Thursday, October 22, 2015

Medical Yoga for Centering, Energizing.

Medical Yoga for Centering, and Energizing              

Maureen Mason, MSPT, WCS, CCI, PYT-C
Celebrate PT month with yoga! October 22
Warrior Series

  What is your mood as you approach exercise?  With a yoga repertoire, you can choose and adapt your own home program to meet your needs. Start an energizing session with mountain pose. Stand tall, and notice all the textures around your feet, from heels to toes, and the inner and outer pressures on the soles.

Taking a few slow breaths here and sensing feet, ankles, knees, hips and pelvis-can help your nervous system to steady and “ground” into appreciation for any aspect of your life. You can practice outdoors, or indoors, and a yoga mat on top of a padded rug is soft and easy.

Getting your feet NAKED is important, our feet get numbed from our footwear and the level surfaces we often walk upon. You can thank your feet for getting you around all your life. 

A yoga colleague Dina Chalom, PT,  cued me to not quickly blast out of this mountain pose into the warrior series, but to really make this a focal point to a start of a session. Sense yourself with stability, being alive, energizing with rhythmic inhalation, exhalation. Grounded feet. Diaphragm breaths are utilized, and the transverse abdominus is engaged to stabilize the trunk, as well as a slight engagement of the shoulder blades, meeting each other, while in front holding the shoulders open. The hand position of prayer pose reminds me to engage both front and back shoulder muscles.
 Mountain pose:feet may be slightly apart as well.
Thank your muscles and bones for holding you steadily in position.

Ginger Garner, of Professional Yoga Therapy, advises hands held together
in mountain and balancing as you step back into Warrior I. Pulling this off 
smoothly requires dynamic stability, holding steady in one part while moving
 Warrior I is a great pose to open up the hips, and focus on stability at the feet and up to the trunk stacked above. Breathing and holding the spine neutral and pain-free, I no longer throw my leg back far and wobble-I lift the leg back into place, pressing down into the back and front foot with equal pressure, and hold and breathe, and allow the small muscles around my joints to work with the larger sling-muscles. This is a therapeutic exercise concept of generating biomechanical stability and co-contraction of muscles around joints.

In  Warrior I, above, I am checking that both hips are in the same plane, not tipped down on one side, and also that the entire pelvis is aligned towards the front. This allows me to really stretch my quad and hip flexor, vs rotating my spine and pelvis back. After I warm up with this series and few other Asanas, I am able to open up the pose more…but this is it for me in an early am photo shoot. Add Arms up for more of a workout with Warrior I.
Thank your digestion for energizing you. Look forward to your next meal.

Warrior II is a great pose to further open up the hips. You can step back into the pose from mountain, and allow your pelvis and body to turn to the side. Check if your hips are level, and your body is stacked comfortably above your pelvis. Look down to your forward knee, as it moves into a lunge it should optimally align in line over the foot, not be diving in towards the ground. I align by consciously activating the deep hip muscles that turn the femur bone outward. 

Warrior II with arms lifted, shoulder blades can lightly meet each other, then palms can turn down to the floor.While here, sense the back ribs lifting a little as you inhale, while at the same time hold the navel in for stability. Keep shoulders soft and easy.
I like to look out over my forward facing fingertips and consider what I want to focus on for the day, to accomplish.Or if this is a sunset workout for me,  I consider a positive emotion to focus upon. When outdoors, I let the natural beauty of the environs refresh me in my own little yoga bubble.
Here, you can thank your lungs for oxygenating all your tissues 

Move into the poses from the prior post for more power, Chair, Plank, Side Plank, and Hip Bridge. 

These Asana poses may be used prior to meditation practice, or to simply be a self care and refreshment time in your day. In yoga philosophy, the poses are part of a lifestyle for wellness; see the 8 limbs of yoga reference. 

After I perform these postures (Asanas) my body feels lighter and my hips move more fluidly as I walk. A great feeling, older, stronger! Look at the link below on yoga for healthy aging. 

