28/02/2020

Electrotherapy for Hay Fever and Other Allergies



Do you suffer from hay fever or have a similar itchy eyes and runny nose response to pet fur or dust mites? Did you know electrotherapy could help to significantly reduce your symptoms?

Allergies are caused by an overreaction of the immune system to harmless irritants such as pollen, grass seed and animal fur.  When the inflammatory immune response goes into overdrive, it releases histamine, which is responsible for the itchy eyes and runny nose symptoms of hay fever.  This is why we take ANTI-histamines to reduce allergy symptoms. However, they can also have some unpleasant side effects such as drowsiness, dizziness, dry mouth, nose, or throat and upset stomach etc. 

The good news is there is another drug free and painless way to reduce histamine levels.

A single frequency (10Hz) interferential treatment is used to calm the immune response to allergens at a cellular level. The 10Hz frequency has been shown to reduce the expression level of the inflammatory cytokine TNF-α which plays a role in mast cell degranulation and subsequent release of histamine.  Lower TNF-α levels result in less histamine being released, and therefore fewer allergy symptoms!

Best results are seen with regular treatment over a period of weeks. For more details or to book please get in touch with me at kateryanbiz@gmail.com

Pricing

IFT only sessions – for hay fever and other allergies 

1x 40min session £40
5x 40min sessions £180 block booking save 10%
10x 40min sessions £350 block booking save 12.5%


References

Emberson Wendy,.  IFT: Interferential therapy workbook, Allied Mouse Publishing, (1995).
Wei, Chang-Ching, et al. "Allergic Conjunctivitis-induced retinal inflammation promotes myopia progression." EBioMedicine 28 (2018): 274-286.
Iwasaki, Masao, et al. "TNF-α contributes to the development of allergic rhinitis." Journal of allergy and clinical immunology 112.1 (2003): 134-140.




23/02/2020

Biohacks for Easing Anxiety


Most people feel anxious from time to time. For some, it is occasional bouts in high stress situations, for others it becomes a persistent state that impacts on their ability to live their life as fully as they want to. Unpleasant symptoms such as feeling unable to relax, having a sense of dread, or overthinking may be all too familiar to you. These will often go hand in hand with some physical symptoms, including churning in your stomach, lightheadedness, rapid and shallow breathing, a pounding heartbeat, restlessness, and getting sweats or hot flushes. 

These symptoms are manifestations of your body’s ‘fight or flight’ response which prepares you to flee from, or defeat, potential threats.  Fight or flight activation is involuntary as it is governed by your sympathetic nervous system which is under conscious control, and this is why anxiety can be so difficult to manage. 

However, the good news is, there are ways you can ‘bio hack’ your brain to encourage the calming part of your nervous system to regain control. Below are some of the most powerful bio hacking techniques (along with explanations or why they work) to ease anxiety.

If you are having or close to having an anxiety attack:

       1. Slow your breathing. If your brain is a sports car your breath is both the accelerator AND the break. Consciously slowing your breath reduces sympathetic nervous system activity (fight or flight response) and activates the parasympathetic nervous system (calming response).  Try gradually lengthening your exhales or ‘box breathing,’ where you inhale for 4 seconds, hold your inhale for 4 seconds, exhale for 4 seconds and hold your exhale for 4 seconds. 

      2. Name objects around you out loud. It may seem weird, but during an anxiety attack the emotional part of your brain (the limbic system) goes into overdrive and the part responsible for reasoning and logic (the prefrontal cortex) shuts down.  Saying the objects around you brings you back into the here and now, disengaging your limbic system and bringing your prefrontal cortex back online. The more present you are, the calmer and safer you will feel.

      3. Impractical to say things out loud?  Try these silent grounding techniques:  Grab tightly onto your chair as hard as you can. Touch various objects around you. Dig your heels into the floor, literally “grounding” them! Remind yourself you are connected to the ground and present in your physical body

Day to day management strategies

     1. Figure out your triggers. Spend some time reflecting on what your main anxiety triggers are and write them down.  This allows you to either reduce your exposure to them; e.g., if it is constant news updates or social media. Or come up with strategies to help (write these down too) when you are confronted with them; e.g., if in crowded spaces or public speaking.  Writing things down is important because it involves your prefrontal cortex. It also frees up some mental RAM allowing you more thinking space which in itself can really help anxiety.  Brene Brown has some wonderful strategies and techniques in her book Daring Greatly.

      2. Do activities that activate your parasympathetic nervous system.  The more time you spend in an anxious state, the more ingrained the neuropathways become, and it starts to be your brain’s default response.  Retraining your brain to spend more time in a relaxed state is possible, but you need to choose to do things that promote it. Yoga and meditation are often seen as the gold standards for this, but other great options include coherent or 6:6 breathing, yoga nidra, Qi gong, massage or even a nice bath.

