the back or externally rotating the hips. But the pelvis should still be level, and the flying leg in line with the torso with the knee pointing strait down.

For those who struggle with balance, try placing the fingertips on a wall in front of you, resting the forearms on the back of a chair or pivoting the torso forward only a few degrees, perhaps even keeping the big toe of the back leg in contact with the ground.

PT Notes:
This is an excellent pose for working on higher level pelvic girdle stabilization. It's great for increasing eccentric strength and endurance of the hamstrings and external rotators of the hip and is particularly useful for sports-related injuries such as patella femoral pain syndrome and ITB syndrome.

Use caution for those with significantly impaired balance and with muscle or tendon injuries that have not fully healed.

Images from Yoga.com and abc-of-Yoga.com.

For more detail here's a nice video clip from Yogaglo.com that shows how to do the pose:

Light the Yule Log

noreply@blogger.com (Lisa B. Minn) — Tue, 20 Dec 2011 19:15:00 +0000

I recently spent a few days in Stockholm, Sweden and gained a whole new appreciation for why we have deep seated customs involving food and light at this time of year. Unless you live near the equator, the short days of December are quite noticeable. But the darkness in Scandinavia is something else. The sun sets in Stockholm at about 2:30 in the afternoon this time of year. I spent 3 nights there and it was truly disorienting to be in the dark at such an early hour. The biological drive to eat comfort food and go to bed early was very strong. And Stockholm is in the south of the country. I can't imagine how strange it would feel to spend a winter in northern Sweden.

The pagan holiday of Yule, which has morphed into Christmas, "was an indigenous midwinter (winter solstice) festival celebrated by the pagan Scandinavian and other Germanic people." The ancient celebrations included burning the Yule log and feasting on a wild boar. (Ah, so that's where the traditional Christmas ham comes from.) The Scandinavians still wish one another "God Jul" or Good Yuletide this time of year instead of "Merry Christmas." Sweden also celebrates a lovely holiday on December 13th called St. Lucia's Day in which the eldest daughther of the family wears a crown of candles and serves traditional buns and coffee to her family.

Wishing you lots of love and light on this darkest day of the year!

The Practice of Giving Thanks

noreply@blogger.com (Lisa B. Minn) — Thu, 24 Nov 2011 11:00:00 +0000

It is easy to be thankful when we sit around a table filled with our favorite comfort foods, surrounded by our beloved friends and family. It's not always so easy to practice gratitude the other 364 days of the year. But with practice, we will recognize that we have something to be grateful for everyday. Practice gratitude everyday and remember:

It is about more than just expressing words:
As we express our gratitude, we must never forget that the highest appreciation is not to utter words, but to live by them. ~John Fitzgerald Kennedy

That we should practice gratitude even when life is hard:
Give thanks for unknown blessings already on their way. ~Native American Saying

That it will shape our character and strengthen our moral fiber:
Gratitude is the sign of noble souls. ~Aesop

Happy Thanksgiving, Everyone!

Pose: Down Dog Prep Pose

noreply@blogger.com (Lisa B. Minn) — Fri, 11 Nov 2011 18:37:00 +0000

This is not a classic pose but a therapeutic posture created by Ginger Garner of Professional Yoga therapy. This pose is great for beginners as well as experienced yogis to practice postural awareness and improve core strength. This pose is best done with a teacher or partner who can observe and give you feedback about your spinal alignment because even the most experienced yogis are often not fully aware of subtle shifts in posture. You can use a mirror for gauging your own alignment but this is limited because you can not observe your posture from different angles and because turning your head to look in the mirror may affect your alignment.

Muscles Strengthened: Serratus anterior, pectorals, triceps, hamstrings, quadriceps, transverse abdominus, errector spinae (including lumbar multifidi)

Points of Body Awareness:
*Is the spine in neutral position: small inner curve in the the small of the back, small outer curve between the shoulder blades, small inner curve at neck?
*Before lifting the knees, be sure the the hands and knees are in optimal alignment:
- The shoulders are aligned directly above the wrists.
- Elbows are strait but not locked out.
- Fingers actively spread, with the index finger pointing strait ahead.
- Hips are aligned directly above the knees.
- The toes are curled under, preparing to take weight onto the balls of the feet.

