Happy Anniversary! Two Years of Yoga for Healthy Aging

by Nina

It’s our two-year anniversary today! Celebrate with us again this year by listening to "Float," one of my favorite songs by Flogging Molly (I love the video, too). I still think that the chorus for this song, “Ah but don't, don't sink the boat/That you built, you built to keep afloat,” works perfectly as a theme for this blog. That, and the ending to the song:

A ripe old age,
A ripe old age,
A ripe old age,
Just doing the best I can!

We’ve had a very productive second year! We now have 492 posts on the blog, covering a wide range of topics, including asana practice, pranayama and meditation, stress management, aging theories, medical conditions, ayurveda, and yoga philosophy. If you are interested in reading earlier posts, you should know there are three different ways you can search the blog for particular topics (or authors). In honor of our anniversary, I’ve just added a new page to the blog that describes the three different ways to search the blog, and when to use which type of search function. Click the How to Search tab at the top of the blog to access it.

We also have well over a thousand subscribers now! If you’d like to become a subscriber, you can sign up to receive each post via email by entering your email address into the “Follow by Email” box on the right side of the blog. After you click the Submit button and fill in the Subscription request, you’ll receive an email asking you to confirm your subscription request. If you don’t see one after 24 hours, check your junk mail folder. Or, if you have a Google account, you can become a Google follower by clicking the Join this Site button.

We’ve also gained a new regular contributor, a copy editor, and a photographer! Our new writer is Ram Rao, Ph.D. He is a Research Associate Professor at the Buck Institute for Research on Aging, where he studies various aspects of age-associated neurodegenerative diseases. And he is also a certified Clinical Ayurvedic Specialist and a registered yoga teacher! Because he grew up in India in a family of Vedic scholars, he brings a different perspective to blog, which I think is invaluable (and I confess, I often consult him privately behind the scenes). And, of course, we all love the story of his grandfather teaching him to meditate in a train station (see Achieving Stillness in Turbulent Times).

Our copy editor is Bridget Frederick, a yoga teacher and writer. Although I curate and edit every single post on the blog, I don’t take the time to proofread (well, I do have other projects that I’m working on as well). So when Bridget offered to take on this task, I was thrilled. In Bridget’s defense, I must confess that while she often edits a post before it is published, there are some days like today that I publish a post before she can get to it and she only edits it after the fact. So if you see an error, it’s probably my fault.

Melina Meza, a yoga teacher who is also a passionate amateur photographer, has been generously contributing her beautiful photographs. I often hear from people on how well the photographs complement the text, and I couldn't make that happen without people like Melina (and Brad, Michele, Joan, and Philip) who are willing to share their photographs with us.

Our blog isn’t “monetized” so this means that all three of these new contributors, as well as our original staff (Baxter, Brad, Timothy, and Shari), are doing this work out of love. I’m so grateful to be working with such an extraordinary group of people!

“Tomorrow smells of less decay
The flowers quick just bloom and fray
Be thankful, that's all you can” —Flogging Molly

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Healthy Living for Fall with Ayurveda and Yoga

by Ram

Fern Leaves by Melina Meza

As you may have noticed, summer is gradually winding down and making way for autumn to take over. The days become shorter, the rhythm shifts, and the light and heat of summer subside. Both yoga and ayurveda stress the fact that we are in sync with our environment so we need to be mindful of the change in seasons. Thus, as seasons change, our body and mind adapt to these changes. This requires us to be aware of the qualities associated with the seasonal changes.

Fall is marked by the domination of vata dosha (constitution). Vata is made of the ether and air elements. It represents the mobile force of the universe, and in our bodies is responsible for all activities that involve movement. Thus, locomotion, digestion, circulation, respiration, elimination, communication, sensory and motor function, cardiac function and nervous system impulses (among others) are all governed by vata. Vata in the mind is responsible for emotions that include enthusiasm, joy, clarity, creativity, fear, worry and anxiety.

