Is Women's Flexibility a Liability in Yoga? Shari's Response to William Broad

by Shari

The latest New York Times article from William Broad Women’s Flexibility is a Liability (in Yoga) sparked a conversation between Nina and me, both whom are long-term yoga practitioners who have grappled with orthopedic injuries. Broad states that he has recently learned that women are at higher risk of hip injuries in a yoga class because of their inherent flexibility compared to men. He quotes a single yoga teacher, Michaelle Edwards, saying that “women’s elasticity became a liability when extreme bends resulted in serious wear and tear on their hips. Over time the chronic stress could develop into agonizing pain and, in some cases, the need for urgent hip repairs.” He also says of arthritis researchers:

The investigators found that extreme leg motions could cause the hip bones to repeatedly strike each other, leading over time to damaged cartilage, inflammation, pain and crippling arthritis. They called it Femoroacetabular Impingement — or F.A.I., in medical shorthand. The name spoke to a recurrence in which the neck of the thigh bone (the femur) swung so close to the hip socket (the acetabulum) that it repeatedly struck the socket’s protruding rim.

I personally can’t stand sensationalism of any type and particularly sensationalism of the fear and scare tactics kind. When I first saw this article, I groaned inwardly. But I then proceeded to read it carefully, including the related links, and then went on to do some additional research of my own. After all that, my response is: maybe.

First of all, I, as a long-term yoga practitioner, am not sure what exactly he means. We all can be overly flexible in some areas of our bodies and conversely overly tight in other areas of our bodies. The biomechanical model of structure and function is a beautiful yin and yang interplay between forces that influence our bodies, and yes, can ultimately change our structure and function. Some changes may not be as beneficial as others so we need to be consciously selective and astute to observe what changes occur with function.

I also think, as in the past, Broad is careless in his citations of his evidence and is vague about these ER records of hip injuries. However, he does cite some orthopedists and one international study that do substantiate his observation that women who put their hips into extreme ranges of motion can injure their hips. Well, this is blatantly obvious to anyone who may be neurologically intact. When a joint is taken into an extreme position there is a pain response recognized by the central nervous system that warns the person to back off. Of course, if we choose to ignore the pain response, then is it the yoga that is causing the injury or is it the person who is foolishly not listening to the feedback their body is providing?

I also think that to address William Broad’s assertion that women are more flexible than men, we need a better working definition of (biomechanical) flexibility:

Flexibility is the range of motion in a joint or group of joints, or, the ability to move joints effectively. Flexibility is related to muscle strength. Flexibility is also the ability to move through a full range of motion.

Flexibility is a conscious movement that has an intricate feedback mechanism between the muscles and the nerves innervating the muscles and the joints and the central nervous system. There are significant protective mechanisms that prevent the individual from overstretching if they PAY ATTENTION to the sensation of pain rather than ignoring it.

So are women “inherently” more flexible than men? Well, it depends who you ask. But all sports attract a body type, and if yoga is considered a “sport” then there is a body type that is drawn to yoga. We all like to do things that are “easy” and for some flexible bodies yoga is “easy.” The rub here is that this isn’t “yoga” but athleticism masquerading as yoga!

So now let us look at his assertion that yoga is the root cause of “femoracetabular impingement”. The literature that I read, including one of his references, states that the subjective symptoms are deep anterior groin pain with associated intermittent catching and locking of the hip joint. In addition, there is a significant decrease in hip internal rotation. The morphology is that there is a breakdown of the hip labrum (how the head of the femur is connected into the cup of the pelvic acetabulum) and the articular surfaces of the femur and acetabulum. There is a structural change in how the head of the femur is sitting and facing, and movement of the hip will continue to tear the tissue structures with a loosening of the integrity of the hip joint. The problem is that a lot of individuals who have this condition are pain free, asymptomatic and don’t know they have it. The concern is that this condition may be a precursor to developing hip arthritis down the road. There are four types of femoracetabular impingement and one type is more common in women and one type more common in men!

Another article that I read stated that the condition is caused by internal rotation of the hip while in 90 degrees of hip flexion. Yes, this can be Uttanasana (Standing Forward Bend)! So is the problem the combination of these two movements? I don’t know, but does that mean you need to stop doing Uttanasana? I don’t think so unless it is causing pain. And, yes, there are some pretty extreme hip positions in yoga which only some of could do when we were younger (maybe can still do them now) but the bottom line is that we need to practice with intention and attention to form, function and our own bodies' abilities and not soldier on through the pain. Yoga, as we have mentioned time and time again, can be physically and mentally challenging, but is not supposed to hurt. So don’t be scared off again by a sensational journalist who claims he is a yogi.

In a future post I would like to present some of the inherent differences between male and female pelvis and hips that might also help to put into perspective the allegation of the differences between men and women.

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Yoga Props: An Introduction

by Nina

Just the other day, I got this interesting request for information on using props.

Another local yoga instructor and I live in a remote/rural area, and attending high quality trainings is difficult at best. We've been looking for a training that focuses on the use of props, but we've had no luck. We are wondering if you could address in your blog, or recommend a good book, about the use of props for seniors. We are looking to create a more supportive class for seniors without taking them straight to a chair.

Well, dear reader, you’re in luck. Because it just so happens that I was trained in the Iyengar style of yoga, and, in fact, the use of props is a modern invention generally credited to B.K.S. Iyengar himself! As the story goes, at the age of 18 (1937), Iyengar was sent by his guru, Krishnamacharya, to Pune to spread the teaching of yoga to “householders .” Observing that his new students—typically older and stiffer than the boys Iyengar had been training with at the Mysore Palace—were often  unable to find a healthy and comfortable alignment in the yoga asanas, Iyengar came up with the idea of using props, including blocks (called “bricks” in India), blankets, straps, bolsters, chairs and others, to help support the students in their poses. Ideally using a prop helps you achieve correct alignment in the pose when your body is not open enough or strong enough to do the pose without the prop. Here’s a photo of Baxter doing Triangle pose with his hand on a block instead of the floor. (To be completely honest, Baxter has tight hamstrings and these prevent him—along with a lot of other folks out there—from being able to do Triangle pose with his hand touching the floor.)

Triangle Pose with Block (on highest height)

I’m telling you all this because your best bet for learning how to use props from a teacher is to find an Iyengar yoga teacher (either official certified Iyengar or Iyengar-style), though I expect by now a lot of other types of teachers have adopted them, too. For those of you who don’t have access to a teacher who is an expert at using props, we do have some information on using props on the blog. Our restorative yoga poses, supported inverted poses, and supported forward bends all use them.

