Adapting Ashtanga

As some of you are aware, I am an Ashtanga yoga pseudo-junkie.  I love everything about it- the breath, the poses, the way it is sequenced, the challenge of it.  However, some of the very things I love (the poses, the sequence) conflict strongly with the philosophy I take with my clients.  I feel movement should be individualized to enhance and correct a person's posture and improve movement, two things Ashtanga doesn't always provide (at least in my opinion).  At times, I find myself conflicted, particularly when a client wants to begin a yoga practice and wants me to be the guide.  Many of my clients have or have had injuries and/or pain and are in their 50s and 60s.  They trust me to help them move better and the clients who end up asking me to teach them yoga do so after we have been working together awhile and they trust me not to hurt them.  Currently, I am teaching yoga to a wonderful woman I will call Kay.  Kay is in her early 60s, practiced a yoga program designed for her by someone 30 years ago for decades, has had hip replacement, needs the other hip replaced, has experienced bouts of vertigo with headstand, has scoliosis, and was injured in the last guided yoga class she took.  Kay strength trains with me twice a week.  We emphasize good hip mechanics, strength, and core stability.  I do not feel Kay is a good candidate for the Ashtanga primary series for a variety of reasons; however, I think elements of first and second series with a strong attention to mindfulness and movement with breath will benefit her posture and her current physical condition tremendously.  We are currently working on Ujjayi breath, slow sun salutations, some of the standing postures (we are skipping revolved side angle because it is difficult for her to hold the hip firmly in the socket during rotation and move from the thoracic spine rather than the lumbar), some of the seated postures (not always with vinyasa between but always with breath), some modified postures from second to improve thoracic mobility, and a modified closing sequence.  Sometimes, I feel a bit fraudulent (this isn't Ashtanga!  I am not being true to lineage!), but I return to ahimsa, which is my guide as a personal trainer and yoga teacher.  To practice ahimsa, I must do what I think is right for the client or student and help, rather than hurt.  While this isn't necessarily "true" Ashtanga, it is Ashtanga that has been adapted to the individual's needs.  Sometimes, I think it is important to practice flexibility in teaching to provide the greatest benefit.  Kay is thoroughly enjoying our yoga practice, and has recently added another day.  She might not be standing on her head anytime soon, but I am confident that she will progress from modified cobra to upward facing dog without pain.  The greatest sense of success as a teacher often comes from what an outsider might view as a simple improvement.

Yours in health and wellness,
Jenn
www.bewellpt.com

Hip extension, running, and the importance of dynamic hip mobility

Running is a dynamic, repetitive movement pattern.  The trouble with these types of activities is if you lack a good, basic movement and you perform a version that is slightly off over and over again, things don't work as well.  It's kind of like a door that is on a hinge slightly crooked.  You don't notice that the hinge is rubbing wrong at first, and the door opens fine the first 50, 100 times.  After a while, the door doesn't swing as well and eventually, the hinge wears down and the door, while it might still open, doesn't function well.  Your body functions much the same way.  You can get away with certain faulty movement patterns for a while, but after enough times, something's gotta give.  In the case of running, the poor knee (which should move forward and back, not side to side) is stuck between two joints that are supposed to be quite mobile (the ankle and the hip).  The movements we perform in our every day lives do not favor ankle and hip mobility; as a result, the knee often loses some of its stability.  Running with hips and ankles that lack mobility is setting that knee up to function like the crooked door hinge.

Hip extension is critical to good running mechanics.  Our society is extremely forward in nature.  We sit, hips flexed, at desks with our heads jutting forward.  This shortens everything in the front of the body and reduces our ability to properly use the muscles in the back of the body.  Schache, Blanch, and Murphy (2000) found a correlation between limited hip extension flexibility and increased anterior tilt during running.  While there is little in the literature that discusses the importance of hip mobility as it relates to running stride, Saunders, Pyne, Telford, and Hawley (2004) point out a strong correlation between running economy and distance running performance; further, muscular stiffness and efficient mechanics are thought to decrease the amount of energy wasted on braking forces and vertical oscillation.  If you do not have good hip mobility, you are going to be unable to extend your hip, leading to a more forward dominant running stride.  This often leads to a running pattern that involves more hip flexion, causing the foot and knee to land more forward.  As a result, the ground and the foot collide each time the foot lands, resulting in more braking forces.  Couple this with poor ankle mobility, and there are more than likely going to be problems.  One way to work on hip extension is to implement a corrective exercise program that emphasizes hip extension and mobility.  Exercises such as squats, lunges, and bridging are great ways to begin to activate the hip area.  More advanced and complex moves such as McGill's airplane, the Cook hip lift, and Bulgarian split squats can reinforce proper hip mechanics and gluteal activation if performed properly.  It is also important to not neglect the ankle area.  Implementing simple drills, such as seated ankle dorsiflexion, ankle circles, and inverserion/eversion, can dramatically increase ankle mobility.  Remember, when implementing a strength and conditioning program, understand your goals and know what movement patterns and mechanics are necessary for success in your chosen sport.  This, coupled with your current static and dynamic posture, should dictate the exercises you choose, not necessarily the exercises "everyone else is doing."  Move well and move often.