*Exhale and draw the navel in toward your spine to activate the transverse abdominis muscle. Inhale and maintain that activation. Exhale and lift the knees one inch off the mat.
*Is your spine still in neutral position after you lift the knees? Most people will lose the inward curve of the lumbar spine (lordosis). Many will also increase the curvature of the middle spine (thoracic kyphosis). Some people will collapse more in the middle spine.
*Can you hold neutral spine position with the knees hovering one inch off the mat for at least 3 deep, slow breaths? (TATD breath cycles)

To Challenge:
*Once you’ve mastered the ability move into the pose and hold neutral spine, work on endurance by holding longer and longer. Progress to 5 breath cycles, all the way up to 10 or even 15.
*Release any unnecessary tension especially gripping in the neck, jaw, or gluteal muscles.
*Once you feel confident with static stabilization, try adding some semi-dynamic work. One way to do this is to learn to transition to a bent-knee down dog without losing neutral spine position.
* Another way to work on semi-dynamic stability is to try isolating scapular protraction and retraction while maintaining neutral spine.
*You can also try doing pelvic tilts with the knees hovering while maintaining stability in the cervical/thoracic spine.

PT Notes:
This is a great exercise for balancing co-contraction of core muscle groups. It is also a good pose to use for assessment of how the muscles are functioning. If the superficial abdominals are overpowering the spinal extensors, you will see a loss of lordosis. This will happen to most people when they first try the pose but they should be able to correct this with minimal cueing. If they can not correct it, it might be an indication of weakness of the spinal extensors or an inability to inhibit the rectus abdominus.

If you observe loss of the normal kyphosis, this may also be due to weakness of the spinal extensors as well as weakness or inhibition of serratus anterior. Excessive tension in the neck and shoulders might be due to a pattern of accessory muscle breathing and a lack of diaphragmatic breathing.

Down Dog Prep Pose is safe for most people but is obviously be contraindicated for those with acute injuries of the spine and extremities or during exacerbation of chronic injuries.

Cultivating a Calm Mind in Rough Waters

noreply@blogger.com (Lisa B. Minn) — Tue, 25 Oct 2011 20:30:00 +0000

“Peace comes from within” -Buddha

Yesterday I was invited to a special stand-up paddleboard (SUP) yoga class. CNN is doing a story on this latest yoga phenomenon so they contacted my teacher, Leigh Claxton. She agreed to teach a class to be filmed for their story and wanted students with a range of experience, age and gender to represent a typical class.

As I walked to class, I wondered how distracted I might be with the presence of a big camera and news crew around. It turns out that the camera and crew were the least significant distraction. When I arrived at class, the beach was empty but the wind was blowing. When we got on our boards to warm up with some paddling, the wind immediately blew us across the cove and the current threatened to suck us out to the bay. So we quickly anchored in the most protected part of the cove. But for a few of us, the anchors were not very effective so we kept drifting away slowly then had to make a mad dash and paddle back to class.

The camera crew was late and when they arrived they asked Leigh to come back to shore so they could set her up with a microphone. To my surprise, she asked me to take over teaching the class. On one hand, I was flattered and happy for the opportunity but on the other hand, I thought... “oh my gosh, I have never taught this before and I have no idea what I’m doing!!!” To make it even more of a challenge, my anchor was effectively useless at the time so as I was trying to teach on the fly... I was literally flying around on my board. I had to keep paddling back toward the class while thinking of things to teach that wouldn’t make anyone fall in. Yikes!

For the record, teaching a SUP yoga class is very different from teaching a regular yoga class. Not only are the poses sometimes completely reversed in the level of difficulty (lunges are difficult, upward facing wheel is easier than usual), but it’s impossible to use your normal, soothing "yoga voice," it’s impossible to make adjustments or provide manual cues, and it’s almost impossible to provide individual feedback.

At some point during class I was lying face down on the board feeling slightly disoriented from watching the rippled surface of the water moving underneath me at an impressive velocity. By the end of the class, my clothes were damp. My hair kept blowing into my eyes. The wind howled as it blew through the masts of the sailboats in the adjacent marina.

But despite the physical and mental discomfort of the day, I truly enjoyed the experience. In fact, I think it might have been the most yogic experience I’ve had so far during a SUP yoga class. It’s easy to relax and and find peace of mind when the sun is shines its warmth upon your face and you hear the water gently lapping all around. But yesterday’s class was a perfect opportunity for practicing pratyahara (withdrawal of the senses) and dharana (concentration). And those are yoga skills we all need to practice off the mat.