     3. Do ‘flow state’ activities. If you find it hard to settle into the practices above, then doing things that put you in ‘flow state’ can be a good alternative. Flow is the state you enter when you become completely immersed in an activity, and the rest of the world falls away. Again, this pulls you out of the anxious state and into the present moment.  Different things work for different people, so have a play and see what is best for you. For example, people often enter flow state when doing creative activities such as arts and crafts, things involving music; e.g., singing or playing an instrument, more intense physical activity; e.g., running, dancing, or  even kickboxing.

    4. Eat well and stay hydrated. If you are constantly amped up on sugar and caffeine, then it makes things so much harder for your body and brain to heal. I love coffee and chocolate as much as the next person, and I am not saying give them up completely… Just make sure you drink water along with your coffee and eat nutrient dense foods to give your body the best possible fuel.


The above are some tried and tested methods for anxiety that have helped me and have scientific evidence to support them. However, they are not an exhaustive list or substitute for proper medical advice. If you are really struggling with your anxiety levels then please seek professional help. The roots of anxiety are often buried deep in our past, and working with a skilled professional to untangle and remove them can be hugely beneficial.

If you are interested in more details of how yoga + breathwork could help you manage your anxiety why not book in for a yoga therapy session? Or message me at kateryanbiz@gmail.com to set up an free chat for more details.

30/01/2020

Is Your Migraine a Pain in the Neck?

Would you like to get rid of your migraines?

Did you know up to 84% of migraines can be attributed to dysfunction of the upper neck vertebrae (C1-C3)?*

👀 Hold tight for the science bit 👀

Disorder of these vertebrae can sensitise the underlying brainstem and nerves which supply the head, inner ear, eyes etc. Research has found that treatment of the upper 3 spinal joints DE-sensitises the brainstem** and significantly reduces symptoms over 4-5 sessions.

From this research a specialist manual therapy technique has been developed which: 
1. Identifies the root cause causing your migraine symptoms
2. Temporarily reproduces your symptoms to confirm and treat
3. Resolves your symptoms by de-sensitising the brainstem.

Interested? email kateryanbiz@gmail.com for more info or to book an initial appointment. 

27/05/2018

Weights for Yogis: Top 3 Lower Body Exercises to Injury Proof Your Practice

This post follows on from my previous post about upper body strengthening to aid and rebalance your yoga practice. Exactly the same principles apply in the lower body.

As yogis we can get a bit obsessed with forward folds and hip openers. I know being able to bite your toes or fold in half is a really cool trick. And I know hip openers can feel really juicy and like they are doing us loads of good (and in some cases they may well be).  If we are always pushing to get further/ deeper into these poses without strengthening at the same time then we can run the risk of overstretching / weakening / injuring ourselves. Particularly the hamstrings, glutes and  pelvic / knee stability.

 Another contributing factor can also be super grippy modern mats which allow us to 'hang out' or sink into or flexibility in standing poses such as warrior 2, triangle etc because we don't need to engage other muscles to stop our feet sliding out from under us (try doing W2 on a 'slidier' surface and you'll see what I mean)

Please note I'm not saying yoga or stretching is bad (I'm a yin teacher afterall!) just that it's about balance and realising there can be too much of a good thing :)

Below are my top 3 lower body exercises to help your lower body stay supple AND strong.They can all be done at home with some dumbbells if you don't have access to a gym. Choose weights that are appropriate for you, if you're new to weights start light and see how you go. Make sure you warm up first! Do consult a medical professional if your are unsure if these exercises are right for you.

Try 3 sets of 10-15 reps of each exercise 2-3x per week and let me know how you get on!


1) Romanian Deadlifts

If you've every tweaked / torn a hamstring (me included!) then you'll know that they can be pretty painful and take a while to heal. It might seem counter intuitive but eccentric contractions (where the muscle is lengthening under a load) are a great way to not only gain functional strength but also to help rehab muscle tweaks and tendon sprains because the help orientate the healing fibers the right way.

  • Stand with your feet hip width apart holding a barbell or pair of dumbells in your hands, arms straight, palms facing back towards your hips.
  • Your shoulders should be slightly down and back, pushing your chest out.
  • With a slight bend in your knees, hinge at your hips, keeping your back straight and lower the weight/s down the front of your legs until you feel a slight stretch in your hamstrings.
  • Squeeze your glutes (bum) and use your hamstrings to come back up to stand.