 Next up: Warrior III, and the Hip and Yoga

Medical Therapeutic Yoga Definition: Medical Therapeutic Yoga is the practice of yoga in medicine, rehabilitation, and wellness settings by a licensed health care professional who is completing or has graduated from the Professional Yoga Therapy Studies program and has been credentialed as a Professional Yoga Therapist-Candidate or Professional Yoga Therapist.
I share this link for the option for you to read more about how one may “ground” or feel connected to the earth, and your feet, during yoga exercise. However specifics on foot and knee alignment as given here may not pertain to you, in other words you may need to have feet slightly turned in or out depending on your ankles, knees, hips and pelvic structure. Look at all the medical benefits of regular yoga exercise

Tuesday, October 20, 2015

The Core, week 4: Pelvic Floor Muscles

The Core, week 4: Pelvic Floor Muscles

“Because you know I’m all about that bass, ‘bout that bass, no treble” 
(Meghan Trainor's fantastic lyrics from “All about that Bass”)

Abdominal core stabilization is not complete without activating the muscles at your base--a group of muscles located at the bottom of your core. You may know them as “Kegel” muscles. They are your pelvic floor muscles (PFM). They play a role not only in core stability, but also in urinary  function, fecal function, and sexual health.

If you don’t want any “trouble” (such as leaking urine, prolapse, or ineffective core activation) then it's time to learn to use your “base”.

How do they (PFM) make my core stronger?

A strong core gives your spine stability when you move or lift something. The core muscles work together to add pressure inside of your abdomen so your spine is stable. If the rest of your core (diaphragm, abs, and back muscles) are all contracting and adding pressure, but you have no “floor” to resist that pressure, then you get a leak of pressure. This leak at best means you don’t build enough pressure to stabilize your spine. For some, it means you leak urine.

How do I strengthen them?
This is the question we are asked at CTS all the time. The answer seems backwards. Most women I see are not weak because they haven’t done enough Kegels, but because they are Kegeling too much, making their muscles short and tight. Or they are long and weak because they bare down often-straining to poo or pee. Or they have scarring from childbirth that keeps the muscles short. And for both men and women I see pelvic floor muscles that are confused or de-activated after a surgery. So here are my best generalized tips on how to strengthen your pelvic floor muscles.

So where are these muscles anyway!?! This is a front view of a model of a female pelvis with bones and muscles showing. The white represents the bones of the pelvis. The brown is the pelvic floor muscles (PFM). They span from the pubic bone to tailbone. 
Here is a sideview.

1.Relax. Do a diaphragmatic breath that you learned last week. Can you feel your pelvic floor muscles stretch when you inhale? If so, you are doing a good job relaxing.
-Are you someone who holds stress in your pelvic floor? Many people do!  Throughout the day, think about tension levels in your pelvic floor and do a diaphragmatic breath to relax if you feel tension.
-Relax when you defecate and urinate! No straining!!

2. Try a basic Kegel, it works for many people. For women it feels like a closure and lift of the vaginal opening. For men it feels like a slight lift of the scrotum. This is the same contraction you do to stop the flow of urine.
                -How long you hold depends on how strong you are. Start with just 2 seconds and build up to 10 seconds. More importantly, rest completely for 20 seconds.   So, if you are new to Kegels, then hold for 2 sec, rest for 20 sec. Only do 10 reps. Three times a day. These are teeny tiny muscles you are strengthening, so they will fatigue quickly and you won’t be doing good if you try to do all 30 in one set.
                -Don’t hold your breath while contracting. No need to use full force effort to contract, a gentle contraction is all you need. Also, keep your hips, buttocks, and legs still. If you do the contraction right, no one should be able to see that you are contracting :)

Do I contract all of my abdominal core muscles together, or is there a better order?
There is a better order! Stay tuned until next week to learn how to activate the final two muscles of your abdominal core and most importantly, how to coordinate them. For now, get really good at both contracting and relaxing your pelvic floor muscles in isolation so you can use them when needed, and give them the break they deserve when not needed.

