SMARTer bodies

Category: Yoga

What is Frozen Shoulder and Why Yoga Will Make it Worse

Frozen shoulder is a physical syndrome in which the range of motion in the shoulder joint is severely limited.

For a more official definition we turn to Web MD:

Image courtesy of WebMD
Image courtesy of WebMD

Frozen shoulder, also known as adhesive capsulitis, is a condition characterized by stiffness and pain in your shoulder joint. Signs and symptoms typically begin gradually, worsen over time and then resolve, usually within one to three years.

Your risk of developing frozen shoulder increases if you’re recovering from a medical condition or procedure that prevents you from moving your arm — such as a stroke or a mastectomy.

Treatment for frozen shoulder involves range-of-motion exercises and, sometimes, corticosteroids and numbing medications injected into the joint capsule. In a small percentage of cases, arthroscopic surgery may be indicated to loosen the joint capsule so that it can move more freely.

It’s unusual for frozen shoulder to recur in the same shoulder, but some people can develop it in the opposite shoulder.

What the above looks like in an individual affected by frozen shoulder can be an incredibly painful and frustrating movement experience. Reaching for any item, washing one’s hair and trying to carry ANYTHING can wreak havoc on an already weakened physical state. Repetitive mishaps (of which can seem minor and unpredictable, like putting on a jacket too quickly) can worsen the injuries that first led one to this state.

So what causes frozen shoulder? Typically, injuries to the rotator cuff are responsible for the onset.

The rotator cuff is made up of 4 muscles: supraspinatus, infraspinatus, teres minor and subscapularis. If any of these muscles or their associated tendons suffer a severe enough tear or strain there may a consequential stiffening of the shoulder. If the injuries are compounded the body’s defense against repetitive injury may kick in and not allow the joint to move above 90 degrees or lateral movement of the arm becomes impossible.

To repeat: This stiffening, tightening of the joint capsule and overall inability to move through the joint is the body’s way of trying to avoid worse injury. Well-intentioned as this may seem it is obviously painful and limiting to one’s quality of life. But to try to force more movement as advised in myriad videos about “yoga for frozen shoulder” can be dangerous and worsen the situation. Our experience in successfully training a few individuals out of this physical myre involved the sensitivity to listen to the body and create a basis of stability based on breathing practices as well as strength-training.

Contact us for more information and keep your eyes peeled for a video that will explain more in detail. Feel free to submit a question so Mel can answer it specifically.  She’ll also discuss why she thinks women tend to get it more frequently than men.

 

Tea and Yoga to Cleanse for This Spring

*A review of a workshop Mel taught with trainer and tea sommelier Natasha Nesic. How are you supporting yourself this Spring? First scene on teamuse.com as written by Natasha.

“I want to debunk the myth that spinal twists wring out the organs. I’ve been seeing that in a lot of yoga journals lately.”

Melissa demonstrated, rotating her torso. “The organs are mostly on the front of the body. They don’t move.”

This was only the beginning of the Spring Cleanse Tea & Yoga Workshop at West End Health & Fitness, held on March 26th, 2017.

“See? Here they are on the front of my body.” She reversed the rotation. “Still on the front of my body.”

Free stock photo of healthy, woman, relaxation, girl

The studio mirrors created multiple reflections of her flexing like a cat, as the workshop attendees and I watched from our mats and folded blankets.

Then we followed suit, pulling knees to chests, tapping into the intimate capabilities of our musculoskeletal system. Who knew that a spine could rotate like that?

With each stretch and bend, Melissa encouraged us to go deeper within ourselves. Breathe, listen to the funny inhabitants of our bellies. And as organs are wont to do, they responded appreciatively.

“Excuse me, that was a burp. That’s an expression of organ function.”

One of the founders of SMARTerBodies, Melissa is an expert at marrying functional physiology with classic asana. Rather than leading us through a flow of up-down-cat-cow-bird-dog-horse-narwhal-etc, she explained each pose as a way of getting to know one’s body, to listen and provide assistance to its needs.

