Yoga for Cancer: An Interview with Cheryl Fenner Brown

by Nina

Cheryl Fenner Brown by Melina Meza

It's a bit dangerous when I actually leave the house and attend a yoga event of some sort. Inevitably I start talking with a yoga teacher who is doing something really interesting, and I start pitching the idea of a guest post or interview on their area of expertise for the blog. Yep, I'm like that—relentless. Recently, I recently ran into a old yoga friend, Cheryl Fenner Brown, who I hadn't seen in several years—we used to practice teaching each other back in the days when we were training to be teachers—and found out about the wonderful work she's doing on yoga for cancer. As usual I made my pitch, and here's the result.

Nina: Tell us a little about yourself and how you got started teaching students with cancer.

Cheryl: I came to yoga in 2001 as a stressed out software trainer and gym junkie. After sitting at a computer all day I would rush to the gym and jump on the cardio machines with a book in my hand, music in my headphones, and usually a TV going somewhere nearby. Multitasking was so ingrained in my workday that it infused my workouts as well. The first time I took yoga and was asked to do one posture and breathe, it opened up my eyes to the freedom within slowing down and focusing on one thing. It wasn’t long until I dreamed of blending my work in teaching adults with my new-found love for the yoga practice, and in 2004 I started the Advanced Studies Program at Piedmont Yoga Studio.

After the 18-month program I still had so many questions, especially about how certain types of postures affect our emotions and energy. I was always asking, “Why do backbends make us feel happy and forward bends create calm?” I soon realized that more training was in store, and I enrolled in the Integrative Yoga Therapy’s Professional Yoga Therapists program first at Mt. Madonna and then at Kripalu in Massachusetts in 2007. The following year I was approached by Piedmont Yoga Studio to begin teaching a class for cancer patients, and the Living with Cancer program began with financial sponsorship by the Piedmont Yoga Community, a 501c3 organization that brings yoga to people with challenges. I continued to give classes at several other area yoga studios but I realized that I needed to connect with a cancer support group who could direct students into the classes. Then, in 2011 a student connected me with the Cancer Support Community of Walnut Creek, and I now teach two weekly classes and a monthly Yoga Nidra class at their location.

As I have continued to teach students with cancer and learned about how deeply this disease affects both my students themselves and their families, I have been humbled by the strength and perseverance I see on a daily basis. Also, I became a satellite caregiver to my father after he was diagnosed with cancer in 2010 and have now lost many friends and students to the disease over the years. I am honored to be able to show these people simple ways in which they can gain back some peace and comfort as they go through this life-changing process. It is truly empowering to witness.

Nina: Why do you think yoga particularly helpful for people with this disease?

Cheryl: When someone receives a cancer diagnosis, their whole world is turned upside down. Treatment decisions can seem overwhelming, and it is more important than ever to tap into the grounding and healing power that a simple, consistent yoga practice can provide. Then, when treatment begins, there are many side effects that can make recovery quite difficult. Often students complain of fatigue, pain, anxiety, insomnia, digestive issues, reduced cognitive function, neuropathy and lymphedema. Yoga asana, pranayama, mudra and yoga nidra are all helpful tools that can bring balance to the body, ease to the mind, and calm to the emotions.

For the past three years I have conducted research into how these yogic practices may help to reduce the side effects of cancer treatment at the Cancer Support Community (the research is fiscally sponsored by the Piedmont Yoga Community). I have gathered some very promising results this year, especially with increasing spiritual and emotional wellbeing. And the latest project is currently underway. You can read more about the project on my website. Research subjects are currently being accepted into the spring 2015 session, so if you or someone you know is interested, contact me at cherylbrownyoga@gmail.com.

Nina: Do you have any poses and practices do you especially recommend?

Cheryl: Yes, I recommend a very slow-paced combination of gentle movements that will stimulate the lymphatic system, which aids the immune system in distributing immune cells throughout the body. Simple movements such as Cat/Cow pose, lateral bends, and twists can be done lying, sitting, kneeling, or even standing so that students can practice with as much or as little activity as they require on any particular day. Calming and cooling pranayama, such as nadi shodhana, and rechaka kumbhaka, are helpful for reducing anxiety and creating a sense of calm. I also incorporate mudras or hand gestures into my classes because they can affect change in the energy, mood, and awareness of the practitioner. Mudras are simple and can be viewed almost like a yoga medicine cabinet; there is a mudra to help almost any physical, emotiona,l or energetic complaint. Restorative practice is also a perfect way to practice during treatment, especially on the days when there is the intense fatigue from chemotherapy and radiation. And, finally, I would recommend yoga nidra, a special form of guided meditation that is profoundly restful and rejuvenating. I have published several yoga nidra CDs that can be purchased or downloaded from my website.

Nina: Anything that should be avoided?

Cheryl: I would not recommend any intense form of asana practice, such as Vinyasa, Ashtanga, or Bikram, nor would I recommend deep, intense twists, backbends, or inversions. Overheating the body is not advised because traditional western medical treatments create residual heat in the body so the best practices are those that cool, soothe, and calm the body and nervous system. After treatment has ended, students can begin to incorporate more active practices as long as they are comfortable.

