Yoga for Medical Conditions: Our Basic Approach

by Nina

Clear Water by Heidi Santschi of Heidi Santschi Garden Design

Lately some of you enthusiastic readers have been requesting that we write a second Yoga for Healthy Aging book on yoga for medical conditions. And we understand why you’d like to have such a book. Yes, wouldn’t it be wonderful if you could look up any medical condition in a book and find a yoga “prescription” there? But to be honest there are three reasons why this isn’t feasible or even a good idea: 

1. Yoga has the potential to help with a huge variety of medical conditions. If we were to write a book with solutions for every medical condition or even the most common ones, it would be a multi-volume encyclopedia. 

2. There are many different types of yoga and approaches to helping the various conditions. Trying to cover all the different ways you could approach a particular medical condition, say, arthritis or multiple sclerosis, would in itself take up a whole book just on one topic (and indeed, there are books on topics like that, though even they don’t usually represent more than one style of yoga). 

3. Using yoga to help people with medical conditions should entail an individualized approach. Because everyone is not the same, a yoga program for everyone should be customized. One person might have a mild form of the condition and another a more serious one. One person might be young and another old. One person might have be an experienced yoga practitioner and another might be an absolute beginner. One person might be stiff and another might be flexible. One person might like certain poses that another one dislikes. And on and on and on. So, trying to give a yoga “prescription” for a medical condition in a book not only isn’t realistic, it’s basically irresponsible. 

But in thinking about this problem, Baxter and I realized some time ago that we could develop a generalized approach to using yoga for medical conditions that would allow you all to learn something about how you might use your own practice to help yourself heal or just become more comfortable physically and/or emotionally, and that might inspire teachers to think it a more generalized way about what is possible and what is not. My epiphany about this had to do with the fact that while there is a very long list of medical conditions, the things you can do with yoga actually is quite short (see 6 Strategies for Using Yoga to Help Medical Conditions). 

So, in this new series (which will include some older posts), I will point you to some basic approaches and strategies that will give you a better understanding of how yoga can be used to help with medical conditions. However, it’s critical for you to begin with realistic expectations about what yoga can do and what it cannot do. After all, there are some dangerous false claims out there in Yogaland about what yoga can do, such as that yoga can “heal” diabetes (see False Claims Harm Yoga). So, I’m going to start this discussion on using yoga for medical conditions with an overview of what yoga actually has the power to do—or not—for different types of conditions. Let’s start by looking at three different real-life stories.

Maria, a student of Baxter’s with osteoporosis, told him about her latest checkup with her doctor. For two years, she has been practicing yoga several times a week at home and once a week in class. Now her most recent DEXA scan—the tool to diagnose and track osteoporosis—came back with evidence of improvement in her bone density, which is considered a reflection of bone strength, with readings almost back to normal. 

Carol started practicing yoga after treatment for breast cancer. She started by attending restorative yoga classes, where breathing awareness and relaxation were the beginning of her recovery. She says, “I learned a new way in which to move my body and breathe through the grief that I felt over losing my good health.” From there, she moved into regular asana classes. “My yoga practice not only gave me the tools with which to heal my body,” she says, “but it also gave me the emotional strength I needed to cope with recovery.” 

Melitta started practicing yoga six months before her first symptoms of Type 1 diabetes, an autoimmune disease that can occur at any age and that requires exogenous insulin for survival. She says, “When I was newly diagnosed, I was in extreme despair—I thought my life was ruined. But yoga saved my life then by allowing me some space and freedom from constant thoughts about my disease. And yoga continues to save my life today by helping me stay calm and focused despite the daily grind of self-care that those of us with Type 1 diabetes must do.” 

As you see from these examples, the type of medical condition you have will influence the way you use yoga to address it. In the first story, Maria used her asana practice to strengthen her weak bones, helping to reverse the condition. In the second story, Carol used her practice to support her healing and to stay emotionally strong during the recovery. In the third story, Melitta used yoga to help her with the stress of having a serious, chronic disease for which there is no cure. 

Let’s be frank, shall we? Although yoga can be powerful tool for helping with medical conditions, there are very few conditions that it can completely “cure” on its own. However, we think that the range of things that yoga can do to help with medical conditions is actually very impressive! We’ve identified three basic ways yoga can help with medical conditions. As we’ve written about these three basic approaches in the past, I’ll provide a brief overview of the three of them and provide links to the detailed posts. 

Prevention: This form of treatment means preventing diseases or conditions from developing as well as preventing a disease or condition that you already have from getting worse. For example, a well-rounded yoga can help prevent problems related to being sedentary, including osteoporosis, sarcopenia, balance problems, and falls. And yoga’s stress management practices are good preventative medicine for fostering good emotional and mental health, at the same time they help foster physical health. See How Yoga Helps with Medical Conditions: Prevention.