I also wrote a post Making Your Own Yoga Props that provides tips for using simple household items (such as books and sashes and bags of rice) in place of “official props.” And, inspired by this reader’s question, I’ll try to write more about props in the coming weeks.

In the meantime, you can learn from using props from yoga books. I’m going to be very bold and recommend one I co-wrote: Moving Toward Balance, the second yoga book I wrote with Rodney Yee. The reason I’m recommending this one is that we both put a lot of thought into how we presented the information on using props in this book. We included a very thorough overview of the types and purposes of props in the chapter “Preparing to Practice,” which even tells you how to fold yoga blankets! And we systematically provided an easy alternative for every single pose in the book, many of which use props. We also tried to keep the use of props very streamlined and simple because we were concerned that for people practicing at home, needing a large number of props to do a pose could be off-putting. Although these “easy” versions of the poses weren’t designed especially for seniors, I think you’ll find many of them totally appropriate versions that are in between the full version of the pose and doing yoga on a chair. And even the ones that don’t use props (such as the easy version of Warrior 2, which has hands on the hips and an only slightly bent knee) will be very suitable for older beginners.

I’ll also recommend The Woman’s Book of Yoga and Health, my most frequently used yoga book. The last section of the book, which is for older women, has some great examples of yoga poses done with props.

You can see classic Iyengar propping in Iyengar’s book Yoga, The Path to Holistic Health. Some of the propping in this book will be very useful to you, though some, well, may just be too complex and/or elaborate. The elaborate setups tend to be employed in specially equipped yoga studios by Iyengar teachers who are trained in their use.

Once you get into the swing of using props, you may find that you are coming up with your own inventions! My own teacher is constantly coming up with new ideas, which stem out of his personal practice. And I myself have come up with a few nifty ideas….

Chronic Fatigue Syndrome and Yoga

by Baxter

Floating Leaves by Melina Meza

As we once again pass through the man-made time shift that is daylight savings time (ughh!), I always notice a general malaise and sluggishness in many of my students.  The frequency with which my folks report colds and flu goes way up, and the request for longer Savasana at the end of class is a regular phenomenon. But on occasion, a student will report ongoing fatigue that goes way beyond the seasonal shifts or illness exposure of the fall and winter season. Some of these students return from a visit to their doctor with a tentative diagnosis of Chronic Fatigue Syndrome (CFS). 

It is very likely you know someone with this condition. According to a 2003 study in the Annals of Internal Medicine, the prevalence—the total number of cases of a disease in a given population at a specific time—of CFS is 235 per 100,000 people, with women three times more likely to develop CFS than men.

But just being tired a lot does not get you the diagnosis of CFS. The Mayo Clinic defines chronic fatigue syndrome as:

“a complicated disorder characterized by extreme fatigue that can't be explained by any underlying medical condition. The fatigue may worsen with physical or mental activity, but doesn't improve with rest.”

In fact you have to have significant fatigue for at least 6 months, along with 4 of the following other signs or symptoms, according to the Mayo Clinic:

• loss of memory or concentration
• sore throat
• enlarged lymph nodes in your neck or armpit
• unexplained muscle pain
• pain that moves from one joint to another without swelling or redness
• headache of a new type, pattern or severity
• unrefreshing sleep
• extreme exhaustion lasting more than 24 hours after physical or mental exercise

The cause of CFS is still unknown, although there are many theories about how and why it develops, including post-viral infection complication, abnormal immune system function or endocrine system function. And there are no specific tests to “prove” you have CFS, so it is important to rule out other conditions that can be associated with fatigue, like sleep apnea, certain medical conditions (like anemia, diabetes or hypothyroidism) and mental health conditions (like depression and bipolar illness, to name a few). 

Patients with CFS can a lot of variability in their symptoms, with some days better than others, and flares of symptoms can happen with minor increases in activity. However, because the condition does not get better with rest, the recommendations for treatment by your doctor will include medications, physical therapy and lifestyle modifications. Encouragingly, the Mayo Clinic site actually recommends yoga to help manage the pain symptoms of CFS. And although the studies of the effects of yoga for CFS are yet to be done, the Centers for Disease Control does recommend yoga as a part of treatment approach for CFS.

Many of the yoga recommendations I have made for other chronic illness would apply here as well.  Start out slowly, with small, gentle yoga practices, even done in bed. Working with an experienced teacher or yoga therapist initially will give you the greatest chance of gaining benefits from adding yoga to your treatment. Since yoga has been shown in studies to have benefits for stress reduction (an aggravating factor for CFS), and improvements in both endocrine and immune function, systems that can be out of balance in CFS, yoga will likely affect more than just the pain symptoms.

And, as we always advocate here at YFHA, “yoga” implies using as many of the tools of yoga as are appropriate for each individual. If you added in an Ayurvedic perspective, attention to diet and sleep would be included in as well. And on days when a more active physical practice seems daunting or counterproductive, breath work, guided imagery and meditation, including yoga nidra, will allow you to still “practice.” Just the ability to do some sort of practice regularly can give the person with CFS a greater sense of control over their health, which can foster a greater sense of healing and improve their outlook. And as the student progresses to greater levels of ability with the physical poses, which a physical therapist would refer to as “graded exercise,” attendance in a gentle yoga class would be recommended to combat the tendency to social isolation that can often accompanies the lives of those with CFS. Due to the uncertainty of how long CFS may be around, establishing a yoga practice as an ongoing, daily part of your life will have benefits far beyond its effect on only one aspect of your health. 

If any of our readers have personal experiences with the pros and cons of yoga for CFS, please write in and share this valuable information with your fellow YFHA readers. Thanks!

Finishing the Year Strong Update & Tex Mex Casserole with Egg Noodles

We last talked about our goal of finishing 2013 healthy and strong and I so appreciate your feedback in the comments.  Your courage to share where you are in your journey helps me be transparent in mine too and I feel like we're in this together.  I got in 4 really great workouts last week, and I feel that that's a good fit for my current schedule through the end of the year.  It takes some planning and preparation to make sure to get to the gym, but if I workout hard for at least 50 minutes, I'm good with 4 days. 

