Anxiety and walking…..Can I link this to the World Cup???

The Football World Cup propels me back to the ground, gravity, feet, balance – themes that I have explored in many blogs and which you can access via the Archive menu on insideyoga.blog.  Whilst engaging with Yale’s Happiness online course, the set exercises have encouraged my mind to pass the ball” back and forth whilst scrutinizing habits and behaviour.  From the “sidelines” came a reference (stored in drafts) to a research study published that found a link between anxiety and walking.  There I had it and after a spot of “dribbling” I found that I could take a “shot at goal”.  Here’s the “ball” –  I hope that it is not a “dummy”.

In 2016, Kent University Psychology School published the results of research that linked activity in the brain’s two hemispheres with a shift in people’s walking trajectories.  The headlines read as follows:

The researchers found evidence that blindfolded individuals who displayed inhibition or anxiety were prone to walk to the left, indicating greater activation in the right hemisphere of the brain.  I was slightly knocked off course by this since I was not familiar with the terms “inhibition” and “approach”.  The Kent University study  indicated that:

………the brain’s two hemispheres are associated with different motivational systems. These relate on the right side to inhibition and on the left to approach…….

The Behavioural Approach System (BAS) and the Behavioural Inhibition System (BIS) formed the basis of Gray’s Biopsychological theory of personality  In the 1970s  Jeffrey Gray hypothesized that these two systems controlled behavioural activity.  A behavioral approach system is believed to regulate appetitive motives, in which the goal is to move toward something desired. A behavioral avoidance (or inhibition) system is said to regulate aversive motives, in which the goal is to move away from something unpleasant.

The findings of the Kent study were based upon 80 right-handed participants. Some data was lost, leaving the final sample of 78 participants (60 females, 17 males and 1 other gender).  The data corroborated previous studies.   Charles Carver and Eddie Harmon-Jones ‘ research in 2009 found that anger relates to an appetitive or approach motivational system, whereas anxiety relates to an aversive or avoidance motivational system..  Importantly, however, the Kent University study found that inhibition (anxiety) contributed towards leftwards walking bias irrespective levels of BAS.  It seems that behavioural inhibition has a more central role in the orienting bias than previously assumed.  The findings helps us to understand a little more about human motivation – about how we respond to challenges, changes, how we adapt and grow.

How do I link such profound research with yoga teaching/practice?  …..Cautiously, one would suggest.  My last blog was entitled “..Why are we doing yoga?..”

Whilst examining my own motivation and that of teachers and students close to me , I recognize how a regular practice of yoga/meditation can have a very positive impact upon stress.  I have also been struck by some who prefer a more rigid approach than Scaravelli-inspired classes often offer – they want to be “told what to do” in a yoga class and find the process of exploration and choice to be too much to handle.  Some have, on occasions,  become quite angry.  I can also understand this.  At some junctures, structure is all-important.  Thus the shape of a yoga pose provides support, holding the pose demonstrates strength.  This in no way undermines such practices..  Regular yoga practice is the key to begin to make changes to our habits – to begin to discriminate between helpful and unhelpful patterns of movement and attitudes.

This brings us back to finding balance.  Last week we explored balance and breath with curiosity .  We identified our footprints and noticed our breathing –  the movement of the diaphragm, the balance between ribs and pelvis in quiet standing (tadasana).  We explored a one-legged balance ( some moved towards tree pose, some explored the movement of the unsupported leg in the hip socket and the stability of the pelvis) and we returned to quiet standing and the breath.  We repeated this with an exploration of Warrior 1 and Warrior 3 – we noted how we, as individuals find support.  Some students moved into other spaces of their own accord – ardha chandrasana, for example.  We compared controlled breathing with our natural breath and noticed whether our breathing adapted to movement – to change.

I wobbled more on my left leg than my right – so there you are.  But, there is hope. Lionel Messi has a very powerful kick from his left foot, but (apparently), he also shoots better with his right than most other left footers. Christiano Renaldo’s “weaker foot” , his left, seems to be as good as his right when scoring goals.  One writer notes, of Renaldo that “You can tell he doesn’t have quite the same power as his right foot but the precision and accuracy are still there…. 

With practice, I will find my way, it may be slow – too slow for some – but I’m beginning to believe that it will really work.  Perhaps it’s more than my feet that is finding balance.

