Rksana: Protective Practice to Sustain Women as We Age

by Robin Rothenberg

Autumn Flowers in Front of a Full Moon by Hiroshige

Menopause showed up inconveniently in my life when I was barely 40. My father-in-law was dying from ALS. My youngest was in the throes of adolescent rebellion. I had just opened my second studio site and my marriage was on shaky ground. Hot flashes (24/7 power surges really), insomnia and mental fog added kerosene to an already combustible mix of life challenges.

While I had always been a strong asana practitioner, during this period I often felt like a gerbil spinning on the wheel to nowhere as I would rotate through my posture sequence. I encountered aches in my hips, knees, and shoulders that I had never experienced before. Sometimes I would just curl up in Child’s pose, exhausted from very little effort. Stripped of the stamina that I had come to rely upon, I was afraid that I would never recover from this malaise. 

Fortunately for me, my teacher at the time was able to put my experience into perspective. According to the Krischnamacharya lineage, yogis viewed life as a series of three stages that we move through. They counseled that practice needs to adapt as the practitioner ages to meet the needs of the current stage. (See Yoga for the Three Stages of Life, by Srivatsa Ramaswami for in-depth information.)

In our youth, the Sunrise Stage, the focus is on developmental challenge: more physically demanding practices that support the maturation of a healthy body and discipline of mind—think Sun Salutations, arm balances, backbends, and strong standing pose sequences. 

For the middle years, the Midday Stage, the golden word for practice is rksana (pronounced rakshana). Rksana means protection. The wise yogis understood that we have many obligations pulling on us, challenging our time and energy during our middle years—children, aging parents, and mortgages to name just a few. Our practices therefore need to stabilize and nourish rather than be yet another depleting demand we impose upon ourselves. Gentle asana, pranayama, restorative poses, and yoga nidra, are invaluable tools for sustaining our physiologic and mental stability. These offer critical support to enable us to meet the complex needs of our family and community and return us to our own center of gravity.

The Sunset Stage is the stage of later life, when we’re retired, and the focus traditionally was more towards God and the next life. Meditation and prayer are considered the primary practices at this stage. 

I realized via this teaching that it was my mind that kept pushing me to compete with my younger self. When I listened to my body, the message was very clear. Pranayama and restorative practices were welcomed like a soothing balm. Asanas that emphasized stability rather than flexibility and stillness over movement were more grounding. 

So when I was asked in 2003 to create a protocol for an NIH-funded study addressing hot flashes in menopause, I wove together practices that incorporated the wisdom of rksana and all I learned about what is particularly beneficial at this time of life. Women from all over the country took part in this study, which utilized gentle asana to stabilize the spine, shoulder girdle, and hips, pranayama to cool and calm the mind, restorative poses to provide deep nourishment, and yoga nidra to aid in relaxation and sleep. Feedback from participants was extremely positive. There was significant increase in nightly sleep. And many of the women expressed a feeling of improved overall comfort with their changing bodies, embracing the need to do less without feeling like they were less.

It’s important for all of us to reassess our practices from time to time, to notice our attachment/beliefs regarding why we “have to” practice in a particular way. A deeper line of inquiry might be: How is my practice serving me right now? What is needed? Challenge or support? Effort or ease? More or less? Our lives aren’t static; parinama (change) is inevitable (Yoga Sutra 1:15). So why would our yoga practice remain static amidst the flurry of life? 

So with a nod to rksana, I encourage you to weave in more of the inner practices like pranayama, mantra, meditation and nidra into your practice to offer additional nourishment for your mind and spirit, and allow your busy body to rest. There are many such practices that you may find beneficial. Here are a few that have been powerful for me. 

Pranayama

Sitali/Sitkari (Cooling Breath): To inhale, curl your tongue like a straw (if you have the genes to do so) or roll the tip of your tongue to the back of your upper teeth, and suck your breath in through your mouth. To exhale, close your lips, rest your rolled tongue to your upper palette and exhale through your nose. Repeat several times to cool your system down. Great ER remedy if you feel a hot flash coming on! 

Moon Breath: For this practice, you breathe in through your left nostril and out through your right nostril. You can use your hand to alternate sealing your right and left nostrils and create a channel on the opposite side. Or you can work with this pranayama virtually by visualizing the flow of your breath continuously from left to right. This pranayama practice is very focusing for your mind as well as engaging the ida (moon/feminine) nadi and your parasympathetic nervous system (Relaxation Response).

Try either of these pranayamas with a silent mantra of “So-Hum,” “Om shanti,” or “Om namaha” (“Letting go and letting be”) on each exhalation.

Asana

In general, work more slowly in your asana practice and use props for support. Balance strength work with stretching, taking care to avoid over-stretching, particularly around your hips, shoulders, knees, and sacroiliac joints. For restorative practice, I particularly recommend Supta Baddha Konasana (see Reclined Cobbler's Pose) and Viparita Karani with legs on a chair (see Featured Pose: Easy Inverted Pose), both pictured below.

Supta Baddha Konasana by Toni Gauthi

Viparita Karani, hips on a bolster or folded blankets,
legs on a chair instead of up the wall

Viparita Karani, hips on bolster or folded blankets, legs on a chair instead of up the wall. 