Week 1: Let’s get acquainted, Core.
Week 2: Alignment - build the scaffolding to support your weak spots while they heal and repair
Week 3: Diaphragm and what Queen Elsa got right
Week 4: Pelvic floor muscles
Week 5: Transverse abdominis and multifidus muscles
Week 6: Shoulder girdle and hip
Week 7: Functional core exercises
Week 8: Round robin demonstration of CTS Physical Therapists’ favorite core exercises.

Happy Moving!

Crystal Hazelton, PT, MPT, OCS

This article is not medical advice. If you have pain or concerns, consult your physical therapist or physician.

The Core: Week 3. Diaphragmatic breathing and Letting Go

The Core: Week 3. Diaphragmatic breathing and what Queen Elsa got right

Take a really nice deep breath…ahhhh

Not only does a deep belly breath slow your heart rate and calm your nervous system, it is also a key component of your core. Why is the diaphragm important? It is one of 4 sides of a canister. When all 4 sides of the canister contract, pressure builds up and stabilizes the spine. If you only do crunches, you build up only one of the 4 sides.

 If you tried several core “exercises” and still are not getting results, first check your alignment, then check your diaphragm function. Correcting faulty diaphragm function has improved problems ranging from back pain to leaking urine while running.

How does it work? 
The diaphragm is a muscle and fibrous tissue that separates the thoracic cavity (heart and lungs) from the abdominal cavity. It is an upside down muscle that is shaped like a dome located at the bottom of your ribs. When it contracts, it moves down towards your abdomen and becomes flat.

The diaphragm is at rest on the left. This is what it looks like when you exhale. Your abdomen will feel hollow. The diaphragm is contracted on the right. This is what it looks like when you inhale, feel your lower ribs open like an umbrella, feel your abdomen rise, and feel your pelvic floor drop.  The red arrows show where pressure is moving.

This downward motion of the diaphragm increases pressure inside of the abdomen. But you still need activation of the other core muscles to maintain pressure for spinal stability. And preferably the diaphragm and pelvic floor muscles need to activate first.

How to breathe with your diaphragm, the basics:
1.     Lie down and relax. Place one hand on your chest and one hand on your stomach just under your ribs.
2.     Inhale through your nose slowly and feel your abdomen rise and the lower part of your ribs slightly expand like an umbrella. Now repeat this and feel the rise all the way to your lower abdomen and even down into your pelvic floor muscles. You should feel them stretch or expand slightly just like your stomach does. (more on the pelvic floor next week)
3.     Exhale slowly and observe the return of your stomach and pelvic floor like a balloon that has deflated
Use the hand on your chest to make sure you aren't breathing with the top of your ribs. You should have twice as much abdominal movement as upper chest movement. 
*Always check alignment first. Are your ribs lifted up, causing chest breath? Are they facing down,  causing an exclusive belly breath?
*When you get good at this, progress to sitting or standing
*Take about 5 min a day for practice with breath work. Get really good at this so that in a few weeks when it’s time to tie this all together you have a diaphragm that is ready to pull it’s weight!