Nina: For people with cancer and want to get started practicing yoga, what do you recommend?

Cheryl: Look for a yoga teacher or yoga therapist who has experience teaching cancer patients, and don’t be shy about telling your teacher that you are undergoing treatment or if you have recently had surgery. Find a class that is billed as gentle yoga or restorative yoga. There may also be cancer support facilities or hospital classes in your area that specialize in yoga for cancer patients, so look around for classes designed specifically for those living with or recovering from cancer.

If you’re in the San Francisco Bay Area, I teach public classes in Oakland and Walnut Creek and also make house calls for private yoga therapy. My schedule is online here.

Nina: And for teachers who want to teach people with cancer, what do you recommend for special training? 

Cheryl: I would recommend additional training in yoga therapy or specific training in yoga for cancer patients. There are many great programs out there all over the country. I personally offer a six-month mentorship for 200-hour certified teachers who are interested in working with cancer patients. The mentorship involves attending and assisting one weekly class and three teaching assignments. I am currently accepting applications into the 2015 Yoga for Cancer Mentorship, and you can find out more on my web site. I also teach a weekend intensive Yoga for Cancer teacher training module through the Niroga Institute in May of 2015. You can register directly with them at niroga.org.

Nina: Thanks for taking the time to share all this with us, Cheryl. Your work is inspiring! 

Courtesy of Melina Meza

Cheryl Fenner Brown, PYT has trained with master teachers from Piedmont Yoga Studio and the Integrative Yoga therapy schools, and she blends both traditional Hatha teachings and alignment principles with subtle energy work and healing. Students appreciate her unique blend of philosophy, asana, mudra, chanting, pranayama, and yoga nidra delivered with compassion and humor. Cheryl encourages each student to honor where they are in their bodies every time they step onto the mat so deep healing and transformation takes place.

With over 420 client hours as a yoga therapist, Cheryl sees clients privately and has taught over 3000 public classes and workshops in studios and cancer centers around the San Francisco Bay Area. She serves on the faculty of the Niroga Institute's Yoga Therapy 800-hour and Piedmont Yoga Studio's 300-hour teacher training programs, and offers workshops and retreats for cancer survivors. She also conducts research on the benefits of yoga for reducing side effects of cancer. For more information about Cheryl, see her web site www.yogacheryl.com. To contact her, email her at: cherylbrownyoga@gmail.com.

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Intermediate Deltoid Training. By Larry Scott

Old School Training

Intermediate Deltoid Training

By Larry Scott

Article taken from Ditillo Blogspot. 

http://ditillo2.blogspot.ca

The goal of most bodybuilders is to build shoulders of really massive proportions. They don't care how, just as long as those shoulders stun the average person with their barn-door width. Unfortunately, this is just about all the average bodybuilder knows about the deltoids. Most are completely unaware of the three heads of the deltoid and how to develop each one. They are:

1. The Anterior, or frontal deltoid.

2. The Lateral, or side deltoid.

3. The Posterior, or rear deltoid.

The lateral is the most popular deltoid head, as it is the one that contributes the most to shoulder width. Steve Reeves was one of the leading proponents of developing this muscle, and it was really a sight to see him working them. He used to do Inclined Side Laterals until the area fairly burst with blood!

Although the lateral head of the deltoid is the most popular of the three, it is not the one worked the most. The anterior head gets that honor. Sounds rather confusing, doesn't it? Well, the answer lies in both the fact that Dips, Presses an Bench Presses work the anterior head very strongly, and also the fact that most bodybuilders simply use improper form in doing their lateral deltoid work.

Finally we come to the posterior deltoid. This poor fellow hardly gets any work at all, it's just left to fend for itself, growing through auxiliary exercises alone. If Nature was quick to do away with dis-used bodyparts, the posterior deltoid would soon atrophy into nonexistence.

Yet this lowly muscle is extremely important in developing depth in the shoulder region, for without it the shoulder will appear flat from the side. And, it appears flat because that's just what it is: flat. 

We have a saying around Vince's Gym, where I train . . . "Sure, he looks good from the front but is he a surfboard?" You've all seen surfboards, or pictures of them . . . they are wide and very, very flat. A "surfboard" bodybuilder is just the same . . . wide, but flat. They have no posterior deltoids at all. If you want this thin and round-shouldered appearance, okay, but if you want the well-rounded look of a champion, then posterior deltoid work is a real must.

The trouble encountered in deltoid work is complex and requires a real study of the movement of each individual head of the deltoid throughout an exercise motion. As mentioned before, the anterior deltoid is usually worked while the trainee is allegedly bombing his lateral deltoid head. The reason for this is the position of the elbows . . . it takes only a slight shift in their angle to transfer the stress of the exercise to the wrong deltoid head.

To help correct this, you should remove your training shirt and watch the movement of the muscle as you are working it. This is one time to really be a mirror athlete, to use that mirror to watch the three heads and make doubly sure you are properly working the muscle.

There are many problems such as this in your deltoid training, and in my exercise routines I've endeavored to answer as many of these problems as I possibly can. That is why I urge you to follow exactly as I explain the exercise movements in these courses. Probably one of the reasons deltoid work is so popular is the difficulty in obtaining them. It's the old law of supply and demand; the harder it is to get, the greater the value.

