Monday, January 5, 2015

More than Stretching: RollEasana Yoga Start to ROLL YOUR "ASS"ANA!

More than Stretching:  RollEasana Yoga   Start to ROLL YOUR " ASS” ANA!
As a physical therapist integrating yoga into my work with clients to help them get out of pain and move more efficiently, I have frequently been asked my opinion on the use of foam rolling and the benefit of static stretching. We are now learning more about how to use these tools to improve our efficiency of movement. The thing is, there is a huge paradigm shift in why and how we stretch as well as how foam rolling may fit into your program.

 First of all here are some facts about foam rolling:
1)Foam Rolling can help decrease post exercise fatigue if performed prior to exercise, this may allow participants to extend acute workout time and volume. Healy et al
2)Foam rolling prior to an athletic activity can enhance joint range of motion without decreasing performance McDonald, Penny et al., Sullivan et al
3)Foam rolling can help decrease post exercise soreness and helps in attenuating muscle soreness while improving vertical jump height, muscle activation, and passive and dynamic ROM in comparison with control. McDonald, Button et al
4)Foam rolling is equally effective as static stretching for improving joint range-of-motion (ROM) but does not acutely reduce muscular strength and power. In addition, the researchers found that while the static stretching group acutely reduced knee flexion torque and one-leg jump distance significantly, the foam rolling group did not. Amico
So what does one conclude from the latest research? Foam rolling is beneficial pre exercise to reduce muscle fatigue and possibly improve exercise performance. It will improve the joint range of motion without decreasing performance (as static stretching has been found to do). Post exercise, foam rolling can help decrease muscle soreness, possibly improving your ability to train again sooner and with less discomfort. For 5 tips on how to practice yoga to prevent injury see my blog post: WAWADIA? How about WCWDIA: 5 tips on What Can We Do in Asana.
For those of you who are practicing yoga just to improve your flexibility, you are missing the point. Flexibility is relative to function. Muscles become stiff because they are neurologically told to contract. The brain tells the muscle to contract in order to do the following:
a. To produce movement (eccentric or concentric)
b. To provide stability
c. To protect joints during novel movements or ranges of motion
Foam rolling is not utilized in order to improve flexibility, but to decrease the neural activation of the resting tone in the prime movers (which are usually the muscles you think are "tight”) Once you reset that neural tone of the tissue, the muscle is better able to build tolerance to the stretch sensation, thus allowing an increased range of motion of the joint. This results in more efficient movement of the joint and allows one to begin to activate those muscles which may have been "lazy” and not doing their job. Those lazy muscles are what caused the brain to tell the compensating muscles to activate more in the first place in order to perform the movement or protect you from injury. Foam rolling should be incorporated into your yoga practice as the first step, specifically addressing the hips and shoulder girdle in order to help regain lost mobility. Then proceeding to practicing asana following these simple steps: BAMA: Breath. AwarenessMoStility (mobility with stability) and Alignment.  .
In order to help address the principles of BAMA, I developed the practice of RollEasana Yoga.  RollEasana Yoga integrates foam rolling into a complete yoga practice. Integrating use of the foam roller and small massage balls into your practice is easy, and learning the sequencing for this practice is important in order to make sure your are properly preparing the body for the asana/movements following the foam rolling.  YogaUOnline has several practices I have developed which are  available for you to access.  Yoga For Athletes, Yoga For Cyclists, Yoga For Myofascial Release :  Awakening Prana, Awakening Your Core and Releasing Your Shoulders.  
There are lots of foam rollers on the market. Most of them are petroleum based, made of various densities of foam in a variety of sizes and colors. You can also use various densities of firm small balls to help with myofascial release in the harder to reach places such as your shoulder and neck muscles, shins and feet. When looking for a foam roller, look for one that has the following qualities: 1) keeps it shape well 2) provides a solid surface to roll on 3) durability. The Perform Better Elite Molded Foam Roller works well in all of these areas. It works well for those who work with private clients or in a gym where it is used heavily by many people.The Foam Roller Plus is a roller which is not as firm, for those who prefer a softer surface. The issue with this foam roller is that it will compress with time, which will be a disadvantage and probably require you to purchase another one in a few years. I was introduced to a specialized foam roller called the LannaRoller. This roller is durable, functional and beautiful. While most foam rollers are petroleum based and pretty unsightly to have in your home, the LannaRoller is all natural, made of a single piece of mangowood. Lanna Rollers are made by artisans in "The Lanna Kingdom" of northern Thailand from sustainably-harvested natural materials: a mango wood core, cushioned with natural latex foam from trees, and wrapped in authentic hand-woven textiles. This roller will never compress and the cover is removable.