Symptom Improvement: This form of treatment means relieving symptoms caused by a medical condition without curing it. In this case you’re using yoga to achieve temporary or long-term improvement of symptoms. For example, someone with chronic low back pain from a ruptured disc can use yoga very effectively to reduce or relieve pain. And, for a limited number of conditions, such as stress headaches, you can actually both relieve symptoms and cure the underlying condition. See How Yoga Helps Medical Conditions: Symptom Improvement . 

Adjunct to Western Medicine: This form of treatment means combining yoga with other forms of treatment. Yoga is especially effective as an adjunct for prevention, to support ongoing treatment of different kinds, to support rehabilitation from illness and injury, and to help provide relief and comfort care for conditions for which there is no cure. See How Yoga Helps Medical Conditions: Adjunct to Western Medicine. 

P.S. A while back, we had some different categories (see 5 Ways Yoga Can Affect Your Health). After some thought, we decided to streamline the categories. (I love streamlining!) But as this is a different way of framing the same material, so you might want to read it, too. 

Subscribe to Yoga for Healthy Aging by Email ° Follow Yoga for Healthy Aging on Facebook and Twitter ° To order Yoga for Healthy Aging: A Guide to Lifelong Well-Being, go to Amazon, Shambhala, Indie Bound or your local bookstore.

For information about Nina's upcoming book signings and other activities, see Nina's Workshops, Book Signings, and Books.

How to Make Yoga Accessible

by Jivana

I trust that all yoga teachers mean well and come to the teaching of yoga out of a love for yoga and a passion for service. With that in mind, I offer the following suggestions for making your yoga classes accessible to all. 

Welcome Everyone to Join

Part of making yoga accessible is welcoming people of all abilities and backgrounds to your classes. The first step is to consider your publicity materials—the marketing imagery you use and the language you use to describe your classes. It’s essential to be clear in your class descriptions about what kind of practices are included: Is the class open to all levels, can people practice in chairs, do you use music, etc.? Getting this information in advance allows for potential students to be more prepared for what they will experience and that evokes a feeling of safety when they come to class.

It’s also important to consider how to make your classes financially accessible. Can you offer sliding scale pricing or scholarships? For many people the price of drop-in yoga classes is out of reach, and yet everyone deserves access to these teachings. 

Invite Each Student to Participate in All Practices

During class, make sure no one is simply left out because you don’t know how to adapt to their needs. Each student can be included in a conscious way, even if their movement is limited, if you find a way to teach multiple levels at the same time. In order to do this, there are some essential elements to include. 

Consider each practice as a spectrum of possibilities rather than a static pose. Rather than approach an asana by teaching one form, instead focus on the over-arching goal and benefit (and even contraindications) of that practice. From this deeper understanding, your students can learn to explore multiple variations. For example, rather than teach a version of Cobra pose as the “full expression of the pose,” first consider the benefits of Cobra, which could include strengthening the back muscles in deep spinal extension, expanding the heart center, and digestive organ massage, among other things. Then consider how you can find those qualities at whatever level the student is practicing, whether it’s in a chair, on the mat, or even standing. 

If you have a new student, and don’t know what their ability is, try a more collaborative approach. Offer suggestions, but encourage self-exploration and self-awareness. In fact, the first thing to do with a new student is to teach them how to practice rather than jumping into specific practices. This means explaining that the breath is a guide to our movements, meaning that if the breath is short or being held, then the body may be straining. 

We also need to teach students that pain is a sign that you’ve gone too far. Of course, some people are in chronic pain and need to be extra sensitive to that experience. Also, some students may have paralysis and can’t feel sensations in a part of their body, so there isn’t any pain. For those students, it’s best to spend time exploring safe movements in a private or one-on-one setting. Also, with a new student it’s always useful to talk about not competing in yoga and about really trying to step back from the edge, that place where challenge turns into pain. 

Offer Variations at Many Levels 

This means that teachers need to learn how to teach multiple levels of physical ability at the same time. I like to think of an accessible yoga class like a jazz ensemble; each student is like a musician playing a riff on a common theme and the teacher is the conductor. It may look chaotic and seem like everyone is doing their own thing, but there is a harmony running through the entire group. This can be a difficult skill to develop, but one that accessible yoga teachers can cultivate over time. 

When teaching a multiple level class, try to find a way to bring all students together for a portion of each practice, even if they’re doing something that externally looks completely different. One way is to set up students in each version of a pose separately, and then give some common instruction to come into the pose together. This creates an opportunity for multiple levels of a pose to be done different ways. 

For example, you can teach chair and mat versions of Cobra pose simultaneously. Bring the students in the mat into a preparatory position with the forehead on the floor, then bring the students on the chair into a preparatory position, lowering their heads down. Now, bring all the students into the pose together using common instructions that work for both. Something like, “Exhale, grounding down, then inhale and lengthen the neck, slowly curling up the head, neck, and chest.” If this is too complicated, at least find a moment when everyone is in their own version of the pose where you can all breath together. Continually reconnecting the group in this way creates a feeling of inclusivity and equity in the class.