See some of you next week for the “post-match analysis”.

 

 

 

 

 

 

 

 

 

 

“..Why are we doing yoga?..”

See the source imageReading Vanda Scaravelli’s Awakening The Spine, I was struck by one of her opening thoughts on page 15:

Why Are We Doing Yoga?

For health reasons? Perhaps a walk in the park would be better. To help someone else? There are so many ways of helping people. To make money?  This is surely not the best way? Out of a sense of duty and discipline?  Or for some obligation towards ourselves coming from our puritanical background?

No, nothing of the kind,  No motivation, no aims, only an agreeable appointment for the body to look forward to.  We do it for the fun of it.

To twist, stretch and move around, is pleasant and enjoyable, a body holiday.  There is an unexpected delight in meeting earth and sky at the same moment…..

Of course, people practice yoga for differing reasons.  I have written many posts on attentive practice of yoga; how small and, often, very subtle very changes to the way we sense ourselves can yield great benefits to mind and body.  The last sentence from the above quote evokes a sense of change in how we move – a useful goal for most of us.  To make good footprints with feet that can adapt to movement and changing circumstances.  To balance our musculature by finding balance through the bones. Vanda, also hints at curiosity I think. That’s why we re-visit the yoga mat; the yoga class – exploring, discovering a sense of well-being and, hopefully, enjoying “the ride”.

Fun?

Change is not always easy.

The science of well-being is very much in the news these days.  Yale’s most popular class ever is commonly known as The Happiness Course.  The course, taught by Professor Laurie Santos, , tries to teach students how to lead a happier, more satisfying life in twice-weekly lectures. The course focuses both on positive psychology — the characteristics that allow humans to flourish, according to Dr. Santos — and behavioural change, or how to live by those lessons in real life.  However, Dr. Santos refers to her course as the “hardest class at Yale”:

To see real change in their life habits, students have to hold themselves accountable each day, she said.

Sounds tough but remaining curious enough to allow real change to occur is tough. In Awakening the Spine, Vanda encourages us to practice yoga with an inquiring, questioning brain…”with a healthy curiosity there will be freedom to explore, freedom to understand…” (p74).  Later in the book she urges us to retain the mind of a beginner – free of habits.  I am lucky to practice with students who do question and this helps me as a teacher.

Dr Santos has developed a 10-week online course.  I have just enrolled on the free non-certificated course.  The bulk of content is in weeks 2-6 but the course is flexible and can be completed at each individual’s pace.  This course will take me through the summer break and is the “homework” that I referred to in class this week.  You thought that I was joking??

Enjoy the ride.

 

 

Sensing our bodies to reduce movement compensation

Feedback following last 2 blogs on the subject of how we increase our body sense in yoga practice.  Using sprinters as a model to sense when we lose support in practice – by repeating the whole movement or by focusing upon a part, backing off, pausing and then repeating.

Parts versus the whole in yoga practice

Functional Movement

Some students felt that completing the whole movement slowly and carefully,  helped them to notice whether the front, supporting, knee caves in; others spoke of the value of pausing.  Sprinter helps us to sense how well we get up from and return to the floor using minimal effort, thus the arrangement of the foot, ankle, knee and hip is all important.  All students agreed that repetition helps to map the movement and to reduce compensation.

Trying to reduce compensation in yoga practice is hard because we all want to complete a movement, to “do” a posture.  Many of us will work through pain.  Whilst it is important keep the body moving following injury, for example,  when we experience pain, our body will create a new movement pattern in order to compensate for the pain. If the new movement pattern is dysfunctional it can create an undesirable chain of events in the body.

A breakdown in the kinetic chain impairs performance.  A breakdown in the early part of a movement may result in a higher workload on the later parts –  leading to injury.  Think about tennis elbow which I mentioned recently. The stages of a tennis serve show that the shoulder is part of a larger movement pattern – a kinetic chain.  Effective performance of the whole kinetic chain will deliver a powerful and effective serve, however any breakdown in the chain will result in a loss of performance. Jamie Murray speaking about the tennis serve, stressed accuracy over speed:

……..Your whole body is engaged and everything has to be spot-on for the serve to work. You can get away with more if you’re just hitting a forehand or a backhand, but the serve is like the full kinetic chain………

