Breathe More, Stress Less: The Transformative Power of Conscious Breathing

Breathe More, Stress Less: The Transformative Power of Conscious Breathing

I recently stumbled upon an article titled, "Master Your Breath, Master Your Health: The Transformative Power of Controlling Breathing." It served as a poignant reminder of how simple breathing techniques can alleviate stress, enhance sleep, lower blood pressure, and contribute to overall mental well-being. For those intrigued by the details, I'll leave the citation below. As we enter the holiday season, let's explore practices that take only minutes but can significantly ease the stress associated with this time of year.

The Breath's Role in My Journey

My journey into understanding the power of breath began during my anatomy teachings in a yoga teacher training program. I realized the importance of exhaling during resistance training in the gym and guiding patients, as a physical therapist, to breathe rather than hold their breath during exercises. As a pelvic floor physical therapist, I found breath invaluable for various purposes, from calming the nervous system to aiding childbirth and stabilizing the spinal column.

A Fascinating Breath Technique

One captivating aspect of breath use is imagining it as an internal balloon, creating a pressure system from the pelvic floor to the diaphragm, rib cage, and glottis. This system safeguards the spine during activities, promoting deep core engagement, improving spinal alignment, and making daily movements more effortless.

Yogic Practices

Yogis have incorporated focused breathing, or Pranayama, into their routines for centuries. This practice, one of the eight limbs of yoga, influences the nervous system, overall health, and body stability. In yoga classes, we learn to synchronize breath with movement and employ energy locks to stabilize postures.

In case you are curious Body in Tune would love to collaborate with you to find your perfect breath practice.

Understanding the Diaphragm

Delving into the anatomy, I rediscovered that the diaphragm's central tendon extends along the spine, affecting the 2nd lumbar to the 8th thoracic vertebrae. This connection sheds light on the stiffness often seen in patients with lower and upper back, neck, hip, and shoulder pain. When we are in pain, we tend to hold our breath, limiting vertebral motion essential for freedom of movement.

The Nervous System Connection

The diaphragm's physical attachments and their proximity to nervous system ganglia highlight the interplay between breath and the nervous system. Tension in muscles and fascia can stimulate the sympathetic nervous system, while using breath to relax around the ganglia encourages the parasympathetic nervous system, promoting a "rest and digest" response.

Breath as a Rehab Tool

Considering these connections, I pondered whether our breathing patterns could be a key element in rehabilitating spinal discomfort and calming overactive muscles. I also learned that these breathing patterns helped to lower stress cortisol in our system which helps to protect our bones with osteoporosis.

Expanding the Practice

Reflecting on the referenced article, I realized the broader impact of pranayama beyond physical health. As a physical therapist, I've started incorporating breathing practices into home self-care programs, emphasizing the importance of slowing down to allow the nervous system to rest and reset.

Good news! Body in Tune would love to collaborate with you to teach you this precise yoga practice and to support your ongoing practice so you can enjoy your life off the mat with confidence.

Practical Breathing Techniques

As the holiday season accelerates life's pace, it's essential to revisit simple techniques for regular nervous system rest and reset. A personal favorite is taking ten conscious breaths between patients, equalizing inhale and exhale. An asymmetrical breath practice, inhaling for 4, pausing for 7, and exhaling for 8, proves effective in quieting the nervous system. Similarly, box breathing, with pauses between inhale and exhale, can be a powerful tool to combat anxiety and racing thoughts.

Incorporating Breath into Daily Life

The beauty of these practices lies in their accessibility—pause and practice them almost anywhere. Whether waiting in line, on public transport, or even at a traffic light, the more frequently you calm your nervous system through conscious breathing, the more profound the impact on your health and well-being.

Conclusion

As stress levels rise during the holiday season, take a moment to embrace conscious breathing. Try these simple techniques and witness the positive change they can bring to your day and overall well-being.

Body in Tune, LLC was born from a belief that quality of life matters; both life and physical balance matters.

I would welcome the opportunity to be part of your support team with regards to your muscles, joints, bones and osteoporosis. The goal is, after all, to help you feel confident in your body so you can play with your grand children, take that long-dreamed of vacation and get outside and enjoy a walk with friends.

Reference:
Master your Breath, Master your Health: The Transformative Power of Controlling Breathing https://neurosciencenews.com/controlled-breathing-health-23594/

Needed: A Sense of Groundness

I had a flare up of my chronic aches and pains last week. And it took me a few days to realize why. It wasn’t actually anything I had done at work or in my daily exercise. It was instead that my body had become tense, my mind on high alert and unpleasant emotions were bubbling up. The result was that my muscles were getting tighter and gripping. This in turn was causing my trigger areas to become more sensitive and painful. These “past injuries” were not getting the blood flow they wanted and felt like there was more compression and tension. So what was happening?

When we woke up last week on Thursday morning, Dennis told me that a former colleague from Colorado had texted to see if we were ok after we went to bed the previous night. There had been a mass casualty event about 20 miles west of our home. “Wait, what?” was my response. How could this happen in Maine?! The crime rate is so low! And everyone is so nice and welcoming!!!

But our quiet world had been shaken, turned upside down. We were reliving feelings we thought we had put behind us in the weeks following a similar event at our grocery store a 5 min walk from our house in Boulder, CO before we moved to Maine. There was uncertainty, fear and tension.

When I was in my yoga teacher training I developed a new level of sensitivity in my body. The little nuances in the muscles and joints of which I had previously been unaware are often brought to the surface. But yoga has also taught me to listen. What is my body telling me? What is my intuition saying and what are the emotions associated with these sensations?

Please understand I am not suggesting that I go down a rabbit hole of self-pity when my back insists that I pick my activities carefully on any given day. Instead this new awareness and listening to the sensations in my body help me stay true to my heart, and to what will make me happy. Tuning into my intuition is all about navigating through life feeling confident and settled in my values, decisions and actions.

So last week I instinctively created my yoga practices and chose meditations that would build a sense of a stable foundation, a sense of resilience and a sense of calm and focus. It allowed me to remind myself that in that moment I was ok.

Intuitively I chose yoga poses that kept me closer to the ground, turning inward and that required that I activate my deeper core. Poses like child's pose, cat/cow and forearm plank. My yoga practice allowed me to respect how my body was feeling which was tense like a coiled-spring and to offer a reset to my nervous system.

In case you are curious Body in Tune would love to collaborate with you to find your perfect movement practice.