You can also demonstrate one version and verbally teach a different one. If you are teaching a chair version of a pose and a mat version simultaneously, tell the students in the chair to watch you as you demonstrate and give verbal cues to the students on the mat.

Another option is to have an assistant demonstrate one version of a pose while you teach a different variation. I would be cautious about using students in this way. It’s not a job of the student to demonstrate for the group, unless you’ve discussed it previously and they are interested in assisting you in this way. 

When setting up the classroom try to make sure that everyone feels like a part of the group. Students practicing in chairs or wheelchairs can be lined up with other students equally. In fact, students practicing in a chair often benefit from having a yoga mat under their chair for additional traction. Physically including everyone in the “circle” sends an important message that all students are equal, rather than creating a subtle hierarchy in the space. 

Give All Students Equal Praise, Support, and Attention

Not every student needs to be praised all the time, but there needs to be an equal share of love for everyone in the room and not just the “advanced” students. Sometimes, just getting out of their house and coming to class is a huge success for someone with a disability or chronic illness. Be careful about always praising physical ability over other forms of ability and effort. What is the goal of yoga anyway, gymnastics or peace of mind? 

Make Sure Touch is Optional 

In a regular yoga class, teachers don’t know each students’ individual medical history and their past experience with trauma. Because of this and for many other reasons, touching without consent should be unacceptable in your class. 

Also, understanding the scope of practice of a yoga teacher is essential before offering touch. Are you adequately trained to offer touch? Yoga Alliance is setting new guidelines for the scope of practice for yoga teachers. It’s essential to understand these guidelines before touching students. Is it legal in your state according to your level of training? In some states it is only legal to touch a client or student if you are medical personnel, a licensed massage therapist, or clergy. 

There are a variety of ways to make touch optional in your classes. First, you can give a general announcement at the beginning of the session telling students that they have the right to not be touched during the class and giving them the tool to do so. For example, you can use consent cards, which students can turn on one side to say they want touch or turn over to say they don’t want touch. However, consent cards may not work well with chair yoga students or visually-impaired students. So consider three important qualities of consent: informed, ongoing and enthusiastic. 

Informed consent means knowing if the students actually understand what you’re asking their consent to do. For example, telling a student simply, “Can I give you an adjustment in that pose?” is not enough information for a student to decide if they want an adjustment. Instead, say something specific like, “Can I move your arm up?” 

Ongoing consent means that if a student gives you consent at one point in the class that doesn’t mean that you have consent to touch at another time. So you need to continue to get consent each time you touch a student, regardless of their previous affirmative response. Ongoing consent means that we open up a dialogue with our students during class, rather than expecting the silent obedience that is the earmark of certain yoga classes. If you feel like you have too many students in a group class to achieve this type of consent, you may need to avoid touch, get assistants, or teach smaller classes. 

Enthusiastic consent means that a non-answer is not giving consent. The student needs to give an affirmative response to being touched. Remember that the teacher is in the power position in this relationship and the student may defer to your judgement even if they don’t fully agree with what’s happening. That’s why these guidelines are essential for creating a safe environment in yoga. Also, it’s more challenging to get consent to touch students who are non-verbal or who have dementia or Alzheimer’s disease. In those cases, it’s best to avoid touch as much as possible or work with that person’s care team to come up with effective communication tools.

Focus on the Positive

We all have judgmental minds, but it is the work of a teacher to find something positive in your students. Can you find something to celebrate in what the students are doing, rather than focus on correcting and adjusting all the time? 

Make Your Teaching Collaborative and Creative 

Support students in uncovering their own self-awareness through the exploration of yoga practices. This can be done by constantly emphasizing their own experience versus what you think they are experiencing. If you teach a practice and say that it’s calming, what happens if the student doesn’t find it calming? Does that mean their experience is invalid? How do they reconcile their own experience with the experience you are wanting them to have? On the other hand, a collaborative and creative approach means that the entire practice is experience through a lens of exploration and present moment experience. Through collaboration with the students rather than a top-down approach, we can encourage our students to take responsibility for themselves. 

Also, encouraging your students’ creativity can deepen their yoga practice if we teach them to approach every practice as a new opportunity—a new moment. We can teach them to bring fresh eyes and an open mind rather than rely on past experience. Rather than building a practice based on what they “should” experience, creativity means that they are open to what they are experiencing. That creativity is expanded when the student is offered a safe container for exploration where questions are asked rather than answered.

Focus on the Essence of Yoga, Connecting with Inner Peace

Remind your students that yoga is a spiritual practice and everyone shares that same essence equally, regardless of what they look like or what they can do. It’s so easy to get competitive with asana practice and think that more is better. Always remember outer ability does not equal inner peace. 