Getting started back into a weight-lifting/workout routine is especially hard because you are so SORE for the first few days.  I had to take Advil a few times, but I'm already fine.  And isn't it funny how after just a few workouts you feel 5 pounds lighter?!  My scale says I'm down half a pound.  It's a start!

via

On Halloween, I ate 2 chocolate chip cookies that a mom from my son's school made and a mini Reese's Peanut Butter cup.  To be honest, the cookies were delicious, but I should have just had one, and the Reese's didn't taste that good- probably because I'm a PB cup snob now, having fallen in love with the homemade variety.  The point is, if I'm going to "cheat" I want it to be worth it!  And I know that finishing the year strong requires some sacrifice and diligence with my food especially during the week.  So, I'm being more conscious of what foods I'm choosing and having something really good to look forward to on the weekend.  On Saturday night, we went out to a great restaurant and I ate oxtails and potatoes- so good, but really rich, so I only ate about 1/3 of what was on my plate.  I had 2 glasses of wine and for dessert, had a big ole ice cream cone that I really enjoyed.  Back on the wagon for Monday.   

My other tip for this week is to SHARE MEALS when you go out to eat, if possible.  I'm usually full after half my meal, but feel like I need to finish, so I'll end up eating too much.  Leftovers from restaurants usually end up in the trash and it's a shame to waste the food and money.  Sharing with someone eliminates that and you don't leave the table feeling so heavy from overeating.  

via

I made a healthy meal last week that I think you might like too.  I warn you that it's not the prettiest dish, but very tasty and full of protein.  It's kind of a Tex-Mex casserole with egg noodles.  I really believe that "abs are made in the kitchen", which is why the eating portion is so crucial to seeing results.  My meals last week pretty much consisted of:

7am- oatmeal and coffee

10am- protein shake 

12pm- this casserole

3pm- tuna sandwich and Sun chips 

6pm- this casserole

8pm- Greek yogurt or hot cocoa

I also stopped in Starbucks a few times (which is a step back from my previous daily addiction).  

Ingredients

1 Jennie O- Extra Lean Ground Turkey

1 Laura's Lean Beef (94% Lean) - or go leaner

1 bag No Yolk Egg Noodles

1/2 container of Philadelphia Cream Cheese (1/3 less fat) - or use fat free

1 cup Shredded Mexican cheese (2%) - or use fat free

1 package Taco Seasoning (low sodium)

Directions

Preheat oven to 350 degrees.

Boil the egg noodles for about 8 minutes, then drain.

Meanwhile, brown the two meats until cooked though, add the seasoning mix with about a cup of water and let it boil until the water and seasoning is absorbed.

Off the heat, add the cream cheese and 1/2 cup of shredded cheese to the meat mixture and stir until all melted and mixed in.  Add in the noodles and stir until combined.

Pour the entire thing into a 9x13 baking dish, top with remaining 1/2 cup of shredded cheese.  Bake for about 20 minutes.

I based this dish on a pin from Pinterest, but lightened it up.  To make it even lighter, use leaner beef and fat free cream cheese and fat free shredded cheese.  Some people may also like to add salsa to this for more flavor. 

If you portion this dish into 10 servings, below is the nutrition information.  I use myfitnesspal.com to calculate the nutrition- it's free and really user-friendly. 

So, how's it going for you?  If you've fallen off the wagon, just get back on!

via Nike

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Breathing, Chronic Obstructive Pulmonary Disease, and Yoga

by Shari

In my “day job” as a home health physical therapist, I see a lot of clients who have significant breathing difficulties. One of the most common breathing ailments is Chronic Obstructive Pulmonary Disease (COPD). COPD is similar to asthma in that some of the symptoms are the same but the etiology of the disease is different. Most significant is the inability to get air out and not being able to get enough oxygen in.

Let me give you a bit of background about breathing and normal airways. Air travels into the lungs via the trachea. It goes down a series of branching airways called bronchi. These bronchi branch into smaller bronchioles and then into millions of tiny air sacs called alveoli. Oxygen in the air passes through the thin walls of the alveoli into the tiny blood vessels nearby, attaches to red blood cells and is carried into the blood vessels to the rest of the body. Carbon dioxide is passed out into the alveoli from the red blood cells and is breathed out. But breathing doesn’t always depend upon the oxygen needs of the body. Breathing can be related to emotions, body tension, sensations of pain, pleasure, and body movements.

Breathing is composed of two main parts: inhalation and exhalation. Inhalation is the process of taking air into the lungs. It can occur with different amplitudes or volume of air. It can occur at a variable rate, and it can be less active. Exhalation is the process of letting air flow from the lungs back outside the body. It can vary in amplitude, rate and effort. You can stop your breathing but, of course, not permanently.

There are two main types of breathing: costal (ribs) breathing and diaphragmatic breathing. In costal breathing the ribs open and close primarily and in diaphragmatic breathing the abdomen changes shape.

The volume of air that one breathes in inhalation is called “tidal volume” and in rest or relaxation it is at a minimum. When we do moderate activity, we increase the amount of air that is bought into the lungs but this doesn’t change the tidal volume.  When we maximally exhale the air from our lungs, there is always some air left in the lungs and this is called residual volume.

Other factors that influence the depth of our breath include rib cage flexibility, (the more flexible the rib cage, the more we can increase the amplitude of our inhalation) and muscular strength of the muscles of exhalation. The diaphragm is the primary muscle of inspiration. The secondary or accessory muscles of respiration include many muscles of the ribs, neck, chest wall, and trunk (abdominal muscles).

The Diaphragm (with ribs cut away)

When we breathe, the diaphragm contracts and moves downward if the abdomen is relaxed. The belly will then gently expand outward and the lower regions of the lungs expand downward. When we exhale, the diaphragm relaxes and moves back up, the belly moves in a bit.

An individual with COPD works very hard to breathe. Often there are postural changes that occur over time that may be structurally compromising the ability of the rib cage to expand and return to resting position. If the anterior chest wall is collapsed and tight, then we don’t have the rib or thoracic flexibility to encourage the lungs to fill to their capacity.  Breathing involves muscles, skeletal and joint articulations and is an interface of organs and movement.  But breathing is also an emotional activity.

Because an individual with COPD is chronically short of breath, they fear movement because it makes them short of breath, so in turn they become chronically deconditioned, and weak due to immobility. The fear of not being able to breathe leads to increased anxiety, depression and more fatigue and stress. Here is where the practice of therapeutic yoga can be so beneficial for an individual with COPD.