I find it interesting how our brains dictate where and how much pain we feel or do not feel when there is an injury or an increase in nervous tension. Last week my brain instinctively knew to look for my “sensitive” areas and if it found tense muscles that it brought to my attention in the form of stiffness and sometimes pain. When life is flowing easily, my brain seems to focus less on these areas as if there had never been pain there in the past.

So my question to myself became what might I do to redirect my brain? My natural instinct was to assess how my body felt, how I had internalized the emotions and also to think about how I wanted it to feel. My yoga practice focused on quieting the nervous system with extra time spent feeling and listening to the breath. Feeling the breath move to different areas of the body and directing it towards the areas where there was tension. We know that when the nervous system is on alert, it tends to increased the resting tone or level of contraction in all the muscles of the body. If there is an area that was injured in the past, it is more likely to react to this increased tension.

I often tell clients that when we have a joint or muscle that is stiff and sore, it’s like the players on a sports team. When one player is slacking off, the rest of the team can get tired faster. We expect the muscles to create perfect, stress-free motion around the joints. However, when the synergistic muscles are not working efficiently together in both timing and force, then one or two muscles are going to get fatigued more quickly. The result is that areas get sore and stiff.

By reflexively creating a yoga practice that would support these areas, help the muscles breath and let go I had a way to help myself feel better physically and mentally. The beauty of yoga is that by putting breath to movement we are not only acting as our own myofascial release therapist, but we are also massaging and stimulating the rest and digest nervous system while quieting and calming the fight, flight, freeze and fawn portion of the nervous system.

Even though I was able to help my body, mind and spirit reset, I deeply understand that my practice does not change the facts of the situation, that so many lives were affected and will continue to be affected. My thoughts and prayers continue to go out to the community and those impacted in whatever big or small way by the events of last week.

Body in Tune, LLC was born from a belief that quality of life matters; both life and physical balance matters.

I would welcome the opportunity to be part of your support team with regards to your muscles, joints, bones and osteoporosis. It would be an honor to help you feel confident in your body so you can play with your grand children, take that long-dreamed of vacation and get outside and enjoy a walk with friends.

Are you ready?

What I Learned in the Berkshires

I spent the weekend biking with my husband in the Berkshire mountains in western Massachusetts. Imagine riding through a tunnel of colorful trees that then open into open farmland with mountains as a back drop. We had a few stops at farms for fresh snacks including quiche, butternut squash soup and apple cider donuts. These were not your average aide station on an organized bike ride!

Here’s what I learned. Yoga played an integral role in making the biking fun!

Yoga prepared my body by helping me manage my aches and pains so that I could enjoy the ride. Yoga has taught me how to focus my breath where and when I needed it, again, to better enjoy the ride and yoga provided the mindset that the numerous hills were all temporary and that the suffering would end.

Yoga and the Physical body

I believe the practice of yoga can influence many different aspects of our lives. I put it to the test this weekend. I have suffered from various aches and pains for a number of years and have found that my yoga practice has been instrumental in helping me manage and even heal from many of them. My latest issue is that my feet fall asleep while biking. It is as if the nerves to my feet can not get enough blood flow, so partway into a bike ride, they start to hurt. And I mean really hurt, enough to make me stop, get off the bike and stretch. Then I just suffer through the rest of the ride.

Where the yoga comes in is that it has helped me activate and integrate some muscles around the pelvis and relax and stretch others such that my mechanics have improved. The result is that not only has my endurance improved but I can have less foot pain for more miles. This particular weekend I made it through the entire ride without having to stop and stretch.

I had been exploring a muscle called the quadratus lumborum for the past two weeks. This muscle is part of the side body and connects the pelvis to the spine and lower rib cage. It is on the back side of the spine and works with the psoas on the front to stabilize the spine. So my home practice focused on how to open and stretch the side body and also how to activate the synergists. The synergists are the teammates to the quadratus lumborum. These muscles include (but are not limited to) the abdominals, gluteals, and latissimus dorsi.

What I have discovered is that if I spend time stretching the side body including the quadratus lumborum and latissimus dorsi and the front and outside of the hip, there is better blood flow to the nerves in my feet. The flip side of stretching is of course activating or strengthening. So my practice has included lots of core work, lots of lunge or chair pose and poses to target activating the upper back extensors and shoulder blade retractors. The reason the strengthening works is that then I have a whole team of muscles working together and my quadratus lumborum does not get overworked and tight enough to affect the blood flow to the nerves in my feet.

Good news! Body in Tune would love to collaborate with you to you to find your perfect movement practice.

Yoga and a Breathing Practice

Something I know from physical therapy is that the how and where we breathe in the ribcage is important. There is a pressure system created by the breath that helps to activate the deeper core and stabilize our posture and spine. My breathing practice has begun to help correct my spinal alignment, ie. posture. I have been known to stand with my rib cage posteriorly tilted (lower ribs jutting forward), rounding my upper back and creating a forward head. When I was taught to breathe more effectively into my lower ribs and posterior diaphragm, my pelvis became more level and my rib cage was better centered over the pelvis. In addition I discovered that my lower and deepest layer of abdominals was more easily and consistently activated. Remember how I talked about abdominals supporting my side body and lower back to help my feet? Well, the new and improved position of the spine and rib cage is taking pressure off of the nervous system as well. A bonus discovery is that when I breathe while biking to support this improved posture, my neck and shoulders do not get as fatigued and my arms don’t fall asleep. Bonus!

Did you know? Body in Tune would love to help you use your breath and pressure systems to better support your spinal alignment.

The Yoga Mindset

One of my teachers, Gina Caputo, ERYT-500, often talked about struggle and ease during her yoga classes and workshops. She reminded us that both are temporary and that we can count on change. She would have us holding a forearm plank for what seemed like a lifetime reminding us that the struggle was only temporary. And what a relief it was to shift to the next pose.

Well I often think of her teachings when I am out biking and this weekend was no exception. The Berkshires are known for their hills. And so anytime a hill seemed just a little too long, I thought of Gina and allowed myself to dig a little deeper and make it to the top of the hill only to be rewarded by the “ease” of a downhill.

During my yoga practice I will often pause in a pose to take the time to look for the struggle and the ease in the pose because this is where the change happens. Whether it is holding a pose long enough to fatigue out the compensating muscles and allowing the deeper more effective muscles time to figure out their job or staying in a pose to build endurance and strength or active the osteocytes to help stimulate bone remodeling and growth for osteoporosis, it is all about shifting and changing.

For me yoga is a practice in awareness.

