Video of the Week Dynamic Triangle Pose Version 2

Compared to last week's Dynamic Triangle pose, this version increases the strengthening of your legs and the sides of your waist, and mobilizes and stretches your arms and shoulders differently. This is an advanced version of Dynamic Triangle pose, so please watch the video for version 1 before trying this one.

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2 Steps to Take Charge of Your Stress or Anxiety

by Nina

Enclosed Field with Rising Sun by van Gogh

Lately I’ve been trying to help several people who are suffering from stress and/or anxiety. Although these people are all quite different from each other—they range from a young woman with a new baby to man with newly diagnosed heart disease to an older man with chronic insomnia—I found myself saying the exact same things to each one of them. And since my advice was, in a way, very basic, I thought I’d write it up for the blog.

One of the things that motivated me to share this advice was that I was struck by something my friend said when talking over her daughter’s problems with her. “Well, I guess, anxiety just comes and goes.” My friend seemed to feel that her daughter was at the mercy of some emotion that took her over periodically and that there was nothing she could do to change that. But I feel that through a combination of educating yourself and making some lifestyle changes, you can empower yourself to deal more effectively with stressful situations and hopefully also reduce the levels of stress and/or anxiety that you are suffering from. 

And the advice I’ve been giving boils down to two simple steps.

1. Learn About Your Nervous System.

The first thing I always tell people I’m teaching to manage stress and anxiety is to read The Relaxation Response by Herbert Benson so they can learn about how their nervous system—specifically the autonomic nervous system—works. I recommend this book because although we have some information on the blog about the nervous system (see Chronic Stress: An Introduction and Stress, Your Health and Yoga), we don’t yet have a comprehensive overview of the nervous system. (I am going to write one tomorrow, though, because I’ve realized how important it is!) 

I feel strongly that educating yourself about your nervous system will help eliminate some of the mystery of what’s happening to you and empower you to make some important decisions. Knowing the symptoms of chronic stress, such as insomnia, digestive problems, headaches, high blood pressure and so on, will help you choose the right solutions (see below) for you and to take action before things get out of hand. And I also believe that knowing about how your nervous system works and understanding the difference between sleep and conscious relaxation (see Conscious Relaxation vs. Sleep) will motivate you to start practicing stress management. Otherwise, you might think—as one friend did—that exercise and sleep are all that is needed.

For example, I can always tell when I’m getting stressed out because I start sleeping poorly, lose my appetite (sometimes even feeling nauseated), and, because my mind is racing, I talk more than usual! If things get really bad, I start to feel a burning sensation in my chest. So rather than just waiting until things get even worse (I have been there—“going over the edge” I call it), I double down and focus my yoga practice on stress management (see Friday Q&A: Practicing to Manage Stress). I believe this has helped keep me emotionally healthy for almost 20 years now.

2. Find Ways to Manage Your Stress and Reduce Anxiety, and Practice Them.

Once you’ve learned about your nervous system and how important conscious relaxation is for your emotional as well as physical health, you should take the time to explore the possibilities yoga offers for helping you manage your stress and reduce your anxiety. We’ve been writing about the different ways that yoga can help you manage stress since the very earliest days of the blog. And throughout the years, we’ve continued to write about this. That’s because we feel that yoga includes such a wide range of possibilities that you’re sure to find something that works for you. Interestingly, the paper I wrote about in Self-Regulation, Psychological Health, and Yoga confirmed this very opinion!

But everyone needs to experiment to find what suits them best. For example, even though breath practices (see Friday Q&A: Breath Practices for Anxiety) are traditionally thought to be helpful for stress and anxiety, one person I’m working with found that breath practices I recommended tend to agitate him. Happily, however, I introduced him to supported forward bends, which he immediately found soothing. Another man I’ve been counseling does find breath work helpful, and he has used to it to relax while getting medical procedures that make him tense. He also really enjoys the guided relaxation tracks we have available on our site (see Audio Tracks). 

I myself love the breath practices and supported inversions (see All About Supported Inversions). But I never enjoy restorative yoga, unless I’m super exhausted, and I don’t like listening to an audio recording of any kind while I practice, which are two of Baxter’s favorite things. Hey, we’re all different, not only in our tastes but in the ways we get stressed out. See The Relaxation Response and Yoga for an overview of the different practices.