-You’ll learn how to coordinate the diaphragm with the rest of the core muscles in a future post. For now, just learn how to do a diaphragmatic breath
-No need to hyperventilate, breathe slowly, and take some regular breaths in between the deep ones.
-Postpartum ladies may need some extra time or assistance getting their diaphragm back into shape thanks to a wiggly little human squishing the diaphragm for many months of the pregnancy. This squishing often also causes the ribcage to expand resulting in an overstretched and therefore weak diaphragm.
-Please stop sucking in your stomach all day! Go ahead and pull it in for that summer vacation photo, but like Queen Elsa said, “Let it GO,” the rest of the time! Where do your guts go when you suck in? They can go up into the diaphragm stopping it from dropping and therefore making it unable to help out with correct pressures. Or, they can go down into your pelvic floor contributing to pelvic organ prolapse for women and hernias for men. This constant pressure on your guts can also add to GI dysfunction such as irritable bowel syndrome, constipation, bladder pain, and bladder urgency. So, give your abdomen a break. Relax your belly more than you contract it. And when it is time to correctly activate your core, make sure all parts of the abdominal core are simultaneously contracted.
---And while we are on topic, sucking in makes your muscles tight and short. Remember last week when I said a short and tight muscle is a weak muscle? So, walking around “activating your core” all day long can actually make it weaker.
A quote from Katy Bowman, one of my favorite biomechanical authors, in her recent book, Move Your DNA:
            “Rather than stretching or adding exercises to address our chronic stress, we will focus on releasing areas of the body most prone to hypertonicity.”

Your homework this week:
Spend time learning how to breathe with your diaphragm.
Use your core when you need it.
Relax your core when you don’t need it. 

Still have no clue how to do a diaphragmatic breath? Never fear, your anatomy loving PTs are here! We can assess your breathing and all the muscular, bony, and neural structures that can possibly affect that breathing. Then, most importantly show you exercises and movement patterns that can help your “core” function as a useful unit.

Happy Moving!

Crystal Hazelton, PT, MPT, OCS

This article is not medical advice. If you have pain or concerns, consult your physical therapist or physician.

Week 1: Let’s get acquainted, Core.
Week 2: Alignment - build the scaffolding to support your weak spots while they heal and repair
Week 3: Diaphragm and what Queen Elsa got right
Week 4: Pelvic floor muscles
Week 5: Transverse abdominis and multifidus muscles
Week 6: Shoulder girdle and hip
Week 7: Functional core exercises
Week 8: Round robin demonstration of CTS Physical Therapists’ favorite core exercises. 

The Core, week 2: Alignment matters

The Core, week 2: Alignment matters

Last week we labeled the muscles that make up your abdominal core. I have two amazing kiddos. Since carrying them in my once toned tummy, my stomach muscles became pretty unrecognizable to me--overstretched, widened, and very very weak. This is common for women postpartum and men with a split in their abdomen (diastasis recti) from heavy weight lifting or a sudden gain in weight.  When something important on a building is broken or weak, the repair guys build a scaffolding system to hold the structure of the building while they fix the weak spot. We need to do the same when fixing our weak and overstretched core. Good alignment is your scaffolding. 

These abdominal core muscles are both strained and weaker when your alignment is off. Another way to say this is good alignment of your bones maximizes muscle function. Why? Muscles stretch, relax, and contract. Their maximum force occurs when they are on a slight stretch. If they are already short, then there is not much room for the muscle to contract.

So, what does good alignment look like? Here are some do's and don'ts:

DON'T! This is my lazy posture. Look at my stomach and compare it to the better posture below. I am not sucking in my stomach in any pic, promise! You can actually make your stomach look smaller just by standing with good alignment (and if vanity isn't enough to convince you, you are helping your stomach heal and make it easier to activate your abs when you stand the right way!)
DO! Much better! Keeping my ribs down and a slight arch in your low back. My low back still looks flat here, hmm looks like I have some stuff to work on...

DON'T: This posture doesn't help either. Here, my abs are overstretched. Can you see that my ribs are lifted up and low back is over-arched? This posture can happen when you wear high heels.

There are three ways to make your muscle short and weak (don't do these 3 things):
1.     Bad alignment during a task. For example, slouch and try to contract your “abs”. Now sit up tall and try to contract them. Where did you feel stronger? Probably when you were upright. That’s because the abdominal muscles generally span from your ribs to your hip bones. If you bring your ribs close to your waist, you are shortening the muscle. Remember this during daily tasks like lifting your toddler’s stroller into the car. If you use the right posture, your core will actually be stronger!
DON'T! Can't quite activate my core because my ab muscles are already too short in this position. See how close my ribs are to my waist.

