Friday Q&A: Breath Practices for Anxiety

Statue and Bird by Melina Meza

Q: I’ve been having bouts of anxiety lately, especially first thing in the morning after I wake up. Is there a short, simple practice that I can do before I get out of bed that will calm me down so I can start my day in a better emotional state?

A: There definitely are some simple breath practices that you can use in the morning before you get up as well as any time during your day that you may find very helpful! In his post How Your Breath Affects Your Nervous System, Baxter gives the scientific background about why breath practices are so effective. And I myself regularly use a simple breath practice to help me relax when I’m feeling stressed and to help me fall back to sleep if I awake in the night.

I discussed your question with Baxter, and together we came up with a list of three practices that you can choose from. In general, all three are different ways of lengthening your exhalation. Because your heart rate is naturally slower on your exhalation than on your inhalation, making your exhalation longer than your inhalation begins to slow down your overall heart rate, sending a message to your brain that everything is more peaceful and calm than it was five minutes ago. This message encourages your brain to support this shift by activating the Rest and Digest or Relaxation Response (see The Relaxation Response and Yoga), which will reduce your stress hormones, quiet your mind, and hopefully quell your anxiety. 

Try all three techniques and see which ones work best for you. When you are initially learning the practices, it is best to do them for shorter periods. But I recommend over time working your way up to ten-minute sessions because it seems to take about 7 or 8 minutes for the Relaxation Response to take full effect. However, in a pinch, even a minute or two of a simple breath practice can help head off an anxiety attack, so even a short session can be very beneficial.

Exhalation Pausing. The simplest breath practice you can do is to pause briefly at the end of each exhalation. You can do this practice in a seated position or even lying in bed, on your back with your head supported by a pillow. Start by practicing basic breath awareness. This means focusing your mind on how your breath moves in your body, perhaps on how your belly rises and falls with your breath or, if it’s easier, how your chest moves with your breath. You could also focus on the more subtle sensations, such as the feeling of your breath moving in and out or your nostrils or, if you prefer, the sound your breath makes in your body. I actually like to lie on my back with my hands on my belly because that makes it very easy for me to feel the movement in my abdomen.

Now you’re ready to try pausing at the end of your exhalation. When you reach the end of your next exhalation, simply add a beat or two—without straining—before moving on to your inhalation. Keep it relaxed and easy. And if the practice irritates you in any way, simply return to your natural breath.

If at any point you realize your attention has wandered from your breath (it will, of course), simply—and without self-judgment—bring your attention back to your breath.

Bhramari (Buzzing Bee) Breath. This breath practice, in which you make a buzzing sound as you exhale, naturally lengthens your exhalation. To practice a simple version of Bhramari, start by inhaling normally through your nose. Then, keeping your mouth closed, make a low- to medium-pitched humming sound in your throat as you exhale. As you make the buzzing sound—which should last the entire length of the exhalation—tune into the literal vibration of the sound waves in your throat and even in your skull and brain. After you complete your exhalation, inhale through your nose, and if you're comfortable, repeat the cycle. Try to make your transitions into and out of each humming exhalation as smooth as possible. See Pranayama for Everyone: Bhramari Breath for more information.

1:2 Breath. In this breath practice, you actually control the length of your inhalations and exhalations, and aim for a ratio of 1:2, for example, a one-second inhalation and a two-second exhalation or a two-second inhalation and a four-second exhalation. 

Before starting this practice, spend a little time observing your natural breath and mentally counting the length of your typical inhalations and exhalations. If your inhalation is longer than your exhalation, start by making them the same length by consciously slowing your exhalation. 

Once your inhalation and exhalation are equal, try gently increasing the length of your exhalation by releasing air more slowly. Keep your breathing relaxed so you are not straining, and if at any time you begin to feel agitated, simply return to your natural breath. As long as your breath feels smooth and relaxed, continue to gradually increase your exhalation bit by bit until it is twice as long (but no more than twice as long) as your inhalation. If the 1:2 ratio feels uncomfortable or if you're gasping on your next inhalation, return to a ratio that is more comfortable. You can gradually work up to the 1:2 ratio with practice. 