Yoga Nidra

Yoga nidra is a guided meditation that progressively releases tension in the body and mind, and has been proven effective at addressing anxiety, chronic pain, and sleep disorders. Regular practice will allow your body to ease into a deep relaxed and restorative state, cool excess heat, and create balance.

Not sure where to start? I have made two CDs that you might enjoy, both of which are available for purchase.

Cooling Nidras for Body and Mind: Guided Relaxation for Women of a Certain Age by Robin Rothenberg, music by Nancy Rumbel. Specifically created for the National Institutes of Health funded study aimed at managing hot flashes in menopausal women, these two guided relaxations includes evocative imagery of river water and gentle breezes induce a state of cool calm. Two 20-minute practices.

Soothing the Spirit: Yoga Nidra to Reduce Anxiety by Robin Rothenberg, music by Nancy Rumbel. This guided relaxation was created to offer refuge to those with overactive minds that spin on the worry cycle. The imagery and evocative music induce a state of calm wellbeing, teaching you how to redirect your mind and free your spirit.

Robin Rothenberg is an internationally respected yoga therapist, who runs both YA training programs for teachers and an IAYT Accredited Training Program for Yoga Therapy. She was certified in the Iyengar method through 1996, and is also certified in the Viniyoga tradition by Gary Kraftsow of American Viniyoga Institute. Robin offers private yoga therapy at a physical rehab clinic outside Seattle, and teaches therapeutic yoga classes focusing on chronic pain and movement disorders, such as MS and Parkinson’s Disease. She has been involved in the development of yoga research protocols addressing back pain, arthritis, insomnia, and menopause. Robin is the author of: The Essential Low Back Program: Relieve Pain and Restore Health, two Yoga Nidra CDs, Soothing the Spirit and Cooling Nidras, and a DVD of the Shema Through the Chakras, which links two spiritual traditions in a beautiful meditation practice.

Subscribe to Yoga for Healthy Aging by Email ° Follow Yoga for Healthy Aging on Facebook ° Join this site with Google Friend Connect

Read More

Menopause as a Transformative Experience

by Beth Gibbs

Metamorphosis of a Butterfly by Maria Sibylla Merian

Rather than seeing menopause just as the end of fertility and the start of aging, we can look at it as both a life transition and as a potentially transformative experience. Given our modern health care and longer life spans, women in first world countries can anticipate spending close to one-third of their lives in a post-reproductive state. Dr. Christiane Northrup, author of The Wisdom of Menopause, said, "The years surrounding menopause and encompassing the gradual change in ovarian function constitute an entire stage of a woman's life, lasting from six to thirteen years." Without reproductive and care-taking responsibilities, women can use more of their time for personal self-development, healing, and realization. And while this transition is often described as the “change of life” and freedom from social and culturally defined roles, each woman’s menopause experience is like a fingerprint—unique and personal. And the way each woman perceives and moves through this transition can transform her inner and outer experience. 

One way we can view this transition is through yoga philosophy, which says that there are four stages of life (ashramas): the student, the householder, the forest dweller, and the renunciate. As a student (or child) one learns about one’s role in society. As a householder (adult), one raises a family and/or makes a contribution to society through relationships, work, or volunteer efforts. As a forest dweller (mid-life) one begins the preparatory work for personal or spiritual realization, and may finally choose to become a renunciate and turn the final years into an opportunity for spiritual wisdom and enlightenment. 

For women, the Forest Dweller stage seems perfectly timed to occur about when you enter menopause, and your children, if you has any, leave home to begin lives of their own. This transition can be seen as a moving away from a more active (rajasic) time of life towards a more contemplative (sattvic) time of life. Many western writers and thinkers, such as Marian VanEyke McCain, Christiane Northrup, and Clarrissa Pinkola Estes, support this yogic view of the female human life span. They point to the drive that moves women at this time to begin an inner journey, address unfinished business, and claim the wisdom and power inherent in this time of life. Seen from this perspective, the menopausal process is a natural transition that can lead to transformation. 

While writing masters project on menopause, I spoke with and surveyed about thirty women about their menopause experiences. In addition, at that time, I worked in a small all-female office, and the three of us shared our experiences openly. In general, I found that women’s responses fell into three categories: Fix and Forget, Menopause as Process, and Menopause as Transformation.

Fix and Forget. Many women I talked to perceived menopause and its symptoms as biological events to be fixed or forgotten. When D. talked about menopause, her conversation centered around which therapist she had last seen and what they had prescribed to fix her problems: one pill for headaches, birth control pills for irregular periods, and something else for mood swings. She told us that she wished for a hysterectomy to "get it all over with." On the other hand, V. said, "I don't remember attaching any great meaning to menopause. It came, it wasn't difficult, it went, and I forgot about it in fairly short order.” Both women overlooked the opportunity to see menopause as a catalyst for healing and transformation. 

Menopause as Process. Menopause often involves much more than physiological changes in the body. This is true even if women are not aware of all the multi-dimensional changes that may be taking place in their lives. This transition has an amazing potential for causing change, as illustrated by the following comments from two women. One said, “It’s a change in my life, an aging process but one I want to control.” The other responded, “I know I’m going to experience many changes and I want to learn how to handle them so I don’t feel so frustrated.”