As important are they are, we often ignore our bellies. When was the last time you had the chance to say hello to your digestive system?

I won’t go into the effect on my own digestive system—please use your imagination—but when paired with her calm voice and breathing techniques, those gentle twists released my spine from countless hours spent training, typing, and tea-ing.

For a moment, all was still.

This was the theme of the day’s workshop: release.

Tea in Cup

Melissa and I had partnered for this event to create an experience of cleansing the self from winter blahs and unwanted negativity. “Detox” is a popular catchword at this time of the year, but the human body is capable of cleansing itself in its own way—no organ-wringing necessary.

For us, a little tea and yoga would help prepare for brighter months ahead. Hence, Adagio’s Sunlit Blooms were perfect for this workshop. They embodied the light, invigorating qualities needed for a sense of rejuvenation. Floral and citrus? Yes, please.

Starting with A Bushel And A Peck, this black and green blend sailed into your mouth on chamomile wings. Steeped for a bare two-three minutes, the base teas of hardy black and sensitive green harmonized like a team of professional opera singers. This is quite a feat for a black-green blend, as these tea types have different steeping times as could possibly go bitter against one another.

Yet luck was with us! Luck, plus the blend’s hidden jasmine, which quietly linked the major tea-voices together. The fact that jasmine symbolizes purity made it all the more fitting.

We transitioned into the next tea, A Tisket A Tasket, for more sweetness and citrus. At first sip, there was the delicate orange scent that accompanied A Bushel And A Peck, but this time it came with a stately green base.

Future blenders, pay attention: the base tea makes the difference. Having that slight edge of vegetal goodness from the green tea allowed the citrus to explode delightfully in your mouth, while a hint of vanilla flavor and lemongrass turned the whole sip into a tropical creamsicle.

Our third and final tea was A Pocketful Of Posies. This caffeine-free blend contained the now-familiar flavor of chamomile from the previous tea, yet here it was set up with lavender, rose, hibiscus, and blackberry leaves for a total bouquet of soothing sensation. People remarked on how calming it was, and we discussed how certain herbs—chamomile, lavender, etc—have anti-inflammatory properties.

And taking care of inflammation is important. Being that the workshop took place at a gym, part of the “spring cleanse” meant thinking about how to apply tea to one’s own health and fitness practice. Whether it’s arthritis, sore muscles or dry skin, you want to be able to treat that inflammation of tissue. Drinking anti-inflammatory tea—and due to the antioxidants present in plant matter, this means that every type of tea is anti-inflammatory—is a great way of reducing and preventing inflammation.

The biggest question, however, was calorie count.

Does tea have calories?

Yes. Everything edible contains calories.

But being that tea is thermogenic, the calories consumed by drinking it are going towards boosting your metabolism, to burn more significant calories from the food you ingested during the day. (Of course, by the time you’ve drunk enough tea to really kickstart your system, the sensationalized “weight loss” is usually water. Let no one forget the diuretic action of tea drinking!)

Yet at the end of the workshop, in the bliss of lavender and yoga-endorphins, calories didn’t really matter.

Spring was here. We breathed and sipped for warmer days.

Bad Yoga Tip #4 REVISITED – Yoga for Headaches. Our Mistake Rectified..

One of our readers pointed out an error we’ve made when describing a function of the blood brain barrier. We had claimed that the BBB was responsible for controlling the volume of blood surrounding the brain, trying to keep cranial pressure safe. Turns out we were wrong. The comment and original post is listed below. It felt important to repost and share. We are not afraid to admit we are wrong. We are extremely grateful to the people who read and share our posts. We are REALLY grateful to those who contribute comments and keep us on our toes. Thank you to Lindsey for making us smarter. This community is essential in our endless journey for knowledge. Remember, fact check, fact check, FACT CHECK!
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Lindsey said: You’re not wrong about the volume of blood in your brain, but it’s not the blood brain barrier making it happen. The BBB isn’t within the circulatory system, but wrapped around it. It prevents molecules of a certain size crossing the capillaries to enter the fluid in your brain. This protects your brain from a lot of bloodstream infections and inhibits many drugs from reaching the brain tissue. However, it doesn’t limit the flow of blood into the vessels that supply the brain. That is managed by the same smooth muscles that regulate flow throughout your body. The brain can eventually be injured by remaining inverted too long, although with training I suspect that period can be extended by active muscular control and positioning.
Sometimes the metaphorical language of something can be very helpful, like, “Breathe into your kidneys.”  You can’t actually ever breathe into any other organ other than your lungs, but directing someone’s attention to their kidneys with their breath can be extremely useful. But when making scientific assumptions you need to have your facts straight.  One’s use of scientific jargon must be clear and definite, particularly in the efforts to legitimize the benefits of yoga in the eyes of the mainstream medical community.