Think about your own weak spots and how they affect your stability in yoga practice.  With Sprinters, those who struggle to make a good footprint, will struggle to take weight through the ankle and foot.   Compensation – the collapsing at the knee – will adversely affect the knee as well as the ankle and hip.  Students with pain in the hip or groin may compensate for reduced movement by side bending (lateral flexion of the spine)  as a compensatory movement which recruits muscles that are not essential to the main movement and this may also cause the front knee to collapse inwards.  When we practice a tree pose movement on our backs, many with hip “issues” will compensate for reduced abduction (outward rotation) of the hip by lifting the hip of the long supporting leg.  This extends and rotates the lumbar spine in a way that is not useful.  Compensation patterns will only work for so long before something breaks down. Your body tries to “speak” to you – through pain – and the weak spot often gets worse. You may be able to identify other compensatory movements in your own practice or from a recent class (please share).

The kinetic chain model helps us to understand, perhaps visualize the damage that can result from compensation but it focuses upon muscle and bone.  In our yoga we  try to listen to our nervous system in order to develop a sense of how the body works as a whole – muscles, bone, fascia, nerves etc and, most importantly how we begin to feel happy in our bodies.  Not as easy, in my opinion,  as teaching or learning about muscles and bones. Returning to tennis (it’s that time of year), Federer’s ability to adapt to changing circumstances on the court and to  serve well under pressure seems to be key to his success.  Atypically, I wrote about  Tom Brady’s ability to make rapid and accurate decisions under pressure.  I suggested that this was part of his whole body sense in an NFL environment.  We could look at other examples in different sports.

Susi Hately is a yoga therapist who writes extensively about compensation in yoga practice.  Her website Functional Synergy features short videos in which she talks about pain and she writes:

...the problem is rarely where the pain actually is….

If you watch the clip on wrist pain, she explains how rigidity in the shoulder blades and shoulder girdle affects movement through the back, ribs and arm.  In some videos, Susi demonstrates using the wide astride leg stance that we do not practice in our yoga classes but her explanation and presentation of functional movement is very helpful. She does stress the importance of moving slowly and carefully; sensing how the body responds.

Have a look at her site and share anything useful.  You may find other sites. We need all the help that we can get to make sense of our practice by cultivating our body sense.  Thus never too late to share feedback about sensing your movement in Sprinters – via the blog, by email or in class.

Have a good half-term.

 

 

 

 

 

Functional Movement

I use the term frequently.   Essentially it is about training movements not muscles.  It mirrors how the body naturally moves and helps to improve that movement.  

In our yoga classes we focus upon our walking pattern quite a lot.  We flex and extend our toes then balance on our haunches.  By strengthening the arches of the feet and the lower legs, our stability improves.   We then add side bending and rotation as we rock from side to side.  As balance increases, we release alternate knees forward – we mimic our gait pattern.  For some, deep knee bends are not helpful and alternatives can help students notice how much movement they do have.  Whilst still working upon the walking pattern, the nervous system begins to generate solutions to movement restrictions.

It is helpful to identify restrictions in rage of motion so that unique dysfunctions can be isolated and improved.  So – what happens when we have practised Sprinters for a long period of time and knee valgus  continues to cause problems in other activities?   Sprinters helps us to notice and to begin to correct dysfunction in foot – ankle knee-hip alignment.; an integral part of our walking pattern.  If the knee caves in when we practice, the body is compensating for a lack of support.  By pausing, we can begin to connect the dots between safe stable movement in a yoga class and movements performed outside the class .

Related image

Is it best then to pause and to go back to the starting point, in Sprinters for example, or to complete the whole movement and to repeat with real attention on the point at which fluidity of movement broke down? 

Let me know what you think.

If we understand how to organize the foot, ankle, knee and hip when practising Sprinters, we have a global model for rising from and returning to the ground; from a chair; for walking and running. But you know that if you have read:

Sprinters – the challenge? The vote?

Knees need to move

Standing and walking – free the pelvis

I work on the premise that the shape of a pose or completion of the final pose is not always as useful as pausing and noticing.  When I lose touch with my breathing, I know that I have lost touch with my yoga.  This has grown out an 8 week Mindfulness Course and from my teachers but this approach is a bit too stripped down for many in a goal-driven  approach to practice.  It demands a high degree of  patience and to some it probably is as exciting as the Raisin Meditation in Mark William’s Book Mindfulness. A practical guide to Finding Peace In A Frantic World  (p73-75).  

