Taking Care While Going into Extension

Going into Extension Range of Motion of the Spine and Hips doesn't always feel good!  And there are reasons for that.  Most are due to the aging process of the spine and probably what you've done through your life to progress that aging process.  In another Blog, "Educated Assumptions for Teaching Yoga for Spine Health", I talk about the normal aging process of the spine and how I create yoga programs and cue to the general population of folks that attend my classes.  The position that I am most cautious about is extension because I respect the aging spine.  However, I also think that it is the most important position and a motion we are losing due to our epidemic of sitting.  As we age, we are stiffer and these postures are going to lead to permanent change unless we address it NOW.

In trying to describe precautions while going into extension, I will use my own spine.  I have degenerative changes between L5 and the top of the sacrum (aka S1).  This means that I have worn down the disc at that level and I have less height between L5 and S1.  Less height means that I don't extend as much as I used to at that level.  Here are a few pictures to show you what I mean:

Lumbar vertebrae and Sacrum with equal space between each level

Degernative Disc Disease

As I move into extension, that L5/S1 level comes to end range quicker and I feel a twinge of pain.  Does that mean I should never go into extension?  Let me say a resounding HELL NO!!!  All the more reason to learn how to go into extension so that this level does not keep degenerating.

What it means is that I need to get my extension from other areas.  In fact, I think the reason that L5/S1 broke down in the first place is because my years of sitting (thank you PhD and academic life!) stiffened my hips and thoracic spine, i.e. the areas above and below L5/S1.

This follows with the concept of regional interdependence.  The body is going to move, and it is going to get that movement from where ever it can.  If the thoracic spine is tight, then the lumbar spine needs to move more.  If the hips are tight then the sacroiliac joints and lumbar spine must move more.

Pain in that area is my warning sign that I am at end of range for that level.  I need to protect that area with a little flexion provided by my lower abdominal muscles and gluteal muscles, while extending in my hips and thoracic spine.  It takes concentration and muscular control to achieve this.  That is why I give the following cues in standing poses like Warrior 2, Triangle and Side Angle:  "draw the tailbone down", "tighten your bottom", and "draw the lower belly up and in".  All of these instructions are to create a little flexion in the lower lumbar region.  I also instruct to NOT over-correct to flatten out the entire low back.  You want to keep the natural lordosis of the low back if that is comfortable.

For some the excessive amount of extension  in the low back demonstrated here would create pain during Warrior 2

I use similar cues to create hip extension while maintaining a "neutral" position of the low back.  Most people are so tight in the front of the hip, that any pose with hip extension like Warrior 1, Low Lunge, and most poses on the stomach immediately create excessive low back extension.

The goal of these poses is first to NOT feel pain in the low back, feel EFFORT (not strain) in the lower abdominals, gluteus maximus and deep gluteal muscles, and to also feel a GENTLE stretch in the hip flexors and thoracic spine.  Don't push into any pose and PLEASE ask for modifications when you feel pain.

I hope this eases some of that tension in your low back and keeps you moving!  Let me know how it goes.

Namaste,

Stephanie

Big Goal: Break it Down

I start each Yoga Physical Therapy Therapeutic class with self-assessments.  I modify physical therapy assessment techniques, describe "normal" values and what should be felt.  Participants can use this information to determine what he/she needs to work on.  

Since my Big Goal for 2017 is Extension, I am using wheel pose, aka backbend, as my self-assessment.  The picture above is my first attempt just as 2016 was ending.  I was able to hold this pose for all of 2 seconds before crashing down to the floor.  It is a good thing that a yoga certification is not dependent on performance of this pose!  What surprised me was where I felt most limited in this pose: forearms.  Wheel pose is full wrist extension with elbow extension.  You can see that my elbows are not even close to being extended.  I know that my hips are tight, and I feel it in my hips and spine but my forearms were screaming.  