If we consider the individual fully and address their physical, emotional, neurological and spiritual nature, we can assist them in learning to move again within the confines of managing their respiratory issues. Learning to observe one’s breathing pattern and to gently try to increase the exhalation compared to the inhalation is quite beneficial for someone with COPD. Gentle asana practice that addresses areas of chronic tightness and postural awareness with improved skeletal flexibility allows more freedom of respiratory movement. Please see all our wonderful prior posts for gentle seated practices and safe gentle yoga poses. Also please reread the pranayama posts because these can be adapted to a COPD breathing pattern if the emphasis is on the exhalation with no retention holds at either the end of inhalation or exhalation. Lastly, trying to walk with good self pacing and breathing awareness (sort of like a meditation practice) is a wonderful way to begin to address the poor endurance that plagues someone with COPD. If you yourself have COPD or know someone with COPD who wants to study yoga, I would recommend individual private one-on-one yoga sessions to start, and then, if and when possible, moving on to a gentle yoga class that is slow paced.

Note: November 16, 2013, Shari and her colleague, Bonnie Maeda, will be teaching a workshop in Brentwood, California on Yoga for Breathing and Sleep Apnea, which covers COPD and other topics. For further information or to register for the workshop, see brentwoodyogacenter.com.

Friday Q&A: Costochondritis

 Q: How can yoga help people that have costochondritis? I have it now and then and I can't do some yoga poses that open the chest as they trigger the pain. I had it for the first time 3 years ago and it never really went away, keeps coming back.

A: Costochondritis (CC) is a fairly common cause of chest wall pain in adults in the US and around the world. According to the Mayo Clinic website: 

“Costochondritis (kos-toe-KHON-dri-tis) is an inflammation of the cartilage that connects a rib to the breastbone (sternum) — a junction known as the costosternal joint. Pain caused by costochondritis may mimic that of a heart attack or other heart conditions.”

This last statement about this kind of pain mimicking heart attack has led many a student of mine with sudden onset of chest pain to the hospital, fearful they were having one! In the case of costochondritis, all the tests come up normal, which is obviously a huge relief, but the pain can persist, as it has for our reader.

Let’s look at some other facets of costochondritis before we specifically look at what yoga’s role is in helping or hurting it. Modern medicine’s view on CC is that most of the time there is no apparent cause for the inflammation between the rib and cartilage, which can be frustrating if you have it because if you knew what caused it, you could change what you are doing to possibly avoid it happening again! So the focus shifts to treating the pain, usually with anti-inflammatory medications like ibuprofen, as well as modifying your activities to avoid movements that aggravate your pain. Since most of the connections between the ribs and breastbone involved are located to the right and left side your breast bone, this is usually where the pain shows up. Apparently, it shows up more often on the left side of the breastbone (same area some heart attack pain can be) and often involves more than one rib.  One distinguishing feature that sets it apart from heart pain or angina, is that the pain from CC often happens with a deeper breath or when coughing. 

And although I mentioned above that most cases of CC have no known cause, some cases are associated with a blow to the chest, heavy lifting or strenuous exercise, severe bouts of coughing, certain types of arthritis, or the spread of tumors to this area. In addition, you are at greater risk of developing a bout of CC if you are woman or if you are over 40 years of age. The diagnosis of CC is usually made when your history is consistent with the kind of pain I described above, if you are tender-to-touch over the side of your breast bone or when you move your chest and arms in certain ways, and if you have ruled out more serious problems, like heart pain, GI reflux or lung related illnesses, like pneumonia. Hopefully, you won’t have to do the ER full heart work up like one of my students had to undergo this past week!

In addition to NSAIDS like ibuprofen, your doc might add other medications to your treatment regimen. If the pain is severe, a narcotic medication might be suggested. If the condition lingers and becomes more chronic (which does not happen often but does happen), certain anti-depressants and anti-seizure medications can be added, not for depression or seizures, but because they have been found useful for chronic pain management. The downside to all these meds is that they often have unwanted and occasionally serious side effects.

On the non-medication side of things your doctor may recommend, you might be referred to a physical therapist, who could teach you gentle stretching exercises (ding, ding, ding!) or the use of an electrical stimulation unit called a TENS unit. On your own, you can experiment with the effect of ice or heat on your symptoms to see if they provide any relief from the pain, as well as good amounts of rest to avoid aggravating activities.

Our reader is interested in how yoga might be used to help costochondritis, but also, I suspect, how to do so cautiously, as she has noticed that the yoga asana can also aggravate or trigger her CC pain. And therein lies the rub. If you are pain free, a regular yoga practice can keep the rib cage and the joints that CC affects mobile and the muscles in the region strong and open. A regular yoga practice has been found to improve conditions that could lead to costochondritis, such as arthritic conditions. And yoga has been found to decease inflammation in those who practice it regularly, so it might help reduce the chances of developing CC in the future.

On the other side of the fence, some forms of yoga and certain yoga poses fall into the category of strenuous exercise or stressful activities for the sternal joints. Dhanurasana (Bow pose) comes to mind as a pose that stresses the joints along the sides of sternum as it stretches the front chest, and a 90-minute power yoga flow with lots of Chatarunga Dandasana could also overtax the front chest joints as well.  So you would want to assess if you developed CC within a short time of doing such poses, and give ‘em a rest if you make the connection.

Hopefully, your yoga practice is not the source of this kind of pain. But once costochondritis shows up, you will likely need to assess, monitor and modify your poses and practices if they seem to trigger or aggravate your symptoms. It is almost always a safe bet you can do supported restorative style poses, as they are less likely to negatively affect the front chest if done with the goal of keeping that area quiet.  And supported, gentle practices are likely to lower your stress response, which should have a positive impact on healing.  They should also allow your immune system to function optimally, thereby reducing the chances of developing new respiratory illness like the common cold, thus avoiding illness associated with coughing. In addition, always think outside the yoga asana box, and add in gentle pranayama (probably not long, deep inhales and exhales for a while), visualizations and meditations in supported positions while the inflammation around the breastbone joints diminishes. 

And as the pain symptoms of costochondritis diminish, gradually re-introduce more active poses and practices to get your body back to its previous healthy balance, hopefully leaving the memory and risk of recurrence of costochondritis in your rear-view mirror. 

—Baxter

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Late-Onset Scoliosis is Common in Older Adults

by Nina

Reclining Nude, back by Henri Matisse

A recent New Times article Scoliosis Can Hit Well Past Adolescence by Jane Brody confirmed something I have been observing in the yoga community: late-onset scoliosis is quite common in older people. I developed the problem myself in my fifties, so I’m quite aware of the condition, and I’ve noticed a large number of other older yoga practitioners with the same problem. Here’s what Jane Brody said about this:

"Although scoliosis is generally thought of as a problem of adolescents, who often require bracing or surgery to correct the curvature, the condition is actually far more prevalent in older adults. In a study by orthopedists at Maimonides Medical Center in Brooklyn of 75 healthy volunteers older than age 60, fully 68 percent had spinal deformities that met the definition of scoliosis: a curvature deviating from the vertical by more than 10 degrees."