Recently, we stumbled upon an article on Yahoo that touted the benefits of certain yoga poses to treat headaches.  Check it out here. Unfortunately, there were too many false statements in this article that jeopardize the legitimacy of yoga as a physical practice and therapy.  Obviously, Kim and I had to put a stop to that.  To be clear, we are NOT criticising the potential positive experience of using these poses in a therapeutic manner. What we are critical of is the “scientific reasoning” that the writer uses to back these statements. The poses themselves have merit when spoken of and applied correctly!According to the Cleveland Clinic, “Headache pain results from signals interacting among the brain, blood vessels and surrounding nerves. During a headache, specific nerves of the blood vessels and head muscles are activated and send pain signals to the brain. It’s not clear, however, why these signals are activated in the first place.”  They identify at least 7 different types of headaches with varying symptoms and effects. The treatment for each kind is just as varied as the symptoms. That being said, it would be hard to imagine a situation in which just 5 yoga poses relieve any and every kind of headache.As stated in the article we are critiquing, “full relaxation” could certainly help with certain kinds of headaches, like tension headaches, which are thought to be caused by tight muscles of the head and neck. However, often trying a new type of physical activity does not manifest as relaxation, but rather the opposite until the body learns the movements efficiently. To a seasoned yoga practitioner, who knows how to do these poses properly, this might actually help a tension headache. To a beginner, the thought process to figure out how to do the pose on top of the muscular tension caused by doing something new may actually make a headache worse.

“Downward facing dog inverts the head to allow blood flow to increase to the brain.” This is something we have heard a lot and is not only not true, but detrimental to the brain. The brain needs a consistent volume of blood for it to work properly. Too little blood to the brain is not good, but neither is too much, which could actually cause a stroke! Luckily, our brain does not allow this to happen and the above information is not true. There is tissue called the “blood brain barrier” that regulates the amount of blood going into the brain and does not allow the volume of blood to the brain to change too drastically when we go upside down. In fact, there is a lot of information out there about this. Jon Burras, a Wellness Consultant and Yoga Therapist, has written an excellent paper on the 8 Myths of Inversions.  As far as downward facing dog relieving a headache, maybe it will. Maybe it won’t. But it will not be due to this reason.

“The cobra pose stretches most of the back, including the hard to reach lower back.”  In cobra pose, you are extending your spine, retracting your shoulder blades, and pulling them down. All of these actions actually cause a large majority of the muscles of your back to contract, not to stretch. In order to stretch the back muscles, you would have to do something like plough pose, to flex the spine. That being said, will stretching the muscles of the back relieve a headache? Not so sure how that is related to a headache… BUT that is not to say that someone couldn’t have that experience from cobra pose, but again it would NOT be for the aforementioned reason.

“Like Downward Dog, the Seated Forward Bend allows blood to flow toward the brain by inverting it a bit. This is a gentler inversion, but perfect if the pain you’re experiencing is behind the eyes or in the forehead region.”  Actually, a forward bend is not an inversion at all.  The force of gravity in this pose is not enough to “increase the flow of blood to the brain” (which we just discussed how that doesn’t work anyways due to the blood brain barrier).  The position, however, is enough to further aggravate a headache if hanging your head forward puts a further strain on your back or neck muscles.  To make the most of it try to consciously release your fluids, brain and eyeballs.  If this sounds inaccessible then use a prop to rest your head on and release into that.