Body in Tune, LLC was born from a belief that quality of life matters; both life and physical balance matters.

I would welcome the opportunity to be part of your support team with regards to your muscles, joints, bones and osteoporosis. The goal is, after all, to help you feel confident in your body so you can play with your grand children, take that long-dreamed of vacation and get outside and enjoy a walk with friends.

Grounded, Strong and Balanced

Yoga Bliss

As you may know I am a physical therapist and also a yoga teacher. I fell in love with yoga for what it did for a shoulder injury but also for the affect on my mental health - quieting the anxious mind. The physical effects on our bodies and our health are equally powerful.

Maharishi Patanjali writes in the Yoga Sutras,

"Yogas chitta vritti nirodhah." "Yoga is the stilling of the fluctuations of the mind."

As a yoga student I enjoy the sense of calm that comes after a yoga class - often called yoga bliss. You might know the sensation. That feeling you get after class where you need to spend a little time cleaning up your space, rolling up your mat, storing your props and speaking with others before you get in the car so that you will see the red lights on the drive home.

Other times we feel very clear, focused and inspired after a class or we feel an improved strength and sense of Self. “Yoga pushes back” is a phrase my teacher Shannon Paige Kenney, RYT-500 often repeated. Yoga can shake us to our core and challenge our beliefs, increase our awareness of body sensations and emotions and asks us to be true to our values.

Now if you are like me and many of my clients, you started yoga as an exercise class to help with aches and pains. For me it was back pain. I loved how yoga poses moved through all three planes of motion creating balance within the body, mind and spirit on and off the mat.

And the private sessions with my teacher that I did early in my practice helped me hear the cues and make adjustments and created awareness of muscles connecting and working together. This is some of why I intertwine yoga into the physical therapy services I offer. Why treat just one piece of the whole when we can use breath and poses to affect the whole body?

In case you are curious Body in Tune would love to collaborate with you to find your perfect movement practice.

Yoga for our Bodies

Building Strength, Coordination and physical Balance

Her goal was to hike 3 miles around Emerald Lake in Banff, Canada.

My client, Mary, came to me after an ankle surgery. She was concerned about being sedentary while waiting to start PT and rehab. Chair and bed yoga was her ticket to sanity during a time when she felt held back waiting for the ankle to heal.

She continued with the yoga while she received PT for her ankle repeatedly telling me her lower back was feeling better. As she was allowed to put more weight on the leg, we progressed to standing and eventually balancing poses, tree pose.

🎉 After 6 months of weekly yoga. Instead of Emerald lake, her husband took her to Rome. She celebrated her strength and endurance by sending me a photo from the top of the coliseum. Then she added that she had actually run to catch a train are well. Needless to say I was quite impressed with her success.

It is important to note that we had found the right type of exercise for her… one that she could stick with and enjoy. I believe that is what made all the difference. And I see the bliss-ed out look in her eyes after each session.

Good news! Body in Tune would love to collaborate with you to design a yoga practice to suit your needs and to support your ongoing practice so you can enjoy your life off the mat with confidence, strength and agility.

Yoga for our health

Becoming postmenopausal is an interesting time of life

I say this sarcastically as there are both positives and negatives. The hormonal shifts affect our sleep, body temperature regulation and weight. There is also research suggesting an increased risk of osteoporosis, heart disease, auto-immune diseases like diabetes.

My postmenopausal clients complain that life is moving too fast and that it often feels as if they have more and more piled on their to-do-list between family, home and work.

Stress and the hormone, cortisol, is a factor in the above issues. Minimizing stress levels helps to decrease the negative effects of cortisol. Increased cortisol levels slows bone rebuilding and remodeling needed to maintain strong bone density and also interrupts our sleep rhythms.

The physical practice of yoga is a form of exercise to many of us, but it can be so much more if we can take the time to listen as suggested by Richard Freeman, author of “The Mirror of Yoga”. He begins by saying that, “Yoga begins with listening. When we listen, we are giving space to what is.”

But what we also notice is that the more we practice yoga, the more connected we are to our values and true Self. We also become better at saying “no” to unnecessary tasks and we get better at recognizing when we want to ask for help or delegate tasks to free up a moment or two. And its funny when we ask for help, our loved ones are so relieved that we might slow down, that they are quite happy to step up.

The more we practice yoga the more aware we become of what we are feeling in the good as well as the stressful times in life. It becomes easier to stay grounded within our bodies and thoughts while navigating life off the mat. Essentially the stronger we are physically, the more often we likely to recognize when we want to say “no” to something that think we should do, because our intuition says otherwise.

Most yoga poses engage the core muscles in some way from our standing poses to seated twists and forward bends. We step up the effects when we add breath to the poses and the transition between poses. More importantly a breathing practice wakes up the diaphragm muscle.

There are breathing practices that are specifically designed to focus and quiet the mind. For example research has suggested that 5 min of an alternate nostril or an asymmetrical breathing practice will have a positive effect on quieting our nervous system and the flight, fight, freeze and fawn responses. Hence the “calm” with the yoga bliss.

The good news is that the right yoga practice will find you once you are on your mat and it can assist with stress management and offer full body strengthening, flexibility, coordination and balance training and improve posture. Done with others it can also be a social event that nourishes the mind, body and spirit.

Body in Tune, LLC was born from a belief that quality of life matters; both life and physical balance matters.

I would welcome the opportunity to be part of your support team with regards to your muscles, joints, bones and osteoporosis. The goal is, after all, to help you feel confident in your body so you can play with your grand children, take that long-dreamed of vacation and get outside and enjoy a walk with friends.

How Yoga Woke Me Up

How Yoga Woke Me Up

When I started yoga, I saw it as exercise class that was making my core stronger and helping my back pain. After my teacher training I realized that it was helping my back pain because I was stronger and more flexible. BUT I was also mentally stronger and more flexible. AND I had more awareness of when my body was tight because I was having an emotional reaction to whatever situation I was facing. How did this awareness come about?

It is in the space between the poses.

A Transition is defined as “the process or a period of changing from one state or condition to another.”

In yoga the transitions or space between poses are important because this is where we connect and learn about ourselves. We can make huge gains in our practice when we pay attention as we move from one pose to another. It is during this time that the brain learns how to control the muscles and as such the movement. It learns which muscles to turn on when, in what order and with the right amount of force to keep our bodies safe and injury free. The is one of the many ways we improve our balance for our everyday activities off the mat.