The qualities (gunas in Sanskrit) of ether and air elements in turn constitute the vata qualities, and these include cold, dry, light, rough, subtle, mobile and clear. To understand the vata dosha, it is important to understand whether the above-mentioned qualities are dominating the body and mind at any given moment. When vata dosha is healthy, these qualities are in a balanced state and the individual experiences optimal health, stability, creativity enthusiasm and excitement for life. The movements of the body are graceful, unimpeded, and yet controlled. Individuals who possess a balanced state of vata tend to be imaginative, energetic, fun, light hearted and full of excitement. 

The fall season is characterized by a cold, windy and dry weather. Leaves change color and fall off the trees. During peak autumn, trees are devoid of leaves or flowers and look dry and barren. As our external environment changes, it increases vata in our own internal environment. If we are not aware of these changes, vata goes out of balance and so do the vata qualities and a totally different personality emerges.

In general, to balance vata, we learn to apply its opposite qualities to any given imbalance. Whether the tools used are lifestyle changes, dietary, herbal, colors, aromas, mantras or massage oils, the underlying principles used to return to balance are the same. It is necessary to increase the qualities opposed to the imbalance. Thus, we combat dryness by bringing in moisture. To counter an excess of lightness, we bring in heaviness, and if there is an excess of coldness, we increase heat. When vata dosha goes out of balance, the individual’s movements become erratic, the body becomes lighter and dryer and weight drops. The person may experience feeling of chillness/coldness throughout the day, the voice becomes too quick and out of context, there is an inability of the mind to focus, the eyes and mind may appear vacant and empty and there may be unexplained pain in the body. Irrespective of our doshic constitution, all individuals will experience these fall changes and need to pay attention to them. People of vata constitution, being more susceptible to the fall changes, should take every precaution to prevent vata from going out of balance. Some of the healthy living practices during the fall season include:

1. Stable Routines: One of the most important lifestyle tools for maintaining health and for supporting healing during the fall season is adopting stable routines. Stability is greatly improved through all activities performed at the same time every day. The routine should include time for self hygiene, massage, meditation, physical exercise and/or yoga asana practice in addition to other daily activities, including but not limited to eating, sleeping and waking up. Meals should be taken regularly throughout the day and at the same time each day. All activities done at the same time each day helps to counteract the vata qualities. For example, if a vata person is experiencing increased dry quality in their body, we will encourage them to utilize moistening, warming and nourishing foods, remedies and practices.

2. Diet to Counteract the Fall/Vata Season: Cold sandwiches, cold salads, and dry cereals with cold milk should preferably be avoided during this season. Such foods can aggravate vata qualities during fall and create a vata imbalance. The food should be preferably cooked (warm), oily (moist) and moderately spiced (warm). Since vata is cold, dry and rough, warm cooked foods made with a little olive oil or ghee have a wonderful soothing effect that immediately calms down the restless vata. Warm drinks such as hot milk or ginger/cinnamon/basil tea also have an immediate balancing effect. Suggested snacks include vata tea with a wheat bread, dates, fresh fruit, or warm milk. Coffee and other caffeinated drinks can be vata aggravating and should be avoided. Sipping warm water and herbal teas throughout the day enhances warmth and hydration. Dinner could be a warm hearty soup and bread. Before bed a cup of warm milk with a pinch of ginger/cardamom and some sugar or honey is recommended for sound sleep.

3. Massage (Abhyanaga): Fall brings dryness and lightness not only to plants but also to the body. To prevent excessive dryness it is a good idea to use oil both in food and on the body. Daily oil massage will not only treat dry skin but it will moisten the joints and tissues of the body as well keeping the body lubricated and healthy throughout the fall season. Warm sesame or almond oil with 1-2 drops of rosemary, lavender or jasmine essential oil is used for the body massage. Apply the oil all over and gently massage the body. If possible, keep the oil on the body as long as possible and do not wash it off. If you take a shower afterwards, do not use soap and pat yourself dry. 

4. Yoga Asanas: The emphasis throughout the fall season is to incorporate an asana practice that softens your lower abdominal cavity, and builds strength and stability in the body and mind. Practice at a slow, smooth and steady pace. Pay attention to detail and use gentle movements. Asanas that aid in pelvic compression and flexion of the hips (iliopsoas, rectus femoris, and adductors) are recommended. Hold each posture for a short amount of time, but do multiple repetitions. Draw into and move from your power center (core). This is the area below the navel and above the pubic bone. Focus on the foundation of the pose to create stability and focus on lengthening your inhalation. Stay connected to the earth. Ground down through your big toes. Engage your entire body by hugging your muscles to the bones. Do not overextend or deplete yourself. Your practice should be strengthening, not draining. If the vata imbalance is severe, a restorative practice is best. Stay warm and conclude your practice with a long relaxation.