Another way to lengthen your exhalation to a 1:2 ratio is to use a gentle version of Ujjayi breathing for your exhalation only. To do this, breath in normally through your nose, with a relaxed feeling in your throat and vocal cords. Then, as you start to exhale, slightly constrict your throat, keeping it very gentle and relatively quiet. This action in your throat is similar to the one who use on your sunglasses when you try to clean them off, and it will naturally slow down your exhalation a bit and bring you closer to the 1:2 ration. As you practice this form of breathing, relax your throat as you inhale, engage your throat a little as you exhale. 

Baxter recommends doing a set number of repetitions of the 1:2 breathe, such as six rounds or twelve rounds. Then let your breath return to its natural length and depth, and notice how things feel internally. 

If controlling your breath in this manner is stressful, practice the exhalation pausing practice described above instead, and maybe give the 1:2 practice another try after you have some experience with breath work under your belt.

Because chronic stress can exacerbate or even cause anxiety (see Chronic Stress: An Introduction), I think it is also important that you address your overall stress levels in general (see The Relaxation Response and Yoga). So see if you can manage to incorporate some time for gentle or restorative yoga or any form of conscious relaxation into your schedule.

—Nina 

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Featured Sequence: Dynamic Cardiovascular Health Practice

by Baxter

Heart health should be at the top of almost everyone’s priority list for the simple fact that cardiovascular disease is the number one cause for death in the US each year. More people will die this year from heart disease than will die from all the cancers combined! So, keeping your heart healthy can translate into a longer, more vital life for many of us.  The practice I am sharing with you today assumes that you do not have any active heart problems at this time. If you are not sure of your heart status, it would wise to visit your primary care doc to have a good physical exam and ask you doctor if you have any limitation on your physical activity. If you get the green light, than this practice should be both beneficial and safe for you to do. 

There are 4 basic components to this practice: 

Dynamic Yoga Sequences. Linked sequence of poses that you move fairly quickly, such as, the Sun Salutations, gradually warm up your body and your cardiovascular system, both strengthening and stretching the muscles and connective tissue that your body’s blood vessels pass through, thus exercising your heart and encouraging more efficient flow through the piping of your system.

Static Poses. Poses that you hold for longer periods increase what is known as the “work load” of your heart, providing a different kind of exercise and challenge for your heart. Those with high blood pressure and diabetes will have to approach these with poses caution and work into the holds very gradually, preferably under the guidance of an experienced teacher.

Gentle Inversions and Restorative Poses. These poses quiet and rest your cardiovascular system and your heart, which is equally important to testing and stressing your system. They allow your heart and nervous system to quiet, and as a result can nicely lower your blood pressure, heart rate and breathing rate.

Pranayama and Meditation Practices. These practices support the effects of the inversions and restorative poses.

Let’s get started!

Dynamic Cardiovascular Practice

1. Modified Sun Salutation (Surya Namaskar): Practice a Mini Sun Salutations as described at Featured Sequence: Mini Sun Salutation. As you stand in Mountain pose at the front of your mat, take a moment to check in with your body and your mind, setting an intention for your heart practice. Since this part of the practice will likely get the heart rate up a bit, feel free to do several rounds—anywhere from two to six.

2. Extended Side Angle Pose (Utthita Parsvakonasana): From Mountain pose, step your feet wide apart, turn your right foot and leg out 90 degrees and kick out your back heel an inch or so. Bring your arms up parallel with the floor and bend your front knee. Then side-bend your hips and torso over your right leg and put your right hand on a block on its highest height, placed snug up against the outside of your front shin. Swing your top arm up and overhead, completing the side angle from your back leg through your torso and into your top arm. Push down firmly into the block with your bottom hand, and feel your right shoulder blade firm into your chest and slightly down toward your waist. Reach your top arm and shoulder blade strongly forward towards your fingers. Since this is a static, held posture that will increase the workload of the heart, aim to stay in it for at least six breaths, and work your way up to 90 seconds over time. Inhale as you come up, relax your arms at your sides and repeat on the second side. 

Note: you can always create a “dynamic” version of any of the standing poses, moving into and out of the pose with your breath, as a warm up to doing it statically.