So that’s it in a nutshell. Become more efficient and pain free in your movements, using the benefits of modern research on kinisiology and physiology to transform your practice to meet your needs and improve your performance during your recreational and competitive athletic activities as well as your daily life. It’s not that hard, just practice your BAMA techniques and watch the magic happen. The first step is to get off your duff and "RollEasana!”
Resources:
1) Guidelines for Foam Rolling: To Roll or Not to Roll: Concerns about Self Massage http://www.elephantjournal.com/2013/03/to-roll-or-not-to-roll-concerns-about-self-massage-ruthie-streiter/
2)J Strength Cond Res.2014 Jan;28(1):61-8. doi: 10.1519/JSC.0b013e3182956569. The effects of myofascial release withfoamrollingon performance.Healey KC1,Hatfield DL,Blanpied P,Dorfman LR,Riebe D.
3) J Strength Cond Res. 2013 Mar;27(3):812-21. doi: 10.1519/JSC.0b013e31825c2bc1. An acute bout of self-myofascial release increases range of motion without a subsequent decrease in muscle activation or force.MacDonald GZ1, Penney MD, Mullaley ME, Cuconato AL, Drake CD, Behm DG, Button DC
4) Int J Sports Phys Ther. 2013 Jun;8(3):228-36. Roller-massager application to the hamstrings increases sit-and-reach range of motion within five to ten seconds without performance impairments. Sullivan KM1, Silvey DB, Button DC, Behm DG
5) Med Sci Sports Exerc. 2014 Jan;46(1):131-42. doi: 10.1249/MSS.0b013e3182a123db. Foam rolling as a recovery tool after an intense bout of physical activity. Macdonald GZ1, Button DC, Drinkwater EJ, Behm DG.
6) Amico, Undated Effects of Myofascial Release on Human Performance A Review of the literature http://www.fiteval.com/Site_1/Research_Study_files/Pilot%20Study%20addition-pdf.pdf
7) Beardsly, Chris Does Research Support the Use of Foam Rolling? http://www.strengthandconditioningresearch.com/2013/10/01/foam-rolling/#button


8) FIELDS, M.D. et al. (2007) Should Athletes Stretch before Exercise? Sports Science Exchange, 20 (1)

Monday, December 29, 2014

Happy New Year 2015! 5 Tips for New Yoga Practitioners from an Integrative Physical Therapist and Yoga Therapist.

Welcome New Yogis:  Awakening your body, mind and spirit through Yoga can change your life for the better!  Here are some tips for a wonderful and safe practice!



1.        Research prior to attending class
Prior to just jumping into a yoga class at your local studio, visit the studio.  Talk with some instructors and ask if you can peek into some of the practices.  Ask them to explain the style of yoga they teach and ask if they have a beginner series.  Just like you would not jump into running a marathon as a new runner, don’t jump into advanced Power Vinyasa Yoga on your first try, give yourself an opportunity to learn the foundations of the practice and explore  the type of practice you may benefit from  in your life. 

2.        Use the props
Props are not there only for beginners, yogis advanced and beginning can benefit from the use of yoga blocks, yoga straps, blankets and bolsters.  Props will help you access the alignment which will make your movement efficient and allow you to grow in your asana practice with less risk of repetitive stress and injury. 



