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Archive for the ‘Pain Management’ Category

For years we were told that the “core muscle” was the ab and there was a great emphasis on working the muscle for a stronger back as well as a slimmer waistline. School gym teachers praised children who could do the most sit-ups and crunches in a minute. Many kids came home with painful backs. Now those routines are out-of-favor because they are harmful for the back.

The January 3, 2013 issue of Harvard HEALTHbeat, writes:

Sit-ups once ruled as the way to tighter abs and a slimmer waistline, while “planks” were merely flooring. Now planks — exercises in which you assume a position and hold it — are the gold standard for working out your core, while classic sit-ups and crunches have fallen out of favor. Why the shift?

One reason is that sit-ups are hard on your back — by pushing your curved spine against the floor and by working your hip flexors, the muscles that run from the thighs to the lumbar spine of the lower back. When hip flexors are too strong or too tight, they tug on the lower spine, which can be a source of lower back discomfort.

Second, planks recruit a better balance of muscles on the front, sides, and back of the body during exercise than sit-ups, which target just a few muscles. Remember, your core goes far beyond your abdominal muscles.

Finally, activities of daily living, as well as sports and recreational activities, call on your muscles to work together, not in isolation. Sit-ups or crunches strengthen just a few muscle groups. Through dynamic patterns of movement, a good core workout helps strengthen the entire set of core muscles — the muscles you rely on for daily activities as well as sports and recreational activities.

This information echoes what Dr. Stuart McGill has been advising for many years. Dr. McGill is a professor of biomechanics at the University of Waterloo, Canada. Dr. McGill is a highly regarded back-pain expert in the sports world. In an informative New York Times article of June 17, 2009, “Is Your Ab Workout Hurting Your Back” by Gretchen Reynolds, it appears that the isolation of the abs (transversus abdominis) for a core workout began with an Australian study in the 1990s. Reynolds writes:

The lab worked with patients in pain to isolate and strengthen that particular deep muscle, in part by sucking in their guts during exercises. The results, though mixed, showed some promise against sore backs.

Perhaps that is how the trend of working the abs started. Dr. McGill says that this thinking spread to trainers and through them to the public. According to him, the core is not just one muscle but a “corset” of muscles that circle the spine and hold it in place. By working on just one muscle the spine is destabilized and it loses its alignment. All the muscles must be balanced in order for the spine to bear large loads. The analogy used is that of a fishing rod. Think of the spine as a fishing rod that is held in place by muscular wires.

“If you pull the wires closer to the spine,” McGill says, as you do when you pull in your stomach while trying to isolate the transversus abdominis, “what happens?” The rod buckles. So, too, he said, can your spine if you overly focus on the deep abdominal muscles. “In research at our lab,” he went on to say, “the amount of load that the spine can bear without injury was greatly reduced when subjects pulled in their belly buttons” during crunches and other exercises.

Hollowing the belly and pressing the spine against the floor is a bad idea that has made its way into yoga studios and routines as well due to cross-pollination with trainers and fitness routines. Dr. McGill says sit-ups put a “devastating” load on the spinal disks. Instead, he suggests a side plank and a “bird dog” (in yoga it is the tiger pose or vyagharasana).

For more, please read The New York Times article, see the short video Core Values that accompanies the article, and visit Dr. McGill’s website www.backfitpro.com for his articles and more information. Readers may also want to visit a previous blog post Do Yoga Classes Hurt Your Back?

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Happy New Year to Everyone!

Current Issue

Each year we find there is more yoga and meditation content freely available. We begin this year with the first digital issue, Winter 2012,  of Yoga International.  This is an excellent publication from the Himalayan Institute based in Honesdale, Pennsylvania. Now anyone with Internet access can read its content.

This issue features a healthy heart guide, breathing techniques to curb emotions, yoga in the Middle East, upward dog and the back, and the story of four women changing the destiny of yoga.

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The Ridgewood, NJ, Whole Body Whole Foods has fully endorsed and backed the guided meditation CD, Being in Flow: Meditations for Peace, Insight, Clarity, and Focus. It is available in the yoga section of Whole Body. All profits go to Sivananda Math, the charitable trust associated with the Bihar School of Yoga. The trust feeds, educates, and provides medical care to some of the poorest and most neglected children in the world. It also has many outreach programs for several villages.