3. Side Plank Pose (Vasithasana): on the Wall and on the Floor: Although the classic version of this pose (Vasithasana) is done on the floor, the wall version of the pose is much more accessible because you stand on the floor and bear less weight on your arm. In addition to it being an upper body strengthener, it also opens up the area of the chest that surrounds the heart! 

To come into the pose, start with your right side to the wall, and reach your right arm out to your side, parallel with the floor, and place your palm on the wall with your fingers pointing up. Engage your right shoulder blade into your chest wall and down slightly towards the right side of your waist. Then, step both feet out away from the wall, until your right foot is positioned directly under your left shoulder. If your balance is good, try bending your left knee and bringing your left foot into Tree pose. Then take your left arm up and overhead, reaching strongly towards the wall with your left arm and shoulder blade, aligning it like the top arm in Extended Side Angle pose. Stay for 6 breaths and work up from there. Repeat on the second side.

If you are feeling strong, try coming into the full pose from Downward-Facing Dog pose. From Downward-Facing Dog, swing your shoulders forward almost into Plank position while keeping your hips lifted. Make your right arm stronger by contracting the muscles of the arm to the bone, and tip your heels to the right, bringing the outer edge of your right foot and the inner edge of your left foot to the floor, with your feet slightly apart. Turn your chest away from the floor and bring your left hand onto your left hip. Since this takes a lot of strength, stay just few breaths at first, and gradually add more time with more practice. To come out, swing back into Downward-Facing Dog pose and repeat the pose on the second side. Afterward, rest in Child’s pose a few breaths.

4. Locust (Salabhasana):  See Locust Pose for instructions on how to do the pose dynamically. Practice the pose dynamically as a way to warm up for the full, static version. In the full, static version, you will lift both legs, your chest and your head, and hold the pose for 10 seconds to start. Gradually add more time until you can do a 30-second hold. Rest for a few breaths before moving on. Because this is a backbend, it will open your chest around your heart and lungs.

5. Bridge Pose (Setu Bandha): Start in Constructive Rest position (on your back with knees bent and heels about four inches from your hips) with a block close by, and establish the normal, slightly arched shape of your lumbar spine. Then lift your hips straight up as you push down into your feet, like an elevator going up a few floors, maintaining the neutral arch of your lower back. Once in Bridge pose, bring some focus to your arms. Press the upper back of your upper arms (right where your arms meet the shoulders) firmly down into the floor while actively lifting the lower tip of your breast bone up to the sky. Then press your arms—which are lengthening towards your feet—firmly down into the floor as well. This will begin to encourage extension of your shoulder joints. 

Now, grab the block and place it under your pelvic bones, positioning it where a belt would be if you were wearing slacks, at whatever height feels good for your body. Stay for 1-3 minutes. This supported, partial inversion will encourage the benefits described above. To come down, lift your hips slightly off the block and move the block out of the way, and then lower your hips straight down, like an elevator returning to the lobby floor. Then, gently roll to your side and come up to sitting.

6. Simple Seated Twist (Sukasana Twist): Take whatever props you need to sit comfortably, from a folded blanket to a block or even a chair (see Learning to Sit on the Floor, Part 2). When you are comfortably seated, inhale and encourage an upward lift through your spine. Then, as you exhale, turn your chest and upper belly to the right, bringing your right hand to the floor behind you and your left hand to your right knee. Try to create the twist from the center of your body and allow your arms to simply support the shape. Stay for just a few breaths, and then release to center and repeat on the second side.

7. Pranayama: In your seated position (see Learning to Sit on the Floor, Part 2), or if you are fatigued, in a supported reclining position, turn your attention to your relaxed breathing pattern. At this point in your practice, it’s time to encourage relaxation and quieting of the heart and nervous system. So working with the gentle lengthening of your exhalations is a simple and excellent way to support that goal. In this breath practice, the classic ratio of the length of your inhale to exhale is 1:2, which could be a one-second inhalation and a two-second exhalation or a two-second inhalation and a four-second exhalation—you get the idea. The key is to keep your breathing relaxed so you are not over-efforting.  I like to do a set number of repetitions, such as six rounds or twelve rounds. Then let your breath return to its natural length and depth, and notice how things feel internally. 

