This week at the regular weekend yoga classes my husband and I attend, the instructor mentioned injuries that occur during yoga or any other form of exercise one may take up in a class or group setting.
It is intriguing and thought provoking that he mentions injuries could occur while doing any form of exercise and not only yoga, when done incorrectly. I would like to share some of my thoughts on the matter.
Human body is an amazing instrument or machine as some call it. When we make or read such a statement, it implies, the inhabitant in the body is other than the body itself. When we are able to look at ourselves from this perspective, things become so much clearer, and we become more diligent and caring when working with the body. Usually we take the body for granted, though let us step back for a moment and look at it from a new perspective. What if we are the caretakers of this instrument? Precisely like a skillful musical artist tunes the instrument and plays it to produce the most melodious music entering our ears, we too must treat the body with utmost care and diligence and hence learn to master it and tune it so it would “listen”. Fancy as the words sound, all it means is to consider all work as worship and to do our undertaking with utmost diligence- that includes exercises or yoga asanas. When done with this perspective, we embark on a journey with a clear goal in mind and work our way through any difficulty that may arise with open mind.
To illustrate this point, I will consider an example. Let us say we are doing Surya Namaskar, and during the process we are becoming aware of our abilities. However, we wish to be : 1)more flexible in order to deepen our poses or 2) increase endurance (activity tolerance) to stay in certain pose for longer period or 3) improve control to execute the transition smoothly and slowly. Whatever the goal, going about it diligently day after day is important, in other words persistence. Once the goal is set, “I will and I can” is of prime importance in our journey to “I am”. The way is always through and never around or over.
Going back to the example let us take up the hasta padasana or forward bend pose:-
• Deepening the posture requires flexibility in the hamstrings. How to achieve this? Say to begin with the fingers tips barely touch the floor. One good way is to start by bending the hip and knee joints in order to reach the floor with the pads of fingers or palm. Then slowly straighten knees till stretch is felt in hamstrings and hold for 5- 10 seconds. Repeat 3-5 times/ session and at least 2-3 sessions/week. You can ensure engaging of the quadriceps and rectus abdominus, which allows the reciprocal inhibition of the hamstrings and back extensors and deepens the pose even if by a millimeter or a fraction thereof. Done steadily and slowly, it impacts the flexibility and you will notice that centimeter of increased bending over a few weeks or months.
• In order to increase endurance or holding the pose longer, breathing techniques are of prime importance. As always, forward bending is deepened when breathing out and holding complete exhaled phase.
• In order to make the transition smooth and slow, again breathing technique is important. In this case, the focus is on prolonging the inhalation, hold and exhalation phases. This gives greater opportunity to execute smooth movements within the existing range. Also pattern deviations are identified and worked upon easier with slow movements.
The body communicates with us and if a pose is done incorrectly and you are “tuned” with the body or possess heightened awareness of it, it can be identified as a discomfort. Conversely if a pose is executed well, there is flexibility and a sense of well-being through release of endogenous hormones like endorphin and enkephalin.
This awareness and observation translates into all that you do during the day and you will find yourself paying greater attention to details in any task you undertake. So does the diligence you bring in with an open mind. Then as it is said, “Sky is the limit”. Not only does this simple practice keep injuries away, once mastered, it enables you to be the best of yourself in any undertaking.
Through skilled physical therapy techniques, increase your awareness and tune in to the body. Contact Stablemovement Physical Therapy through facebook page or visit us at www.stablemovement.com
Last week we saw an overview of the gait cycle. The basic phases in gait cycle and the fundamental components of the stance and swing phases. The subsequent week’s post will consist of elaborating the biomechanics of the various joints in the lower extremities and the trunk.
We will consider the body from the ground up or from the foot to head. The foot is made up of 26 bones and 33 joints! Though the amazing fact is it works flawlessly as one unit. While it will be boring to consider all the joint movements, it is good to know that the foot moves in multiple planes ensuring smooth transfer of weight from the heel (calcaneum) to the toes (phalanges). The major foot movements include lifting up at heel strike, pushing back at push-off phase, as well as the subtle rotational motion (pronation-supination) during weight transference from heel to toes.
The ankle joint is formed by the two lower leg bones (tibia and fibula) with the foremost tarsal (seven tarsal bones in all) bone called the talus. The two leg bones form an inverted cup shaped cavity which is deep and houses the head of talus. This cavity is also known as the ankle mortise and is responsible for the stability of the ankle joint. The ankle joint is a hinge joint and the only movement possible here is upward (dorsiflexion as in heel strike) and downward (plantarflexion as in push-off) movement. The side to side and rotational movement during weight transfer occurs at the tarsal and metatarsal joints. The heel bone or the calcaneum is the largest bone in the foot.
