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Wednesday, July 31, 2013

Healthy Spirits: New Stuff at Castro

 
 
New at CASTRO:

1. Stone R & R Coconut IPA (limit 3 per customer)

2. Sierra Nevada Tumbler Brown Ale

3. 21st Amendment Hop Crisis

4. Bruery Hottenroth Berliner Weisse

5. Clown Shoes Crunkle Sam American Barley Wine

6. Evil Twin Imperial Biscotti Break

7. Evil Twin Nomader (Brettanomyces witbier)

8. Evil Twin Justin Blaeber (blueberry Berliner-weisse)

9. Stillwater Sensory Series No.2: Small Black (black saison)

Yoga for Menopause: Fatigue

by Nina
Rose Light by Melina Meza
When I was going through perimenopause, the worst symptom I had was fatigue attacks. Although fatigue or exhaustion is a classic symptom of perimenopause, I'm pretty sure I made up the term "fatigue attack" because I needed a special term for how it felt to me. I'm a pretty energetic person who gets a lot of things done in a given day, and my yoga practice during that time was quite athletic. But during that period, once in a while, I'd suddenly feel so drained of all energy that all I wanted to do was collapse into a puddle on the floor. There was something essentially different about these hormonally based episodes of fatigue than normal tiredness, and I remembered that same feeling of utter exhaustion from my pregnancies (although those were combined with nausea). So I knew it wasn't something I could fight with energizing poses, such as backbends or sun salutations. Fortunately, I got some guidance from two different senior teachers, Rodney Yee and Patricia Walden, who both helped me figure out a good way to practice when I was feeling that way.

When I first talked with Rodney about a fatigue practice, he came up with a sequence of supported inverted poses (see Just In Time for the Holidays: Inverted Poses). However, the first pose in the sequence was Downward-Facing Dog with head support (traditionally the beginning pose in a supported inverted pose practice), and I complained to him (whined?) that when I was feeling exhausted, that pose felt like to much. So he changed the sequence to start with a long Legs Up pose (Viparita Karani) so I could have a nice rest to start and then move on to more active inversions. That was a revelation to me who had only done that pose at the end of a practice. Learning I could rest at the beginning of my practice instead of the end—that I could break a rule that wasn't even a really rule— was a revelation. I started to realize I had a lot more freedom to adapt my practice to my particular needs that I had known. And practicing was a good way to get through a fatigue attack and did leave me feeling refreshed.

Later I took a workshop from Patricia Walden on Yoga for Menopause. She, too, recommended a combination of restorative poses and supported inversions. Eventually, when the book she wrote with Linda Sparrow, The Woman's Book of Yoga and Health, was published, I started to practice her menopause fatigue practice on a regular basis. This sequence is quite long and some of the poses may not appropriate for many of you, but I'll list all the poses here just in case.
  1. Supported Reclined Cobbler's pose (Supta Baddha Konasana)
  2. Supported Seated Forward Bend (Paschimottanasana)
  3. Supported One-Legged Forward Bend (Janu Sirsasana)
  4. Simple Seated Twist (Bharadvajasana)
  5. Downward-Facing Dog with head support (Adho Mukha Svanasana)
  6. Standing Forward Bend with head support (Uttanasana)
  7. Headstand (Sirsasana)
  8. Inverted Staff pose (backbend in a chair) (Viparita Dandasana)
  9. Chair Shoulderstand (Sarvangasana)
  10. Half Plow pose (Plow pose with chair) (Arda Halasana)
  11. Supported Straight Leg Bridge pose (Setu Bandha Sarvagasana)
  12. Legs Up the Wall pose (with variations) (Viparita Karani)
  13. Relaxation pose (Savasana)
Regardless of whether you try this sequence or not, it's worthwhile to look at the strategy behind it. It begins with Supported Reclined Cobber's pose (Supta Baddha Konasana), which is a very restful and relaxing pose. Next are a couple of supported seated forward bends, which are also quieting and restful but a bit more active than the first pose. The simple seated twist is even more active, and definitely stimulating. So now, after having a rest and being a bit energized, you're ready for the more strenuous poses: Downward-Facing Dog with head support, Standing Forward Bend with head support, Headstand, and Inverted Staff pose (backbend in a chair). From there, with the Chair Shoulderstand, Half Plow pose, Supported Straight Leg Bridge pose, and Legs Up the Wall pose, you are moving into the quieting, soothing supported inversions, ending with the most restful of the group. You are also getting a balanced asana practice, with a combination of forward bends, backbends, twists, and inverted poses. (I should say this my analysis of the sequence, not Patricia's.)

As with any sequence, you could shorten this sequence by leaving out certain poses (especially if there are ones you don't normally practice) but still keep the remaining poses in the same order. Or, you could come up with a sequence of your own that combines restorative and supported inverted poses in a way that allows you to rest in the beginning, move toward more active poses, and then rest again at the end. The important thing is to acknowledge your fatigue, and adapt your practice to your current condition, thinking outside the box as needed. And, remember, doing even just one pose (such as Reclined Cobbler's pose or Legs Up the Wall pose) will very likely make you feel better than doing nothing.

Naturally, if you aren't going through periomenopause or menopause (or aren't a woman!), you can still do a practice like this whenever you feel exhausted.

Tuesday, July 30, 2013

Forbes Magazine Gives Yoga a Thumb$ Up

by Baxter
View From Above by Melina Meza
I love it when capitalist magazines find something good to say about yoga, even if it is how it is making someone lots of money. But in this case, Forbes says yoga might save the US trillions of dollars in lost productivity for our economy. How so, you ask? Why, for a start, by reducing the dropout rate from high schools in this country, rates that shockingly range from 30% in most places to over 50% in our urban “war zones.” (I call them war zones because of the continual violent backdrop that these children are subjected to day in and day out; where just walking to and from school, let alone being in school, is a constant cause for anxiety and worry about getting hurt or killed.)

What was a delight to see is one of the featured yoga experts quoted frequently in the article, BK Bose, in whose Niroga Institute in Berkeley, CA, I have had the great pleasure of teaching for the past several years. Bose, who started his career as a software engineer in the high tech industry in Silicon Valley, has more recently focused his work on bringing yoga to under-served communities, and training teachers to work with these special populations. These include classes at the Alameda County Juvenile Hall, low-income public schools and low-income senior centers, to name just a few. His work, as with most small operations around the country, is done as a non-profit venture. Even on its smaller scale, the results of the yoga classes are significant.

And after all, if we can influence the health of our youngest at an early age, that should lead to a longer, healthier life as they age (and, of course, many of our readers have school-aged children). The key underlying factor that Bose identifies as the culprit in so many of the challenges our young face is chronic stress. We have written on many occasions about the ways in which yoga can help us deal with stress. But what about in our kids, and in the growing number of kids that have to deal with gangs, substance abuse, and crime in their neighborhoods? This adds a whole new twist on doing straight up mindfulness techniques. These techniques can work quite well for children who don’t have the kinds of violent communities that Bose’s programs work with, as you will see below.

For me, as I read the article, I found one concept that comes from mind-body research defined in a new way that I could relate to from my own yoga teaching.  I often refer to the mind’s background chatter as “monkey mind” or “restless mind,” and the tendency is for this kind of thinking to have a background feeling of anxiety or stress associated with it. The following paragraph from the Forbes article talks about what mindfulness practices do to the brain, including the new phraseology “default mode network (DMN)” which I find confirming of my own observations:  

“In 2011, a Harvard study showed that mindfulness is linked to increased gray matter density in certain cortical areas, including the prefrontal cortex and regions involved in self-referential thoughts and emotion regulation. There seems to be a strong connection between mindfulness and the brain machinery involved in self-regulation. Other work has shown mindfulness to be linked to relative de-activation of the default mode network (DMN), the brain system that’s active during mind-wandering and self-referential “worry” thoughts, which are generally stressful in nature.”

