Friday Q&A: Stretching, Science and Autoimmune Diseases

Q: I'm wondering to what extent, and at what rate, we should expect to be able to increase our flexibility as we continue to age. I've made significant progress over the years, and have generally learned how to be mindful enough not to overdo. However, every so often I overstretch without realizing it - whether it's my back trying to get a fuller forward bend, or my Achilles tendon while pushing the envelope. I'm in my 50s and have been doing regular yoga for about 5 years. It's made an immense difference in my core strength and balance and flexibility and I'm much less injury prone now. And yet, every so often, it's my yoga practice that puts me out of commission. 

A: Baxter and I discussed your question, and he agrees with me that there is no fixed extent or rate for increasing flexibility as we age, as this will differ from person to person. His advice is to maximize the effectiveness of your stretches while minimizing potential injury by holding your stretches longer rather than pushing harder. He mentioned that it takes at least 45 seconds to get your muscle to fully release. And my kinesiology teacher taught me that in order to change the resting length of the muscle (the length the muscle returns to after stretching), you need to stretch it for 90 seconds. So I use a timing of 90 seconds for many of my stretches. —Nina 

Q: Does yoga have any good stretches for a 60 year old stiff person?

A: Yoga has a very large number of poses that allow you to stretch a very wide variety of muscles, no matter how stiff you are. So the first question to ask yourself is: where exactly am I stiff? Some of us are stiff all over and some of us are flexible all over, but it turns out that many of us are flexible in some areas and stiff in others. Identifying which areas you need to stretch will help you chose the poses that will be most helpful to you. That being said, there are a couple of poses that we highly recommend for their versatility. Downward-Facing Dog pose is especially wonderful because it stretches your legs, hips, shoulders and arms, all at the same time.

If this pose is too demanding, you can do an easy variation, Half Dog pose (also called Right Angle pose). With your hands at shoulder-height on the wall or resting on the surface of a table, walk back so your hips are directly over your feet and your arms are parallel to the floor.

Baxter recommend that you warm up for these poses with some dynamic movement, such as swinging your arms above your head or moving your legs around in your hip joints. —Nina

Q: How would one go about investigating the effects of yoga on aging scientifically?

A: This question is intriguing and so important that Brad will devote an entire post to the subject sometime soon.

Q: Just curious about how autoimmune diseases are related to aging? Some seem to be inflammatory conditions I think, and that makes me wonder about allergies, yoga and aging. 

A: This is a very big and complicated question! And there’s no quick, simple answer, as the mechanisms behind many of these diseases (not to mention aging itself) are not fully understood. But Baxter says, “Not all autoimmune diseases are created equal.” Different autoimmune diseases arise at different stages in life, so not all are related to aging. Also, not all are related to inflammatory conditions. So that’s why we’ve decided that on this blog we’ll discuss the autoimmune diseases associated with aging individually, over time. Is there any particular disease that concerns you? 

We are going to try to do a Q&A every Friday, so keep the questions coming. You can leave a question in a comment or you can email us at nina@wanderingmind.com.

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Can't Begin to Tell You

by Nina Zolotow

Path in the Mist by Brad Gibson

It was an idyllic Sunday afternoon in Seattle, warm weather, blue skies, and the company of old friends. During a lull in the conversation, J asked me, “Nina, could you show me that yoga pose you told me about, the one for stress that you said anyone can do? And could you repeat what you told me about the relaxation response and how the pose helps trigger that?”

As I did my best to demonstrate Savasana (Relaxation Pose) with legs on a chair using the lawn and the outdoor furniture as my yoga props, I reflected on how many times I get asked questions like these by my friends. And while I quite enjoy explaining the basics to both friends and students, I’ve always wished there was a place where I could send people to look up the poses and practices when they are on their own. My hope now is for this blog to become that place, an ongoing resource of practices and information that I personally have found helpful over the years.

As a long-time yoga practitioner, I’ve been using my home practice for years to help me address my changing physical and emotional needs. I’ve learned to ask myself each day, “What is the best practice for me today? Do I need to stretch to make up for a day of hiking or do I need to do backbends to make up for day spent in front of a computer? Do my problematic shoulders need attention? Or do I need to do a calming practice to restore my equanimity after a stressful day?” When my mother was dying of cancer, I was able to spend a lot of time with her. But I also understood how important it was for me to stay strong and steady for the long haul. So after each visit with her, I would come home and spend 20 minutes in my go-to relaxation pose, Viparita Karani (Legs Up the Wall pose). I can’t begin to tell you how helpful this was for me (and I’m someone who in the past had terrible problems with anxiety and stress).

But what works for me won’t necessarily work for you. We all have different bodies, personalities, and needs. That’s why I’m hoping to make this blog very interactive, a place where you ask questions and request information, and where we can all learn together.