Northrup calls menopause, "the mother of all wake-up calls," our body's way of letting us know the need to do inner work, to heal an experience, conflict or issue in our lives. The increased psychic energy available for this inner work is related to a woman's fluctuating hormone levels that alter the brain chemistry by “sparking” changes to the temporal lobes associated with enhanced intuition, the right brain hemisphere. Northrup states, "At midlife, the hormonal milieu that was present for only a few days each month during most of your productive years to spur you on to reexamine your life just a little at a time, now gets stuck in the on position for weeks or months at a time." 

K. recognized this. She was experiencing hot flashes and mental confusion, and told me that she no longer felt “normal.” Her doctors advised her to take estrogen, and seek counseling. But she was able to find some relief through yoga. At the time, she was in the early stages of her “waking up” process. She recognized menopause as a process but was not ready to go deeper. Women who accept the idea of menopause as process will find many opportunities for conscious self-healing and change.

Menopause as Transformation. Using the metaphor of a butterfly, Marian VanEyk McCain, author of Transformation Through Menopause, describes menopause as a cocoon: 

"A cocoon is, in a way, a place of rest, almost a place of death, for it is a place where some creatures go in order to die out of their previous form. Thus it is also a place of rebirth, a place from which the new form, in its own time will emerge." 

Often what dies during this phase are illusions that keep women from examining their deepest dreams and shadow material. And what gets born is a new and different concept of self that can result in an increased energy for life, a “post menopausal zest,” and often a view of themselves for the first time as complete beings who are worthy of existence just because they live and breathe.

L., a post-menopausal grandmother, said, “Spiritually, I feel as though I'm free at last to pursue my own preferences in life. No longer young, I have little value in this society. On the one hand that's very annoying, but on the other, my invisibility also opens the door out of the gilded cage of others' praise and approval.”

Support from Yoga During the Transition

Alternative and complimentary modalities of health and healing, including yoga, provide you with a range of opportunities to support this life transition. A consistent practice of yoga modified for individual needs and abilities can help you recognize, accept, and integrate your menopause experience. Yoga practices can also help you manage stress levels and many menopausal symptoms (see Yoga for Menopause: The Big Picture).

One practice I particularly recommend is the Sun Salutation (Surya Namaskara), a flow of poses that moves your physical body through an optimal range of motion, brings awareness to your breath, and can calm your mind. Moving through the posture flow slowly can serve to cool and calm. Moving faster with more repetitions will warm and energize. And Sun Salutations are easily adapted to accommodate all levels of ability. (See Featured Sequence: Mini Sun Salutation for information on one of Baxter’s favorite versions.) 

Other yoga practices that I recommend include:

• Yamas and Niyamas: Use these tools to examine your values and behaviors (see The First Branch of Yoga: The Yamas and The Second Branch of Yoga: The Niyamas).
• Asanas: The Warrior poses (Virabradrasana 1, 2, and 3) are good for building strength and confidence, Downward-Facing Dog pose (Adho Mukha Svanasana) and forward bends are good for calming, Legs Up the Wall pose (Viparita Karani) or Easy Inverted pose  for 10 minutes are good for relaxing and calming, Upward-Facing Dog pose (Urdva Mukha Svanasana), Plank pose, and backbends are good for energizing, and twisting poses are good for focus and concentration
• Pranayama: The 2:1 Breath for calming (see Friday Q&A: Breath Practices for Anxiety), Kapalbhati for energizing, and Alternate Nostril Breathing (see Balancing Your Nervous System with Alternate Nostril Breathing) for balance.
• Mudras: Adhi mudra for calming, Urdhvam Merudanda mudra (gesture of the upper spine) for opening to new ways of seeing, Hakini mudra for balance, and Jhana mudra for concentration.
• Relaxation: Use a favorite guided relaxation or Yoga Nidra recording (or see Audio Tracks).
• Meditation: Either yogic concentration or mindfulness practices.

Beth Gibbs, MA, E-RYT 500, is a certified yoga therapist through Integrative Yoga Therapy. She is a senior member of the IYT teaching faculty and directs the school’s Professional Yoga Therapist Internship Program. Beth has a masters degree in Yoga Therapy and Mind/Body Health from Lesley University in Cambridge, MA., and is the author of Ogi Bogi, The Elephant Yogi, a therapeutic yoga book for children with a companion manual for adults who work with children. Most recently, she served on the Educational Standards Committee for the International Association of Yoga Therapists. Her website: www.proyogatherapeutics.com.

Subscribe to Yoga for Healthy Aging by Email ° Follow Yoga for Healthy Aging on Facebook ° Join this site with Google Friend Connect

Read More

Yoga for Menopause: Managing Hot Flashes

by Beth Gibbs, MA, E-RYT 500 

Marigold and Water by Melina Meza

From the yogic perspective, menopause is a moving away from a more rajasic (active) time of life towards a more sattvic (contemplative) time of life—a transition from the Householder to the Forest Dweller stage of life. This view of the female human life span is supported by many western writers and thinkers, such as, Christiane Northrup, Susan Lark and Susun Weed, who have written books about the experience of menopause. They all point to the urge or drive, which often occurs during the menopausal years, that can move women to begin the inner journey, address unfinished business, and claim the wisdom and power potentially inherent in this time of their lives. Each woman’s menopause experience is like a fingerprint—one of a kind, unique and personal. Yoga, therefore, is an excellent companion on this path, both to aid the journey and to help manage symptoms. 