Off the mat in our day to day lives there are both physical and emotional/mental transitions. Yoga is a practice of the intertwining of mind, body and spirit. It allows us to connect with our physical strength and coordination and also increases awareness of our thoughts and emotions. For me, yoga helps me be more aware of when I’m getting “triggered” emotionally.

The Physical Transitions

Examples of physical transitions might be how we move getting out of bed, climbing stairs, lifting groceries or when playing a sport.

When we practice yoga, we may well be inadvertently preparing for more than the above mentioned transitions. Yoga is a practice of intertwining of mind, body and spirit. It allows us to connect with our physical strength and coordination. The way we move our bodies makes a difference in the wear and tear we put on our bodies. If you have osteoporosis, it can be the difference between a compression fracture, a fall or maintaining vitality as we age.

My Ah-Ha Moment

During a yoga class we teach our bodies to move in and out of poses. An ah-ha moment for me came when my teacher, Shanon Paige Kenny, ERY-T 500, was offering a specific cue to rotate in the hip joint from warrior II to lunge. It was to spin my pelvis around the hip joint to move my body from facing the long side of the sticky mat to face the front framing my front foot with either hand. I “found” and learned to engage my deep hip rotators and core to control the spinal and hip movement. As I think back I was learning to keep the hip and spinal joints safe, avoiding the flexion and rotation stress to the spine/vertebra, and as it turns out safer for my bones as well.

As a physical therapist I teach my patients to avoid twisting and bending the spine simultaneously when we lift especially when they have back or disc issues or osteoporosis. This transition in yoga was actually strengthening my hips and pelvis and teaching me the coordination I needed to use better body mechanics in my daily life. I say “win-win!”

The Wobble

Transitioning in and out of balance poses is key. Have you ever noticed your ankle wobbling in tree pose? Or stepped from tree pose back to a high lunge? Or moved from lunge to a forward fold at the top of your mat? These transitions improve strength and coordination in the legs, hips and pelvis. The stronger the muscles that connect the leg to the hip and pelvis along with your core, the more quickly you will react when you slide on loose gravel or misjudge the last step. So embrace the wobble. It is your nervous system learning how to control the movement of your body. And as we know falls are not acceptable especially if we have osteoporosis.

In case you are curious Body in Tune would love to collaborate with you to find your perfect movement practice to address your pain, balance or osteoporosis.

The Mental Transitions

There are also more mental and emotional transitions in life from being pregnant to taking a newborn home, the back to school events, beginning to take on more caregiver roles with aging parents or packing up your belongings and moving across the country. I suggested that yoga is a practice of intertwining of mind, body and spirit. Personally, it helps me to be more aware of when I’m getting “triggered” emotionally.

With that awareness comes a choice of how I want to interact with and react to the world around me. What energy I want to offer out and receive back. If I practice regularly, I am much better at surfing the transitions with fewer ups and downs or frantic moments. My husband has kindly mentioned that I need to keep practicing yoga because it makes me a nicer person. And I will be the first to admit I am much more patient when I have a regular yoga practice.

I first became aware of how yoga might play a part in my life’s transitions during my first yoga teacher training. I knew on some level that yoga “did” something to help me feel more calm, at least for a day or two after my weekly class. But during our training we read the Upanishads and I learned about the levels of consciousness. The 4th level was about being in the present moment. And I mean really being there, moving from one moment to the next without the anxiety of worrying about the future or ruminating on the past.

In the yoga class that I so enjoyed, my teacher offered such a string of cues for movement in and out of each pose, when to breathe in, when to breathe out, that it was all my brain could do to keep up. That meant that for the 60—75 min of class, I let go of all the other “things”: the grocery list, the “I should have saids”, the work stress, the life stresses, etc. As such I was really present and my brain could breathe.

My brain was so grateful! But in reality, this was also programing my brain to look for opportunities to quiet my overactive mind or to at least hang onto the “yoga bliss” for as long as it could.

Good news! Body in Tune would love to collaborate with you to teach and support you with a yoga practice so you can enjoy your life off the mat with confidence.

Vinyasa yoga - vinyasa means “to place in a special way”

When we pay attention everything changes. I invite you to pay attention to the detail of moving in and out of yoga poses, and notice what shifts begin to happen in your life. I invite you to notice how you feel internally and mentally after your next yoga class and see if here is a difference in how you feel and react during the next difficult conversation.

Body in Tune, LLC was born from a belief that quality of life matters; both life and physical balance matters.

Life is always changing. How will you meet your next transition?

We would welcome the opportunity to be part of your support team with regards to your muscles, joints, bones and osteoporosis. The goal is, after all, to help you feel confident in your body so you can play with your grand children, take that long-dreamed of vacation and get outside and enjoy a walk with friends.

Quality of Life Matters...

I Believe Quality of Life Matters.

Balance matters; both physical balance and life balance. My secret weapon is my yoga practice that aims to keep me in the moment, welcome change and to manifest opportunities in life. What about you?

A number of years ago I started into the profession of physical therapy thinking I was going to help all my patients heal from injuries and return to all the activities and sports that they loved. Graduating from school and moving into clinical practice was a wake up call.

Every patient presented a different challenge. Some responded well to the physical therapy others needed more support. There was always more to learn about physical therapy; the techniques, ways in which we could help and the research that supported or didn’t support these techniques.

Physical Therapy is an Art and a Science.

The art comes in when I listen to my patients and my intuition rather than just applying the research or evidence based practice. I have taken numerous post graduate continuing education courses about physical therapy protocols, technique and have spent countless hours learning and bettering my skill set so that I could understand the multitude of diagnoses and symptoms that might walk into the clinic. Some of those courses, however, tapped into the more intuitive side of treatment.

Learning to Trust my Intuition

Learning to trust my intuition and then perhaps back it up with the research made the practice of physical therapy interesting. It fed my soul.

But when a shoulder injury from a fall skiing was not responding to the traditional physical therapy model, nor the acupuncture or massage, I started missing out on my regular activities. Daily activities including work activities and manual therapies were harder. As I was compensating for the injury, my neck and back became more achy and stiff. Soon I was unable to do the connecting vinyasas in yoga class. I had to stop going to class and I felt my quality of life plummet..

My yoga teacher met with me and offered a home practice that didn’t require weight bearing on my arm. This practice was all of about 20 min a day but over the course of 6 weeks, my shoulder pain decreased and the physical therapy started working.

It wasn’t until I enrolled in a yoga teacher training to “learn more about yoga” that I learned what had really happened with the home practice. The practice was so well designed that it did not irritate my shoulder, but rather I did poses that supported my posture, strengthened the upper back and improved my range of motion. And as it turns out, the practice had an amazing effect on my nervous system.