Here are some of the ways in which the CD has been helpful to people who have used the meditations:

Benefits to Creativity

Numerous studies have highlighted the benefits of meditation in terms of fostering creativity; a group of Dutch researchers, for instance, found that the practice promoted “divergent thinking”, in which many new ideas are generated. After listening to this CD, I definitely agree: while my mind often feels freighted with clutter, these tracks have brought a sense of calm and awareness, which in turn bring about heightened perception and creative abilities. I can see why Disney’s creative team has hired a meditation teacher! 

There are a couple of features that set this CD apart from the other meditation offerings. For one, the narrator has a wonderfully soothing voice that allows me to instantly relax and achieve the desired mental calmness. With other meditation tracks, I feel that this relaxation often spirals into a deep stupor and leads me to eventually fall asleep; here, however, the relaxation does indeed promote Insight into Problems and convert Stress to Rest.

Furthermore, each track has clearly been carefully considered, with a clear and logical progression guiding the individual through the practice. I have given this CD to a couple of friends, who have similarly spoken of a clear mind and enhanced creativity after going through the tracks. There is something very peaceful, almost addictive, about the ability to redirect your mind away from endless distractions and toward a more useful goal.

Barry J.

Improve productivity

When I first read about flow in a paper by the Hungarian psychologist Mihaly Csikszentmihalyi, the idea of complete immersion in a single, well-defined task sounded great. I had even experienced being in flow at times — it felt like the distinction between a task and my performing that task completely disappeared. The only problem was that I couldn’t get myself into this state whenever I wanted: sometimes I happened to fall into it, but most of the time I didn’t and wasted a lot of time trying to force it.

This CD actually helps me get into flow whenever I want. Different tracks work well for different types of tasks. For example, if I’m about to practice the piano, I will listen to Still Body Clear Mind, whereas if I’m about to work on a math problem, I will listen to Insight into Problems. Now, I’m finding that I don’t always need to listen to those two tracks whenever I want to get into flow since the CD effectively trained me to get into flow on my own. So while I do continue to listen to both of those tracks, now I’m listening more to Stress to Rest and Sound of Silence to get into flow for tasks that are less well-defined than music practice or math problem sets.

If you’re looking for something that’s relaxing, this CD works very well, but its real benefit comes from improving productivity. Once you’re in that state of flow in which you get things done so much faster than before, stress goes away on its own.

Max W.

The CD is also available from:
select Whole Foods Whole Body stores on the East Coast
select yoga studios in New York
iTunes
Amazon
Namaste Books (Union Square, NY)

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As I look around my friends, so many women I know have had breast cancer. Almost all have had successful treatments. As they share their experiences, journeys, and resources, women are unfailing in their support toward each other. That support is so important for emotional well being. To support all women in their struggle with breast cancer, I am posting again some of this blog’s previous writing on breast cancer.

February 17, 2012

Pooling together the recommendations of readers of this blog (thank you for sharing!) and my own suggestions for outstanding websites on research information regarding complementary therapies, here is a list of seven:

1. www.berniesiegelmd.com (support, positive spirit-based approach)

As a physician who has cared for and counseled innumerable people whose mortality has been threatened by illness, Bernie embraces a philosophy of living and dying that stands at the forefront of the medical ethics and spiritual issues our Society grapples with today. In May 2011, Bernie was honored by the Watkins Review of London, England, as one of the Top 20 Spiritually Influential Living People on the Planet. He continues to break new ground in the field of healing, supporting changes in medical education to “humanize” medical practice.

Source: http://www.berniesiegelmd.com

This is a commercial website that offers support as well. We normally do not recommend commercial websites/products. However, many readers have found Dr. Siegel’s books helpful in developing a positive attitude toward cancer and mortality. His books are widely available at many public libraries and so our readers do not have to purchase anything.

