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Yoga as Delay Management

May 17, 2012

young woman meditating at airportIf you’ve paying attention to your life over the last few days, you likely noticed, repeatedly, that things do not go as planned.  On an almost daily basis, our expectations are dashed in small or large ways.  And yet, when the unexpected happens, which should actually not be a surprise (since it happens so regularly), we often react with surprise, disbelief, frustration, anger, and dire predictions of how tragic the day will now become.

It does not have to go down like that!

This was brought home to me not once, but twice on a recent teaching trip to North Carolina.  On my way there, my midday flight was on time, we boarded smoothly, I settled into my window seat, greeted the passenger to my right in the aisle seat, his wife seated across the aisle from him. Retired and now enjoying the hobby of growing grapes at their home in Northern California, the couple were heading to a family gathering on the East Coast.

As we settled in, I noticed that a luggage bin just in front and above of our seats was askew, not able to close all the way.  A subtle but distinct alert went off in my head: this could actually cause a delay in our take off.  I had a connection to make on the other side of the country and part of me realized I might miss it.  At that moment, noticing my inner worry, I chose to close my eyes and focus my attention on my breath as a way to calm myself, also realizing I really could not do much about the bin myself.  When the mechanic arrived and began trying fix the bin, my traveling neighbor do not go inward, but began to make unhelpful suggestions to the mechanic, who shot back an angry look.

At other times, I would have picked up on the anger and anxiety I felt coming from them toward me, too.  But the simple breath awareness that I continued to do allowed me to stay centered in myself and watch with curiosity rather than judgment, at the interaction to my right.  In short order, the bin was taped shut and we were off without much delay at all.

On my way home, with an even tighter connection through DC, I checked online before heading to the airport to make sure my first flight was on time, and it was.  My host insisted on popping into the terminal when we got to the airport to make sure things were still on time, and they were.  There was hardly anyone going through security, so in short order I was at the gate, where all seemed on schedule, until about 10 minutes later when it was announced the incoming plane would be an hour late, the exact amount of time I had between flight. I might not make it home tonight, I thought.

Although not life threatening, my protective system, fondly called the fight-or-flight response, was about to be activated.  Instead, I stood up, took my bag and got a place in the line leading up the departure counter with about six fellow travelers ahead of me.  Once again, centering on the breath, I observed that the first folks at the counter would be a while, so I sat down next to my bag on the carpeted floor, (after all, I could be here a while!) closed my eyes for a few calming moments, and realized while I waited to speak to an agent here, I could call an agent, too!  Putting my ear bud in, I dialed the airline’s number, heard the robotic voice tell me it could be 10-15 minutes before a live person took my call.  Another moment to choose: freak out, get angry or utilize the time otherwise.  So I choose to do some simple seated poses: Sukasana forward bend, Virasana, and Ardha Matsyendrasana twist.  By the time the agent on the phone picked up, I was actually in quite a good mood, thanked him for working on a Sunday afternoon, and found out there was one seat left for the last flight home that night, and I would get it!

Obviously, you and I know that these things don’t always turn out so well, but by having some tools, yoga tools that is, in your pack, you can weather the expected unexpected stuff that we know is going to happen.

My yogic prescription for delay-management:

1) Start practicing simple seated breath awareness now, today, and do it often. When you need it, it will be second nature for you to turn to its calming and centering effects.

Try this: Focus your mind on the sensations of the in breath, then the out breath. Keep coming back to this, even when worrying thoughts attempt to capture your attention. Keep it up for 2 minutes and gradually lengthen the practice to 5 or 10 minutes. The timer on your smart phone can help.

2) Identify a few seated poses you can do in a chair or on the floor.  Forward bends and twists always seem like good choices for me, but you might want a seated backbend if that’s helpful in keeping you open and calm when uncertainty shows up.

Also, try consider these: Cobbler’s Pose forward bend; Sage’s Twist (Marichyasana III); and gentle backbend over the back of a chair, keeping your hips on the seat.

3) Have some truly relaxing music on your iPod or phone, and even consider having a short Yoga Nidra recording there, too, for times when the delay is longer.

The goal is to eventually feel the same way about days that flow without a hitch as you do those with lots of unexpected twists and turns: centered and ready for all of it!

Baxter Bell, MD, teaches in the San Francisco Bay Area and internationally, and is director of the Piedmont Yoga Studio's teacher-training program in Oakland, California. He is a contributing writer for Yoga Journal magazine and for the International Journal of Yoga Therapy, and created Yoga Journal’s Yoga for Stress DVD. Follow him on his other blog, Yoga for Healthy Aging or his website bellyoga.info

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Practice for the Season

May 2, 2012

Camel PoseAs I write this, spring is fully underway. Flowers are blooming, the previously frozen waters are flowing, and the thermometer has already already begun its climb northward. Despite these external changes, many yoga students cling onto the same kind of practice year-round, be it hot yoga, Iyengar alignment-based practice, or vinyasa flow, with little regard given to the time of year.