Exercises

All three of these courses are good. The first course is the easiest to feel, the second is a little more difficult, and the third is the hardest to feel. Try each course for a period of six weeks, then go on to the next. Each course is designed to take up where the previous one left off, in a logical progression. And remember, you are trying to develop your deltoids and consciousness of feeling the correct muscles working with these three courses. After that, the advanced courses will be applicable and will work efficiently, but not before. 

The three courses together represent a complete plan of shoulder development up to the intermediate stages. When you're ready for the more advanced training you should have symmetrical deltoid development, with impressive muscle size in all three heads.

Also, a final reminder is in order. Because the deltoid region is one of the very hardest to work correctly, you should read the exercise descriptions carefully and follow them exactly.

Now, here is your beginning course. The movements are not too difficult to perform, and they will help you get accustomed to the feel of the various muscles working.

Exercise 1 - Barbell Press

This is a movement where you can really use some weight. That is, you should do all your exercises in proper form, but in some, such as this one, you should also use as much weight as you can while keeping good form. In other movements the weight is not so important.

Start by holding the bar at your shoulders, with a grip slightly wider than the shoulders. If you wish, you can try it with an extra-wide grip . . . this works the deltoid equally well, and for our purposes where you hold the bar is just a matter of personal preference. I alternate between the two widths for a little variety.

When looking for bodybuilding results, the most important point to remember in doing this exercise is to keep the elbows as far back as possible while you're pressing the weight. If the elbows stray forward, the stress of the movement is transferred to the triceps in large part. Also, don't cheat with your legs . . . keep the knees locked throughout the movement.

Sets and Reps: beginners do at least 3 sets of 8 reps. Intermediates do 4 to 5 sets of 8 reps.

Exercise 2 - Upright Rowing

Try not to get weight-happy in this exercise, for your form is the most important factor. Wait until you have the movement down pat before you start to add more plates.

If you are doing the exercise correctly for our purposes you will notice the front and side deltoid heads and the trapezius starting to grow over time. An important point to remember for correct growth is to try not to lift the shoulders while you are doing the movement. Your arms are supposed to be doing the moving alone, otherwise the trapezius will get too much work.

Hold the bar in the center, either about six inches apart or with your hands together, depending on your preference. I usually do it with a little distance between the hands. Lift the bar straight up to your neck, keeping the elbows out in front of you. Lower SLOWLY and repeat.

Sets and Reps: beginners do 2 sets of 10 reps. Intermediates do 3 or 4 sets of 10 reps.

Course Number One

Exercise 3 - Incline Lateral Raise, Two Arms
The weight used in this movement is not too important, but the form is. Remember, these courses are designed to help you achieve proper performance of the exercises, and feel the chosen muscles working to the maximum. In doing that, you will prepare yourself for the more advanced work ahead and gain some of the muscle you desire as well.

Don't try to cheat in this exercise at all . . . lie with your chest flat against the incline bench (facing the high end)), and don't try to raise it at any time during the movement. Just raise the dumbbells as high as you can, out to your sides.

If you prefer, turn your head to the side for a bit more comfort. And, if you think the puny weights you're using aren't doing any good, you're wrong. The burn you get from this exercise alone makes it worth it weight in muscle . . . keep it up and you'll get some really sensational results.

Sets and Reps: Beginners do 2 sets of 12 reps. Intermediates do 3 or 4 sets of 14 reps!

Exercise 4 - Bentover Side Lateral Raise

The weight is a little more important in this movement than in the last, but form is again of paramount importance. Make sure you do it right, and don't be afraid to increase the weight when you can.

The exercise is excellent for working the side and rear deltoid heads, but you should watch yourself in the mirror very closely to make sure you're doing it correctly. Be sure to keep your shoulder low at all times, and just lift the arm. Do one arm and then the other right away . . . you don't need to rest between them.

Sets and Reps: Beginners do 2 sets of 12 reps. Intermediates do 4 sets of 10 reps.

Course Number Two 

The exercises are a bit more difficult in this group. The experience obtained from the previous course should make you ready for this batch, though. Inasmuch as the movements are more difficult, you should pay closer attention to the exercise descriptions and your performance of them. 

Exercise 1 - Standing Alternate Dumbbell Press

This is the heavy one of the group, so you should try to use all the weight you can while still maintaining proper form. Hold the dumbbells at the shoulder, and press one of them overhead. As the first one starts on its return trip down, press the other dumbbell up, so they are working in alternate fashion. And remember, for the desired effect, keep your elbows out.

Sets and Reps: Beginners do 2 sets of 8 reps, each arm. Intermediates do 4 sets of 8 reps.

Exercise 2 - Barbell Front Raise

A little cheat may be used in this movement, and consequently use a good, heavy weight. Just be sure you are lifting it up with the shoulders, not throwing it up.

Hold the bar with a shoulder-width grip, and lift it up and out with your arms locked throughout the movement. Do not use too much upper back motion, rather try to keep your upper body as stiff and motionless as possible.

