¡Profesores de yoga por favor, por amor al yoga, paren de enseñar!

Originally posted on Yoga para todos:

Autora: Jacquelyn Rae

Traductora:Crista Castellanos

Hoy en día podemos encontrar profesores de yoga por todas partes. En apenas 200 horas, cualquiera puede ser un profesor de yoga. Y tal vez ese es el problema actualmente.

El hecho de que todo el mundo pueda ser profesor de yoga no es lo que me molesta. Lo que encuentro inquietante es que, tras un corto curso de 200 horas y armados de un certificado, graduemos “profesores” que muy frecuentemente no tienen las herramientas para realmente enseñar la ciencia del yoga.

Para resolver este asunto, le pido lo siguiente a todos los profesores de yoga:

¡Paren de enseñar yoga!

BKS Iyengar Yoga Convention, London Convención de yoga Foto: http://www.theguardian.com/lifeandstyle/2014/aug/22/my-teacher-bks-iyengar-yoga

Pero no me callen tan pronto. Permítanme elaborar esta idea.

Cuando empecé a enseñar yoga solía estar muy nerviosa en mis clases. Todos los días me preguntaba: ¿Les gustara mi clase? ¿Qué pasaría si se me olvida lo que…

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On death

Now, there really isn’t anything radically wrong with being sick or with dying.  Who said you’re supposed to survive?Who gave you the idea that it’s a gas to go on and on and on?

And we can’t say that’s it’s a good thing  for everything to go on living, from the very simple demonstration that if we enable everybody to go on living, we overcrowd ourselves.

So therefore, one person who dies in one way is honourable because he’s making room for others

We can also look further into it and see that if our death could be indefinitely postponed, we would not actually go on postponing it indefinitely.  Because, after a certain point we would realise that that isn’t the way in which we wanted to survive.  w

Why else would we have children? Because children arrange for us to survive in another way, by, as it were, passing on a torch, so that you don’t have to carry it all the time.  There comes a point where you can give it up, and say ” now you go.”

It’s a far more amusing arrangement for Nature to continue the process of life through  different individuals than it is always with the same individuals.  Because, as each new individual passes through Life, Life is renewed.  And one remembers how fascinating the most ordinary, everyday things are to a child.  Because they seem them all as marvellous, because they seem them all in a way tat isn’t related to survival and profit.  When we get to thinking of everything in terms of survival and profit margin, as we do, then, the shapes of scratches on the floor cease to have Magic.  And most things, in fact, cease to have Magic. So therefore, in the course of Nature, once we have ceased to see magic in the world anymore, we are no longer fulfilling Nature’s game which is to be aware of itself.  There’s no point in it anymore.  And so we die. And so something else comes to birth, which gets an entirely new view.  It is not, therefore, natural for us to try to prolong Life indefinitely.

But we live in a culture where it has been rubbed into us, in every conceivable way, that to die is a terrible thing.  And that is a tremendous disease from which our culture, in particular, suffers.

The gentleman says it much better than I can.  Please enjoy the video.  I will blog this week, promise.

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A Summer Sequence for Strong Shoulders- *FREE* Printable Download

alteayoga:

Here is a nice shoulder sequence. Not all the arm balances are advisable for breast cancer survivors, but by paying attention to the modifications that are possible in each pose (eg: not raising the arms as high, not extending the shoulders as much, doing more dynamic work and less static), you will benefit for the stabilising effects of these postures.

Originally posted on queen street yoga:

killarneyFor me, a summer in Ontario isn’t complete without at least four or five days of back-country of canoe camping in Killarney Provincial Park. Killarney is about a 5 hours north of Kitchener-Waterloo on the north side of the Georgian Bay. It boasts some of the most beautiful lakes, scenic mountains and dramatic rock faces that I’ve had the pleasure of canoeing and hiking along.

killarney canoesIf you’ve never been canoeing, let me teach you a new vocabulary word: Portage (noun or verb). I’m glad Canadians are at least bilingual enough that you can pronounce it the more elegant way en francais up here. Honestly, Americans butcher this word. Pronunciation aside, when you hear portage think carrying a huge pack on your back and a canoe on your shoulders for anywhere between a few dozen meters to a kilometer or more! Given that I’m only 5’3” and the canoe…

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PMPS: Post Mastectomy Pain Syndrome

Introduction  

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Among breast cancer patients, a common complaint is numbness or tingling in the upper-inner arm.  This is called neuropathy and is often down to damage to one particular nerve:  the intercostobrachial nerve.