Mindfulness practices, then, help us change the way we are thinking, or at least the way we are focusing our minds, which changes our stress response. For a young person, this might equate to changed behavior, in which he or she has more control over emotional reactions that might lead to trouble. Bose, however, notes that in his students who live in violent communities and are more often directly or indirectly victims of trauma, mindfulness is not going to work.  As the article points out:

“This is all well and good, Bose adds, but there’s an obvious caveat. When they’re in the midst of stress and trauma, few kids have the ability to sit still enough to take part in a sitting practice. “If you’re not ready to sit in classroom,” says Bose, “you’re not ready to do sitting meditation. If you have drugs and gangs and violence all around you, you simply can’t sit still. Teachers tell us that they often yell at kids 100 times a day to sit and pay attention. It doesn’t work. And to ask them to do this in the context of meditation can have a worse-than-neutral effect – it could be disastrous.”

He says that you have to go beyond mind-body research to trauma research, which tells us that physical activity can help the brain deal with stress and trauma.

“Trauma research tell us that we hold trauma in our bodies… Neuroscience says mindfulness; trauma research says movement. All of the sudden you’ve got moving meditation or mindfulness in motion. Mindfulness alone isn’t going to cut it for these kids.”

Even for adults who carry a lot of anxious energy stored up in their bodies, we here at Yoga for Healthy Aging have advocated for the necessity of movement practices, sometimes more vigorous yoga styles, as an initial stage in leading to deeper relaxation and stress reduction in your daily practice. Turns out to be true for kids with trauma, too.

The take-away from this Forbes exposure of yoga to a larger audience in the US and for us yogis here as well is that it may prove invaluable to teach young and old alike to do yoga, combining active asana and quieter mindfulness practices for maximum benefit. And that it would be a good idea to change policy on a national level to fund such ventures, so everyone at least has access to trying yoga, to see if it works for them. What an interesting, and possibly wonderful, world that could be! 

Healthy Spirits: CROOKED STAVE EARLY BOTTLE RELEASE! (Please Read Carefully)

 
Healthy Spirits proudly announces that we have been selected as one of only two stores in the Bay Area for the early release of the highly anticipated Crooked Stave Artisan Beer Project!


At 5:00pm Tuesday, July 30th (Today!) the following Crooked Stave beers will be available:


Vieille Artisanal Saison

Surette Provision Saison

St. Bretta Whitebier 100% Brettanomyces


Price is $8.99 per bottle plus tax & CRV. Due to the great demand for these exceptional beers there will be a limit of one (1) bottle of each variety per customer.

Bottles will go on sale at both shops 5:00PM sharp. No sales or reservations will be made before that time.

We hope you will take advantage of this great opportunity to grab some Crooked Stave before its official release!

Monday, July 29, 2013

Yoga and Menopause: An Overview

by Shari
Mushroom in Winter by Melina Meza
Nina and I were talking a while back and we realized that we hadn't yet written any posts on menopause. Well, considering that this physiological episode is a major event in every woman's life, we thought it was about time to take this on, and decided that I should start the ball rolling so to speak. Although each woman’s experience of menopause is very personal and individual, there are certain similarities that we all experience, including the end of the ability to give birth! Now this is not to imply that all woman make the decision to become pregnant and raise a child, but the physiological ability to become pregnant is age-related.

To begin our exploration of menopause, I read the book Yoga and the Wisdom of Menopause. A Guide to Physical, Emotional and Spiritual Health at Midlife and Beyond by Suza Francina. This book was published in 2003 but the information it contains is still pertinent. It provides good background information about what menopause is, and how yoga can be applied in all the stages that lead up to menopause as well as during menopause to help alleviate some of the more common issues that woman have to deal with. The usage of yoga was the unifying theme throughout the book.

Moving to specifics, I'll start by defining what menopause is and how you know you are in it. "Meno" means "month" in Greek and "pause" comes from the Greek "pausis" for stop. So menopause is the cessation of menstrual periods, an end to the monthly cycle. There are three stages:
  1. The first stage is perimenopause (“pre-menopause"), when the change in hormonal functions leading up to menopause occur. Typically perimenopuase begins around age 40 (but remember this is a rough estimate) but can begin in one’s 30’s. This stage typically lasts around 5 years, but sometimes lasts for 15 years. In perimenopause women may notice changes in their menses where they are lighter and longer to heavier and more frequent. There are many hormone fluctuations and sometimes this time is called “puberty in reverse”
  2. The second stage is menopause itself because the menses stop. Menopause is considered official 12 months after the last period. The average age of women whose menstrual periods have stopped is 52. Though a woman’s period has stopped, it doesn’t mean that the hormonal levels are stabilized and this period is categorized by emotional shifts, hot flashes, hot surges or flushes.
  3. The final stage, which lasts the remainder of a woman’s life, is post-menopause when the woman’s body has adjusted to its hormone levels.
Most often when we think and talk about menopause, we focus on the physical discomforts, emotional roller coaster ride and weight redistribution in our bodies. But it is a time where we all are learning to adjust to our physical changes, energy changes, and mental challenges. Now Nina has written extensively in the past about emotional health and moods as well as management of depression through the usage of yoga. All of her recommendations can be applied very directly to the challenges some women experience during the stages of menopause.

My particular interest in reading this book was usage of yoga and its effect on the endocrine system and easing menopausal symptoms, especially the management of stress. The book provides illustrations of restorative poses to counter the stresses of a body adjusting to widely fluctuating hormonal levels. Supported Relaxation pose (Savasana), Supported Child's pose (Balasana), Supported Backbends with a bolster, Legs Up the Wall pose (Viparita Karani), and Supported Reclined Cobbler's pose (Supta Baddha Konasana) are highlighted repeatedly in personal vignettes as a prescription for health. (not necessarily in this order). Supported standing poses, inversions, and twists are also recommended, with the woman using a wall or a chair to prevent overly exhausting herself during asana practice. A guiding principle that is cycled back over and over again is that our practice of yoga changes as our body changes. This is not just due to physical aches and pains or the limitations in mobility, energy or strength but in how our intuitive self begins to guide us more in our asana practice.

What I liked most about this book was its celebration of the cycles of a woman’s life. Throughout the book there is joy about entering into an initiation that all women are a part of. The usage of asana is as a guiding tool to help us navigate this unknown territory. The author presents her book as a way to nourish one’s soul through the practice of asana.

Friday, July 26, 2013

Friday Q&A: One Leg Shorter than the Other

Q: I recently learned that my back pain for two years now (surgery recommended) is due to my right leg being shorter (2nd opinion from another back surgeon). My right shoulder and right hip are higher than the left side. Is there a yoga exercise or two that could help me correct this and alleviate the back lumbar pain?

Upper Leg Bone
A: This is a great question, and quite a common finding for many people: having one leg shorter than the other. And as your second surgeon seemed to point out, the presence of one leg shorter than another and low back pain in the same person could be related. Most individuals have a small difference in their leg lengths. Because this is so common, if the difference between right and left is small enough, it does not typically contribute to lower back pain. This is usually the case for people if their leg length difference is less than a ¼ inch. (On a personal note, when I went to my chiropractor recently for a shoulder/neck issue, she mentioned that I had a slight leg length discrepancy that I had never known about. And it turns out I have occasional lower back and sacral pain!)

When you get leg lengths that differ greater than 1/4 inch, that is when it can contribute to lower back pain. And if you have a leg length difference of greater than ½ inch, you are six times more likely to have an episode of lower back pain. That is pretty significant!

For those not familiar with Leg Length Discrepancies (LLD), I’d like to give a little more background. The two main causes of LLD are: 1) poor alignment of the pelvis and 2) having one leg that is structurally longer than the other. Other potential causes include an injury (such as a fracture), bone disease, bone tumors, congenital problems (present at birth) or neuromuscular problems, but these are much less common. Regardless of the reason, your body wants to be symmetrical and will do its best to compensate for the length difference. Certain other conditions can be present along with leg length discrepancy, such as scoliosis, lumbar herniated discs, pelvic torque, greater trochanteric bursitis, hip arthritis, piriformis syndrome, patellofemoral syndrome and foot pronation. I’ve written about a few of these other conditions elsewhere in our blog. But if you have one of these other diagnoses, you may want to ask your doctor to check you for a leg length discrepancy.