This post will address hot flashes, a common physical symptom experienced by many women during the menopausal transition. Christiane Northrup, M. D., defines a hot flash this way in her book The Wisdom of Menopause: Creating Physical and Emotional Health During the Change:

“Also known as vasomotor flushing, the hot flash occurs when the blood vessels in the skin of the head and neck open more widely than usual, allowing more blood to shift into the area, creating heat and redness.” 

Typically triggered by falling estrogen levels during peri-menopause, hot flashes usually stop a year or two after the actual menopause date, which is determined retroactively, after a full year without a period. However, in some cases women may experience hot flashes for years. Hot flashes often start with a sense of warmth, which can escalate to feelings of intense heat usually felt in the scalp, face and chest area. A flash may also be accompanied by tingling, nausea, increased heart rate, or perspiration. Over time, if not addressed or treated, hot flashes may result in depression and sleep deprivation. 

Hot flashes can be mild or severe and their duration can be influenced by external factors, such as diet or a woman’s reaction or response to stress. In general, it is thought that the higher a woman’s stress levels are in response to stressful events, the more hot flashes she may have or the more intensely she may experience hot flashes. Conversely, the more effectively a woman handles stressful situations, the more likely she is to experience milder hot flashes or have less intense reactions to them.

Of course, yoga postures, breathing practices, and meditation are all effective methods of stress reduction and management (see The Relaxation Response and Yoga). And forward bends, classic or modified, are typically recommended to calm, cool, and relax a body under stress (see Supported Forward Bends: Peaceful Poses). As a yoga therapist, I recommend that anyone dealing with stress from any source, find a way to incorporate a regular well-rounded yoga practice, including asana, pranayama, relaxation and meditation, several times a week into their lives. 

That said, hot flashes cay still occur, anytime, anywhere and under any circumstances. Therefore, I advise women who are experiencing hot flashes to have a couple of “off the mat” yoga techniques at hand that can be done anytime, anywhere and under any circumstances. Pranayama (yoga breathing techniques) and mudras (hand gestures) can help with the physical goals of cooling the body as well as the energetic goals of calming the mind and grounding emotional states. With practice you may be able to reduce the occurrence and intensity of hot flashes, and begin to restore a sense of control to a time of life that can often feel uncontrollable. 

Cooling Breath

The Cooling Breath is a modified version of Sitali Pranayama, and can be done anytime, anywhere. This breath practice will often stop a hot flash if you can catch it just as it begins. If you can, practice the Cooling Breath regularly so that it is readily available when you feel a hot flash coming on.

Instructions:

1. Sit (or stand) in a comfortable position with your spine straight. 
2. Open your mouth, purse your lips like you were going to whistle and slowly draw cool air in over your tongue and into your lungs.
3. Close your mouth and exhale slowly through your nose.
4. Repeat for as many times as you like and as often as needed.

You can also practice the Cooling Breath in bed if you have hot flashes during the night.

Adhi Mudra

The Sanskrit word adhi means “primordial” and refers to our natural state of being, our truest nature from the yogic perspective. The gesture is said to bring the breath to the base of the body, help with anxiety, and instill a deep sense of grounding and stillness. According to Joseph and Lilian LePage in Mudras for Healing and Transformation, Adhi Mudra slows the breath and lengthens the exhalation, which reduces heart rate and blood pressure.” Practice Adhi Mudra regularly so it is second nature when you find yourself experiencing a hot flash or in a stressful situation.

Instructions:

1. Sit comfortably with your spine straight. 
2. Soften your chest and shoulders.
3. Close your eyes or keep them slightly open and gaze down at the floor. 
4. With both hands, form soft fists by placing your thumbs across your palms and folding your fingers around your thumbs (Adhi Mudra).
5. Rest your hands, knuckles down, on your knees or thighs.
6. Hold the mudra and sit quietly for 2 - 5 minutes as long as you are comfortable.
7. Focus on your natural breathing process. Or, if you like, you can practice the Cooling Breath while practicing Adhi Mudra.
8. When you are ready to come out, release the mudra and stretch your body in any way that your body needs to stretch.

Beth Gibbs, MA, E-RYT 500, is a certified yoga therapist through Integrative Yoga Therapy. She is a senior member of the IYT teaching faculty and directs the school’s Professional Yoga Therapist Internship Program. Beth has a Masters degree in Yoga Therapy and Mind/Body Health from Lesley University in Cambridge, MA, and has served on the Educational Standards Committee for the International Association of Yoga Therapists. Her website is: www.proyogatherapeutics.com

Subscribe to Yoga for Healthy Aging by Email ° Follow Yoga for Healthy Aging on Facebook ° Join this site with Google Friend Connect

Read More

Yoga for Menopause: The Big Picture

by Nina

Lake at Sunset by Melina Meza

Today I thought I’d collect all the posts we have on menopause so far into a single post. That way, newer readers will get a good idea of the material on this topic that’s already available and long-time readers don’t have to use the search function to find the relevant articles. 

With the exception of the post on hot flashes, Shari and I wrote all the posts on menopause. After all, we’re the two YFHA staff members who have been/are going through through the experience personally, and between the two of us, we experienced different problems and symptoms. (The reason neither of us wrote about hot flashes was because even though we had them—or at least I certainly did—we didn’t know any effective yoga solutions to recommend.)

