Beth Hinnen

So. My shoulder thing is still going. Lots of crunchy noises (which the sports medicine guy said are no big deal, unless there’s also pain) and the occasional sharp pain (which is moving from the top of the arm to the inside of the shoulder blade). It’s lessening and lessening, but still not gone. I know this stuff takes forever to heal, so I’m trying to be patient. But I’m also trying to keep my practice habit intact. I was already struggling with slacking, and then the injury confused me almost to the point of inaction (much like a muscle in spasm). I’ve been wondering how much rest my shoulder needs, how much work and what kind, how much stretching / massage / release, and, most of all, what is up with my Down Dog? (My left shoulder doesn’t feel anything like the right one now.) I’ve been unable to distinguish pain that is strengthening my shoulder from pain that is further aggravating it. So, I’ve been looking for some specific guidance on what poses to practice, and what poses to avoid.

A friend who also has a left shoulder injury (from a skiing accident, much more glamorous than my sleeping accident) recommended Beth Hinnen at Integral Yoga. She studied Structural Yoga Therapy, an Iyengar-based system of individualized therapeutic yoga, and wrote her final paper on rotator cuff injuries. (Note: I don’t know any other teacher training that makes you write a thesis.) The class is general Hatha II, with a mix of men and women, young and old. We did some gentle warmups, three rounds of Sun Salutes with variations, some standing poses and inversions, and closed with pranayama and meditation. (Warning: there is chanting, for those of you who can’t take it.)

I’ve been three times now, and been helped greatly by each class. In the first class, after I introduced my injury (not that it’s a separate being…), she gave me some great adjustments in Down Dog. She really emphasized the external rotation of the upper arm bones, while keeping the inner rotation of the forearms, until my shoulder blades simply couldn’t wrap around the side of my ribs any more. She eliminated my overarched back by waking up my abdominal lift and containing my flared lower ribs. I felt strong in the pose again, and not scared to practice it any more!

The second class started with the Joint-Freeing Series, a sequence of wrist, elbow, and shoulder movements that’s also great for arthritis. She also gave us shoulder tips in each and every pose. But I had a flashbulb moment at the very first instruction. From sitting, she had us bring our arms straight out in front of us, and stretch them forward. “Now pull the shoulders back, into their sockets, and feel them relax downward.” Well, mine were the opposite: relaxed when stretched forward (out of the socket), tense and awkward when drawn back home. So I’ve been working on that adjustment for three weeks now, and noticing crazy subconscious postural habits. (I really think injury is 90% posture, and 10% irritant.)

In the third class, the Cobra instructions were really helpful. Lying on the belly, palms under the shoulders, relaxing the lower back and butt. Keep them relaxed as you raise the forehead an inch off the floor. Try again. Try again. It’s amazing how much we overuse our lower back. This method helps release the lower back, and strengthen the upper. We also did Locust with arms by the side, out perpendicular, and in front, for three more levels of strengthening.

Beth was also kind enough to bring me the handouts from the shoulder workshop she teaches: anatomy articles from Yoga Journal, diagrams of the rotator cuff bones and muscles, and instructions for the Joint-Freeing and Shoulder Strengthening Series. She taught me Cat Bow, a short pushup from Table Top (with the shoulders in front of the wrists) that helps strengthen the serratus etc. These two series take about 15 minutes total, so I’m trying to practice them every day.

It feels really good to have a strategy now. I really appreciate all the tips Beth gave me; I have a path back into my poses. If you have a rotator cuff injury, a slipped disc, a bad knee, or really any kind of confusing pain, I urge you to check out the research papers on the Structural Yoga Therapy site. It will give you an amazing introduction to the field of individualized yoga therapy, if you haven’t encountered it already.

Your lower left hand

Another interesting day in Yoganatomy today… and of course I had to write about it cause Leslie (hi, Leslie!) pulled me out and changed my posture…

Today we learned about the feet, everyone’s favorite body part. The cool thing about Leslie’s class is that he focuses on the WHYs and HOWs of anatomy, instead of the WHATs. Meaning, I still can’t name the muscles in the feet, and we didn’t review a laundry list of bones, but I could now tell you how the load-bearing system distributes weight throughout your step. More on that later.