3.       Listen to Your Intuition  and consult the teacher after practice.  
 If you are in an expression of a posture and it just feels wrong   and you notice any of the following:  a.  breath is labored and you are having difficulty calming it down ,  b. you feel  sharp, burning or stabbing sensations,  or c.  you feel pain in a joint,  modify the posture to a position which is less stressful for you that day.  Then AFTER class, consult the teacher regarding that pose and many times, she or he can help you understand what might be right for you.  In a class with several students, it is sometimes difficult for the instructor to address everyone’s individual needs, and it is your responsibility to take care of yourself by being proactive. 



4.       Understand that yoga is a practice. 
This may be a cliché, but it is really true.  Yoga is a physical practice when we go to an asana class, certainly.  But it is more of a practice of learning how to observe yourself.  We utilize the asanas and breath as tools to tap into self awareness.  Through this self awareness we begin to understand how we react to various situations which occur on your mat.  This could be anything from noticing you get angry at yourself when you can’t perform a posture to your expectations or arising sadness that may creep in during a certain posture.  We then use this knowledge to help us take what we learn about ourselves and apply this awareness of our reactions to real life situations.  One of the best quotes I ever heard was “ the person you become  on your yoga mat is the person you are in the world”….think about that!



5.       Enjoy yourself, be in the moment.
In our society of striving to be the best and the greatest, sometimes we forget to celebrate the joy of just experiencing and being.  Yoga helps you to take the time to be present, no cell phones, no work or outside responsibilities,  for that time you are on your mat.  Practicing mindfulness while on your mat will result in a happier and more joyful state of being as well as better health.  This is not just yoga jargon, but has been proven by scientific research! 


So, what are you waiting for!  Come practice some yoga asana, improve your physical, mental, emotional and spiritual wellbeing.      Atha yoga anushasanam
Now, the teachings of yoga begin. 
—Yoga Sutra 1.1

The time is NOW!   





Saturday, November 29, 2014

WAWADIA? How about WCWDIA: 5 tips on What Can We Do in Asana? ( A response to Matthew Remski)

Mathew Remski has recently started a project called WAWADIA.(Whatare We Actually Doing in Asana?) which is creating lots of discussion in the yoga community.  As a physical therapist and biokinesiologist, this question has been loudly blaring in my mind since I have started my yoga practice over 14 years ago.  In the beginning, I assumed it was because I did not know enough about the practice, so I would just follow my  teachers when they would confidently say things such as “this is the pure posture as taught to me by Swami What’sHisName when I was studying with him for the last 15 years,  so just do it! “  As time passed and I deepened my knowledge of the practice, doing the requisite 500 Hour Teacher Training and eventually studying yoga therapy,  I realized the dirty little secret that Matthew so astutely reveals…we don’t really know What We are Actually Doing in Asana!  And neither did Swami What’sHisName. 




  In a recent podcast, The Liberated Body hosted  by  Brooke Thomas,  Matthew mentions that in addition to this question, he would like to ask “what can we do in asana to make it a safer, more efficient practice biomechanically for the body?”  This response is to offer some suggestions, based on my 25 years in the field of physical therapy, the last 10 which have been working with persons on an individual basis using yoga asana as one of the tools to help them heal structural injuries, not just a few of which have been “because”  of yoga.  These are things you can do now, until the time comes when the majority of yoga instructors begin to understand that the in depth knowledge of how the body moves can only enhance their teaching and help their students keep coming back, without injury. 