We have to have time to be in the mindset to pause, of course. It’s easy for me to pontificate I know, but we can make time in a class setting  by not rushing to get to the final pose, by not competing.  Whilst we share the commonality of functional human movement, we are all  unique and moving outside out range of comfort usually results in compensation and injury.  This does not mean that you can’t challenge yourself, it means that through intelligent awareness you move better and move more.

If you have time, there is always the chocolate meditation . A little more exciting perhaps?

As is this clip – 3 Knee exercises from the Russian Systema System  which focuses upon breathing, movement, relaxation and posture.   Go to 0.55 seconds in and look at the movement which could be an extension of our rolling from side to side and from head to tail!!!  (Reactions please).  Then go to about 1.35 mins and listen to the presenter’s words about proprioception and where the body is in time and space. 

***Not a suggestion for your weekly practice, rather an interesting comparison with the way we find our feet when we practice tree pose.  We do not lock the knee of the supporting leg (ever) and we often move the free leg around in the hip-joint.  I sometimes ask students to imagine the movement of an oar in  the water. The presenter echoes the  principles that we adhere to:

Relax,. Relax more

Move better. Move more.

 

 

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Parts versus the whole in yoga practice

Related image

My mini-series on common structural problems presented in a yoga class , has highlighted a “part” of the body that is not functioning as well as it might and I have attempted to  show how our whole body movements help to improve the function of component parts” as we “map” movements through slow, repetitive practice.

Human movement involves the interaction of several limbs, and the nervous system controls whole-body movement.  Several muscles may cross the same joint and, therefore, a specific movement can be achieved through many combinations of muscle activity.  Despite the many different types of movement that bodies might perform, our functional movement patterns are pretty predictable.  A well-defined feedback loop results in movement which optimizes accuracy and energy efficiency :

.…. optimal controller that minimizes the overall cost generally has a purely feedback form, called an optimal feedback controller, where the sensory information obtained during the execution is exploited online to determine the next motor output …….

If part of a movement is faulty, we expend more energy in competing that movement and the balance is upset.   The feedback loops is disturbed because we may not have been fully able to listen to the nervous system.  As a result our body cannot anticipate changes as well using sensory imput.  Then the next step or the next change may produce tension and that tension may become habitual in that movement sequence.  When being taught by Peter Blackaby last year, I found his image of running a film and stopping to review a frame that needs to be edited, to be very useful.

A video entitled Optimal Feedback Control for Character Animation  may  provide some slighty amusing ideas about varying our class practice but, more to the point,  it shows how a mapped movement is more able to respond to changing circumstances – “perturbances”.  Our regular mapping of walking patterns strengthens the feedback loop which is so important as we age..

In class we map movements from A to B. – from all fours to standing for example.  We rock on our feet and use flexion to come to standing.  We investigate dog pose to notice  how the body supports itself, how our breath adapts to movement.  We stop and notice how the parts of the movement add to up to the whole.  We do not necessarily make the shape that we recognise as dog pose.   It can be useful to “back off” to go back to the first element of the movement – to strengthen the mapping of the movement.  We do not get “uptight” about “core” (excuse the pun) , rather we notice the expedition of movement; activity; spryness; agility.  You may have a better word but if it is connected with Sprinters, it may not be printable!!

It’s all in the practice :

A cliché perhaps but I was recently, reminded of its importance.  In demonstrating how movement in my feet/ankles had improved (or so I thought!), I quickly realized that my sense of movement was flawed.  The students were very kind in their helping me to get to this state of realization.  I had not mapped the movement as I had thought.  I might say that my feet are a long way from my head but this would not “wash” methinks.  Clearly, I wasn’t sensing the difference between my perception of the movement and my performance of the movement.

So – Off to the mat.  Time to sense those toes and ankles!  See some of you next week.

 

 

 

 

All power to the elbows. Noticing what helps in a functional approach to yoga.