8. Easy Inverted Pose (Viparita Karani modified): Finish your practice with this partial inversion. See Featured Pose: Easy Inverted Pose for complete instructions. While in the pose, focus your attention on the area of your heart, visualizing your heart as strong and steady, and also relaxed and rested. Try keeping your attention in this general area as you rest for five to ten minutes before returning the your day.

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Featured Sequence: Mini Sun Salutation

by Baxter and Nina

The Mini Sun Salutation a simple, accessible version of the classic Sun Salutation, which skips the Plank or Pushup pose and the Upward-Facing Dog or Cobra pose that is usually included after the Downward-Facing Dog pose. This modified Sun Salutation is a great way to warm up for a full Sun Salutation, and provides a simple alternative for people who are just starting to learn this sequence.

Because you move quickly from one pose to another in this sequence, the mini Sun Salutation cultivates agility (Cultivating Agility with Yoga), one of our four essential physical skills for healthy aging. The sequence also benefits your cardiovascular system (see Yoga for Heart Health), both strengthening and stretching the muscles and connective tissue that your body’s blood vessels pass through, thus exercising your heart and encouraging more efficient flow through the piping of your system.

This sequence is also quite invigorating, and can uplift you if you’re feeling depressed or stimulate you if you’re feeling lethargic. If you’re feeling anxious, you can use a Sun Salutation to work off some of your excess energy before you move onto more relaxing poses (see 10 Ways to Soothe Anxiety with Yoga).

Mini Sun Salutation

1. Start by standing in Mountain pose (Tadasana) at the front of your mat, with your hands in Namaste position in front of your heart. Take a moment to check in with your body and your mind. For your first round, start out at a reasonable pace and let yourself warm up gradually. 

2. On an inhalation, take your arms overhead into Arms Overhead pose (Urdhva Hastasana).

3. On your exhalation, bend forward into Standing Forward Bend (Uttanasana) with your fingertips on the floor if possible. If you can’t reach the floor with straight legs, either place your hands on your shins or bend your knees slightly.

4. On your next inhalation, bend your left knee and step your right foot back onto a High Lunge pose. Keep your fingertips on the floor on either side of your front foot. If it is not possible for you to touch the floor, support both hands with blocks. 

5. As you exhale, step your left foot back in line with the right foot and come into Downward-Facing Dog. Consider staying for 3-5 breaths. Since Downward Dog is a partial inversion, you are assisting in the return of blood from the veins of the body back to the heart, as side benefit of most inversions for heart health!

6. On your next inhalation, swing your hips forward as you step your right foot to the front of your mat, coming into High Lunge once again. (Sorry, no photo yet of left foot forward in the lunge.)

7. On your exhalation, step your left foot forward to meet your right foot and come back to Standing Forward Bend (Uttanasana). 

8. On your next inhalation, bend both knees and sweep your arms and torso up into Powerful pose (Utkatasana). 

9. Stay in Powerful Pose for a breath. Then, on your next inhalation, straighten your legs and body back to Arms Overhead pose.

10. On your exhalation, release your arms and bring your hands into Namaste position if front of your heart. Take a moment in Mountain pose to check in with your body and your mind before continuing onto the next side.

Repeat the sequence again, this time leading with your left foot. Since this part of the practice will likely get the heart rate up a bit, feel free to do several rounds—anywhere from two to six.

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The Second Branch of Yoga: The Niyamas (Your "To Do" List)

by Ram

Path at La Cavee, Pourville by Claude Monet

In my post Ashtanga Yoga: Following the Eight-Fold Path Ashtanga Yoga: Following the Eight-Fold Path, I defined Ashtanga Yoga (Ashta=eight; Anga=limbs) as the eight-fold path/eight rungs/limbs/steps of yoga, whose practice helps us to discriminate between ignorance and awareness and truth from illusion which is the means for liberation or enlightenment. I followed it up by discussing the first of the eight steps Yamas  as moral and ethical strategies that guide us to lead a conscious, honest and ethical life.