In case you are curious Body in Tune would love to collaborate with you to find your perfect movement practice to address your pain.

Levels of Consciousness

During the practice I had reached a different level of consciousness. I was present and focusing on my breath for that 20 min. Apparently the 60-75 min yoga class I had been attending was doing just that helping me to be present and quieting my nervous system.

Quieting the Nervous System?

Well when our nervous systems are all revved up by stress, anxiety and worry, it makes our muscles more tense and guarded. This in turn often creates more general aches and pains in the same muscles. And since my brain already knew that I had an injury, it followed those nerve pathways directly to the shoulder and all the supporting muscles in the upper back and neck. This created more pain.

So if I am actively quieting my mind by the steady breathing practice associated with the yoga postures, I was helping to relax my muscles and quieting my over active brain. In essence I was giving my brain permission to “let go” and not worry, be less frantic, etc.

It was these types of sensations that had originally drawn me back to my second yoga class and started my journey of discovery. Now I understood!

Yoga Changed Everything

Naturally I had to add this into what I was already doing in the practice of physical therapy. It has made me a more holistic practitioner. It is as if I have finally given myself permission to treat the whole body, not just the injured parts that show up with the person seeking my help. It feels like a natural progression, using yoga awareness, connection, breathing practices and postures to help my patients address all the aspects of their injuries.

Yoga is about creating the space, awareness and connection within ourselves. And when we can allow this, the physical therapy works much more quickly.

Good news! Body in Tune would love to collaborate with you to teach and support you with a yoga practice so you can enjoy your life off the mat with confidence.

Yoga is an Adventure of Self-Discovery

Judith Lasater, PhD, PT offers, “Yoga is an adventure of self-discovery.” And when we are ready to connect within ourselves, we can begin to listen and trust our intuition when it comes to managing aches and pains. We might become more accepting of the situation. We might find that the yoga practice as your physical therapy homework allows the worry and the aches and pains to be less invasive. We can instead begin to feel confident in our body’s healing capabilities, to trust that the body may have already healed the injury and what we need is for the brain to feel confident in that healing and begin to allow movement without pain.

We may find that a yoga practice increases flexibility, strength, and coordination, improves posture and helps us manage stress. This in turn makes room to experience equanimity, a balance in our lives. The return of the quality of life is often all we seek.

As a women's health and orthopedic physical therapist I have a toolbox of in depth knowledge and understanding of how physical alignment, muscle strength and flexibility affect our lives. My yoga training allows me to address more than just the physical, but also the effect of the emotions surrounding the injury and the sudden loss associated with feeling isolated from our favorite activities.

This is not to say I am treating and mental health issues. That would be outside my scope of practice. It is more that a yoga practice can allow us to feel more connected and the breathing associated with the postures allows us to quiet nervous system to focus our brains attention on maintaining efficient alignment of the spine and joints in the extremities. Attention to our physical alignment will overflow into life off the mat.

Body in Tune, LLC was born from a belief that quality of life matters; both life and physical balance matters.

We would welcome the opportunity to be part of your support team with regards to your muscles, joints, bones and osteoporosis. The goal is, after all, to help you feel confident in your body so you can play with your grand children, take that long-dreamed of vacation and get outside and enjoy a walk with friends.

Why Does it Hurt When I Sit?

Pelvic pain is not something we easily talk about with friends or colleagues. Yet it can be a huge disruption in our lives. It can affect our ability to sit in the car, at the table to have dinner with friends or family, in an important meeting at the office or even to enjoy intimacy. The pain can be short lived or it can be chronic. There can be many causes of this pain including but not limited to a simple muscle spasm from over stressing the body during a workout or competition, an ill-fitting bicycle or bicycle seat, childhood or recent trauma, surgery, a fall, fracture or the progression of a back injury.

So what can you do about this?

First, know that you are not alone and that there are options. It would be prudent to check in with your physician to rule out any serious disease. Second, get to know your pelvis, hips and pelvic floor.

The pelvic floor muscles span the underside of the pelvis like a hammock. They connect from the pubic bone to the tailbone and between the sides of the pelvis and ischial tuberosities or sit bones. They have three main jobs: Support the internal organs, sphincter the bowel and bladder and enhance sexual function and pleasure. Also of note is that these muscles are a primary supporter and stabilizer of the sacroiliac joint. They interdigitate with the deep rotators of the hip, Adductors (inner thigh) and gluteus maximus through fascial connections and work with the deep stomach muscle, the transversus abdominus.

The muscles can irritate nerves to the pelvic floor and can affect the alignment of the pelvis contributing to sciatica. Common symptoms of dysfunction in the pelvic floor include: urinary urgency, urine leakage, pain with sitting, tailbone pain, pain with intercourse, erectile dysfunction, numbness to the upper inner thigh or lower back pain. As you might expect none of these symptoms are normal. Many are common, rarely discussed.

When the muscles are tight or in spasm, they cut off their own blood supply causing more pain and spasm. They are often too fatigued from the constant spasming to adequately contract to stop the flow of urine so leakage can occur as well. Spasm in the pelvic floor muscles may be due to (but not limited to) scar tissue from childbirth, past fractures to the pelvis or hip or post prostatectomy. The scar tissue can pull on the muscles preventing them from contracting smoothly or may cause the muscles to compress nerves and blood supply to the region creating a pain cycle.

In case you are curious Body in Tune would love to collaborate with you to find your perfect movement practice to address your pain.

But what if the pelvic floor muscles are the victim instead of the cause?

In a perfect world the muscles in and around the pelvis would work together like a series of ropes and pulleys to support our pelvis in the ideal position allowing for easy mobility and static positions. Sadly, this is often not the case. We are talking about all the more external muscles that attach to the boney pelvis, some of which have fascial connections to the pelvic floor muscles.

In addition to the reasons for pelvic pain listed above, we may repeatedly assume postures or perform repetitive activities such that the muscles get stronger moving into the posture or the repeated motion. Imagine the position we assume when we look at our cell phones and the position we sit in on a bicycle or in a kayak or at our desk. Then think about where the dishwasher is relative to the sink, the toilet paper relative to the toilet and which side of the bed your bedside table sits.

Over time we will repeatedly contract our muscles into these positions or directions. The result is that these movements will get stronger than its opposing muscles and it will get harder to move the opposite direction (but not impossible).

So what does all this have to do with the pelvic floor muscles?