I was the same way until a few years back when I came across an interesting article that proposed a specific focus for each season based on Ayurvedic principles.

Ayurveda considers winter connected to something called kapha dosha and the water element, which we will get into in a moment.  And summer is associated with pitta dosha and the fire element.  Spring, where we find ourselves now, is considered a transition time, and is not associated with any of the three doshas (the third dosha is called vata and associated with the wind element, and is prominent during the fall and early winter).

Doshas refer to your physical and mental constitution. Each person has a dominant dosha or a blend of two (an equal balance of three, or tridoshic, is also possible).

In the winter season, kapha dosha is dominant for everyone, and we usually come out of winter with a bit of excess, which can lead to imbalance and even illness. When it’s in balance, kapha dosha it supports healthy growth of muscle and bone, provides a feeling of being grounded, makes our thinking and movement more fluid, and we have better endurance, follow-through, patience, and several other desirable qualities.

When out of balance, though, kapha’s cold, damp and heavy nature can result in increased mucus, weight gain, allergies, asthma, respiratory illness, and digestive sluggishness, just to name of few things.  It tends to settle in the lungs and stomach, and secondarily in the joints, connective tissues, heart, and brain!  So spring cleaning using yoga tools can help for a healthy transition into better balance.

Since winter is typically a less active time, your spring yoga practice needs to add in more movement.  Slow vinyasa is one way to provide this.  Linking movement and breath in a more consistent and regular way also helps with stimulating the body appropriately.  Slower and longer inhale/exhale patterns can be helpful.  Utilizing ujjayi breath, which is mildly heating, during practice could also help with eliminating excess Kapha.  Other pranayama techniques considered helpful in spring are Kapalabhati, Nadi Shodhana, Bhastrika, and Surya Bhedana.

There are some asana poses considered to be kapha-reducing, especially those that stimulate the processes of elimination. Inversions are said to be balancing for kapha dosha, so Shoulderstand and Headstand, if in your repertoire, can be included in home practice.  For stimulating digestive fire, the wind of the belly (the samana vayu), and for increasing flexibility and decreasing body fat, a whole list of poses can be added to the practice: seated spinal twists like Ardha Matsyendrasana, Navasana, Simhasana, Bridge, Paschimottanasana, Matsyasana, and Camel Pose.  Due to its purported affects on the glandular system, the seated posture Siddhasana, along with Shoulderstand and Headstand are considered beneficial from an Ayurvedic viewpoint.

There are certainly more refined practices you can add to your home practice as you get more comfortable with those suggested here.  This can include mudras and unique ways to approach Savasana and even yoga nidra. But this information you have here can help to get you started now.  If you want to learn more about yoga and Ayurveda, consider checking out David Frawely’s book Yoga and Ayurveda.

Baxter Bell, MD, teaches in the San Francisco Bay Area and internationally, and is director of the Piedmont Yoga Studio's teacher-training program in Oakland, California. He is a contributing writer for Yoga Journal magazine and for the International Journal of Yoga Therapy, and created Yoga Journal’s Yoga for Stress DVD. Follow him on his other blog, Yoga for Healthy Aging or his website bellyoga.info

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The Truth About Forward Bends

April 18, 2012

Supported Paschimottanasana

Starting with the very first yoga class I recall taking, I’ve heard teachers wax poetic about seated forward-bending poses, like Paschimottanasana. How helpful they are for calming the nervous system, quieting the mind, for turning inward, and so on. Meanwhile, my hamstrings would be screaming, my lower back starting to ache, and my mind racing, asking “When will this pose end, and what the heck is this teacher talking about?!”  And even though my experience with seated forward bends has changed some over the years, they are still a very mixed bag for me and for many of my students.

The poses in and of themselves are not inherently good or bad, but I’ve observed that only about 10 percent of students find them physically easy and accessible as they are typically presented, and the other 90 percent need some serious guidance to do them safely.

Even a recent Yoga Journal Daily Insight newsletter that arrived in my inbox referred to the paradox of the forward fold, and although useful, it only told part of the story.  So I thought I’d try to set the record straight (as I understand it) and also give a few helpful hints on how to do these poses so you receive these benefits with a modicum of composure without hurting yourself.

Let’s start with the spine, as a bit more detail here can be helpful.  First off, I like to establish the Prime Directive (huh?) with out sounding too Star Trek geeky: Always begin by creating even upward lift through your entire spine.  At least then you will be creating as much potential space between the individual vertebrae as much as possible, especially in the lower back where we are most concerned.