Just to be clear, I love the practice of yoga.  It has helped me become healthier and happier and I have seen this occur in the many clients who I have worked with who have embraced the practice.  My livelihood is dedicated to spreading the practice of yoga to others, and helping them learn how to use it as a tool to help them in their lives, but it is only one tool.  I am not condemning anyone who teaches asana practices, but instead challenging them to perhaps dig a little deeper, not to accept and teach practices that they don’t fully understand and to get in on the discussion and conversation that Matthew started.   We all know that asana is only one small part of yoga, but let’s face it, it is the biggest part that modern society is now practicing, and it’s the part that is causing the physical injuries that William Broad discussed in his now infamous article,  HowYoga Can Wreck Your Body  in the NY Times. 

  This article got national exposure, and scared (maybe appropriately?) many people away from yoga practice.  Below are some tips  to address some of the things we can start today,  things which on the cutting edge of modern research I might add, to help us prevent injury from the practice of yoga, as well as use it to maintain structural health and possibly heal a structural injury. 



1.       Stop practicing yoga to stretch tight muscles, it doesn’t work! 
This radical thought will probably rock the yoga world.  When the general yoga population is polled as to why they practice yoga, the majority state it is to gain flexibility.  Unfortunately, the latest research is showing that stretching does not really change your flexibility and that flexibility probably does not help improve function or performance.   Any changes you are seeing in flexibility are due to the changes in the nervous system, not how hard you pull on your hamstings or how deep you go into a backbend.  For a deeper discussion on this particular issue, read a few blogs by my wonderful colleague Jules Mitchell, who spent the past two years investigating the research on stretching and yoga.  She describes what stretching is and what is isn’t, and what we really need to do in asana to actually increase muscle stiffness to improve efficiency.   


2.       Get a one on one assessment of your body’s structure and weak links by a qualified yoga teacher, personal trainer, physical therapist or yoga therapist trained in structural assessment.   This is probably the most important tip.  You may think that I am just promoting my profession (which is true), but I have good reason.  It is virtually impossible for your yoga teacher to know what your individual body’s’ needs are and address them adequately in a group yoga class.  We all have our body’s history of lifestyle and trauma; emotional, physical and mental.  This is held in our body and manifested through dysfunctional movement.  When we practice yoga, we are moving the body biomechanically, with various levels of force and contraction through movement patterns.  These movement patterns are affected by our individual alignments, weaknesses and strengths. 

     In order to make your practice fit your body, you must know where you might be compensating, where your muscles might be overworking and learn to use the asana practice to create more efficiency and balance in your  movement patterns.

3.       Individualize your practice to address your needs.  You may think that getting an individual assessment means you have to practice alone, and not attend a group class.  But to the contrary, having this knowledge will transform your practice to one that is specific to your needs and instead of getting hurt, you will stay healthy or even begin to heal.  Attend the group class after you learn from your yoga assessment session how to adjust the postures to meet your goals.  Yes, they probably will tell you to do a short 15 minute home practice a few days a week to target certain areas more intensely, but you can take that knowledge into your practice, be it Bikram, Ashtanga,  general vinyasa or restorative, and make that practice your own. 


4.       Consider adding foam rolling for myofascial release into your asana practice.  Since we now know we don’t really stretch our muscles (i.e. change their length), we can use the foam roller to help improve mobility of the muscles and connective tissues to allow the nervous system to more efficiently activate your muscles.  Research into foam rolling has found some wonderful benefits which will help you learn to release overactive muscles and activate those that need to awaken in order to improve efficiency and alignment.  As described in the review by Chris Beardsley entitled Does Research Support Foam Rolling, foam rolling is beneficial pre exercise to reduce muscle fatigue and possibly improve exercise performance.  It will improve the joint range of motion without decreasing performance.   Post exercise, foam rolling can help decrease muscle soreness, possibly improving your ability to train again sooner and with less discomfort.  Foam rolling is not utilized in order to improve flexibility, but to decrease the neural activation of the resting tone in the prime movers (which are usually the muscles you think are “tight”) 

      Once you reset that neural tone of the tissue, the muscle is better able to release and relax, thus allowing an increased range of motion of the joint.  This results in more efficient movement of the joint and allows one to begin to activate those muscles which may have been “lazy” and not doing their job.  Those lazy muscles are what caused the brain to tell the compensating muscles to “tighten up” in the first place in order to perform the movement or protect you from injury.  To learn how to incorporate myofascial release into your yoga practice, check out Yoga TuneUP and Rollasana. 




