Preventing Migraines (and Other Headaches), Part 1

by Nina

Supported Child's Pose

A dear friend of mine, with whom I’ve stayed on many vacations and have traveled with, suffers from terrible migraines; the kind where all you can do is curl up on the fetal position for 24 hours in a dark room. So even though I don’t have migraines myself, I’ve witnessed first hand how awful they can be. Baxter had some good suggestions yesterday (see Yoga for Migraine Headaches) for how to use yoga to get through a migraine headache. But wouldn’t it be nice if you didn’t have to get a migraine in the first place?

Unfortunately, since there are many different triggers for migraines, including different types of food,  it is impossible for us to give you any guaranteed solutions. However, we do have some recommendations for yoga practices you can try. Suffering from a migraine is such a miserable experience and these yoga practices will benefit you in many other ways, so it really seems worth giving them a shot. And everything we’re going to suggest here applies to ordinary tension headaches as well as to migraines, so listen up, everyone!

In his book Yoga As Medicine, Timothy McCall identifies two possible triggers for migraines and other headaches that we can address with yoga: stress and muscle tension in the head, neck and back areas. Today I’m going to talk stress and tomorrow I’ll post something about muscle tension (see Preventing Migraines and Other Headaches, Part 2).

Okay, now to address stress. In his book, Timothy says, “Since stress is a major factor in both tension headaches and in migraines, yoga can certainly play a role in prevention.” And he goes on to say that “There is scientific evidence that relaxation techniques and biofeedback can be effective for both tension and migraine headaches, lessening the duration as well as the frequency of attacks.” That sounds pretty promising to me!

I’ve been ranting about the subject of chronic stress and the importance of stress management since we started the blog (see Chronic Stress: An Introduction  and The Relaxation Response and Yoga), but as a reminder, I’ll simply reiterate that yoga provides a huge selection of possibilities for stress management and you can pick and choose from amongst them according to your experience level, temperament, schedule, and/or personal preference. All of the following yoga techniques reduce your stress levels by switching your nervous system from stress mode (Flight or Fight) to relaxation mode (Rest and Digest). This type of relaxation is something you cannot achieve with a nap or even a full-night’s sleep (see Conscious Relaxation vs. Sleep).

•    Meditation. See How to Meditate for information on how to meditate.

•    Breath practices (pranayama). See Your Key to Your Nervous System for information your nervous system and your breath. For stress reduction and headache prevention, be sure to avoid stimulating and/or overly complex breath practices and focus on simple, calming practices.

•    Restorative poses with a focus for the mind (such as your breath or the relaxation of your muscles).

•    Inverted poses. Studies by Dr. Roger Cole proved that inverted and semi-inverted poses, where your heart is higher than your head, trigger the relaxation response through the mechanisms that control your blood pressure. This is why supported inversions, such Legs Up the Wall pose and Easy Inverted Pose (legs on a chair), are so effective for stress management (See Just in Time for the Holidays: Inverted Poses).

•    Corpse pose (Savasana) with a focus for your mind (such as your breath, the relaxation of your muscles, or peaceful imagery). See Savasana for information.

•    Yoga nidra (yogic sleep), a long, structured form of Savasana. See What is Yoga Nidra? for information about yoga nidra and the Audio Tracks tab at the top of the page for a mini version of yoga nidra that you can stream or download.
 
If you find it difficult to settle in and relax because you’re too restless or anxious when you lie down, first try any active asana practice to burn off steam (although you might want to be careful with backbends—I’ll address that tomorrow) and then move on to relaxation practices.

If you are interested in practicing a combination of inverted and restorative poses, you might like to check the headache sequence in Yoga As Medicine, which includes the following poses:

1. Legs Up the Wall pose
2. Supported Reclined Cobbler’s pose
3. Chair Shoulderstand
4. Half Plow Pose (with chair)
5. One-Legged Forward Bend with head support
6. Full Seated Forward Bend with head support
7. Breath Awareness

Note that this sequence was designed for an experienced practitioner, and if you aren’t familiar yet with or can’t get comfortable in Chair Shoulderstand and Half Plow pose, you may want to skip over those two poses. An easier alternative to those two poses would be to do a Supported Straight Leg Bridge pose (must photograph that for our blog one of these days!). The teacher who designed this sequence also recommended his student use a head wrap (a large bandage that is wrapped around the head to relax the eyes) while practicing, so that may be something you could experiment with. Start wrapping the bandage clockwise at your forehead, go down to your eyes, and then come back up again. Tuck the loose end to secure the bandage.