The signs and symptoms of LLD can include:
  • one leg being obviously longer than the other (mine was not obvious to me!)

  • affected posture, especially secondary scoliosis or one shoulder higher than other (and scoliosis could lead to secondary LLD)

  • problems with gait
  • pain in the lower back, but also hip, ankle or knee
Lower Leg Bones
As mentioned above, LLDs can be the result of legs actually being of different lengths or the pelvis being torqued and tipped. This leads to two ways of classifying LLD:  a structural leg length discrepancy or a functional leg length discrepancy. A structural leg length discrepancy is a hereditary circumstance where one leg is simply longer than the other leg. This is determined if your pelvis and sacroiliac joints are symmetrical and the leg length is simply due to one leg truly being longer than the other, say via an X-ray.  Functional leg length discrepancy is diagnosed when there is a torsion or pelvic rotation, commonly a sacroiliac (SI) joint dysfunction, which causes one leg to function as though it is longer or shorter than the other. In order to determine if a true structural discrepancy exists, a physical therapist must treat the pelvis and return it to a neutral position before measuring for the leg length discrepancy. Once the pelvis is symmetrical, if the leg length discrepancy goes away it is classified as functional.  If it remains and has a measurable difference, it is a structural leg length discrepancy.  So our questioner of the week may want to begin by finding out if she has a structural or functional LLD, before deciding how yoga can be applied.

How does your western MD and Physical Therapist usually address leg length discrepancy? Structural leg length discrepancy can be treated with a heel lift in the shorter leg’s shoe. You want to let your physical therapist determine the height of the lift, since it is determined by how much lift is needed to restore proper biomechanics in the pelvis and lower back. I know of at least one student of mine who wears a thin-soled shoe on one foot during her yoga practice, as well as a heel lift in one shoe outside of yoga class. This seems to compensate and correct her imbalance and allows her to fully participate in all of her standing poses, especially the symmetrical ones such as Mountain pose (Tadasana), Powerful pose (Utkatasana) and Standing Forward Bend (Uttanasana). In rare instances, surgery may be recommended to either shorten or lengthen the limb. This is always accompanied by a course of physical therapy, which helps to stretch muscles and maintain joint flexibility, which is something yoga asana could compliment.

For a functional leg length discrepancy where the real issue is the tipping and torque of the pelvis, no heel lift is required. Instead, a physical therapist would use proper manual therapy techniques and specific therapeutic exercise to treat and normalize pelvic and lower extremity compensations.  In yoga styles where alignment is a main focus of the poses (such Iyengar and Anusara), the asana practice could function to restore pelvic evenness. Once the pelvis is even, you should re-measure your legs. If they are pretty close to even, your leg length discrepancy was functional; if not, you could have an underlying structural leg length discrepancy that might still require a heel lift.  I wish there were one or two poses I could recommend without knowing all this student’s particulars, but that is not possible without an more thorough history and physical exam.  In general, a well-balanced yoga practice that includes reclining, seated, standing and some easy inverted poses could serve as a good starting point. But since low back pain is present, I’d recommend looking for a specialty class on yoga for back pain, where you are more likely to have a teacher experienced enough to give you some special guidance.


—Baxter

Thursday, July 25, 2013

More Love for Baroreceptors: Supporting Your Head in Restorative Poses

by Nina

When I first starting taking yoga, I was confused about why my teachers were always rushing put to a folded blanket under my head when I was lying on my back. Something about the position of my head when I was lying on the floor was driving them crazy, but what was it? And why was it such a problem?

Later I learned that they were adding this support because, when my head was flat on the floor, due to tightness in my shoulders, my neck was arching up and back and my chin was tipping away from my chest. Putting the folded blanket under my head allowed me lie with my chin pointing toward my chest like this:
This was considered to be the proper--and healthy—position for the head in supine poses. So I went along with it. But secretly I continued to wonder why. In case you have already noticed, I'm like that—always wanting to know the whys as well as the hows, always wanting to dig a bit deeper. Which is probably why I ended up as a yoga blogger, but I digress.

Anyway, it was only when I learned about baroreceptors that I found a satisfactory explanation. As I mentioned yesterday (see Why You Should Love Your Baroreceptors), when your neck is slightly flexed (the position when your chin is pointing toward your chest), the position puts some pressure on the baroreceptors in your carotid arteries. And this pressure can cause the same response as an inverted pose does on your nervous system—switching you from fight or flight to the relaxation response. The opposite neck position with your neck in extension (a backbend position with your chin tipping away from your chest) can have the opposite effective, stimulating your nervous system.

Of course, this understanding of the role of baroreceptors in yoga poses is very recent. In fact, the understanding of the role in regulating blood pressure in general is pretty recent as well. So the yoga teachers, like B.K.S. Iyengar, who developed restorative yoga discovered the best position for the head through personal observation, not science. (That says a lot about personal observation, doesn't it?) Interestingly, the head position Jalandara Bandha, with neck flexed and chin pointing down toward the chest, used in seated poses for pranayama, which is much older than restorative yoga, was probably adopted for the same reasons. Yoga practitioners noticed that head position enhanced the quieting effect of the practice.

I thought I'd tell you all this not just because you might not have made this connection on your own, but because I also realized there might be some people out there who don't have teachers running to put a folded blanket under their heads every time they lie in a supine restorative pose. So that's both the how and why for you. The how is that when you lie on your back, if your chin does not easily point down toward your chest, always add some support under your head. The why is that having your chin pointing down toward your chest will enhance your relaxation due to slight pressure on your baroreceptors.

Long live head support!

Wednesday, July 24, 2013

Why You Should Love Your Baroreceptors: Stress Management Made Easy

by Nina
I found this nice little illustration of baroreceptors that I'm excited to share with you. Okay, I admit it, I'm a little obsessed with baroreceptors. But that's because ever since I found out how our baroreceptors help regulate our blood pressure and I understood how we can use this aspect of our anatomy to switch our nervous systems from fight or flight to relaxation mode, I've not only included supported inverted poses in my practice on a regular basis but I've been on a mission to spread the word. Using supported inverted poses for stress management is one of easiest ways—at least for me—to calm yourself down because all you have to do is set yourself in the pose and stay there for a while. The shape of the pose itself causes the baroreceptors to work their magic.

As I wrote in my post Just in Time for the Holidays: Inverted Poses, the reason that inverted poses trigger the relaxation response is due to the pressure sensors called baroreceptors that are connected to the nerves controlling your heart rate and blood pressure. Your baroreceptors are located in the wall of each internal carotid artery at your carotid sinus (the arteries on each side of your neck that carry blood from your heart to your brain).
And in the wall of your aortic arch (just above your heart).
Aortic Arch
These baroreceptors detect any changes in your blood pressure, stretching when your blood pressure is high and shrinking when your blood pressure is low. If your baroreceptors detect a fall in your blood pressure, they send signals via your nerves to increase your heart rate, constrict your blood vessels to raise your blood pressure, and switch your nervous system to fight or flight mode. Likewise, if your baroreceptors detect abnormally elevated blood pressure, they send signals to slow your heart rate, relax your blood vessels to lower your blood pressure, and switch your nervous system to relaxation mode. And now I have a picture to illustrate this!
In an inverted pose, your heart is higher than your head, the opposite of its position when you are upright. With your heart higher than your head, gravity causes more blood to flow in the direction of your head, creating more pressure than usual on your carotid sinus and aortic arch. As the arterial pressure is increased, your baroreceptors are stretched and signals are transmitted to your central nervous system as if your blood pressure was high throughout your body. Feedback signals are then sent back to your body to reduce the arterial pressure, slowing your heart rate, relaxing your blood vessels, and releasing hormones that decrease adrenaline production. This automatically switches your body to relaxation mode.