2) Goblet Squats

Sqauts are fab, they help strengthen the glutes, quads, hamstrings and calves.They also work out your core, stabilizing muscles, which improves the communication between your brain and your muscle groups increasing stability around the hip, knee and ankle joints.

  • Stand with your feet a little wider than shoulder width apart.
  • Hold a weight against your chest, with your elbows tucked in. If you’re using a dumbbell, hold it vertically. If it’s a kettlebell, hold the sides of its handle.
  • As you squat, keep your elbows inside the line of your knees, and the heels of your feet flat on the ground.
  • Go as low as you can in this position, then come back up, pushing through your heels. Keep your movements smooth and your abs engaged throughout.





3) Reverse Lunges

Another all round exercises that particulary strengthens the glutes and the quads. The spilt stance challenges your balance more (even better for stability and mucle control) plus it allows you to "even out" strength and muscular imbalances by bringing your weak side up to par with your stronger side

  • Stand with your feet shoulder width apart. Your hands should be on your hips or if you're using weights holding them by your sides. Look directly forward, keeping your chest lifted.
  • Start the lung by taking a step back, contacting the floor with the ball your foot, allowing your knees to bend to lower your body. Keep lowering until your knee nearly touches the ground. Move slowly with control paying attention to the your alignment. Your front knee should stay stacked over your ankle in line with your foot, your hips level and your upper spine should remain neutral.
  • After a brief pause, return to the starting position by driving through the heel of the front leg to extend the knees and hips.
  • This movement can be done completely on one side before switching, or can be performed in an alternating fashion








15/04/2018

Weights for Yogis: 4 Upper Body Strengthening Exercises to Boost your Yoga Practice

Do you use you yoga as your main form of physical activity? Do you have niggles in your shoulders, wrists, or elbows when you practice? If yes then you might benefit from adding some upper body strength training into your practice.

Yoga is wonderful and has many benefits for mind and body. However,  yoga practice tends to neglect some movement patterns and overemphasis others which can lead to imbalances developing in the body. As yogis it's easy for us see how yoga can benefit other athletes but perhaps it's time to recognise how other forms of fitness can help us.

Below are my favourite upper body strengthening exercises to complement the areas yoga tends to miss. They can all be done at home with some dumbells and a theraband if you don't have access to a gym. Choose weights that are appropriate for you, if you're new to weights start light and see how you go. Do consult a medical professional if your are unsure if these exercises are right for you.

1) Pull ups / Pull Downs

Broadly speaking (unless you do aerial yoga or have access to an Iengar rope wall) yoga lacks pulling movements. We do loads of pushing in chaturanga, plank, downdog, and arm balances but very little pulling. Pulling is to pushing what back bending is to forward bending.  a fantastic way to balance the shoulders and back , creating strength and mobility.

Or if you can't do pull ups do assisted pull ups or an active hang where you retract shoulder blades and get your lats involved. If you don't have access to a bar then you can use a pull down machine in the gym or loop a theraband over the top of a door. The point is start PULLING to balance out the all the pushing.



2) Dumbbell Shoulder Press
These strengthen the shoulders and upper back.Plus, because they are done with free weights which require more control they also recruit the stabilising muscles of the wrists and elbows which is great news if you practice arm balances as well and downdog and plank.


  • Stand with your feet shoulder-width apart and a dumbbell in each hand.
  • Hold the dumbbells up by your shoulders, with your elbows out at a 90-degree angle.
  • Without leaning back, extend through your elbow and raise the weights directly above your head. Then slowly return to the starting position.

Aim for three sets of 10-12 reps.
N.B this can also be done seated if prefered or if you  have low back issues




3) Dumbbell Bent Over Row
Another pulling exercise :) - these help strengthen your entire back (upper middle and lower) plus shoulders, biceps and triceps.


  • With a dumbbell in each hand (palms facing your torso), bend your knees slightly and bring your torso forward by bending at the waist; as you bend making sure to keep your back straight and your core engaged. The weights should hang directly in front of you as your arms hang perpendicular to the floor and your torso. This is your starting position.
  • While keeping the torso stationary, lift the dumbbells to your side. keeping the elbows close to the body.
  • On the top contracted position, squeeze the back muscles and hold for a second.
  • Slowly lower the weight again to the starting position as you inhale.

Aim for three sets of 10-12 reps.




4) Standing Internal Dumbbell rotations

These help take care of the rotator cuff (the set of 4 muscle and tendons that keep the head of the humerus in the glenoid fossa or shoulder socket). The rotator cuff is really important for both shoulder stability and smooth movement. Unfortunately repeated chaturangas and planks place alot of stress on the rotator cuff. In particular, the muscle at the front (subscapularis) which controls internal rotation. Use these internal rotation exercises to help strengthen and balance your rotator cuff.