For those who are interested in trying the relaxation pose I was demonstrating to my friend in Seattle, here is a short video that’s pretty good. I have one quibble with it, however. If you pay close attention you’ll notice that although the teacher first says that the folded blanket should be at the base of the chair legs, she moves the blanket away from the chair legs just she goes into the pose. Do what she does not what she says, people! The blanket should be 6 to 12 inches from the chair legs, so that the angle of your thighs when you are in the pose is easy and comfortable, and so your calves can release and relax on the chair seat. If you find the blanket under your pelvis irritates your back, you can do the pose without it.

What I love about this pose (which goes by many names but which Baxter and I are calling “Easy Inverted Pose”) is that unlike most of the other inverted poses, which can be difficult or uncomfortable for some practitioners, almost everyone can do this one comfortably.

Tomorrow we'll have our first Q&A.

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Full Disclosure

by Brad Gibson

The Light on the Water (from Muir Beach) by Brad Gibson

Okay, so it took me ten years to finally listen to my wife Nina and take up yoga. I may be slow, but I’m not an idiot. So what was the epiphany? There were actually several. 

The first was listening to my wife Nina and Rodney Yee at a book signing in Los Angeles talk about how restricted most of us are in using and exploring our bodies. As adults we typically sit, stand up, walk, and lie down. That’s pretty much it. Compare this to our younger selves, where we rolled down hills on our bellies, spun ourselves so we were so dizzy we crumpled to the ground, and did handstands on the lawn. And all that just for the fun of it.

The second was attending a seminar given by a well-regarded scientist from the University of California San Francisco. Here I learned about the startling plasticity of the human brain, and its ability to rewire and reorganize itself based on various environmental and behavioral stimuli. One particular example struck me: that the regions in the brain that control movements to our fingers are spatially distinct and this spatial resolution and control can be lost if the hand is constrained in motion over long periods of time. These regions then shrink and become partially fused, resulting in the inability to use the hand in a way we are accustomed, and more like a paw. The good news was that this is largely reversible if the constraint is removed. The brain—along with the slow recovery of the hand —can then restore these neural connections. The significance to our aging brain and body was clear, both in a negative and positive sense. We must actively fight against the restricted physical activity that we impose on ourselves, as well as the loss of dexterity that is the result of this behavior. Otherwise, this can become a vicious cycle as we react to our aging bodies by imposing further restrictions to our movements, and our brain’s ability to control and balance these movements becomes diminished as a result. 

My third epiphany was a bit more vain, but important to me nonetheless. As I was attending a party in the Berkeley hills on a warm summer evening, I was struck by how many beautiful women were there. Now this party was not one of the faculty or science-type parties that I usually attend, but one made up of by yoga practitioners of many stripes and ages. But as I pondered this—admittedly over a few glasses of very good vodka and some really delicious food—I realized that these people held their bodies in a posture and poise that I was not generally accustomed to. They were not just physically fit, but healthy and vibrant. Okay, my wife did point out the next morning as I told this story that I not only didn’t have my glasses on, but was also pretty drunk by this point. Fair enough. But over the years—and under more sober conditions—I have found this observation to hold up pretty well. 

So as a scientist who studies the biology of aging and the many diseases that are associated with aging, I have come to my own personal conclusions on the importance of practicing a mind/body discipline like yoga. And as I approach my 59th birthday, the immediate realities of physical and mental loss become more apparent. And I am not one of those people who think I can avoid this. I do believe, however, that we have the capacity to regain some of theses age-related losses, and if not, at least slow down their progression. Regaining or maintaining a higher level of balance, physical dexterity, and cognitive function and resolution is therefore something that is attainable and has the capacity to make huge impacts on the quality of our lives. The aging component that works against all this and drives these declines, however, is scientifically and mechanistically poorly understood. This is what makes my scientific life and work so interesting. But as far as I can tell, the basic processes underlying human aging are largely inescapable, at least as we currently understand them. That doesn’t mean we can’t intervene or we have to give up, nor that some of the losses we associate with aging can’t be mitigated. We probably need to practice both acceptance and active engagement as we confront our own aging—part of the underlying philosophy of yoga that I am still struggling with. In any case, it can’t hurt to strive to feel better and think more clearly. There are few things that I would consider more important.

My primary interest in participating in this ongoing discussion on “yoga for healthy aging” is to examine evidence on how practicing yoga might intervene and in some cases reverse some aspects of the mental and physical decline we think of as normal aging. In doing so I have to first acknowledge that there is a lot of crap out there, and as a scientist I would want to bring rigorous and critical thinking to the process of evaluating these claims. Most published studies or claims just don’t stand up to rigorous scientific and statistical scrutiny because of poor study design, small sample size or the lack of good controls. But I also I don’t want to fall into the trap of constantly seeking to debunk or ridicule studies that attempt to establish a connection between yoga (or other related disciplines) and possible beneficial effects on aging or limiting age-related diseases. Rather, I’m more interested in trying to extract whatever useful information I can from these aging studies and see if it can be applied to improving one’s yoga practice.