At heel strike the heel bone is everted, that is the heel lands on the outer edge. This is the initial impact of landing at heel strike. The initial impact is absorbed by pronation in the foot when the talus rotates antero-medially allowing the leg bones (tibia and fibula) to come into weight bearing position, to transfer the entire body weight to the foot. The anterior leg muscles like the tibialis anterior, the extensor hallucis longus, and extensor digitorum slowly lengthen permitting smooth lowering of the foot to the ground. As the knee flexes and weight is being transferred to the foot, it initially pronates or winds for impact absorption and then unwinds or supinates to allow maximal contact of foot with the ground (early stance). The transverse tarsal joints (talo-navicular and calcaneo-cuboid) are loose and accommodate the foot to uneven terrain. At mid stance, the body moves over a stable foot and the weight gradually shifts to the forefoot from tarsals to the five ray-like metatarsal bones (mostly 1st-3rd metatarsal rays). Here the arches with their muscular and ligamentous support are very important for weight transfer. The posterior leg muscles like the tibialis posterior and the peroneus longus are key muscles locking the transverse tarsal joints hence making the foot into a rigid lever. The foot continues supination as the heel lifts off the ground and the ball of the foot (1st metatarsal head) bears most load during the end of push-off phase. The Achilles tendon, which initially lengthens, now has sufficient potential energy to propel the body forward with a strong concentric contraction.
Amazing isn’t it? The subtle movements in the joints of the foot, the display of combination of stability as well as mobility and the impeccable timing with which this is executed (considering average walking speed of adult is 100-115 steps/minute!)
[For ease of understanding, here is a list of the bones in the foot:
7 tarsal bones: talus, calcaneum, navicular, cuboid and the 3 cuneiform bones
5 metatarsal bones: five rays one of each leading to the corresponding toe
14 phalanges: 2 in the big toe and 3 each from the 2nd to 5th toe.]
For a long time, before the advent of gyms and even today, walking is one of the most popular forms of exercise. The easiest and most enjoyable, hands down winner with no equipment needed, only willingness.
There is a lot of propaganda nowadays on the right kind of footwear, on trendy outfits to exercise, even water bottles that match to quench the thirst while walking. While it is true that the right kind of footwear may alleviate or mitigate certain symptoms, it is but a tool to make the walk comfortable. Great and in vogue as these paraphernalia sound, these are just additions which take away from the simple joy of walking carefree.
We take walking for granted. Have you ever found yourself thinking: “Now I must step forward with the right foot, now the left” or “I must place the right foot 6-8 inches forward,” or “I need to push with certain force to propel forward for the next perfect step?” They all sound absurd, don’t they? Yet your body knows exactly what to do when walking for equal steps every time. However what is also wonderful about the human being is the ability to bring any task into full awareness in a moment’s notice. So here is a physical therapists perspective on what is called “the gait” aka walk.
I bet all of you must have observed, walking consists of a pattern or a series of events that repeat themselves. This series of events from a certain point to the consecutive similar point is what constitutes the “gait cycle.” So for example, from the left heel making contact with the floor, to the next time the left heel comes into contact with the floor is one complete gait cycle or stride, and this keeps repeating itself for the duration of walk. Half of this cycle, that is from left heel strike (or contact), to right heel strike is a step.
Now it may seem like it is the legs that do most of the work during walking. This is only partially true. The trunk and upper body also play a big role to ensure that the body moves forward and stays in the forward facing direction all the time. While the pelvis turns, the trunk and shoulder girdle stabilizers are silently working to maintain a constant direction. The arms also swing to balance the forces generated in the lower limbs to make this possible. Phew! Who knew?? Maybe the next time you walk, your awareness of this profound activity will increase.
At all times while walking, one foot is always in contact with the ground. This is what makes walking a unique activity. There may be parts of the cycle when both feet are making ground contact. For example, when the left heel strikes the ground, the right foot is pushing off (this is an example of both feet in ground contact) and when the left foot is loading and accepting the body weight, the right foot is in swing phase (off the ground and hence an example of one foot in contact with the ground).