Most people have foot problems. And we usually blame our shoes. Which is legitimate, but not for the reason you might expect. Leslie says that foot pain is caused by the increasingly uniform surface of the Earth, combined with the binding technology of our shoes. Our feet evolved to move over irregular surfaces: rocks, roots, pebbles, mud. Sidewalks and gel-aero-spring-max shoes take away the challenges for the feet, and so their muscles weaken. Fallen arches, plantar fasciitis, and all sorts of other pain result.

My sister has plantar fasciitis, which ended her glorious Division I soccer career, so I’ll just tell you (the Internet) what I tried to tell her voicemail today:

When muscles are not challenged, they become weak, and atrophy. In the foot, this leaves space between the bones of the arch and the connective tissue (plantar fasciia) beneath. The space calcifies with heel spurs and inflames the tendons, aka plantar fasciitis. Typical treatments like stretching the calves, to reduce the pull on the heel from above, don’t address the pull from below. Rebuilding the muscles of the foot, by walking barefoot, or standing on wobbly surfaces, will treat the real source of pain. Orthodics and other shoe devices might help manage acute pain for a short time, but as long as the foot is weak it will have problems. A year or two of strengthening and rebuilding the feet will do wonders for the whole body, since each step ripples up the skeleton.

A side note: Dr. Scholl’s sandals, flip-flops, and even Birkenstocks are not so great, if they make you grip your toes to keep the shoe on. Tai chi slippers, sandals with ankle straps, and anything with a flexible sole will allow the whole foot a stronger relationship with the earth.

Elite runners have known this for years, and often run in little more than socks. The big shoe companies are finally catching up — Nike Free offers three stages of shoe that actually move you away from technology and towards barefoot. (The stages let you gradually rebuild your foot muscles, you can’t jump your poor weak feet straight into a barefoot marathon.)

So, back to the movement of weight through the foot. Ideally, it travels from the strike point in front of your heel, down the lateral side and across the ball, spiraling out between your big and second toes. Leslie had us walk around to feel this pathway, with two points to work on:

1. Move from your center of gravity, with the body as a whole unit (as in Chaturanga) instead of flicking the legs out in front to lead. This translates to a little forward lean, a little weight in the toes, without sticking your butt out to counterbalance.
2. Keep the point where your foot leaves the ground (the ball of your foot, between your first and second toes) on the earth a little longer. This creates a little more spring in the step.

The combination of all three was too much for me, and Leslie called me out for a curious “skating” gait I’d modged together. I tend to lean backwards and rest my weight in my heels, and apparently I lead with my legs, so when I kept the back foot a bit longer on the ground, there was kind of a slingshot effect as my whole body-and-then-leg had to move forward. Leslie had me stop, and lean forward. My heels came off the ground. He said to ground the heels, and lean my sternum into his hand. I hesitated. “Like Chaturanga,” he said. (The yoga pushup that builds great core strength.) I had to kind of think through those alignments, and what they’d be like perpendicular to the ground, and then I leaned forward. My toes activated, but with my center strong I felt it all the way up the front of my body! And when I walked forward it was all one piece, not my loosey-goosey floating flock of birds. Very cool.

So, sorry Leslie, I spilled my guts about your whole class, but you do give people their first visit free so here it is, with a Thank You!  :)

This came from some notes for a class I recently gave — thought I’d share.

What does Bliss feel like? Is it extreme pleasure, or is it (as Swami Satyananda Saraswati, among others, says) more accurately defined as the absence of pleasure or pain, a state beyond mere pleasure and pain, a pure merging with all that is.

So, what does this mean for our yoga practice? That yoga is not practiced to make us FEEL anything — although certainly both agony and ecstasy can be induced. It is all too tempting at times for some of us to push for a feeling (of ecstasy) and through pushing too hard, wind up in agony. The reverse can be true, too……that by enduring a bit of agony, ecstasy may come as the reward. Then again sometimes, for some of us, it’s just about feeling something, ANYTHING (see my earlier post, The Yoga Addict :).  However, this is not the true goal in asana.