Sets and Reps: Beginners do 2 sets of 10 reps. Intermediates also 2 sets of 10 reps.

  

Exercise 3 - Incline Bench Lateral Raise, One Arm

This is the exercise that the great Steve Reeves used to do all the time, and when done correctly it works solely on the side deltoid head, swelling it to large proportions. But this is another one of those exercises where weight is of minor importance compared to the exercise form, so you must do it properly for best results.

The arm is never locked out during the movement, rather always keep a slight break in it. The most important form factor is the position of your palm . . . everyone tends to bring up the inside of the palm, the thumb side, and this is where they go wrong. This will primarily work the anterior deltoid head, and not the lateral one. And, it's this side head you're trying to work hard. 

Well, the answer is to keep the rear of the palm higher than the front. This will severely limit the amount of weight you can use, but it also is the only way to correctly activate that elusive side deltoid.

Sets and Reps: Beginners do 2 sets of 10 reps. Intermediates do 4 sets of 10 reps.

Exercise 4 - Shrugs

This is a fairly easy exercise to do right. Remember when a teacher in school would ask you a question you didn't know the answer to? You just shrugged your shoulders . . . and that's all you do in this movement too.

The weight you can use is considerable, as the traps can really stand it. Hold the bar with a shoulder-width grip, and simply lift the shoulders up and return them to their normal position. You can alternate with a circular motion, if you wish.

Sets and Reps: Beginners should again do 2 sets of 10 reps. Intermediates do 3 sets of 10 reps.

Course Number Three

This is the most difficult of the three courses to perform correctly, but with your previous deltoid training you should be able to get through it okay. Let's get started . . . 

Exercise 1 - Standing Dumbbell Press

This is the heavy exercise of the group, so you should try for all the weight you can properly handle. And, keep trying to increase it whenever you can.

This exercise was one of the great Reg Park's favorites, and we all know what great deltoids he had! It is simple to do, and all the comments I've made before on Pressing still go. Keep the elbows as far back as you can, and simply press the two dumbbells overhead, with the palms facing away from you, to the front.

Sets and Reps: Beginners do 2 sets of 8 reps. Intermediates do 4 sets of 8 reps.

Exercise 2 - Alternate Front Raise

Use a fairly heavy pair of dumbbells for this exercise, and make yourself really strain. Hold the dumbbells in front, resting on your thighs. Raise one up to shoulder level, keeping the arm locked and the outside of the palm as high as the inside, then as you are lowering it raise up the other one. Keep alternating until you've completed your set.

Sets and Reps: Beginners do 2 sets of 10 reps. Intermediates do 3 sets of 10 reps.

Exercise 3 - Standing Side Lateral Raise

As in most of the lateral raise movements, form is the most important factor. Use only a weight that will pump the muscle well, and don't allow your form to suffer because of too much weight.

Allow a slight bend at the waist, and hold the two dumbbells in front of you. Bring the dumbbells up to the sides, remembering to keep the outside of the palm higher than the inside at all times. If you do not do this, the emphasis will be placed on the frontal deltoids, and your work will be wasted. Keeping the palms in this position restricts the amount of weight you can do, but will give you much better results in the end.

Sets and Reps: Beginners do 2 sets of 10 reps. Intermediates do 4 sets of 10 reps.

Exercise 4 - Rear Lateral Raises

This movement directly affects the rear head of the deltoid, and there is no better exercise for this bodypart. We use it religiously around the gym. 

Once again, the weight is of little importance compared to the exercise form, and the position of the palms is all-important. If you allow them to stray, the trapezius instead of the deltoid will be getting most of the work. Note also that the arms are not locked out, as this too would weaken the affect on the rear deltoid.

Many times this exercise is done with the head on a bench or something of similar height, for this takes the strain off the back and enables you to concentrate more on the movement. Try it and see if it helps you. Also, do not raise the dumbbells above the level of the shoulders, as this again will affect the traps more than the delts.

Sets and Reps: Beginners do 3 sets of 10 reps. Intermediates do 4 sets of 12 reps.

In Closing

There is a popular phrase that goes, "Little things mean a lot", and in bodybuilding this is especially true. You can see from the comments I have made how important little things like the angle of the palms, the lock of the elbows, keeping the arms back while pressing, all are essential to the success of your deltoid workouts.

Deltoid work has always been one of my favorites, and I hope you are as interested in it as I am. But you must be, or you wouldn't be reading this course. Well then, my best advice is to keep your eye unceasingly on the little things in your deltoid training, and to persevere in your training. As the delts are one of the smaller muscle units of the body, gains are often hard to see, and frustration is easily built up if you don't see new muscle blossoming rapidly. 

You have to work hard for anything you get in life, and in bodybuilding this is especially true. You spend all that time in the gym, sweating and suffering for that body of yours . . . so make sure that training is effective by always keeping your eye on those little things and always putting 101% into your training. That way your success is assured.

Best Wishes.