Because there are baroreceptors in your carotid sinus (the arteries on each side of your neck that carry blood from your heart to your brain) inverted or partially inverted poses where your neck is flexed (that is, your chin is pointing toward your chest), as in Shoulderstand, Plow pose, or Bridge pose, puts added stimulation on your baroreceptors, which may enhance the calming effects of the inversion.

Any yoga pose where your heart is above your head is considered to be an inversion. Inverted yoga poses include full inversions, such as Headstand and Shoulderstand, where your heart is directly over your head and the rest of your body is also fully inverted. Partial inversions, such as Downward-Facing Dog pose and Standing Forward Bend, where your heart is less directly over your head and your legs are either not fully or not at all inverted, are also considered inverted poses and will have similar calming effects. As long as you are warm, quiet, and comfortable in the inverted pose, all you have to do is let the baroreceptors work their magic. Naturally, supported versions of the poses (such as Shoulderstand with a chair or Bridge pose on blankets) are more relaxing than the versions of poses in which you must support yourself, so if you’re practicing inversions for stress reduction, choose the supported versions. See Just in Time for the Holidays: Inverted Poses for a complete list of the inverted poses.

I'm such a believer in these poses that I recently had a friend (thank you, Erin Collom) take photographs of me doing all the supported inversions, so I could write in detail about the individual poses. For now, here's a photograph of a Supported Standing Forward Bend, a surprisingly calming pose.

Caution: Inverted poses may be unsafe for those with certain medical conditions (see here).

Tuesday, July 23, 2013

Yoga Better than Injections for Low Back Pain

by Baxter

A July 18th New York Times blog post entitled Alternatives for Back Pain Relief surprised me when it proclaimed that a modern and widely used treatment method for low back pain is no longer considered effective, especially for chronic or long-standing low back pain. That treatment is the use of injections into the areas of pain. The injections usually contain the inflammation-decreasing drug cortisone, but can also have ingredients like morphine, ibuprofen and vitamin B12 in the mix. Over the years I have had many patients come to me with low back pain, and from their reports, the effectiveness of the injections never seemed particularly strong. For some patients with new acute low back pain, who experienced more serious signs and symptoms, like radiating pain to the leg or actual weakness, the injections more often seemed to provide some temporary pain relief.

However, several new studies have revealed that, when looking back at those patients treated with injections, the injections were not significantly more effective than no treatment at all. And one study indicated that those who did not get injections for a pinched nerve in the lower back fared better down the road than the patients who received an injection course.  In the commentary published in a recent issue of JAMA:

“Based on the available data, the JAMA authors conclude, doctors “should not” recommend injection therapy to their patients with chronic low back pain.” 

That may be a hard pill for some doctors to swallow, as there has been a steady increase in the use of injections for low back pain, mainly because it is relatively inexpensive, can be done as an outpatient in the office, has fewer risks compared to surgery, and makes the docs some bling. The possible one positive use of injections is that is does often provide some temporary relief of low back pain symptoms.

The New York Times post then went on to reference a recent systematic review of yoga for low back pain that we reported on here early this year. This study looked back at all of the best designed studies on the subject and concluded that there was “strong evidence of short term effectiveness of yoga for low back pain and moderate evidence of long-term effectiveness of yoga.”

But although the New York Times post mentions the clear benefit of yoga for short-term back pain, it does not emphasize the second claim that the study discovered: moderate evidence for yoga's help over the long term. I took another look at the study itself, and discovered an important caveat: the authors would only recommend Viniyoga style practice for long-term benefits, as the other yoga methods studied did not demonstrate the same benefits. As they state:

"The American Pain Society's guidelines recommend that clinicians consider offering yoga to patients with chronic LBP (lower back pain). However, this recommendation is limited to Viniyoga-style yoga as the net benefits for other yoga styles could not be estimated."

Now, I love Viniyoga and integrate its methods into my own practice and teachings, along with the wisdom of the Iyengar method and some other modern yoga styles I’ve learned over the years as well. But I suspect that some of the alignment-strong styles, like the Iyengar method, will prove to be helpful in the long run as well, but we will need better studies to bear that out. That said, for those who are not familiar with Viniyoga (a term coined by American yoga teacher Gary Kraftsow for the yoga he learned from T. Krishnamacharya and TKV Desikachar) I would recommend to you two books to learn more:
  1. The Heart of Yoga by TKV Desikachar
  2. Yoga for Wellness by Gary Kraftsow
For now, this is all good news for those of us dedicated to our practice. As one of my students said to me just this morning after class, it's his regular yoga class that keeps his back in the best shape over time since he first developed low back pain many years ago. I’d love to hear back from our readers about your experiences with yoga for low back pain, so send me your story!

And don’t forget, my live webinar on Yoga for Healthy Digestion starts today, Tuesday July 23, 2013 on Yoga U online! Click here to learn more about it and sign up to join me Tuesday and Thursday from  8:30 EST (5:30 PST).

Monday, July 22, 2013

Unclear on the Concept: Yoga as a Treatment

by Nina

Wet Handle Bars by Melina Meza
“A comprehensive review published in May in The Clinical Journal of Pain finds that there is “strong evidence for short-term effectiveness” of yoga against back pain, although whether the benefits last beyond a year is less certain.” — Gretchen Reynolds, NY Times Sunday Magazine

In this Sunday’s New York Times Magazine, there was a short article called “Spinal Trap,”
about alternatives for treating back pain. The subtitle was “How do you solve back pain? Don’t ask your doctor.” We’ve already heard from Baxter on this topic, when he confessed that he had little to offer his patients when he himself was a family doctor (see For the Young and Old: Back Care). And you’ll be hearing from him soon about the comprehensive review mentioned in the quote above.

For now, I’d just like to rant a bit about the second half of the sentence:

“strong evidence for short-term effectiveness” of yoga against back pain, although whether the benefits last beyond a year is less certain


At first, I was just confused. What does she mean it is less certain whether the benefits last beyond a year or not. If you’re doing yoga for your back pain and it helps your back pain, why wouldn’t it continue to help your back pain for as long as you kept practicing? But Brad pointed out to me the underlying confusion in this statement. He said, “She’s thinking about yoga like physical therapy. In other words, it’s like a “treatment” you get from the doctor, something you’d do for a couple of months to “cure” your back pain, but then when you felt better you’d stop the treatment. And then maybe the pain would come back eventually.”

Ah, so that's what she meant. But how completely unclear on the concept is that? Naturally, if something in your life is causing you back pain, whether it’s your posture at your desk or in your car, standing all day at your job, too much gardening, lifting your children, lack of exercise in general, stiffness in certain areas of your body, lack of strength in certain areas of your body, you can’t just go back to your old way of life and expect the results of a short session of yoga classes to see you through the rest of your life. That would be like thinking you could do a few months of weight training to get stronger, and then expecting that would keep you stronger for years to come.

Brad laughed and said, “Yeah, and it’s not like there’s a “cure” for aging.”

So, yes, we’re afraid that whether you are practicing yoga for back pain or another condition, or just, you know, for healthy aging in general, it’s going to require an ongoing commitment. But it’s free, has no unpleasant side effects, and oh, yeah, it actually works.

Friday, July 19, 2013

Friday Q&A: Helping a Student with a Hip Replacement

Hip Joint from Behind
Q: I am a relatively new yoga instructor that teaches Gentle Hatha to (mostly) seniors.  Recently, a gentleman came in with bilat hip replacements from 10 and 12 years previous. He rides his bike and is in pretty good shape for a gent in his 60's. His hips were replaced by a posterior approach. How cautious do I need to be with this man? Do we modify mostly in the early days after the operation? Of course, I've modified the asanas to his ability and told him to not push it to the extreme. So is it fresh post op that we worry mostly about or for decades following? Thanks!