Our Fabulous Fascia

noreply@blogger.com (Lisa B. Minn) — Tue, 18 Oct 2011 10:46:00 +0000

Fascia is perhaps the least understood and appreciated tissue in the body. But healthy, well-functioning fascia is critical for normal function of our musculoskeletal systems. Patrick Ward, athletic conditioning specialist and massage therapist, wrote a nice article about the anatomy and function of the thoracolumbar fascia. What is truly fascinating to me is the fact that there are cells in fascia that are similar to smooth muscle cells and are controlled by the autonomic nervous system. As Patrick points out in his article, breathing and relaxation are key elements of keeping our fascia in a healthy state. He states, “Respiratory function is one aspect of the autonomic nervous system that we actually have direct control over. We can change our breathing and help to elicit a parasympathetic response to allow for greater relaxation and potentially less overall tissue tone/tension.”

I often refer to the thoracolumbar fascia while teaching. I most often talk about it when students are in Child’s Pose. In this posture the thoracolumbar fascia is stretched and it’s a bit easier to feel. Try to do the following exercise to practice mobilizing your own thoracolumbar fascia:

*In Child’s Pose, become aware of the back body.
*Visualize the thoracolumbar fascia, which is a thick sheet of connective tissue
that connects the back of the pelvis to the back of the ribcage.
*Inhale and feel the fascia stretch.
*Exhale and feel it release.
*Inhale, the back body expands and the fascia stretches.
*Exhale, the fascia releases as it slides between the between the skin and muscles.
*With each exhalation, feel it release more and more.
*Repeat for at least 10 breath cycles.

Asana Analysis: Seated Straddle/Upavistha Konasana

noreply@blogger.com (Lisa B. Minn) — Tue, 11 Oct 2011 10:48:00 +0000

This pose is one that is commonly seen in yoga classes as well as on athletic fields. But as popular as it is, it’s one that is actually quite difficult to do properly. Most people have tight hamstrings, let alone adductors (inner thigh muscles) so it’s hard for most people to even get into a good starting position for this pose. But with proper instruction, appropriate modifications and adequate support seated straddle pose can be a great way to improve flexibility and prevent groin strains.

Muscles Stretched: adductor longus, adductor magnus, adductor brevis, gracilis, pectineus, hamstrings (especially semitendinosus and semimembranosis)

Muscles Strengthened: quadriceps, anterior tibialis, errector spinae of the lumbar spine, transversus abdominus

Points of Body Awareness:
*Make sure the toes and knee caps are pointing strait up toward the ceiling.
*Energize the legs by pressing the back of the knees down into the floor and flexing the ankles so the toes pull back towards the knees.
*Do not slouch. Do not bear weight on your tailbone. Roll your pelvis forward so the weight of your torso rests on the front of your sit bones.
*Are you in a neutral spine position? Is there a small, inward curve in the small of your back? Do you sense your spine lengthening up and out of your pelvis?
*Only once you have established this length, should you begin to fold forward.
*Start your forward fold from the lower belly in order to maintain some length in the lumbar spine.
*As you fold deeper into the pose your spine may begin to round a bit but make sure that you are not at the end of your range and that your weight has not rolled back onto the tailbone.
*Keep the navel gently lifting toward the spine. This will engage your transversus abdominius and support the lower back.
*Are your legs still grounded? Are the knee caps and toes still pointed up to the ceiling or have they rolled in or out?
*Feel your ribs lifting and spreading with each inhalation and releasing and returning to center with each exhalation.
*Hold for 5-10 slow, steady breaths.

To Modify:
If you are unable to sit up strait and find the inward curve of the lumbar spine, sit up on folded blankets or a bolster. If your hamstrings or inner thighs still feel so tight that you can’t get into the pose with proper posture, try to narrow the width of the legs a bit and/or bend the knees.

For many people the forward fold part of this pose is not necessary. Sometimes just sitting up strait is a more appropriate focus of upavistha konasana. Place the hands behind you on the floor or on blocks instead of in front. Use your arms to support the effort to lengthen the spine.