2. www.eckharttolle.com (support, positive spirit-based approach, free online videos of Tolle’s talks, online courses, interviews, newsletter)

Eckhart is a spiritual teacher and author who was born in Germany and educated at the Universities of London and Cambridge. At the age of 29, a profound inner transformation radically changed the course of his life. The next few years were devoted to understanding, integrating and deepening that transformation, which marked the beginning of an intense inward journey. Later, he began to work in London with individuals and small groups as a counselor and spiritual teacher. Since 1995 he has lived in Vancouver, Canada. Eckhart Tolle is the author of the #1 New York Timesbestseller The Power of Now (translated into 33 languages) and the highly acclaimed follow-up A New Earth, which are widely regarded as two of the most influential spiritual books of our time.

This is a commercial website. Again, this blog does not normally recommend commercial sites. However, Tolle is a best-selling author whose books are widely available at most public libraries and readers do not have to purchase them. In addition, the site does offer a considerable amount of free, helpful content.

Source:www.eckharttolle.com

3. www.insightmeditationcenter.org (meditation instruction based onvipassana, audio and printed transcripts)

The Insight Meditation Center (IMC) is a community-based urban meditation center for the practice of vipassana or insight meditation guided by Gil Fronsdal and Andrea Fella.

The site offers support and some free online transcripts and beginner’s classes on insight meditation.

Source: http://www.insightmeditationcenter.org

4. www.mahasriyoga. com (meditation and breathing instructions; numerous Yoga Nidras, guided meditations, breathing/pranayama online audio tracks)

This non-commercial website has numerous online Yoga Nidras, guided meditations, breathing, and pranayama tracks (including Gujarati tracks). It also features in-depth yoga and meditation book reviews. There is a good selection of  vegetarian, vegan, low-carb, and gluten-free recipes.

Source: www. mahasriyoga.com

5. www.nccam.nih.gov (research)

The National Center for Complementary and Alternative Medicine (NCCAM) is the Federal Government’s lead agency for scientific research on the diverse medical and health care systems, practices, and products that are not generally considered part of conventional medicine.

Source: http://www.nccam.nih.gov

This is perhaps the best website for research and evaluations of different therapies.

6. www.pedcam.ca (research and support)

I realize that this is not a breast cancer resource. It has been left in place as it is part of the original post and in case any finds it a useful.

Created in 2004, the Pediatric Complementary and Alternative Medicine Research and Education (PedCAM) Network is a Canadian network that aims at disseminating a wide range of CAM information and building collaborative relationships between researchers, educators, clinicians, and policy-makers, both nationally and internationally. PedCAM is an academic, non-commercial organization, housed within the Complementary and Alternative Research and Education program, Department of Pediatrics, University of Alberta.

Source: http://www.pedcam.ca

7. www.rccm.org.uk

The Research Council for Complementary Medicine (RCCM) is a UK-based charity founded in 1983, dedicated to developing high quality research in CAM. 

Source: http://www.rccm.org.uk

The site provides links to many research journals.

This selection covers research, support and positive approach, as well as free online mind-body therapy audio tracks. Readers do not have to spend hundreds of dollars to have access to excellent guided and mindfulness meditations. Our selection also reflects the global readership of this blog and how patients and families are able to access the best information from around the world.

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Once the foundation is laid and the body prepared with the practices listed in the previous two posts, the next step is balanced breathing where the breath is comfortably paced. This breath is also called equal inhalation and exhalation and samavritti pranayama. It calms the mind, making it quiet. The breath will gradually become deeper and longer.

The exercise begins by relaxing the body and making it still. Then the attention is drawn to the belly. The breath is observed as an inhalation and exhalation. The inhalation and exhalation are measured by counting 1, 2, 3, etc. from the start to end of inhalation and then the exhalation. Or if it is easier, count how long it takes for the belly to softly rise with the inhaled breath and fall with the exhaled breath. The two are then made even or equal–for instance it could be three seconds to inhale and three seconds to exhale. So there is a gentle and active control. (Kapalbhati and bhastrika are intentionally not given here as I do think that people need direct guidance from an experienced teacher to determine if it is suitable for them, and if so at what pace and rate. A teacher must also observe these two breaths to make sure the breathing is done correctly, that there is no hyperventilation and elevated blood pressure.)