ICBN

The intercostobrachial nerve (ICBN) is connected to the brachial plexus and innervates the axilla, medial arm and anterior chest wall.  The brachial plexus is a group of nerves that originate in the neck and whose basic function is to move the arms.  (plexus definition:  a network of nerves or vessels in the body. an intricate network or web-like formation.)

It is well known that many breast cancer survivors have problems with mobility, strength and sensation in the arm of the affected side.  Today, we are going to talk about the specific complaint of tingling, numbness, pain and loss of sensation in the armpit and the inner arm.  Here is an image, lifted from the pdf whose link is in the references section, that illustrates perfectly the areas of skin that are innervated by the ICBN.

icbn skin innervation

Area of skin innervation by the ICBN

PMPS

Intercostobrachial neuralgia, also known as Post-mastectomy Pain Syndrome (PMPS) is estimated to occur in about 33% of breast cancer survivors. I can’t find reference to whether these are 5-year remissions,  or longer or shorter intervals, but 33% seems to be the agreed upon figure, and this is for PMPS that persists for longer than three months after the breast surgery.  There are other nerves involved in PMPS, but it appears that the the ICBN is the main nerve affected in most cases.  Thus, some people say it is more correct to refer to Intercostobrachial neuralgia.  However, as that doesn’t exactly roll off the tongue, let’s stick to PMPS and try not to think about PMS (ouch!).

Why does it hurt?

 

axilla dissection

Axilliary lymph node dissection.

The origin of the pain is either:

  • nerve damage during surgery, or
  • scar tissue around the nerve.

Surgery in the axilla is usually to remove lymph nodes, and these are deep to the ICBN. Here is an image of the technique that is used to remove lymph nodes.  I lifted it from the medscape article that is cited in the references section.  Radiation therapy (RT) tends to damage nerve tissue and promote the formation of fibrosis, is also a cause of the PMPS.

Here is a wonderfully concise description of the surgical reasons for PMPS:  

“The most commonly cited theory of chronic postoperative pain in breast cancer patients is the intentional sacrificing of the intercostobrachial nerves. These sensory nerves exit through the muscles of the chest wall, and provide sensation predominantly to the shoulder and upper arm. Because these nerves usually run through the packet of lymph nodes in the armpit, they are commonly cut by the surgeon in the process of removing the lymph nodes.” (http://www.cancersupportivecare.com/surgerypain.html)

I tried to understand what a “lymph node packet” might be, as this isn’t a term that we use in MLD speak.  I think that it is a surgical term for the bundle of lymph nodes that is excised.  [An article unrelated to PMPS and ICBN contained this phrase “We prospectively assessed 61 pelvic lymph node dissection specimens (packets) in 14 consecutive patients undergoing radical cystectomy.” ]

What to do?

As usual, when we use yoga therapy for breast cancer rehabilitation, we must respect limitations.  Firstly, PMPS won’t be cured by practising yoga.  But, it can be helped.  Secondly, there is variability in the extent and severity of pain and impairment to range of motion.  So, adopt a personalised approach and be patient.  Use simple, slow movements with breath synchronisation to achieve optimum results.  If you are a yoga teacher, you probably believe in prana.  I certainly do, and no matter how scientific the tone of my posts, I will absolutely vouch for the healing effects of good prana circulation.  So, when teaching, keep your students focused on the practice, not on the results.  Also, use your own healing energy and direct it towards them.  Wish them well.  Ask for guidance and the blessing of whatever guiding energy you believe in.  