A bit about what happens with back-bending forward-bending of the spine:  When you back bend, the front edges of the vertebrae move away from each other and the back edges move toward one another, wedging the spongy intervertebral discs toward the front of the spine.  This turns out to be not such a big deal, because there is only a strong ligament there and no nerves for the disc to push into.  However, the reverse effect is true with forward bends: When you round your spine forward, the back edges of the vertebrae move apart, the front edges toward one another, and the disc gets wedged in the posterior direction.  This can be a potential problem if the discs begin to bulge into this space, because right behind the back of the vertebrae runs a very important and sensitive structure: your spinal cord.  That’s right, all the bundled nerves that pass between your brain and the rest of your body, in this case your lower body, pass down just behind the discs.

If your spinal structures, ligaments, and muscles are in good health, then forward bending may not be a problem for you. But for the average person with some hip and hamstring tightness, the situation is a bit different. As you start to go into the forward bend, you are encouraged to tip the pelvis forward (good idea!), but before you have tipped very far the hamstrings act like a brake and stop any more forward movement of the pelvis. This is even more pronounced when you are sitting on your mat than when standing. In a standing forward bend, at least gravity gives the hips a little help in allowing the pelvis to rotate a bit more.  But if your pelvis stops tipping, how do you fold more deeply?  You do it by forward folding your vertebrae.  The mildest negative consequence of this can be strain of the muscles in the lower back.  But repeated effort to go deeper in a seated forward fold could potentially cause the discs to bulge backwards in the bad direction, possibly bulging into the nerves in the spinal canal, resulting in one-sided pain with symptoms even traveling down the leg.  If the situation were to worsen, a ruptured disc could result.  These last two situations are often related to chronic back pain and sciatica and are an unwanted side effect of poorly executed poses.

Fortunately, this does not have to be the case.  One day, just a few years back, my teacher suggested we try all the seated forward bends with a bolster under the knees. A bolster! Can you believe it? At first I thought this would be a bit too much, but to my surprise and delight, I did Janu Sirsasana (Head-to-Knee Pose), Triang Mukha Eka Pada Paschimottanasana (Three-Limbed Forward Bend), Ardha Baddha Padma Paschimottanasana (Half-Bound Lotus Seated Forward Bend) and Paschimottanasana (Seated Forward Bend), and I enjoyed them all in a way I never had before.  My body was at ease, my breath was relaxed, and my mind was finally quiet.

You may not need such a large prop, or any prop at all, but I do strongly suggest that you bend your knees in small increments until you find the magic moment when your pelvis can take on most of the forward-bending action, allowing for the lumbar spine to maintain a bit more neutrality (versus having to go into extension as is sometimes recommended).  And even if you are in good spinal health, and can withstand a certain amount of forward rounding of the spine, if you’re trying to go further into the fold by pulling strongly with the hands on the feet, a strap, or whatever you can reach, you only increase the pressure on the low back and discs in the dangerous direction.

With these modifications, it may finally be the day for you, as you fold over the thighs, that you can collect all those accolades that forward folds are said to hold.

Baxter Bell, MD, teaches in the San Francisco Bay Area and internationally, and is director of the Piedmont Yoga Studio's teacher-training program in Oakland, California. He is a contributing writer for Yoga Journal magazine and for the International Journal of Yoga Therapy, and created Yoga Journal’s Yoga for Stress DVD. Follow him on his other blog, Yoga for Healthy Aging or his website bellyoga.info

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Sleep Well

April 3, 2012

A good night's sleep.Among the various hats I wear in the world, one of my favorites is that of director of the Piedmont Yoga Studio’s Deep Yoga Program, our teacher training program in Oakland, California.  My current group of future teachers are now only three months from graduation, and although as a rule they all seem to be enjoying the training, it is an added stress (albeit a positive one) on their already busy lives.  Just last session, we delved into the therapeutic benefits of yoga on a variety of health conditions.  I went around the room and asked each of the 23 trainees to briefly share the issues that have found yoga to be helpful for in their own lives.  About a quarter of the participants mentioned insomnia or sleeplessness as their number one problem that their yoga practiced has helped.  If you have followed the yoga research news in the past few years, you will know of a study from Harvard funded by the NIH that has looked at applying yoga practices to improve insomnia.  In my own backyard, fellow faculty member at Piedmont, Ann Dyer, not only a gifted yoga teacher but a world class vocalist as well, released a wonderful yoga DVD, Z Sleep, which I and others have found invaluable for our sleep-deprived students.