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Samyama: The Trinity of Dharana, Dhyana, and Samadhi

by Ram

Misty Morning on the Seine, Sunrise by Claude Monet

In earlier posts I discussed the first five of the eight-fold path or eight rungs/limbs/steps of Yoga as described in the Raja Yoga section of the Yoga Sutras by Patanjali. Each step or limb prepares us for the next higher step. Thus, the first three limbs (yama, niyama, and asana help to prepare the body and enable practitioners to become more flexible, stable, and grounded. The fourth limb, pranayama, consists of breath practice and is designed to allow you to gain mastery over the respiratory process while building a connection between the breath, the mind, and the intellect. The fifth limb, pratyahara, helps us to discriminate between the harmonious and disharmonious impressions that we draw in through the five senses.

Pratyahara serves as a fulcrum regulating external practices like asana and pranayama to internal observances like dharana (focus), dhyana (meditation) and samadhi (deep absorption). The three internal observances that also constitute the last three limbs in the Yoga philosophy have been described as “trayam ekatra samyama” and translates as “the three processes of dharana, dhyana, and samadhi, when taken together on the same object, place or point is called samyama”. While the first five limbs help us develop our power of focus and concentration, we continue to get distracted by our actions and our attention travels as well. Our focus constantly shifts as we try to become more adept at a particular posture or breathing technique. With a balanced breath, it becomes easy for the mind to focus on a single object or thought process while avoiding other mental dramas.

Dharana

Think about dharana or focus as the preparatory step towards attaining a deeper meditative stance. Dharana helps to reduce the chattering of the mind and filters out all irrelevant thought processes. To attain mastery over dharana, start out by focusing on any sound or a mantra (the silent repetition of a sound), or practice with an image or an object in mind. The most important thing to remember is that the goal is in the practice. If your mind wanders, just gently bring it back to focus without any judgment. Bringing the mind back to the object or the mantra—as many times as it takes—is what dharana is all about. The practice of dharana is not concentrating on the object rather it is the awareness with which you redirect the mind, again and again. This very practice—the mind running or getting distracted, you bringing it back—in essence is dharana.

Dharana does not have to happen only when we sit down to meditate. You can practice dharana when you are on your mat as well. Notice how your senses are acting during a pose: are you inundated with lot of thoughts, action, and dramas about the specific pose or are you intimidated by your neighbor’s perfect pose? Notice if your mind is very busy, constantly judging yourself or your neighbors. Can you gently practice pratyahara, let go of your sensory impressions, and start focusing on the pose itself? To “be in the pose” requires practice of dharana, letting go of the ego and focusing just on the pose so as to find your true self. Dharana gets easier as you practice it. When you get familiar with dharana, the mind becomes a much less restless place to be. Notice the joy, the pleasure, and bliss when you are able to successfully focus on something.

Dhyana

Since Dhyana (meditation) is a progression of dharana, the same techniques of dharana can lead you to dhyana. An extended period of focus prepares the path for dhyana. When the mind stops wandering and maintains a continuous period of stillness, at that point you are in dhyana. Dhyana or meditation is a state of being in which you are keenly aware without a need for focus and with the mind at its quietest. In that state of mind you no longer possess bodily awareness, the sense organs are not distracted, and the stillness produces few or no thoughts at all. In this state there is nothing else you can think about.

We can experience this state on the yoga mat as well. As you come back to a pose again and again, you are now able to do it smoothly and hold the pose without any distress or chattering mind, and you then become so overwhelmed by the pose that it becomes everything that you can think about. You are not distracted and you don’t want anything else as you feel transformed in that pose—you have achieved a complete state of satisfaction—this is dhyana. It comes when a process turns into something totally natural and there is nothing else you want to think about. It is not easy to reach the state of dhyana; one has to work towards it by means of dharana. It is for this reason that in the Yoga Sutras, dharana, dhyana, and samadhi are described as a three-staged process called samyama.

Samadhi

 As you start to focus on an object or a mantra or some task, and as you naturally gravitate towards it and become one with it, you experience samadhi, “the insight.” Patanjali describes this eighth and final stage or limb as insight, rapture, or a state of ecstasy—a state in which the individual merges with his or her point of focus and transcends the self altogether.

Having a continuous practice of meditation helps the individual to achieve the state of samadhi. As you sit to meditate, both mind and body relax into a state of deep and profound restfulness. Any dramas in the mind or emotional upheavals get dissolved without effort, and a personal experience of complete peace, joy, and creativity unfolds. Anyone can learn this, and it does not require concentration or mental effort. The benefits are immediate, tangible, and cumulative, and the practice itself is relaxing and enjoyable. Seasoned meditators can naturally and effortlessly go into this state of insight. In this meditative state there is no separation between self and the world around; the individual experiences complete oneness and in that state there is only peace. One can get a similar experience on the mat as well.

After an hour of asana practice on the mat, your experience of samadhi is heavily dependent on the status of your mind. You experience oneness and complete peace when you are totally unaware of “I” or “mine” with the body, mind and intellect working in complete unison. This experience may be momentary, maybe even a fleeting second, but it is an experience of truth, uncontrollable joy, and peace.

