New Tricks for Old Dogs: Working with Bunions

by Baxter

It was my first class with Donald Moyer in the new year, January having flown by and February upon us. I checked in with him before class began and mentioned an unusual aching in the lateral aspect of my left foot that I had been experiencing for about two months. It was not bad enough from preventing me from my normal activities, but I noticed it when turning my left foot out to 90 degrees for many of my standing poses. He gave me some pointers for the day’s practice, and then class began. 

About half way through the class, while we were in Standing Forward Bend (Uttanasana), Donald had us slip a strap between our big and second toes, and bring the loose end over the top of the big toe and down to the floor to the inside edge of the toe. He asked us to gently pull the strap to move the big toe medially, so that it lined up more evenly with the first metatarsal, the foot bone just before you get to the toe itself (the toe bones are called phalanges, and the big to has two, the other toes all have three).

In addition to re-aligning these two parts of the foot and toe, the bones of the toe rolled a bit medially on their axis. Donald made an offhand remark about this being beneficial for treating bunions (hallux valgus for you Latin lovers) and then we moved on. But treating bunions! Sweeter words were never spoken. I come from a family of bunion formers, my mom’s mother, my wonderful Grandma Lopresto, had an impressive one on each foot for as long as I could remember. Interestingly, I don’t remember her complaining about them much.

What, you may be asking yourself, is a bunion? Well, a bunion is a condition in which your big toe deviates toward your second toe instead of lining up with your first metatarsal. And although bunions have a genetic component and do tend to run in families, another huge factor is shoes that smash the toes together. While these shoes are often for fashion purposes only, I do teach to one group of students whose shoe wear is all about function and their passion for climbing. And while the shoes these folks wear help keep them on razor thin ledges, they do lots of harm to their impressionable toes and feet.

According to the PubMed Health website, bunions occur more commonly in women and people born with abnormal bones in their feet. Certain kinds of shoe wear, specifically narrow-toed, high-heeled shoes, may also lead to bunion formation. And although it can seem a bit unsightly, it is only when pain develops that most people seek help.

How can you tell if you are developing a bunion? You may begin to see a thickening or actual bump forming where the toe and foot meet on the inner edge of the foot. On the opposite side of the big toe, a red callous may form from the big toe and second toe rubbing on one another. Pain can occur in this joint, aggravated by certain shoes. 

What is the mainstream treatment for bunions? First off, they often tell you to wear different shoes, ones with a low heel and a wide area for the toes. That alone could do the trick. Sometimes special pads can be placed on the bunion or between the big and second toes, and wearing a toe spacer at night can start to influence the alignment of the toes. If that does not work, there are only a mere 100 different surgical approaches to treat bunions. One of my long time students has had both toes operated on, and says it made a huge difference for her, eliminating the pain. However, it has had an effect on her balance.

So, here was Donald offering up a really simple way to affect the toes! A few years back, my colleague and friend JJ Gormley shared her favorite method to get the big toe back on track, which you can do at your desk. With your feet parallel, place a can of your favorite organic goodies between your inner arches and put a veggie rubber band, one of those strong ones, around the big part of your big toes, so they deviate a bit towards the midline between your feet. You can do this for 10-15 minutes a few times a day, and watch for results.

Obviously, if either Donald or JJ’s techniques result in worsening symptoms, stop them right away! But if not, give it a go. And remember, since a lot of the problem stems from being in shoes, yoga itself can go a long way to help the problem, as you are barefoot and you are strengthening and stretching many of the muscles and other structures that can affect the big toes.
 
For more information on yoga and bunions, there is a good article by Doug Keller in Yoga + Living Magazine from 2008 that you can find online. I hope the photos of Donald and JJ’s bunion recommendations are helpful in your home practice.

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A Week of Yoga Practice

by Nina

Is anyone else a fan of the brilliant food writer M.F.K. Fisher? I not only love her beautiful writing, but also her ideas. When I first started reading her work, I remember being struck by a simple but profound of advice she had for eating well:

“Instead of combining a lot of dull and sometimes actively hostile foods into one routine meal after another, three times a day and every day, year after year, in the earnest hope that you are being a good provider, try this simple plan: Balance the day, not each meal in the day.”

(You can read her entire advice on this subject on the Less Is Enough blog.)

What Fisher meant was that you did not have to eat every single food group at every single meal (what we used to call a “square meal,” something American nutritionists used to insist on) but rather you could have grains for breakfast, a salad or soup for lunch, and meat or fish with vegetables for dinner. You'd still get all the nutrition you needed—just not all at once! Thirty years later, I still follow her advice.