Image result for medial epicondyle
The elbow joint made up of the lower part of the humerus and the upper ends of the ulnar and radius, which make up the forearm. The joint allows us to 
                                            – bend the elbow (flexion)
                                            – straighten the elbow (extension)
                                            – turn the palm up (supination)
                                            – turn the palm down (pronation)
In these simple movements there is a functional interplay of the  shoulder, elbow and wrist which means that examination of all three joints may be necessary. In our “integrated approach” to yoga practice, we try to discover through small functional movements, areas that comply and those that do not comply .  We then try to balance the areas that do not comply so that compensation is reduced. 
Whenever handling persistent elbow pain treatment consider:

  • The shoulder and elbow both share the long bones of the arm and any deviation of shoulder function will affect the elbow.
  • The shoulder and elbow need to work smoothly together to prevent excessive strain and pain in the elbow.
  • Thus the focus needs to improve the function of the shoulder as it relates to the rest of the chest and back. If shoulder movement is restricted, the muscles in the arm will have to work harder in simple movements  – and on a daily basis.
  • We need to improve the way the scapulae move around the back and areas above, below and in between the scapulae and the spine that get “stuck”.

Common spots for injury are at the lower end of the humerus where the two bony prominences (epicondyles) on either side are attachment sites for ligaments, tendons and muscles. Tennis elbow (lateral epicondylitis) is characterized by pain on the outside of the elbow and Golfer’s Elbow (medial epicondylitis) features as pain on the inside of the elbow.  Only a small proportion of suffers actually play the sports.  Problems result from repetitive patterns of overuse. Consider common activities which may involve holding patterns in the shoulders, upper spine and ribs:

Typing; gripping a computer mouse; teaching, ballroom dancing with it’s emphasis upon holding posture; supermarket checkout operators; cooking; diy; childcare -grandparents lifting children for the first time in a number of years(!)??  Weight-bearing yoga poses that the body is not ready for.  You can probably think of many more.

There are many sites with exercises for the above conditions. Arhthritis UK has many fact sheets.  Great Western Hospital, Swindon, is useful for strengthening and conditioning the muscles of the forearm to help with tennis elbow.   

Exercises for  – golfer’s elbow from Leicester NHS Trust.

What we do in class.  When we are on all fours we mobilize the spine and shoulders.  Side bending and thoracic rotation is particularly helpful.  We strengthen the bones and as we place the hands and turn them around on the floor, we are working eccentrically – strengthening whilst lengthening the flexors in the forearm and fingers.  This counteracts the flexing and griping that we regularly do with a “mouse” /keyboard usage.  This should help with golfer’s elbow pain.  For tennis elbow we may benefit from turning hand around so that the back of the hand is on the floor and gently drawing the flexed hand along the mat and “flicking water off the fingers” at the end of the movement.  We regularly practise functional movements of the shoulder, arm, elbow and wrist whilst lying on our side.  In this way, we notice areas that comply with the movement and area that we need to “whisper” to.

This approach develops proprioception in the joints in smaller ranges of motion and is very beneficial to people with hypermobility. Yoga is an attractive pursuit for those with hypermobility.  Therapy for hypermobile people should be focused on strength building, with a balanced approach to stretching. This translates into doing smaller movements, with more repetition, as opposed to going to an extreme range of motion and holding. That is why we use dog pose to stabilize and to free up the shoulders.  We take the pelvis back to the heels and spend sometime noticing whether the pelvis can be lifted up through the action of the feet and legs. In this way, we do not “achieve” the shape of dog pose by compensating with muscles around the shoulders and ribs.  What we do is lengthen the spine and roll it through an undisturbed shoulder girdle.  We reduce compensation.

Compensation – the recruitment of muscles that could be quiet will generally affect our breathing.  Thus when we use the opening minutes of a session to examine our breathing, we can notice whether tightness in the diaphragm means that we use muscles in the neck and shoulders to help lift and widen the ribs.  If we don’t notice, we will never change.  In yoga classes, teachers will always encourage you to “go back and notice”; repeat in different positions; be curious about how your ribs move in other patterns practised in the session and be patient with yourself.

When we “brace” or strive to “complete” a pose (to make a shape), we should notice and back off – but we don’t.  Some of us stop but it is also a good idea to go to the first stage and to notice at which point the discomfort/bracing kicked in.  Be “brave enough” to go back and explore.  Our yoga practice is not about the end pose.  That is why we tread slowly and carefully along our journey.
Looking forward to seeing some of you during the next half-term.

 

 

 

Helping hands – and wrists in yoga practice

Image result for images of hands in namaste

Images of hands in namaste or reverse namaste commonly symbolize the serenity that accompanies yoga practice.  Whereas a more common experience is pain in the wrists and hands which means that “stock” poses – cats, dog, plank etc – become problematic.  Our advice is to explore and to back off where necessary but, in a class setting,  this is very difficult for students to do when others are fully “in the pose”.