Thus, the ultimate objective of yoga is reigning in the fluctuations of the mind to achieve complete liberation from mental turbulence—seeing things as they truly are and experiencing only peace. This would be the state of samyama, the ultimate step—peace or enlightenment—which can only be experienced individually. As BKS Iyengar aptly put it, “You must do the asana with your soul.” This would mean being in samyama, which requires cultivating the quality of focus, concentration, and letting go of the ego, including your body image, to feel open, grounded, and calm and experience oneness with your true self. In this state, you experience contentment and enjoy a sense of accomplishment. It’s a great positive spiral and it results in improved health and happiness.

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Friday Q&A: Ehlers-Danlos Syndrome (EDS) and Yoga

Winter Leaf by Melina Meza

Q: Any comments for someone with Ehlers-Danlos Syndrome (EDS) that would like to practice yoga?

Well, most of you know by now I have comments about just about everything! And I suspect that most of you have not heard about Ehlers-Danlos Syndrome (EDS). But it turns out, I know two individuals with this inherited syndrome. I have had one regular student with EDS and know of another long time practitioner with it, too.

But before we get to my recommendations on how to approach your asana practice if you have Ehlers-Danlos Syndrome, here is the Mayo Clinic’s description of EDS:  

“Ehlers-Danlos syndrome is a group of inherited disorders that affect your connective tissues — primarily your skin, joints and blood vessel walls. Connective tissue is a complex mixture of proteins and other substances that provides strength and elasticity to the underlying structures in your body. People who have Ehlers-Danlos syndrome usually have overly flexible joints and stretchy, fragile skin. …. For example, overly flexible joints can result in joint dislocations and early-onset arthritis.”

The people with this syndrome who have the vulnerable blood vessels are much more rare than those who have joint and skin changes, so I won’t go into this truly uncommon variation of the syndrome. As for the more common presentation, I will point out right here that the overly flexible joints can start out as an apparent blessing to someone with EDS who is just starting out to learn yoga. After all, many yoga poses that have “advanced” variations often require unusual amount of joint flexibility. So, EDS practitioners might seem to “excel” quickly in mixed-level classes, where they are likely to be regularly introduced to harder postures.

The down side of this extra flexibility arises when these students do indeed start moving their joints into greater ranges of motion than most of us can do, and doing so on a regular basis. The other group of students who are also likely to have similar ability are women with the hormone Relaxin present in their bodies during and after pregnancy. While for pregnant women, this extra flexibility is short lived, this unfortunately is not true for people EDS. However, in both groups, excessive stretching of the joints can result in more and more unstable joints, which can lead to a variety of problems:

• balance can worsen
• joints can become more prone to dislocation;
• the ends of bones can rub on one another irregularly and eventually lead to early forms of arthritis
• underlying source of joint pain can develop

 So if I was informed that I had a student with EDS, I would caution them to go very gradually into poses requiring exceptional flexibility, under the guidance of a teacher who can give them external feedback on where to stop, as their joints won’t like do so. (The teacher would be using their personal and observational experiences of teaching other “normal” students the poses to gauge when the overly flexible student might need to back up or not go so far into a pose.)

And, secondly, I would encourage them to focus more on poses that promote strength and stability around the major joints, with an emphasis on contracting the muscles around the circumference of the joints while performing the pose. I’d apply this idea to the ankles, knees, hips, shoulders, elbows, wrists, and the entire spine. So, instead of encouraging the deepest, bendy-est, twisty-est pose possible, there would be more strength around all vulnerable joints, (which might limit the depth of range of motion as some joints).

As an example, in Triangle pose (Trikonasana), which could lead to overstretching of the front leg hip and knee joints, I’d suggest that prior to tipping into the full pose, you should contract and firm the muscles around the front leg hip joint and knee joint prior, and maintain the feeling of strength while entering and staying in the pose. Heck, I’d even have you do it on the way out, too! This action won’t allow you to go down quite so far into Triangle as you could by allowing the muscle around those joints to relax fully, especially the movement at the right hip joint. In addition, you front knee will be less likely to hyper-extend.

Obviously, this concept can be applied to poses more reliant on strength as well as those that favor more flexibility. And hopefully the teachers in our reading audience can emphasize to these students the deeper goals of yoga, such as promoting mental-emotional balance, non-harming (of oneself, in this instance), and longevity that might steer your EDS students to a longer-term practice that is most appropriate for their bodies and lives.

To read more about Ehlers-Danlos Syndrome, see Ehlers-Danlos syndrome by Mayo Clinic.

—Baxter

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Honestly? Progress Report on the Side Plank Pose Challenge

by Nina

Truth Rescued by Time, Witnessed by history by Francisco Goya

How’s the Side Plank Pose for Scoliosis Challenge working for you? I’m still practicing the pose as promised, but to be honest the experiment is not turning out the way I’d hoped.

I started out practicing the pose every single day, two times on my convex side and one time on my concave side. After several days, I started feeling wrist and hand pain in the pose. So I decided to start practicing the low version of the pose on my forearm on alternate days, just to give my hands and wrists a break. I also started doing wrist flossing on the days when I practiced the full version of the pose as a prevention strategy to try to ward off wrist problems. 