5. Pranayama: In India, pranayama is generally taught in the two seasons of transition, fall and spring. During the fall season, start the day with Nadi Shodana (alternate nostril breathing) to help to purify the bodily channels. A regular practice of pranayama during the fall season helps to tune our breath, body and mind (see Yoga and the Mind-Body Connection). Pranayma practices could include Alternate Nostril breathing, Ujjayi pranayama and Surya Bhedana (Sun-Piercing), which create balance by providing warmth and stability to the body and mind. (Timothy has already introduced us to the concept of Pranayama with his article on Bhramari Pranayama and he will be addressing other Pranayama practices as well.)

6. Meditation: Follow your pranayama practice with several minutes of mindfulness meditation. During the fall season and for the overactive vata mind, meditation is one of the best ways to be grounded and to find calm and stillness.

7. Other Activities: Always stay warm. Wear clothing made with soft fabrics and earth colors (grounding energy). Get enough sleep. Enjoy regular, relaxing and peaceful walks in nature to calm the mobile body. Other great activities during this season include gardening, culinary activities, and creating art and music. Make sure all activities are followed with a sufficient rest period. Pay attention to the influences that you allow into your life—from the foods you eat to the amount of time you spend in front of a computer, cell phone or TV. As we get ready to welcome fall, let us experience perfect health, bliss and freedom every moment and throughout the season.

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Available on Video: Yoga for Healthy Digestion Practices!

by Baxter

Since I last wrote on subject of yoga and your digestive system (see Irritable Bowel Syndrome and Yoga), I completed two live one-hour lectures on the topic for YogaU Online, which are now archived and available on their website if you had hoped to join me live but could not. See yogauonline.com to access these lecture.

And, in addition to the information-packed talks, I completed a one-hour video practice on Yoga for Healthy Digestion in August! It is part of the package you get if you purchase the sessions from YogaU, and it is the first significant video practice I’ve produced in a long time, so I am pretty pleased to have it to share with you! To give you a sense of how I came up with the practices on the video, I wanted to share a bit about how yoga is applied to imbalances in the digestive system.

As I discuss in my talks on yoga and the digestive system, when you have an imbalance in your digestive system, it can often be classified in one of two ways: either a condition of excess digestive energy, such as with heartburn or reflux disease or a condition of deficient digestive energy, such as with chronic constipation. This way of looking at digestive imbalances comes from the work of TKV Desikachar, which I was exposed to back in 2005 when I studied at his center in India. Addressing these imbalances can then be done by applying a particular yogic quality to the practice you design to bring the situation in to better balance, towards homeostasis. 

If a condition is one of excess energy, you’d address it with a calming, cooling, restorative approach. The word we use in the world of yoga therapeutics to describe this is Langhana. On the other hand, if the condition is one of deficiency, you’d address it with a more stimulating, active or heating practice, known as a Brahmana practice. There is a slight paradox here however, for if your deficient condition is really causing you to be depleted, you can always start with a more Langhana style approach, and as your energetic reserves improve, switch to a more Brahmana style practice.  So, you can never go wrong going with the quieter, calming, gently grounding yoga practices, which include gentle asana, restoratives, pranayama (such as a 1:2 ratio inhale:exhale breathing), and guided meditations, to name a few of the Langhana tools.

In the video, you will get a 30-minute practice that exemplifies Langhana practice for conditions of excess and another 30-minute practice that exemplifies a Brahmana practice or conditions of deficiency. I hope you find both the talks and the video helpful as you attempt to get your digestion into optimum balance! You can find them both at yogauonline.com.

