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Archive for August, 2012

This outstanding, well-thought, and well-crafted post is reprinted with permission from Alison Eastland, a yoga teacher in Australia and the host of huonvalleyyoga.com. Alison’s writing on back care was featured on this blog in the popular post Do Yoga Classes Your Back Hurt?.

This is the question I get asked most, and the answer is often not what new students expect.

My way of teaching involves choosing from a range of Yoga techniques to suit the participants in my classes. Taking into consideration participants’ daily lives, posture, state of mind, and energy levels, as well as any injuries or stresses they may be dealing with, I draw on a range of Yoga practices including physical sequences, breath awareness, mindfulness and physical alignment to re-create ease and steadiness in body and mind.

I do not describe my teaching as fitting into a particular “style”. However, I was trained as a Yoga teacher by Wendy Samek of Adelaide who has trained with the Iyengars in India every two years for many decades. Her training gave me an appreciation for working with varied physical postures and making the physical practice accessible to all bodies, including those with injuries. Wendy had also studied with several European and Indian teachers, and passed on to me knowledge of pranayama (breathing) and flow sequences, such as Surya Namaskar.

Working alongside Physiotherapist Robyn Jay in Adelaide with her clients further developed my appreciation for alignment and physical ease in Asana practice. Study I undertook during retreat at the Satyananda Mangrove Centre, New South Wales, helped me to develop my practice using a more wholistic range of techniques including Yoga Nidra, Mantra, and Karma Yoga. In my teaching I also incorporate techniques I learned from Kausthub Desikachar and Donna Farhi, and I draw from my training in Buddhist meditation techniques, Guided Imagery, and even my experiences with Dru Yoga and Qi Gong. I’m also influenced by the work of teachers such as Judith Lasater, Gary Kraftsow and Jason Crandell.

Which of these influences I draw on in class, depends on the group of people in front of me and how they seem to be responding to the practice. One of the best descriptions of this philosophy of teaching I’ve heard was offered by Leigh Blashki, a founding member of the Yoga Teachers’ Association of Australia, Director of Training Programs at the Australian Institute of Yoga Therapy, and Vice President of Yoga Australia. At a retreat for teachers at Niche, Tasmania, we were discussing the difficulty of being pigeon-holed into a “style” by prospective students and all the assumptions and pre-conceived ideas that can entail. Leigh said that if someone named Karen rings him and asks what style of Yoga he teaches, he would like to say that he teaches “Karen Yoga”, or if  Robert turns up for a session, then he would be teaching “Robert Yoga”. This makes perfect sense to me, considering that each person has a unique body, temperament, and constitution, and has had different life experiences.

Of course, this is a very challenging way to teach; for example, if someone super-fit and physically active with a very busy mind comes to class from their day at the office, and so does someone who is physically tired from a day of manual labour, and so does someone who has some chronic physical conditions, I am going to have to try to find a happy medium. This is part of the reality of teaching in a rural area with a small and widely varied population, and this is why classes, rather than individual sessions, are always a compromise. However, classes remain a good way to make Yoga practice affordable and accessible for many, and are a nice way to spend time alongside others who are also interested in their  well-being.

All this can, understandably, be confusing for beginners who expect a named style such as  Iyengar Yoga, Ashtanga Yoga, Satyananda Yoga, or Bikram Yoga. However, these styles are really very recent, modern developments in the history of Yoga, which is thought by many scholars to be around 5,000 years long. Traditionally, Yoga teachings were passed from a teacher to an individual student, and those teachings were offered based on the student’s individual constitution and temperament. Classes, where physical sequences are taught to groups, only became common in the early 20th Century.

The most well-known modern styles were developed from the teachings  that  T. Krishnamacharya gave to B.K.S. Iyengar, Pattabhi Jois and T.K.V. Desikachar to suit their individual temperaments. B.K.S Iyengar went on to develop Iyengar Yoga, Pattabhi Jois’ style went on to become Ashtanga Yoga & influenced the development of “Power Yoga” in America, and Krishnamacharya’s son, T.K.V. Desikachar, went on to develop Viniyoga.

Some of Krishnamacharya’s sequences were developed from a blend of Hatha yoga, wrestling exercises, and Western gymnastics to suit the temperaments of the highly active Indian youths he taught. These techniques have been very influential in the evolution of Ashtanga Vinyasa Yoga, Flow Yoga, and Power Yoga.