DO! Ah, now I can easily contract my abs, protect my back, and get an extra squat in for the day while I lift this cute wiggle worm.

Check out our amazing aide Alliena's demonstration of how to pick something up off the ground correctly.

DON'T! Nope, can't contract abs here. It's hard to see her ribs in this picture, so you can look at her spine. Do you see how curved it looks? Her stomach muscles are shortened in this position. 
DO! Yes! She is not squishing her abs here. It will be easier to activate her core if needed. An added bonus: this position protects your back even if you pick something up that is light, such as a pen!

 2.     Tight muscles.  Muscles are amazing, they adapt to what our posture tells them to do. Bad alignment over time causes the muscles to decrease length. An easy example is if you sit most of your day, the muscles on the front of your hip will get cozy in that position, thereby becoming short. You experience this as feeling tight (psoas anyone!?!).

3.   Overactive muscles. Because muscles adapt, if you keep them contracted (muscle length shortens when it contracts) all the time, they will stay short which makes them weak. Therefore, sucking in your core all day long is NOT a way to strengthen it!

Or, you might be making your muscles long and weak by over stretching them. 

Look what happens to my stomach when I wear 3 inch heels.
DON'T! Sad overstretched abs (I confess, you'll see me wearing cute heels at times. But not when walking or long periods of standing are involved)
My low back arches and and pushes my abs forward.

DO! Happy abs that have no strain or stress

What is your body doing when you put on make-up, brush your teeth, or fix your hair?  Here I am putting on make-up, being lazy as I lean my stomach on the counter. 

DON'T! Stomach is overstretched, back is arched

DO! Standing upright without arching my back or leaning on the counter
Alliena demonstrates the wrong and right way to reach into a cabinet.

DON'T! Her ribs are lifted up, this over-stretches her abs

DO! She correctly keeps her ribs down, this makes it easier for her abs to engage

So, using a bit of logic. To make your core stronger, use good alignment, relax your abs unless you need them (more on this later), and stretch your muscles so they have good length.

If you cannot get into good alignment, you need to spend extra time improving the motion at certain joints. Your physical therapist can help you identify these joints and prescribe specific exercises to improve your alignment.

Hoping this helps you move better! Here is the line up for the rest of this core series.

Week 1: Let’s get acquainted, Core.
Week 2: Alignment - build the scaffolding to support your weak spots while they heal and repair
Week 3: Diaphragm and what Queen Elsa got right
Week 4: Pelvic floor muscles
Week 5: Transverse abdominis and multifidus muscles
Week 6: Shoulder girdle and hip
Week 7: Functional core exercises
Week 8: Round robin demonstration of CTS Physical Therapists’ favorite core exercises.

Happy Moving!

Crystal Hazelton, PT, MPT, OCS

This is not medical advice. If you have pain, contact your physical therapist or doctor.
For more great pics and specific information on diastasis recti, checkout the blog at 