Here are a few suggestions for sequences that you can integrate into your own practice and bring some flexibility and mobility to the chest and inner arm region.  Note that all sequences mobilise the brachial plexus in general.   

ICBN PMPS sequences

ICBN PMPS sequences

 References

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Practical stuff for the pericardium

In my last post, I described the pericardium and offered some information about how it may be affected in breast cancer survivors.  Here are a few suggestions for sequences that could go into your own yoga sequence and help focus it on the diaphragm/pericardium

practical pericardium

practical pericardium

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Yoga therapy for the pericardium

a grey and purple mandala

Harlequin Mandala

Radiation therapy (RT) has improved life expectancy for many cancer patients.   However, it is well known that RT has long-lasting side effects that can range from mild to severe. Breast cancer patients treated with RT are at risk of damage to any of the structures near to the breast.  This includes the heart, lungs, pericardium, skin, lymphatic vessels and nodes, and skeletal muscles.  Today we are going to talk about the pericardium, what it is, how it may be affected/damaged in yoga therapy students, and how we can present a hatha yoga class to benefit and rehabilitate the pericardium.

What is the pericardium?

The pericardium is “a fibrous sac that attaches to the central tendon of the diaphragm and fuses with the adventitia of the great vessels superiorly.”  The great vessels are the large blood vessels that carry blood to a from the heart.  The adventitia is the outermost layer of the wall of a blood vessel.  So, the pericardium is:

  • A fibrous sac (two-walled, in fact, with fluid in the space between).
  • Attached to the central tendon of the diaphragm (the main muscle of breathing).
  • Fused with the outermost walls of the big blood vessels of the heart.

What does the pericardium do?

The pericardium has four functions.

  • It protects the heart from infections,
  • It protects the heart from knocks and jolts (this due to the fluid in the space between the two sacs),
  • It lubricates the heart and
  • It prevents excessive swelling of the heart in the case of a sudden increase in blood volume, which is usually associated with other illnesses or problems with sodium levels in the blood.

Unsurprisingly, given its roles, in Traditional Chinese Medicine, the pericardium is also referred to as the heart protector.  The pericardium meridian runs down the inner arms, between the two tendons of the inner forearm, crosses the palm and then runs along the middle finger, terminating at its tip.  Anyone who has treated secondary lymphoedema of breast cancer will observe that the affected areas coincide spectacularly with the pericardium meridian…

What happens to the pericardium during cancer treatment?

Fibrosis is the thickening and scarring of connective tissue usually as a result of injury.  The injury in this case is a radiation burn. Bear in mind that there are diseases that cause a primary fibrosis (cystic fibrosis, for example).  We are not talking about yoga therapy for such diseases here, although some of the underlying theory may be applicable.  We are discussing yoga therapy for breast cancer patients who may have pericardium fibrosis caused by RT.  This would be a secondary fibrosis, just at the lymphoedema seen in breast cancer patients is secondary to lymph node excision or what have you.

RT has a tendency to burn the surrounding tissue as well as the tumour.  The pericardium is already defined as a “fibrous sac” and the fibrosity that can develop as a result of radiation burns is our main concern here.  Bear in mind that different RT techniques will have greater or lesser probability of damaging the pericardium.  I observe that women with deep tumours often have RT tattoos on the other side of the chest, meaning that at least one ray had to cross the chest the get to the tumour.  Shudder.  Indeed, this article (from 2010) says that 20% of oncology patients who have had RT in the chest develop constrictive pericarditis.  This is called “radiation-induced constrictive pericarditis.” Constrictive pericarditis is a medical condition characterized by a thickened, fibrotic pericardium, limiting the hearts ability to function normally.

Let’s also take a moment to recall that chemotherapy often damages the heart.

Yoga poses for the pericardium.