A: This is a great question and I am glad you asked it. In most cases, the hip replacement should outlast an individual’s lifespan. The literature states that total hip replacements typically last from 15-to-20 years after the initial surgery, but in some instances they can last over 30 years. But this is neither a guarantee nor assurance, for the simple reason that life is unpredictable.  Many factors affect the future of a hip replacement, such as accidents, fractures, late infections, and deterioration in overall health. Also, how well you take care of yourself down the road is something the surgeon cannot control. The longevity of a hip replacement thus depends on many factors, including the following:
  • Surgeon skill in implanting the components
  • Known history or track record of the implants
  • How well you take care of yourself and your health
  • Understanding and respecting the limitations of a prosthetic lifestyle
  • Your activity level and body weight
  • Avoiding high impact or extreme sports
Medical literature states that the most common reasons for individuals needing subsequent hip replacement surgery include:
  • Loosening of the implant. 
  • Dislocation of the implant
  • Infection, such as staph infections either around the time of surgery or later through the introduction of the bacteria into the blood stream.
It is believed that the most common reason why hip replacements fail is because the weight-bearing surface wears out and the prosthesis begins to loosen. So, what is hip replacement loosening? When a hip replacement is placed into the body, it is either press-fit into the bone or cemented into position. Either way, it is fit tightly into the bone of the thigh (femur) and pelvis so that the implant cannot move. Hip replacement loosening occurs over time, and can cause problems with the normal function of the hip replacement prosthesis. When implants loosen, the hip replacement can begin to move small amounts. This can be caused by the shaft of the prosthesis becoming loose in the hollow of the thighbone or due to thinning of the bone around the implant.

Loosening of the joint can occur at any time, but it normally occurs 10-15 years after the original surgery was performed. Signs that the joint has become loose include pain and feeling that the joint is unstable and that there is increased loss of hip mobility. Another operation (revision surgery) may be necessary, although this cannot be performed on all patients.

Both physicians and patients are very concerned about the problem of hip replacement loosening because a hip replacement revision surgery (replacement of a joint replacement) is a much more difficult operation and hip replacement revisions are often not as successful as the first operation. After revision operations, patients tend to recover less overall motion of the joint. Also, the longevity of the implant decreases with each revision. Therefore, physicians tend to avoid joint replacement surgery until absolutely necessary, and try to get as much mileage out of each replacement as possible.

In about 1 in 20 cases, the hip joint can come out of its socket. This is most likely to occur in the first few months after surgery when the hip is still healing. But, unfortunately some people’s hips will dislocate very distant to the original hip replacement. My advice here is that a hip doesn’t typically dislocate without warning signs. Pain that increases as an activity is continued is the most prevalent symptom.

So how cautious should you be with your student? The surgical hips will have a certain degree of motion that is limited by their soft tissue, hip capsule, how the prosthesis sits in the acetabulum, and so on. Start by checking your student’s range of motion while he is lying in a supine position. Test all the movements of the hip (hip up toward chest with knee bent, same knee position but bring it out to side for abduction, and turn the hip out in abduction for external rotation by bringing the bent knee up toward the armpit. Then look at his hip mobility while standing: hip flexion, abduction, external rotation and extension. You should also see if he tolerates adduction by having him sit on a chair and cross one leg over the other. If he can't do this, then any pose that has internal rotation must be modified significantly. You should have your student do this for both hips to get a sense of how it feels to his hip and see if there is any pinching or grabbing. Then you can modify the asanas accordingly.

If you ask a surgeon if his patient has any precautions after three months post op, he will generally say no, but he will modify his statement telling the patient to “use your own judgment.” So do we continue with precautions forever? Well, that is an area of disagreement. I err on the side of moderation saying, “If it makes you anxious or causes pain, discomfort, pulling, or pinching, please stop.” A student can have the potential of dislocation forever if they are not mindful on how they move and move repeatedly into discomfort. And remember the combined positions of flexion, abduction and internal rotation are the holy triad. If your student can tolerate the movements separately then you can find his limits and slowly challenge his hips, but both you and he must be aware of how the hip feels. NO PAIN should be elicited from asana and that means soreness after class or the next day. Learning how to ask how a movement feels is tricky because not everyone will say something hurts, so this includes learning which words your student uses to describe sensation changes.

So for your student, keep making sure that he observes his body’s limits and doesn’t push beyond his current activity. And congratulate him for coming to your class and investing in his continued health!

—Shari

Thursday, July 18, 2013

Yoga and Dementia: Welcome News

by Nina

A Rainbow at the Dam by Melina Meza
"Dementia Rate Is Found to Drop Sharply, as Forecast”

Now that’s the kind of headline I like to see! Yes, an article in the New York Times this week Dementia Rate Is Found to Drop Sharply, as Forecast announced the results of two different studies that showed that the incidence of dementia—in one case in England and Wales and in the other case in Denmark—was declining. And the reasons for this are very exciting to us here at Yoga for Healthy Aging.

“Yet experts on aging said the studies also confirmed something they had suspected but had had difficulty proving: that dementia rates would fall and mental acuity improve as the population grew healthier and better educated. The incidence of dementia is lower among those better educated, as well as among those who control their blood pressure and cholesterol, possibly because some dementia is caused by ministrokes and other vascular damage. So as populations controlled cardiovascular risk factors better and had more years of schooling, it made sense that the risk of dementia might decrease.”

So what they are saying here is that, along with being better educated, controlling blood pressure and cholesterol can help prevent dementia. And that means yoga can help. Foremost, yoga’s stress management tools can help you keep your blood pressure low. As I discussed in Chronic Stress: An Introduction, living with chronic stress can cause high blood pressure. So practicing stress management (see The Relaxation Response and Yoga and Stress, Your Health and Yoga will help you keep your blood pressure in check as it benefits your health in many other ways. Stress management can also help you maintain a low cholesterol diet by reducing stress eating and giving you more willpower to stay away from high cholesterol foods (see Yoga, Stress and Weight Management and Healthy Eating, Stress and Self Control). Healthy eating is also fostered by mindfulness (see Meditation and Healthy Eating) so if staying away from high-cholesterol foods is a problem for you, a meditation practice may be helpful.

For me, yoga even provides an ongoing education. Yoga philosophy is food for my intellect as well as providing inspiration for living my life with greater equanimity. Why, just this week I learned a lot from Ram’s post LINK, and the week before I learned from writing my own post Modern Yoga and Hinduism. So if yoga philosophy and history are of interest to you, a whole world of new knowledge and intellectual stimulation awaits you.

The New York Times quoted Dr. Anderson, of the National Institute on Aging, saying:

“With these two studies, we are beginning to see that more and more of us will have a chance to reach old age cognitively intact, postponing dementia or avoiding it altogether. That is a happy prospect.”

Wednesday, July 17, 2013

Healthy Spirits: New at Castro

 
1. Allagash Confluence

2. Firestone Walker Pivo Pils

3. Rogue Honey Kolsch

4. Dogfish Head Festina Peche

Hindu, Hinduism and Yoga: Connecting the Dots

by Ram 
Locked Door by Melina Meza
What is the connection between Hinduism and yoga? And hatha yoga in particular? And Iyengar yoga in particular?

This was the question put forth by one of our blog readers and Nina aptly provided a reasonable perspective in her post Friday Q&A: Modern Yoga and Hinduism. But Nina also asked me to provide additional information to satisfy a broader audience. This reader’s question and Nina’s suggestion that I add my two cents to this topic is akin to opening the Pandora’s box of Hindu philosophy. Nevertheless, to have a better understanding of these concepts, it would help for all of us to be firmly established in our “higher Self”—a place of higher awareness. It is from this pedestal of higher awareness that consciousness expands, illusion of this physical body and materialism disappears and we realize our true nature. So here I go in simple terms.

1. Who or what is a Hindu?

The exact definition of this term has eluded many a scholar. The word “Hindu” is an adjective to the term “Hinduism.” There’s so much controversy to both these terms that even the Supreme Court of India, which has repeatedly been called upon to define “Hindu and Hinduism,” has not been able to satisfy a broader audience with its inconsistent definition to mean different things at different times. The term could refer to the people born in India or it could refer to an individual who practices a certain religion originating from India. However, Muslims, Christians, Jains, Sikhs, Buddhists, Jews, Zoroastrians among others who are born in India do not prefer to be referred to or described as “Hindus.”