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Interview with Shari and Bonnie on Yoga for Chronic Pain

by Nina, Shari, and Bonnie

Grasses and Reflections by Brad Gibson

Shari Ser and her teaching partner, Bonnie Maeda, who is a registered nurse and a yoga teacher, will be teaching a special workshop on yoga for chronic pain this coming weekend, on Saturday, September 21 (see Brentwood Yoga Center). So I thought that it would be a good time to interview the two of them about this important topic. —Nina

NINA: Why did you two decide to teach workshops on yoga for chronic pain?

BONNIE: As I began teaching yoga with a therapeutic approach, it was evident that discomfort and pain were often a component for the student living with a chronic illness or injury. With the philosophy of teaching yoga to the whole person in a holistic way, I felt that there needed to be an awareness in the practice of the individual's experience of pain. As a teacher, I was also aware of another component for these students: the fear of pain (or of increasing their pain) was present as they practiced yoga.

The development of the workshop came after much thought and research on pain management. Iyengar yoga, with its focus on alignment, use of props, and teaching to the individual's abilities, is a wonderful healing modality for this student population. A workshop is a great way for a student to be introduced to a gentle yoga practice, as well as begin to know how to listen to the messages of the body, which will protect them from injury and pain while practicing a yoga sequence. For a yoga teacher attending this type of workshop, it will provide information about the physiology of pain, and how to support and maintain the safety of a student in a yoga class.

SHARI: People often come to yoga because they are in chronic pain and nothing they have tried in the past has alleviated this pain. Pain is very difficult to quantify and objectify, and our language to describe pain is often unsuccessful. The International Association for the Study of Pain defines pain as "an unpleasant sensory and emotional experience associated with actual or potential tissue damage or described in terms of such damage.” In his article in Yoga Therapy Today “Know Pain? A Brief Guide to Understanding Pain for Yoga Therapists,” Neil Pearson quotes Australian Physical Therapist, Lorimer Moseley, Ph.D.:

"Pain is a multisystem output that motivates and assists the individual to get out of a situation that the brain concludes is dangerous."

The key point is that pain is real, whether or not a diagnosis confirms it, and pain will be responded to by the whole person, including body, mind and spirit. This is where the application and practice of yoga can be so important because we meet the student where they are and practice with them. We don't do yoga "to” them!

NINA: What is chronic pain and what are some typical conditions that cause chronic pain?

BONNIE: Pain itself is defined as an unpleasant sensory and emotional experience. It is also the way the brain interprets this information that contributes to the experience as well. Acute pain is of short duration as a result of injury, surgery, or illness. Chronic pain is an ongoing condition persisting longer than six months. Kelly McGonigal, Ph.D., author of Yoga for Pain Relief, defines acute pain as a response to some kind of injury or illness. It begins with a real threat to the body and leads to a reasonable protective response. Chronic pain differs in three ways: 1) The body can become more sensitive to the threat of possible pain symptoms leading to feelings of fear and anxiety, 2) The brain can become more likely to interpret situations as threatening, and sensations as painful (eliciting a pain response), and 3) In chronic pain with the experience of repeated reactions to pain, the ability to differentiate the many aspects of the pain response (sensations, suffering, and stress )get blurred.

Some conditions associated with chronic pain are back pain, headaches, arthritis, fibromyalgia, and pain related to a specific illness.

SHARI: We can understand chronic pain if we put it into a mind-body-spirit experience. Pain changes everything that we do. It changes how we breath, how we move, and what we will or will not do. The anxiety that “if I do this will I suffer more later” is always present. Often there isn’t a direct correlation between activity and pain exacerbation so sometimes knowing what is possible isn’t an option because it changes. What doesn’t change is our anxiety and fear. Some of the physiological changes that pain causes include: 

• Breathing changes (the breath is more shallow and shaky) 
• Muscle tension changes because the body is in a constant state of “alert” 
• How we move changes dramatically as we try to protect the area of pain—sometimes people will stop all movement that they deem extraneous while others will grit and bear it only stopping when the pain is so intense that they can’t continue. 
• Body image (how we view ourselves) changes 
• Thinking patterns change: we are less optimistic and our emotions may be more changeable 

NINA: Why is yoga particularly helpful for chronic pain?