Yours in health and wellness,

Jenn

Schache, A.G., Blanch, P.D., & Murphy, A.T., (2000).  Relation of anterior pelvic tilt during running to clinical and kinematic measures of hip extension.  British Journal of Sports Medicine, 34(4), pp. 279-283.

Saunders, P.U., Pyne, D.B., Telford, R.D., & Hawley, J.A. (2004).  Factors affecting running economy in trained distance runners.  Sports Medicine, 34(7), pp. 465-485. 

Monthly goal setting and the importance of mindfulness

This year, I decided to set monthly goals rather than the typical New Year's resolutions.  I diligently wrote out 6 months worth of goals in January, which I re-visit at the beginning of each month to make adjustments and add to, given on how well I accomplished the previous month's goals and to account for the unpredictability of life.  Included are personal and business goals, and it has proven to be an extremely effective way for me to stay on track, personally and professionally.  As March ended, I dutifully pulled it off the refrigerator, revealing a sheet with my plan for my April.  I took it down and began reading through when my eyes came to rest on something that was a bit of a surprise: "Practice second series for 8 weeks."

I was a bit taken aback.  Maintaining a high level of physical activity is not something I struggle with, and while I had placed a handful of physical goals on my monthly goal sheets (I completed a half marathon in March, for instance), I hadn't given much thought to my yoga practice, probably since I had written the goal way back in January.  "Huh," I thought to myself.  "I guess it's time to step up my yoga."

Here is the funny thing about writing a goal down like that.  You feel compelled to do it.  Or, more accurately, you feel compelled to do it if you're me.  I could easily have crossed it off, or placed it somewhere else.  But that would have been failing.  Who, you might ask?  Well, me I guess. I would have known I hadn't done this thing that in January seemed like a good idea.  And it would eat at me, because that is how I am.

So, in the middle of my last quarter of graduate school, buying my first house with my husband, fulfilling my Maid of Honor duties for my sister, and running my business, I began adding second series postures into my three day a week practice.  It's worthwhile to note that while I have been practicing Ashtanga yoga for years, I rarely have the opportunity to practice with a teacher.  In addition, I have been stuck in primary series purgatory (psp) for a very long time.  I go through periods where I begin second series, but then something unforeseen happens, such as riding my bike into a moving car (it was the garbage truck's fault), which makes me step back and return to psp.  In all fairness, I am unable to do some of the key postures that indicate one is ready for second series, such as supta kurmasana; however, the redundancy of the primary series has led to things like handstands after navasana and tripod headstand after bakasana after utkatasana.  As a result, it would seem second series would be a welcome opportunity to mix things up.

A month into it, I can genuinely say it has been a welcome distraction from real life.  It gives me an opportunity to focus and challenge myself in ways I had been avoiding.  It can be difficult to push beyond one's comfort level.  My handwritten goal on the refrigerator has forced me to step out of the familiar and into slightly hard, which can be a little bit scary.  I have 4 weeks left, and am happily practicing pincha mayurasana in the middle of the room.  Who knows what the next four weeks will bring?

Something that has been brought to my attention lately is the importance of performing complex movement patterns.  This benefits not just the body, but the brain as well, leading to increased attention, higher levels of learning, and perhaps even a less anxious state.  This is different than simply plodding away on a treadmill or exercise bike, although I would argue that I am mindful while running and cycling outside, constantly making minor adjustments to improve efficiency.  Yoga certainly falls into this category, as does dance, tennis, and anything else that requires focus.  Dr. Ratey's book "Spark" does an excellent job delving into the psychological benefits of movement.  One of the critical ways to accomplish a higher level of mindfulness during movement is to turn off screens, focus on what you are doing and how you are feeling, and get outside.  The fresh air can be a wonderful way to be more present in the moment and identify how your body feels.