Furthermore, that definition does not hold when you look to India’s neighboring country Nepal, which is the world's only Hindu kingdom. And what about the Hindus of other Southeast Asian countries like Sri Lanka, Indonesia, Cambodia, etc. who are not born in India? The next time you visit a Nepali restaurant or if you happen to meet an Indonesian or Cambodian, ask them if they are Hindus and the reply will be in negative.

“Hindu” could be categorized with words like Muslim, Christian, Buddhist or Jew, however, while the latter terms denote a specific religious order, the term “Hindu” does not define a specific religion. A Christian is a person who accepts the gospels as his or her scriptural guide and believes that Jesus is the incarnate God. A Buddhist follows the guiding principles from the Tipitaka and believes in the Buddha. A Muslim accepts the Qur'an as their scriptural guide, and believes that there is no God but Allah. However, “Hindu” neither belongs to the category of words like “Muslim,” “Christian,” or “Buddhist” nor to the category of words like “American,” “British,” “Australian,” or “Chinese.”

Interestingly, in the Sabda Kalpadruma, which is one of the oldest comprehensive Sanskrit dictionaries written in the 18th century, the term “Hindu “is defined as:

Hinam dushyathi Iti Hindu”- A hindu is one who dispels unhealthy thoughts and actions.

Personally, this definition sounds not only appropriate but it is empowering as well. Thus, going by this definition, any individual in this universe who does not harbor unhealthy thoughts and whose actions are not detrimental to self and others is a Hindu. So the staff of this blog, or the readers, or other individuals might well be “Hindus” if they harbor healthy thoughts and perform harmonious actions. How many of us are willing to embrace this definition?

2. If Hinduism is not a religion, what religion do Hindus follow?


Naturally, if Hinduism is a religion, the people following it are Hindus. But if there is no true religion called Hinduism, what about those people born in India who are not Muslims, Christians, Jains, Sikhs, Buddhists, Jews, Zoroastrians, etc? What religious order do they follow? Furthermore, what religion is followed by those “Hindus” who are free from unhealthy thoughts and whose actions are not unfavorable?

In general, what determines whether a person is a follower of any particular religion is whether or not they accept, live by and strictly follow the scriptural authority of that religion. By that definition, a true Hindu who dispels unhealthy thoughts and actions is following the religion of Sanatana Dharma—“The Eternal Natural Law.” Sanatana Dharma is a religion that calls upon all Hindus to live in accordance with the divine laws as revealed in the Vedic scriptures. These ancient scriptures called Vedas expound an absolute set of duties or ordained practices incumbent upon all “Hindus,” regardless of ethnicity, gender, class, social order or sect. There are several Vedic texts that give different lists of the duties, but in general Sanatana Dharma consists of day-to-day living by virtues such as honesty, selfless service, non-violence, purity of thoughts, words, deeds and actions, mercy, patience, forbearance, self-restraint, generosity, goodwill and respect for every being. A very popular invocation drawn from the Vedic text and corroborating the principles of Sanatana Dharma also demonstrates the concern for universal affiliation:

Om sarve bhavantu sukhinah. Sarve santu niraamayaah.

Sarve bhadraani pashyantu. Maa kaschid dukhbhaag bhavet.


May all beings be happy. May all beings be healthy.

May all beings experience prosperity. May none in the world suffer.

Thus, the religion followed by true Hindus is Sanatana Dharm, a religious order that promotes coexistence and well defines the concept of pluralism.

3. What is the connection between Hinduism and yoga?


It has been the historically accepted standard that if you accept the Vedic texts as your scriptural authority and live your life in accordance with the principles of “sanatana dharma” as mentioned in 2, you are a Hindu. For all members who lead the Vedic path, Hinduism promotes not only tolerance and respect for individual differences in all aspects of life, but also acknowledges the existence of more than one path to the “Supreme God Principle” otherwise known as Satyam or Truth. This concept of pluralism is best captured in the ancient Sanskrit hymn:

Ekam sat vipraha bahudha vadanti”—Truth is only one, the wise call it by many names.

How does one see, perceive or achieve truth? Among the hundreds of paths known through history are six classical philosophical paths to achieve or perceive truth collectively called as Shad Darshana (Shad= six, darshana= awareness). These six paths are understood as varied attempts at describing Truth and the path to it. Each path to truth has its own founder or author, and the authors of these six systems of philosophy were individuals of the highest order who not only saw truth but had devoted their lives to the study and propagation of the path to truth. Elements of each path form part of the Hindu fabric of daily existence.

Yoga is one of those six paths whose objective is to achieve, at will, the cessation of all fluctuations of consciousness, and the attainment of Self Realization. Codified by Patanjali, who authored the Yoga Sutras or the aphorisms of yoga, this philosophical path is of great value to the seekers of the state of spiritual absorption. Yoga aims at the final state of spiritual absorption through eight component parts, together called Ashtanga Yoga. Yoga is wholly dedicated to putting the high philosophy of Sanatana Dharma into practice to achieve personal transformation through transcendental experience.

4. What is the connection between Hinduism and hatha yoga in particular? And Iyengar yoga in particular?

If my replies to the above three questions are clear, the answer to this question is fairly easy to follow. Any individual who cultivates pure thoughts and performs harmonious actions is a Hindu. As a seeker of truth, this individual has six principle paths to achieve enlightenment. As described above in 3, yoga is one such path. In the Yoga Sutras, Patanjali expounds adherence to eight steps to experience truth and achieve enlightenment. Swatmarama, a 15th/16th century yogic sage pulled out specific modules from the complex Yoga Sutras and compiled the Hatha Yoga Pradipika, which focused exclusively on asanas, pranayama, chakras, bandhas, nadis and mudras as a means to purify the body and the mind.

Just like any modern texts, the Hatha Yoga Pradipika was subjected to numerous revisions, editions and interpretations by a multitude of authors. Through his dual knowledge of Sanskrit and English, BKS Iyengar made it very easy for Westerners by drawing from the Yoga Sutras and the Pradipika and developing his own style of hatha yoga that lays emphasis on detail, precision and alignment in the performance of posture (asana) and breath control (pranayama). BKS Iyengar systematized nearly 200 classical yoga poses and more than one dozen different types of pranayama to ensure that students progress gradually from simple poses to more complex ones and develop their mind and body in a step-wise manner. Thus, the yoga predominantly practiced in the West deviated from the classical philosophical aspects since it consists of mostly asanas understood as physical exercises and as a stress-reducing practice.

4. Additional Query: Is chanting necessary in an asana class?


I checked some of the ancient texts and there is no mention of chanting alongside an asana class. To my knowledge, chanting in a class does not in any way enhance the spiritual experience compared to a class where there is no chant. There is no sutra in the Pradipika asserting that asanas be accompanied by a Gayatri chant or an invocation to Patanjali. My advice to any teacher that wishes to have chanting is to use chants, quotes or lines from all traditions and religious background so that the class turns into a purely non-denominational experience. Personally, chanting is secondary; instead I would look to see if the teacher is a “Hindu” who brings in qualities prescribed by the Sanatana Dharma.

Note: Nina and other readers may finally ask, am I a Hindu? I was born and raised in India to Hindu parents. I started my journey on the path of Sanatana Dharma several years ago when I embraced the sciences of yoga and ayurveda. I am trying my best to cultivate healthy thoughts, dispense harmonious actions and provide selfless service to the society. I leave it to all of you to decide if I am a true “Hindu.”

Tuesday, July 16, 2013

Yoga and Healthy Eating: How Yoga Helps You Tune in to the Effects of Your Dietary Choices

by Baxter

Fresh Bread and Fresh Butter
made and photographed by
Rosie Gibson
It is always a bit bittersweet for me come mid-July when I return from my annual yoga retreat at the Feathered Pipe Ranch  in Helena, Montana. It is a magical place for my students, and me, and most of our every-day needs are met by the staff at the Ranch, freeing us up to dive deep into the yoga and community. 