If the sequence from Yoga As Medicine is too long or complicated for you, any simple restorative sequence could be very effective. Try our Mini Restorative Sequence, which includes three classic restorative poses that almost everyone can enjoy.

So how often should you do these stress reduction practices? I think that if you are chronically stressed out and suffering from debilitating headaches, you should practice six or seven days a week for at least 15 minutes (keep in mind that could be 15 minutes of meditation or 15 minutes in Legs Up the Wall pose). I realize that sounds like a lot. It will take some work—if you can call relaxing “work”—to bring your overall stress levels down. Keep in mind that the payoffs could be huge, as stress management can result in many additional health benefits besides reduced headaches, such as lower blood pressure and a stronger immune system, as well as quality of life benefits, such as increased equanimity and maybe even happiness. And if any of you take up this headache reduction challenge, I’d love to hear back from you about the results.

Check back tomorrow for tips about how to use yoga poses to release neck, shoulder and back tension that can trigger headaches.

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The Pyramid Training Program. By John Bubb, former NABBA Pro bodybuilder

The Pyramid Training Program

By John Bubb, former NABBA Pro Bodybuilder

Exclusive for Bodybuilding Mauritius

Follow-up plan for people who have been doing the original Bulk Up schedule.

Those of you who started the original Bulk Up plan (click here to read) when it was first published must have completed your three months suggested time plan and be wondering where to go next. Even people who started when it first appeared on the blog will be getting towards the end by now. You will remember that I said that you should forget you are bodybuilders for six months and concentrate on  Power Lifting Type workouts. This will not only thicken your physique, but make you much stronger so that when you return to the more conventional bodybuilding type training your poundages will have increased substantially and you will be able to use more productive weights on higher reps. We will keep the same days for body parts as before.

With my friends outside the gym

MONDAYS AND THURSDAYS: CHEST & TRICEPS

Exercise # 1: Barbell Bench Press on Flat Bench 

Don’t worry, you will be using D/Bells and Inclines next time!

Exercise 1: Flat bench barbell presses

Sets and reps

Warm up set: Start with 1 set of 15, really silly light – as before.  

Working sets: 

• 1 set of 8 heavy (but make sure you get 8)
• 1 set of 6 heavy (but get 6. If you start failing at this point you’ll never make the really heavy reps later)
• 1 set of 4 heavy (as above)
• 1 set of 2 heavy
• 1 set of 2 flat out
• 1 set of 4
• 1set of 6
• 1 set of 8.

Notes:

• Treat the first sets of 8,  6,  4 as a build up. Use heavy weights but make sure that you achieve the required number of reps. After you have done the two sets of two try to use slightly more weight on the final 4,  6,  8 than you did in the build up. REMEMBER You don’t gain anything from failed reps

• Every fourth workout perform two flat out singles after the first set of two. This will give you something to aim at and give you an indication of your progress.

• We won’t worry too much about arms on this schedule, just concentrating on the compound exercises. When I used to do power lifting programmes back in the sixties my arms used to grow even though I wasn't doing any pure arm movements at all. Trust me, it works!

• However we will do a little triceps work just to aid the Bench Presses and keep you in touch.

Triceps work

Exercise #1: Triceps extensions (Push-downs)
Use the pulley machine and do 2 sets of Triceps Extensions (Push-downs) 2 X 10.   

Exercise 1 for triceps: cable pushdowns

Exercise #2: Close grip bench presses

1 X 10 Very light.

3 X 8 heavy.

If, like me, you find these hurt your wrists, do Seated French Press with a single heavy dumbbell.

Try to train with two training partners so that you've always got spotters and moral support.

Exercise 2 for triceps: close grip bench press or French press

TUESDAYS & FRIDAYS: LEGS, BACK AND BICEPS

Exercise#1: low, Very strict Thigh Extensions.  2 X 20.

Leg exercise #1: Leg extensions (2 x 10 reps)

Leg exercise #2: Conventional Squats

Exercise #2: Conventional squats

1 x 20 Very very light.

1 X 10

1 X 8

1 X 6

1 x 4

1 X 2

1 X 2

1 X 4

1 X 6

1 X 10

Notes:

• Do these exactly the same as the Bench Presses and try a couple of singles after the first set of two Reps every four or five workouts.

• DON’T BE TEMPTED TO TRY SINGLES EVERY WORKOUT OR YOU WILL BE DISAPPOINTED AND FRUSTRATED. OBVIOUSLY THE SAME APPLYS TO THE BENCH PRESS.

• KEEP RECORDS AND GIVE YOURSELF A NICE SURPRISE EVERY FOUR OR FIVE WEEKS.

As before, substitute DEADLIFTS for squats every third workout.

Every third workout substitute squats for deadlifts

We will continue much as before.

Do that really light set of 8 to 10 to warm-up.

Then do 4 fairly heavy reps

Then do 2 really heavy.

Then 4 singles adding weight each set.

Then a final set of 6 fairly heavy.

Some people might feel that this is not enough, but I always found that I made better progress on Dead Lifts if I didn’t do too many and I seemed to make my best gains on the singles and low reps.

"Bench press, squats and deadlifts are really the basis of all bodybuilding"

Remember, Bench Press, Squats and Dead Lifts (The compound exercises) are really the basis of all bodybuilding. If you only concentrated on these three for two years you would make more general progress than the young skinny lad who rushes around the gym doing endless sets of arm exercises.

BACK

Exercise #1: Lat Machine Pull-downs to chest (Very Strict) Shoulder width grip.  1 X 20

Exercise #2: Low Pulley Rowing, light and strict, Close Grip.  1 X 20

Exercise #3: Single Arm Rowing with D/Bell 1 X 10 light, Then 5 X 6 heavy. Try to do these really strict, feeling the muscles stretch and contract. NO TWISTING AND HEAVING – like all those around you are doing!!!

BICEPS

Again, we won’t go mad. Just a few token sets to keep you in touch and put your mind at rest.

Strict Incline D/Bell Curls

1 X 15 very light.

5 X 6 heavy, BUT, still very strict.

Calves

Finish up with your favourite calf exercise (is there such a thing!!)    five or six sets of 20.

Important guidelines

• Don’t forget, lots of rest between sets on the compound exercise. I don’t care what anybody says, you shouldn’t sacrifice the poundages you use by rushing into the next set too quickly.

• ALWAYS USE CORRECT STYLE.

• GO DOWN TO PARRALLEL ON YOUR SQUATS EVEN IF IT MEANS USING SLIGHTLY LESS WEIGHT.

• EAT LOTS OF PROTEIN – CHICKEN, TURKEY, FISH AND SOME BEEF.

• DRINK AT LEAST 3 PINTS OF PROTEIN SHAKES A DAY. CHOOSE ONE THAT YOU LIKE SO THAT YOU ENJOY DRINKING IT. IT SHOULDN’T BE LIKE TAKING MEDICINE! IF IT IS YOU WILL EVENTUALLY GIVE IT UP.

• ONLY EAT GOOD CARBS AND AVOID ALL JUNK.

While you are on this course don’t be tempted to do extra on the days in between. Train hard four days a week and rest as much as possible on the days in between. This doesn’t mean that you’ve got to lie in bed for three days a week. Just follow a normal way of life without too much exertion.

I’ll see you in three months with your next follow-up.

John Bubb for Bodybuilding Mauritius

________________________________________________________________

About the Author

John Bubb is a former NABBA professional bodybuilder with more than half a century of experience in the iron game. John has six top four finishes at the NABBA Pro Mr. Universe from 1967 to 1971, including a runner-up placing to Arnold Schwarzenegger in 1968. 

John has trained several bodybuilders from many countries and has remained very active in the bodybuilding arena decades after hanging his posing trunks. He is one of our most prized contributors at Bodybuilding Mauritius and we feel very honoured to have someone of the calibre of John dispensing advice to all of us with such enthusiasm. 

We at Bodybuilding Mauritius are very keen about old-school bodybuilding as we believe that in order for bodybuilding to have a future it must look back at its past. We couldn't ask for a better guru of Golden era bodybuilding than "Iron Grandpa Bubb". 

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Yoga and Migraine Headaches

by Baxter

We’ve had a few different requests over the past months to talk about the condition of migraine headaches and how yoga might be helpful in addressing them. So Nina and I are splitting up the topic into two focuses. Tomorrow Nina will share with you some ideas around yoga as a possible preventative strategy for migraine headaches (see Preventing Migraines and Other Headaches, Part 1 and Part 2), and today I will tackle the use of yoga during a migraine attack. And we might even get Brad to weigh in on the topic, as he lectures to the pharmacology students at UCSF on medications used to treat migraines. As we talked about the subject during a recent meal, he shared an opinion about treating acute headache attacks with yoga. “F#*k the yoga,” he joked, “Take the drugs!” As he may go into in more detail here later this week, he feels the modern abortive migraine meds are so effective that it might be foolish to not take them, as migraines can take the sufferer out of circulation for a day or more if a severe headache takes hold (see Brad's Perspective on Migraine Headaches). However, yoga has some effective solutions to offer, too, and there is no reason you can’t combine medication and yoga.

Let’s back up for minute and talk about what a migraine headache is. It is actually important to distinguish this from other forms of headache. In my medical practice, I used to get patients coming in with reported “migraines,” who were actually having more common musculoskeletal headaches that were very strong. They were under the impression that any “bad” headache was a migraine. To clarify the distinction, according to MayoClinic.com:

“A migraine headache can cause intense throbbing or pulsing in one area of the head and is commonly accompanied by nausea, vomiting, and extreme sensitivity to light and sound. Migraine attacks can cause significant pain for hours to days and be so severe that all you can think about is finding a dark, quiet place to lie down.

Some migraines are preceded or accompanied by sensory warning symptoms (aura), such as flashes of light, blind spots or tingling in your arm or leg. Migraines may progress through four stages — prodrome, aura, attack and postdrome — though you may not experience all the stages.”  

Since the physiology of the stages of the headache is quite complex, for now I’d like to suggest that the “acute” attack really starts with the “prodrome,” which can be a period of time a day or two prior to the actual onset of the headache symptoms, and can include any of the following signs or symptoms: constipation or diarrhea, depression, food cravings, hyperactivity, irritability or neck stiffness. As you can see from this list, these symptoms could also be associated with other things going on in your life, but the person with migraines begins to notice patterns that can help them predict the coming of headache over time.  So, if you are migraine sufferer who has identified these prodrome warnings, this could be the time to pull out some yoga tools best suited to this phase of things. I will get to more specific recommendations shortly.

The second stage mentioned is the “aura,” which, interestingly, the majority of migraine sufferers do not get before the headache shows up. But some do, and it can give them another opportunity to intervene, either with their meds or some yoga or both. The aura usually lasts from 10-30 minutes, and can be in the form of some visual phenomena, like flashing lights, or loss of vision, or pins and needle sensations in an extremity, or speech or language problems. There are even some people, like Brad himself, who typically only have the aura and do not go on to experience the full-blown headache.

If things progress to a full blown headache, it is typically a pulsating, throbbing pain on one side of the head, and can be accompanied by nausea, vomiting, fatigue, light, sound, and even smell sensitivity, and can last from 4 to 72 hours.  Once the headache subsides, the postdrome period that follows can often leave you feeling fatigued for a day or two. Migraines occur with differing frequencies for different people, and at least one of my students reports a distinct connection with her migraines and her monthly menstrual cycles.

When considering how to use yoga to attempt to short circuit the start of a full blown migraine or to mitigate the severity of the symptoms if you are already at the aura phase, there will be different approaches. In the one to two day prodrome period, taking some time to do a balanced, yet generally gentle asana practice, could possibly stop things from progressing further. The exact practice might be modified if GI symptoms predominate (doing Legs up the Wall, for example, if diarrhea predominates), or if neck pain is your early clue of a possible impending headache (doing gentle neck stretches, for example). In general, I’d recommend milder versions of all of your more active poses, with more focus on a calming connection to your breath than trying to work hard from a musculoskeletal view. And save time for a few restorative poses and perhaps a guided meditation with a stress-reducing focus.

Once you are at the aura stage or onward, the possibility of yoga halting a headache is much less likely, and certain kinds of yoga practices actually could aggravate the headache.  Inversions, for instance, are one of the biggest aggravators that my student reported to me, and even lying down flat in Savasana could be too much at times. However, supported poses, where the head is elevated a bit, like Reclined Cobbler’s pose can be quite helpful.

Since many headache sufferers head to a quite dark room anyway, setting up in Reclined Cobbler’s pose, using an eye pillow while in there, could potentially speed up recovery times.

I hope you've found this helpful, and if you have any recommendations from your own experience, please let us know!

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Ahimsa (Non-Violence) and Healthy Aging

by Ram 

Peaceful Valley by Brad Gibson

Himsa in Sanskrit means violence, which is defined as the intentional use of force or power on self or against a person or a group that results in a physical/psychological harm, mental disturbance, injury or death. Going by this definition, there is no difference between a person who is harboring severe judgment and negativity towards self or others and a person who walks with a gun into a classroom and randomly shoots at the students. Both have committed himsa or violence albeit to different degrees. We have also have heard or witnessed acts of himsa perpetrated in yoga studios as well.

Violence of any kind has profound effects on the health of an individual. Studies have shown the following:

• The stress of being in an abusive relationship has the obvious physical and psychological impact: it often increases one’s vulnerability to illness and may cause the victim to be more susceptible to disease.
• Battered victims experience depression, feelings of low self-esteem and helplessness coupled with somatic complaints.
• Chronic abuse causes serious psychological harm. Victims experience panic disorders, phobias, anxieties and depression that may last for several years. Their ability to trust and form emotional attachments are severely impacted.
• Victims often complain of enduring the effects of violence over many years and some even develop extreme symptoms years later in response to major life stressors.

Moreover violence severely impacts healthy aging and life expectancy is reduced in traumatic individuals. Recent studies have shown that the United States suffers far more violent deaths than any other wealthy nation. The United States has about six violent deaths per 100,000 residents. Homicide and suicide together account for about a quarter of the years of life lost for U.S. men compared to those in those peer countries. Children who are exposed to different types of violent childhood events suffer from all kinds of stressors that negatively affect their overall development. A ten-year study finds that a traumatic childhood reduces life expectancy by 20 years among adults who experienced six or more particular types of abuse or household dysfunction as kids. Thus, violence in all forms is taking its toll on the life expectancy of the U.S. population. The solution to this grave problem is shunning violence and cultivating ahimsa (non violence), the opposite of himsa. Ahimsa— which also refers to non-harming or non-injury—is the first of the five yamas in the yoga sutras of Patanjali. The five yamas serve as moral, ethical and societal guidelines for a harmonious living. Patanjali considered the yamas as universal vows, and preached that they be practiced on all levels: by way of thoughts, actions, and words. Verse 2.3 in the Yoga Sutras describes ahimsa as:

ahimsa pratishthayam tat vaira-tyagah

As a Yogi becomes firmly grounded in non-injury (ahimsa), other people who come near will naturally lose any feelings of hostility — trans. by Swami Jnaneshvara.

Going by the above translation, ahimsa would mean physical, mental, and emotional non-violence towards self and others. For those who are always in contact with individuals who experience natural inner peace and a non-harming attitude, there is a tendency for them to give up their hostilities, ill will or aggression in return. It is a natural process that everyone experiences in the presence of a truly non-violent person.

How does one cultivate ahimsa? Empathy and compassion are two excellent tools to foster ahimsa as they allow us to accept events as they are and act with an open and loving heart. Empathy and compassion replace violent tendencies with kindness, acceptance and love. Practicing it on oneself helps to cultivate the same feelings towards others. So how about cultivating some ahimsa in our lives starting now!

Kindly and non-violently,

Ram

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Friday Q&A: Cat-Cow, Back Extensor Muscles, and Mountain Pose

Following on the heels of one of our recent posts about osteoporosis (OP) came this inquiry about some suggestions for particular asanas:

Q: What about the cat pose in cat/cow sequence? Can you make any possible modification in focusing more on rounding the fanny end of the spine, rather than the shoulders?  Best poses for back extensor strengthening? Anything that reinforces Tadasana?