“The ultimate relaxation pose (Corpse Pose), this can be useful if you are having trouble relaxing.”  Savasana in and of its self is not a guaranteed gateway to relaxation in the face of physical challenge.  We’re sure someone has already tried lying down, they just didn’t call it Savasana, and it didn’t work. You’ll have to “try” a little harder to relax then just lay on the floor.  Use props under the knees and head, or an eyemask if you’re feeling sensitive to light.

“The Cooling Yoga Breath (Sitali) is great to help lower blood pressure and help the blood vessels in your brain to relax and ease your pain.”  There is no explanation in the article as to how this might work.  In fact, using Sitali actually constricts the volume of air you are able to take in one breath.  This can cause a feeling of panic until one figures out how control the timing and depth of the breath.  Think of suddenly breathing through a snorkel tube.  The stress can actually raise your blood pressure.  You have better chances of lowering your blood pressure by slowing down your regular breath.

Bad Yoga #17: Don’t Use Your Glutes in Bridge Pose (Setu Bandha Sarvangasana)

Bad Yoga #17: Don’t Use Your Glutes in Bridge Pose (Setu Bandha Sarvangasana)

I love treating my group classes like an open forum for discussion of all things yoga, movement…and reality TV. Picture me in a toga leading the class through Socratic dialogue. Recently, in one of these glorious moments of learning a student asked, “When we’re in bridge pose (Setu Bandha Sarvangasana) aren’t we supposed to release the glutes?” I had never heard of this cue, but others definitely had as evidenced by every other student in the class saying that they were also struggling to relax their butt muscles while holding the bridge shape.

No, people, you don’t understand. I thought I might actually pass out. This had to be one of the most egregious cues in the history of movement anything. I asked the student what the purpose of this cue was and she said, “We are told to relax our glutes to release tension and strengthen the quads.” Honestly, this is a moment that, even in memory, leaves me dumbfounded. It’s just so bad.

This fine tidbit is one of many tragic misinformation bombs that are dropped daily in yoga classes. Ok, so here’s why not using your glutes while in bridge is a bad idea. You need to use your glutes to get your pelvis in the air in the first place. Ideally, the muscular work of this bridge is then distributed along the entire back line of your body. But the gluteals, hamstrings and calves are the dominant muscle groups used to maintain the shape and height of your bridge. What I’m describing here is a kinetic chain; a group of muscles working together. To interrupt an integral part of that chain by releasing the buttock muscles could be injurious especially with repetition. (Note: The push of the feet into the floor with a strong and well distributed force is also essential to the shape of this asana. But for the sake of time and keeping this post at a decent length we’ll not go further into that.)

So, is it even possible to do bridge pose without the glutes?! Maybe…weird shit happens all the time, but it’s doubtful.

You could probably eventually train your butt to relax when you’ve reached the top of your bridge. If you are successful you can expect your pelvis to drop, which means you won’t get to experience the full length that your hip flexors and quads reach while achieving this hip extension. This stretch in the front of the body is a great reason to do bridge, especially if you spend a lot of time at a desk sitting (perpetual hip flexion). However, when the pelvis (i.e. physical support against gravity) drops in your new sad-bridge, those same quads and hip flexors could be overworked in a terrible compensation pattern resulting from desperate attempts to maintain length. Imagine an arch. This is the shape we are creating. But we are human and not stone. In order to create a nicely integrated shape it must be dynamic and the muscles of our backline contract to support the shape against gravitational and other compressive forces. Thus, in this asana: no gluteal support = inefficient compensation patterns. Also, the pelvis dropping a bit from its position  could aggravate already present low back issues (chronic pain, stiffness, herniations, etc.).

On an entirely superficial note, who doesn’t want strong, well-developed booty? I know I’m Puerto Rican (and Mexican) and, therefore, biased. But why not safely practice yoga and look good while doing it?

 

If you’re afraid of getting giant, bubbly booty because that’s not your thing (again, unimaginable in my world) do not worry. It takes more than a regular yoga practice to get that look. On the other hand, if you are interested in it, Kim and Marcus, the SMARTer personal trainers on our team can get you there. Be prepared to eat. A lot.