The nature of the spine is to be blissful.  The nature of the spine is to be a channel for force to flow through. It is not for force to act on. THIS IS SO IMPORTANT! Sadly, so many of us are so accustomed to feelings of pain in the spine that the mere absence of pain may translate as pleasure. To be an effective channel, the spine should not be obstructed. It should not be disturbed. The spine should be supported, but not locked in a vice grip. The spine should feel free.

Of course, this is not to say that the spine does not move in yoga and in life! As we know, the spine has an incredible range of movement. Healthy mobility and healthy stability are not mutually exclusive. They always coexist. They rely on one another.

If there is an obstruction to the flow of energy through the spine, how can we remove the blockage without putting force on the spine? We utilize the breath to unclog the channel. We use the breath to access the force behind the breath — prana, chi, life-force, mojo.  This is the key: movement of the spine, whether slight or extreme, is always initiated from the inside, from a base of support and freedom.  Movement of energy through the channel of the spine  inspires the outward movement of the body, rather than forcing movement of the outer body in hopes of clearing the spine.  So, from a practical perspective, what does this mean? How do we support the spine in an authentic way, through a wide variety of movements?

Let’s first re-think the spine. What are some words we would use to describe the spine? Perhaps what comes to mind first is the skeletal spine. Which is, of course, important, but over-emphasis on this one system may lead us into a narrow experience of the spine described by words like “bony”,”fragile”, “segmented” …all of these are accurate descriptions of the spine in a sense, but they are not the whole story. The spine, like the rest of the body, is multi-dimensional. All of the body’s systems operate through movement of energy through the channel of the spine. And all of the body’s systems support one another, not just the skeleton supporting everything else.

What about the digestive system? My current yoga teacher Lisa Clark poetically refers to the digestive tract as the “serpentine spine”, and emphasizes using the digestive tract as support for the skeletal spine in asana practice. This has been incredibly effective for me in finding not just fluidity but also strength in my practice, as I learn to source strength from the dense, buoyant and moist quality that the organs offer. In fact, developmentally, the organs form before the skeleton. The spine and ribcage grow around and in response to the organs. So it makes sense to move from the organs and allow the skeleton to follow, thinking of the body as a suspension in the matrix of gravity and levity, rather than letting the organs just “hang” from the outer structure. Considering the entire digestive tract — from mouth and soft palate to the anus — as an aspect of spine is a powerful tool for rethinking the axis of the body and where movement comes from, which in turn can profoundly affect the quality and experience of movement itself.

What are some other aspects of the spine? There is the nervous system, that delicate and sensitive passageway for electrical impulses and cerebro-spinal fluid, that precious transmitter of movement from the brain to the body at large, of sensation from the rest of the body to the brain. What are the qualities of this dimension of spinal awareness? How does awareness of these qualities affect movement?

A useful exercise may be to practice a simple movement (like rolling up from uttanasana to tadasana, or good old cat/cow) initiating movement of the spine from different systems — from bones, from the jelly-like disks between the vertebrae, from the lungs, from the nervous system, from the organs, etc. To take it a step further, allow the movement to evolve carried by whatever system is being focused on. See what asanas may spontaneously arise from awareness of the different aspects of “spine”. I have found that by allowing the bony spine to be supported and “carried by” other systems, instead of trying to use the bony spine and muscles to support and “carry” the other systems, the inner channel of the spine is liberated, and energy may flow more freely, thereby inspiring further movement (or stillness).  When the spine is calm in asana and we are not distracted by extreme physical sensations, we can attune ourselves more fully to our breath and the  subtle sensations of prana  moving through sushumna, the etheric level of spine, the true “core” of the body. When the central channel of the body has been cleansed this way, gently and  from the inside, that is when the illusive feeling (or non-feeling) of Bliss is likely to spontaneously arise.  That “pure merging with all that is.” And that’s what it’s all about, right?