An important part of yoga is learning to befriend yourself and quiet the inner conflict in the mind. That inner cease-fire comes through acceptance and self-love, not necessarily through gymnastic ability and outer achievement.

Make Individual Empowerment and Community Building Your Goals 

The goal of teaching yoga is to empower your students to find peace of mind through their own practice and not to become reliant on you. So encourage them to build a home practice, even if it starts very slowly. To do this, we need to focus on empowerment by teaching general techniques regarding how to practice and why we practice. Empowerment also comes from being told that we’re worthy of spending the time taking care of ourselves and that finding time to get on your mat is an essential part of self-care.

Community building actually goes along with this. Many people are isolated and don’t have a community. Yoga classes can act as social networks, and many people with disabilities and seniors, in particular, need that kind of support. So can you spend time helping to build those social connections? Can you have the students introduce themselves at every class? Can you spend a few minutes checking in and asking people how they are doing? Can you spend a few minutes after class socializing and encouraging the students to talk to each other?

Focus on Service and Love 

The goal of yoga is self-realization, and, simply put, self-realization is the experience of pure love—beyond the ego-mind’s endless desires. So taking yoga off the mat means to come from a place of love, which is known as service, or karma yoga. As a yoga teacher we have the opportunity to practice karma yoga when we’re teaching. To teach from a place of love for our students can simply mean putting their best interest first and considering what would be most beneficial for them, as well as being kind, patient, and loving in our approach and demeanor. 

Working on all these levels, we can begin to open the practice of yoga to people of all abilities. What’s so powerful is that by doing so we simultaneously open our minds to a deeper understanding of the meaning of yoga. We can experience the truth of yoga—that it is a pathway to connect with our true self. This true self resides in all of us, regardless of our physical ability, past trauma, bank account, race, gender identity, or any kind of identity. It’s not a question of including people who are usually left out; it’s about understanding the truth behind all these labels: that we are ultimately all made of that same essence. Like I always say, yoga is not about having a flexible body, it’s about having a flexible mind, a mind that is clear enough to allow for the truth to shine through. 

“In my view, making yoga more accessible is not fundamentally a moral or social justice issue. One version of such a moral thought process might be that everyone has a ‘right’ to do yoga and we ‘should’ make this possible. While I believe that this is true, it does not get to the crux of the matter. Rather than being fundamentally a moral issue, making yoga accessible to everyone is revealing the truth about yoga. The ultimate heart of yoga is open to all comers. The underlying yogic realization is not exclusionary. I think this distinction is important. It means that everyone has equal access to the heart of yoga because of the true nature of yoga, not because social justice demands it.” —Matthew Sanford 

Namaste: Reverence on Three Levels

by Ram

The Soul of the Rose by John William Waterhouse

According to what I learned in India from my grandfather and other Sanskrit scholars, “namaste” is a revered Sanskrit word with a deep and profound meaning. It’s not a simple act of bringing your hands into Anjali mudra and muttering the word under your breath. It’s also not just a general greeting, like “hello” or “good morning.” You have to mean it when you are saying it because words like namaste have deep effects on the body, mind, and intellect as they can transform an individual. 

This seven letter Sanskrit word is made of two words: namas + te:

Nama = bow, obeisance, deference, awe, salutation, acknowledgment, adoration, worship, respect, adulation, esteem, appreciation.

Te (do not stress on the Te as in Tea, instead think of the name Theo and say Te similarly such that it rhymes with They). Depending on the context, preceding or the succeeding word, Te could mean = you, they, that. 

The appearance of “s” letter has to do with Sanskrit phonetics and grammar that is not relevant to this post. 

If you have an individual saying Namaste to another individual or to a group, it therefore would literally mean: saluting you/you all, obeisance to you/you all, acknowledging you/you all, worshipping you/you all, adoring you/you all. 

Namo vaḥ and Namo vam, are enclitic words and confined to Sanskrit grammar. It is rarely used in regular Sanskrit conversation and represent shortened versions of Namas + Te (Namo vaḥ and Namo vam are akin to the English enclitic words “can’t” and “won’t”). 

If someone addresses you with a “namaste” and you are generous with your blessings and wish that the addressee (individual or a group) receives twice the benediction/adoration, you reply “Namo Namah.” Namo Namah is Namas Namas (of Namaste) repeated twice for emphasis and simultaneously doubling the blessing. Once again, the use of Namo Namah and not Namas Namas is solely due to Sanskrit grammar and word conjunction. 

“Namaskar” is “namaste” in the Hindi language. In South Indian language namaste takes the form as “namaskara” or “namaskaram.”  

When you tell someone, “Thanks, I appreciate it,” do you really mean every word or do you say it loosely? Words are not just elements to utter or write, they carry energy and travel through space as vibrations that can impact the receiver both negatively and positively. Notice our feelings and our state when we hear certain pleasing words or violent words. Pleasing words calm and de-stress us while spiteful/vicious words ruffle us and disrupt our calm demeanor. Namaste is a pleasant sounding, harmonious, and revered word that has its energetic effects on body, mind and intellect. And unlike what some fanatics profess, namaste is not bound by religion. Its effect and meaning is beyond any religious connotation.