Just trying to wheel pose every day to reach my goal would be frustrating.  So I decided to break this pose down and work on components of this full body extension.  As I describe is a previous post, other yogis suggest other difficult poses in order to progress wheel pose, such as reclined hero.  I decided to make big modifications and use props to help.  

The focus of this pose is wrist extension on blocks at the wall to open the forearms, elbow extension, and upper back extension.  I am pushing into the wall to provide some weight bearing into the hands, just like in wheel pose.  However, I can hold this position much longer than 2 seconds which will help to open the forearms muscles.

I love my therapeutic ball!  This is my version of reclined hero pose.  As the front of my thighs open, I can adjust the ball backward to sit a little deeper into the stretch.  I contract my gluts a little as I am trying to increase hip extension.  You can see the slight flexion of the hips and this is at the end of my range of motion.

Supported wheel on the ball.  I "hang out" in this pose almost every day.  My neck likes the support most of all.  Here, I can work on alignment of my hips (i.e. neutral rotation), engage the gluts and lower belly to take pressure off of my low back, create hip extension, and open in the chest and shoulders.

With any Big Goal, it helps to break it down into smaller parts.  This way I can feel a little progress and success each day.  Small achievements feel better and keep me motivated.

So how are you doing with your goal/s in 2017?  It is OK to readjust and look at the big goals in smaller segments.  Don't beat yourself up if you got off track.  Keep cheering yourself on and stay positive.

Namaste,

Stephanie

Source of Pain: Go Beyond Physical

What is happening just before you notice the sensation of pain?

I’m talking about the usual, familiar, probably daily pain in your neck, back, jaw, head or wherever it is for you.  You notice it on most days.  But what is happening just before you notice the pain.  Rewind your life just 30 seconds.  What were you thinking?  What did you read?  What was the conversation? Or most importantly, what were you feeling emotionally? 

We tend to blame pain on a physical incident, i.e. poor posture, moving wrong, effects of getting old.  But the more I do this work on myself and with others, I am beginning to believe that it goes BEYOND the physical.  When I ask the questions above to clients in interviews about pain, I get some blank stares, some slow head nods, and every once in a while I can see the light bulb turn on and shine bright.  It is the latter that excites me the most.  I know that this realization will begin to allow compassion and healing to occur.

So if you are in the blank stare or slow head nod category right now, let me help clarify the need to goBEYOND the physical.  I give you an example of own neck pain.  I thought I was getting a handle on it but it has really been bothering me for the last several months.  Here’s how it starts:

I feel a sting behind my eyes.  I hold back tears or even sometimes let them flow a little.  My jaw clenches.  I feel sadness and a heavy heart.  The base of my head and neck now hurt.  I am reminded of losing my Mom.  And it happens every day.

I can work through it 2 ways:

1.      Resist, Resist, and Hold Back the Tears.  Not in front of other people.  Not in front of the kids.  Raging headache and neck pain by the end of the day.

2.      Breathe, Breathe, Breathe.  Allow myself to feel the sadness.  Allow myself to cry.  Remember that the sadness is because she brought so much love and joy to my life and to my family.  Share a memory of my Mom with the kids or even with a stranger! Remind myself that these are expected emotions and that I am allowed to feel them.  As I really allow myself to feel the sadness then the neck pain diminishes a little.  Headache avoided.

So this is a big, glaring example.  But I had neck pain before this trauma.  The pain I had then was caused by little traumas like this or even more so “dramas” in my head.  Creating stories to keep myself from feeling.  Being tough and not allowing myself to feel fear, disappointment, guilt, etc.  I heard Brene Brown say on a Super Soul Sunday interview with Oprah, “the body keeps score, and it always wins”.   Every time I denied an emotion, i.e. stuffed it down, my body kept score.  And it lets me know it is winning with back pain and neck pain.

We cannot separate emotional from physical pain, especially when it is chronic.  But we can recognize and acknowledge the relationship.  My emotional pain is on the surface, but I’m sure I have some buried too.  I may need to dig deeper to find the source of other aches and pains.  It may not be easy, but I know it will be worth it.