Other times a restorative or yin version of seated straddle pose is a more effective way to release tension and achieve the calming benefits of this pose. Fold forward onto a prop that can support your torso.
There are many ways to do this and the props will vary according to your flexibility. For a lot of support, use a Swiss Ball or the seat of a chair. For less support, use a combination of bolsters and blankets. Or you can rest your forehead on a block or blocks. Your back may be somewhat rounded with this variation but make sure that your weight is shifted forward, onto the front of your sitting bones (ischial tuberosities) rather than slumping back toward your tailbone.

To Challenge:
The traditional version of upavistha konasana involves grasping the big toes and bringing the chin and chest to the floor. This takes years of practice for most people so don’t attempt to work toward this end without the guidance of an experienced teacher.

A less risky variation is a core strength version of seated straddle. First lengthen up out of the pelvis, find neutral spine position then reach arms overhead. Keep spine long as you pivot forward from the hips. Your torso will start at 90 degrees to the legs and then tilt forward 10 to 30 degrees, depending on your strength and flexibility. This will only work if your back is strait and not at all rounded. It can be done sitting up on props. Hold for about 5 breath cycles.

PT Notes:
Seated Straddle is contraindicated for anyone with HNP, adductor strains or pelvic injuries. This pose could aggravate SIJ problems but variations of the pose can be therapeutic if done properly.

This is not a pose I teach often but it is a good pose to teach to certain groups.
*It is important for those with regular asana practice to learn to do properly, given it’s potential to cause or aggravate common injuries. This is especially important for those super-flexible and/or hypermobile yogis.
*It is good for athletes. This stretch is often part of stretching routines done pre- or post- workouts. Adductor strains are a common injury in many sports so it is important to keep the adductors flexible. This pose is not the only stretch athletes should do to prevent groin strains but it is one that can be beneficial when done properly.
*Those with adductor spasticity, from diagnoses including cerebral palsy and stroke might benefit from this pose. Given enough support, this pose can help to maintain or possibly even improve ROM of the hips. A more restorative or yin version may be more effective due to the prolonged holds and increased relaxation. Or theoretically a more active version could be more effective if the client’s spasticity responds to reciprocal inhibition.

Opening image comes from My Yoga Online.

The upright modification image is from Practice Notes.

The image of a restorative version is from Do Restorative Yoga.

All three websites provide good content on upavistha konasana so check them out!

PT for Mothers-To-Be

noreply@blogger.com (Lisa B. Minn) — Tue, 04 Oct 2011 20:21:00 +0000

All physical therapists (PTs) should have some basic knowledge about women’s health including how to address general musculoskeletal complaints of pregnant women. But some physical therapists are experts in women’s health and are certified as clinical specialists in this area by the American Physical Therapy Association (APTA). In order to become certified they must pass an exam after having completed a clinical residency or 2000 hours of work in women’s health. PTs who are certified in women’s health have skills that most PTs do not. One of these skills is the ability to evaluate and directly treat the pelvic floor.

Much of women’s health is focused on urinary stress incontinence because this a problem that has been shown to respond extremely well to physical therapy treatment. Stress incontinence often develops during late pregnancy or after birth. PTs can use biofeedback to help patients remember how to use their pelvic floor muscles and can give them specific exercises to to improve strength and endurance of those muscles.

But women’s health PTs can help pre- and postnatal patients in many other ways too. If women have pain during pregnancy, PTs can evaluate the source of the pain and may be able to perform techniques such as myofascial stretching and trigger point release that help relieve the pain. They can use gentle techniques to restore pelvic alignment and they can teach patients effective body mechanics to minimize her symptoms. They can also treat postnatal problems such as pudendal nerve injury, incontinence, pelvic pain caused by scar tissue and back pain related to diastasis recti. San Francisco PT, Liz Miracle specializes in pre- and postnatal patients in San Francisco. She states that yoga and aquatic exercise are the most effective forms of exercise to complement the teaching and hands-on work she does in the clinic.

Some women’s health specialists, like Ms. Miracle, run cash-only clinics but physical therapy may be covered by insurance if your doctor refers you for evaluation and treatment of a specific problem. Unfortunately, many doctors are either not aware of the benefits of physical therapy for pregnant women or do not think it is necessary. There is often an attitude of, “You’re pregnant and so it’s normal to have aches and pains. You’ll feel better after your delivery.” Sadly this is an attitude that is all too common in the medical community as well as the general public.