Spinal extensions, backbends, outwards arm rotations, held inhales, arm raises with inhales and basically anything that stretches the chest and moves the diaphragm will be therapeutic for the pericardium.  However, as usual, there are limitations and contraindications that must be considered.  A glance at this page is useful in that it demonstrates a number of poses that quite frankly could not be used in the classes that I give.

Firstly, recall that fibrosis is not reversible.  It can be improved and loosened, but under normal circumstances, it is chronic.  I mention this to help you pace your program and not expect miracles.  I also warn strongly that overwork and tears are not desirable.  So, work within your students’ limits.

Referring back to the last page I mentioned, the “puppy dog pose” could be modified to a cat-cow sequence, breathing out with rounding the back and in when arching.  Another typical viniyoga sequence is moving slowly between cat pose and child’s pose.

cat-child's pose sequence

cat-child’s pose sequence

Another typical sequence is alternating between standing on the tiptoes with the arms reaching up (keep to shoulder height in some cases, elbows may also need to bend, ideal is palms facing at the top) and a half-squat with a spinal twist.  If you alternate sides and breathe in when you go up and out when you go down, you get a really nice loosening effect in the mid-trunk without really running risk of injury.

twist utkatasana - tiptoes sequence

twist utkatasana – tiptoes sequence

What can be interesting is using breath retentions to increase the lung volume and mobilise the intercostal and the serratus anterior muscles.  Next week I will post a sequence that I use and love.  Right now, I have to go.  It’s been a long post and I think that I have communicated what I set out to.

To yog is to live.  Keep at it!!!

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Let your yoga sing

Why practise?

It is well and good to analyse the physiological and anatomical reasons for practising hatha yoga.  It is well and good to tell you why you ought to practise and what you ought to do. Yet, there is another way to saying the same thing and it is much simpler.  

Dear reader, happened upon this blog, you should practise yoga just because.  Just because yoga makes your body sing.  Because when you become very very still and very, very quiet, you can hear that miracle of your own song, your very own vibration.  You can connect with a timeless quality that is nonexistent in practically every other sphere of your existence.

 You should start practising yoga right now, even if it’s nothing more than sitting in a straight-backed chair, breathing in and raising your arms to shoulder height, then breathing out to lower them slowly down again.  Even this simple movement, isolated from any other posture, breath or sequence, repeated with enough intention and presence will bring you into a place of peace that you cannot know under different circumstances.  It is as simple as being quiet enough to listen, quiet enough to hear, your own song.  

Why, you may ask, ought I listen to my song?  There is music on the radio, on the TV, on Spotify…there are so many things to listen to, surely it’s not that important.  You err, I will reply.  You don’t know what you don’t know until you know it.  You are deaf to the chorus of your bodysoul and if you choose not to even look, then you are cowed and craven, too.  This is not to insult, not to chivvy, but yes, I would like you to wake up.  No matter how hard I try to detach from my longing to awaken each and every one of the beautiful human souls on this planet, no matter how unrealistic and even juvenile this deeply held longing may appear, it is there, it is real.  I want you to wake up and the best tool I can offer you is yoga.

 Why hear your song?  Why listen?  Because then you can hear all the messages from within and without.  You can then hear your body tell you which foods give life and which foods burden you.  You can then hear your soul’s messages about which company to keep, and for how long, and which relationships are toxic and which are good.  You can hear the live-giving messages from Nature, the chant of the wind and the whisper of the trees.  

And why might this be important for breast cancer survivors?  Well, because your song is your life singing.  And your life – so rudely threatened by disease – is pretty darn important to you, I will wager.  Yoga integrates movement, breath and mind/thought to bring about harmony in all three spheres.  I do not say this it should be practised to the exclusion of all other sports or creative activities.  But, it complements so well anything else you do that it should be practised alongside your other activities, and not left until last but given priority and done with constancy.  

Why practise?  Because you can.   Because you are here.  Because you are alive.  Because yoga makes you feel more alive.  Because yoga has been around forever and keeps coming out tops from practically every angle.  I yog just to know that I am alive.  Om. Peace out.

softones mandala

softones mandala

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