At this year’s retreat, I focused on many of the concepts we talk about here at Yoga For Healthy Aging, including therapeutic sessions on topics ranging from arthritis to digestion. One of the lovely things about going on these sorts of retreats is that all of your meals are prepared for you, and all you have to do is show up for meal times. The Ranch is no different, and they pride themselves of the variety of healthy, mostly organic foods that they prepare for us each year, from Indian to Thai to Mexican, to the “Toledo Lunch” (a throwback to my childhood favorite, grilled cheese sandwiches and tomato soup). In addition, they always have tempting desserts, from fruit cobbler to fresh baked cookies and cakes to something outrageous called Chocolate Decadence! The downside to this, at least from my perspective, is that the food is served buffet style, so there is the daily opportunity to overeat, despite the overall healthy options provided (minus some of the desserts, of course!)

I have to remind myself to be more mindful about my eating when at the Ranch. It is very easy to make a second trip up for some more of my favorite things, even when my first plate of food was more than sufficient to satisfy my hunger. Satiety is different than eating until I feel “stuffed.” which unfortunately happened a few times last week. But because I was also on retreat in my own way, even though I was teaching twice each day, I was able to have the time to meditate consistently first thing in the morning for about 15 minutes. I found that as I sat quietly focused on my breath or simple mantra (see How to Start a Meditation Practice), I became acutely aware of how my body was feeling and responding to the previous day's food choices. I also would recall if I woke in the middle of the night with indigestion, gas, bad dreams, or the urgent need to use the bathroom. This feedback allowed me to more consciously set an intention around my food choices for the rest of the day.

Since I tend to desire more processed sugar than is healthy for me, (is it really healthy for anyone?), I began to modify my breakfasts, the only meal I prepared for myself in the little teacher’s cabin kitchen, leaving out the jam on my toast and adding in a piece of fresh fruit to satisfy that sweet taste desire that I have. And I began to notice that my energy levels were higher for the rest of the morning as the week progressed. Quite motivating! I have to admit that dessert time was still a tough one, but was at least more mindfully dished and consumed than earlier in the week. 

Surprisingly, I realized I was looking forward to being back in my own kitchen where I could more easily design my meals for not just quality, but also quantity.  All these insights about behavior changes and choices arose directly out of the introspective practices of yoga, like simple breath awareness. They were there for me, and they are available for you, too. As we keep reminding you, consistent practice is a key feature of transformational practice. I did my meditation first thing today again, and my continued healthy, well-proportioned meals choices are reflecting it!

I've been thinking a lot about healthy eating and healthy digestion because my two-part online course at Yoga U is coming up soon. To sign up for the course, you can register here. For a free audio interview with me on yoga for healthy digestion, download the interview here.

Monday, July 15, 2013

Medical Conditions Benefited by Yoga

by Nina
Just a quick post today to let you know that Timothy McCall has updated his list of medical conditions that are benefited by yoga (as demonstrated by scientific studies). There are 75 conditions!

1.    Alcoholism and Other Drug Abuse
2.    Anxiety
3.    Asthma
4.    Atrial Fibrillation
5.    Attention Deficit/HyperactivityDisorder (ADD/ADHD)
6.    Autism
7.    Back Pain
8.    Balance Problems
9.    Breast Cancer
10.    Cancer (General)
11.    Carpal Tunnel Syndrome
12.    Chronic Fatigue Syndrome
13.    Chronic Obstructive Pulmonary Disease (COPD) e.g. Emphysema
14.    Congestive Heart Failure
15.    Depression
16.    Diabetes
17.    Drug Withdrawal
18.    Eating Disorders
19.    Epilepsy
20.    Fatigue
21.    Fibromyalgia
22.    Gait (Walking) Problems
23.    Guillain-Barré Syndrome
24.    Heart Disease
25.    Hemorrhoids
26.    High Blood Pressure
27.    HIV/AIDS
28.    Hypothyroidism
29.    Infertility
30.    Inguinal Hernia
31.    Insomnia
32.    Irritable Bowel Syndrome
33.    Kidney Failure
34.    Lymphoma
35.    Mental Developmental Impairment
36.    Menopausal (and Perimenopausal) Symptoms
37.    Menstrual Disorders
38.    Metabolic Syndrome
39.    Migraine and Tension Headaches
40.    Multiple Sclerosis
41.    Muscular Dystrophy
42.    Neck Pain
43.    Neuroses (e.g. Phobias)
44.    Obesity/Overweight
45.    Obsessive Compulsive Disorder (OCD)
46.    Organ Transplant
47.    Osteoporosis
48.    Osteoarthritis (Degenerative Arthritis)
49.    Ovarian Cancer
50.    Pain (Chronic)
51.    Performance Anxiety
52.    Pleural Effusion (Fluid in Lung Lining)
53.    Polycystic Ovarian Syndrome
54.    Post-Heart Attack Rehabilitation
55.    Post-Joint Replacement
56.    Post-Polio Syndrome
57.    Post-Operative Recovery
58.    Post-Stroke Rehabilitation
59.    Post-Traumatic Stress Disorder (PTSD)
60.    Pregnancy (both normal and complicated)
61.    Psoriasis
62.    Restless Leg Syndrome
63.    Rheumatoid Arthritis
64.    Rhinitis (Inflammation of the Nose)
65.    Schizophrenia
66.    Scoliosis (Lateral Curvature of the Spine)
67.    Sexual Function
68.    Sinusitis
69.    Smoking Cessation
70.    Stroke
71.    Total Knee Arthroplasty
72.    Traumatic Brain Injury
73.    Tuberculosis
74.    Urinary Bladder Dysfunction
75.    Urinary Stress Incontinence

Timothy has created a special PDF document that lists these conditions along with the scientific publications that confirm the benefits that yoga provides. And he has generously granted permission for copying and distributing this document. You can find it on his web site: http://drmccall.com/yoga/YAM--75Conditions.pdf.

Friday, July 12, 2013

Friday Q&A: Modern Yoga and Hinduism (and the Encinitas Ruling)

Arjuna Listening to Krishna
“Yoga is an art, a science, and a philosophy. It touches the life of man at every level, physical, mental, and spiritual. It is a practical method for making one’s life purposeful, useful and noble.” —B.K.S. Iyengar from Light on Yoga

 Q: There's been a news story this past week about parents in a school district somewhere who tried to shut down the teaching of yoga because it was, supposedly, religious indoctrination. The story said that the school board disagreed, the explicit parts of the classes that mentioned (discussed? preached?) Hinduism were eliminated, and yoga continues to be taught there.

I've taken yoga for a long time and in none of my classes has there ever been anything said that I could identify as Hindu. What is the connection between Hinduism and yoga? and hatha yoga in particular? and Iyengar yoga in particular?


A: This question has been in the news lately due to the case in Encinitas, California, where parents sued the school system for including yoga in the schools (see the Washington Post article). The ruling was very clear, as San Diego Superior Court Judge John Meyer said:

"Yoga as it has developed in the last 20 years is rooted in American culture, not Indian culture. It is a distinctly American cultural phenomenon. A reasonable student would not objectively perceive that Encinitas school district yoga advances or promotes religion."


In my opinion, the answer to this question isn’t quite so clear and is a lot more like that icky relationship status on Facebook: It’s Complicated. In fact, it’s so complicated that Ram Rao and I will both be addressing this question (look for a separate post from him next week). Today I’m going to try to give a little background that will hopefully shed some light on this issue.

To start, it’s important to understand that while no one really knows for sure exactly how old yoga is or how it began, yoga clearly evolved as a part of Hinduism. The early yoga scriptures, the Upanisads, are definitely religious. Yoga is defined in the Svetavatara Upanisad as:

"When, by means of the true nature of atman, which is like a lamp, a person perceives the truth of Brahman in this world, he is freed from all bondage, because he has known the Divine, which is unborn, unchanging, and untainted by all things." —trans. by Edwin Bryant

The famous yoga scripture The Bhagavad Gita, written between the ninth and fourth centuries BCE, is an explicitly Hindu text, portraying the Hindu god Krishna as the source of yogic wisdom and recommending devotional yoga as a path to liberation. This work, which Mohandas K. Ghandi referred to as his “mother,” is an essential part of modern yoga, though people often—as is done with The Bible—pick and choose the quotes they use.