During one of my earlier posts and the presentation at New Seasons Market, I have mentioned the center of gravity of the body (COG) and the base of support (BOS) and the relationship between the two. Walking displays a wonderful working relationship between the two where the COG translates in a horizontal figure of 8 pattern, that is “∞”. This motion is extremely smooth and graceful, no jerks or sudden change in direction and it is in this smooth transition that an entire gait cycle is completed. Noteworthy is the fact that, even when one foot is pushing off and the other is simultaneously making heel contact, balance is maintained with utmost poise (grace) even though the BOS seems small and precarious (a few square centimeters only!). Ah! The reverence we now feel for this simple form of exercise is mind blowing.
Let us delve into further detail and look at one complete gait cycle. The foot in contact with the ground is in stance phase, the foot off the ground is in swing phase. These two occur simultaneously. Three main components of stance are:
1. heel strike or initial contact with ground
2. foot-flat or mid-stance also the phase in which load is
accepted by the leg
3. push off or terminal stance.
The swing leg is also going through three components:
1. early-swing, when the foot has just lifted off the ground
2. mid-swing, when the foot is smoothly sailing forward
3. terminal-swing, when the foot is preparing to make contact
with the ground.
Putting the two phases together, the left foot is in heel strike as the right foot is going from push-off (the double leg stance phase) to the pre-swing phase. As the left leg accepts the weight, the right leg is off the floor or in early swing (single leg stance phase) then into mid-swing as the body is propelled forward and in the final phase the left foot pushes off as the right foot enters from terminal swing and into heel strike. As observed earlier, there is a brief moment when both feet are in contact with the ground. This is half a cycle or step and is repeated on the contralateral side, that is the right foot is now in heel strike with the left foot entering swing phase from push-off and this repeats itself till the point where the left heel comes to strike once again, completing one stride or one complete gait cycle.
And this is just a very basic overview of the gait cycle. It may sound like a very romantic affair… and why not? Valentine’s Day is just round the corner. Fall in love with yourself, one step at a time, every time as you explore the wonder that you are with StableMovement Physical Therapy. For more information, find us at: www.stablemovement.com or call (408)252-8790.
Ah! Finally we come full circle and to the twelfth pose in Surya Namaskar. The series started in November (18th November, to be precise), comes to an end with this weeks’ post.
The 12th asana or pose is the pranamasana, which is basically tadasana with the hands folded in a “namaste.”
• Posture: From the 11th pose or the backward bend, bring the two arms down with elbows bent and the hands joined together in “Namaste,” and thumbs close to your heart. Simultaneously, bring the spine to neutral from a backward bend/ extended position and roll the pelvis to neutral as the hip joints revert to neutral. The spine should be elongated as in imagining a string pulling upwards from crown of head. The lower extremities are relaxed with neutral position of knee and ankle joints as the weight is effortlessly transferred. The shoulder blades or scapulae are pulled back. Simply put, stand tall with open chest and folded hands. To add challenge, you may bring both the feet together with the big toes and heels touching each other. This really activates the trunk and leg muscles to maintain balance.
• Muscles: The shoulder extensors, adductors, internal rotators, the elbow flexors, and wrist extensors are the prime movers, bringing the arms into Namaste position. The rhomboids, levator scapulae, and the pectoralis minor rotate the scapula down to neutral from upward rotated position. The rectus abdominus and the gluteus maximus contract to bring the spine and pelvis to neutral. The stabilizer muscles (transversus abdominus, obliques, multifidi, and the piston action of diaphragm with pelvic floor muscles while breathing) of the trunk are activated to maintain neutral, elongated spine.
• Breathing: Slowly exhale as you come into neutral from the backward bend position, coming to maximal exhalation at end posture. Stay in this pose with eyes closed, breathe in and out several times, holding the breath after a complete inhale and a complete exhale.
“Om Bhaskaraya Namaha”
“I bow to Him who is the cause of luster.”
When I began the post series on Surya Namaskar, I wrote: “ Not only is it important to do the 12 postures with accuracy, but also the performance must exude tremendous grace throughout, including a smooth transition from one posture to next.” With this post, I conclude the Surya Namaskar series. Though I have done my best to put in words and simple sketches what is a very sacred exercise and way of being, words are not enough to express it in entirety. At some point, I would like to do a live session in the community and call on you all to participate in any way you are willing. Please look out for the dates and venue.
Ami Gandhi is a licensed physical therapist in the state of California. She is the owner of StableMovement Physical Therapy, a small boutique practice in San Jose that offers patient centered, one-on-one, hands-on physical therapy.