  • Hold a light dumbbell or cable handle attachment in one hand with the elbow of that particular arm creating a 90 degree angle between your upper arm and your forearm.
  • Your forearm should be parallel to the floor and your elbow should be tucked against your side.
  • Internally rotate your forearm (i.e bring your fist inwards, across your body) ensuring it stays parallel to the floor.
  • Hold the contracted position before rotating externally to return to the starting position.


Repeat for 3 sets of 12 – 15 repetitions per arm.



Hope you've found this post useful! Part 2 - exercises for the lower body coming soon!

08/04/2018

4 Ways to Enhance Your Yin Yoga Practice

Practiced mindfully yin yoga can be a wonderful way to enhance somatic awareness, relaxation and a sense of proprioception. Yin yoga is much less about making a 'correct' target shape and much more about finding the right shape for YOU to explore.

Everybody is unique. How far we can go into, and the kind of sensations we experience a yin pose vary widely from person to person. So how do we practice sensitively to get the most from a yin yoga class?

Below are 4 key points to keep in mind when practicing yin yoga to have a safe and beneficial class.

Start at an appropriate depth – especially when new to the practice it is important to be kind to the body. Go to a point where you feel a gentle stretch (4 to 6 /10 intensity), stop and wait. You may like to use props to help support The long holds can significantly change the sensations experienced during the pose.

Breathe with your whole body. Use your breath to help you soften into the poses. Your breath is also a very good indicator if your depth is appropriate. If you find you can’t breathe smoothly and easily the chances are you are in a little too deep and it's a good idea to ease out a little.

Be mindful of the sensations happening in your body as you hold the pose. Notice how they change, in intensity or if they travel and make adjustments accordingly.  If something starts to feel too much, or you start to feel any numbness / tingling ease out, if you feel your body opening maybe you might like to move a little deeper.

Cultivate stillness in mind and body. This can be the hardest part! Yin teaches you how to stay with something even if it not totally comfortable. This staying helps train the mind to be more focused and allows a deeper awareness of the body to develop.

Thanks for reading and I hope you found this post helpful. Wishing you a wonderful yin practice!



09/09/2017

Yoga for Athletes...How yoga can help you reduce injury, recover faster and improve your performance

What do Andy Murray, the New Zealand All Blacks, and Paula Radcliffe all have in common?  They are all top athletes who practice yoga to help them stay in peak physical condition. But, why is yoga so beneficial for athletes? Read on to find out more…..

Three of the most obvious benefits of yoga are relaxation, increased flexibility and breath control. Being supple as well as strong, the ability to stay cool under pressure and the ability to regulate your breath are key for any athlete. However, there are a whole host of more subtle benefits that come from a regular yoga practice which lead to an enhanced sense of body awareness.  The benefits include improved coordination, balance and proprioception (our sense of where we are in space).

Athletes, of any level, need to prevent and recover from injury and enhanced body awareness is the foundation for this.

In terms of injury prevention an athlete with enhanced body awareness is more likely to move smoothly and in harmony with their own biomechanics therefore reducing the risk of overuse injuries. If a niggle starts to develop during training it’s often very tempting to try and push through but they are able to stop, assess and adjust to avoid it developing into something major. Good balance and reflexes reduce the risk of trips and give a better chance of self-righting if you do start to fall.

But what happens if the worst comes to the worst and you develop an injury? Yoga can still help with that! The key for effective rehab is rest in the very early stages and then (and this is the tricky part) enough movement to help the tissue fibres heal correctly but not so much as to re-injure them.  Yoga can provide safe and low impact cross training during recovery, plus the enhanced body awareness can help the athlete better sense how much movement / pressure their injury can safely take during the rehab process.

So if you’re an athlete of any level why not give yoga a try? You might be surprised by the results.
If you have an injury that is bothering you then I offer tailored yoga rehab and sports massage combi packages to get you back to peak condition as quickly as possible. I also offer yoga rehab workshops for sports clubs. Get in touch with me at kateyinyoga@gmail.com for more info.




05/04/2017

Meditation and Biophotons: Cultivating Inner Light

We are all beings of light. Our cells emit low intensity 'packets of light' called biophotons, in the UV and visible regions of the electromagnetic spectrum.[1]

Yes you read that correctly, humans emit light and not just any kind of light. The biophotons we emit are highly coherent and can communicate with themselves and their surroundings on a quantum level [2]. The full scope of  biophotons within the body hugely complex and still not fully understood, but we know they are a key method of cellular communication[3] and may even explain the unification of cells within the body[4]. Suddenly the traditional image of a meditating yogi radiating light in perfect harmony with themselves and the universe doesn't seem so far fetched after all!