One technique that Ann promotes and I have found useful, is to design a special asana practice that you use to prepare for sleep.  In other words, it’s a practice you would likely do near bedtime, possibly in or near your bedroom.  If you have not had a chance to do any yoga poses earlier in the day, you can incorporate just about any pose at the start of the practice, but I recommend those that have some forward-bending aspect to them, especially at the hips and possibly gently in the rest of the spine to help quiet the mind and body. (If you have super tight hamstrings and hips, bend your knees.)

I’d start with any standing variations, like Half Dog at the wall, or Wall-Hanging Forward Fold, where you stand 12-inches facing away from a wall but resting your buttocks on it,  and fold forward.  Depending on how stiff or tight you are, you can gently pulse in and out of the pose, or simply hang here as quietly as possible.

Ann recommends to let the head hang toward the floor.  I have found this can add extra release of my mental energy and I have adopted this recommendation for my practice and those I give to others.

From standing variations, you can work on a chair, doing Seated Forward Folds and Seated Twists, and then eventially sitting on the floor and doing Seated Forward Folds, liberally using blocks and bolsters as props so there is just the lightest amount of physical effort. By simply quieting the body, the mind will begin to quiet as a prelude to sleep.

Finally, reclining poses on the back, such as Legs up the Wall and Corpse Pose, are the perfect finish.

In addition, 2 breathing techniques are particularly helpful in my experience.  The first is a classic pranayama technique that is know to have a quieting effect on the autonomic nervous system, which is an essential shift that needs to happen to fall asleep easily.  It is accomplished by lengthening the exhalation to twice the length of the inhale, which lowers the heart rate.  I have recently been doing the following pattern: 3 normal breathes in a row, and on the 4th round, gently, but actively,  squeezing the exhale out to twice the length of the inhale.  Then, allowing the next inhale to arise naturally out of the longer exhale.  Repeat this 4-breath cycle at least 6 times.  Notice if this creates more physical and mental relaxation.  If it does, add it to your pre-sleep routine.

The second technique when I wake up in the middle of the night and find that mind has turned on its “thought factory” quickly.  It is a variation on counting sheep that I learned in India years ago in my yoga studies.  I use the 12 creases of my 4 fingers on one hand like the markers on an abacus, the ancient counting machine.  I use my thumb on the same hand to move around the spaces.  I have two patterns I use, but you can make one up that is easy for you to remember, and then practice it when you are wide awake a few times, so you’ll have the hand pattern already in your memory bank when you need to use it.  Start with the tip of your thumb on your number one space, and after every cycle of inhale/exhale, move it to the next space on your pattern.  If you make it to 12 and are still awake, slide your thumb back to 1 and begin again.  Keep the breath pace relaxed, with no sense of urgency to complete the 12 movements quickly.  I find I will often drift off to sleep in 1-2 rounds, and even if it takes me longer, I am at least not focusing on the stressful thoughts that likely were keeping me up in the first place.

Finally, consider your sleep preparation: are you getting to bed at a reasonable time?  Are you permitting some time between watching action packed or stressful dramas, or time on the computer or phone, before the lights go out?  I’d recommend 45 minutes as a safe bet for the mind to shed some of the tension created by those activities.  Are you limiting your fluid intake after dinner?  Are you careful not to overdue the caffeine, alcohol or other substances that can interfere with a good night’s rest?  And can you remember to begin preparing for sleep first thing in the morning, by noting what worked and what did not seem to work the night before, and consider doing a brief morning meditation to set your intention to have good sleep preparation throughout the day?  Just like any benefit we hope to derive from our yoga, it will require a regular, daily effort in order for the possibility of success.  Why not start today?

 

Baxter Bell, MD, teaches in the San Francisco Bay Area and internationally, and is director of the Piedmont Yoga Studio's teacher-training program in Oakland, California. He is a contributing writer for Yoga Journal magazine and for the International Journal of Yoga Therapy, and created Yoga Journal’s Yoga for Stress DVD. Follow him on his other blog, Yoga for Healthy Aging or his website bellyoga.info

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Yoga and Lupus

March 20, 2012

Woman with her eyes closed. Several years ago, I wrote something for Yoga Journal about using yoga as an intervention for lupus, or Systemic Lupus Erythematosus (SLE).  Since then, I get the occasional question about yoga’s role in helping to manage this difficult illness, and just last week, I got both an email from a student, as well as a new student in class with lupus, so I thought it was a good time to revisit this issue for anyone suffering from or teaching someone with lupus or any other autoimmune condition that can negatively impact joint health and flexibility.

Here’s what I had to say back then:

Systemic Lupus Erythematosus (SLE) is a chronic autoimmune illness (that is, one in which the body attacks itself). It’s sometimes likened to rheumatoid arthritis, except that the inflammation of SLE can affect not only the joints but almost every other bodily system, including the skin, heart, lungs, and kidneys.