And lastly, a full disclosure: I’m a firm believer in science. I am also a believer in western medicine, although with some qualifications. My concern with western medicine is that it can overreach itself at times and rely on vastly incomplete scientific knowledge in coming to diagnosis or treatments. Or worse yet, it can incorporate many cultural biases. That said, it’s by far the best and most successful form of medical practice that we have. I am also aware of limitations in the scientific method. Not so much as a philosophy or discipline, but rather from the standpoint of recognizing the difficulty of scientific inquiry in tackling highly complex phenomena or systems. And as complex biological systems go, humans are at the top. This makes it exceedingly difficult for scientists to predict, investigate or fully understand how we respond to various environmental, temporal and behavioral changes. And yes, yoga would fall under these latter categories, as would aging itself.

Despite all this, I believe there are important things that we can do that can impact and alter our aging status and overall health, and that yoga has the potential to be a key player in this process. Indeed, some reasonable information already exists on how yoga might lower blood pressure, or reduce muscle atrophy (sarcopenia), stress, or cognitive decline. These and other such topics will be ones that my colleagues and I will try and tackle.

Do any of you have questions for our scientist?

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Teaching a Man to Fish

by Baxter Bell

Having started out in the healing profession as a medical doctor, I always remember back to the times when patients presented with physical affects of aging. In those days, when my prescription pad was my only option, I felt I didn’t have many good tools for helping them. For example, when a patient would present with complaints of lower back pain related to arthritis, I would typically prescribe anti-inflammatory medication, rest, ice and heat, and possibly a few visits to a physical therapist. These days I find it much more effective to start with modified yoga practices and lifestyle modifications before moving on to a typical western treatment.

Yoga is a treasure chest of options, techniques and tools, some of which have developed over thousands of years. And these days, when people in my classes and therapeutic sessions present with difficulties that are the direct result of aging (such as arthritis, auto immune diseases, and high blood pressure), I feel like I can truly offer something of benefit. By giving my patients new skills for self care, including yoga poses, breath work, and meditation techniques, I am, as the Chinese proverb says, teaching them to fish:

“Give a man a fish and you feed him for a day. Teach a man to fish and you feed him for a lifetime.”

Through this blog I’m hoping to be able to help you the same way. I’m also excited about the topics we’ll be taking on for the personal impact the information will have on my own life. I have been practicing yoga coming up on 20 years now, and as I look around at my contemporaries in age and background, I get the impression that my health is better than most of theirs. But I have big questions about why this is happening. For this reason the current scientific research on aging is very intriguing to me. And the process of getting new information and digesting it, and then figuring out its applicability and validity is one that I love. I start to look at it with a critical eye to determine how beneficial it is both to my patients and myself, and then present it in a more realistic and accessible way. The blog will allow me to the share this ongoing process with you.

We'll be answering questions this week in a Friday Q&A post, so please ask any questions you have for me by leaving a comment. Tomorrow, Brad will hold forth.

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In the Kitchen

Mt. Tamalpais Above the Fog—Sometimes We Can Get There by Brad Gibson

It came to us while the three of us were in the kitchen, preparing a meal together and talking about how these days, as we age, our yoga practices are designed to address our changing needs and concerns: wasn’t it about time the three of us finally collaborated on a project? “Yoga for healthy aging,” Nina said. “And a blog would be a perfect way to start.” Baxter was concerned that we might not have enough material for an ongoing project, but Brad said, “No way. We’ll never run out of topics!”

You see, between the three of us, we have a wealth of special information and techniques we'd love to share with you.

Baxter Bell is an MD, a medical acupuncturist, and a long-time yoga teacher. Besides teaching regular asana classes, he specializes in yoga for back care and anatomy for yogis. He'll be recommending yoga poses and other practices for you that address various physical aspects of healthy aging, including strength, balance, flexibility, circulation and agility.

Brad Gibson is a professor at the Buck Institute for Research on Aging, where aging and age-related diseases are the sole focus of the institute. As more is discovered about the aging process, our understanding about how to support healthy aging with yoga will increase. Brad will help you keep in touch with the latest scientific discoveries, and we'll explain their connection to specific yoga practices.

Nina Zolotow is a yoga writer as well as a certified yoga teacher and a long-time yoga practitioner, and her special area of expertise is yoga for emotional wellbeing (including yoga for stress, insomnia, depression, and anxiety). She’ll be recommending yoga practices for cultivating equanimity because as we age, reducing stress is more important than ever, both for our physical health and our peace of mind. 

This week each of us will take a turn letting you know a little more about ourselves and why we decided to take on this project. After that, we hope to take requests! Below is a list of the general topics we are planning to take on. But please leave a comment if any you have any special questions or concerns you like us to address.

• strength 
• balance 
• flexibility 
• agility 
• circulation 
• stress 
• cognitive functioning 
• equanimity 
• specific age-related diseases (such as arthritis, high blood pressure, Parkinson’s, diabetes, etc.) 
• what is known (and what is not known) about the aging process 

Tune in tomorrow to hear from Baxter. 

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Interview with Paijar Upau–1 week before Mr ATM 2011.

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Mr Asia 2011–Bangkok, Thailand.

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