But even with all these modifications, I started feeling like this pose wasn’t agreeing with my body. I’d been having some lower back pain and stiffness before I started practicing Side Plank Pose every day, and it felt to me like the pose wasn’t helping that in any way. In fact, I began to develop a kind of dread about doing the pose. In my home practice, I really try to listen to my body and not just power through things because they are supposedly good for me. So finally I took a few days off from practicing the pose.

The next time I returned to practicing the pose, it felt a lot better to me. And I made a decision that I would no longer practice it six or seven days a week. Because I knew that practicing a strength building pose three or four times a week is often enough to build strength, I decided to go for a more modest strategy. Maybe this way of practicing would take me longer to improve my curve (if that happens—I learned that the type of low lumbar scoliosis I have is very rare) but it felt a lot safer. And I have continued as well to do my wrist flossing after doing Side Plank Pose. I’m happy to say that while I still don’t know what’s happening with my curve (I will be checked soon), my body is feeling better and my dread of doing the pose is over.

When I told Baxter about the modifications I was making, he wrote me the following:

“I agree that doing the same pose every day is going to produce some problems for students in the wrist, elbow or shoulder on the weight bearing side, although Loren denies that was a problem in their study.”

So how’s it going for you? Please let me know in the comments. Are you still practicing the pose? How does it feel to you? And how does your back feel? Did you decide to change anything about how and when you are practicing the pose? If you want to add wrist flossing to your practice as a preventative measure, we have a post on it Featured Sequence: Wrist Flossing.
 
For those of you who are not taking the challenge, do you follow your intuition in your home practice?

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Preventing Frailty with Yoga

by Nina

Old Woman with a Shawl and a Walking Stick
by Vincent van Gogh

“The fundamental problem with frailty is a reduced ability to bounce back from biological insults, such as infections and injuries. A relatively minor illness from which a non-frail elderly person would readily recover can throw a frail patient into a downward spiral of additional illnesses, sometimes leading to death.” —Richard Gunderman, The Atlantic  

Although I wrote about frailty a long while back (see Any Activity is Better Than None), I focused mainly on the recommendation to exercise as a way to preserve your muscle mass and strength, thereby avoiding declining from vitality to frailty as you age. I quoted a New York Times article "Aging Well Through Exercise" that cited several studies on exercise and aging, and included the following quote:  

“We think these are very encouraging results,” said Dr. Vonda Wright, an orthopedic surgeon and founder of the Performance and Research Initiative for Masters Athletes at the University of Pittsburgh Medical Center, who oversaw the study. “They suggest strongly that people don’t have to lose muscle mass and function as they grow older. The changes that we’ve assumed were due to aging and therefore were unstoppable seem actually to be caused by inactivity. And that can be changed.”  

But I didn’t really define what frailty is or why it is so important to prevent it. Now I’ve read a new article from The Atlantic The Challenge of Treating Frailty, which I felt did a good job job of defining exactly what frailty is.

Two elderly patients are admitted to the hospital. Both have the same condition, maybe pneumonia, maybe a hip fracture. Both are the same age. And both will get more or less the same medical care. The difference is hard to pinpoint, but from the moment they enter the hospital, a doctor can often tell that one will do well and the other poorly.

For a long time, medicine lacked a term to describe the patient who would do poorly, but now we have one: frailty. Frail patients are not sick—they have no particular diagnosable disease. But if they do fall ill or suffer an injury, they are much more likely than non-frail patients to fare badly. In one study that followed a group of elderly patients over seven years, the frail were more than three times likelier to die than their non-frail counterparts.

The article goes on to say that that precise definition of frailty is still evolving, but that frail people generally share a number of comment traits:  

• weight loss of more than 10 pounds in the last year
• frequent exhaustion
• low levels of activity
• slow gait
• poor grip strength

The article concludes by saying that our health care system is not well designed for dealing with frailty because it is designed around the diagnosis and treatment of particular diseases. So an elderly person who is suffering from frailty in general is going to go untreated until they suffer a crisis—at which point it is too late.

“To respond effectively to the challenge of frailty, the traditional approach of waiting to intervene until older people develop particular diseases won’t work. But promoting a more robust state of health through living habits could decrease vulnerability.”

So what are these “living habits” you may be wondering. As I already wrote in Any Activity is Better Than None, the big one is, of course, exercise, which not only preserves muscle mass and strength, but also, as the article says, enhances the function of the brain, the endocrine system, and immune system. Yoga, of course, provides a very adaptable form of exercise that be done by people of any level of ability or state of health, so it’s a form of exercise that is suitable—and beneficial—for people of any age . And although the article didn’t mention flexibility, balance, and agility as important physical skills to maintain as you age, we’re pretty sure these physical skills that yoga helps you maintain—along with strength—are important for preventing the development of frailty.

The article mentions two other living habits:

Good Nutrition. While the article says a well-balanced, varied diet that includes adequate amounts of calories and protein is important for avoiding frailty, it only recommends making that happen by having other people should check on the elderly to make sure they’re eating right. But what if you’re the elderly person? I’d say that one of main reasons older people don’t eat well, is that it can be difficult for them, especially if they are frail, to shop for and prepare food. So practicing asana to keep up your strength is going to have the benefit of making it easier for you to take good care of yourself by eating well.