It affects women by a ratio of 10 to 1 over men; they commonly develop it between their 30′s and 50′s. It is considered a progressive illness, meaning it gradually worsens over time, and it alternates between periods of remission and flare-ups. Studies examining the relationship between arthritis and exercise have found that moderate aerobic exercise can be beneficial, so you might assume the same would be true for SLE.

My recommendations for an asana practice depend on whether you are in a symptom-free or flare-up stage. To improve joint health when symptom-free, you should focus on proper alignment of the joints, creating maximum space in the joint, and putting the joints through a full range of motion. A beginning-level Iyengar-style class (or an Anusara-style class, or any other alignment-focused class) would be ideal, along with a gentle vinyasa practice for range of motion.

Things shift dramatically during flare-ups, when most sufferers experience profound fatigue. It’s good to move to a more restorative practice during those periods. When you have pain, joint inflammation, and a skin rash, your body needs help to shift from the high-alert focus of the sympathetic nervous system to the quiet, immunity-supporting role of the parasympathetic nervous system.

A regular yoga practice can also help the mind observe itself during the stress of pain and physical limitations. The limbs of yoga most helpful in this regard are pratyahara (sense withdrawal), dharana (concentration), and dhyana (meditation). I’ve witnessed patients completely change their relationship to their chronic illnesses through the application of these ancient methods.

…

These recommendations still stand. And in terms of new mainstream treatments, not much has changed. In fact, the given line is that there is no cure for SLE, and the goal of treatment is to control symptoms of the disease.  The main “tools” that Western physicians typically prescribe are nonsteroidal anti-inflammatory medications, like ibuprofen, for arthritis and lung symptoms; topical steroids creams for skin rashes; and stronger antimalaria drugs and oral steroids for skin and arthritis symptoms that worsen. And they recommend talk therapy to deal with ensuing depression and mood changes that often arise as the illness progresses.

Well, a lot of yoga practitioners with lupus have something to say about their experiences in how the practice can help manage the disease.  Blogger Daisy Seale-Barnes, who writes Living Well With Lupus, even stated simply and eloquently that yoga lowers her stress levels, and less stress has meant fewer lupus symptoms for her!

The main areas of benefit of yoga on SLE include the following:

Improved flexibility and mobility
Improved physical energy
Stress management
Pain management
Improved mood and coping

Lupus is a variable disease, meaning it affects each patient differently, making yoga a near perfect intervention since the practice can be individualized for the array of symptoms each person is dealing with. Developing a home practice and finding a good public class that is right for you can go a long way in making a difficult illness more manageable.

A 2009 study on the potential benefits of yoga for rheumatoid arthritis patients showed reduced joint pain and swelling after an eight-week yoga program modified to accommodate their reduced flexibility and other symptoms.

Since lupus patients often develop arthritis on top of their chronic whole body inflammation, a reasonable correlation could be made that yoga might have the same benefit for SLE that this study found for arthritis.  Also, in addition to the recommendations I made in 2006, I’d add yoga nidra to the list of restorative practices that can be particularly beneficial for lupus folks for almost any of the symptoms that happen to arise on any given day.

Baxter Bell, MD, teaches in the San Francisco Bay Area and internationally, and is director of the Piedmont Yoga Studio's teacher-training program in Oakland, California. He is a contributing writer for Yoga Journal magazine and for the International Journal of Yoga Therapy, and created Yoga Journal’s Yoga for Stress DVD. Follow him on his other blog, Yoga for Healthy Aging or his website bellyoga.info

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Sun Salutes for Any Body

March 8, 2012

Over the years of teaching and leading Sun Salutations (Surya Namaskar), which I personally enjoy doing myself, I have observed time and again, the challenge of one particular transition in the sequence: going from Down Dog to High Lunge as you finish up one round of a salute.

There can be any number of reasons why this is so challenging for some of us. The muscles around the hip can be strong but tight. Body proportions, such as a longer torso paired with shorter legs and arms, can make it tough to get the foot all the way up between the hands.  And if you have a larger midsection, this can also interfere with the movement.

Although I have taught many tricks on improving the forward stepping of the leg you are bringing into lunge, I had a new idea on a recent teaching trip in Washington, DC.  Why not create a Sun Salute that omits that transition while retaining essentially everything else the series has to offer? And so was born the Severed Sun Salute!  Or as some have already preferred, the Fractured Sun Salute (we can be so sensitive to some words!).  I present it here, as I have already been getting lots of good feedback from teachers in the DC area who learned it and are teaching it to their students with encouraging results.  It has two parts and a lot of steps, which I’ll discuss and demonstrate below.

Part 1:

Stand in Tadasana at the front of your mat.

Anjali mudra at top of mat.