Even a mild version of scoliosis can result in chronic pain of different types. While your pain could be in your back, it might also be in your hip (because scoliosis can make your hips uneven) or even your leg and/or knee (because scoliosis can make one leg “virtually” shorter than the because that hip is higher).

Baxter, who teachers Yoga for Back Care, has already written about scoliosis (see Friday Q&A: Scoliosis). But I decided to write about it today because I think it’s important for us all—students and teachers alike—to realize what a common problem this is. And if you (or a student of yours) are having mysterious back pain, hip pain, or leg pain, it’s worth being checked out to see if this is causing the problem. Some people just don’t think of it! I personally know of two cases of women with pain who didn’t realize they had scoliosis. In one case, the yoga student’s teacher casually mentioned, well, of course, you have scoliosis, because it was visible to his sharp eyes. She had no idea! And in another case, it was I myself who noticed it while I was assisting a fellow student doing a backbend. I just asked her, “Do you have scoliosis?” She was surprised I had asked, but we when talked afterward, it turned out she was having quite a lot of pain, including in her hip. So I encouraged her to get checked out by a health professional, and sure enough, she did have scoliosis.

Getting checked out is not necessarily a big deal. A health professional can do a visual test that is quite simple (he or she will watch your spine as you come bend into a forward bend), although in same cases, if your scoliosis is very mild, you may need an X-ray to detect it. But it is worth knowing the source of your physical problems because, yes, yoga can help. Even Jane Brody had a yoga pose recommended to help her:

Determined to minimize further shrinkage and to avoid pain and nerve damage, I consulted a physiatrist who, after reviewing X-rays of my misshapen spine, said the muscles on my right side, where the spinal protrusion is, were overdeveloped relative to the left. He prescribed a yoga exercise — a side plank — to strengthen the muscles on the left and exert enough of a tug on my spine to keep it from protruding farther to the right. He suggested that the exercise might even straighten the curve somewhat.

That pose sounds like Vasisthasana (aka Side Plank pose) to me! And there are whole lot of other yoga poses you can do to strengthen your back and balance your curve. So if you’ve been diagnosed with this condition, seek out a yoga for back care teacher who understands scoliosis, take a Yoga for Scoliosis workshop, or check out Elise Browning Miller’s web site (she’s a long-time yoga teacher who uses yoga to manage her own scoliosis) for info on her books and DVD and other resources.

Healthy Spirits: New at Castro

New @ Castro Store:

Anchor Christmas 2012  ($14.99/6pack)  & 2013 ($12.99/6 pack)

Anderson Valley Winter Solstice ($9.99/6 pack cans)

Allagash Merveilleux Ale ($17.99/375ml)

Sleep, Alzheimer’s Disease and Yoga

by Nina

Sun Behind Clouds by Melina Meza

One of the worst fears I think we all share about getting older is of developing dementia. Just recently I had a long phone conversation with a woman who is trying to deal with a mother in the early stages of Alzheimer’s Disease, and it was just so sad. I had some advice for her, but no solutions, of course. Then I heard a news piece on NPR “Brains Sweep Themselves Clean of Toxins During Sleep”  that gave me  glimmer of hope.

Scientists have been trying to figure out the purpose of sleep for a very long time. A recent study “Sleep Drives Metabolite Clearance from the Adult Brain”  published in Science Magazine, proposed a fascinating new theory. The team of researchers from the University of Rochester discovered that while the brain sleeps it clears out harmful toxins, a process that may reduce the risk of Alzheimer's. According to the NPR interview, during sleep, the flow of cerebrospinal fluid in the brain increases dramatically, washing away harmful waste proteins that build up between brain cells during waking hours. Professor of Neurosurgery and an author of the study, Dr. Maiken Nedergaard, said, "It's like a dishwasher."

The waste proteins getting washed away during sleep are toxic to brain cells, which could explain why we don't think clearly after a sleepless night and why a prolonged lack of sleep can actually kill an animal or a person. The results appear to offer the best explanation yet of why animals and people need sleep.

“Thus, the restorative function of sleep may be a consequence of the enhanced removal of potentially neurotoxic waste products that accumulate in the awake central nervous system.” Lulu Xie, et al.

Alzheimer's Disease researchers say this research could help explain a number of recent findings related to sleep and AD. Dr. Randall Bateman, Professor of Neurology  at Washington University said this about beta amyloid, which is the main component of certain deposits found in the brains of patients with Alzheimer's Disease.

"Beta amyloid concentrations continue to increase while a person is awake. And then after people go to sleep that concentration of beta amyloid decreases. This report provides a beautiful mechanism by which this may be happening.”

The team of scientists discovered the cleaning process while studying the brains of sleeping mice. Dr. Nedergaard said that during sleep the system that circulates cerebrospinal fluid through the brain and nervous system was "pumping fluid into the brain and removing fluid from the brain in a very rapid pace.” When the mice went to sleep, their brain cells actually shrank, making it easier for the fluid to circulate. But when the mice woke up, their brain cells enlarged again and the flow between cells slowed dramatically.

The researchers speculated that the reason the brain doesn’t do this cleaning all the time is because the cleaning uses a lot of energy, and it’s probably not possible for the brain both to clean itself and at the same time be aware of its surroundings, talk, move, and so on. So getting enough sleep—which we already know is vital for our physical and mental health—may be one key to preventing Alzheimer’s Disease as you age.

But what does all this have to do with yoga? Well, if you’re having trouble sleeping, yoga can help with that. Because insomnia is so often related to stress, yoga’s stress management techniques can help you quiet your nervous system so you fall asleep more quickly and sleep more soundly. For  information on how yoga can help you sleep better, see Yoga for Insomnia, Part 1  and Day to Night: Yoga for Better Sleep. The Supported Inverted poses I wrote about recently (see All About Supported Inversions) are poses that I've found particularly helpful.

We’re so careful here at YFHA not to make any false promises and of course as this research is new, we can’t promise that getting enough sleep will definitely make a difference for you. But encouraging you to get a good night’s sleep can’t be harmful in any way, and if this gives you more motivation to practice stress management techniques, which are helpful for preventing a whole host of health problems, we’re doing you a favor. And if you'd like to add an additional practices to encourage brain health, start meditating on a regular basis (see Meditation and Brain Strength) and keep practicing your yoga asanas (see Yoga for Brain Health?). 