As mentioned above the pelvic floor muscles are a sling of muscles between the sit bones. There is an outer sling of muscles that attach the leg bone to the pelvis. These 6 deep hip rotators have a fascial connection to the pelvic floor. So if there is tightness in one hip, it is likely that it will pull awkwardly on the pelvic floor all the way across to the other hip. The same is true when we examine the front of the hips or hip flexors and compare these to the gluts or back of the hip.

Or, if the front of the hips stiffen and shorten and we don’t use the muscles on the back of the hips, we may develop what practitioners call an imbalance. This alters the position of the pelvis which in turn will affect the ability of the pelvic floor muscles to contract and relax as needed and may result in spasm and pain.

The result is that the pelvic floor muscles may start trying to help the outer and bigger muscles of the hips. They get over worked. They get tired. And if we add an injury to the hip, pelvis or lower back, voila, they get pissed and may become painful.

Good news! Body in Tune would love to collaborate with you to teach and support you with a yoga practice so you can enjoy your life off the mat with confidence.

So what can we do?

Start with the breath. A breathing practice will not only quiet your nervous system allowing muscles to more easily and relax but also invite awareness to the sides and back of the diaphragm. When we focus the breath within a practice, we can improve the coordination of the pelvic floor muscles, diaphragm and core stabilizers which in turn will help balance and improve the mobility of the hips and pelvis and can have an amazing effect on pain in the hips, pelvic floor and lower and mid back.

At Body in Tune, LLC we weave together the techniques of pelvic floor physical therapy and guided yoga sequences. You will learn ways to manage and ease your symptoms so you can be active and keep up with friends and family.

Body in Tune, LLC was born from a belief that quality of life matters; both life and physical balance matters.

We would welcome the opportunity to be part of your support team with regards to your muscles, joints, bones and osteoporosis. The goal is, after all, to help you feel confident in your body so you can play with your grand children, take that long-dreamed of vacation and get outside and enjoy a walk with friends.

The Case for Chair Yoga

Yoga is available to all of us

Yoga is available to all of us, even the asana or postures of a yoga practice by including the use of props like a chair. Using a chair offers an opportunity to practice safely, to focus on the deeper muscles and inner connections and as a starting point to gain strength and flexibility to make a standing practice more fun and effective.

Now don’t scoff - just because you are sitting down or holding onto a chair, doesn’t mean you are not practicing yoga or that you can not work hard enough to get the physical as well as the mental, emotional and spiritual benefits of the practice. If are like me, you are targeting bone density and osteoporosis with your yoga practice. You might even say that you can work harder because you are sitting down or using the chair for support and therefore, see and feel improvements in your strength, flexibility and balance sooner.

Using the chair for support might look like one finger touching the chair or grasping the chair, but in both cases that gives you what is called a tactile cue. This cue tells your body where you are in space, if you are upright or tipping over. and is also known as proprioception. Proprioception is one of three key element to maintaining your balance.

When I learned and certified to teach Dr. Fishman’s yoga vs osteoporosis, I had not been one to use props except blocks to reach the floor with my tight hamstrings.

But that changed when we did tree pose with our foot on the chair rather than against the standing leg.

Suddenly, I was not fighting to stay balanced. I was better able to focus and fine tune or refine the pose. I was able to access more muscles which according to Dr. Fishman provides an opportunity to stimulate more bone remodeling. I was able to find the deep hip rotators which is exactly what you want when you are doing yoga to strengthen your bones, improve bone density and fight osteoporosis.

Yes, tree pose is standing on one leg which has been shown to improve bone density in the leg and to improve core strength and posture. But if you finesse the pose by finding and intentionally using the deep hip rotators, you have the potential for greater gains.

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In case you are curious Body in Tune would love to collaborate with you to find your perfect movement practice.

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Why is this deep hip strength important?

When we take the time to focus on the deeper muscles and inner connections, we improve the coordination of the deep stabilizing muscles and the large (global) stabilizing muscles. Our mobility and balance are best when these muscles work together efficiently. An added bonus is decreased incidence of outer hip pain.

Many women in our post menopause years experience outer hip pain often called gluteal tendonitis or bursitis. It is often because you are using the global muscles instead of the deep stabilizers. Global stabilizers tend to be muscles that are bigger and longer muscles that move us through space. The deeper or segmental muscles are shorter and stabilize the proper alignment of the joints they surround. Together the deeper and global muscles improve the mechanics and efficiency of the joint and our motion. This can also slow he development of arthritis in our joints.

After menopause the deeper muscles seem to get lazy if we don’t keep after them. If we miss using the deeper muscles, the global muscles try to do it all. The result is one or more angry, overworked muscles and constant soreness and stiffness and often the outer hip pain. Balancing the use of these muscles is one thing we are looking for when doing yoga for osteoporosis.

More importantly these deeper muscles create the torque through the bones needed to stimulate bone remodeling. They help prevent arthritis, stimulate bone growth in the hip and are the root of our balancing muscles.

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Good news! Body in Tune would love to collaborate with you to teach and support you with a yoga practice so you can enjoy your life off the mat with confidence.

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So what does this have to do with chair yoga? Allow me to take a moment to explain.

The use of props, like a chair, takes balancing out of the equation. So if you are practicing yoga to maintain strength, agility and to improve bone density, the chair allows you to focus on the muscles. The we first learn yoga, many of us rely on on the joints and ligaments and global stabilizers. But the more we practice, the more awareness and sensation we might feel. Such that when you place your foot on the seat of a chair rather than against your leg, you recognize that when you are not fighting to keep your balance, you can feel for the deeper muscles and focus on the other energetics of the pose. This means more muscles working together, improved strength, coordination, and more stimulation of bone growth. All of these are better for someone with osteoporosis.

There are times when the chair is recommended as a starting point for the yoga vs osteoporosis poses. That is when you have osteoporosis or have had a previous fracture and therefore, are more likely to suffer another fracture. The chair minimizes the risk of a fall from loss of balance. For example a seated warrior II or extended side angle allows you again to refine and target the deeper hip rotators, focus on your trunk alignment, knee positions and your breath because we took balance out of the equation.

Similarly, it also makes it easier to maintain a tall spine when doing the seated twist poses. When we sit on the floor and have tight hamstrings, that has a tendency to cause us to round our spine. When seated in a chair, there is less tension on the hamstrings such that we can keep the spine tall and straight to get the appropriate forces through the spine to build bone without risk of compression with the twist. Not only is this better practice of the postures, but remember the osteoporosis precaution of avoiding twisting and bending at the same time? Yoga once again is more accessible if you can keep your spine safe.