Eight weeks to understanding THE CORE

Eight weeks to understanding THE CORE
WEEK 1: Let’s get acquainted, Core.
This just might be my favorite topic (nerdy, I know). It’s one of the most asked about concepts from people with various musculoskeletal problems. But what IS the CORE!?!
The Core is certainly a VIP (Very Important Part of your body). Let’s not insult it by thinking it plays only one role. In the 1980’s we wanted that six-pack! One single muscle, the rectus abdominis was our focus for toning our core. That muscle happens to cause forward flexion of the spine (remember 200 crunches/day, anyone?) But what about sideways, backwards, and rotational motions? Can you even move the spine well if your hips are weak and wobbly? What does The Core actually look like? It is passive structures (things that don’t move like bones and ligaments), neurologic structures, and active structures including all the muscles in between your shoulders and hips. Yep, everything between those 4 limbs. Whether you are concerned with diastasis recti (a split in your abdomen), back pain, SIJ pain, shoulder pain, elbow pain, or getting toned “abs”, this inclusive physical description of The Core is relevant for you. 
What roles does The Core play? A strong core has been linked to decreased low back pain, decreased pain with chronic rotator cuff injury in the shoulder, and decreased impact of diastasis recti among other things. It stabilizes joints, moves joints, decreases the compression load of spine, and transfers loads. So, the term “Core stability” that was coined in the late 90’s just doesn’t cover all the cool stuff your core does. Let’s clarify by saying core strength is the force produced by core muscles. And core stability is the foundation that those forces are able to move on…still with me? How about an example? A baseball pitcher strengthens his core muscles with specific individual exercises. However, he has good core stability when he is able to successfully transfer force from when he winds up his left leg, plants, rotates at the hip, then transfers that force through his core and into his right pitching arm. This load transfer occurred thanks to good range of motion of several joints, good coordination, and strong enough muscles that pull on the passive structures (bones, ligaments, and connective tissue). 
The most commonly referenced muscles for the core are located between the ribcage and pelvis. These muscles form a canister shape in the abdomen with a top, bottom, front, back, and sides. Let's call this THE ABDOMINAL CORE. They include:
-transverse abdominis (TrA) – deepest muscle in the front and side of abdomen
-rectus abdominis - the most superficial front abdominal muscle, aka six-pack muscle
-internal and external obliques – muscles on part of your front and side contributing to your waist
-multifidi - deep spine muscle adding to the back wall
-diaphragm – just underneath the ribcage, this forms top of the canister
- pelvic floor muscles – spanning the pubic bone to tailbone, this forms the bottom of the canister
Now, to give a sturdy “stable” base for these abdominal core muscles to work properly, you also need strong hip and shoulder girdle muscles. Therefore, all muscles from your hip, pelvis, abdomen, and shoulder girdle get to be included in this core-labeling party. 
Hopefully you can now see why there isn’t a set of 5 exercises I can give you to “strengthen your core”. You need to move, strengthen, relax (more on this later), and coordinate every muscle from your shoulders down to your feet. 
(Dear fellow biomechanical nerds, if you are freaking out right now thinking I’m focusing too much on muscles and ignoring the critical neuro side of the neuromuscular system, just bare with me. It’s a lot of info for a fb post!)
Over the next 8 weeks, I will address how you can strengthen specific muscles of your core. Stay tuned as this is only an introduction to this fascinating force transferring dynamic VIP! 
Week 1: Let’s get acquainted, Core.
Week 2: Alignment - build the scaffolding to support your weak spots while they heal and repair
Week 3: Diaphragm and what Queen Elsa got right
Week 4: Pelvic floor muscles
Week 5: Transverse abdominis and multifidus muscles
Week 6: Shoulder girdle and hip
Week 7: Functional core exercises
Week 8: Round robin demonstration of CTS Physical Therapists’ favorite core exercises. 
Phew! Overwhelmed yet? Let’s take this one step at a time. This week’s tip: focus on stretching your hips, low back, thoracic spine and shoulder in a pain free way (in as many directions as you can) so that you can be ready to get into good alignment next week. Good alignment is essential for maximum muscle strength! Snap a photo. I’d love to see your favorite stretch!
Enough typing for now. Time for me to take a movement break and enjoy a stroll with the fam.
Happy Moving!
Crystal Hazelton, PT, MPT, OCS
This article is not medical advice. If you have pain, consult your physical therapist or physician.

Thursday, October 15, 2015

Yoga for Cardio Wellness and Power

Yoga for Cardio Wellness, and Power: Medical Yoga
Maureen Mason MSPT, WCS, CCI, PYT-C
October 2015                                                       

Part 3 of 9
Celebrate PT month!

Yoga can power up muscles, and key yoga asanas are illustrated here. Also, yoga appears to have cardiovascular benefits similar to those seen in the standard advised aerobic fitness training protocols. The latest research identifies reductions in blood pressure and improved lipid profiles in a groups practicing yoga for 12 weeks or more. This is great news for the 80% of the population that do not perform aerobic training regularly.