A: Even though the motivation for asking for these three suggestions may not have been directly related to osteoporosis, Cat/Cow is great as a weight-bearing posture for strengthening the wrist bones.  Poses that strengthen the back torso extensor muscles, which attach all along the spinal column, would strengthen the bones of the spine. And Mountain pose (Tadasana) done with engaged leg muscles is weight-bearing on the feet, so could translate into strengthening of the bones of the legs and hips. That said, let’s now look at the specific issues at hand:

Starting with Cat pose in the dynamic practice of Cat/Cow, we usually encourage the spine to round evenly toward the ceiling, keeping the arms engaged and elbows straight, releasing the crown of the head towards the floor, and tipping the pelvic backwards into retroversion, with the sit bones and tail bones turning down.  If you observe a group of students doing this, you will see some students who seem to have more movement and rounding in the upper back and some who seem to have more in the lower back. There can be many reasons for this, which we won’t go into today, but if you want to emphasize the pelvic tuck and lumbar flexion part of the formula, you might try the following at home:

1. Find a landing that is just one step off the floor.
2. Come into hands and knees position, with your knees and shins on the low landing and your hands down on the floor.
3. Practice Cat/Cow as usual, and see if you don’t have more awareness of the lower back and pelvis. If you are not sure, switch it around with shins on the floor and hands on the landing and see what you feel.

Also, more actively hollowing the lower belly up towards the spine as you exhale into Cat shape can bring more rounding of that “fanny end” of the spine. Finally, doing the pose positioned sideways to a mirror that gives you visual feedback can help you see where you tend to have more movement, and you may be able to play around and bring more movement into the lower half of the spine.

The back extensor muscles, which line the entire back of the head to tailbone region of body, primarily take the spine into back bending actions, but can also contribute to some rotation of the spine, as well as side-bending. If we just consider the back bending actions of these muscles, anything from the obvious Cobra, Locust, Upward-Facing Dog, and Bridge poses and on into the more advanced backbends will strengthen the back extensor muscles nicely. And you can play with both dynamic or static versions of these poses as I have written about previously. And even a pose like Warrior 2, with a slight feeling of backbend and rotation, will work these muscles likely. Also, every time you come up from Standing Forward Bend (Uttanasana) to arms overhead, as you do in Sun Salutations, you are activating your extensors nicely. Use your deductive skills to look at other poses and see if you can imagine the extensors in action as well.  There are lots more in addition to those I have mentioned.

And as for ways of reinforcing the alignment of Mountain pose (Tadasana), I like to do a reclining versions of this pose, on the back, with the feet pressing into the baseboard of a wall, putting even pressure in the balls and heels of the feet. I also recommend standing with the back to a wall, with the heels close to the wall—perhaps just a few inches away—and with the buttocks flesh lightly touching the wall. Depending on the build of your chest, your shouldblades may or may not touch the wall. From this position, lengthen up to the crown of the head.  Also, all of the poses that strengthen your extensors, as discussed above, are helpful for achieving better posture in Mountain pose. I like to do Locust pose (Salabhasana) first dynamically (moving in and out with the breath) and then held for several breaths, and then practice Mountain pose to see if there is a change in posture.

Give all this a try in your next home practice and see how it all feels to you.

—Baxter 

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Got Salt? Yoga, the immune system, and the problem with some scientific studies

by Nina

Currents in Salty Water by Brad Gibson

So I’ve been seeing these articles about a particular scientific study circulating in the blogosphere that claimed the study was proof that yoga improved your immune system system. One example is from Can Yoga Boost Your Immune System? at salon.com, which claimed:

“This latest study confirms those findings, links them to the body’s immune system, and suggests this effect may be instantaneous.”

Naturally, as a dedicated yoga blogger, I decided I needed to check these articles out because I need to share the good news with our readers, too, right? But my initial readings left me scratching my head a bit (for example, “a comprehensive yoga program rapidly produces internal changes on a genetic level”), so I decided to consult with my handy scientist co-bloggers to find out more, specifically what the relationship is between changes in gene expression and the immune system.

Dr. Ram Rao put it this way:

“The article describes effects of Yoga on genes that influence the immune system. There are so many factors that affect gene expression (environment, diet, pollutants, stress etc) and so the authors looked to see if Yoga did the same.”

That makes sense, right? So far, so good. But Dr. Brad Gibson said it this way:

OK, what they were measuring was gene expression profile changes in PBMC.

"Right before and after each regimen, 20 ml blood was drawn, PBMCs were immediately isolated, total RNA was recovered and used in gene expression profiling experiments interrogating >47,000 independent transcripts in two hybridization runs"

First, PBMCS (according to Wikepedia) are "peripheral blood mononuclear cell (PBMC) is any blood cell having a round nucleus. For example: a lymphocyte, a monocyte or a macrophage. These blood cells are a critical component in the immune system to fight infection and adapt to intruders."