Yours in health and wellness,
Jenn

Scapular stabilization and why we assess

My last blog addressed scapular winging and the importance of serratus anterior activation.  Below is a circuit I often use with clients when I want them to focus on proper scapular alignment and strengthening of the SA.

1. Begin in a plank position, as noted in picture A.  Your wrists should be under your shoulders, your feet should be about hip width apart, and your ears should be aligned with your shoulders, chin slightly tucked.  Resist the floor with your hands, filling in the space between the shoulder blades (if the person isn't getting this cue, I place my hand gently between the shoulder blades and encourage the person to press into my hand).  Hold for 10 seconds or 5 breaths.
2. Lift the hips up and back into down dog, as in picture B.  Press firmly into the index fingers and gently externally rotate the humerus.  Notice how the shoulder blades feel, as though they are gently wrapping around the ribs without elevating.  Hold for 10 seconds or 5 breaths.
3. Lower on to your forearms for dolphin (picture C).  Resist the floor firmly with your forearms.  Make sure the shoulders don't elevate to the ears and keep the neck long.  Again, note how the shoulder blades feel.  Hold for 10 seconds or 5 breaths.  
4. Flatten back into a forearm plank position.  Continue resisting the floor with the forearms and be sure the space between the shoulder blades is still filled in.  The back of the neck should be long, and the chin slightly tucked.  Hold for 10 seconds or 5 breaths.

Rest for 5 seconds, and repeat the circuit 1-3 more times, depending on the person's endurance.  This brings awareness to the shoulder blade area and encourages healthy spinal alignment.

I am excited to announce I will be holding a static and dynamic assessment workshop Saturday, May 19 (for more info, www.bewellpt.com or www.montereyyogashala.com).  Static posture assessment and dynamic movement assessment allow a human movement professional to identify muscular imbalances and potential injury risk.  While the accuracy of movement assessment and how it applies to injury is still being studied, it has been my experience that identifying impaired movement patterns and employing a corrective approach restores movement efficiency, and often reduces pain the individual is experiencing.  The ability to move freely and without restraint is something that is often taken for granted; assessments enable a human movement professional to establish a baseline and improve freedom of movement, both as it relates to everyday function and physical goals.  Assessments enable the professional to design programs that will help an athlete move better, the yogi or dancer improve stability, and the parent perform activities with his child without injury.  I am looking forward to sharing my passion about this topic with others, and hope to see you there!

Yours in health and wellness,

Jenn

Scapular Winging

Something that has shown up repeatedly while researching shoulder dysfunction for graduate school is scapular winging.  This occurs when the scapula collapse back and out, causing the bone to look like a wing, rather than lying flat against the back.  While there can be a number of reasons scapular winging occurs, in a gym setting, one of the main causes is serratus anterior weakness.  The serratus anterior is a muscle originates at the ribs and inserts on the medial border of the scapula.  One of it's primary jobs is to stabilize the scapula.  Lack of scapular stability can be problematic for a number of reasons.  Using the joint by joint theory, the scapulothoracic joint (SC joint) should be a stable joint.  If there is too much mobility in the SC joint, the mobile joints surrounding it, namely the glenohumeral joint and the thoracic vertebrae, are likely to become more stable than they should be.  This can cause a variety of problems, due to less efficiency of movement in the shoulder, which increases risk of injury in the shoulder joint and upper back area (Escamilla, Yamashiro, Paulos, and Andrews, 2009).

Not everyone has scapular winging while standing.  I most often see it when clients attempt to perform a push-up, or in yoga, when students move from plank to chatarangua (something which is often glossed over, at least in the Ashtanga practice).  To correct for this, I first focus on plank position.  I encourage clients to press firmly into their hands, sliding their shoulders away from their ears and maintaining a neutral spine.  From their, I ask them to "fill in the space between their shoulder blades."  If that doesn't work, I place my hand between their shoulder blades and ask them to press into my hand.  I have them hold for 10 seconds, relax, and repeat 3 or 4 more times.  Once we have established a good base there, we work on lowering into a push-up without collapsing the scapula.  As time goes on, people are able to lower themselves down while maintaining good scapular control.  While the scapula retracts during the motion, it shouldn't collapse ahead of the chest lowering down; rather, it should all move as a unit.  With so many people spending hours on end at computers and desks, it is extremely important to pay attention to the cervical and thoracic region, emphasizing proper alignment and good biomechanics at the glenohumeral and SC joints.