Except that levels of  biophoton emission seem to be the opposite of what one might expect. Biophoton emission is actually lower than average in regular meditators [5] and higher than average in those who are sick [6] and on the affected side of stroke patients[7]. Almost as if  our inner light drains out of us when our bodies are under stress.

The explanation seems to lie in our DNA. One of the major discoveries of Fritz Albert Popp, the pioneer of biophoton research, is that DNA is a major source of biophotons. Popp found that biophoton emission increases when our DNA unwinds[8]. This unwinding can happen as a result of:

  1.  Cell growth where the DNA splits to allow its information to be duplicated.
  2.  Cell death when the dead cells are broken down by the body  
  3.  Damage to the DNA itself due to toxic chemicals or radiation. 

So what does this mean for us as meditators? Simply put this even more evidence for the healing benefits of meditation! Regular meditation reduces inflammation[9], and free radical levels in the body. Free radicals are highly reactive chemicals that damage cells and DNA. Lower free radical levels lead to less cell and DNA damage, and decreasing biophoton emission[5]. In modern life our bodies are being bombarded with free radicals like never before from pollution, pesticides, certain food additives, cosmetics etc.The power of meditation to reduce the impact of these chemicals on our systems and potentially help heal or reduce the risk of inflammation related disease should not be underestimated.

Another amazing property of biophotons is that they can be influenced by our intention. A study in  2012  found that when subjects actively imagined light in a very dark environment their intention produced significant increases in biophoton emission from around their heads[10]. This is huge as it is strong evidence that we can influence physical process with the power of our minds. Again this links back to meditation and has implications for our potential abilities to direct healing around our bodies.

To conclude, biophotons are an amazing, hugely complex and surprisingly under researched phenomenon of life. They are in overarching cellular communication, a measure of health, potentially instrumental in healing and can be influenced by our minds. There appears to an amazing synergy between their properties and the effects of meditation. And again meditation is proved to have enormous benefits for our wellbeing with the power to protect and harness our inner light.

References

[1] B. Ruth, F.A. Popp, Experimentelle Untersuchungen zur ultraschwachcn Photonenemission biologi~her Systeme, Zeitschrift Naturlbrschung,  1976, 3 Ic  741-745.

[2] Cohen, S., Popp, F.A. Biophoton emission of the human body. Journal of Photochemistry and Photobiology B: Biology, 1997, 40(2): p187.

[3]Sun, Y., Wang, C., and Dai. J.. Biophotons as neural communication signals demonstrated by in situ biophoton autography. Photochem Photobiol Sci. 2010, 9(3): p315

[4] Popp, F. A., Properties of biophotons and their theoretical implications, Indian Journal of Experimental Biology, 2003.41(5): p391

[5] Eduard, P. A., Van Wijk, H. K,, Bosman, S., and Van Wijk. R., Anatomic characterization of human ultra-weak photon emission in practitioners of transcendental meditation(TM) and control subjects. J Altern Complement Med. 2006, 12(1):p31

[6] Takeda, M. et al. Biophoton detection as a novel technique for cancer imaging., Cancer Science. 2004, 95(8): p656

[7] Jung, Hyun-Hee, et al. Left-right asymmetry of biophoton emission from hemiparesis patients., Indian J Exp Biol. 2003, 41(5):p452

[8] Popp, F. A., Nagl, W., Li, K. H., Scholz, W., Weingartner, O., and Wolf, R., Biophoton emission,
Cell Biophysics, 1984, 6(1): p33.

[9] Kaliman, P., et al., Rapid changes in histone deacetylases and inflammatory gene expression in expert meditators, Psychoneuroendocrinology, 2014, 40, p96

[10]  Dotta, B.T., Saroka, K.S., and Persinger, M.A., Increased photon emission from the head while imagining light in the dark is correlated with changes in electroencephalographic power: support for Bókkon's biophoton hypothesis. Neurosci Lett. 2012 513(2): p151





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04/03/2017

Healthy Shoulder Movement in Downward Facing Dog, Warrior One and Other Asanas

'Reach your arms overhead and bring you shoulder blades down your back.' How often do you hear this well intentioned cue or something similar uttered in a yoga class?

Probably fairly often, and as a teacher I know I have said it plenty of times. In theory it's a good cue aimed at preventing students hunching their shoulders up around their ears when they bring their arms overhead or move into downward facing dog. Instead of hunching, we would like our students to feel breadth across the back of their shoulders and free around their necks.