5.         Finally, move through your practice with BAMA (Breath, Alignment, Mostility and Awareness)

a.        Breath:  the foundation of the asana practice.  We all know it, it’s undeniable, yet I have been to many a yoga practice where I did not hear the students breathing or the instructor really cuing the breath.  All I can say is please include this as the foundation of your practice. 
b.      Alignment:  if your body is out of alignment, your movement is inefficient and you will create overuse injuries from repetitive stress.  This is well established in the literature. Shirley Sahrmann, PT, PhD, FAPTA was a ground breaking physical therapist in the area of movement dysfunction.  Her philosophy, if we move with poor initial alignment, we are setting ourselves up for failure and possible pain.  If you are a kinesiology geek, her text, Diagnosis and Treatment of Movement Impairment Syndromes is a must read.  If you aren’t, just trust me, alignment is important.
c.       Mostility:  Mobility and Stability are the keys to efficient movement. Since one is codependent on the other, I came up with a new term, Mostility.   If you have decreased mobility of a joint, it is usually due not to a tight muscle, but to a combination of fascial restrictions and connective tissue from an injury or repetitive movement dysfunction coupled with poor activation of the prime movers as well as some muscles compensating for that poor activation with over activation.  A prime example, the hamstrings in someone who is active in athletics tend to get what they perceive as tight.  This tightness is actually increased contraction of the hamstrings to compensate for relative inactivity of the gluteus maximus, which is the primary hip extensor.  Once the athlete learns to turn on the gluts as the prime mover instead of the hamstrings, his tightness miraculously decreases. This athlete could practice this in an asana practice by paying attention in poses like Shalambasana as to how he turns on his hip extension, activating the gluts before the hamstrings.   This is just one example of how knowing what to activate and how can change your movement patterns.
d.      Awareness:  One word, Feldenkrais.  What is it?  The Feldenkrais Method is experiential, providing tools for self-observation through movement enquiry.  It is used to improve movement patterns rather than to treat specific injuries or illnesses.  Feldenkrais taught that increasing a person's kinesthetic and proprioceptive self-awareness of functional movement could lead to increased function, reduced pain, and greater ease and pleasure of movement. Wow, that sounds like yoga with awareness to me. 
So what is the conclusion?  What We Are Doing in Asana is still being debated and investigated.  It is only through the work of those who are brave enough to bring this issue to our attention that we can begin to address the impact of this practice in creating injuries.  Purists may balk that this is taking the yoga out of the yoga practice.  But to the contrary, what could be more in line with the practice of yoga than practicing ahimsa in our asana practice?    That is…do no harm. 

Update on WADWADIA!  If you would like to contribute to Matthew's research and help him write his book, you can pre order it and/or provide financial support. Click HERE for more info! 
Chrys Kub is an integrative physical therapist who incorporates therapeutic yoga as a tool in her practice.  She is also an educator in therapeutic yoga through teacher trainings and the yoga therapy program with Holistic Yoga Therapy Institute.  She provides continuing education in yoga therapy online through YogaUOnline, HomeCEUConnection.com  and PTCourses.com.  She also travels throughout the United States presenting yoga therapy at conferences and to health practitioners to help spread the benefits of yoga to all who are willing to learn.  You can  Chrys at  fityogatherapy@gmail.com

Links:


2)      Liberated Body Podcast

3)      Brooke Thomas



4)      How Yoga Can Wreck Your Body 


5)      Jules Mitchell  


6)      Does research Support Foam Rolling?


7)      Yoga TuneUp  



8)      Rollasana 



9)      Diagnosis and Treatment of Movement Impairment Syndromes


10)   Chrys Kub