Now for The Big Picture! Here's a list of all the topics related to perimenopause and menopause that we've address on the blog so far. If you feel we've left out anything you'd like us to address, leave a comment on this post or drop me a line via the Contact Us page.

Overview

Shari started our series with an overview of menopause in her post Yoga for Menopause: An Overview, in which she defines menopause and describes the three stages: perimenopause, menopause, and post-menopause.

Joint Problems

Shari wrote about joint problems, something both she and I have been experiencing, in her post Yoga for Menopause: Joint Problems. In this post, she discusses arthralgia, the term for menopausal joint problems, and addresses four aspects of using yoga to cope with these problems: pain management, range of motion, muscle strengthening, and acceptance.

Headaches

I wrote about headaches, something my sister-in-law experienced in a seriously debilitating form, in my post Yoga for Menopause: Headaches. In that post, I included links to Baxter’s general posts on headaches, both tension headaches and migraines. I also discussed the relationship between diet and headaches, and provided some tips for changing your diet (if certain foods seems like a trigger for headaches).

Hot Flashes

Guest writer, Beth Gibbs, who is a certified yoga therapist through Integrative Yoga Therapy, wrote our post on hot flashes Yoga for Menopause: Managing Hot Flashes. In this post, she provides background about how yoga can help reduce hot flashes in general and provides two different techniques that can help you head off a hot flash as it is starting.


Fatigue

This was my major symptom during perimenopause, so I had a lot of experience with using asana to both rest and stimulate myself to counteract the effects of what I called a “fatigue attack.” See Yoga for Menopause: Fatigue for information about the combination of restorative and stimulating poses you can use to combat fatigue.

Frozen Shoulder

Although many of us haven’t even heard of frozen shoulder until we get one, this is actually a common problem during menopause and one that I’m all too familiar with. In my post Yoga and Menopause: Frozen Shoulders I discuss what frozen shoulder is, describe the three stages (painful stage, frozen stage, and thawing stage) and recommend yoga practices for each of the stages. 

Insomnia

Because we already had a number of posts on this topic for the general audience and didn’t feel that there were different solutions for menopausal-based insomnia, we didn’t write a specific post on insomnia during menopause. So if this is a problem you’re having, start by reading my post 5 Tips for Better Sleep 5 Tips for Better Sleep. This post provides an overview of the basic yoga solutions for insomnia and provides links to other articles on our blog for details.

Depression

Because we didn’t feel that there were different solutions for menopausal-based depression, we didn’t write a specific post on depression during menopause. So if this is a problem you’re having, start by reading my post Tamasic and Rajasic Depression. This post provides an overview of the basic yoga solutions for depression. You can also see Balancing Your Emotional Body with Counter-Poses for suggestions. (I’m starting to realize there’s a bit of a gap here, so I should probably write an overview article on depression in the future, and maybe even write a few sequences….)

Acceptance

The very first post that appeared on our blog on the topic of menopause was my response to a question from a reader. Friday Q&A: Menopause. In this post, I emphasized how valuable the yogic practice of “acceptance” was while going through menopause. I still believe this is essential.

Wisdom from Judith Lasater

During our researches, Shari turned to one of her own teachers, Judith Lasater, for advice about yoga and menopause. See Judith Lasater on Yoga and Aging for Judith’s answer to the question “As you went through peri-menopause and menopause, how did you change your personal practice to address your symptoms and adapt to your changing body?”

Subscribe to Yoga for Healthy Aging by Email ° Follow Yoga for Healthy Aging on Facebook ° Join this site with Google Friend Connect

Read More

Judith Lasater on Yoga and Aging

After the Fire by Brad Gibson

As Shari and I were discussing our series on menopause and perimenopause, Shari had the idea of contacting her former teacher, well-known yoga writer Judith Lasater, to see if she had some advice for us. To our delight, Judith agreed to do a brief interview with us for the blog. After some back and forth, we decided to ask her a single question. We love her answer, and hope that you will find it inspiring. —Nina and Shari

Q: You've been practicing yoga since you were a young woman. As you went through peri-menopause and menopause, how did you change your personal practice to address your symptoms and adapt to your changing body?

Judith: When I began my yoga practice in 1970, I had the idea that I would pretty much be following the same practice routine forever that I had established from the beginning.

Nothing has been further from the truth. At the beginning I adapted my life to fit my practice. I started going to bed earlier so that I could awaken to practice in a quiet morning environment. I changed my diet, what I read, who I hung out with, and soon, my job, as I decided to begin teaching yoga.

But over the years, the opposite has happened. Gradually my practice has evolved to fit my life. There were adaptations with pregnancy, motherhood, and, of course, with peri-menopause and menopause.

Hopefully with aging one becomes more naturally introspective and less influenced by the external world. As I entered peri-menopause, I noticed a definite shift of my interest. It was as if a “natural” pratyahara was taking place.

I wanted to meditate longer, practice pranayama longer, and my asana practice changed as well. Soon fifty percent of my practice consisted of supported backbends and supported inversions, especially Viparita Karani (Legs Up the Wall pose), Supported Sarvangasana (Shoulderstand) on the chair and Supported Halasana (Plow pose) on the Halasana bench.