Yours in health and wellness,
Jenn
www.bewellpt.com

Escamilla, R.F., Yamashiro, K., Paulos, L., & Andrews, J.R., (2009).  Shoulder muscle activity and function in common shoulder rehabilitation exercises.  Sports Medicine, 39(8), pp. 663-685.
Picture taken from http://www.trihardist.com/2008/06/stop-slouching-winged-scapula.html.  She does a nice job explaining scapular winging and how it impacts sports performance.  She also has come great exercises to begin to correct this issue.

Evolution Kettlebell Groundwork Workshop- a review

This weekend, I had the honor of attending the Evolution Kettlebell Groundwork (EKG) workshop.  The workshop was held at Wolf Fitness Systems in Salinas, CA and conducted by founder/owner John Wolf, a charismatic, enthusiastic proponent of circular strength training (CST).  Prior to attending, I watched some of the movements online and researched the basic principles of CST so while the moves weren't completely foreign to me, they were still outside of my normal realm of body movement.  I strength train 2 or 3 times a week, using primarily body weight movements and practice the Ashtanga yoga primary series 2 or 3 times a week, with some second series thrown in.  I also either swim, bike, or run daily (I love being outside), so I consider myself in decent shape.  However, to say some of the movements taught were alien to me would be an understatement.  John has a very methodical approach, grooving the foundation of the movement pattern before advancing to complex variations with and without kettlebells.  The workshop was physically challenging with an emphasis on form.  He cares strongly that people understand the movements and took the time to watch everyone perform the patterns, making corrections when necessary.  I can see why people are drawn to him as a coach and teacher.

The series of movements taught in the EKG program are fun and look really cool (there is something gratifying about that, although it's obviously not the only reason one should be drawn to a particular style of programming).  It would be strongly applicable to clients participating in MMA or other martial arts.  I could see a large amount of transfer in the flexibility mixed with strength.  It would also be a good complement for yoga practitioners looking to gain strength.  I do think there is a lot to be said for working dynamic mobility and stability, rather than emphasizing static mobility and stability.  This is why I still strength train- I think it is more functional than what I can do on the yoga mat.  Interestingly, there were a handful of Crossfitters there this weekend.  I admired their openness to learning a new modality, and John had a great way of keeping the workouts challenging while emphasizing safety, which seemed to resonate with them.  Everyone appeared excited about the material and it was obvious everyone in the room was sufficiently challenged to want to gain proficiency in the EKG program.  As mentioned earlier, I was unfamiliar with many of the moves and some of them were extremely difficult for me.  I am fairly certain the 160 seconds of squat thrusts were the longest 160 seconds of my life, which means I should do them a lot (my warped personality at work.  If I can't do it, I must master it because it must be good for me).  While not all of the moves are applicable to my style of training or my clientele, I definitely took away things that can be adapted and integrated into my programming.  It has been interesting to watch my training evolve over the years.  In my ninth grade English class, my reading habits were compared to a goat's; I loved to dabble in a variety of genres and subjects.  I feel like my professional career exhibits a bit of that.  The more I learn, the more I find myself picking a little of this and a little of that to use with my clients and ultimately help them move better.  Now that graduate school is winding down, I will be attending the FMS certification and the dynamic neuromuscular stabilization certification in the fall.  Elements of EKG and CST were reminiscent of things I have seen in Gray Cook's stuff, which is heavily influenced by DNS.  I appreciated the fact that John mentioned this workshop wasn't about the "why."  It was about the movements.  The "why" would be a whole other workshop.  I love the why, but that wasn't what was I there for and, because of background, I understood the why behind the warm up, work, and cool down.  The only thing I would change (and this is simply a personal philosophy) is if I were teaching the system to someone who was hyper mobile, I would utilize stability movements in the warm up rather than mobility warm ups.  95% of us need the mobility warm ups, but once in a while you get a person who has far too much mobility and not enough stability.  These people are more challenging because they have less awareness of where their body is in space and lack the strength to keep everything "plugged in."  Kino MacGregor, a well known Ashtnaga teacher, came to yoga hyper mobile.  Every day, she worked on the strength elements of the practice i.e., holding plank, holding chatarangua, lifting her body off of the floor using the strength of her arms.  In this way, she built the stability to support her mobility.  Because the movements in the EKG system favor mobility, I would emphasize the stability aspect of each movement, not taking someone to end range until stability was gained throughout the range of motion.  Again, this isn't a problem most people have, but once in a while, you get someone who does.

