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Monday, August 20, 2012

Balance and Safety

by Shari

A lot of my students tell me that they have balance issues and want to improve their balance with yoga practice. There is no unifying factor on why these students have balance issues. Some are due to injuries with surgical repairs (ankle fractures or other bone fractures, joint replacements of the hips or knees, spinal surgeries). Some are due to soft tissue injuries of muscle, tendons or ligaments. Some are due to brain injuries, such as strokes, multiple sclerosis, or Parkinsons Disease. Some are due to coordination issues, visual issues, inner ear issues. Some are part of medication side effects. I think you are getting the picture. So how does the yoga student and teacher address their own or their student’s balance issues?

I don’t specifically ask people if they have balance issues but instead I observe how they are in class. Then I am very free with using the wall as my favorite prop! I LOVE THE WALL! I can face it with the front of my body, I can have it behind me or I can be perpendicular to it. It depends on what I am working on at that particular time and the needs of my students. If there is a “yoga horse” in the place that you practice then it can be an even better love affair! I use the wall to allow me not to be afraid. Fear of falling can occur in all ages of students. Falling when you are younger is a lot less injurious than when you are in your 50’s and 60’s. Young bones “bounce” but older bones shatter. There are many reasons for this but the simplest can be attributed to osteoporosis and how we fall. Certain body parts are more prone to breaking than others and the surfaces that we fall on also contribute to fracture risks.

Bones of the Right Leg
The other unfortunate thing is that as we age we are less efficient in making new bone through the “remodeling process.” Bone is living tissue and it is constantly being formed and remodeled throughout our lifetime but like all parts of aging things get less efficient and slower (sigh). So falling in yoga class or during practice is not good for anyone’s health or confidence. For standing poses for some students, I may use a combination  of the wall and a chair, having them use both to assist in their balance as they are learning poses and then later on for them to increase their endurance when holding a pose. I think of blocks more as making poses accessible but not as a tool to safeguard from falling because they are too small and unstable themselves. If I have someone in class who is very unsteady I might place them in a corner so they have three points of stability (feet, side and then with a chair).

You may remember from a previous post Nina and I did way back when she interviewed me on balance (see Aging and Balance), we talked about balance receptors being found in hands and feet in large number. Being barefoot in class is really an important component of balance, and whenever possible I encourage my students to be barefoot if possible. Sometimes usage of a sticky mat isn’t as optimal as not using one (it may be easier to balance directly on the floor), so you have to decide what works best for you. Learning how to feel the intrinsic muscles in your feet (which Baxter has been so eloquent on in his recent posts on feet) and hands WILL affect balance in standing poses and some inversions.

Also, remembering to use your eyes in yoga class is also going to affect your balance (again see Aging and Balance about vestibular reflexes). Focusing on a fixed object as you move into and out of one-legged poses helps with stability. Keeping your head in neutral and not compressing your upper cervical spine into hyperextension (thrusting your chin forward) will also improve your balance (there are balance receptors at the base of your skull).

Other factors that affects our balance and safety are our individual levels of flexibility, strength and endurance. Being able to access a pose requires a certain degree of flexibility as well as alignment. When we try to do poses we aren’t ready for, we almost certainly will fall (think Headstand, arm balances, and Shoulderstands). These are truly advanced poses and take years to safely prepare to do them. Fatigue and endurance are factors in balance because we are unable to access the required muscular strength to perform an asana when we fatigue.

Lastly anticipation is also a factor in how balanced you are. The mental mindset “I always fall in Ardha Chandrasana when I do it on my left” pre-programs those pesky neural circuits into anticipating that you are going to fall so they aren’t going to be able to prevent it. Now I am not saying to disregard past experience or history it just that always doing the pose so that you fall isn’t a way to learn how NOT to fall in it. Learning to sense your balance changes within a safe context is extremely important as we try to improve our balance.

Balance like strength and flexibility is not static but improves with practice and time. I have a current student with me who began yoga because his wife told him to. He is a retired physician and told me when he started that he had cerebellar problems and couldn’t balance. Well he was correct the first year. He is now going on his second year with me and is now starting to do Ardha Chandrasana with just one foot at the wall. He can also now balance on each foot when he does tree pose (not very long but the time isn’t the issue but that he is starting to be able to do it). When I recently mentioned to him that his balance is improving he agreed and said, “I didn’t think it ever would and I am as surprised as you by it.”

I am truly humbled by the body’s ability to transform. That's one of the things that gets me onto my mat daily!
 

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