What does all this mean for the Yoga beginner? I believe it means that the Yoga techniques available to us today have evolved and adapted in response to the culture and lifestyle of the people practising it, & that it will continue to do so. Patanjali’s Yoga Sutras, thought to have been written around 200 AD and considered by many teachers to be a foundation text for modern Yoga, do not even mention any of the physical Yoga postures we think of as being so important today. All the Sutras say about the physical part of Yoga, is that our posture should be steady, and easeful…and this is usually translated as referring to seated posture for meditation: Sthira Sukham Asanam (Seated posture should be steady and comfortable).

The best thing about all this, is that there’s a way of practising Yoga to suit everyone. Even within “styles” or “schools” of Yoga, individual teachers can be very, very different. If you don’t feel like the first teacher you go to is right for you, keep trying until you find a teacher and a class that suits you. While I prefer not to follow a named style, I have great respect for those who do follow a particular lineage of teachers and this is often a good way of ensuring a teacher has undertaken some rigorous training and has had to meet the high standards of their chosen tradition.

You’ll know the right class and practice when you find it, because it will make you feel steady, and at ease.

With thanks to:

“Yoga’s Greater Truth”, by Mark Singleton, Yoga Journal

Leigh Blashki, Vice-President of Yoga Australia

Niche, Tasmania http://www.nichetas.com.au

Wendy Samek, The Centre Om

T.K.V. Desikachar (see his book, “The Heart of Yoga”).

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Admittedly, there is some gratification in knowing that medical advice now supports what should have been part of asana teaching for decades. A 45-year old woman, a glaucoma suspect, is advised by an ophthalmolgist to avoid inverted positions such as a headstand and  “semi-inversions” such as downward dog. This was discovered in the post by the ophthalmologist Dr. Carolina Valdivia on her blog http://www.glaucoma-eye-info.com/yoga-positions.html.

With increased attention regarding yoga injuries in the main stream media, there is some openness now that did not exist some years ago. This is a welcome change for everyone. Yoga injuries are not a badge of honor or any indication of a high level of personal commitment to an asana practice. This attitude to yoga is completely misguided. The risks and limitations of asanas are still not part of most yoga teacher training programs.

Dr. Valdivia answers the following question by a 45-year old woman from New South Wales, Australia:

“Hi Dr. Valdivia. I have been very recently diagnosed as a glaucoma suspect, but at the moment my eyes are healthy. I am not taking any medication for it.

I practice yoga and my eye specialist has told me that because I am a glaucoma suspect I should not attempt any fully inverted yoga poses (legs above the head, for example: headstand) and to limit time spent in semi-inverted yoga poses and postures (head below the heart, for example: downward dog).

My question is, how many seconds can I safely hold the semi-inverted yoga poses and postures before I create an eye pressure problem?”

In response to that question. Dr. Valdivia gives an extended and thorough explanation that readers can read via the above link. However, for people who do not like to click, here are the commonly identified triggers which cause a temporary increase in intra-ocular pressure (IOP) that must be avoided not just for glaucoma but for macular degeneration, high myopia, retinal tears, and retinal detachments.

  • Abrupt or sustained physical exertion, such as lifting a heavy object.
  • Squatting.
  • Bending over, while standing or sitting, so that the head is below the heart.
  • Straining during defecation.
  • Playing a brass or woodwind musical instrument.
  • Wearing constrictive clothing around the neck.
  • Various acrobatic or gymnastic maneuvers.
  • Certain yoga positions.

 Several scientific studies have specifically investigated the effects of yoga positions on generating high intra-ocular pressure in adults. The concern has been that not only do certain yoga positions carry a risk of creating a transient eye pressure problem, these positions often are held for extended periods, which carries the risk of sustained high intra-ocular pressure.

Here is an outstanding table from Dr. Valdivia’s post that illustrates how some commonly practiced inversions increase intro-ocular pressure:

The table below presents combined (meta-analysis) data obtained from 12 published studies looking at the effects of various yoga positions on intraocular pressure (IOP). Particular emphasis is given to inverted yoga poses and those that are semi-inverted. Participants in the studies were free of ocular disease, were between the ages of 22-63 years, and ranged from intermediate to advanced levels of proficiency. Average intraocular pressure at a seated position for this combination of studies was 15.2 mmHg.