I recommend applying the same advice to your home yoga practice. Rather than trying to make every single yoga practice like a balanced “meal” by including some of everything, you can focus each day on one or two of the major classes of poses. And by the end of the week, you’ll have done a very wide range of poses, balancing your body by moving all your joints within their range of motion and reducing problems associated with repetitive stress.

So what are the basic pose “food groups” you could think about trying to cover in a week? Leaving out a few poses that don't fit that well into general categories, they are:

• Standing poses
• Backbends
• Forward bends
• Twists
• Inverted Poses
• Restorative poses

Depending on how many days a week you want to practice (and how long you want your practice to be) you could focus on single class of poses each day, or you could combine two or more in a given day. If there’s something in particular you want to work on (such as balancing or abdominal strengthening), you could add that into your practice on a regular basis. Does this mean that even though your teacher always includes standing poses in every single class, you can skip them yourself at home? Yes. That's exactly what I mean.

A Pose You Can Skip from Yoga: The Poetry of the Body 

It does make sense to do a little balancing, however, by adding one or more counter poses to the end of your practice. After doing backbends, it’s helpful to do a twist, leg stretch or another back releasing pose. After doing forward bends or twists, I recommend doing a gentle back bend to restore the natural curve to your spine. And after standing poses, inverted poses or restorative poses can help calm you down and relax your muscles before Savasana.

I hope this helps you feel more comfortable about starting a home practice because the main thing is just to jump right in. I’ll do another post soon on how to plan a single practice, but in general there are no hard and fast rules, and there is no reason why your home practice has to look like a class.

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Interview with Baxter Bell by Life Style Maven

Today on the blog Life Style Maven there is an interview with Baxter Bell by Cailen Ascher, a yoga teacher, writer, and blogger. She asks Baxter the following questions:

• What does yoga mean to you?
• What style of yoga do you teach/practice? Why? 
• Do you have a favorite yoga sutra?
• What is your mission statement as a teacher? 
• What inspires you and your practice? 

So if you'd like to learn more about Baxter's teaching, check it out here!

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New Features

by Nina

I spent a little time this weekend changing the layout of the blog and adding a few new features. If you haven't already noticed, at the top of the blog you'll now see tabs that will take you to special pages on the blog.

The "Audio Tracks" tab takes you to the page where you can stream relaxation tracks (and other audio tracks as we add them) or get access to our Band Camp site to download tracks.

The "About Us" tab takes you to the page where you can find biographical content and links for both the writers and photographers whose work you see on the blog.

The "Contact Us" tab provides easy access to email addresses you can use to contact the bloggers.

On the right-hand side of the blog, I've added a Search function that allows you to search the blog for particular posts by their content and I've also turned on the feature that displays an alphabetical index to the blog posts. Now that we've got a substantial backlog of posts, it seemed like it was time to make it easier for you to find old posts.

Looking Closely by Michele McCartney-Filgate

If there is anything else I can add to the blog to make it more usable, please let me know.

For you technically minded people out there: what I'd really love to do is to create two tabs at the top for searching, one to provide access to the search function and the other to provide access to the index list of labels. But I have not figured out how to get those blogger "gadgets" onto the body of separate pages (and off the home page). If anyone can help me with this, please let me know!

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Friday Q&A: Future Topics

by Nina

No reader questions came up this week on the blog, so today I'll ask you all a question.

Q: What topics would you like us to cover in the coming months? You can ask brief questions for the Q&A, suggest topics for longer pieces, or recommend experts to be interviewed or perhaps write posts as guest bloggers. You can leave your answers as comments on this post (or any other post), send email to me (click the Contact Us tab at the top of the page) or message me, Nina Zolotow, on Facebook (where I'm the only person with that name!).

Stalactites or Stalagmites? I Can Never Remember by Brad Gibson

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Airport Yoga: Baxter's Interview on Washington Post Blog

Baxter was interviewed yesterday by the Washington Post health blogger about the new San Francisco Airport Yoga Room and the benefits of doing yoga at the airport, and you can see the post here.

In his interview, Baxter admits that it is unlikely that anyone would stop at an airport yoga room after they arrive at their destination, however, during the time before you take off or when you layover in an airport between flights, practicing yoga can be beneficial.

"The general tenor of travel these days is so stressful, it’s almost designed to get the blood pressure up and stimulate the fight-or-flight response. Stretching [as in doing yoga] can switch from the sympathetic, fight-or-flight nervous system to the parasympathetic, or rest and digest, system. That could go a long way toward reducing stress."