Now, I want to know, have you heard this cue? If so, ignore it! If you believe it, help me understand. One last thought: when I explained all this to the misled student mentioned above she said, “Well, shouldn’t we learn to do this pose supported by our bones?” I ask, “What moves your bones???”

 Want to hear more about this topic? Listen to this awesome podcast from our friend Ariana and colleague who interviews a cool movement teacher Joanne Elphinston. Then listen to all her other podcasts!

Want to train that butt and legs? Watch our apprentice, Abby, demonstrate killer bridge pose variations.

Bad Yoga #16: If I Twist the Wrong Direction the First Time Then I’ll Hurt Myself?

Bad Yoga #16: If I Twist the Wrong Direction the First Time Then I’ll Hurt Myself?

Our dream came true when one of our readers wrote to us with the most fabulous question:

I’d like to see if you can answer a question for me. I’m currently working on my 500 hour yoga certification. This past weekend one of the teachers, in talking about twisting postures, insisted that twists must be done to the right then left to follow the path of the intestines. She went so far as to say that you are putting your students digestive health at serious risk to do twists left then right. This just doesn’t seem likely to me. So please, if you can answer this question; does it matter which direction twisting postures are performed? I’m working on a scientific based workshop about asanas and would love to have some data regarding twists.

Thank you for your help,
Bruce Peterson

Great question and people are now sending them to us for answers. Happy happy day!!!!! (um, please do this more.) Ok, well, here’s our answer. Feel free to let us know how you think we did. Thanks again Bruce!

colonBe aware that systems of medicine that are explicitly based on the use of energy flowing through the body (i.e., acupuncture, ayurveda, etc.) may be more supportive of what your teacher is suggesting. Some people use yoga in this kind of therapeutic way. We don’t (but do support other beneficial aspects of yoga), so we’re going to keep our explanation in the context of the physiology we do refer to in SMARTerYoga™. This is partly the difficulty of culturally appropriating spiritual/esoteric practices like yoga and trying to apply them to a different demographic.

  1. Right to left is the direction in which the colon is structured and it moves its contents along this pathway. So, that’s accurate, so far….
  2. The enteric nervous system is very sensitive and responsive to touch. So, if you were doing visceral massage I would go with what’s typically been taught and massage right to left in order to help facilitate the movement described above. But, twists are not massage and do not provide the direct pressure that a massage would.
  3. Let’s put “yoga advice” in the context of daily living. If the advice you were given is true then you should be worried of ever having to spontaneously rotate your trunk to the left. This happens countless times in a day. Imagine having dropped something on the left and you pick it up with your right hand. Does that mean you now have to develop an OCD-like ritual to compensate for twisting “against your colon?” Doesn’t seem functional for easy living.
  4. Never have we read anything in movement literature that suggests otherwise. Maybe double check by looking in Lexus-Nexus or PubMed articles? Or collect data by working with students/private clients and document them as case studies.
  5. Neuroscience! The human brain is bilaterally organized, meaning we have a right and left hemisphere that is connected by the corpus callosum. When these two halves of the brain control our limbs they do so contralaterally. Left brain is in charge of the right side of the body and right brain is in charge of left side of the body. Guaranteed, if you google, “trunk rotation and bilateral organization of the brain,” you will find a plethora of scientific and movement oriented literature that suggests crossing our midlines is necessary for optimal brain function. I highly doubt that our brains and bodies would be constructed in this way if we had to be so careful about, what is to most of us, casual and unconscious movement. If, having been born structurally normal, I shouldn’t have to care about which direction and order I rotate my trunk. It does’t make evolutionary sense and it flies in the face of the principle of homeostasis.
Bad Yoga #15: Practicing Chaturanga Will Make Your Shoulders Stronger…NOT

Bad Yoga #15: Practicing Chaturanga Will Make Your Shoulders Stronger…NOT

We will not be the first, nor hopefully the last, to write about the dangers of trying to do Chaturanga without proper strength training. Our hope is to disabuse the general public of false beliefs. One being that all things “yoga” are a safe way to mindlessly approach movement while under the guidance of an often under-qualified instructor. Chaturanga is one of the most challenging postures in any yoga class. It’s a straight plank with your elbows bent and tucked into your sides. Google it and you’ll see what’s up.