 

Inhale the arms overhead into Urdhva Hastasana (Upward Salute),

and on the exhale, fold over into Uttanasana (Standing Forward Bend).

Uttasana (Standing Forward Bend)

Inhale your left foot back into High Lunge, and as you exhale, bring the left knee down to the floor, the right hand to the right knee, and rotate your belly and chest to the right.

High lunge

 

 

 

 

 

Low lunge with twist.

 

 

 

 

 

Inhale and lift the left knee as you return to full High Lunge.

High lunge

 

 

 

 

 

Step forward to Uttanasana as you exhale, and inhale your arms up. Exhale hands in front of heart in Anjali Mudra. Repeat the sequence on the second side. Do this a few rounds.

When you’ve finished, stand at the front of the mat, close your eyes, and mentally repeat the pattern without actually moving. Allow your mind to fully experience the new pattern.

Part 2:

Opening your eyes, dosey doe to the back of your mat (you might even imagine a little square-dance tune!), and stand at the back edge facing the front.

Walk to back of mat.

Anjali mudra at back of mat.

Inhale the arms up, and exhale into Standing Forward Bend.

Urdhva Hastasana (Upward Salute)

Uttasana with bent knees.

Get all 10 fingers on the mat, even if you need to bend your knees a bit, and on your inhale, walk your hands toward the front of the mat.

walking hands forward or back

 

 

 

 

 

As you exhale, push the hips up and back into a nice Downward-Facing Dog.

Adho Mukha Svanasana (Downward-Facing Dog)

 

As you inhale, come forward into either Plank, High Cobra, or Up Dog.

Plank

Upward-Facing Dog

 

As you exhale, walk your hands back toward your feet until you are standing in Uttanasana at the back of your mat.

walking hands forward or back.

 

 

 

 

Uttanasana with bent knees.

 

 

 

 

 

This last move takes some practice to do efficiently.  It is helpful to use Ujjayi breath to extend the exhalation and give you enough time to get into Uttanasa.

Now, inhale up to Urdhva Hastasana, and exhale to finish in Anjali Mudra.

Arms up.

 

 

 

 

 

 

Anjali Mudra

 

 

 

 

 

 

 

Repeat the sequence 3 more times, and once again, when you finish, close your eyes and mentally match your breath to the imagined pattern.

In addition to providing you with an accessible alternative to traditional Sun Salutations, this new pattern will challenge your mind to adapt and learn new movements.  I believe these kinds of slight variations in practice will keep our minds agile and adaptable as we age.  Give it a go!

Baxter Bell, MD, teaches in the San Francisco Bay Area and internationally, and is director of the Piedmont Yoga Studio's teacher-training program in Oakland, California. He is a contributing writer for Yoga Journal magazine and for the International Journal of Yoga Therapy, and created Yoga Journal’s Yoga for Stress DVD. Follow him on his other blog, Yoga for Healthy Aging or his website bellyoga.info

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Painless Pigeon

February 15, 2012

A lot of the poses we explore in classes fall into the category called “hip openers.”  This is a bit of a misnomer, as what they really are are poses that increase the lateral or external rotation of the femur (thigh bone) at the hip joint.  Many of my favorite poses, like Bound Angle, Garland, and Half Lotus, involve this particular action at the hip joint.  Ultimately, these poses, I believe, are preparations for sitting meditation practice when done in cross-legged seated positions, like Perfect Pose (Siddhasana), Easy Pose (Sukhasana) or Lotus variations (Padmasana).

Back to the misnomer of hip openers: The hip can actually open in many directions, including the front, back, sides of the joint, as well as internally rotating, as in Hero Pose (Virasana).  This is a good place to bring Pigeon into the discussion.

One-Legged King Pigeon Pose (Eka Pada Rajakapotasana), often just called Pigeon Pose, combines external rotation of the front hip joint and extension of the back leg (which opens the front of the back leg’s hip joint).  And if you have average flexibility like I do, you probably use props to do the pose safely and effectively, and possibly quite a few—a couple of blankets, a block, maybe even a bolster.  One reason this is helpful is that the front knee can be vulnerable to strain or injury if your front hip is really tight. The props tend to keep the front leg’s knee happy and healthy and the back leg’s knee cap comfortable.  And I personally get a lot out of this way of exploring Pigeon.

However, one day a few years back, my wife, Raven, also a yoga teacher, taught a version of Pigeon without props that gave me that satisfying sense of release and opening in my front hip and increased extension in the back leg without the risk of tweaking my front knee! She quipped that this version is called Wounded Pigeon on the Side of the Road.  And you will see why in just a moment.  This variation has become a mainstay in my yoga tool box, so without further adieu, here it is:

 

Sit in Sage’s pose, Bharadvajrasana, at the front right corner of your mat, shins tucked to your left, your outer right thigh parallel and up against the right side of your mat.  Support your torso on your right hand, placed a bit to your right.  You are going to keep your right buttock and hip on the mat at all times during this variation, I repeat, at all times!  Lift the left leg off the right and move it back just clear of your right foot.  Then, while leaning just a bit to the right, move your right shin forward until it is flush up against the front edge of your mat, making a 90 degree angle with your thigh.