Leslie Kaminoff, owner of The Breathing Project and my current anatomy teacher, just shared some notes from his workshop at the SYTAR (Symposium for Yoga Therapy and Research) yoga conference in Los Angeles:

Some Suggestions for Individualized, Breath-Centered Yoga Practice

Finding our individual form of asana practice is something we all need to do, even the most strict Ashtangi. Our body proportions are all different, so we can’t force ourselves into our image of the pose. If your femurs have short necks, you won’t reach Lotus easily or at all. (And if you keep forcing it, you will wreck your knees.) If your spinous processes are long, your backbend will be limited to the space before they touch. Certain shapes can only be made by certain skeletons. This doesn’t mean we’re not “doing” the pose if we vary from its most popular depiction; the DIRECTION of our limbs and centers creates the space or compression that defines the asana.

This relates to one of the most important lessons I’ve learned from Leslie: work from a SPINAL perspective, not a SPATIAL perspective. The silohuette of your pose doesn’t matter; the inner relationships do. Are your vertebrae actually rotating in your twist, or are you just moving the arms and shoulders to appear more rotated? I’d say asanas are an arrangement of joints more than limbs. Work from the inside out, and let your breathing evaluate the “success” of a pose.

Leslie and not-me

On Friday I went to see my anatomy teacher Leslie Kaminoff, who noticed my blog posts bemoaning my injury and kindly invited me to come in to his clinic. Yay for blogs! I sit in class every week and watch him fix people, but I kept thinking my shoulder would be better tomorrow, or tomorrow, or maybe tomorrow…

I did my little demo of snap-crackle-pops around the left shoulder blade, which he said was probably tendonitis (inflammation of the tendons). I told him about the pinch in the upper arm, and how I’d tried to treat it according to my trigger point book, which pointed me to a big painful knot on the back of my shoulder blade. He said that the spasming muscle was probably the teres minor, more than the infraspinatus, since I felt the knot better with the arm over my head. He asked about my job and computer use, so I described my work station… turns out that elbows on the desk is “really, really bad. There’s your problem.” Villain!

Then came the treatment. It’s like a bit of chiropractics, a dash of Thai yoga massage, and a pinch of Shiatsu all mixed up as a breathing lesson. He found a rotated vertebrae in my neck and fixed that. He found all the “stuck” vertebrae in my back, and popped them. He stabilized the center of my diaphragm (aka “pushed on my tummy”) to force my ribs to expand upwards as I breathed. And he cranked me into this one twist that I swear popped the fused vertebrae in my tail. Then he stretched out my hip flexors, my hip extensors, and my neck. We hadn’t even gotten to my shoulder yet.

All these adjustments were like adding an extension onto my house. When I sat up, it was like I had a third lung; I just kept inhaling. He said that when we have an injury, we have to look at what’s supporting it. So, a neck or shoulder condition can result from tightness (or collapse) in the ribcage. When we have good support below, we can have full mobility above.

Then we adjusted the shoulder a bit. He pressed his thumbs into my back as I moved my arms from side to side, up and down. I felt the knots underneath squirming and trying to escape. He popped the humerus back into its socket a bit, I don’t know how. And then we were done!

I can’t get over the fact that the solution to this is breathing better. It makes sense; if I loosen up my ribcage, I can stretch my shoulders from the inside, too, 24 hours a day! But it seems so easy. As with my meditation, and asana practice, I’m going to have to beat myself over the head with the “secret”: it’s all about your breath! Maybe I’ll take it literally, Monty-Python-style. That’ll convince the masochist in me. I will still be squelching the knots under my neck with my tennis ball; it’s a new favorite sport, and I have to undo all my computer poses. But it’s amazing how posture — the way we align ourselves in the 22+ hours OUTSIDE of yoga practice — will make or break our health.