However, the other famous and essential yoga scripture, the Yoga Sutras (written in the second century BCE) while theistic (referring to Isvara or “The Lord”) is not explicitly Hindu text in the same way. As Edwin Bryant says:

"I might add here that Patanjali’s Yoga Sutras is not an overtly sectarian text in the sense of prioritizing a specific deity or promoting a particular type of worship as is the case with many Hindu scripture, including The Bhagavad Gita. Therefore, as a template, it can be and has been appropriated by followers of different schools and traditions throughout Indian religious history and certainly continues to lend itself to such appropriations, most recently in nonreligious contexts in the West." —from The Yoga Sutras by Patanjali

In fact, as yoga evolved, several other religions adopted the yoga techniques and philosophy, including Jainism, Sikhism, and Buddhism.

Regarding hatha yoga, which came much later, we can look to the Hatha Yoga Pradipika (written in the 15 century CE), as it is the classic manual on hatha yoga. This document is considered a Hindu text but is similar to The Yoga Sutras in not being an “overtly sectarian.” Ram will discuss this text in detail in his upcoming post.

So far, however, the yoga described in these texts does not much resemble the yoga we are currently practicing in the West, especially the asana part. It was only in the 20th century that pivotal figures such as T.K.V. Krishnamacharya and B.K.S. Iyengar developed the modern asana practice as we now know it (see Yoga Body: The Origins of Modern Posture Practice by Mark Singleton). During this period, for many practitioners in the west, “yoga” became disassociated from its spiritual aspects and the asana practice was adopted as an exercise system. Thus, many of us have the experience that our questioner referred to of attending yoga classes that do not include any spiritual practices or any references to Hindu yoga scriptures of the past.

And even for those teachers who regularly teach the spiritual aspects of yoga, the general consensus is that yoga is not a religion per se, and that anyone of any religion or non-religion can practice it. Since the questioner asked specifically about B.K.S. Iyengar, I will confirm that this is his point of view. He recently said:

Yoga is an Indian heritage, not a Hindu property. Patanjali's Yoga Sutra, which forms the basis of the system, addresses all humanity not just Hindus. Just because yogis did not travel as widely as they do today does not imply that the practice belonged to one community or place. Patanjali calls yoga sarva bhauma, a universal culture. And yoga is an individual's evolutionary journey as a sadhaka (seeker) from the body to the self. Where is the room for doubt here?

The complicated part comes when you face the fact that the famous Indian teachers who profoundly influenced modern yoga as we know it were/are Hindus themselves. Regarding Iyengar, he, himself, is a Hindu Brahmin and much of his writing is, in fact, very theistic (see Light on Yoga and Light on the Yoga Sutras). And in some yoga traditions, even those taught in the west, Hindu practices, such as chanting and reading from the scriptures, are included in the classes. Regarding the Encinitas case, I was surprised to read this:

Yoga instructor Jennifer Nicole Brown, who demonstrated some of the yoga positions in court, said when parents complained about their children chanting, she removed it from the lesson.

It turns out that the type of yoga that was being taught in Encinitas was Ashtanga Yoga, the yoga system promoted by K. Pattabhi Jois, a student of Krishnamacharya, who was a Hindu. So what were these children chanting? I decided to check it out. The translation for the opening chant for the Ashtanga series is:

I bow to the lotus feet of the Supreme Guru which awaken insight into the happiness of pure Being, which are the refuge, the jungle physician, which eliminate the delusion caused by the poisonous herb of Samsara (conditioned existence).
I prostrate before the sage Patanjali who has thousands of radiant, white heads (as the divine serpent, Ananta) and who has, as far as his arms, assumed the form of a man holding a conch shell (divine sound), a wheel (discus of light or infinite time) and a sword (discrimination).

That sounds the teeniest bit Hindu to me, I have to say. And I can see why the parents complained about the chanting. So that’s what was removed from the school’s curriculum. Also—and this seems kind of silly—some of the names of poses were changed.

So I believe that while it is completely possible to practice yoga without being a Hindu or participating in Hindu religious activities, it is naive to say that modern yoga is totally “American” and has nothing at all to do with Hinduism. How you make your peace with this is up to you. I’ve known people who actively embrace the connection between yoga and Hinduism. Others may wish to be selective about the type of yoga they do, and choose their teachers and classes with care.

—Nina

Thursday, July 11, 2013

Meditation and Compassion

by Nina 
Lake Tahoe by Melina Meza
“Nonetheless, the current finding is the first to clearly show the power of meditation to increase compassionate responding to suffering, even in the face of social pressures to avoid so doing. As such, it provides scientific credence to ancient Buddhist teachings that meditation increases spontaneous compassionate behavior.” —Paul Condon, et al

Just a quick heads-up today about a recent scientific study about the effects of meditation practice on compassion that was written up in last Sunday’s NY Times The Morality of Meditation.

In my post Practicing Yoga Off the Mat, I wrote about my desire to cultivate compassion toward others in my life to foster better relationships. In that post, I cited Yoga Sutra 1.33 in describing my off-the-mat practice:

By cultivating an attitude of friendship toward those who are happy, compassion toward those in distress, joy toward those who are virtuous, and equanimity toward those who are nonvirtuous, lucidity arises in the mind. —trans. by Edwin Bryant

Lately we’ve also been addressing meditation on the blog. In Is Meditation an Essential Part of Yoga Practice, Timothy wrote about the importance of meditation, describing it as “a fabulous tool to study your mind and slowly gain more control over it.” But according to Buddhist tradition, meditation also provides important inter-personal benefits as well. This is why a group of people, including psychologist Paul Condon, neuroscientist Gaëlle Desbordes and Buddhist lama Willa Miller, decided to conduct a study looking at these particular benefits to the practice:

“Contemplative science has documented a plethora of intra-personal benefits stemming from meditation, including increases in gray matter density (Hölzel, Carmody, et al., 2011), positive affect (Moyer et al., 2011) and improvement in various mental health outcomes (Hölzel, Lazar, et al., 2011). Strikingly, however, much less is known about the inter-personal impact of meditation. Although Buddhist teachings suggest that increases in compassionate responding should be a primary outcome of meditation (Davidson & Harrington, 2002), little scientific evidence exists to support this conjecture.” —Paul Condon, et al

For this study, the scientists recruited 39 people from the Boston area who were willing to take part in an eight-week course on meditation (and who had never taken any such course before). They randomly assigned 20 of them to take part in weekly meditation classes, which also required them to practice at home with recordings, while they told the remaining 19 that they had been placed on a waiting list for a future course.

After the eight-week period of instruction, the scientists staged a situation designed to test the participants’ behavior before they were aware that there was an experiment. Would a participant who was waiting in the lab’s waiting area give up his or her seat when a fourth person, using crutches and wearing a boot for a broken foot, entered the room and audibly sighing in pain entered the room in which all seats were taken and the other two people ignored her? The scientists reported that the results were significant because while only 16 percent of the non-meditators gave up their seats, the proportion rose to 50 percent among those who had meditated. And this after only eight weeks of practice!

Of course, the question that immediately arises is: why would eight weeks of meditation have this effect on a person’s compassion for others? At this point, they can only speculate. David DeSteno, one of the scientists, wrote in the NY Times article:

“Although we don’t yet know why meditation has this effect, one of two explanations seems likely. The first rests on meditation’s documented ability to enhance attention, which might in turn increase the odds of noticing someone in pain (as opposed to being lost in one’s own thoughts). My favored explanation, though, derives from a different aspect of meditation: its ability to foster a view that all beings are interconnected.”

Regardless of why it works, using meditation to cultivate compassion will no doubt help foster better relationships not just with total strangers but also with people in your life. If you’re not already meditating and want to start, see Timothy’s post Starting a Meditation Practice.
 

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