Next, lean more to the right and a bit forward so you can begin to take your left leg back behind you until it is straight, allowing the leg to angle back and to the left back corner of your mat.  For those with back hip tightness, you may want to let your leg stay over to the left and even rest the inner edge of your left foot on the floor.

If you have more flexibility, you can carefully wiggle the left leg more in line with left hip and parallel with the long edge of your mat, even turning the toes under and lifting the back knee to increase the stretch of the back leg.

With the torso more upright, the work gets focused on the back leg, but if you begin to fold the upper body over the front thigh, you will find that deep satisfying stretch in the right hip and buttock areas.  The right knee should remain blissfully silent!

To come up, simple reverse all the actions to get back to your starting position in Sage’s pose.  Then, shift over to the left side and go for Wounded Pigeon on the other side!  Students with hip injuries or arthritis, as well as those with hip replacements, should get guidance from a qualified and experienced teacher when learning Pigeon, no matter what variation they do. 

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Cultivating Awareness

January 31, 2012

With all the excitement and controversy of the New York Times’ excerpt of William Broad’s book, I’ve had some interesting conversations with colleagues and students about the topic of yoga-related injuries. One interesting factoid came from Yoga Journal contributing editor Jason Crandell, who discovered that each year there are about 86,000 emergency room visits for people who trip on their pets!

It made me consider how important it is to maintain a certain amount of awareness regarding your immediate environment all the time. Just as I would never consider getting rid of my loving pup just because I might trip on him due to inattention, so to I am not going to stop my incredibly beneficial yoga practice because of the much lower chance of injury.

I am not feeling defensive about the topic of yoga-related injuries. They are a reality, as are injuries with any physically based practice, which yoga asana is. I even teach workshops around the country to teachers in training on how to avoid injuring their students.  And I myself have sustained a few injuries over the 18 years I have been enjoying hatha yoga.  On one memorable occasion, it was directly due to my inattention.

On the very first day of my own teacher training, we were at the walls working on Handstands, and I was distracted and looking around the room as my classmate next to me came down from his arm balance attempt. Just so happened my hand met his descending foot, and I broke one of my metacarpal bones. From that day on, I have been very aware of those around me as I practice.

So what can you do to lower your chance of injury due to distraction and inattention?  The Yoga Sutra prescribes a specific set of mental practices that have bearing on this idea: one pointed focus or concentration, known as dharana, is practiced to hone the ability to concentrate on the present-moment circumstances. And discernment or discrimination, known as viveka, is practiced to give us the opportunity to evaluate our possible choices moment by moment.  (If you are looking for a great source to learn more about these concepts, check out Nicolai Bachman’s Yoga Sutra Workbook and audio CD collection.)

I use my mat as the place to practice these fundamental concepts. By setting the intention to focus on my poses, while simultaneously widening my field of perception to be mindful of those around me, I practice dharana. I practice viveka by evaluating my environment to pick the optimal spot to practice, and also to pause and consider the poses I’m being asked to explore, especially if I don’t feel prepared to do a more physically challenging pose. I have moved to a different spot in a room to better see the teacher, to move away from other students who don’t seem to be paying attention to what they’re doing, or just to have space to practice challenging poses, like Handstand.

I highly recommend integrating these yoga philosophy concepts into your yoga practice, boosting your attentiveness level and lowering the chance of these kinds of injuries. Plus, you’ll actually be present to win, as they say, the fruits of your endeavor!

Baxter Bell, MD, teaches in the San Francisco Bay Area and internationally, and is director of the Piedmont Yoga Studio's teacher-training program in Oakland, California. He is a contributing writer for Yoga Journal magazine and for the International Journal of Yoga Therapy, and created Yoga Journal’s Yoga for Stress DVD. Follow him on his other blog, Yoga for Healthy Aging or his website bellyoga.info

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Yoga Injuries: The Bigger Picture

January 10, 2012

yoga class in headstandOn Sunday, an excerpt of the upcoming book, “The Science of Yoga: The Risks and Rewards,” was published on the New York Times Magazine. One of my students emailed the link to the article with subject line “Bad Press?” and the simple question, “What do you think?”