In The Koshas: A Yoga Model for Healthy Aging, Beth Gibbs alluded to the five layer koshas encompassed by the three bodies namely physical, subtle and causal/karmic, which need to be completely integrated and functioning in harmony to achieve wellness and wholeness. For the sake of simplicity, I will refer to the three bodies Physical, Subtle and Causal/Karmic as Body, Mind, and Intellect. This is relevant because when “namaste” is uttered consciously, we wish that the energy associated with this term positively affects one or all three aspects of individuality: Body, Mind and Intellect.

Body. It may sound as a customary greeting similar to hello and is often used in yoga and Ayurveda classes ,where the teacher may utter the word in the beginning or end of the class. It is also a customary greeting among Hindus before initiating a conversation and is used with all people, young, old, friends, and strangers. While it may not carry any significance for the addressee or the addressers, in reality it is extending a warm welcome to each other and showing respect that you are equal to one another. The utterance of this word strikes an instant connection, clears away any doubts or discordance, and removes any barriers of resistance. Acknowledging the oneness and equality paves the way for an animated conversation. It also marks the beginning or ending of a conversation. There is no customary rule that it has to be said in a yoga class. I do it at the end of my yoga class: to thank the participants for having attended my class, to thank the participants for a meaningful session, and to acknowledge the studio for providing me the space to teach. Just one word to give thanks to everyone involved in the event! In the Ayurveda classes that I teach each month (each class is eight hours long with multiple breaks), we say “namaste” when we take breaks and resume the classes. I do it for the same reasons as mentioned above. 

Mind. When you say namaste, at the level of the mind you are the recognizing the divinity in yourself and acknowledging the divinity in others. As a teacher of any subject, you want to see the best of your students and you get an utmost pleasure if your students inculcate and practice your teachings. In a yoga class setting, by saying namaste, you are acknowledging mentally that your students gravitate towards the yogic lifestyle (following the yamas and niyamas and gaining expertise over asanas and pranayama) and to successfully building and strengthening the connection between the body and the mind. Additionally, namaste serves as a blessing that their mind is set free of materialistic desires so as to prepare the intellect for contemplation.

Intellect. At the level of the intellect, by saying namaste you are acknowledging the “true you” (purusha) and the true self in others. You recognize that the true you is the same in all others as well. In a yoga class, you are also letting go of your ego as a yoga teacher. No matter how famous and skillful you may be in your asana practice, you continue to be humble, ready to teach, and learn from others, inculcating in your students positive feelings and experiences, transforming all negative experiences, having no judgement, giving and receiving blessings, and viewing all individuals as a manifestation of that supreme divinity. 

Thus, at the highest level namaste is not a loose word but a revered greeting. There is no specific time, venue, or event when this can be said. The argument that it need not be said in yoga class since it is not followed in yoga centers in India does not hold good, since there is other yoga-relevant stuff that happens in the West (dog yoga, aqua yoga, couples yoga, tantra yoga, yogalates, etc) that is not followed in India. To use this word, you need to be open hearted and generous with your good wishes and blessings to others and to society. Say “namaste” and let go of your ego and personality, feel open, grounded, and calm. And experience oneness with your true self and see everyone and everything else as an embodiment of that true self: “the oneness”. You also have a choice of directing the vibrations of this word to just one level or all three levels of individuality—body, mind and intellect. After saying it, notice if you are experiencing contentment and a sense of accomplishment. It’s a great positive spiral and it results in true happiness. 

Now you may understand why I sign off all my mails to Nina with “Namaste.” Thanks to this divine soul, I am able to pen my thoughts and communicate with you all through this blog.

Namaste!

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Subscribe to Yoga for Healthy Aging by Email ° Follow Yoga for Healthy Aging on Facebook and Twitter ° To order Yoga for Healthy Aging: A Guide to Lifelong Well-Being, go to Amazon, Shambhala, Indie Bound or your local bookstore.

All About Your Feet

by Baxter 

Feet by Vincent van Gogh

One of the most frequent requests that I receive from our readers is for information about conditions related to the feet, and one of your all-time favorite posts is one I did about bunions. And the importance of healthy feet really came home for me when I read Atul Gawande’s powerful book on issues of aging Being Mortal, and I noted the emphasis gerontologists place on assessing foot health in the older patients as a predictor of future function. 

On a personal level, I have noticed as I am getting older that the health of my feet is vitally important for independence and my continued participation in activities that are important to me, including my asana practice, my new-found love of tennis, desire to travel, and walking and hiking. In fact, over the past few months, I have experienced an unusual periodic tender swelling around the ball of my right foot that lingers for up to a week and definitely interferes with my regular activities when it shows up. Fortunately—even though I am not yet clear on why—a modified approach to my asana practice including practicing non-weight bearing poses and lots of Legs Up the Wall pose seems to help resolve my symptoms. 