But you might counter that you need balance to avoid falls. And then ask why shouldn’t I do these standing? Well, there are cases for both.

So long as you are working hard in the seated pose, chair yoga offers you a way to gain strength and flexibility in the muscles and awareness of your joint position and alignment in space. Similarly using the chair for your hand instead of the block or the floor in twisted triangle, you are more likely to keep your spine extended and straight.

The other side of balance is flexibility.

You need flexibility around the joints to allow for good alignment but also for balance.

The seated poses allow you to use reciprocal inhibition to improve your flexibility. Those are big fancy words that mean when you contract a muscle the nervous system tell the opposing or antagonistic muscle to relax and lengthen. An example is when you tighten your quadriceps or front of thigh muscle, your nervous system tells your brain to relax and lengthen the hamstrings, the back of the thigh muscles.

You might even begin to notice how you can move deeper into a pose when you are not stretching to your limit in your hamstrings and hips. In fact you might find that you gain flexibility by not working at your edge of flexibility all the time because you activate surrounding and antagonistic muscles. This in turn allows the tighter muscles to relax and not fight the stretch, resulting in more length or flexibility.

We can start with the focus on avoiding falls, keeping good alignment, gaining strength and flexibility in more muscles and improving our agility and bone density. But know that there are many more benefits than we have discussed here. I would love to challenge you to give a few chair yoga poses a try and if you can find ways to challenge yourself and deepen your yoga practice. I practice yoga for my bones and my physical, mental, emotional and spiritual health. What about you?

Body in Tune, LLC was born from a belief that quality of life matters; both life and physical balance matters.

We would welcome the opportunity to be part of your support team with regards to your muscles, joints, bones and osteoporosis. The goal is, after all, to help you feel confident in your body so you can play with your grand children, take that long-dreamed of vacation and get outside and enjoy a walk with friends.

Confused About Osteoporosis/Osteopenia? - Part 2

In Part 1 of this topic we talked about osteoporosis, how bones build, remodel and break down and the rate at which each of these happens. We also gave some thought to how you might choose to approach the diagnosis. We also offered an explanation to the precautions of “don’t bend and twist and don’t fall” in an effort to help us choose exercises to help us prevent falls and fractures.

We were talking about which gardener you are (your approach to receiving the diagnosis).

Just as you tend your garden to help it grow, help flowers bloom and grow amazing vegetables, you may want to tend to your bones. This may come in the form of medications your doctor prescribes and reviewing your diet, your stress management and your level and type of exercise.

You may realize you would like support. You may seek out professionals who understand the diagnosis, understand your body at each stage of life and who can collaborate with you to make choices that set you on a path to have your bones looking like a well tended garden year after year.

What about exercise…. There are so many choices

Exercise is defined in the physician’s desk reference as physical activity. So especially if you are someone who tends to sit a lot, when looking at your level of activity during the day, it may help to think about the amount of activity and movement you do during the day. That means you get to count housecleaning, laundry, yard work, gardening, as well as what most of us consider as exercise - walking, jogging, running, cycling, aqua aerobics, yoga etc.

The research tells us that both high and low impact exercise can affect the health of our bones, ie. build bone density.

High impact might include

• jogging

• running

• jumping

• stairs

where as low impact includes

• walking

• elliptical

• stair stepper

• dance

• yoga

We also read that resistance training aka lifting weights is beneficial. As is balance and proprioceptive exercises.

In case you are curious Body in Tune would love to collaborate with you to find your perfect movement practice.

So about yoga as an option?

Yoga has been shown to improve balance, posture, strength, flexibility, coordination and to decrease stress levels.

All the important pieces wrapped up into one exercise. Even better is that there are 12 yoga poses that when performed for the right amount of time and with the right amount of vigor have been shown to improve bone density. All that in 15-20 min, 3-4 times per week.

Good news! Body in Tune would love to collaborate with you to teach you this precise yoga practice and to support your ongoing practice so you can enjoy your life off the mat with confidence.

Resistance Training

Unless you are familiar with and comfortable with a regular weight training routine, you may consider consulting with a specialist. Resistance training comes in many shapes and sizes, so to speak. There are many options from weight machines to free weights, circuit training to functional fitness, group personal training classes and physical therapists. The one-on-one personal training and physical therapists would be able to design a specialized program just for you with the resistance and repetitions specific to your abilities and needs.

Tending to our balance

Balance and proprioceptive exercises are also important to minimize the risk of falls. We will want to train both static balance like standing on one foot as well as dynamic balance which is what keeps us upright when we are walking and looking around or stepping off a curb in the middle of conversation with a friend, for example. Proprioception is our sense of where we are in space. For example imagine walking into the bathroom. If you have been living in the house for a number of years, your hand knows exactly where to reach for the light switch even if the room is dark. Our brain has been trained through repetition to know exactly how to place the arm and hand to turn on the light with minimal effort. This sense of where the arm is in space is similar to how our feet and ankles have learned to give the brain information about whether the surface under foot is level, uneven, slippery, loose gravel and more so that the brain can tell the muscles of the legs, ankles and feet to react appropriately ultimately keeping us upright and on our feet.

In the past I have been surprised each fall when I begin my ski conditioning. I learn that even though I trained my balance and reaction times for last ski season, my brain and body needed a refresher after months of not practicing over the summer season. In other words I restart almost at square one every fall. But I am always relieved to find that my body remembers quickly and gets back in tune quickly so that now I have to challenge my balance in different ways. All this to enjoy skiing more with less worry of falling, less risk of injury and better endurance so I don’t fatigue after one run.

The point is that balance needs to be an ongoing practice to keep us safe from falls.

The good news is that according to the research you can train your balance with things like aquatic exercise and tai chi classes in addition to the usual balance classes and exercises. Both have the added benefit of improving endurance as well. The longer you can move around before getting tired, the less likely you are to fall.

So for those of you with an osteoporosis or osteopenia diagnosis, we have over the last two blog posts

• reviewed your precautions and why they are important

• given some thought to how you want to approach your diagnosis

• discussed types of exercise you might consider including my favorite YOGA

Body in Tune, LLC was born from a belief that quality of life matters; both life and physical balance matters.

I would welcome the opportunity to be part of your support team with regards to your muscles, joints, bones and osteoporosis. The goal is, after all, to help you feel confident in your body so you can play with your grand children, take that long-dreamed of vacation and get outside and enjoy a walk with friends.