Today’s article focuses on Niyamas, the second of the eight rungs or limbs. If the Yamas are "don't do" practices," the Niyamas are the “to do” practices. These are personal observances/practices of self-training and deal with how we relate to the environment around us as well as to our own selves. The five niyamas are: 

1. Saucha=cleanliness
2. Santosha=contentment
3. Tapas=spiritual austerities
4. Svadhyaya=study of the sacred scriptures and of one's self
5. Isvara pranidhana=surrender to divinity 

Saucha (Cleanliness): Many teachers discuss this topic as cleanliness of the body. But Saucha is cleanliness and purification at the level of both body and mind. In addition to keeping our body clean and eating healthy food, it also includes harboring pure thoughts. A purified body brings clarity and purity to the mind. A clear and pure mind draws only harmonious impressions that allow the individual to walk on the path of truth, so Saucha lays the foundation to understand our true nature. Therefore, it becomes essential to find time each day to practice the observance of Saucha. 

Santosha (Happiness/Contentment):  To be contented and happy even while experiencing life’s difficulties becomes a process of growth through all kinds of circumstances. Santosha means being happy with what we have rather than being unhappy about what we don't have. Humans are always seeking for more and never seem contented with their materialistic possessions and internal fantasies. This leads to misery and triggers the disease process. However, if we are contented with our wants, wishes and needs, and truly happy with our lifestyle and what we currently have, it will help us in the journey to absolute truth and the highest realization. Your own test for Santosha would be about whether you respond through the five senses and react to the changes in all the circumstances of life or whether you listen to your inner voice and are not swayed by the material instincts. For more on this, read my article Santosha: Happiness and Longevity.

Tapas (Spiritual Austerities): This term is derived from the root word “taph,” which means blaze, burning, discipline, and illumination, and refers to a burning desire or a disciplinary approach to achieve one’s aims and aspirations. Several teachers translate this term to mean austerities; the reason being that in order to reach your goal in life, you need to have motivation, fiery discipline, focus and intense commitment. These qualities help to burn/ward off the mental obstacles and physical impediments that keep us from being in the true state of yoga. The goals of Tapas are:

• stopping being dictated by the five senses
• reigning in the mind
• listening to the voice of intellect
• performing mindful actions

When you act from your intellect and nurture your burning aspirations, you are freeing yourself from the many mindless actions that cause suffering. The effort you use when you engage tapas is directed toward cultivating meaningful and healthful habits whose practice now seem effortless. No longer is it a discipline, but a way of life.

Svadhyaya (Self Study): This term is derived from the root words Sva=Self and Adhyaya= study, education, knowledge, wisdom. I interpret Svadhyaya as education of the self, introspection, and self-realization. Self-study and realization help the mind to become clear or pure and develop deeper mind-body awareness. A clear mind is not affected by stress and produces a healthy body, thus creating a greater connection with one's own pure, essential nature. The path to self-realization is also through introspection and contemplation of our own life’s lessons. Introspecting about our emotions, thoughts, actions, and reactions helps us to learn about our own self and our true nature. When we reflect on our flaws and allow our mistakes to serve as learning lessons, we have the opportunity to grow. By turning a witness to your own self, you begin to notice what’s happening within you—your sensations, thoughts, emotions, and feelings—thus, through the process of self study you are empowering your self. 

Ishvara Pranidhana (Surrender to Divinity): This term is derived from the root words Isvara=state of collective consciousness and pranidhana=presence, dedication, devotion, and surrender to the fruits of practice. When we expand our individual consciousness and merge with the universal consciousness, we experience true self. Our world is a reflection of our own consciousness, and our experiences in the world are determined by what is going on within our consciousness. This individual identity masks the true nature of consciousness. Through the process of awakening and surrendering to the outcome of our actions we have the ability to take actions that do not serve the ego but which originate from our own consciousness. Through study, inquiry, reflection, and awareness, our consciousness is able to pierce through the illusory world, achieve mind-body awareness, and ultimately attain enlightenment. Notice and observe that ultimate state is divine, loving, and peaceful, and gives the feeling of oneness with body, mind and spirit.