Namaste,

Stephani

Tools to Help me Extend and Connect

I needed a plan to work toward my goals to Extend and Connect Every Day.

Body:

As I always do, I started with the physical. I have some ideas of my own for modifications of poses that will help me progress to wheel (backbend), but I like to see what the yoga community thinks so I googled "progressing wheel pose yoga" and got several hits.  Most offered step-by-step corrections to the full pose or other poses that are like wheel pose, such as: reclined hero, upward bow, and camel.  But my problem is that all these poses are too hard.  I can’t even begin to get into reclined hero!  I needed to really break down wheel and work on the components for each region of the body. I also needed body weight support so I got my tools ready:

• large therapeutic ball
• foam roller
• my usual props: bolster, blocks and strap
• yoga wall

I will be sharing how to use these props to "open up" into extension.  I’m excited to see how this will open me up to new realizations, new opportunities, and new possibilities. 

 Mind:

Tools:  Books and maybe Counseling

I am about mid-way through Brene Brown's book: Gifts of Imperfection and I hope to work through the other 2: Daring Greatly and Rising Strong.  I have loved her TED Talks on Empathy and Vulnerability.  Gifts of Imperfection seems to be on the right track as far as "opening up" as the title states it is "your guide to a wholehearted life". I believe that we assume a flexed posture not only because of our positions throughout the day, but because we are protecting our hearts. As we draw our shoulders inward and cave in our chest we close in around the heart. I am convinced that this is the physical manifestation of closing down rather than opening up. It is more risky to open up and live the life you are supposed to live. It is hard work to determine what that life is. It's easier to live how others expect.

As far as counseling, it has been a tough year with the loss of my Mom. As my son describes it: "my heart is empty". He has said this several times and at first I didn't get what he meant. But I think the loss has lead to having less emotional resiliency.  I am frequently on the edge of crying. I need strategies to think about and honor my Mom but also build up my emotional resiliency.

Spirit:

Tools: Meditation and More Books!

I ended 2016 reading You Are Here by Thich Naht Hahn, How to Meditate by Pema Chodren, and Seven Spiritual Laws of Yoga by Deepak Chopra.  All of them contain good lessons on how to integrate the practices of meditation and yoga into daily life. These books make me want to go back to the New Testament and read more about the life and teachings of Jesus. I want to honor the religion of my upbringing while exploring other teachings of spirituality. I think the deficiency of my religious upbringing was understanding the difference between spirituality and religion.  So I will be reading more by these authors and could use recommendations.

If you have goals, you need a plan.  It doesn’t have to be rigid.  You can allow for tangents if your interest moves you in a different direction.  But I find getting organized around my plan is the best way to succeed.

Namaste,

Stephanie

Extension Lesson #1: Stand Up!

Since first reading the book Sitting Kills, Moving Heals by Joan Vernikos, retired NASA Scientist, I have been inspired to STAND UP!  From a postural perspective, sitting keeps our hips and knees in a flexed position.  For most of us, this also results in a backward tilted pelvis (posterior pelvic tilt) and a flexed low back.  When the low back flexes or rounds, the rest of the spine follows and we get the HUNCH with flexion through the upper back, rounded shoulders and forward head.  Manifestations of sustaining this position day after day can occur anywhere in the body, i.e. headaches, neck pain, back pain and (yes!) even foot pain.

Dr. Vernikos studied the physiologic effect of weightlessness in space.  To mimic these effects on earth, she studied the effects of bed rest.  She says that the next worse thing that we can do is sit for 8 hours a day!  Sedentary adults experience similar physiologic decline as astronauts in space and it affects every body system: cardiovascular, musculoskeletal, digestive, neurological, etc.  Even if you exercise the recommended amount (150 minutes moderate intensity or 75 minutes vigorous intensity each week), you will not fully overcome these deleterious effects over time.