He even suggests a few inverted poses that you might do in the yoga room. Of course only the San Francisco Airport has a yoga room, so what's the ordinary traveling yogi to do? Well, you know all those chairs you have to sit around on while waiting for your plane to board? You can use them as props for an "office" yoga practice (see "After the Retreat: Office Yoga" right here on our blog).

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"I think I have sciatica"

by Baxter

If I had a dime for every time I have heard this from friends, students and patients, I would be doing all right! Usually, any time someone gets a pain in the back that travels below the buttock, they believe they are suffering from sciatica. And some of them may be right, but others could have something else going on. So before we go any further, let’s step back and try to define what sciatica is, which is easier than that might seem, as it is really a symptom, not a medical condition or disease. What that means is that even if you do have sciatica, you are just at the beginning of a journey to find out the underlying cause of you symptom.

Sciatica gets its name because of the relationship to one of the body’s important nerves, the sciatic nerve, which is really made up of several nerve roots from the lower lumber and sacral region of the spine. These separate nerve roots emerge from the sides of the spine and join together to make a bigger nerve that travels down the back of the legs all the way to the feet. It has a couple of jobs: it supplies sensation to the muscles of the backs of the knees and lower legs, and it also provides sensation to the backs of the thighs, part of the lower legs, and the soles of the feet.

Let’s take a look at what the NIH, National Institutes of Health (see here) have to say about sciatica:

Sciatica refers to pain, weakness, numbness, or tingling in the leg. It is caused by injury to or pressure on the sciatic nerve. Sciatica is a symptom of another medical problem, not a medical condition on its own.

Sciatica usually affects people on just one side of the body. And it turns out that the "symptom" called sciatica is actually a constellation of other symptoms. Here’s what the NIH has to say about that and the pain associated with sciatica:

Sciatica pain can vary widely. It may feel like a mild tingling, dull ache, or a burning sensation. In some cases, the pain is severe enough to make a person unable to move. The pain most often occurs on one side. Some people have sharp pain in one part of the leg or hip and numbness in other parts. The pain or numbness may also be felt on the back of the calf or on the sole of the foot. The affected leg may feel weak. The pain often starts slowly. Sciatica pain may get worse:

• After standing or sitting
• At night
• When sneezing, coughing, or laughing
• When bending backwards or walking more than a few yards, especially if caused by spinal stenosis

Okay, so far so good.  But that, again, is a pretty broad set of symptoms that could account for this thing we are calling sciatica.  So, if we are going to put our finger on the underlying cause, what are the most common culprits?

A few of the more serious and common causes include a slipped disc in the lower lumbar area of the spine, Piriformis Syndrome (a condition associated with a deep muscle in the buttock area beneath the gluts that comes in contact with the sciatic nerve as it heads down the leg), pelvic injury and fracture (which could include sacroiliac dysfunction, a not uncommon problem for yoga students) and tumors.

Interestingly, a lot of cases of sciatica will resolve on their own without a lot of testing or heavy duty treatment. In the old days, they used to recommend bed rest for these kinds of symptoms, but we know now that it is prudent, after a brief period of rest, no more than a few days, that gradual return to everyday activities can be helpful, with gentle spinal movement and core strengthening very helpful for recovery. This is, of course, one way yoga can help. In fact, yoga is an excellent way to promote gentle spinal movements, safely strengthen the abdominal area and the lower back muscles, as well as stretch several muscle groups that are associated with general lower back pain that could include sciatica, such as the psoas and the piriformis muscles.

In addition to acute treatment with over the counter meds like ibuprofen and acetaminophen, as well as ice and heat, the NIH also makes the following recommendations for early treatment:

Bed rest is not recommended. Reduce your activity for the first couple of days. Then, slowly start your usual activities after that. Avoid heavy lifting or twisting of your back for the first 6 weeks after the pain begins. You should start exercising again after 2-3 weeks. This should include exercises to strengthen your abdomen and improve flexibility of your spine. (Go yoga!)

If your symptoms are not improving, you are having weakness in one leg, you noticing a foot is kind of drooping when you walk, or you have difficulty controlling your bowels or bladder, don’t put off a visit to your doc—schedule is as soon as you can. In these situations, you might need more evaluation, which might include X-rays, MRIs or local injections to help reduce swelling around your nerves if they are determined to be the culprits.

And if you are going to utilize yoga as a healing tool, look for the most qualified and experience teacher around to work with. Later this week I will share the experiences of a good friend and colleague of mine who had sciatica arise during a retreat a few years back and the almost miraculous technique he learned to eliminate this symptom.

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