Thus, Niyamas help us to perform those activities that not only empower us but the society around us as well. Such beneficial activities do not disturb the Self’s natural balance and the environment around us. Performing these activities assists us in gradually recognizing our true nature. The body is at ease; the mind attains peace.

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Practicing Difficult Poses

by Nina

During my fifties, I had two bouts of frozen shoulder that really set me back as far as which poses I could practice. As I began recovering, I decided to gradually work back into practicing some of the more challenging poses that had once been part of my weekly practice but that had become inaccessible. There was one pose I wasn’t sure that I’d ever be able to do again because my shoulders just didn’t have the mobility they used to have: Upward Facing Bow pose (Urdva Dhanurasana). But because I had loved practicing this pose—it’s very uplifting—I decided to give it a try. Besides, I knew that any form of the pose, even with crazy amounts of props or assistance from a partner, is still the pose, so if I never got back to where I was, well, what of it? It’s like Brad said back in the very first week of our blog (see Full Disclosure),

We probably need to practice both acceptance and active engagement as we confront our own aging—part of the underlying philosophy of yoga that I am still struggling with.

To work toward full Upward Bow again, I started by practicing the pose over a chair back, walking my hands down the wall. This allowed me to experience the shape of the pose—and get that wonderful opening in my spine and shoulders—without pushing up from the floor, something I was no longer able to do. I also worked on building back my upper body strength with Downward-Facing Dog pose (Adho Mukha Svanasana), Side Plank pose (Vasithasana), and Upward Plank pose (Purvottanasana).

Eventually I felt ready to try pushing up into the pose with my hands on slanted blocks, a technique that makes it easier for people with tighter shoulders to get into the pose. After some time practicing with slanted blocks, I moved onto flat blocks for a quite a while. Because that seemed pretty challenging, I thought the flat-block version might be it for me, but then, one day I was lying on the floor ready to use the flat blocks when I suddenly had a intuition that I was ready to do the pose without props. So I gave it a try and it was easier than I was expecting! Now I’m 62 and I’m practicing the full pose on a regular basis, and I’m even starting to toy with the idea of practicing a backbend that was much harder for me back in the day: Dwi Pada Viparita Dandasana.

I’m telling you all this today because we received an email recently that I thought brought up some really important questions that are applicable to everyone.

I have a question I wrestle with daily. As a 57 year-old female who practices gentle yoga 3-5 times most weeks, I find I am working toward the "maintenance" phase of my yoga practice as well as other areas of life. This means letting go of the goal of adding more difficult postures. For example, I chuckle at how my hamstrings now tighten between practice and I feel that I am starting over as a new student at the beginning of each practice. So, the question I wrestle with is: "Do I want to enjoy my practice and accept this aging process or try to ramp up my practice (in a safe manner)." Discerning what is aging and respecting your body is sometimes difficult. I would value your knowledge about the physiology of the bodily changes that occur during middle age.

From my observations—and I’m sure Baxter will back me up on this—there is no built-in schedule for the physiology of changes that we experience during middle age. So we can’t really tell our reader—or any of you—at what age your body will change or how. For example, I remember when a well-known, long-time Iyengar yoga teacher needed both her hips replaced in her fifties. On the other hand, I can think of another well-known Iyengar yoga teacher in her late sixties with an extraordinary practice who seems as physically adept as ever. According to his son T.K.V. Desikachar, Krishnamacharya was still practicing advanced yoga poses until the age of 96 when he broke his hip. 

Clearly your body will eventually change in a way that will make it impossible for you to do everything you once could. But how and when that will occur is highly individual probably based on genetics, your body type, and your fitness levels. So you’ll need to use your powers of observation to gauge how your particular body is changing and what your own abilities are at a given time.

First, you should consider any physical problems or illness you might be experiencing. Does that condition preempt your ability to do certain poses safely? For example, arthritis of the neck would preempt Headstand or deep backbends where the neck is in full extension and knee problems would preempt Lotus-based poses. This is sensible behavior for anyone of any age, and if you have doubts, you should consult your doctor or health care provider. But if you’re in good health with no physical problems, I don’t see why you should rule out adding difficult poses to your repertoire. 