BONNIE: Yoga is beneficial for someone coping with chronic pain for many reasons. Studies have shown that mild to moderate exercise actually decreases physical pain! The increased flow of oxygen to the brain and muscle tissues improves your energy levels and sense of wellbeing. And combining breath awareness with the physical movements of a yoga practice helps release muscle tension held in your body. In addition, for people with certain conditions, such as arthritis, moving your joints through their range of motion and stretching your muscles can decrease the intensity of your pain or relieve your pain completely. Finally, practicing yoga on a regular basis may affect the response to pain, decreasing the level of perceived suffering.

SHARI: Yoga provides a system for the individual to re-learn how to inhabit their bodies. It assists the brain in learning to re-categorize noxious stimuli versus safe stimuli. The brain and body are on overdrive when you are experiencing pain for long periods of time. According to Neal Pearson, “yoga provides a path toward calming the body- mind- spirit…. And through yoga we can create positive neuroplastic change, leading to less pain, better movement and improved quality of life in the face of chronic pain.”

When we are doing an asana or preparation for an asana, it is through the gentle self exploration of learning how to move with the breath that we begin to approach pain with respect and humility. Learning how much movement is available and learning to respect those limitations is a way to improve function and movement over time. There can never be a time frame on how long it will take to get better!

NINA: Which are a few of your favorite practices for addressing chronic pain?

BONNIE: Setting the tone for a gentle yoga practice within a safe environment is primary when you teach individuals with chronic pain or when you start to practice on your own. So begin a sequence in a chair or on the floor, which helps reassure the practitioner that he or she can can practice at his or her own level of ability and comfort. Breathing and body awareness are a beneficial way to begin the practice, as it gives you time to feel comfortable, and to start to build confidence in yourself and the choices you make as you move through the practice.

Continuing with range of motion/stretching of the major joint structures offering modifications as needed. Standing poses are often fatiguing for people with chronic pain, although important to offer. To build strength and stamina over time, be sure to incorporate restful poses with attention to the breath between the standing poses.

Always end the practice with a restorative pose followed by Savasana to elicit the relaxation response. This reduces stress held in the body and creates a renewed sense of vitality.

SHARI: In general, I would say that you encourage the joint surfaces to move to their capacity without increasing pain responses. Utilizing props encourages the student to maintain the position for longer periods of time than they might actively be able to hold a pose. The longer a muscle is held in a gentle stretched position, the longer the muscle memory will last. Also, if pleasure is learned to be associated with movement, then the individual/body will crave that movement because of the pleasure association.

Doing standing poses builds strength and it is important to be both strong and flexible. Individuals who have restricted their movement for long periods of time will need to build strength slowly. Alternating between sitting and standing allows the student to begin to build strength within a safe context.

My favorite pose for addressing chronic pain is positioning your body in a supine pose with props (various versions of Supported Savasana). Ginger Garner, MPT (Professional Yoga Therapy) presents a wonderful three-tiered blanket set up for deep breathing. The blankets are set up so the lumbar spine is supported, the thoraco-lumbar junction is supported and the head is supported. I like to put a bolster under the knees and pad the heels, and support under the arms if necessary. I love this pose because it allows me to open my chest and to feel the rhythm of my breath. It allows me to focus my attention on my inhale and exhale, giving my mind something to focus on while supporting my physical structure. The more I breath, the better I feel!

If this position doesn’t work then try any restorative position that comforts and supports the body in as many places as possible. I like to think of the support as taking up “the gaps” so the whole body can touch the supporting surface.” If there are no gaps, then the muscles can be encouraged to release. By concentrating on the breath and, if possible, lengthening the exhalation, you can gently stimulate the Relaxation Response (the parasympathetic system).

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Friday Q&A: Forehead Massage and Endorphins

Q: I was wondering if you could help me find out if there is any medical evidence that endorphins are released when we roll our forehead on the mat in yoga? Some of the teachers that work for me say that and I just wondered if there is any medical evidence to support that? Or it just feels really good?