So, what they are suggesting is that the observed changes in the gene expression profiles in blood immune cells (PBMCs) in Yoga practioners is correlated with an improved immune function. However the second bit is pure speculation.  They see a change, but it's anybody's guess if this represents a better or healthy immune system.  They provide some guesses, but….

Okay, I admit it, that phrase “the second bit is pure speculation” was a bit disappointing. I’d just wasted my time (and theirs) on an idea for a blog post that I couldn’t really use because, after all, on this blog anyway, we try to back up our claims with good science. But a few days later I realized I actually had more of a contribution to make on the topic than some of the other blogs because while everyone else was simply parroting some kind of good news about yoga they didn’t really understand, I had an actual real-life scientist weighing in on the significance of the study and he said to take it with a giant BUCKET OF SALT.

However, before writing the post, I decided to do a bit more research by looking an the original scientific journal article that everyone was quoting from Rapid Gene Expression Changes in Peripheral Blood Lymphocytes upon Practice of a Comprehensive Yoga Program—you know, just in case. And here is the abstract from the study:

One of the most common integrative medicine (IM) modalities is yoga and related practices. Previous work has shown that yoga may improve wellness in healthy people and have benefits for patients. However, the mechanisms of how yoga may positively affect the mind-body system are largely unknown. Here we have assessed possible rapid changes in global gene expression profiles in the peripheral blood mononuclear cells (PBMCs) in healthy people that practiced either a comprehensive yoga program or a control regimen. The experimental sessions included gentle yoga postures, breathing exercises, and meditation (Sudarshan Kriya and Related Practices – SK&P) compared with a control regimen of a nature walk and listening to relaxing music. We show that the SK&P program has a rapid and significantly greater effect on gene expression in PBMCs compared with the control regimen. These data suggest that yoga and related practices result in rapid gene expression alterations which may be the basis for their longer term cell biological and higher level health effects.

Whoa, I’m thought, somehow we went straight from “wellness” and “benefits” to specific claims about the immune system. Then there were all those vague words like “suggest” and “may.” But, of course, I’m not scientist, so again, I consulted with Brad. Here is what he said: 

Look at their last sentence:
"These data suggest that yoga and related practices result in rapid gene expression alterations which may be the basis for their longer term cell biological and higher level health effects."

That is, they don't know whether the change in gene expression patterns they observed has anything to do with the yoga practice, let alone a more healthy immune system.  This is a general problem of small correlative studies of this type.  At best I would say this is an intriguing pilot study (low N, not really statistically significant enough to establish even correlation), which will need considerably more work to establish:
(1)  'causation' (i.e., yoga practice causes these genetic expression changes as opposed to some random or other variable that wasn't accounted for)
(2) 'benefit' (the expression changes that are observed are actually beneficial and lead to an improved immune system)
(3) 'mechanism' (why these gene changes lead to a more healthy or robust immune system).

My translation? The number studied was so low that correlation couldn’t be established. Causation definitely was not established. And then there was a bunch of speculation. So, yes, get out the salt everyone, and sprinkle liberally! (For you non-American readers out there, we have an expression “take it with a grain of salt” that means you should be skeptical about something. So I like to joke about buckets of salt, when I think a lot of skepticism is warranted. And, as much as we love yoga, this is not the first time we’ve looked at scientific studies of yoga that indeed warrant quite a bit of skepticism.)

Note: I’m pretty sure that yoga is good for the immune system, however. Stress compromises the immune system—this is known medical fact—and yoga reduces stress. Spending more time in Rest and Digest mode (where your body restores itself) rather than Fight or Flight mode (where your body depletes itself) is therefore good for your immune system.

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Yoga and Pain Management

by Shari

Since I have been on a “pain alert” myself for the past 10 days (a very cranky knee is having trouble settling down), I thought I would discuss the difference between acute and chronic pain, and how yoga may assist in pain management.

More than 115 million people nationwide (1 in 3 Americans) suffer from some type of long-term pain, according to the Institute of Medicine. People often try to alleviate pain with conventional therapies and medications. According to the CDC, narcotic pain medication addiction and overdosing accounted for over 16,651 deaths in 2010. When conventional treatment fails, people will often turn to complementary medicine techniques, and yoga is often tried to alleviate pain symptoms.