A 2014 survey by the American Podiatric Medical Association of 1000 adults aged 18 and older noted that 77 percent had experienced foot pain. And as people age, there is an increase in complaints of foot pain! The presence of foot pain is also associated with an increase chance of indoor falls in older adults, and a 2011 Australian study showed that a foot care program, consisting of foot exercises, inexpensive orthotics, and shoe advice, reduced falls in older adults with foot pain by 36% over a one year period. So, addressing various causes of foot pain with yoga could not only decrease pain and improve function, but could hopefully even reduce falls due to foot pain. 

After receiving yet another inquiry recently on a condition of the feet (see Friday Q&A: Sesamoiditis and Yoga), I was curious to review the past posts we have done here on the feet and consolidate them so our readers would have a single place you could refer to when searching for foot-related information on the blog. I hope this will be useful for you as yoga practitioners and for those of you that are also yoga teachers. 

I've divided the posts into three categories: basic information about the feet

Basic Information about the Feet

In Video of the Week: Anatomy of the Feet I provide an introduction to the anatomy of the feet, including basic structures, landmarks, and functions.

In Video of the Week Anatomy of the Feet, Part 2 I focus on the movements you make with your feet and ankles and how these movements related to some yoga poses.

In Video of the Week: Anatomy of the Toes along with basic toe anatomy, I discuss how your toes move, what their functions are, what which kinds of common problems they can have.  

In Getting to Know Your Ankles I focus on the basic anatomy of the ankles. 

In Parallel or Not: Aligning Your Feet I share my recommendations for how to position your feet in standing poses.

In Your Feet On My Mind I identify some of the basic variations there are among different people's feet. 

Importance of Healthy Feet for Healthy Aging

In Want to Improve Your Balance? Take Off Your Shoes! Nina writes about the importance of practicing yoga with bare feet and going barefoot in preventing falls.

In The Importance of Preventing Falls, inspired by the book Being Mortal, I describe why maintaining foot health is so important as you age.

Specific Foot Problems 

In Friday Q&A: Flat Feet I discuss what flat feet are and how to work with them in your yoga practice.

In New Tricks for Old Dogs: Working with Bunions I discuss how to use your yoga practice to improve your bunions.

In Friday Q&A: Bunions, a Can, and a Rubberband I recommend a simple practice you can try to improve your bunions.

In Friday Q&A: Foot Cramps I discuss what foot cramps are, how to practice when you're having them, and how to avoid future cramps.

In Friday Q&A: Plantar Fascitis I discuss what plantar fascitis is, how you can practice when you have it, and how you might use yoga to help the condition.

In Friday Q&A: Morton's Neuroma I discuss what Morton's neuroma, a condition of the ball of the foot, entails and how you can use yoga to help you heal. 

In Friday Q&A: Difficulty Standing on the Balls of the Feet I discuss how to practice when there is difficulty standing on the balls of feet after surgery for Morton’s neuroma.

In Friday Q&A: Sesamoiditis and Yoga I discuss what sesamoiditis (a condition of the toes) is and how to practice yoga as you are healing form it.

In Friday Q&A: Hammertoes I discuss what hammertoes are and provide a sequence to practice for those who have the condition.

In Friday Q&A: Big Toe Stiffness (Hallux Limitus) I discuss hallux limitus, which causes big toe stiffness, and provide tips for how to practice for those with the condition.

In Friday Q&A: Feet and Comments Shari and I both weigh in about how to practice yoga if you wear orthotics in your shoes.

In Yoga for Foot Pain I discuss how to practice yoga after a traumatic foot injury.

In Ankle Sprains  I recommend how to practice yoga after an ankle sprain. 

Subscribe to Yoga for Healthy Aging by Email ° Follow Yoga for Healthy Aging on Facebook and Twitter ° To order Yoga for Healthy Aging: A Guide to Lifelong Well-Being, go to Amazon, Shambhala, Indie Bound or your local bookstore.

Follow Baxter Bell, MD on YouTube, Facebook, and Instagram. For upcoming workshops and retreats see Baxter's Workshops and for info on Baxter see baxterbell.com.  

Video of the Week:Hands-Free Half Lord of the Fishes Pose

In this version of Half Lord of the Fishes pose you place a strap around your hips and top leg to support your upright posture and allow a hands-free variation. Practicing the pose hands-free will provides more strengthening of your core and spinal muscles used to twist your spine than the classic version of the pose.



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Follow Baxter Bell, MD on YouTube, Facebook, and Instagram. For upcoming workshops and retreats see Baxter's Workshops and for info on Baxter see baxterbell.com.  

Friday Q&A: Who Can Use the Name "Yoga for Healthy Aging"?