Psychological Resilience. The article says that “relationships with others and cultivating a positive, hopeful outlook on life plays a big role in helping many older patients stay active and vital.” On our blog, we’ve talked about the importance of community for healthy aging Sangha: The Importance of Community and provided information about how you can join the yoga community can support you Eight Ways to Join the Yoga Community. We’ve also talked about how managing your stress levels can help prevent depression and anxiety (see Anxiety, Yoga, and Brain Chemistry and keep you psychologically robust as well as physically robust. And, finally, we have many posts about how yoga philosophy can help you cultivate equanimity as you age, allowing you to stay connected to life instead of withdrawing into inactivity and solitude (see Positive Psychology vs. Yoga Philosophy).

I don't know about you, but I think we're not only up to the challenge of "treating frailty" by getting older people to start doing yoga (see Yoga May be the Best Activity for the Elderly), but we are also excellently prepared to prevent frailty from developing in the first place. Yesterday I wrote about healthy aging in general (see Yoga for Healthy Aging is Not Science Fiction) and how our mission here at YFHA was to help you understand the ways that yoga can help you increase your health span. Using yoga to help prevent frailty as you age is exactly one of the things we had in mind.

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Yoga for Healthy Aging is Not Science Fiction: A Real-Life Mission Statement

by Nina 

Field of Mars by Marc Chagall*

“As more people are living longer and fewer are dying young from diseases caused by infections or insufficient food, exponentially more middle-aged and elderly people are suffering from chronic noninfectious diseases that used to be rare or unknown.” —Daniel Liberman

I’m just finishing up the Mars trilogy by Kim Stanley Robinson, a science fiction epic that takes place in the near future about the very first human settlers on Mars. The series spans a period of about 200 years, and several characters you meet at the beginning of the series are still alive at the end. When these characters are in their seventies and eighties, a longevity treatment is developed by Mars scientists that allows the original Mars settlers to continue to live active, healthy lives for an unknown amount of time. Although these characters do develop certain long-term memory problems (mostly about their middle lives), they continue to do productive scientific work, are energetic, physically fit and disease free, and even have active romantic and sex lives. Near the end of the series, a few of them die quite suddenly, not of any long, lingering diseases but very quickly of heart failure. And that seems to be the end that most, if not all, of them, will be facing.

Oh, if only old age was really like that, right? But this science fictional scenario actually exemplifies the very issues I wanted to talk about today. For when we talk about “healthy aging” on our blog, Sax, Nadia, Ann, Coyote, Michel, Maya and others in the Mars trilogy are ideal role models, not because of how long they live but for how healthy, physically active, and intellectually engaged they remain until the ends of their lives.

Lifespan. I guess this is rather obvious, but our “lifespan” is the period of time during which we are alive. But that lifespan could include any number of years spent in poor health. Sax, Nadia, Ann, et al in the Mars trilogy don’t have problems with ill health because in their science fictional world modern medicine can fix almost everything (although one man does die of leukemia). But here in the real world there are many medical conditions that just can’t be cured yet.

Morbidity. Right now, although our lifespans in first world countries have increased significantly due to better nutrition and modern medicine, as Daniel Liberman said in the quote above, middle-aged and elderly people in first world countries can suffer many years of ill health before they die. Lack of exercise, poor eating habits, and stressful lifestyles cause heart disease, strokes, diabetes, osteoporosis, and other chronic problems. This period of ill health during your lifespan is referred to as morbidity.

Now let’s do a little bit of very simple math:

Lifespan – morbidity = health span

Health Span. To put it in words, your “health span” is equal to your lifespan minus the amount of time you spend in ill health. This is the period in your life during which you are generally healthy and free from serious or chronic illness. For the people in the Mars trilogy, since they are very healthy until they suddenly die of heart failure, their health spans are very close to the length of their lifespans. But I’m sure in real life we all know people who live for years in a very debilitated state, perhaps in a nursing home, and I think we can all agree is not a future we would want for ourselves, if we can help it. (See Longevity vs. Morbidity for information about the epidemic of morbidity in the first world.)

So, to be clear, when we talk about yoga for “healthy aging,” we’re not talking about yoga for increasing your lifespan or your longevity. We’re talking instead about doing what you can to keep your health span as long as possible. And while you are makiing your health span as long as possible, we hope you'll also be making the period of time you spend in ill health near the end of your life as short as possible (this is called "compressed morbidity").

And, yes, we believe that yoga can help with this. Our mission here at YFHA is to explore all the ways that yoga can help foster your physical, mental, and emotional health during your lifespan (see Opening Your Yoga Toolbox). And because we’re not living in a science fictional universe, we must acknowledge that there will be times when ill health is unavoidable. But yoga has sometime valuable to offer you during those times as well, including both spiritual wisdom to guide you and tools for cultivating equanimity that will help see you through hard times.

This is all pretty basic stuff, but it’s worth saying because we want to set realistic expectations. We’ve certainly seen prominent new age health gurus out there claiming that you can “reverse aging,” choose your “biological age,” or “change your relationship with time” with yogic practices. But that really is science fiction. And here in the real world you deserve more than that.

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