I found I needed this intense internal focus time in my life to integrate not only the physical changes that I was experiencing, but also the life changes of parenting teenagers and young adults. Additionally I was becoming the major emotional and familial support for an aging mother.

When I chatted with other women yoga teachers my age, we found we were all moving in the same direction with our practice. We began to eschew so much action in the practice and instead were increasingly nourished by cultivating the receptive consciousness of quiet poses for at least half of our practice of asana.

The most important thing I learned about this process is a lesson I still learn repeatedly. I would distill this lesson into a “mantra” of these three words: Trust yourself first. This will guide you well as you transition through life’s stages.

Note from Nina: For photographs of Judith's favorite poses and more information on them, see Judith Lasater's Favorite Poses.

Judith Hanson Lasater, Ph.D., PT, has taught yoga since 1971. She is a founder of Yoga Journal magazine, President Emeritus of the California Yoga Teachers Association, and was selected by Natural Health Magazine in 2010 as the only yoga teacher out of five people honored for their contribution to promoting natural health in the US during the previous 40 years. She has written eight books on yoga including the most recent: What We Say Matters and YogaBody. See judithlasater.com for more information about Judith, her teaching schedule and her books.

Read More

Yoga and Menopause: Frozen Shoulders

by Nina

When I was doing research for my post on menopause and headaches (see Yoga for Menopause: Headaches), I was very surprised to learn that the most common complaint that Japanese women have during menopause is not headaches (which is what I previously thought) or hot flashes (the most common complaint in the US) but frozen shoulder. As many of you probably know by now, I experienced two bouts of frozen shoulder during perimenopause/menopause. Although I knew this condition was common among women my age, no one I consulted about the condition really tied it directly to menopause, although there was some speculation that it might be related to hormonal changes. That's because they all said  no one really understands what causes this temporary (though very painful) problem. So it was very interesting for me to learn that in Japan it is considered a problem related to menopause. And because we've been focusing recently on menopause and I'm very, well, experienced, with this particular problem, I decided this would be a good time to write about it. (By the way, men also get frozen shoulders, and all the advice in this post will pertain to them as well.)

So to start, what exactly is frozen shoulder? According to the Mayo Clinic web site:

"Frozen shoulder, also know as adhesive capsulitis, is a condition characterized by stiffness and pain in your shoulder joint. Signs and symptoms typically begin gradually, worsen over time and then resolve, usually within one or two years.

Treatment for frozen shoulder involves stretching exercises and, sometimes, the injection of corticosteroids and numbing medications into the joint capsule. In a small percentage of cases, surgery may be needed to loosen the joint capsule so it can move more freely.

Frozen shoulder typically develops slowly, and in three stages. Each of these stages can last a number of months:

Painful Stage: During this stage, pain occurs with any movement of your shoulder, and your shoulder's range of motion starts to become limited.

Frozen Stage: Pain may begin to diminish during this stage. However, your shoulder becomes stiffer, and your range of motion decreases notably.

Thawing Stage: During the thawing stage, the range of motion in your shoulder begins to improve."

I'd like to expand on this a bit. First of all, your range of motion, especially if you're a fairly flexible yoga practitioner like me, is drastically reduced. Basically, at the frozen stage you can barely move your arm, in any direction. Even lying on your back, with your arms resting directly on the floor can be painful because your arm needs to be in a completely neutral Tadasana position to be pain free. And the pain is really pretty bad! Sleeping is difficult unless you prop your arm up on a pillow so it doesn't hurt, and of course if you move your arm around in your sleep, pain may wake you up. Some ordinary household tasks are difficult or impossible because you can't raise your arm or carry heavy objects, like shopping bags. Eventually lack of use makes your arm weak, so when you're over the frozen shoulder, strengthening is important.

It's essential to have an expert diagnose you for frozen shoulder because other shoulder problems, such as a torn muscle, are treated very differently. But the tests for frozen shoulder are very simple and not invasive, because with a torn muscle, someone else can move your arm for you, but with a frozen shoulder, your arm just won't move at all. So your doctor or physical therapist, will simply move your arm for you in various directions.

Once you have a diagnosis, how can yoga help? Well, first yoga provides a lot of good shoulder stretching exercises, which are recommended by the Mayo Clinic. The sequence that Baxter and I developed for tight shoulders (see Featured Sequence: Opening Tight Shoulders) was partly influenced by the routine I developed for myself to stretch my frozen shoulder. Try poses 2 through 7 from this sequence. Of course, when your shoulder is frozen, your arm will not be able to be straight up the wall as in the photos, but even if you have to bend your elbow and creep the frozen arm just partly up the wall, that will still be a good stretch. This is one case where moving into the pain is actually beneficial rather than harmful. And I actually found that stretching left me feeling better afterward, so that helped motivate me to practice through the pain. And, hey, look at me now! (See Living Proof for my testimonial about the effectiveness of shoulder stretches.)