Our practice is less about doing the pose and more about feeling the movement of bones; balancing the structures that hold those bones. In class we have been trying to help with wrist and elbow pain by improving the function of the shoulder blades and shoulder girdle.  Standing and making fists then stretching the hands, as we roll the arms back and gradually raise the arms to a comfortable level – feeling the shoulder blades respond to support the shoulder girdle.  When we lie on one side with the knees bend and the hips stacked, we investigate the movement of the shoulder, shoulder blades and arms.  We explore movement rather than stretch since the emphasis upon “stretch” can become addictive – stretching more and more  can lead to instability.  A website on tendinitis states that understanding the stretch point is the first key to healing injuries:

The Stretch Point is just a very small stretch, but we’ll need to measure how small it is to make sure we’re doing it right and doing it the same way each time. The stretch point is the amount of stretch that subsides when held for 15 seconds.

Let’s try it – put both hands together in front of your face as if you were going to pray. But, these are very subtle sensations, so do this in a quiet place, when your mind is quiet and where you will have no interruptions. Next, raise your elbows slowly out and upwards keeping your hands in the same position. When you feel a very small stretch, stop and hold that position. Start counting – you should start to feel the stretch fade. If it fades substantially within 15 seconds, you just found the Stretch Point, congratulations. If it takes 45 seconds, your stretch was too strong, try again.

The site also contains videos of movements using a door frame that are similar to our making fists, stretching the hands and gradually raising the arms.  The door frame provides support and the turning of the head to one side is useful, I think.  However, I had to be careful to “control” my jutting ribs as I did these.  I am more questioning of other aspects of the site but you can judge for yourself.

An information leaflet produced by Oxford University NHS Trust is very useful.

In our practice, we regularly extend the toes and curl the toes, we should perhaps get into the habit of doing the same with the fingers – mapping the movements in our motor cortex.  For example, making soft fists and slowly working through the range of movement in the wrists (as we do with our spine) – flexing, extending, sideways movement, rotations.  Such movements are illustrated on the NHS Inform website.

In our sensory approach to yoga we focus less on structure and more on the intention for movement. Muscles constantly adjust their tone to control our movements. In “Theories of Movement”, Peter Blackaby writes:

.… Repeating movements, exploring and experimenting with how they feel help us get a better grasp on how our body carries out our intention…..

When we explore spinal movement on all fours and the wrists complain, we move the hands around, move the shoulders, turn the hands.  We sense areas that do not “comply” with the intention of the movement –  namely freeing the spine and releasing tension in the chest and shoulders.  It may be more useful to stay in this exploration of how well the hands meet the ground than rolling up into dog pose.  By sensing whether we can “plant” the hands rather than “push”, we provide a more balanced support for poses such as dog and plank.  This requires patience and willigness to be present with our movement and breath – perhaps one of the most difficult aspects of our practice.

If you get time, have another look at the 3 blogs on shoulders:

As ever, if you find anything helpful , in this blog or from another source, please share it.

With the arrival of spring and the hope of a good few months of outdoor activity, the next post will be on common upper limb problems such as tennis elbow and golfer’s elbow.

 

 

Plantar Fasciitis

Image result for images for plantar fasciitis

This is the first in a series of posts covering common problems that present in a yoga class.  Plantar fasciitis is a nasty pain in bottom of the foot. It causes mainly foot arch pain and/or heel pain.   Pain is quite often at the front of the heel

 Plantar – “relating to the sole of the foot”. Fasciitis – “inflammation of the fascia”.  Fascia is a thick connective tissue and the plantar fascia is a tough fibrous band which supports the arch of the foot. It runs from the calcaneus (heel bone) forward to the heads of the metatarsal bones (the bone between each toe and the bones of the mid-foot).

Plantar fasciitis is a common and often persistent kind of overuse injury. It  affects runners, walkers and hikers, and nearly anyone who stands for a living — cashiers, for instance — especially on hard surfaces. Walking on concrete and running on pavement are probably risk factors.