Finishing the Year Healthy & Strong

*First let me apologize for having to truncate my posts (causing readers to have to click "read more" to read the post in its entirety) because my blog content has been stolen by some thief with a domain registered in India.  Thank you Leanne for letting me know- I had no idea.  Back in August 2012, several well-known bloggers started truncating their posts because "scraper sites" had been stealing their blog content.  I never worried about it and, as a reader, I find truncated posts kinda annoying, so I never did that.  But I have to now.  My entire blog- every word and photo has been scraped and is now appearing as original content on another blog.  So annoying! And the worst part is, I haven't yet figured out what I can do about it.  So, I just wanted to explain why I'm now truncating my posts- apparently this makes it much harder for the thieves.  I hope you'll keep reading!

* * * * * 

I think I need to get your attention and my own regarding the reality that the holidays are just around the corner!  I get giddy with excitement this time of year.  Halloween is in a couple days, which really just marks the beginning of the real holiday season for me.  I love everything that is related to this time of year, including the coziness of colder weather, wearing red and feeling festive, getting together more with family for longer, relaxed gatherings, celebrating family traditions, shopping for gifts for family and friends, decorating the house, and yes, of course, all the yummy FOOD and DRINKS!

But seriously, do we have to just check out in the health department this time of year?  I've already gained a few pounds in last couple of months as I've slacked off my workouts and discovered this ridculously delicious gelato that I've been induldging in too often.  It happens.  But, we need to be reasonalbe and balanced.  I know I'm less happy and more uncomfortable when I'm heavier.  Just a few extra pounds on my very short frame (5'1) makes my jeans too tight.  And even a couple extra pounds are hard to lose.

I want to look and feel GREAT this holiday season!  

via Nike

So, I am committing to get back to my workouts and eating healthy for the last two months of the year.  Of course I will induldge in my favorite treats in the next couple of months.  I will make homemade toffee and peanut butter cups and other comfort foods.  I will drink wine and champagne.  But, I will use portion control and stay active.  

Right now, I'm doing 50 minute workouts at my gym that consist of a 10 minute warm-up on the treadmill (I like a 10 incline and a speed of about 3.5), 30 minute workout with weights, active rests, and ab exercises, then 10 minutes on the stairclimber to finish off.  I don't know about you, but when I'm working out, I'm MUCH more likely to consider my food choices, opting for healthier meals because I don't want to workout and then "blow it" by eating junk.  I didn't just work my *ss off to throw it away!

I know it's cold.  I know it's the holidays.  I know we're busy.  But can we finish this year healthy and strong?  Can we do it together?  

Let's ENJOY the holidays this year and all that that means, but let's also be mindful to make healthy choices and NOT gain extra weight that we will have to fight hard to lose come January!  It's WAY EASIER to prevent the weight gain than to try to lose it later, right?!

If you're on board with me, let me know in the comments! :) I'll be posting periodically about how I'm doing and y'all keep my accountable.  I weighed myself last night at 110 pounds, and a more reasonable weight for me is 103-106.

To help keep me on track, I'm cooking meals in advance and portioning them out for no-brainer, quick and easy meals.  My top two meals that I like to eat and are healthy, packed with protein and low in calories are: 1) Tex Mex, and 2) Grilled Chicken with Brown Rice and Veggies.  I'm okay eating the same thing repeatedly with small treats on the weekends because I've seen the results that come with eating this way.  Also, have you ever realized how much time we spend thinking about what we're going to eat? Having meals pre-planned and prepared eliminates that and makes more time for other things.  People ask if my husband and child eat this way too and the answer is sort of.  My husband does, but my child is so picky, he's still mostly eating grilled cheese or PB&J at dinner.  He used to like the Tex Mex meal a lot, but recently decided he hates it and won't even take a bite.

I'm all for food I can easily assemble.  I make a big batch of brown rice that I boil in low-sodium chicken broth and/or salt-free Tony Chachere's seasoning for added flavor, steam a large amount of my favorite veggies (for this dish carrots, broccoli, mushrooms), and grill boneless, skinless chicken breasts.  I put about a cup of rice, and a half cup of chicken and veggies in small tupperware containers and add a splash of low sodium soy sauce.  Instant meals. 

The Tex Mex cassorole below is the second fave.  You can put it in a whole wheat tortilla too for something different but I usually eat it straight out of the container.  Get the recipe HERE. 

For snacks, I make protein shakes with fruit and spinach and I love Greek yogurt.  Omelets with all-whites and veggies are also another favorite.  I eat oatmeal for breakfast.  If I want something sweet at night, I'll make a hot cocoa.  The key is finding some healthy meals and snacks you can eat over and over to make it a no-brainer.  Even if you can't get those workouts in, if you make healthy food choices and manage your portions, you will be in great shape. 

So, are y'all on board?  Will you maintain your weight or even get in better shape during this holiday season?  Let's finish 2013 healthy and strong!

* * * * * 

Home Practice: Is There an Optimal Length?

by Baxter

Hours of Operation by Melina Meza

This past August I was back in Ocean Springs, Mississippi at River Rock Yoga, leading a weekend workshop. One of the students, who has been a regular in class with me there over the years, brought in a few pointed questions for me that he hoped I could address on YFHA. He has been a regular reader since we started, and practices yoga on his own as well as attending classes regularly. In his search for the perfect home practice, he was very curious if I thought that there was a recommended minimum time for a home practice, realizing that some yoga is better than none!

In his own attempt to answer the question, he cited an April, 2013 article in an issue of Prevention Magazine which claimed, referring to a study done in postmenopausal women, that 42 minutes of vigorous exercise over 3 days (that means 14 minutes a day) maintains telomeres. As regular readers of this blog will know, telomeres are little “caps” or tails on the end of DNA stands that may have a relationship to longevity of certain cells in the body. Recent yoga studies have shown a positive relationship between yoga and telomere length. However, I don’t think the yoga practices in these yoga studies were only 14 minutes long, and likely would not fall into the category of “vigorous exercise.” However, this is an intriguing idea, and I’d say if you could hit the 14-minute mark in your home practice, that is a good start—more on that in a minute.

My student also cited “100 New Scientific Discoveries” issue of Time magazine, where he came across this:

“Researchers [in Stockholm] say that even a single 20 minute workout can lead to epigenetic changes that help make muscles work better.” 

For those not familiar with the field of study known as “epigenetics,” I offer this Wikipedia definition:

“epigenetics is the study of mitotically or meiotically heritable changes in gene expression or cellular phenotype, caused by mechanisms other than changes in the underlying DNA sequence—hence the name epi- (Greek: επί- over, above, outer) -genetics.” 