To continue with your regular yoga practice, you'll need to modify your arm position in standing poses. For example, in Tree pose have your arms in namaste, in Warrior 2 pose have your hands on your hips, and Triangle and Extended Side angle poses, when your frozen arm is on top, just keep it tucked against your side or with your hand on your hip. In seated forward bends, you'll need to support your frozen arm, perhaps on a block, as you won't be able to reach for your feet. In restorative poses, be sure to place a folded blanket under your arms to support them so the frozen arm doesn't fall into a painful position. For poses you just can't do, like inversions or backbends, come up with an alternative. I did Standing Forward Bend and Widespread Standing Forward Bend with my head on a block instead of Headstand and Legs Up the Wall pose instead of Shoulderstand. You won't be able to do most backbends, so try practicing a passive, supported backbend of some kind to maintain mobility in your spine during this period. If you're in class, ask your teacher to help you find appropriate alternatives.

For the stress and pain associated with this condition, practice conscious relaxation in your favorite form (see The Relaxation Response and Yoga). When asana just seemed too hard for me because almost anything made my arm hurt, I experimented with a long version of yoga nidra.

Finally, after your shoulder is back to normal, your arm is going to be very weak from lack of use. Now is the time to do some arm strengthening poses! See Upper Body Strengthening the Easy Way and our featured upper body strengthening poses for ideas.

Of course, it is no fun going through this, but a frozen shoulder is a temporary condition. And with the help of yoga you can regain both flexibility and strength. Hey, I'm even back to doing arm balances!

Subscribe to Yoga for Healthy Aging by Email ° Follow Yoga for Healthy Aging on Facebook ° Join this site with Google Friend Connect

Read More

Yoga for Menopause: Joint Problems

by Shari

Shari's Go-To Pose

I feel a little foolish presenting this topic because until quite recently I didn’t associate my various injuries or aches and pains as part of menopause. I didn’t really connect the dots; I just figured that I must be doing something wrong to cause myself injury. This has really come home to roost with my current knee injury that could be something I might have to address with surgical intervention! And my conversations with Nina about menopause prompted me to take a closer look at this problem that isn’t just my own personal issue.

It turns out there is actually a term for this experience: arthralgia. A diagnoses of arthralgia is given when the joints become swollen, stiff or painful during menopause. Joint pain associated with menopause is also referred to as “menopause arthritis.” It can affect hips, knees, back and extremities (how about the whole body?).  In the journal "Semin Arthritis Rheum 2009," the researchers state that genetic alteration, menopause-related estrogen deficiency and aging cause changes in joints with resultant cartilage damage. The changes in the joint are what physicians call osteoarthritis but they don't classify it beyond that. However, these researchers recommend that primary osteoarthritis be classified in the three categories listed. The literature also presents some disagreement in the usage of arthralgia and arthritis. In one source arthralgia is classified as non-inflammatory and arthritis as inflammatory. But pain is experienced in both situations.

Menopausal joint pain is often described as increased stiffness with joint swelling that increases at the end of the day. For some women, the pain may shoot down an extremity as well as feel hot within the surrounding area, which gets worse (not better) after exercise. In menopause and perimenopause the radical hormonal fluctuations are affecting the joints but researchers can’t say exactly how. They do state that changing levels of estrogen play a major role in joint pain caused by menopause. It is known that estrogen helps control joint inflammation and as estrogen levels decrease, inflammation can increase. Concurrent with the sensation of pain experienced in menopausal joint pain, range of motion may become limited (such in as the condition called "frozen shoulder").

So if it's possible that menopause is causing sporadic back or neck pain, the questions some of us may then grapple with are: "Do I investigate hormone replacement therapy?" and "Do I make dietary changes to work with my changing hormonal levels?" These are personal issues that we all grapple with, but the context of this blog is to address our menopausal symptoms with the practice of yoga! In general, for joint pain—whether menopausal or not—there are certain issues our yoga practice should address:

1. pain management
2. range of motion
3. muscle strengthening
4. acceptance

Pain Management: The key point here is how we can manage the pain (maybe not alleviate it) so we can function. What I am learning in my own pain management is that it is counterproductive to ignore it. I have to use the pain response to guide my own movements in asana. For instance, I cannot squat to the floor as I am used to doing, nor can I sit in Hero pose (Virasana) anymore (with any combination of prop usage). Do I need to sit in Hero pose? No, I don’t. Do I need to squat? Well, I do need to bend my knees to get up and down from the floor to practice yoga as well as for functional tasks. So I have learned how to do it so I don’t hurt my back and I can smoothly execute my tasks. When I do try to test things out, my knee responds with increased swelling and a nasty ache that is not fun, but I'm learning to adapt. For asana, I try to keep the injured body part within its comfort zone, and if that is not possible, I do something else in my practice. For me standing poses have always been a favorite part of my home practice, but now I find that seated forward bends are better. Certain twists are challenging for a sore knee but with a bit of creativity some of them can be nicely modified. If I was a student in a class and my teacher could not come up with a modification for me to safely do a pose, I would not do that pose and would wait until I could rejoin the class.

Yoga postures where the blood is flowing toward the heart also help with pain management, especially for swollen extremities. That means inverted poses. Try to figure out which inversions feel good to you, and then practice them daily.  For me, my go-to pose is Shoulderstand with a chair. In the past I would always choose the active Shoulderstand, but now the more passive version is more nourishing for me. When all else fails, Legs Up the Wall pose (Viparita Karani), either with straight legs on the wall or bent legs on a chair—anywhere you can make your legs higher than your heart—is lovely.