Most common symptoms:

  • Morning foot pain  – even after a night’s rest the feet are tight and contracted and you feel the need to stretch them.
  • Pain pattern – As you walk around in the course of a morning the pain reduces but then it recurs.  It may reduce when you sit but then increases again when you get up and put weight on the foot.  Movements that stress the foot such as balancing up on toes, walking upstairs can increase the pain.
  • Compare both feet – can you pull the toes up on the unaffected foot – further and without pain compared to the affected foot?  Tight big toe especially that doesn’t extend like it should.  Need to stretch the toes out over time.

Plantar fasciitis is not the same thing as heel spurs and flat feet, but they are related and often confused.  Heel spurs are abnormal bony growths on the bottom of the heel.  They can occur if you have plantar fasciitis but they do not cause plantar fasciitis.  Those with flat feet or high arches may be prone to heel spurs – read the post on Arches – high and low.

Plan of action:

  • Rest and ice – rolling the sole of the foot over a frozen bottle of water
  • Tennis ball massage of the sole of the foot –  see post.    Trigger massage of the foot ach can help, as can reflexology
  • Stretching exercises are targeted towards stretching the calf muscles:  –gastrocnemius –  Put foot on a lower stair (or block) – keep leg straight and hold for 30 secs x 3 times
  • soleus –  same as above but keep the front knee slightly bent
  • Stretching feet -Sitting down with the affected foot supported on a mat/chair – heel down and toes up.  Pull the big toe down for 10 secs x 5 times.
  • Protective heel pads and custom made orthotics are useful
  • Cortisone injections
  • Wearing shoes in yoga classes if the pain is severe

There are, however, so many contributing factors to plantar fasciitis – flat feet, pronation, high arches, tight calves, running, walking, not running, not walking etc and not everyone with one/some of the above experience such pain.  Yoga classes which tend to foster a whole body holistic approach to movement are helpful, I think.

It’s difficult to stretch the plantar fascia and the first stretch in the morning can be painful.  The foot exercises that we regularly practise in class may be too much if the pain is severe, so make sure that you perform the alternatives from standing.  Our “hovering” manoeuvre into dog pose means that we hold a stretch on the bottom of the foot for longer than normal before we push the pelvis up through the action of the feet.  We tend to go in/out of movements and thus massage the soles of the feet.  Our rocking balance on toes and ball of the foot , spreads the toes, strengthens the arches of the feet and the front of the foot.  The piece de resistance is sprinters and I have written much about this.  In dog pose many people cannot lengthen both legs but we can lengthen alternative legs to stretch the calf muscles.

In the marvellous sprinters, we aim to lengthen one leg only – the back leg and thus stretch the gastrocnemius and soleus muscles.  As we progress and become more balanced, we are also able to lengthen the front leg – which is good for the knee.  We always keep the front foot rooted but we roll through the back foot and thus massage the plantar fascia. I have written many a time and oft about the benefits of Sprinters.   The more we practise, the more we embed the movement into our sensory motor cortex and begin to address the biomechanical issues that may cause plantar fasciitis. Sprinters helps us to balance the relationship between the foot, ankle and knee so that when we walk, run, dance or stand we have a chance of being well-organized.

There are many, many videos on You Tube relating to plantar fasciitis.  If you find anything particularly useful, please share it.  If you have pain in the ball of the foot or a rigid big toe due to a bunion, the foot and toe stretches mentioned above will also be of help.

 

 

 

 

 

Pain: self-help in our yoga practice?

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After mentioning Dr. Esther Sternberg’s The Balance within: The Science connection Health and Emotions,I was interested to hear about research into harnessing the power of our immune systems (Radio 4 – Today Programme on 8th February).

Through advances in immunotherapy the immune system is “nudged/tweaked” – boosted or dampened to help the body cope with the inflammation that accelerates and contributes to disease.  Reference was made to Daniel Davies’ book The Beautiful Cure: Harnessing Your Body’s Natural Defences.  Davies is Professor of Immunology at Manchester University and he describes the scientific quest to understand how our immune system is affected by stress, sleep, age and our state of mind.  The linked Guardian review advises:

……..Do not underestimate the importance of immunology. This field relates to you personally . ……………. The best chapter concerns what we really know about how stress affects the body’s ability to respond to attack (measurably and negatively), and how tai chi or laughter interact with our immunity. Answer: we don’t really know, because most of the studies have been not very good……….