Overall, the EKG certification workshop was a worthwhile, fun experience.  We are so fortunate to have someone like John in the area who is willing to share his expertise with other professionals in the community.  I would highly recommend this to others interested in learning a different, functional way of programming, especially those working with individuals participating in multi-directional sports or athletics.  Just be prepared to work and be prepared to be sore in some interesting place- all with a smile on your face.

Yours in health and wellness,
Jenn

Strength and conditioning programs for runners

Designing strength and conditioning programs for runners is something I love doing.  Helping runners move better, become more economical, and improve performance while reducing injury risk is enjoyable and, as a runner, something I work on regularly myself.  Why do runners need a strength and conditioning program, you might wonder?  A research review performed by Saunders, Pyne, Telford, and Hawley (2004) concluded strength training improved running economy in elite runners.  A small study performed by Berryman, Maurel, and Bosquet found that while plyometric training and dynamic strength training were more effective at reducing the energy cost of running than just running, plyometric training led to the greatest cost reduction.  However, this does not mean everyone should run out and add jumping to their routines.  Progression is important, as well as proper periodization based on goals and race schedule.  Below are some guidelines for individualized program design, based on research and experience.

1. Perform a needs analysis, or have someone perform a needs analysis on you.  A needs analysis consists of goals (are you competing in road races, or just running recreationally), movement assessment, and analysis of posture.  Patellofemoral pain is a common complaint among runners.  A comprehensive movement assessment can identify risk factors, such as knee internal rotation and hip adduction during a single leg squat, which are believed to contribute to PFP (Noehren, Pohl, Sanchez, Cunningham, and Latermann, 2011).  It also identifies potential muscle imbalances and flexibility issues which might affect running gait.  
2. Don't perform exercises sitting.  You don't run sitting.  You run using your entire body to stabilize while you are propelling your body forward, one foot at a time.  Train you muscles standing up.
3. Include movements on one leg.  Balance is important, and runners spend a lot of time on one leg.  Things like single leg squats windmills, and  walking lunges challenge the kinetic chain and work dynamic balance at the same time.
4. Use proper progression.  The exercises described above are great, but should only be performed if you can do a perfect double leg squat, anterior reach, and stationary lunge.  The quality of the movement is critical.  Training faulty movement patterns will simply lead to more faulty movement patterns.  In order to progress, some flexibility work or foam roller work may be required.
5. Roll.  Use a foam roller prior to your strength training program to reduce activity to muscles that are overactive.  In runners, this typically includes the IT band, quadriceps, and calves.  This will allow the proper muscles to be recruited for various movements.  Ideally, a runner would roll almost daily, including before runs.  If it hurts, know that if you continue to roll, over time it will hurt a lot less.
6. Periodize your training program.  This is particularly important if you are racing.  Heavy weights and plyometrics will improve running economy; however, they also cause soreness.  It is important to figure out when you should be building strength, working on power, and allowing for recovery.  I use the base building period of an endurance athlete's program to work on strength, speed training portion to incorporate some plyometrics (this requires excellent feedback from the athlete.  You don't want to hinder the speed training workouts.  I make sure I do plyometrics with the person when speed training is done for the week), and taper to focus on quality/endurance movements, using one or two plyometric exercises if the person has been strength training for a long time.  
7. Remember quality.  Don't do something too soon (such as add jumping motions).  Work on improving movement quality first.  This might take some time, but it will be worth it in the end.
8. Don't forget the rest of your body.  While we don't use our arms to run, we do lose muscle mass as we age.  What good is all of that running if we can't lift ourselves off the floor if we fall?

Yours in health and wellness,

Jenn

www.bewellpt.com

Saunders, P.U., Pyne, D.B., Telford, R.D., & Hawley, J.A., (2004).  Factors affecting running economy in distance runners.  Sports Medicine, 34(7), pp. 465-485.

Berryman, N., Maurel, D., & Bosquet, L., (2010).  Effect of plyometric vs. dynamic weight training on the energy cost of running.  Journal of Strength & Conditioning Research, 24(7), pp. 1818-1825.

Noehren, B., Pohl, M.B., Sanchez, Z., Cunningham, T., & Lattermann, C., (2011).  Proximal and distal kinematics in female runners with patellofemoral pain.  Clinical Biomechanics, (Epub ahead of print).