Of course, if you’re completely satisfied with what you’re doing, there is no need to change your current routine. But if working toward a challenge pose appeals to you, this is a good way to enrich your practice. (It’s no secret that my home practice started with my wanting to learn some challenging poses—see Yoga: The Poetry of the Body.) 

You do want to work toward the more difficult poses in baby steps so you don’t suddenly throw yourself into something you’re not ready for. As a trained yoga teacher, I knew how to work toward Upward Bow. However, if you don’t have this kind of information for the poses you want to take on, you could consult with your yoga teacher about recommended steps toward that pose. Then, as you start taking your first baby step, let go of all thoughts of success or failure and simply focus on your practice. In this way, your asana practice becomes a form of true yoga: 

Set thy heart upon thy work, but never on its reward.

Work not for a reward; but never cease to do thy work.

Do thy work in the peace of Yoga and, free from selfish desires, be not moved in success or failure.

Yoga is evenness of mind—a peace that is ever the same. — trans. by Juan Mascaro

This way, no matter whether or not you actually achieve your challenge pose, you’ll be prepared to handle it. And outside the yoga room, this yogic approach allows you to cultivate equanimity in your daily life. See Acceptance, Active Engagement and The Bhagavad Gita for more on this topic.

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Friday Q&A: Yoga for Surgically Repaired Scoliosis

Q: I have a new student in my basic class who has a rod in her back due to scoliosis.  Has anyone had this experience and have any suggestions? She is young and healthy.

A: Some of our readers might think that this is an uncommon occurrence in a yoga class, but I myself have had several students over the years with scoliosis who had undergone a “fixation” procedure to try to improve the straightness of their spine, to try to prevent the abnormal curves of their scoliotic spine from getting any more dramatic, or to reduce the pain from the scoliosis. 

The first successful procedure of this kind was the placement of a “Harrington rod”—named after the doctor who pioneered the technique—along the length of the spine, usually from the upper chest (thoracic spine) down into the area of the lower back (lumbar spine). The rod is then “fixed” to the spine via wires and screws. The rod essentially immobilizes the part of the spine it is connected to from moving in any direction (see All About the Spine: Anatomy and Movements). Since the introduction of that surgical technique, several others have also been developed and are used today.

So, once a person with scoliosis (see Friday Q&A: Scoliosis) has had this procedure done, how would that affect their yoga practice? The section of the spine that is fixed to the rod is now not likely to change shape over time, but has very little movement possibilities. It turns out that the joint at the top of the spine directly above the last fixed vertebra and the joint at the bottom of the spine just below the last fixed vertebra are now the spots where the spine can still move. That means that these two areas are where forward bending, back bending, side bending, and twisting movements might be able to actually take place. But this puts an excessive burden on those two areas, and they run the risk of being overworked and becoming a future source of dysfunction and discomfort!

Fortunately for me (and you!) I ran into a local expert on yoga and scoliosis, Sandra Razieli, at the farmer’s market the other day and we talked for a while about her approach to working with this situation. I should mention that Sandra herself has scoliosis, and has used yoga to address her own challenges with the condition, as well as teaching specialty classes on scoliosis for many years. She stressed the following four goals in working with scoliosis when there are rods attached to the spine: 

1. Work on lengthening the spine. Although the practitioner should focus on lengthening the spine in all poses, I’d particularly recommend practicing poses such as Mountain pose (Tadasana), Downward-Facing Dog pose (Adho Mukha Svanasana) or variations, Plank pose (Phalakasana), Triangle pose (Trikonasana) that encourage internal lengthening via imagining lengthening from the tailbone to the crown of the head actively while in the pose. In addition, partial inverted poses where the spine lengthens with gravity, such as Standing Forward Bend (Uttanasana) and Wide-Legged Standing Forward Bend (Prasarita Padottanasana), if done without allowing the force of gravity to round the spine into forward bending shape, may also be beneficial. For Uttanasana, consider reaching the arms out to a chair seat, and for Prasarita Padottanasana, consider lengthening forward with the torso and hands, as in Downward-Facing Dog pose.