Chair Forward Bend
tugging the forehead skin down toward the eyes

A: Thanks for the interesting question!  I am uncertain if your are referring to rolling the forehead on your yoga mat from side to side, while in Child’s pose or rocking the forehead forward and back in a similar position. A technique I was taught by one of my early teachers was to place the forehead on the floor or a low prop like a block while in Child’s pose and then to push the head forward and give a slight tug to the forehead skin towards the chin. My teacher claimed this would have a calming effect on the nervous system, and that moving the opposite way (moving the skin of forehead toward the crown of head) would stimulate the nervous system. I have observed some truth in this pronouncement in my own practice and share it with my students. I cannot find any specific scientific study to explain what might be happening in the brain, but it seems possible that this has some feedback to the autonomic nervous system to shift from sympathetic to parasympathetic (Fight or Flight to Rest and Digest). Whether this is a result of the neurotransmitter class called “endorphins” or not, I also cannot say. But it does feel really good! I found the following info about endorphins on wisegeek.org and it indicates that massage can cause a release of endorphins, so I guess it is possible that this little scalp maneuver could support that assertion:

“Any type of physical activity that causes pain, such as exercise and eating spicy foods, releases endorphins in the brain. Excitement, laughing, crying, or engaging in risky activities can trigger the release as well. The body also releases them while relaxing with a massage, dancing, or when falling in love.
 
Endorphins, also known as endogenous morphine, are an arrangement of amino acids known as opioid peptides. These chemicals function as neurotransmitters that help regulate moods, sleep patterns and the way one responds to pain and stress. When present in the body, endorphins act as a natural painkiller and are able to provide a sense of comfort, wellness and happiness.”

Additionally, in Yoga as Medicine (by our contributing writer Timothy McCall), Timothy shares a similar exercise on pages 11 and 12, this one done while sitting, with the heel of the hands creating the same effect I describe above. Timothy notes that most people find the drawing of the skin down is more calming to the nervous system, but does not theorize exactly why. Yours truly is pictured doing the exercise! 

If this idea is new to you, give a whirl and let us know what you observe.

—Baxter

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Judith Lasater's Favorite Poses

by Nina

In her interview with us (see Judith Lasater on Yoga and Aging), Judith Lasater mentioned the poses that she currently practices, citing "especially Viparita Karanai (Legs Up the Wall pose), Supported Sarvangasana (Shoulderstand) on the chair and Supported Halasana (Plow pose) on the Halasana bench." By chance—or maybe not by chance if you stop to think about it—those are some of my favorite poses, and I recently had a friend take some photos of me doing them so I could share them on the blog. Then, as it happened, someone left a comment on the interview with Judith, asking us to share two of the poses with you: the Shoulderstand in a Chair and Supported Halasana with a Halasana bench. That was the kick in the pants I needed. (We've covered Viparita Karani many times on the blog—see Featured Pose: Legs Up the Wall pose.)

Here is a photo of the Shoulderstand in a Chair. I'm doing the pose with my legs straight up because that's the way I prefer doing it. Some people, however, practice this pose in more of a backbend, with their legs supported on a bolster and their feet over the back of the chair. But I find that position less comfortable.

Shoulderstand in a Chair

And here is a photo of Supported Halasana (Plow pose), sometimes called Arda Halasana (Half Plow pose). Okay, fine, I don't have a Halasana bench (a specially designed piece of furniture), but you probably don't, either. So I use a chair for Supported Halasana, instead. Yes, the good news is that you don't need a special piece of furniture to do this pose, but if you are using a chair, you need one that has no bar between the two front legs because you need to be able to get your head underneath the chair seat. And you also need a chair that either has no back panel or that has a space between the panel and the seat that is large enough to fit your legs through (I'm on the small side, so I can use a chair that has a back panel).

Supported Halasana

If you've never done these poses before, you may be wondering how the heck you get into them. Since I practice them all the time, and teach them whenever I teach yoga for better sleep, stress management or emotional wellbeing, I can tell you! However, quite frankly the process is complex enough that I've decided to do separate posts for each of the poses (we took photos of all the steps in and out of them, which will make that easier). But I will tell you that it's like learning to drive a car; at first the process is complicated and a little stressful, but with practice you get to a point where getting in and out becomes automatic and you don't even have to think about it anymore.