In this case, exercise is influencing how the genes of muscles express themselves leading to improved muscle function. I’ll take it! And 20 minutes sounds even better to me than 14 minutes for a home yoga practice.

And real life examples of the power of a regular practice are equally compelling to me as scientific studies. Recently, a long-time student of mine who has chronic back pain experienced a distinct change in his daily health. In the past, he had come to my back care yoga class regularly, but eventually found that some of the poses we did would actually flare his chronic back pain. So we met privately and developed a home practice he could do for 15-25 minutes daily, if he so chose. He found that he would do the practice 2-3 times a week, and it helped his overall back pain nicely. 

But then two months ago, he asked if we could audio record a practice that lasted about 40 minutes. He explained that his partner had become interested in doing some yoga at home and wanted something they could do together in the morning before work. We came up with a balanced routine that included poses beneficial for back health, but also breathing practices and a good Savasana at the end. When he returned for a follow-up recently, it was not the lower back symptoms he reported on, but that the chronic loose bowel movements he has suffered with every morning for years had diminished and stopped, replaced by a normal movement each am. He was thrilled and felt it was a direct effect of his new daily morning practice. And for him, 40 minutes a day works just fine.

We know from the work of cardiologist Herbert Benson, that 10 minutes of meditation is the time frame for the body to shift to the Relaxation Response (the Rest and Digest side of the autonomic nervous system), and by 20 minutes the effects are even more profound. And, of course, there are many other variables to consider when you design your home practice, as you can see from the 24 posts we have done to date that address the topic of home practice. We know, for example, that one study showed that it was regular home practice, more than attending classes over time or regularly, that seems to relate to long term health benefits of yoga (see Does Home Yoga Practice Make You Healthier? and Home Practice: The Best Way to Improve Your Health and Well-Being).

But like most issues we have discussed here over the years, the answer to this question of the optimal minimum time for home practice is really “It depends!” But, given what my astute student has uncovered, as well as research findings on the benefits of regular practice, my observations of my students and my own practice, I’d feel comfortable recommending that you try to hit that 20 minute mark, and on days when you feel like going longer, there is nothing to stop you! 

Pratyahara, the Sense of Sound and Hearing

by Ram 

In a Tunnel by Melina Meza

"Deafness separates us from people" —Helen Keller

In my last post Pratyahara and Healthy Aging, I introduced the topic of pratyahara and defined the term as “Using our our senses with total/complete awareness.” It is through the five senses that we bring in impressions into our mind and body thereby absorbing the world around us. Thus, we are what we eat, smell, see, hear and touch. Since our five senses serve as portals or gateways into our body, mind and consciousness, it becomes very important to be aware of what we are drawing in through the five senses. If we absorb harmonious impressions, we will in turn be healthier. If we take in that which is unhealthy, the mind and body suffer. Thus, physical and mental instability can arise if we bring on low-quality sensory impressions.

The sense of sound is perceived by the ears and through these sense organs we bring in the sounds of the environment. Sounds can have profound effects on our physiology. Ask a person who is living in a war zone and being exposed continuously to high decibel sounds of machine guns or bombers flying overhead. Compare that to the sounds of your breath during a yoga session or to soft sounds of nature. While the former can result in a pathological condition including profound hearing loss, the latter uplifts our mind and spirits.

Hearing loss is a major public health issue and is the third most common physical condition after arthritis and heart disease. Approximately 20 percent of adults in the United States experience some degree of hearing loss, with aging and chronic exposure to loud noise being the two most common causes. There exists a strong relationship between age and hearing loss. Age-associated hearing loss (aka presbycusis) is characterized by changes in the inner ear, which deteriorates as the individual gets older. While the loss may be mild or severe, it is permanent and irreversible.

Other causes of hearing loss include ear-trauma, damage/injury to the ear, infection, common cold, or earwax buildup. Furthermore, hearing loss is often accompanied with severe ringing in the ears (tinnitus) that in itself is very discomforting. In addition, degeneration or loss of function in the vestibular system (the part of the inner ear that is responsible for movement and sense of balance) can lead to balance deficits. Abnormalities in balance function can result in vertigo (sensation of spinning) or disequilibrium (sensation of being off balance and resulting in frequent falls). When balance is impaired, an individual has difficulty maintaining an upright orientation.

Since sound is a form of energy wave and we are all affected by what we hear, we need to be aware of the nature and kind of sounds and create a harmonious auditory environment around us. Other preventative measures to keep the ears healthy include yoga and pranayama, which provide immense benefit to the ears and sense of hearing.

Many traditional yoga poses are focused on balancing the body and the mind. When looking for beneficial yoga poses for the ears, we need to focus on asanas designed to increase balance, including but not limited to standing balancing poses like Tree pose (Vrkshasana), Extended Hand-To-Big-Toe pose (Utthita Hasta Padangustasana), and the Warrior poses, especially Warrior 3 (Virabhadrasana 3). If you have a hearing loss that is associated with spells of dizziness, you need to modify your yoga practice and also avoid holding the poses very long.

In his recent post Dizziness and Yoga Baxter provided tips regarding do’s and don’ts of specific poses to relieve vertigo. If the hearing loss is due to an acute infection, poses such as Downward-Facing Dog offer relief by releasing pressure from the ears. Plow pose (Halasana) aslo offers a host of health benefits, including potentially relieving sinus pressure. Notice that in these poses the heart is higher than the head; as a result these poses increase the blood flow to the head which can help restore ear health. For beginners or for people with existing ear issues like pain or pressure, I would suggest doing the above with suitable props. Check Nina’s extremely informative post All About Supported Inverted Poses on supported inversions where she discussed the above-mentioned asanas and other poses using suitable support .

Additionally, pranayama (deep breathing exercises) can help alleviate pain or ringing in the ears associated with tinnitus. In his recent posts Tim McCall described Bhramari pranayama and  Anuloma-Viloma/Aternate nostril breathing. In addition to its immense benefits on the heart and toning down the agitated mind, the role of these pranayama techniques is described in classical texts for in relieving problems associated with the ear and the sense of hearing. Pranayama can be done in conjunction with the yoga poses mentioned above., however, I prefer doing pranyama at the end of a yoga session to achieve greater benefits and relaxation.

Whatever options you choose to keep your ears and sense of sound intact, remember that the power of choice and the power to control our environment that surrounds us lies within us. Let us use this power and surround ourselves with a healthy auditory environment. I am reminded of notable German physicist G.C. Lichtenberg’s famous quote:

"What a blessing it would be if we could open and shut our ears...."