2. Stress the “strengthening” aspects of the poses. Strengthening the muscles of the front body, back body and side body enables these muscles to assist in keeping the spine long and in its neutral curves. I’d say that some of the same poses I just mentioned for lengthening will also promote strengthening, and you could add in any version of Side Plank pose (Vasithasana), Hunting Dog pose, and Reclined Leg Lowering pose (Urdhva Prasarita Padasana) as well.

3. Focus on directing your breath into the area of the rib cage where there is still compression. Breathing into compressed areas in all yoga poses can help to widen and open up the chronically narrowed spaces between the ribs that result from the curved and twisted spine.

4. Minimize twisting actions. Twisting actions can stress the two mobile spinal joints at the top and the bottom of the fixation, and can also stress (and potentially loosen) the fixation of the rods to the spine. 

Sandra also recommended looking up her good friend from NYC, Debra Wolk, who has a studio dedicated to yoga for those with scoliosis Yoga Union Center for Back Care. Debra offers classes, trainings and workshops for those with scoliosis, both with and without rods in place. This New York Times article Yoga Classes, Even With a Fused Spine features her studio and the wonderful work she is doing. 

—Baxter

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Learning to Sit in a Chair

by Nina

If you were to see me sitting at my desk right now as I write this you might think I look a bit strange. Because while I’m writing, I have a yoga strap wrapped around my thighs and my feet are resting on a yoga block. Why am I doing this?

Well, Baxter’s recent post on sitting (see Learning to Sit on the Floor, Part 2) talked about how to use props to sit help you sit comfortably on the floor, and that reminded me that for someone like me who spends many more hours a day sitting in a chair than on the floor, using yoga props at my desk can help me sit more comfortably in my chair! And lately my right hip and leg has been bothering me (I have mild arthritis in my right hip—see Goodbye, Lotus Pose), so I’ve been looking at what I can do both in my yoga practice and in my daily life to reduce my discomfort. And one thing I’ve been noticing is that I tend to sit with my legs crossed, even though I can feel it is hurting my hip—such a strong habit. So I realized that if I wrapped a strap around my legs, I’d be unable to cross my legs—yes, that feels better.

As it happens, using a strap like this can be helpful for most of us. Baxter recommended using a strap around the thighs in his post Friday Q&A: Sleeping on an Airplane to keep your legs symmetrical while you sleep. So if you sit at your desk with crossed legs and want to break yourself of the habit (hours of sitting in an asymmetrical position could be stressful to your body), try tying your legs together. Have it be loose enough so your knees are in line with your hip joints (not touching) but tight enough so the strap supports your thighs in place.

In his post about sleeping on an airplane, Baxter also recommended using a small pillow, folded blanket, or even a piece of rolled-up clothing for lumbar support. I’m sure many of you would find this helpful for maintaining the natural curves of your spine as you sit. Here are his instructions:

First, scoot your butt as far back into the seat as you can. Tip forward from your hips a bit, then place your lumbar support in the small of your back and lean back into it. Feel free to tinker with it so it feels just right for you. 

While I was noticing how my sitting position improved with the addition of the strap, I observed once again that because I’m on the short side, my feet don’t fully rest on the ground when I’m sitting on a chair, especially if I’m sitting with my butt against the back of the chair. So I decided to add the block under my feet—yes, that feels better, too. 

I thought I’d share all this in case you’ve never thought about using props to improve your seated posture while you’re in a chair. People who are on the shorter side like me will often benefit from a footrest, either official or unofficial. People who are tall on the other hand will benefit from raising the seat of the chair so that as Shari mentioned in her post Learning to Sit on the Floor, Part 1 their knees are lower than their hips. Some people have adjustable office chairs, but if you don’t, you could add a firm folded blanket or a firm cushion to your chair seat to raise the seat up. This will make it easier for you maintain the natural curve of your lumbar spine—important for the health of your back—as you sit in your chair.

If you tend to slump and feel like going to extremes, you could even use a yoga strap to prevent your back from rounding. 

How about you? Do you ever use yoga props at your desk? And if so, what do you use? I’d love to hear your recommendations!

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