How we can play our part in these medical advances in terms of diet, lifestyle, sleep etc, forms part of much popular discussion but it is a very under-researched area.  Self help books abound and Davies examines some of the associated”bunkum”.    Yoga is one of the resources used by many of us to move away from pain and towards health.  However, as yoga teachers it is always important to stick to our area of expertise and to help students refer to appropriate professionals when needed.

Using yoga practice with care and intelligence does help if we “notice”.  I keep “banging on” about this and was intrigued to hear Michael Shannon, one of the stars of the Oscar nominated “Shape of Water” talking about his approach to acting.  His love of “repetition” enables him to reflect on acting and to improve his practice.  He stresses that it is not about achieving perfection, it is about noticing:

…What I am not noticing…… What I am not paying attention to .…”

(Late Night with Seth Meyers)

“Yes!!!”, I cried and this cry of enthusiasm led me to attempt to summarize this short,  generalized  look at pain;  how we move away from it and how we move towards well-being:

  • Practicing in a relaxed way is the only way that we notice.  A student struggling with balance on Thursday vocalized this in class and as she let go of tension she felt more balanced …well on one side at least!!
  • Noticing your breathing does your breathing adapt to your movement? Fluid, changeable breath is a good thing in this respect.
  • Move within a range that does not increase pain.  Allow the body to move as it can at present and please don’t force it to adopt a “pose” or hold a position that creates tension and exacerbates pain.

Being part of a supportive social network enhances our immune system and is noted by Dr Sternberg (p89).  Finding a yoga class in which you feel safe to practice, to rest, to ask questions and to compare notes is desirable, if not obvious.  At home, rolling out the yoga mat is often the hardest part of practice. The next few posts will cover some specific conditions that often feature when students join a class.  I will include some of the things that we do in class that you can take “onto your mat”.

 

 

 

 

 

 

 

 

 

 

 

 

 

Emotions and Pain

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In Dr. Esther Sternberg’s The Balance within: The Science connection Health and Emotions . She explains the link between the central nervous system and the immune system, exploring how immune molecules made in the blood can trigger brain function that profoundly affects our emotions,  This  interplay of our emotions and our physical health is intrinsically affected by stress.

Yoga classes provide us with the luxury of devoting time to breathing, relaxation and meditation – key factors in reducing the stress associated with pain.  Space is created in which we can explore the invisible threads that weave mind and body together. This is perhaps what distinguishes yoga practice from exercise classes.

The impact of pain upon health is the focus of study by The Emotion and Pain Project which highlights the rising number of people suffering with pain and the lack of capacity in our healthcare system to treat these patients one-to-one.  Dr Amanda Williams, UCL Clinical Psychologist says that there are more than 4 and half million GP appointments every year for chronic pain and many more in specialist settings.  She talks about how pain affects our mood, social life and how we feel about ourselves.  Dr Nadia Berthouze describes how emotion is expressed in the way that pain suffers move and by tension held in the muscles.

This project hopes to develop rehabilitative-assisted technology that provides feedback to each sufferer based upon their emotional state.  the technology is formulated for each individual.  In time such feedback should help sufferers to regain confidence in movement.  This is what we try to do in our practice of helpful functional movements and the project aims are very exciting.

In Your Body Speaks its Mind – Stanley Keleman, I linked somatic therapy which explores the relationship between mind and body in relation to each individual’s life/past.  Through somatic therapy, clients begin to recognize holding patterns and how the body may not be able to free itself of tension.  Those who stay with yoga classes that explore functional approach to movement seem to make the transition from expecting a “quick fix” towards a long view of internal physical perception.

However, a yoga teacher preaching such things may sound rather “wishy-washy” when you are pain. In the case of osteoarthritis which affects many people, “heavily used joints become damaged and in an attempt to stabilize the joint, cells move in and make tough fibrous tissue which stiffens the joint ..” (Pain The Science of Suffering by Patrick Wall p.86). Self-help exercises linked from Arthritis Research was of more a more immediate help to a student suffering with tennis elbow ; as was advice given to another student to use a foam roller to relieve the immediate pain caused by iliotibial band syndrome – I hope.

I have come across a site promoting a Pain Toolkit which was developed by Pete Moore, himself a persistent pain sufferer.  The site also features short videos on understanding pain.

If you view any of the resources, please let me know how you get on.  Leave comments on the site so that others can benefit from your experience.