However, what we are actually asking our students to do is dislocate their shoulders! Unlike the hip, the shoulder is optimized for mobility rather than stability. That means instead of there being a nice deep socket for the head of the upper arm bone (humerus) to sit into there is only a small shallow area on the side of the shoulder blade (scapula). A bit like a golf ball in a tee, see below.



So if you start trying to bring the shoulder blades down while the arms are raised, the head of the upper arm bone starts to separate from its socket on the shoulder blade. Not the healthiest movement pattern to be promoting, especially for anyone with shoulder instability. As teachers we would still like to discourage hunched shoulders in down dog or warrior one, so what to cue instead?

Happily mother nature is already one step ahead. The shoulder blade naturally rotates outwards once the arms get past 90 degrees. This is to avoid the bony projections above the shoulder joint blocking the movement of the arm bone as it elevates further as shown in the photo sequence below.


We can still cue our shoulders, or our students shoulders, not to hunch but by encouraging the natural rotation of the shoulder blade instead. A helpful cue in downward dog might be: 'Wrap your shoulder blades around towards you underarms'. In warrior one 'Roll your little fingers in towards each other'. By shifting the focus from down to breadth we can work with the body not against and still achieve open shoulders and free necks. Try it and see what you think!



19/02/2017

Yoga Is The First Step In Managing Back Pain: NICE Update Their Guidelines

Back pain is the second most common reason for long term sickness in the UK and costs the NHS millions annually. Yet it is often very difficult to identify an origin for the pain and up to 85% of sufferers show no identifiable cause. These cases are lumped under the umbrella of 'non-specific back pain'. This type of is pain is from cumulative injuries, caused by a variety of factors including poor posture, repetitive movements, too much sitting, obesity and psychosocial considerations.

Yoga included as a non-invasive treatment

The latest NICE guidelines (published 6/1/17) for low back pain and sciatica recommend group yoga or tai chi classes as a main component of non-invasive treatment! This is brilliant news as it means the evidence is finally there to support what many yogis have known for years: yoga can be a very effective treatment for back pain. But what is it about yoga that makes it so powerful? For answers we need to look at the body's response to pain a little more deeply.
Unfortunately because it is hard to pin down a cause of back pain it is often challenging to treat, leading to chronic pain conditions for millions of people. Once the pain becomes chronic a number of changes occur in the nervous systems, muscles affected and psychological state. These changes cause feedback loops which amplify or even cause pain even if the original cause has healed.

How yoga helps with back pain

One of the most significant feedback loops is the interplay between fear/hypervigilance of pain, muscle tension as a result of the fear, and ongoing pain which creates further inflammation and more pain. A schematic of this relationship can be seen in Figure 1, which clearly shows how treatment is unlikely to be successful unless these secondary factors are also addressed. The NHS and NICE now view chronic back pain as a multifaceted condition which requires a multifaceted treatment package.



Figure 1. Chronic pain cycle

The good news is yoga can form a major part of that multifaceted treatment package in one go! One key piece of advice to those with chronic back pain is 'keep moving'. Yoga definitely helps with that, improving both core strength and flexibility. Increasing core strength is key because it reduces the load on the spine and back muscles, increasing flexibility and allowing people to move more freely.

But, that's not all. At the heart of yoga is the connection of mind and body through breath which promotes relaxation and much greater internal awareness. Or in medical terms, yoga stimulates the parasympathetic nervous system or PNS (the system responsible for rest, digestion and healing). Different elements of yoga stimulate the PNS in different ways allowing all the elements of the secondary chronic pain feedback loop to be targeted simultaneously (see Figure 2).


  • Pranayama connects mind and body, promoting relaxation. 

  • The asanas teach the body how to regulate and reduce muscle tension in key areas 

  • Meditation: teaches the mind to draw away from hypervigilance, easing over-sensitised neural pathways and decreases inflammation in the body.




  • Figure 2. How yoga targets the chronic pain cycle.

    Reducing cost & the use of opiates

    Additionally the shift away from painkillers and towards yoga as a first line intervention for back pain could dramatically reduce the amount of opiate painkillers prescribed. This is a huge benefit to patients as it avoids the potential side effects, and addiction risks of opiates. It also benefits the NHS in terms of reduced drug costs and demands on clinician time.
    To conclude, the inclusion of yoga in the NICE guidelines for low back pain and sciatica is a huge breakthrough for patients and for those of us who dream of seeing yoga thoroughly integrated into the NHS. Yoga has great potential as an intervention for many conditions and I hope this will be the first of many more NICE.
    This blog was written in conjunction with the Minded Institute who are running a course on yoga therapy for low back pain and sciatica in April.