So it they take so much practice to learn, why should you bother? Well, as many of you know by now, I'm a huge fan of inverted poses in general (see Just in Time for Holidays: Inverted Poses). Because you are upside down in these poses, they automatically trigger the relaxation response (see Why You Should Love Your Baroreceptors). And perhaps because these poses are slightly more physically active than restorative poses, the rest they provide feels more refreshing to me. So when I'm fatigued, a supported inversion practice is just the trick. These two poses provide the extra advantage of placing your legs higher than your heart (as well as your heart higher than your head). Having your legs higher than your heart means that gravity helps return the blood in your legs to your heart, improving your circulation and reducing swelling in your feet, ankles and legs. So these poses are wonderfully restorative for your legs when you've been on your feet all day, whether standing for your work, walking or running.

Chair Shoulderstand is one of the most soothing inverted poses because you are both supported and completely inverted. Although full Shoulderstand is considered a calming pose, the reality is that for most people—even relatively flexible people like me—the unsupported pose just is not that comfortable. Chair Shoulderstand, on the other hand, is very comfortable and you can hold the position for quite a while. I like to hold it for at least 6 minutes, because I can feel my "quiet switch" turn on after around 5 minutes. And you can do the Chair Shoulderstand in place of full Shoulderstand in any sequence. 

Supported Halasana is a very quieting pose because you fold inward in addition to being inverted. Furthermore, as you hang from your hips in this pose, the traction on your back that this pose provides feels wonderful, particularly if your lower back is bothering you. That said, I really don't think this pose is for everyone. People who don't have flexible necks can find the extreme forward bending of the neck (flexion) in this pose uncomfortable. And some people with round bodies find it very difficult if not impossible to fold their bodies into this position. In this case, turning the pose upside down into a seated forward bend with head support is great alternative.

Supported Seated Forward Bend

Typically, if you were going sequence Judith's three favorite poses, you would do Chair Shoulderstand first, then Supported Halasana, and finally end with Viparita Karani (Legs Up the Wall).

Tip: for women with large breasts, which tend to fall into your face in these poses, I recommend tying a strap around your upper chest before going into the pose.

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Fizzy Yoga!

by Shari

Trees in the Ocean by Brad Gibson

I recently looked into physioyoga (aka "fizzy yoga") because I was very displeased with the knee rehabilitation I was currently receiving from a local and very well-respected (in the medical community) orthopedic physical therapist. I was displeased for a number of reasons but the most glaring issue was my feeling that she was myopically looking at my problem. She focused solely on my injury, not on the many parts of  the “whole me” that predisposed me to injury, and when I brought up the various imbalances in my body, she politely listened but refocused the visit on my acute injury. I would leave feeling frustrated, but I would dutifully do my home exercise program and feel my mind disconnect from my body as I was doing them. Though we could “talk shop” about my injury, she didn’t understand or appreciate my yoga practice and couldn’t recommend anything other than “take a couple of weeks off and rest your knee.” Well in my world that recommendation wasn’t going to pay my bills!

So I decided to be more pro-active. I found a local sports medicine internist who did less invasive office procedures and had my knee drained of the edema and injected with cortisone for pain relief. I also knew that I had to find another type of physical therapist who could look at me as a whole person, not just my knee injury, and begin to assist me in the road to healing. I figured I needed to meld the traditional medical approach with the CAM model (complementary alternative medicine) to begin to address my knee injury.

I was already a member of a group called Bridge Builders to Awareness in Healthcare, an internet group of rehabilitation professionals who all practice yoga and use yoga as a therapeutic modality or therapy to treat a wide variety of chronic and acute health care conditions that have not been successfully treated in the reductionistic American health care system. Perusing this site, I found a lot of talk about “fizzy yoga” and “physioyoga.”

On the various news feeds that I have on my computer there was a lot of talk about one of the stars from “Sex and the City” who was healed from a knee injury under the care of a “fizzy yoga” therapist. Her comments about how “fizzy yoga saved my life” were sensational to say the least, and I was intrigued not only by the name but by the enthusiastic endorsement.