I thought I would first define the difference between acute and chronic pain. An acute injury will typically resolve within three months of the body’s normal healing process. Chronic or persistent pain is pain that lasts more than this time frame. Acute pain is associated with tissue damage. Pain (nerve) receptors are activated with an acute injury because the body is trying to protect the damaged area - this minimizes usage so normal healing can occur.

But with chronic pain, the brain’s perception of the cause of the pain changes. The inhibitory mechanisms of the central nervous system become faulty, and we may avoid physical activity because we have learned “If I do this, it will hurt.” We may be afraid that, because we are in pain, activity will further damage or injure the area. But generally the tissue damage is healed after three months, and avoidance of physical activity is therefore no longer beneficial in the healing process.

However, the brain may now remember stress and pain in an exaggerated way, as if it were in a continuous sympathetic feed back loop of fight or flight. So some of us can become hyper vigilant about everything that causes pain. But one of the beauties of yoga practice is how helpful it can be for people both in acute and chronic pain!

Physical asana has properties of both squeezing and soaking areas of the body. Compressive forces, with and without weight bearing, and long restorative poses move fluid, assisting the body to decrease edema in a joint after an acute injury. Decreasing the edema reduces the pressure on nerves and muscles, resulting in a reduction of pain symptoms. (However, it is key to understand how much can you can move your cranky joint and when you need to stop, so see When to Stop Practicing Yoga for information.) Along with the practice of physical asana, long relaxation poses and Savasana can help because of their restorative qualities and the way they quiet the sympathetic nervous system while stimulating the parasympathetic system (the relaxation response). And at this time, modifying the asanas that you regularly do is important. This way, you can still get the benefit of the asana with modifications, and then as the injury heals you can slowly bring the full asanas back into your regime.

For chronic pain the “prescription” is a bit different. Chronic pain is a global body phenomenon. When your body is in chronic pain you walk differently and you may even sit differently. Your attention is often directed to the painful region because keeping it still may make it worse and positional change needs to be frequent. The individual may be chronically exhausted because the ability to sleep well has been affected. There may be difficulty in completing tasks in a timely manner so things “start to slide” and don’t get done. Because energy is limited, the individual may rush through tasks to get things done and then be in more pain because they hurried. It is a terrible wheel to be on and difficult to get off onto solid ground!

In my own practice and teaching of yoga, I try to share with my students how yoga helps to focus the mind, quiet the breath and improve the mental focus. Yoga meets us where we are NOW. Yoga is nonjudgmental and everyone can do yoga. Yoga teaches us self-awareness. Yoga gives hope where there may be no hope.

Simple grounded breathing while you sit on a chair or lie in bed in your position of comfort is a great way to start. Set a timer and do simple breathing for three to five minutes. Notice how this may affect your mind and sense of self. Progressing to GENTLE range of motion of all body parts within your ability and not pushing yourself is beneficial. You can even do your range of motion activities in your position of comfort. Notice your pain levels (0-10) at start of practice and then again when you are done. If your pain levels stay the same, you are teaching your body NOT to be afraid of movement. Once your confidence has improved, then you might be ready to join a local class. Look for instructors who will be sympathetic to your pain but not overly solicitous. Make sure the teacher understands that you will stop when you need to, not necessarily when the teacher tells the class to release the position. Try to set aside five minutes a day to practice your own breathing awareness and your own Savasana. It becomes your sacred time to care for yourself.

Remember, the results may be slow in coming but persistence and gentleness are the keys to relieving and managing both acute and chronic pain.

Note: For my achy, swollen and hot knee, I am trying to work with my available range of motion, not moving too much into pain but inching into the pain and then backing up and repeating multiple times trying to make the available movement  smoother. Also, stretching related areas like my hip flexors, hamstring muscles, gastroc/soleus is really helpful for pain relief of my knee. In the standing poses, I’m working with gentle isometric contractions but not going into my full knee flexion (bending)—pumping a lot. I’m doing a lot of passive inversions like Viparita Karani (Legs Up the Wall pose) and Chair Shoulderstand, with pumping from my ankles. And, finally, modifying poses, for example, for Virasana (Hero pose), which I was previously able to do without any props, I now use two blocks stacked up high because I have just about 100 degrees of flexion (ability to bend the knee). And, lastly, cautious, aware walking. Patience is the crux though I am not a very patient individual.

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