12/02/2017

How the Shape of Your Bones Affects Your Yoga Practice

In yoga we tend to talk a lot about muscles and connective tissue, but very little about bones. We talk about soft tissue being tight, stiff or flexible and how to change it. Often there is the underlying assumption that if you are diligent enough with your yoga practice then you will eventually be able to do any pose you wish. This assumption might be true if soft tissue was the only limiting factor in yoga. But that simply isn't the case, sometimes you come up against the hard portion of your anatomy: Bone.

Skeletons are the framework for yoga practice. They are all uniquely proportioned and as yogis they define our individual limits. If your legs are much longer than your torso you will never be able to touch your nose to your toes in a forward fold no matter how flexible your hamstrings are. Or, if you come up against a hard 'bone on bone feeling as you move into to pose that is your anatomical end point. Hips are a key area where we can come up against this 'bone on bone' feeling and I'm going to explore the reasons in the remainder of this post.

Figure 1, below is of  the top of two femurs (thigh bones). It shows the heads (which fit into the hip socket) and the necks attaching to the shaft of the femur, This picture is commonly used to illustrate the anatomical extremes of femur development. The bone on the left has a small head, and a long slim neck coming straight out from the shaft. The bone on the has a large head with a short thick neck, angled forward from the shaft. It's easy to see how these variations could mean different ranges of movement for the individuals involved. However, the shape of femur head and neck are only part of the story

Figure 1. Top view of two femurs


The shape and depth of the hip socket play a huge role in hip range of motion (ROM) as well. Figure 2.a, below shows scans from a hip imaging study . The blue shows a very shallow hip socket and the red a very deep one. Figure 2.b shows what happens to an individual's ROM when you take into account of the shape of the femur AND the hip socket. As can be clearly seen a shallow hip socket and narrow femoral neck allow a large ROM but with a deep socket and thick femoral neck the ROM is much reduced.

But what does this mean for us as yogis? Simply put if you have the hip configuration on the left you poses which require a lot of hip ROM e.g. pigeon or cow face are likely to be quite easy easy for you but you may struggle more with poses that require a lot of stability eg tree or warrior three. If you have the hip configuration on the right then pigeon may be very difficult but balancing on one leg might seem like the most natural thing in the world!

Figure 2. a) Shallow and deep hip sockets. b) Hip ROM combining shape of the femur and the hip socket.


The point here is not to beat yourself up one way or the other but simply learn to work with your body as you practice rather than trying to force yourself  into a position that might simply be impossible for your body. Give yourself permission to modify alignment to allow for your body geometry. Good yoga teachers should understand and respect this (provided you are not doing anything unsafe!) and be happy to provide modifications for you if you are unsure!

 For example, if you come up against a bone on bone feeling in pigeon then you could try moving the front knee out to  the side more to give yourself more space.Or if you feel stuck in janu sirsasana try bringing your torso more to the inside or outside of your straight leg.


23/01/2017

Inflammation, Yoga and the NHS

In September I started a physiotherapy degree at Kings College London and dived deeply into the realms of human anatomy, physiology and disease. So far it has been fascinating, overwhelming and frustrating. Fascinating because the human body is amazing and it's a privilege to be learning about it in such detail. Overwhelming because I'm not sure how I'm going to memorise everything I'm being taught. And to find out about the frustration read on!

As a yoga teacher and scientist I have a strong belief in the healing potential of yoga. I have seen it many times in the students I teach, in myself and in the growing body of scientific research into various therapeutic applications of yoga. I am always viewing the body from a yoga perspective as well as a physio perspective. I look for links between the two areas and ways yoga might help in some conditions. The more I learn, the more convinced I am that yoga could be beneficial in so many health conditions. But the greatest potential for yoga is in reducing one of the major pandemics of the western world; inflammation.

Inflammation is the single most recurrent theme in my course. Lecturers come back to it again and again when talking about things that can go wrong within the body and how to reduce inflammation when it has got out of control. Sometimes, the causes of inflammation are obvious e.g. as a result of a sprained ankle, but in other cases, such as a spontaneously occurring frozen shoulder, we simply don't know. 

We do know inflammation can affect any part of the body, muscle, nerves, connective tissue, joints etc. We know it is helpful as part of an acute healing response but extremely unhelpful if it becomes chronic, linking in to chronic pain and other issues. And we know diseases which cause inflammation in the body, stress and external irritants can all increase risk of other inflammatory conditions. However, reducing inflammation is very poorly understood, especially when it becomes chronic. Except yoga can do just that.