The shoulder joint is one of the most complicated and unstable joints in the human body. The shallow structure of the scapula’s curved edge, in which the head of the humerus sits, makes this joint prone to injury. If you’re going to repeatedly attempt movements like Chaturanga then you need to know that the alignment cues that go into making the asana’s classic shape (the elbows at 90 degrees) can put much strain on the front of the shoulder joint.

The spine in this posture is supposed to be held in an elongated line. In other words, The curvatures of the spine are meant to be held in balance, without one of the four curves looking exaggerated. Your lumbar curve is not overly pronounced and your thoracic spine extends to reduce the look of a hump. (We recently heard a yoga teacher tell students to draw in the lower belly in order to “puff up” the lower back. The last few sentences are the anatomical description for the experience that cue is trying to convey.) This foundation of core strength must be established firmly before attempting the posture. Try holding the spine in this line while lying on the ground (supine) and not letting it shift while you move your limbs. This takes focus and skill just lying down. The challenge will become increasingly more difficult while trying to resist gravity in Chaturanga. Once you properly train the core you can move on to shoulder function.

The front of the shoulder joint is most at risk. Let’s suppose you can properly maintain core strength/spinal alignment. But now, you must stabilize the shoulder complex, especially as you bend through the elbows. All this means is that your shoulder blades don’t peel off your ribs, a movement known as “winging.” Scapular stabilization is related to strength and the proper function (timing) of your rotator cuff muscles, lats, anterior serratus, pecs, trapezius, etc. The size and shape your scapulae and the heads of your humerus will influence how well you can control the shoulder blades in Chaturanga. (Note: Everything you do in yoga is going to be influenced by prior physical occupations and body proportions.) Performing Chaturanga repeatedly, without the ability to stabilize, can lead to damaging the tendons of your rotator cuff and even possibly the tendon of the biceps. My biceps?! Yes. The biceps help you position the scapula over the hands and also help you bend your elbows. So, if your scapulae wing and shift forward towards the ground the head of your humerus will most likely be shifted forward in the joint and the end of your clavicle can catch and pinch the aforementioned tendons.This same pattern of injury can occur in badly performed overhead patterns, especially when there’s weight involved. Translation into yoga speak: Downward Dog.

So if you really want to do Chaturangas and be safe here’s how:

Look to other forms of exercise to prepare your body.

Being able to do sustain a full plank with scapular stability is a healthier place to start when trying to build up to Chaturangas. Then move on to practicing pushups with the arms and hands wide away from the body. This is a less strenuous position for the shoulder joint. If the second you start lowering to the floor (bending your elbows) your shoulder blades start winging off your rib cage then you should assess, with the help of a movement professional, what you need to do to progress in a healthy way. While in yoga class, you should evaluate how ready you are for advanced vinyasa flows which include many chaturangas as you transition (Note to ego: Just drop to your knees when making these transitions till your ready. Or don’t and end up with scapular dysfunction. Whatevs.)

Not all Yoga moves are appropriate for all bodies. This may be disappointing, but it’s true. One of the biggest lies/misconceptions about a yoga practice is that it has to look a certain way or that your physical self must somehow conform to a specific style of performance. Not true. At All. If you know that doing Chaturangas, or any other asana, hurts then stop. You don’t have to include it. If you want it then go about pursuing your goals intelligently. Don’t believe the hype about practicing everyday to get stronger. Practicing the same pattern over and over will only (maybe!) make you stronger in that pattern, even if you are doing it incorrectly. Insisting on this kind of repetition can potentially lead to overuse injuries.

*The subject of this post was explored at the request of Anna Bluman. She is a fellow anatomy nerd and awesome yoga teacher. If you’re in London go see her! We would.