YOGA POSE

AVERAGE IOP AFTER
INITIATION

INCREASE IN IOP

Salamba Sirsasana
(headstand)
33.6 mmHg +18.4 mmHg
Urdhva padmasana
(Inverted Lotus)
33.2 mmHg +18.0 mmHg
Parsva Sirsasana
(side headstand)
33.5 mmHg +18.0 mmHg
Parivrttaikapada Sirsasana
(Revolved Split-Legged
Headstand)
33.9 mmHg +18.7 mmHg
Pincha Mayurasana (peacock
feather pose)
31.5 mmHg +16.3 mmHg
Eka Pada Viparita Dandasana (one-legged inverted-staff
pose)
28.2 mmHg +13.0 mmHg
Utthita Pada Sirsasana
(extended-leg headstand
pose)
33.7 mmHg +18.5 mmHg
Valsalva Maneuver
(attempting to forcibly exhale
while keeping the mouth and
nose closed)
38.1 mmHg +22.9 mmHg
Adho Mukha Vrksasana
(handstand)
34.8 mmHg +19.6 mmHg
Salamba Sarvangasana
(Shoulder Stand)
25.4 mmHg +10.2 mmHg
Urdhva Dhanurasana
(wheel pose)
22.4 mmHg +7.2 mmHg
Halasana (plow pose) 19.0 mmHg +3.8 mmHg
Adho Mukha Svanasana
(downward-facing dog)
19.9 mmHg +4.7 mmHg
Setu Bandha Sarvangasana
(bridge pose)
24.3 mmHg +9.1 mmHg
Urdhva Mukha Svanasana
(upward-facing dog)
14.5 mmHg -0.7 mmHg
Viparita Karani
(legs-up-the-wall pose)
14.0 mmHg -1.2 mmHg
Virasana (hero pose) 13.8 mmHg -1.4 mmHg
Padmasana (lotus pose) 13.7 mmHg -1.5 mmHg

Meta-analysis by Carolina Valdivia Cáceres, MD and Ángela Pattatucci Aragón, Ph.D., 2011.

Dr. Valdivia advises the woman:

Spikes in high intraocular pressure appear to be immediate upon entering yoga poses and postures. Thus, there appears to be no safe period of time for you to practice either inverted yoga poses or semi-inverted yoga positions.

Here we have one doctor saying no inverted or semi-inverted positions and one saying semi-inverted positions are not to be held for extended periods of time. What is “extended period of time”? To me, it is anything beyond 10-15 seconds but depending on the individual experience even that may be too much–we generally did not hold more than 5 seconds.

Why the gratification? Because ever since I have been teaching yoga, new students were asked about any medical conditions and family history of eye problems. Returning students were asked about changes in medical conditions. This way, they could be cautioned about what to avoid and modifications, where possible, could made for them. When people who said they had a family history of glaucoma (or high blood pressure, cardiac problems, GERD, high myopia, hernia, etc.) were told they could not do the only inversions we did sometimes do–the shoulderstand and the plough (a modified plough), the explanation was almost always received with disbelief. They said that no other teacher said this to them and it was taken as an unnecessary restriction that limited the physically challenging practice they wanted.

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There has been a recent spate of eye issues in our family and that presents an opportunity to discuss a serious, negative effect of certain asanas for various eye issues. A of lack of knowledge among practitioners and teachers is a matter of some concern. Contraindications of various asanas and some pranayamas should be a vital part of yoga teacher training curriculum.

It is particularly important to be aware of inversions and their effect on intra-ocular pressure (IOP)–or eye pressure. Look at the case study of a 46-year old woman, Yoga can be dangerous–glaucomatous visual field defect worsening due to postural yoga, in The British Journal of Ophthalmology, October 10, 2007 issue. The woman had worsening glaucoma a year after starting a regular practice of headstand. The effect was reversible after she stopped practicing it. In 10 non-yoga practicing volunteers, the headstand increased IOP two-fold. The study concluded:  “Therefore postural (head‐down) yoga exercises are clearly not recommended for patients suffering from glaucoma.”

To illustrate the point,  the study has pictures of the woman’s visual field some months before starting postural yoga,  one year after starting postural yoga,  and one year after stopping it.

Another study, Progression of glaucoma associated with the Sirsasana (headstand) yoga posture by researchers from the Department of Ophthalmology, University of Texas, Southwestern Medical Center in Dallas concluded: “Transient increases in IOP associated with the yoga headstand posture may lead to progressive glaucomatous optic nerve damage and visual field loss.”

In talking to ophthalmologists and a retinologist, it is clear that they have deep concerns regarding inversions and particularly when the inversions are held for prolonged periods.

Source:

Br J Ophthalmol. 2007 October; 91(10): 1413–1414.

PMID: 17276961 [PubMed – indexed for MEDLINE]

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