Q: Who can use the name "Yoga for Healthy Aging" for their yoga classes? 

A: The short answer to this question—which we get asked a lot—may surprise you: absolutely anyone. We don’t have a copyright or trademark on the phrase “Yoga for Healthy Aging.” So, if you or someone in your community wants to have a class or workshop by that name, you can. 

However, only those who have taken our teacher training program and have been certified as a Yoga for Healthy Aging teacher use the phrase “Certified Yoga for Healthy Aging Teacher” in their class listings and advertisements. 

And I like to request that if you are not certified but are inspired by our work and use information, sequences, etc. you get from our blog and book, we would appreciate it if you credit us in class listings and advertisements. You can do this by including any of the following phrases (or something similar): 

“Inspired by the book Yoga for Healthy Aging: A Guide to Lifelong Well-Being by Baxter Bell, MD and Nina Zolotow”

“Inspired by the blog Yoga for Healthy Aging, co-founded by Baxter Bell, MD and Nina Zolotow” 

“Inspired by the book Yoga for Healthy Aging: A Guide to Lifelong Well-Being by Baxter Bell, MD and Nina Zolotow as well as the Yoga for Healthy Aging blog.” 

And when you use your phrase in online material, we’d appreciate it if you would include the links to our blog and/or book information. 

Thanks so much for asking about this and we really appreciate your consideration and respect. 

—Nina 

Subscribe to Yoga for Healthy Aging by Email ° Follow Yoga for Healthy Aging on Facebook and Twitter ° To order Yoga for Healthy Aging: A Guide to Lifelong Well-Being, go to Amazon, Shambhala, Indie Bound or your local bookstore.

For information about Nina's upcoming book signings and other activities, see Nina's Workshops, Book Signings, and Books.

Upcoming Yoga for Healthy Aging Intensives

by Baxter

July 2018 Yoga for Healthy Aging Intensive Attendees

Because we have been receiving inquires regarding when the next 30-hour Yoga for Healthy Aging Intensives will take place, I’ve decided it’s time to update you. We have completed our scheduled programs for 2018, but we are now scheduling for 2019 and beyond. 

As of this writing, we have the one definite intensive on the books for 2019 and we’re very close to finalizing another. Although we don’t yet have the details (such as costs, how to sign up), this will be available on my website www.baxterbell.com in the next two or three months. For now, use this information to save a date in your calendar: 

• The definite intensive is: Namaste Yoga Studio, Berkeley, CA, June 24th-28th, 2019. 

• The not-yet-finalized intensive, which will be a residential retreat, is Kripalu, in Massachusetts, for fall of 2019. We will announce it on the blog when it’s finalized. 

We are also looking for more venues for 2019 and 2020! Because we have the West and East Coast of the US covered, we are hoping to offer the course in other parts of the US and abroad. So if you have a yoga studio or retreat center in the US Southwest, Southeast, or Midwest or anywhere else in the world that would be interested in hosting a Yoga for Healthy Aging intensive in the future, please let us know. Email me at baxterbell@mac.com with your proposals.

About the Yoga for Healthy Aging Intensive

The course will provide instructions on maintaining your physical, mental, and emotional health as you age. The main focus of the course is on preventative strategies, covering: 

Strength
Flexibility
Agility
Balance
Stress Management
Circulatory System and Heart Health
Brain Health
Equanimity

Baxter and Melina Meza will present the scientific background that explains how and why yoga works to foster healthy aging, so you’ll understand which techniques to use when. They will also teach you the essential yoga poses, yoga sequences, and other practices that will set you up for a lifetime of practice.

This intensive is designed for relatively healthy, relatively physically able participants who have one or more years of yoga experience. Not included in workshop: 1) Instructions for seniors who cannot stand unaided and need to practice in chairs and 2) Information about yoga as therapy for specific medical conditions.

For certified yoga teachers, this course will provide supplemental, specialized training in yoga for healthy aging techniques, which you can then teach to your own students. For yoga students this course will provide you with the tools to create a personalized yoga program that meets your particular needs and concerns.

For teachers who want YHFA Certification, you will need to:

1. Attend all the sessions during the intensive.

2. Attend the extra session at the end of the intensive, where you’ll do a short teaching demonstration.

3. Pass the take-home, open-book final that Baxter and Melina provide using the book Yoga for Healthy Aging: A Guide to Lifelong Well-Being.

4. Provide a copy of your basic yoga teacher certificate (minimum 200-hour training required) or resume reflecting equivalent experience.

PRICING 

This will be determined and available once courses are confirmed and online 

ABOUT THE TEACHERS

Baxter Bell, MD, C-IAYT, eRYT500 is co-author with Nina Zolotow of Yoga for Healthy Aging: A Guide to Lifelong Well-Being and a co-founder of and regular contributor to the Yoga for Healthy Aging blog, where he shares his knowledge of medical conditions, anatomy, and yoga with practitioners and teachers across the world. In addition to teaching classes, workshops, teacher trainings, and retreats internationally, Baxter has been a presenter at Yoga Journal Conferences and the International Association of Yoga Therapy’s Sytar Conference, and teaches online courses at YogaUOnline.