As it turns out, I’ve given this a lot of thought over the years. As a physician and yoga teacher, I’m interested in sharing the benefits of yoga with my patients and students, while realistically cautioning them on yoga’s risks for certain injuries, such as the risk of wrist strain with arm balancing poses if one is not properly prepared. I have noted that certain styles of yoga, especially those that seem to have a more aggressive quality to their practice like the Mysore Ashtanga series, if one is a beginner, tend to produce consistent kinds of injuries in students, such as shoulder injury from repeated Chaturanga Dandasanas.  But I also know that there are many factors that go in to the development of an injury, and consider yoga poses to be one of many potential issues to address—your age, general level of fitness, history of injury from other activities, as examples. And I have no difficulty acknowledging the reality of asana risks, and in fact teach workshops on how to avoid the potential pitfalls highlighted here.

Perhaps the problem I see here is that this article creates an ongoing case for the negative potential of yoga asana, without balancing this with “rewards” Broad promises in the title of his book.

There are some valid observations.  Broad features the experiences of yoga teacher Glenn Black, who cites a shift in the demographics of yoga practitioners, from people in India who are used to squatting and sitting on the ground to Western urbanites, arriving from the office or the car, sometimes ill-prepared for the physical demands of asana practice. He also mentions the lack of experienced teachers and instructors that push their students hard, with strong adjustments and ego-driven practices. Black also reminds us that one of yoga’s purposes is to diminish ego, not indulge it.

But then, the author goes on to mention the yoga community’s apparent silence on the topic of yoga-related injury:

“They celebrate its abilities to calm, cure, energize and strengthen. And much of this appears to be true: yoga can lower your blood pressure, make chemicals that act as antidepressants, even improve your sex life. But the yoga community long remained silent about its potential to inflict blinding pain.”

Although this may have been true in the past, since I got involved in yoga in the mid-1990s, I would say there has been a much more open conversation going on about the benefits and risks of yoga practice.

Broad continues to build his negative case, citing several instances of yoga-related injury, and mentioning statistics showing an increase in yoga-related injuries reported by U.S. emergency rooms, from 13 in 2000 to 20 in 2001, and up to 46 in 2002. What is not considered, however, is the simultaneous increase in the number of yoga practitioners during that time. In just 10 years, it’s estimated that the number of people doing yoga rose from 4 million to as many as 20 million. This could imply an overall decrease in the incidence of injuries, not the reverse.  Statistics can be a tricky thing sometimes.

And as more formal study of the risk of injury has been done in recent years, the author makes an interesting statement regarding recent findings:

“The numbers weren’t alarming but the acknowledgment of risk … pointed to a decided shift in the perception of the dangers yoga posed.”

Ah, refreshing, even though the tenor of the article implies the opposite, that we should be alarmed!

Because I work in the area of yoga therapeutics and work with students who have injuries, some unrelated to yoga, some aggravated by their practice, and, on rare occasion, caused as a result of their practice, I might have a more balanced view of what to expect from a modern Western practice of yoga.  I have often suggested to the teachers I train that there should be a disclaimer at the first class a student takes. Something like this:

“It is entirely possible that at some time during your practice of physical yoga, hatha yoga asana, you will experience an injury. Don’t be shocked or surprised by this. It is true of any physical endeavor. This may be due to your inexperience, attending a class that is beyond your present level of skill, underlying propensity for your body to become injured, inexperience of your teacher or many other factors. Part of your responsibility as a yoga practitioner, is to take the best care of yourself you can, ask questions when concerns arise, investigate the qualifications of your instructors, and so on.”

Then I suggest they also mention all the rewards one can anticipate, in including improved range of motion of the joints and improved physical strength and stamina. Plus there are mental-emotional benefits of being more grounded, peaceful and centered, just to name a few.

I couldn’t agree more with Glenn Black’s final quote: “My message was that ‘Asana is not a panacea or a cure-all. In fact, if you do it with ego or obsession, you’ll end up causing problems.’”

And I would add, if you develop a broader yoga practice, one that is not solely a physical substitute for other forms of exercise, but one that includes the full spectrum of what yoga is about—regular pranayama practice, meditation, exploration of the philosophy of yoga, involvement in Karma yoga in your communities—you are much more likely to reap the potential positive benefits of yoga and diminish the risk of injury highlighted in this excerpt.

 

Listen in as Baxter Bell, MD, Yoga Journal Editor in Chief Kaitlin Quistgaard, and yoga teacher Jason Crandell discuss this topic on Forum on KQED, the San Fransico NPR affiliate station.

 

Baxter Bell, MD, teaches in the San Francisco Bay Area and internationally, and is director of the Piedmont Yoga Studio's teacher-training program in Oakland, California. He is a contributing writer for Yoga Journal magazine and for the International Journal of Yoga Therapy, and created Yoga Journal’s Yoga for Stress DVD. Follow him on his other blog, Yoga for Healthy Aging or his website bellyoga.info

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