Finally, once you’ve identified the practices that work for you, you need to practice them regularly. This is crucial! Although some of the practices can provide quick, temporary relief, none are going to instantly re-balance your nervous system. After all, it probably took a while for your nervous system to become over-stressed, so it will take some time to return it to normal. But making the commitment to actively take care of yourself by practicing regularly is empowering—you are no longer at the complete mercy of outside forces—and that in itself is a huge step to take.

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Friday Q A Pain After a Knee Replacement Part 2

This week’s question is a follow-up question that came in after the post we did on yoga and knee replacements (see Knee Replacements and Yoga) and Shari's answer to another reader about pain after a total knee replacement (see Friday Q&A: Pain After a Total Knee Replacement). It seems that pain isn't uncommon after a knee replacement, but in this case, the pain is coming several years after the replacement:

Q: My partial knee replacement was April 2007. I started back to Yoga this past summer-one day a week, but I found child pose with the knees wide uncomfortable, but I did do it for a few weeks this fall. I now have some pain in my knee and I'm hoping that I haven’t loosed the cement in the joint. Any help would be appreciated.

A: Thanks for writing in about this new pain in your knee. As always, I am not able to diagnose or prescribe a yoga program for you without first doing a more detailed history and physical exam in person, but I can share some thoughts that come to mind from the situation you find yourself in.

One of the challenging things to discern for new yoga students, or those returning after a long break from doing yoga is: How to gauge if “uncomfortable” is a potentially harmful warning sign from your body? This is tricky, because it may simply be that you are getting some intense sensation feedback from the body as you stretch and strengthen parts of your body that have been neglected for a long time. With the knees in particular, learning to recognize the difference between the healthy stretch sensation of the muscles and connective tissue lengthening versus the compression of the tissues and bones that often happens deep folds of the knee joints is an important skill to cultivate. The compression sensations can sometimes indicate pinching of tissues that could lead to inflammation, injury or bruising that may not resolve quickly or could lead to more chronic pain. It is sometimes hard to skip these poses—like Child’s pose—in a public class since they are so common unless you have an alternative offered by your teacher.  I often suggest that folks with knee pain flip onto their backs and draw the knees to the chest, essentially an upside down Child’s pose. Then almost all the pressure is off the knee joint and usually no pain is felt. The other thing to try is to vary the distance of the knee spread in regular Child’s pose until you find a distance that does feel uncomfortable.

It is also important to recognize that undergoing a knee replacement does not equal having the same healthy knee anatomy and movement you had before the surgery and the underlying knee problem that lead to your surgery. One of my students who had knee surgery to clean out a lot of arthritis damage to his cartilage found that his range of motion was less after the surgery than before, but he was now pain free. His challenge became how to gradually see if he could improve the range of motion without leading to recurrent pain.And another student of mine who had one knee replaced, but also had a second bad knee, found that although the new knee operated normally, the second knee become more painful secondary to the new way he was walking with essentially two very different knees. And sadly, having a successful repair does not guarantee that future dysfunction and pain will not arise.

In this case, it is also important to recognize the effect of the passage of time on both the surgerized knee and your other knee. A substantial amount of time has passed from 2007 until this summer of 2013. And with that the knees can undergo gradual changes in the architecture and function of the joint, such that the repaired knee can undergo undesirable changes, and unrelated changes could also have taken place. It could be that something has loosened in the replaced knee parts, but it could just a likely be some other structure, tendon, muscle or other structure, that could be the source of this new pain. This needs investigating! 

Until you have an exam and get a diagnosis from your orthopedic MD, avoid the positions that create immediate or delayed pain in the affected knee. Poses like Child’s pose include Hero pose, Thunderbolt pose (as well as poses that have just one leg in the deep flexion fold at the knee joint), front knee in Pigeon pose variations, the front knee in deep drop knee lunges, and any Lotus preps or full and half Lotus pose. Even some simple seated poses like Sukasana (Seated Crossed Legs) can be worth avoiding until you know what you have going on. Once you get a clear picture of what is happening, I’d suggest setting up a private session with an experienced yoga teacher or yoga therapist to design a home practice that can address your unique situation.

—Baxter

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