All these steps help make the mind still and focused to prepare it for meditation.

Here is a free audio track for balanced, paced breathing (requires no iTunes or MP3) from Mahasri Yoga that anyone with Internet service can easily access:

Samavritti Pranayama

Samavritti means equal or uniform movement. In this breathing the flows of inhaled and exhaled breaths are of equal duration and intensity. The breathing is paced, but it is paced to your own comfort and not to a given count–usually four to six seconds. As the breath is observed with uninterrupted awareness over an extended period of time, the inhalation and exhalation spontaneously become equal. The breathing pattern becomes more rhythmic and this has a calming effect on the body and mind. This is an important step in pranayamaSamavritti pranayama is soothing and creates a feeling of equanimity. As you get more comfortable with it, you can add one more second to each inhalation and exhalation to slowly make the breath longer and deeper, gently increasing the lung capacity. Never go beyond your comfort level–there should be no shortness of breath, tightness in the chest, any discomfort. Notice the changes in your body and the mind as they change with the rhythmic, balanced breathing. Breath retention should be done under expert guidance after the initial stages are completed and is not included here.

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To safely learn to control the breath, stretch it and make it deeper, here are the basic foundations to pranayama. The audio links are to tracks on Mahasri Yoga.

Whole Body Breathing

Conscious breathing requires some effort initially but after some practice it becomes a natural part of you. Another deeply relaxing practice, whole body breath is simple and effective. There is a gentle expansion and contraction of the body.

Belly Breath

A deeply relaxing practice, the belly breath is one of the first breaths taught in yoga. Also known as abdominal breath, it is a simple and effective way to slow down the breath and mental activity. Awareness is shifted from the mind to the belly. The belly is a space of stillness, a vast ocean of peace. Anxiety brought down to the belly dissolves in this ocean of tranquility. The belly breath is the most relaxed and efficient breath (once you get used to it, particularly if you are a chest breather). It is much more difficult and strenuous to deepen a chest breath than it is to deepen the belly breath. The body gets the most oxygen with the least exertion. It is an effective way to increase lung capacity.

Full Yogic Breath

An energizing and soothing practice, full yogic breath is a basic core breath. It flushes out the entire respiratory system. The breath becomes deeper, more relaxed, and more efficient. The muscles of the belly, midriff, and chest are gently engaged. The breath is experienced in different parts of the torso. A gentle expansion of the body helps stretch and elongate the breath. The stretch and expansion are predominantly vertical as opposed to horizontal. A vertical stretch engages the diaphgram so it actively moves the lower parts of the lungs. This movement helps flush out the lower lobes, areas that normally get little movement.

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Mahasri Yoga is now on You Tube. Certain breathing practices help significantly with hypertension. It is hoped that the following two audio tracks in English and Gujarati recently uploaded on You Tube will be helpful and enjoyable:

Mahasri Yoga: Pranayama-Body Stillness (English)

Mahasri Yoga: Pranayama-Body Stillness (Gujarati)

Dealing with hypertension in its early stages, using yoga and breath awareness, is much easier than when it progresses extensively. Prevention is better than cure. These are simple, effective, basic practices used before starting the more familiar pranayamas.

As stated on www.mahasriyoga.com/pranayama:

“The first step to having an effective pranayama practice or meditation practice is learning to use the breath to still and calm the body. As long as the body is restless or tense, the mind is drawn to the body and distracted by it. Making any progress in pranayama is difficult in the agitated or distracted state.

Conscious breathing, used to become aware of the physical body, will allow you to stop running ragged with the mind and emotions. It gives you a way to slow down, to stop. When you breathe in, know that you breathe in. When you breathe out, know that you breathe out. Without your attention, your awareness, the emotions run out of energy and slow down. With the awareness focused on the breath and body instead of on thoughts, the mind becomes still, the body calm.

A still body, not a sleeping body, tends to increase attention span and pacify a restless mind. A restless body can be a reflection of a scattered and unfocused mind. This practice will help the body become still and quiet, the mind more focused. It is also effective in releasing stress and pain.”

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