But what if I told you that you did not need to exercise?  

Will this make you happy?

So what is the answer?  

STAND UP!  

And do so frequently throughout the day.  Even using the recommendations for Correct Sitting Posture won't help if you sustain that position for 8 hours.  It is not how long you sit in total each day, but how long you sit at each stretch.  Find any excuse to stand up from that chair.  When someone comes in your office to talk: stand up.  Place your water bottle across the room so that have to: stand up.  Drink lots of water during the day so that you have: stand up (and take a walk)!

Break up your morning, move during lunch, and break up your afternoon with what Dr. Vernikos calls G-Habits:  Frequent (all day long), Habitual, Non-Exercise, Movement. Along with standing up, you can also do things like:

• change your posture at your desk (try pelvic tilts in sitting or simply reach overhead)

• heel raises while sitting

• stand on one leg (try putting your socks on while standing)

• try a rocking chair instead of a recliner to watch TV

• walk tall (think book on the head or runway model)

• use the stairs

Back to Extension!  The position of standing puts your knees, hips, and low back into extension.  A great way to check your standing posture is to place your back against the wall.  With your heels slightly away from the wall, can you touch bottom, mid back, and head on the wall?  I see the most problem with getting the head on the wall while maintaining the chin in a neutral position.  You should be looking across the room rather than up at the ceiling.

This book inspired me to develop the workshop:  Work Day Yoga.  It consists of over 20 easy movements to do throughout the day.  My guess was that you would want to develop some healthy habits in the new year.  So here is the schedule:

• January 22 1-2:30 at Dublin Community Recreation Center

• January 29 1-3 at beYoga and Wellness in Upper Arlington

• March 5 4-5:30 at Balancing Owl Yoga in Dublin

(you can find links to these sites under the calendar on the Schedule page of my website)

Please comment if you do other activities throughout the day that keep you moving!  We could all use some good ideas.

Namaste,

Stephanie

Extend and Connect in 2017

My overarching goals of 2017 are to Extend and Connect in all aspects of my life: Body, Mind, and Spirit

Physical/Body:  Improve whole body extension (especially the hips and upper spine) and use wheel pose (i.e. backbend) as metric for success

As I watch students in my class attempt yoga poses that require extension range of motion, I see an epidemic in the loss of this motion.  It has happened because of a culture that promotes sitting and the flexed position.  I too feel the loss.  I wonder how it happened, but then look back at when I began to sit.  In 1995, I started a full time academic position and started working on my PhD.  So began the life of sitting which continued for 20 years.  Even now where my primary job is working as a yoga teacher, I find myself sitting in the car, still sitting at a computer, sitting on the floor during yoga classes, sitting, sitting, and more sitting.

Join me each week as I share how I am gradually increasing my ability to extend.

Mind: Extend my knowledge and articulate/express this knowledge to connect with others

As I posted late in last year, my gift is as a teacher.  I always loved teaching in Physical Therapy because it meant I got to keep learning.  And I love to learn, so this part will be easy.  But translating knowledge in a way that it really connects with others will be the challenge.  Sometimes you can be so full of knowledge (and full of yourself) that you miss whether your students are grasping the information.  For me, the joy is in seeing someone “get it”. That is, translating knowledge into true knowing.  Like the student that said she missed yoga in taking a week off due to an illness.  Her body “got it” and then her mind “got it”.  Only she can judge how this practice touches her spirit.

Hopefully I will see you in one of my classes in 2017 so I can connect with you.

Spirit: Talk openly about how yoga affects me spiritually in order to create spiritual connections.  

I have this goal simply because I believe that these are the most important connections we can have.  This will be uncomfortable for me because I like to keep this stuff to myself.  But I think it is important and will keep trying. 

Don’t be surprised if I touch on spiritual issues in class.  Thanks in advance for your support.

Namaste,

Stephanie