Post Hike Stretches

After finishing a very enjoyable winter walk in the woods I found my hips tightening up and then noticed a stiffness in my back when I went to sit down. Many of my students have complained of this as a common occurrence after longer hikes, walks, and even jogging. But I have found that a few minutes on my yoga mat will ease the stiffness and can leave me feeling much more fluid for the rest of the day.

A quick review of the anatomy will help us decide which yoga poses will be of assistance. The uphill and downhill portion of a hike will stress muscles differently. The core is essential in stabilizing the spine and pelvis so that the legs can propel us forward. (But that is for another posting.) The uphill portion of the hike will work the gluteals, hamstrings and quadriceps (butt, back and front of the thigh, respectively), while the hip flexors support the spine and lift the leg. The downhill portion will tend to extend or arch the lumbar spine as the pelvis tilts forward stressing the hip flexors. The quads control the descent with each step and the sides of the hips (abductors and rotators) will balance the pelvis when you have one leg going up and the other going down.

The purpose of the stretches is to increase blood flow to the worked muscles decreasing lactic acid build up and stiffness. So I found that opening the joints of the spinal segments eased the back tightness and relaxed the hip flexors while stretching the hip rotators and buttocks eased the hip stiffness.

Elevated Legs-up-the-Wall Pose

I recommend a supported bridge pose with a folded blanket under the sacrum (the bone at the base of the spine between the pelvic bones). Extend your legs up the wall and perhaps stabilize around the knees with a strap so that you can really relax your legs. You may want a towel or pillow under your head and neck to ease the tension in the neck and shoulders. Let your arms fall by your sides, palms up if possible. But if you feel as if you have to hold them there, allow the palms to face the body or the floor. Rest in this pose for 3-5 minutes while breathing mindfully. This pose helps to relax the lower back and opens space for the nerves exiting the spine to breath and get fresh blood supply. In turn it relaxes the hip flexors innervated by these spinal nerves.

Supine Twist

Next, try a supine twist. Lie on your back and hug your knees into your chest for 30 seconds. Spread your arms out to the side, shift your hips slightly to the right and drop your knees off to the left and look up or turn your head any amount to the right for 5-10 breaths. Support under the knees with a blanket or block as needed to minimize the tension in the neck and shoulders. Exhale as your bring your legs back up to center and repeat on the other side.

Supine Figure Four Stretch

Lastly, try a figure four stretch also known as reclined pigeon. Lie on your back with your knees bent, feet flat on the floor. Lift your right knee and cross that ankle on the left knee. Reach your hands around the right thigh. If needed use a towel or a strap around the thigh as an arm extender so that there is minimal stress on the neck. Gently pull the left leg towards you allowing the right knee to open out to the side. Hold for 5-10 breaths. Exhale as you lower the feet to the mat. Repeat on the other side.

If you are someone who tends to notice more aches and pains after your outdoor activities, then a series of private yoga sessions might help keep you going. We will review your goals and develop a home practice that will help you balance muscles, decrease stress and improve your enjoyment of all your activities.

The Science Behind Yoga Vs. Osteoporosis

Osteoporosis is a systemic disease in which bones become fragile and more likely to break. It can progress painlessly until the point of fracture if left untreated. Essentially the body starts to lose bone faster than it makes bone. A bone density or DEXA scan defines osteoporosis as a t-score of less than or equal to -2.5 below the standard deviation. Osteopenia is the early stages of bone loss and is measured as a t-score of -1.0 to -2.5 below the standard deviation.(1)

The numbers tell us that 44 million people or 55 percent of the people aged 50 and older in the US have either osteoporosis or low bone mass. The International Osteoporosis Foundation reports that 1 in 3 women over the age of 50 and 1 in 5 men over the age of 50 will experience an osteoporotic fracture during their lifetime. Unfortunately a prior fracture is associated with an 86% increased risk of another fracture. The inherent risk of osteoporosis is a fracture.(2)

So how do we build bone in the first place? There are a group of cells responsible for building new bone and cleaning up bone as it breaks down. It is a constant give and take. To build bone we need to stimulate cells called osteocytes. Once activated the osteocyte will pull calcium and phosphorus from the blood stream to build bone. These cells respond to pressure, stress and strain. Within the osteocyte there are osteoblasts that are responsible for building new bone. I like to call them the construction workers. Another cell, called osteoclasts are responsible for breaking down bone and cleaning up old and/or broken bone. I like to call them the janitors.(3)

The loss of bone density can be caused by genetic, hormonal, metabolic and nutritional factors.(2) Normally we build bone until around the age of 30. Then the rate of breaking down bone begins to speed up and the rate at which we build bone slows down, meaning we can start to see more osteoclasts than osteoblasts. This is where exercise including yoga can help.

Wolff’s law tells us that the architectonic of bone follows the line of force to which bone is exposed, meaning that bone grows to resist the forces we put through them. The pressure outside the cell turns into electrical energy which creates a molecular change inside the cell. It works into the nucleus of the cell and changes the DNA of the cell. The forces stimulate the osteocytes and osteoblasts to build new bone. Research tells us that we need to maintain a deforming force for 12-72 sec to stimulate the osteocytes (greater than 72 sec cells go into a refractory period). The force can be compression, torsion or a tensile force.(3,4)

With exercise like yoga we can use gravity and our muscles to create the forces needed to stimulate new bone growth by holding the poses for the suggested 12-72 seconds. Dr. Loren Fishman (www.sciatica.org) and his team have studied 12 poses and found that yoga was a safe and effective means to reverse bone loss in the spine and femur (upper leg bone).(5) He continues to study more yoga poses and their effects on bone density. I teach these poses and more in my Yoga vs Osteoporosis Workshops and classes.

1. Osteoporosis and Musculoskeletal Disorders. National Osteoporosis Foundation. https://www.iofbonehealth.org/. 2017.

2. Data & Publications. International Osteoporosis Foundation. https://www.iofbonehealth.org/. 2017

3. Fishman L, Saltenstall E. Yoga for Osteoporosis [PowerPoint]. YogaUOnline. 2016.

4. Frost HM1. Wolff’s law and bone’s structural adaptations to mechanical usage: an overview for clinicians. Angle Orthod. 1994;64(3):175-88.

5. Lu Y, Rosner B, Chang G, Fishman L. Twelve-Minute Daily Yoga Regimen Reverses Osteoporotic Bone Loss. Topic in Geriatric Rehabilitation. 2016;32(2):81-87.