Women’s health physical therapists also offer prevention strategies that minimize or completely prevent problems during pregnancy and childbirth. They can make sure that women are doing pelvic floor strengthening in an appropriate and effective way. This has been shown to decrease the incidence of incontinence.1 They can also teach women to do perineal stretching which has been shown to decrease tearing during childbirth.2 Unfortunately these services must be paid for out of pocket. Although it would likely save health care dollars in the long run, insurance does not support such preventative services.

Women who are interested in working with a PT certified in women’s health can find someone in their area by going to the APTA’s “Find a PT”. Ms. Miracle stresses that pregnant or post-partum women should look for a therapist that has training and experience with techniques such as myofascial release and skin rolling and also that they have a strong background in orthopedics in addition to competence in pelvic floor evaluation and treatment.

References:
1 Pelvic floor muscle training for prevention and treatment of urinary and faecal incontinence in antenatal and postnatal women. Hay-Smith J.; Mørkved S.; Fairbrother K.A.; Herbison G.P.;Editorial Group: Cochrane Incontinence GroupPublished Online: 21 JAN 2009.

2 Preventing Perineal Trauma During Childbirth: A Systematic Review. Eason, E.; Labrecque, M.; Wells, G.; Feldman, P.; Obstetrics & Gynecology: February 2003 - Volume 101 - Issue 2 - p 313-319

Happy National Coffee Day!

noreply@blogger.com (Lisa B. Minn) — Thu, 29 Sep 2011 15:30:00 +0000

Coffee often gets a bad rap for it's ability to rev us up and get us addicted to its magical powers of taste, aroma and energy enhancement. While it's true that it can be addictive, it can contribute to restless and insomnia and it is known to aggravate gastrointestinal problems, there are also many proven benefits of consumption of a daily cuppa joe:

*Decreased risk of Alzheimer's and Dementia
*Decreased risk of gallstones
*Decreased risk for Parkinson's disease
*Improved cognitive function
*Decreased risk of Type II Diabetes
*Protection the liver, heart and blood vessels
*Decreased risk of some cancers including oral and esophageal
*Helps keep us 'regular'
*Cavity prevention
*Reduced risk for gout

And the latest news, according to a report in the September 26 issue of Archives of Internal Medicine, coffee consumption has been linked to a decreased risk of depression in women.

I admit it, I used to be addicted to the stuff and so I gave it up for a while. After many months of coffee free days, I now enjoy it more than ever. My new rules for consumption:
1) Never drink it first thing in the morning. Now I always have a cup of herbal tea when I first wake up and save the coffee as a mid-morning treat.
2) Never drink it every day. Daily = habit.
3) Only drink the good stuff.
4) Never imbibe after 2pm.

So that is how I practice brahmacharya/moderation when it comes to consuming this magical elixir. What is your take on coffee consumption? Do you abstain? Are you addicted? How does coffee fit into a yogic lifestyle?

Sources:
Wikipedia
Science Daily

Yoga for Women

noreply@blogger.com (Lisa B. Minn) — Tue, 27 Sep 2011 22:36:00 +0000

If you are a regular reader of Pragmatic Yogi, you’ve no doubt noticed that the frequency of my posts declined quite a bit over the summer. One of the reasons I wasn’t focused on my blog was that much of my attention was on prenatal yoga. I took a week-long course called "Teaching Yoga for Pregnancy, Birth and Beyond” which was followed by two months of independent reading, writing, teaching and research required to complete the certification for the course. As a result, I have lots of information that I will pass along in the next few weeks.

For example, here are three ways a yoga teacher might modify poses for a pregnant student who came to a regular class:
1. Use cow pose (spinal extension in hands/knees position) in place of cobra/mini-cobra. This allows a pregnant woman to do a backbend without lying on her stomach.
2. Pregnant women, at any stage of their pregnancies, should not do parivrtta parsvakonasana or side angle twist (pictured on the left below). Instead, do an open variation by placing the same side elbow on front thigh and reaching the top arm up and back (below right). This is a mild twist that keeps the abdomen and and front torso open.

3. When the baby gets big enough (usually not until the 3rd trimester), they have the potential to compress the vena cava, the largest vein in the torso. This would cause her to feel breathless or dizzy. So when women get to the point of feeling uncomfortable lying on their backs, they can do side-lying savasana (opening image) or Queen's Pose instead of traditional savasana.