Melina Meza, eRYT500, BS Nutrition is a certified YFHA teacher and Ayurvedic health educator, who has been sharing her knowledge of yoga for over 20 years. Since 1997, Melina has been teaching at 8 Limbs Yoga Center in Seattle, where she is co-director of their teacher-training program. Meza is the author of the Art of Sequencing books and contributing photographer for Yoga for Healthy Aging blog. Currently residing in Oakland California, Melina facilitates year-round yoga workshops and retreats. 


Subscribe to Yoga for Healthy Aging by Email ° Follow Yoga for Healthy Aging on Facebook and Twitter ° To order Yoga for Healthy Aging: A Guide to Lifelong Well-Being, go to Amazon, Shambhala, Indie Bound or your local bookstore.

Follow Baxter Bell, MD on YouTube, Facebook, and Instagram. For upcoming workshops and retreats see Baxter's Workshops and for info on Baxter see baxterbell.com.  

Stress-Related Disorders and Autoimmune Diseases

by Nina

Photo by Heidi Santschi of Heidi Santschi Garden Design

Just a quick post today to let you know about a recent scientific study Association of Stress-Related Disorders With Subsequent Autoimmune Disease that aimed to answer the question, “Are psychiatric reactions induced by trauma or other life stressors associated with subsequent risk of autoimmune disease?” 

I might have to unpack that question for you. First of all, what are the “psychiatric reactions” that they are referring to? They list the conditions as: 

“Diagnosis of stress-related disorders, ie, posttraumatic stress disorder, acute stress reaction, adjustment disorder, and other stress reactions.”

I’m actually not familiar with the disorders mentioned here other than PTSD. But it turns out that acute stress reaction is an anxiety disorder and an adjustment disorder is when a person’s reaction to an event is greater than what you would normally expect for that kind of event. As for the “other stress reactions,” I’m not sure what those might be, but I would assume they would include prolonged anxiety and depression.

And, second, what is autoimmune disease? There are actual several autoimmune diseases, including rheumatoid arthritis, lupus, and multiple sclerosis. But what these all have in common is that they are diseases caused by our immune systems attacking healthy parts of our bodies, including tissues, joints, muscles, nerves, or skin, as if they were foreign invaders. Normally, your immune system can differentiate between your own cells and foreign ones. foreign cells and your own cells. But, in an autoimmune disease, for reasons that we do not yet understand, the immune system identifies your own cells as foreign ones. Needless to say, these are very serious chronic diseases. So knowing if having a stress-related condition increases the risk of developing developing an autoimmune disease would be very useful information. 

To answer this question, the authors of the study looked a very large group of people, including 106,464 patients with stress-related disorders, such as PTSD, panic disorder, anxiety, etc., 1,064, 640 matched “unexposed” people, and 126,652 full siblings. And they found that stress-related disorders were indeed “significantly associated with risk of subsequent autoimmune disease.” (In their study the incidence rate for people who had stress-related disorders having autoimmune disorders was 9.1 per 1000 person-years compared with 6.0 in the matched unexposed group and 6.5 in the sibling group.

Their conclusion was:

“exposure to a stress-related disorder was significantly associated with increased risk of subsequent autoimmune disease, compared with matched unexposed individuals and with full siblings. Further studies are needed to better understand the underlying mechanisms.” 

So, there you have it. There IS an increased risk for those with stress-related disorders of developing autoimmune diseases. However, the scientists don’t yet know why. Knowing the underlying mechanisms would help us identify exactly how to lower the risk for those people. However, until then, we do know that yoga can help both with stress and with stress-related disorders, including PTSD, anxiety, and depression. For example, the work of people like Dan Libby, Ph.D. of the Veterans Yoga Project, who works with veterans who have PTSD, and Richard Miller, Ph.D. who has an iRest Program for Healing PTSD, have shown the benefits of yoga to support the healing process in those with PTSD. And, of course, we have lots of information about how yoga can help with prolonged anxiety (see Yoga for Anxiety: The Big Picture).

To me this new evidence strengthens the argument for practicing yoga for stress management on a regular basis to help yourself become more stress hardy and for practicing it as part of your self-care when you are undergoing stress (see Stress Management for When You're Stressed ) or have suffered from trauma. 

Subscribe to Yoga for Healthy Aging by Email ° Follow Yoga for Healthy Aging on Facebook and Twitter ° To order Yoga for Healthy Aging: A Guide to Lifelong Well-Being, go to Amazon, Shambhala, Indie Bound or your local bookstore.

For information about Nina's upcoming book signings and other activities, see Nina's Workshops, Book Signings, and Books.