So. Next step is to rearrange my whole computer setup, ugh. (And up my olive oil intake, it’s the best anti-inflammatory and that should help my tendonitis… along w/the icy New York weather.) I guess I need a higher chair, or a lower desk. But I already went today and bought one of those ugly laptop stands, so my computer is floating six inches above my desk (like a good yogi) with a new keyboard underneath. My big head is no longer looking down at my screen, pulling on the back of my neck. My elbows are opening downward, and my wrists are flat. And my shoulders are relaxed.

POSTSCRIPT — I forgot an interesting part. Leslie said that the infraspinatus (or was it subscapularis?) and rhomboid muscles work in opposition, and while we do a lot of rotator cuff strengthening in yoga (chaturangas and other “pushing” movements), we don’t have a lot of poses or movements where we “pull” our arms back or shoulder blades together and strengthen the rhomboids. So he said I could loop a strap around a door handle, hold it with straight arms, lean back, and pull from the shoulder blades in little pulses to strengthen the rhomboids. Without overdoing it, of course. I think I might try to get myself back onto an erg…

Don't make me do it!

If you’ve had low back pain, you know how incapacitating it can be. One wrong step, and some mysterious stranger stabs a knife between your vertebrae. If you haven’t, and you’re practicing yoga, please read this article on the threats of twisting.

The one thing I would add is an insight from Leslie Kaminoff (again): the lower back does not twist. Really. There’s only 5º of rotation possible in the lumbar spine. It just follows the direction of the sacrum. We can get a feeling of twist there, by engaging the abdominal muscles and feeling them wrap around the spine, but most of our twisting happens in the thoracic and cervical spine. So T11-T12 is a common place for injury, since it’s the first really rotating spinal joint. Make sure you’re spreading your twist throughout the spine.

Joe Miller

This weekend I had an old yoga friend in town, which was really great because I got dragged to Vinyasa classes and Burning Man decompressions instead of bars and Broadway. I got to talk about Warrior I for twenty minutes! Because this fall, the real issue is whether your front heel should align with the middle of your back arch or not. And don’t get me started on the sitbones.

Her friend, who also studied at Atmananda with us, goes to Joe Miller’s Vinyasa class every Saturday at Om Yoga (near the Strand). It was rainy and windy, and my stomach ached, but I went (since that’s what you do when friends are in town… and they have free passes).

According to his bio, Joe has done the full Yoga Anatomy / Breath-Centered Yoga training with Leslie Kaminoff. (The same one I’ve just started.) I’ve been wondering how teachers work this material into their classes. Good answer: Start off with an illustration of diaphragmatic movement, using interlaced fingers and the movement of the elbows/forearms. Clear and interesting.

Joe was quite knowledgeable, and had an amazing eye. He could spot a tipped ankle from across the room. He leads the anatomy portion of Om Yoga’s teacher training (I think), and gave us many subtle details on the poses, without being overwhelming. In Down Dog, for example, he told me I needed to lift the undersides of my arms up, all the way to the shoulder socket, especially on the left side. This made total sense; I’ve had some crackling and weakness in my left shoulder lately that finally made me realize I tend to work my right arm more than my left. [Or, I might have a weak serratus anterior on the left side, and need to do some one-armed pushups! Thanks to Edya Kalev at the Breathing Project for that one.]

I am ROCKING Marichyasana A here

Major bonus: Joe also explained Marichyasana (A) so that I finally understand what the hell it’s supposed to be doing. When sitting in that tightly bound forward bend, I get either the lean forward (which tips me sideways) or both sitbones down (which tips me backwards). It’s one or the other, and since I never knew the primary purpose of the pose — hamstring stretch? abdominal compression? — I couldn’t prioritize my movement. Joe says both sitbones should be down, but there is a strong lift of the sternum (using the arm against the bent leg) that will then create the forward movement. And it all became clear to me… [singing angels noise]

We did several poses from the Ashtanga series, including the seated jump-backs that I normally hate (they are so arbitrary!), but I could watch my friend do them breezily and be proud. The class and sequence were well-paced (I definitely broke a sweat) considering the amount of information Joe was giving. It’s hard to cover a lot of anatomical detail without going into super-talky workshop mode.