"Pregnancy, Birth and Beyond" also covered yoga for women who are not pregnant but may need extra care at other times in life. Here are some ways to adapt a regular yoga practice during menstruation:
1. Generally decrease intensity. For example, instead of plank->chaturanga/hover->updog sequence during sun salutations, do a more gentle sequence of hands/knees->8-point posen(chest down)->mini cobra.
2. Do viparita karani (legs-on-wall pose) instead of any other inversions (headstand, shoulderstand, forearm balance, etc.) to avoid retrograde blood flow into pelvic cavity and to encourage the downward flow of apana,.
3. Try face-down savasana instead of supine savasana. This may facilitate deeper relaxation help relieve cramping.

And speaking of women’s health did you know that Oprah.com recently published an in-depth article called ‘Physical Therapy for Your Lady Parts’? It states, "Women's heath physical therapists (WHPT) are often the problem solvers that gynecologists, obstetricians, urologists and other doctors call when confronted with a gender-specific medical mystery, like discomfort during sex, after childbirth or while going to the bathroom."

More about pre- and postnatal physical therapy next time!

Photo of side angle variation from Laurence Turner's Pregnancy Yoga.
Photo of side angle twist from J.Crew.

Asana Analysis: Queen's Pose

noreply@blogger.com (Lisa B. Minn) — Tue, 20 Sep 2011 10:58:00 +0000

This is a restorative pose that I learned during my prenatal teacher training and it is one that is a very popular way to finish a prenatal class but you don’t have to be pregnant to enjoy it. This pose is similar to Reclined Bound Angle but is more supportive and relaxing.

Muscles Stretched: No muscles should be stretched in this pose. Because pregnant women have large amounts of a hormone called relaxin, they are already naturally flexible so stretching is not usually a goal in prenatal yoga.

Points of Body Awareness:
*Be sure that you feel completely supported by your props. You should not feel any stretching or pulling in the shoulders, neck, inner thighs or anywhere else.
*Your hands can be resting on your belly or on blocks or cushions along your sides.
*Allow the belly to relax completely. If you are pregnant, this is a good time to be aware of your baby and your connection to him or her. If you are not pregnant just enjoy the sensation of your belly rising and falling with the breath.
*Stay in this pose for as long as you like. Ideally, you can spend at least 10 minutes here for the benefits of deep relaxation.

To Modify: This pose requires a lot of props so be creative with what you have. Wrapping a blanket around the tops of the feet, as pictured above, provides a surprising amount of support to the legs. You may not even need extra support under the thighs.

PT Notes: The torso is supported upright at an angle of 30-45 degrees. This prevents vena cava compression in women in their 2nd and 3rd trimesters. It is also a good option for others who do not tolerate lying flat including those with vestibular problems, hiatal hernias or congestive heart failure. It is also an ideal pose to practice when fighting a cold or experiencing nasal or sinus congestion.

See Reclined Bound Angle for notes about using this posture for those with adductor strain or pelvic floor dysfunction.

Go for the Flow!

noreply@blogger.com (Lisa B. Minn) — Fri, 16 Sep 2011 19:57:00 +0000

Stand-Up Paddleboard (SUP) yoga is the latest craze sweeping the country. I have the good fortune to live in Sausalito, CA where Sea Treks offers 3 classes a week. I tried it last week and I have to say that there is good reason for its popularity. It is FUN! Yoga purists will surely dismiss it as yet another way we’ve exploited the sacred form of yoga. But I say, go out and give it a try! (Provided you are injury-free and don’t have a strong aversion to water)

My experience showed me how SUP yoga provides unique benefits that traditional yoga can not offer. This particular form of yoga is great for improving balance. One aspect of balance is the ability to react effectively to an unpredicted perturbation. In other words, to be able to catch ourselves when we least expect it. In traditional yoga, we practice balance by decreasing our base of support, for example standing on one leg. Or sometimes we go upside down which might challenge our visual-vestibular system. But we are still on stable ground. It may be difficult but there is nothing unpredictable about it. The paddleboards used for yoga are actually very stable but they are in constant motion, which requires a higher level of proprioception in order to stay centered.