Range of Motion: As we've mentioned many times on this blog, to keep your joints healthy you need to move them through their range of motion (see Range of Motion: Yoga's Got It Covered). But too much movement into and out of pain is counterproductive. So finding the amount of motion you can do without increasing your pain response is crucial. And non-weight-bearing positions generally work better than weight-bearing poses. What does this mean? Well, lying on your back and bending your knee to its limit is non-weight bearing. Standing and putting weight on your legs to bend them is weight bearing, and when we bear weight, we compress the joint. When there is inflammation and swelling, weight-bearing compression just aggravates the inflammation and things feel worse. Time is also an important factor. Let’s say I can bend a body part for five seconds without a pain response, but if I hold it for fifteen seconds I get pain. The idea is to hold the joint in position and release it before a pain response occurs. If you have immediate pain, then that position probably should be avoided for now. In asana, using a chair for standing poses can still allow you to experience the benefits of the pose but can decrease weight bearing on the lower limbs to help you avoid increase of pain while still working with your range of motion.

Muscle Strengthening: We have to keep our bodies strong because as menopause progresses our ability to build healthy bone is affected and weight-bearing activities are what stimulates the bone to remodel. A simple technique for building strength is timing your poses (see Arthritis, Exercise and Yoga). But it may not be immediately obvious where you need strengthening. My current physical therapist (who is not a yogi) is addressing my knee injury not by strengthening my knee, but instead working on my hips. That means buttock muscles and hamstrings. Interestingly, my hips (on both sides) were a lot weaker than I thought, and I'm someone who was aerobically walking two miles a day and had a strong standing pose practice! So I am humbly learning how to do exercises that target specific muscle groups. I personally am finding this more challenging than I thought, so here is when I am trying to employ some yogic principles of breathing into the challenge and trying to engage my mind to embrace my hip abductors. If you want to work on strengthening, it might be a good idea to consult a professional, such as a physical therapist, so see which areas you should focus on.

Acceptance: We all grieve when we suffer a loss. For some women menopause is a period of grief because of the loss of the ability to bear children. I felt that acutely when my youngest child was weaning himself from breast feeding. He was 3 ½ and it was time for both of us. It was very smooth, but in my heart I did feel sadness because I knew I would never nourish my children that way again. The feeling of loss in menopause is very subtle for some of us and not so subtle for others. We are changing and there really isn’t anything we can do about it. Some of us dye our gray away because that holds our fears of aging at bay. Others have cosmetic procedures to deny the changes in our aging bodies. We all cope differently, but eventually we all do look at ourselves in the mirror and come to accept what we see. And as Nina talked in her recent post about fatigue (see Yoga for Menopause: Fatigue), sometimes we have to accept that we can’t do things at the same pace as we have always been used to. When we experience joint pain in menopause and have made our individual choices of how we want to live our menopause, yoga allows us the opportunity to explore avenues of acceptance. We will all find our way eventually.

Subscribe to Yoga for Healthy Aging by Email ° Follow Yoga for Healthy Aging on Facebook ° Join this site with Google Friend Connect

Read More

Yoga for Menopause: Headaches

by Nina

Tough Weed by Melina Meza

My sister in law, who never suffered much from headaches before, found that menopause brought on debilitating migraines. Other women find that normal, tension headaches become more frequent with hormonal fluctuations. In fact, although the most common complaint women in the US have during perimenopause and menopause is hot flashes, in Japan (where hot flashes are less common) women complain much more frequently about headaches.

Baxter and I have already written on the blog about migraines and other headaches, both on how to prevent them (see Preventing Migraines and Other Headaches, Part 1 and Part 2) and how to practice when you have one (see Yoga and Migraine Headaches). Unfortunately we don't know of any special techniques for treating hormonally triggered headaches (in the book The Woman's Book of Yoga and Health, in the chapter on menopause, Patricia Walden simply recommends her standard headache practices for headaches experienced during menopause). However, I thought it might be helpful for those of you who are suffering from hormonally induced headaches if we provided links to our earlier posts on headaches in a central post on menopause.

In my sister-in-law's case, it wasn't yoga that helped her with her migraines (she doesn't practice yoga). Eventually, she realized that it was her diet that was triggering the migraines, and that diary was a trigger. Many of us assume that because we didn't have food sensitivities when we were young, that we must not have them now. But personal experience has taught me that many of us do develop new food sensitivities during perimenopause/menopause. So if you're suffering from headaches, it may be time to practice yoga for healthy eating. To do this, use mediation and mindful asana practice to help you tune into your body and observe how your eating habits affect your health. See Meditation and Healthy Eating and Got Mindfulness? among other posts on this topic.

And if you are having trouble avoiding the foods that turn out to be triggers for you, try using yoga for stress management to help you resist temptation and make better food choices. See Healthy Eating, Stress and Self Control for some ideas.

Take good care of yourselves, dear friends.

Subscribe to Yoga for Healthy Aging by Email ° Follow Yoga for Healthy Aging on Facebook ° Join this site with Google Friend Connect

Read More

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.

Subscribe to Yoga for Healthy Aging by Email ° Follow Yoga for Healthy Aging on Facebook ° Join this site with Google Friend Connect

Read More

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.

Subscribe to Yoga for Healthy Aging by Email ° Follow Yoga for Healthy Aging on Facebook ° Join this site with Google Friend Connect

Read More