It is so great to find a wonderful teacher who hasn’t left New York to start touring the world…

Leslie Kaminoff at the Breathing Project

I just had to make a quick post about the open house I attended Wednesday at The Breathing Project. Leslie Kaminoff gave an amazing lecture on breathing and anatomy in yoga, I’m seriously considering signing up for his anatomy classes instead of heading for the Iyengar Institute. His approach is less detail-oriented than Iyengar’s; he says it’s “impossible” to manage a laundry list of alignment instructions while you’re doing a pose. “As soon as you’re focused on your right pinky, your left eyelid goes out of alignment.” So at the end, he says the guidelines for each pose have to come from inside. After all, “There’s no such thing as an asana — where are they right now? where are they stored? — there’s only people. Individuals. There’s Amy’s Down Dog, or John’s Down Dog, but there is no universal Down Dog.”

I think this approach is much more in line with the book I’m working on with Sabina Stahl, which is called Intuitive Lifestyle. It’s more about finding your intuition in asana practice, eating, and general life. So I’ve been reviewing a lot of anatomy notes, but wondering how precise and thorough we’re going to get. Also, in the four years since I did my teacher training, I’ve encountered some conflicting directions on anatomy, so I’ve been wondering how we’re going to reconcile those.

Leslie has a really interesting background. He started out at Sivananda in the seventies, when his father invited him to a class over on 25th Street. He ended up becoming a swami and heading up the LA center. “The early eighties were an interesting time to be a swami on the Sunset Strip.” Jane Fonda had her studio just down the road, it was the birth of the aerobics and body building movements, and the Nautilus machines allowed people to weight-train safely for the first time. He ended up leaving the ashram and working at a Sports Medicine center. There, they treated all the injuries associated with the exploding popularity of high-impact aerobics etc.; they treated Jane Fonda herself. He saw hundreds of x-rays of spines, and was startled to realized most spines don’t look anything like the nice straight columns we see in the books. The idea of asking these spines to do these yoga poses was terrifying, and he stopped teaching yoga for a few years. Eventually he went back to New York, to work for a famous osteopath, and then to the Krishnamacharya Yoga Mandiram in India. He would ask Desikachar WHY these poses had such profound effects, but no one there could answer his questions. So he began researching the anatomical basis for yoga’s benefits, and that study culminated in his book with Amy Matthews, Yoga Anatomy. The book is in its fifth printing in one year; there was “a real hunger” for this type of information.

It was also interesting to hear “you know, the study of yoga anatomy is only 30 years old. At Sivananda, it was ‘Now we will do Shoulder Stand. Do it.’ Maybe they would say ‘work the hands towards the middle back’ but that was it. Only when Mr. Iyengar landed in Ann Arbor did we start to get details.” Likewise, “the study of Bandhas is only 12 years old. Ashtanga was the first system to really make a big deal out of them,” so the precise study is still young.

One last nugget: “As a teacher, you can focus someone on a spatial goal, or on a spinal goal.” The former is trying to push them into a particular shape, the latter is more about the relationship between the parts.

Or one more: “Either we’re doing these postures to get them right, or to be free.” Eventually, we will lose any pose we’ve achieved (to age or infirmity), so we should aim for freedom and not achievement in the asanas.

Amy Matthews also taught a wonderful class about anatomy according to the Body-Mind Centering principles of Bonnie Bainbridge Cohen, and Jill Satterfield led us through a deliciously slow, mindfulness-meditation-oriented hatha class. Is New York City finally slowing down?

PS — All quotes are approximate.

The Spirit of Sharing by Tom Geisler

I’ve been meaning to share this amazing illustrator (Tom Geisler) who has drawn out the internal organs as they respond to emotion. Very cool!

No word on whether you can go backwards, and stimulate the organs (aka do yoga) to generate the emotion.

I tried medical illustration once and it was a bust, it is so hard to visualize such detailed configurations of three-dimensional objects that you’ve never seen. Quite impressed with Tom’s work.