On the Bridge Builders site, I found an article by a Canadian physiotherapist (that is their name for the profession that I call physical therapist) named Shelly Prosko, BPT, PYT, CPI, who wrote a definition of physioyoga for a local news station. Briefly, physio-yoga therapy (PYT) is a type of rehabilitation where the client (patient) and the  medical practitioner enter into an equal partnership toward healing. It is a holistic approach, where the focus is on individual self empowerment and self healing. The physio-yoga therapist is the guide in addressing the imbalances between body, breath, and spirit of the client within the guidelines and principles of yoga.

Upon further reading, I came across some writings by one of the influential originators, Matthew Taylor, MPT, EYT, about the new 21st century health care system (see here). In brief, he draws many parallels between soft tissue structural changes (body), effects on breathing patterns (spirit) and central nervous system vigilance (mind) , emotions (mind) that all interact to create dis-health. I felt that I had finally found my health care community and wasn’t “alone” with how I approached individuals in my physical therapy work!

Okay, so now not only was I hooked, I wanted to find someone in my area to assist me on my path to healing because I knew I couldn’t do it by myself. Looking on Ginger Garner’s Professional Yoga Therapy site, I found someone who was geographically close to me. I read the testimonials that prior patients had written so I could get a sense of her treatment approaches. (This was scary because usually all of my connections are from word of mouth and this was the first time I was doing a search “blind.”)

But from the moment that I walked into this fizzy yoga therapist's office I could feel the pragmatic shift in her model of health care delivery!  She asked me numerous questions, actually LISTENED to my answers and did an incredibly through structural evaluation (physical-therapist based) and started putting associations together between my various weak links. Together on that first visit, we worked on a simple home practice that made sense to me as well as to my knee. Well, I knew that together we would figure this out! We were partners together. It was more egalitarian and not hierarchical so there wasn’t a power discrepancy. Each and every visit I have had after the first is a meeting of minds. I come with my requests for care, she discusses her observations and together we work.

Though it still isn't 100 percent, my right knee is regaining function! I can now kneel with padding for very short periods of times. I can squat, though I still can't come upright without pain. I can sit in Virasana (Hero pose) on one block and I can do Child's pose. I still can't do a lot of the activities that I was doing before the injury, and now my uninjured knee (noting how much it was compensating) has become cranky as well. But I've made a lot of progress over the last 6 months, and hopefully with time I will make even more progress.

So that's my personal testimonial! But what about you? Should you seek a fizzy yoga therapist for your physical problems? Would there be any problems or conditions that would preclude you from seeking care of a fizzy yoga therapist/physio-yoga therapist? I would answer there is only one scenario where this type of health care approach wouldn’t work. If an individual wants to be “fixed” and take no active responsibility in their rehabilitation then I don’t think this system would work for them. You can’t just receive but do have to be an active participant. The fizzy yoga therapists are licensed health care professionals and are vested with the ability to practice their profession by the state they live in. What is different—and this is a huge difference—is how they approach the issue of injury and illness.

Finally, what would I recommend in looking for a fizzy yoga/physio-yoga therapist? I would start with the links listed above and add to that another link http://www.professionalyogatherapy.org/patients/find-therapist to search for someone geographically convenient. I would not choose an individual who has only taken a couple of weekend yoga continuing education classes, and then attempts to use yoga as a modality like other types of “exercise approaches.” In this type of yoga therapy, the clinician really has "walk the walk,” and can’t be an armchair or book yogi. Your therapist's personal practice is really important, in my mind, for them to use yoga as a healing modality. The depth of personal practice can be shared and modified to individual client needs.

Now you might be wondering, since I myself am both a yoga teacher and a physical therapist, am I going to become a fizzy yoga therapist and not just a patient? I think I have been doing yoga with my physical therapy patients for years, but I just never was upfront about it. I'd say things like: "Balance training; lets do some standing poses!", "Respiratory distress? Lets work on ujaaii breathing or deep belly breathing and posture, posture posture! Where is the still point?", and "Self pacing skills? Let's learn to move with intention." The difference is that I have never identified what I do with my patients as "yoga" unless they say to me "this is like yoga!" Because I work under the constraints of Medicare, I have to play by the rules. But my therapeutic skills and my yoga skills complement each other and aren't put into diagnostic boxes when I work clinically. So for now, I would classify myself as "an undercover fizzy therapist."

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