SUP yoga is an excellent core strengthening workout. The pointer dog pose (opposite arm and leg reach) was never so challenging. I was also amazed at how difficult standing lunges were, especially the transitions in and out. But oddly enough, upward-facing wheel never felt so good! Backbends are usually easy for me but often they don’t feel so good. I think that being on the paddleboard automatically ‘woke up’ the deep, stabilizing muscles in my spine and around my shoulders and helped me to do the pose without a bit of pain. My technical, physical therapist explanation is that the unstable surface helped to facilitate co-contraction which created better stability around my joints.

During my first class I noticed that sensation was enhanced. I noticed in the beginning of the class that I was very aware of the sensation of my feet on the board. I was also aware of feeling the breeze on my face and the sounds and scents all around. I have a teacher who is both a yoga teacher and an ayurvedic practitioner and she recently encouraged me to cultivate more apana vayu into my practice. Because I tend toward a hyper-flexible body and and hyperactive mind, her advice was to bring a more solid and grounded quality to my asana practice. It may seem counter-intuitive that I actually felt more grounded while standing on a wobbly board but I did. I think it had a lot to do with all of that increased proprioception which made me especially aware of my feet on the board.

And finally, probably the biggest reason that I appreciate this new craze of doing yoga on a paddleboard is that it hooked my husband! My husband, who sits at a desk all day, really needs yoga. I can sometimes drag him into a class or prod him into a session at home but after our first SUP yoga class, he took the initiative to sign us up for weekly classes. I’m sure that there are a lot of others out there, who are like my husband. People who have nothing against yoga and know that it’s good for them but don’t have a spark lit until they have a yoga experience that is outdoors, on the water, and with toys! SUP yoga is not a replacement for a traditional yoga practice at home or in a studio but it certainly can be a wonderful addition.

Read more about SUP Yoga in your area:
Key West
Seattle
Los Angeles
Sydney
Chattanooga

The Invisible Skeleton

noreply@blogger.com (Lisa B. Minn) — Tue, 13 Sep 2011 10:19:00 +0000

Healing = Response to stress begins to normalize. Return of normal mechanisms of handling stress, like trabeculae in bone.

I came across this definition of healing while I was taking a course in Musculoskeletal Imaging this summer. I thought it was quite an interesting definition. It is an explanation that could be interpreted on a purely mechanical level. Trabeculae are little fibers of bone (or beams, according to the literal Latin translation) that can be seen on x-rays. They are the result of Wolff’s Law or the normal response of osteoblasts (bone-making cells) to mechanical stimulation such as weight-bearing or muscle tension.

But this definition can also be very important on a psychosocial or spiritual level. We can’t really visualize stress management skills or coping strategies but surely they are just as important for human health. If we don't have adequate emotional trabeculae or psychological beams to handle stress, we can be ‘broken’ by a spiritual crisis or a flare-up of a mental illness or a lack of social support. We say that people can “snap.” We say this when they are overwhelmed by stress and as a result do things like neglect personal health and hygiene or lose their tempers over little things or commit senseless acts of violence. Snap is also the sound a bone makes when it breaks. Snap is what happens when our mechanisms of handling stress, any kind of stress, are not adequate.

Physical therapists know all about how bones heal. But how often do we think about the invisible threads of healing? Sometimes a broken bone is just a broken bone. But sometimes broken bones come with emotional trauma or other stressors. Sometimes our patients might be slow to heal because their mechanisms for handling psychological, emotional or spiritual stresses are impaired and they simply don't have the energy to heal on a physical level. And now there is evidence* that cultivating such energy through a disciplined practice of breathing, meditation and chanting can actually help fractures to heal more quickly.

Yoga can help our patients cope with all the different types of stresses. By yoga, I certainly don’t mean send your patient with a delayed union fracture to the local yoga studio for a vinyasa classs. But I do mean help guide your patients to seek healing on whatever level they need. Maybe that means meditation or counseling. Perhaps they need a social outlet or cultivation of a new hobby. Combining physical therapy and yoga means helping patients to heal their bodies as well as strengthening their invisible skeletons.

*The effect of add-on yogic prana energization technique (YPET) on healing of fresh fractures: a randomized control study.Oswal P, Nagarathna R, Ebnezar J, Nagendra HR. J Altern Complement Med. 2011 Mar;17(3):253-8. Epub 2011 Mar 9.

Image from National University of Singapore