Yoga and meditation have been proved to reduce inflammatory blood markers in patients with cancer1, heart failure2 and chronic pain3 and in members of the general population4. These are all rigorous studies published high impact journals and are just a snapshot of the wonderful research being done into the therapeutic benefits of yoga and meditation.  But not once have they been mentioned as useful interventions in any of my lectures. A situation which I find incredibly frustrating! From a patient perspective, they are being denied drug free and enjoyable way to help treat themselves which has proven physiological and physiological benefits. For the cash strapped NHS yoga offers great potential as a cheap, safe and efficient (particularly group classes) way to reduce inflammation in patients with many different diseases.

How yoga and meditation reduce inflammation will be the topic of a future blog, but now the evidence is available I don’t understand why it is taking so long for them to be routinely offered to patients. We are gradually starting to see some patchy inclusion but it’s still very much on the whim of individual hospitals and wards. My dream is to see yoga thoroughly integrated into the NHS and for that to happen it needs to start being included in NICE guidelines. A huge break though has happened with the most recent set of NICE guidelines for lower back pain which include yoga for the first time! Hopefully this will be the first of many more inclusions for yoga but it’s important to keep up the pressure.

If you are a patient and think yoga could help especially if you are suffering from inflammatory conditions then talk to the health care professional/s (HCPs) treating you. One of the key priorities in the NHS is ‘client focused care’ e.g giving the patient as far as possible what they want. If there is increasing patient demand for yoga then more HCPs will start to listen. If you are a HCP be open minded about the benefits of yoga and maybe even have a look at some of the research out there. You might be surprised at the quality and the results! If you are a yoga teacher again why not investigate some of the research and keep you students informed. Finally if you are a researcher keep doing research the more we have the more convincing our arguments. I know from experience it can be quite difficult to get funding for this kind of research (I was tantalizingly close to doing a project on yoga for chronic pelvic pain which fell though at the last minute) but please keep trying and if anyone would like to collaborate on a project then please get in touch!!


1. J.K. Kiecolt-Glaser,. et al., “Yoga's Impact on Inflammation, Mood, and Fatigue in Breast Cancer Survivors: A Randomized Controlled Trial” Journal of Clinical Oncology, vol 32, no. 10, pp. 1040-1049, 2014. 

2. P. Pullen, et al., “Effects of yoga on inflammation and exercise capacity in patients with chronic heart failure,” Journal of Cardiac Failure, vol. 14, no. 5, pp. 407–413, 2008.

3. A. Wren, et al., “Yoga for persistent pain: New findings and directions for an ancient practice,” Pain, vol. 152, no. 3, pp. 477–480, 2011.

4. P. Kaliman, et al., “Rapid changes in histone deacetylases and inflammatory gene expression in expert meditators,” Psychoneuroendocrinology, vol. 40, pp. 96–107, 2014.








25/07/2016

Edge, Time and Props: What is the Difference Between Yin and Restorative Yoga?

There have been lots of discussions about yin vs. restorative yoga. Is one better than the other? Should you use props in yin? Where is the line drawn between the two?  Personally, I feel the difference simply comes down to ‘edge’, ‘time’ and emphasis. As discussed in my previous post the emphasis in yin is a gentle stretching of the connective tissue while softening the muscles, in restorative yoga the emphasis being is deep relaxation with no strain in body or mind.  Edge is used to describe the amount of sensation/stretch felt in the pose and time is the duration of the pose.  For example, in a yin pose you might feel quite a strong edge in the target area of the pose and hold it for 3-5 minutes, in a restorative pose you might feel little or no edge and hold for 5-10 minutes.

What about props?


Props may be used to help the body stretch, strengthen, balance, relax or improve body alignment. Restorative yoga poses tend to involve a lot of props to ensure the body is completely supported and thus feels safe to completely relax. It also means the poses are comfortable to be in for extended periods of time. For example in the restorative child's pose pictured below; there is a blanket for padding under the knees, the abdomen and chest rest on the bolster which raised at one end to provide extra support for the head and neck. If desired extra blankets can be placed under the ankles and between the hips and heels.


While fewer props are used in yin they can still be very important in helping students experience a pose more comfortably and safely. They allow students to hold an appropriate edge without over stretching (e.g. placing a rolled up blanket under the knees to protect tight hamstrings in a forward fold.) They can also be used to help relax other part of the body not directly involved, in particular supporting the head and neck so they are not dangling and adding additional strain to the shoulder girdle. In the yin version of child's pose below there is only a blanket under the knees for padding. If the forehead if it does not easily touch the floor, a block or  folded up blanket my be placed underneath it to avoid straining the neck and back. Some people also enjoy having a block or blanket between their hips and heels for a little more support for the lower back.


Yin and restorative yoga are both wonderful additions to a traditional yoga practice and offer peace from the hustle and bustle of everyday life.  Why not come to class and give them a try?