Faith

just fyi . . . 

via Candy to My Soul

Friday Q&A: Yoga for a Sprained Ankle

Q: Nina—how bout yoga for a sprained ankle...got some ideas?

A: Why, yes, thank you so much for asking! Last year Baxter did a three-part series on the ankle that is worth revisiting or visiting for the first time if you’ve never read these posts. So check out Getting to Know Your Ankles, Ankle Sprains, and Recovering from Ankle Injuries.

In part 2, Baxter says that a typical recommendation from your doc is to elevate your foot and leg above the level of your heart, and because there are lots of yoga poses that are done lying on your back with the legs elevated, these poses could assist in the healing process. So in the acute phase of injury, try supported inverted poses such as Legs Up the Wall pose, Chair Shoulderstand, and Easy Inverted pose. See All About Supported Inversions for some other possibilities, and links to instructions for them.

Naturally, while you are recovering and need to keep the weight off your ankle, you will need to avoid standing poses. But there are so many other poses you can still do, including seated and reclined poses. If I were in your situation, I’d continue to practice what I could to maintain my flexibility while my ankle was healing. So try some seated poses, such as hip openers, twists, and forward bends, while keeping your ankle in a neutral, pain-free position. Of course, you’ll want to avoid poses that put pressure on the ankle, such as any variation of Hero pose (Virasana) or Half Lotus (Arda Padmasana). Also, many of our office yoga poses, which you can do seated in a chair, will be suitable for you. Reclined poses, including passive backbends as well as restorative poses, can be very effective at opening your body without putting any stress on your ankle. Again, just be sure to keep your ankle in a neutral, pain-free position. It’s kind of an interesting to challenge to figure out how to practice when you need to avoid aggravating an injury (right now I have a plain old skinned knee, so I need to avoid kneeling—it turns out that comes up more frequently in practice that you might imagine).

If the pain and inconvenience of having a sprained ankle is causing you to stress out—which I imagine it would—add in some stress reduction practices, such as meditation, yoga nidra (see the Relaxation Tracks tab at the top of our page), breath awareness or pranayama, or even just a nice long Savasana. Check the index on the right side of our blog for posts on all these topics.

Once the acute phase symptoms have diminished, Baxter says that you can turn your attention to a more typical asana practice, adding in his seated ankle rolls and alphabet spelling exercises (see Ankle Circles). At this point, you can focus on the strengthening aspects of the poses for the ankle and foot area, so add special attention to activating as many of the muscles surrounding your ankles and feet as you do your standing poses.

—Nina

Healthy Spirits: Exclusive Fifty Fifty Brewing Release!

 

 



 

TODAY'S THE DAY! FiftyFifty Brewing Company Healthy Spirits: 15th Anniversary is now available at Castro and Clement! It's a blend of porter and barleywine, aged for over 6 months in our hand-picked Four Roses bourbon barrels. $25.99/22oz

Beer of the Month Club members will be getting a bottle of this in their November selections, which should be available for pick up later today.

Healthy Spirits: Fifty Fifty Brewing-Healthy Spirits 15th Anniversary Release

 

 

 



We will be releasing our latest exclusive beer tomorrow afternoon!

Fifty Fifty: Healthy Spirits 15th Anniversary is a blend of porter and barleywine, aged for over six months in our hand-picked Four Roses bourbon barrels. $25.99/22oz

We'll release these bottles for sale as soon as they are delivered, which is likely to be in the early afternoon. Watch facebook and/or our beer blog for updates!

(FYI Beer Club members will be getting a bottle of this in next month's selections)

Restorative Yoga Better Than Stretching for Reducing Subcutaneous Fat in Overweight Women

by Nina

Just a quick announcement today about some research findings I think you’ll all enjoy hearing about. Baxter and I read about a recent study, designed by Maria G. Araneta, PhD, MPH, of the University of California, San Diego, to determine whether obese women would see a loss of fat from less intense exercise instead of aerobic activity. Although not a huge study, the group sizes were larger than most of those we see in recent studies, with the yoga group of 88 having a mean age of 55 years with an average BMI of 36 kg/m2 and the stretch group of 83 having a mean age of 54 years with an average BMI of 32.5 kg/m2.

Along with her co-authors Matthew A. Allison, MD, MPH, Elizabeth Barrett-Connor, MD, and Alka M. Kanaya, MD, Dr. Araneta presented the results at the 73rd Scientific Sessions of the American Diabetes Association in Chicago (June 21-25). And their findings showed that the restorative yoga practitioners lost significantly more subcutaneous fat over the initial six months of the study period, and kept losing it during a maintenance period with less direct supervision! This is important because all the women participating in study had metabolic syndrome, which the Mayo Clinic defines as:

Metabolic syndrome is a cluster of conditions — increased blood pressure, a high blood sugar level, excess body fat around the waist and abnormal cholesterol levels — that occur together, increasing your risk of heart disease, stroke and diabetes.

Metabolic syndrome affects 44% of the U.S. population older than age 50. And reducing abdominal fat may help reverse the syndrome.

Although the team is still reviewing the data, they’ve speculated that one explanation for the difference between the effects found with restorative yoga and stretching may be that restorative yoga reduces levels of cortisol. As Timothy wrote in his background post Stress, Your Health and Yoga, cortisol levels rise during times of stress and is known to increase abdominal fat. And in Baxter’s post Cortisol and Good Health Baxter wrote about the dangers of prolonged periods of stress and high levels of cortisol. I wrote specifically about the relationship between stress, cortisol and weight management in my post Yoga, Stress and Weight Management. So we'll be very interested to see the follow-up studies.

In Baxter's post on cortisol, he actually recommended restorative yoga along with yoga nidra as stress reduction—and cortisol-lowering—solutions. However, meditation (see Starting a Meditation Practice) and supported inversion poses (see All About Supported Inverted Poses) are also helpful. For a complete overview of how to use yoga to switch your nervous system from the Stress Response (Fight or Flight) to the Relaxation Response (Rest and Digest), see The Relaxation Response and Yoga.

In her presentation, Dr. Araneta did not recommend restorative yoga as a replacement for aerobic activity; instead, she said this “complementary” practice could provide a means of gentle movement for those severely obese patients for whom other activity is not practical. But as I wrote in Restorative Yoga: An Introduction, restorative yoga is a complementary practice that benefits all of us.

If you haven't already, check out Baxter's video of the classic restorative pose, Reclined Cobbler's pose!