    According to research from the European Journal of Preventative Cardiology “Compared with individuals who did not participate in any physical activity, those who practiced asana-based yoga reduced their LDL-cholesterol levels by 12.1 mg/dL and systolic blood pressure by 5.2 mm Hg and increased their HDL-cholesterol levels by 3.2 mg/dL. In addition, the yoga practitioners also saw significant reductions in body-mass index, diastolic blood pressure, total cholesterol, triglycerides, and heart rate. Overall, the yogis lost 2.35 kg compared with non -exercisers…. Yoga, it appears, might provide a benefit in terms of improving cardiovascular risk profiles similar to that of physical activities like cycling or brisk walking, say researchers".
Medical Yoga, as prescribed individually in the Professional Yoga Therapy method, considers safety, stability, and sequencing of yoga poses to build strength. No wobbling or painful twisting or nerve irritating maneuvers should occur when performing yoga for health benefits. Props such as blankets, blocks, and bolsters are used for optimizing alignment and comfort.
Here are a few key poses, I am showing "modified" versions per my own flexibility, strength, and safety; asanas can help you develop power without hitting the gym for 90 squats and lunges with machines or free weights. These are performed with breath control and engaging spinal neutral-avoiding pivoting or arching excessively. 

Yoga Asanas for strength and power:

 Chair  Pose
I love this, as it provides a "hip hinge" while engaging abdominals, low back, pelvic, and leg muscles in a functional pattern that carries over to spine protection during activities of daily living. It is a mini squat with a slight forward lean. Add arms reaching up for an upper/lower body hold. My shoulders are tight on reaching up and I "substitute" by arching my mid back too much, so I warm up with just legs and trunk. 

This is great for post partum moms lifting babies, as it allows the strong hip to be the hinge vs the spinal segments. 

Boat Pose
The boat is often performed with legs out straight-but-anyone reading this have tight hamstrings? This also requires a flexible lower spine and tailbone, and breathing while holding lower abdominals in. You can build up to it by practicing pilates style roll backs.


I am not a perfect straight line with this, but am better at lowering my hips without over arching my back and sagging. A key control tip here is to dial in scapula-thoracic stabilization with a shoulder lock, or in lay terms, turn on a slight shoulder blade pinch vs hunching shoulders into a rounded position. How long can you hold this? A great goal is to build up to 60 seconds.

Side plank
The truth is that it has taken me months to develop the ability to hold the side plank without my hip cramping and my shoulder giving out.
 But you may notice my back appears to be arching-big deal, but it could become a pivot and compression point, and strain.So I am building on this, with a dose of yoga 3 to 4 x a week, 30 min sessions mostly. 
 In order to have strong hips for walking, and for runners, the side plank should be held for 30 sec. for women, and 60 sec for men.

What are your favorite Asanas? And do you have a question regarding yoga safety and your joints or spine? Log in and let us know!

For PT month we have private Physical  Therapist training sessions available, call for details.

Next up: Warrior series. Yoga for energizing.


Chu P, Gotink RA, Yeh GY, Goldie SJ, Hunink MG. The effectiveness of yoga in modifying risk factors for cardiovascular disease and metabolic syndrome: a systematic review and meta-analysis of randomized controlled trials. Eur J Prevent Cardiol 2014; DOI:10.1177/2047487314562741. Abstract
 Namaste, Yogis: Review Suggests Yoga Improves CVD Risk

James A. Raub. The Journal of Alternative and Complementary Medicine. December 2002, 8(6): 797-812. Psychophysiologic Effects of Hatha Yoga on Musculoskeletal and Cardiopulmonary Function: A Literature Review doi:10.1089/10755530260511810. Volume: 8 Issue 6: July 5, 2004

Medical Therapeutic Yoga: