Brain Health: An Interview with Ram Rao

by Nina and Ram

New Growth by Melina Meza

I’m trying to learn more about brain health so I can write a brief overview about how you can use yoga to foster brain health. And since we just happen to have a handy expert on the topic—Dr. Ram Rao—I thought I’d interview him as a way of doing my research. You lucky people get to see my interview in its complete form today. —Nina

Nina: What are the types of dementia? And what is the probability for developing one of these forms of dementia as you age?

Ram: Memory loss can be a simple age-associated phenomenon or due to a pathological condition. Age is one of the known risks for memory loss or forgetfulness. Age-associated memory loss is not the same as dementia. If a person experiences forgetfulness without having any underlying pathological condition, then the memory loss is solely due to age. Age-associated memory loss is not disabling and does not impact or interfere with daily performance.

Dementia is a pathological term to indicate loss of memory and other mental abilities including thinking and reasoning. The condition can be severe so as to interfere with daily life. Any damage to the memory centers can trigger the onset of dementia. Although many diseases trigger dementia, some forms of dementia may improve greatly when the underlying cause is treated. Dementia can arise due to:

• NeuroDegenerative diseases, including Alzheimer's disease, Parkinson's disease, Huntington's disease (a rare inherited disorder), and multiple sclerosis
• Vascular disorders that results from multiple strokes in the brain
• Traumatic brain injury due to accidents, severe injuries to the brain, hits to the brain
• Infections, including meningitis, HIV
• Chronic alcohol or drug use
• Depression
• Developmental abnormalities

Nina: Can yoga help us reduce our probabilities of developing memory loss? If so, how?

Ram: According to the Mayo Clinic, memory loss can be prevented by: 1) physical activity/exercise, 2) staying mentally active, 3) being socially active, 4) eating a healthy diet, 5) leading a stress-free life and 6) sleeping well.

There are so many scientific studies that indicate benefits of yoga (asanas, meditation and pranayama) in combating stress, keeping the individual physically and mentally stable and active, improving the digestive capacity and also helping in the sleeping process, all of which will result in combating age-associated memory loss. Yoga does this through multiple cellular mechanisms.

Nina: How can yoga help prevent strokes?

Ram: Yoga (asanas, meditation and pranayama) has been shown to improve the health of the heart and blood vessels, reduce blood pressure, reduce arrhythmia, reduce anxiety and depression, and improve metabolic parameters including blood lipid profiles all of which help in keeping stroke at bay

Nina: How can yoga help reduce chances of getting Alzheimer’s Disease?

Ram: In a recent study involving patients with early signs of Alzheimer’s disease (AD), it was shown that Yoga and Meditation increased functional connectivity in the areas involved in memory and also decreased the early degenerative changes that are typically seen in these regions, suggesting that Yoga and meditation have a positive impact on the regions of the brain related to AD. According to one Harvard researcher, yoga and meditation need to be included as part of the treatment regiment for dementia and Alzheimer’s patients. All the above-mentioned risk factors for stroke including hypertension, atherosclerosis, abnormal lipid profile, and stroke can trigger (AD).  Since Yoga has been proven to improve all these conditions, in turn it can also reduce the onset and/or severity of AD.

Nina: How about general mental acuity? Can yoga help us stay mentally sharp as we age?

Ram: Yes, there are numerous studies that show that practice of yoga (asanas, meditation and pranayama) has beneficial effects on the emotional well-being and general mental acuity without any of the side effects. It’s no wonder that a recent article in Yoga Journal on yoga’s effects on mental acuity was aptly entitled Yoga-Better than Prozac. That in itself sums up the power of yoga. Yoga increases brain chemicals such as endorphins and enkephalins that contribute to a feel-good response and ward off mental stress. It is akin to stimulating the brain in a positive way, which results in optimal brain function all of which can keep an individual alert and sharp.

recomended product suport by amazon

Friday Q&A: One Leg Shorter Than the Other (Rerun)

Q: I recently learned that my back pain for two years now (surgery recommended) is due to my right leg being shorter (2nd opinion from another back surgeon). My right shoulder and right hip are higher than the left side. Is there a yoga exercise or two that could help me correct this and alleviate the back lumbar pain?

Upper Leg Bone

A: This is a great question, and quite a common finding for many people: having one leg shorter than the other. And as your second surgeon seemed to point out, the presence of one leg shorter than another and low back pain in the same person could be related. Most individuals have a small difference in their leg lengths. Because this is so common, if the difference between right and left is small enough, it does not typically contribute to lower back pain. This is usually the case for people if their leg length difference is less than a ¼ inch. (On a personal note, when I went to my chiropractor recently for a shoulder/neck issue, she mentioned that I had a slight leg length discrepancy that I had never known about. And it turns out I have occasional lower back and sacral pain!)

When you get leg lengths that differ greater than 1/4 inch, that is when it can contribute to lower back pain. And if you have a leg length difference of greater than ½ inch, you are six times more likely to have an episode of lower back pain. That is pretty significant!

For those not familiar with Leg Length Discrepancies (LLD), I’d like to give a little more background. The two main causes of LLD are: 1) poor alignment of the pelvis and 2) having one leg that is structurally longer than the other. Other potential causes include an injury (such as a fracture), bone disease, bone tumors, congenital problems (present at birth) or neuromuscular problems, but these are much less common. Regardless of the reason, your body wants to be symmetrical and will do its best to compensate for the length difference. Certain other conditions can be present along with leg length discrepancy, such as scoliosis, lumbar herniated discs, pelvic torque, greater trochanteric bursitis, hip arthritis, piriformis syndrome, patellofemoral syndrome and foot pronation. I’ve written about a few of these other conditions elsewhere in our blog. But if you have one of these other diagnoses, you may want to ask your doctor to check you for a leg length discrepancy.

The signs and symptoms of LLD can include:

• one leg being obviously longer than the other (mine was not obvious to me!)

• affected posture, especially secondary scoliosis or one shoulder higher than other (and scoliosis could lead to secondary LLD)

• problems with gait
• pain in the lower back, but also hip, ankle or knee

Lower Leg Bones

As mentioned above, LLDs can be the result of legs actually being of different lengths or the pelvis being torqued and tipped. This leads to two ways of classifying LLD:  a structural leg length discrepancy or a functional leg length discrepancy. A structural leg length discrepancy is a hereditary circumstance where one leg is simply longer than the other leg. This is determined if your pelvis and sacroiliac joints are symmetrical and the leg length is simply due to one leg truly being longer than the other, say via an X-ray. Functional leg length discrepancy is diagnosed when there is a torsion or pelvic rotation, commonly a sacroiliac (SI) joint dysfunction, which causes one leg to function as though it is longer or shorter than the other. In order to determine if a true structural discrepancy exists, a physical therapist must treat the pelvis and return it to a neutral position before measuring for the leg length discrepancy. Once the pelvis is symmetrical, if the leg length discrepancy goes away it is classified as functional.  If it remains and has a measurable difference, it is a structural leg length discrepancy. So our questioner of the week may want to begin by finding out if she has a structural or functional LLD, before deciding how yoga can be applied.

How does your western MD and Physical Therapist usually address leg length discrepancy? Structural leg length discrepancy can be treated with a heel lift in the shorter leg’s shoe. You want to let your physical therapist determine the height of the lift, since it is determined by how much lift is needed to restore proper biomechanics in the pelvis and lower back. I know of at least one student of mine who wears a thin-soled shoe on one foot during her yoga practice, as well as a heel lift in one shoe outside of yoga class. This seems to compensate and correct her imbalance and allows her to fully participate in all of her standing poses, especially the symmetrical ones such as Mountain pose (Tadasana), Powerful pose (Utkatasana) and Standing Forward Bend (Uttanasana). In rare instances, surgery may be recommended to either shorten or lengthen the limb. This is always accompanied by a course of physical therapy, which helps to stretch muscles and maintain joint flexibility, which is something yoga asana could compliment.

For a functional leg length discrepancy where the real issue is the tipping and torque of the pelvis, no heel lift is required. Instead, a physical therapist would use proper manual therapy techniques and specific therapeutic exercise to treat and normalize pelvic and lower extremity compensations.  In yoga styles where alignment is a main focus of the poses (such Iyengar and Anusara), the asana practice could function to restore pelvic evenness. Once the pelvis is even, you should re-measure your legs. If they are pretty close to even, your leg length discrepancy was functional; if not, you could have an underlying structural leg length discrepancy that might still require a heel lift.  I wish there were one or two poses I could recommend without knowing all this student’s particulars, but that is not possible without an more thorough history and physical exam.  In general, a well-balanced yoga practice that includes reclining, seated, standing and some easy inverted poses could serve as a good starting point. But since low back pain is present, I’d recommend looking for a specialty class on yoga for back pain, where you are more likely to have a teacher experienced enough to give you some special guidance.

—Baxter

recomended product suport by amazon

9/11 Anxiety and Yoga (Rerun)

by Baxter

Some years ago, when Nina and I were working on a series of yoga classes for stress management, I read the book The Relaxation Response by Dr. Herbert Benson, and an interesting finding from the work he did has stuck with me. He noted that his blood pressure patients who meditated regularly not only saw improvements in their blood pressure readings, but they also had certain substances in the blood stream that increased or decreased. One of those substances was lactate, or lactic acid, which is a byproduct of cells using sugar or glucose for fuel. It had already been noted back in the 60s that folks with anxiety disorders often had elevated levels of lactate in their bloodstream compared to individuals without anxiety. Since meditation seemed to lower lactate levels, it seemed like a great potential treatment.

More recently, an article in Scientific American looked at lactate and other markers in the body that could account for why some folks develop panic disorders, an extreme form of anxiety. Studies done in the last two years point to the pH in the brain as a possible causative factor in the experience of fear, and by extension, anxiety. It seems a more acidic pH in the brain is associated with more active trigger of the fear centers in the brain. In fact, there are receptors at individual synapses, the spaces between two nerve cells, that respond to elevated levels of acid. In the area of the brain strongly associated with the emotion of fear, the amygdala, this increase in local pH can trigger fear responses.

They also noted that carbon dioxide levels, when increased in the blood stream and the brain, lead to greater acidity. Other studies have demonstrated that patients with panic disorders are more likely to have an event if they inhale a higher concentration of CO2, compared to non-anxious individuals. These researchers also addressed the lactic acid phenomena that Dr. Benson noted years before: patients with panic disorder tend to generate excess lactic acid in their brains. We all generate lactic acid in our brains as sugars are burned as fuel, but for people with panic attacks, even normal mental activity to lead to an accumulation of lactic acid in the brain.

So if a decrease in pH in the brain—whether due to CO2 build up or lactic acid build up in certain areas of the brain—could be a trigger for anxiety and panic attacks, how could yoga diffuse this situation? Well, way back in the 60s it was already observed that the “relaxation response” that arose from simple meditation practice could lower the pH in the blood stream. This might indicate that it could be lowered in the brain, too. So I’d give high marks to establishing a regular meditation practice, even if only for ten minutes at a time. Secondly, certain pranayama practices could theoretically lower blood CO2 levels slowly and gradually, but whether that would lower CO2 levels in the brain is uncertain. That sounds like it would be worth a trial, however. And finally, the authors of the study noted that “one of the many beneficial effects of aerobic exercise training (like running or cycling) is that metabolically active tissues (including the brain) become more efficient at consuming–removing—lactic acid.”  And although not all yoga asana practices are aerobic, some are to a certain degree. So, physiologically, your asana practice, especially if it is more vigorous, could be the third prong in your yoga tools approach to anxiety, panic attacks and fear.

Here is a link to the 2010 Scientific American article here so you can get more details on the work I’ve alluded to: scientificamerican.com. And may you and yours be safe and anxiety free this 9/11 anniversary. 

recomended product suport by amazon

Thursday Building Unity Farm - The Land Awakens

Now that we’ve had a few days above freezing, work on the land can finally begin.

In April, the ponds and streams of Unity Farm begin to fill with spring peepers, salamanders, and wood frogs.     The melting snow recharges the wetlands and turns the low lying trails into mud.  In an effort to protect the land from the erosion of foot traffic during mud season, I built two new removable bridges that enable travel for woodland maintenance.   I added a new trail off the Woodland Trail called the Vernal Pool trail, pictured below.   Those with a natural curiosity who visit the farm can watch the developing amphibians of Spring.

Last weekend provided enough warmth to open the cider house for bottling.   I moved the mead and cyser (half mead, half cider) from the indoor fermentation areas to the cider house and let them settle for a day to maximize clarity during the final bottling.  Using a racking wand, my wife bottled while I capped.    We’ve cellared the finished bottles and they’ll be ready to serve chilled this Summer.    It's called Queen's Mead because Queen Elizabeth I preferred a lighter, less alcoholic mead and that's what we made.  We also have 60 liters of hard cider to bottle this Spring, likely over an April weekend.

The duck pond has been covered with ice for the past 5 months.    Last Fall, the ducks were too young to travel across the barnyard and swim in the pond,  but now that they’re mature and wandering, the pond is within reach.   For the first time last weekend, the pond was thawed enough for the ducks to discover it, pictured below.   Kathy and I are convinced that they’re in duck paradise and may never leave.

Also last weekend, the ground was soft enough that we were able to create 10 level blue stone bases for the bee yard and move our meadow hives to the orchard, as pictured below.    We placed pine branches in front the them, forcing the bees to "reorient" to their new location instead of flying back to their old hive spot.  I built bases for ten hives while Kathy nailed together new hive bodies and painted bases, landing boards, and covers.    We’ll move two more hives into the bee yard this weekend and add new bees/queens to the remaining hives in April, May and June.

The weekend ahead will be filled with herd health, beginning the Spring health maintenance for the alpacas and llama, with toenail trimming, vaccinations, physical exams, and weighing.    Thus far, it appears all animals made it through the brutal winter with no ill effects.  

We’ll also do additional trail work, new mushroom area inoculation, and wood splitting.   Those 4 pounds I gained over the winter will disappear with the longer days and the endless physical activity of farming.

recomended product suport by amazon

The March HIT Standards Committee

The March HIT Standards Committee focused on the Standards and Interoperability (S&I) Framework projects for 2014, an overview of the 2015 Certification Notice of Proposed Rulemaking, and a first review of the standards maturity for the proposed Meaningful Use Stage 3 criteria.

Doug Fridsma presented the S&I update.  Importantly, a new initiative has been launched to coordinate decision support and clinical quality measures as related activities. EHRs should provide alerts and reminders from pathways, protocols, and guidelines intended to improve quality.  Also, a new initiative will connect EHRs and the Prescription Drug Monitoring Program (PDMP) to improve workflow, hopefully supporting single sign on and patient context passing so that PDMP data is one click away from any EHR.

Steve Posnack reviewed the 2015 Certification Notice of Proposed Rule Making, highlighting the changes from 2014.  He noted that the concept of the Complete EHR is no longer needed.   Providers buy the certified technology they need to attest and it may be that modules, an EHR, and an HIE meet all the attestation needs, not a single monolithic product.  The Implementation Workgroup will review the impact of the 50 new proposals in detail and we will discuss them at the April meeting.

I presented a task force review of the 19 Meaningful Use Stage 3 proposals.

Below are a few comments from the task force and the Standards Committee members.   Although the bulk of our comments focused on standards maturity, we also commented on provider impact and development difficulty, hoping to offer helpful “in the field” feedback to the Policy Committee.

Clinical decision support - it would be very challenging for an EHR to track every response to every decision support intervention and no standards exist for such tracking.  Maybe the best way to encourage decision support is via payment reform which links outcomes to pay.

Order tracking - there are standards for closed loop lab ordering but not closed loop referral workflow.   The Harvard Risk Management Foundation recently funded a project to define all the steps in closed loop referral management, pictured below.   Given the lack of standards and the development burden of this workflow, a focus on lab seems most appropriate.

Demographics/patient information - although standards exist for occupation and industry, other new demographic standards such as gender identify and sexual orientation are a work in process.  Here’s a great reference describing one approach. There could be a significant impact on EHR development if new demographics selections affect patient education materials, decision support, and quality measures.

Advance directive - a pointer to an advanced directive such as a URL would require little development and the standards are mature.

Electronic notes - Although the standards to transmit free text within a clinical summary are mature, the “high threshold” (likely over 50% of patients to have notes) could be a high burden first step.

Hospital labs - The HL7 2.51 standards are mature but a minority of hospital reference labs support comprehensive LOINC codes.

Unique device identifiers - The standard is well described but the implementation difficulty could be high if the electronic record had to validate the UDI against a national database and enable reporting on UDIs in the case of recalls.

View, download, transmit - the standards for clinical summaries are mature except for the representation of structured family history.  The requirement to make data available to patients within 24 hours could present workflow challenges.

Patient generated health data - certifying multiple methods of data capture creates a burden on developers.  Maybe a less prescriptive approach, focusing on the ability to receive patient data in some fashion would be best.

Secure messaging - overly prescriptive workflows could force the retooling of existing high functioning products.    Maybe a less prescriptive approach, focusing on the ability to support effective patient communication would be best.

Visit Summary/clinical summary - the nature of the clinical summary text (structured, unstructured, timeliness) could have workflow and development implications.

Patient education - the requirement is for only one language other than English and the Infobutton standard can support this.   A single language other than English may not achieve the policy outcome desired.

Notifications - although the HL7 admit/discharge/transfer standards are mature, the notion of gathering the Direct addresses of care team members and sending event data via Direct is a novel workflow.

Medication Reconciliation - identical to stage 2, no concerns

Immunization history - The HL7 2.51 content and CVX vocabulary standards are mature.  The transport specification created by the CDC (SOAP) is well tested.   The questions we raised - is there a role for Direct in transmitting immunization data to registries since Direct is used for other transmissions in Meaningful Use?   Is REST an alternative to all Meaningful Use “push” and “pull” transactions.   The public health community is passionate about the use of SOAP.   There are pros and cons to using something different for public health transport than other areas of Meaningful Use, so it is likely there will be further discussion.

Registries - the development effort required to submit provider chosen data elements to  registries would be significant.   Standards do not exist for this purpose.

Electronic lab reporting - identical to stage 2, no concerns

Syndromic surveillance - identical to stage 2, no concerns

There will be more discussion in upcoming meetings as both FACAs recommend iterative improvements as input before rule making.

recomended product suport by amazon

Stuck in a Rut? (Rerun)

by Nina

Creative Front Yard in Austin by Nina Zolotow

I don’t know about you, but sometimes I get stuck in a rut with my yoga practice. I have a few different sequences that I’ve developed for myself, and I tend to fall back on them again and again. Then I start to get a little bored. So lately I’ve been making a conscious effort to change things up a bit. Of course it would be a lot of work to write a completely new sequence for myself every day. So instead I’ve been focusing on spicing up my typical sequences. It’s kind of like deciding to remodel a room in your house by making just a few changes, such as buying new curtains or throw pillows, rearranging the pictures, or even just by adding a vase of fresh flowers. Sometimes a small change can make everything else look different.

 Here are a few tips for “remodeling” your home practice:

1. Add a new pose to your sequence, one that you never practiced at home before or haven’t practiced in a long time. I’m pretty good about working my way through the various standing poses on a regular basis, but I always forget about Dancer’s pose for some reason. Welcome back, Dancer's pose!

2. Replace a stretch you typically do one way with another pose that stretches the same area. For example, to stretch the fronts of my thighs of my thighs the other day, I tried replacing my Reclined Hero Pose with Frog pose. I hadn’t done that in years!

3. Subtract a pose you always do just to see what happens. Do you always practice Downward-Facing Dog or Triangle pose? What would happen if you skipped them? Would your other poses feel different?

4. Start working on a pose you think you “can’t” do. For example, maybe you think you can’t do arm balances, but even taking the shape of a pose like Crow without lifting your feet off the ground is doing a form of the pose. Maybe you can even lift one foot off for a second or two. Keep it light and playful, and you might find this adds a new element of fun to your practice. 

5. Face down a pose that you dislike. On a day when you feel up to it, try doing that pose that you really dislike (you know which one I mean) just briefly. Whew! Sometimes it can be exhilarating to take on something you’ve been avoiding (kind of like finally cleaning out your closet).

Readers, do you have any other tips for spicing up a sequence? Let us know in the comment section!

recomended product suport by amazon

"Transferring" and Yoga: Wisdom from Jane Fonda (Rerun)

by Baxter

Nina recently shared with me some fascinating information about Jane Fonda, who has lived many lives, from actor to fitness guru to political activist, just to name a few. Fonda reportedly used to practice a more strenuous yoga two hours a day. “But,” she says now, “those days are long gone. It got to be too hard.” All of that hard work has paid off even as Fonda approaches her golden years, though. She puts it this way:

“Every single time I go to get out of a car now, I say ‘Thank you, Lord, I have strong quads. Because if I didn’t have strong quads, I couldn’t be independent. You have to keep your back and legs strong so you can remain free and independent.”

Truer words could not be spoken! In my years as a Family MD, I cared for a lot of seniors, seeing them in my office if they were still living independently, or making trips to the nursing home if they needed special care. And one of the key skills that often allowed my aging patients to remain at home, which is were they all preferred to be, was the ability to “transfer” independently. By this I mean that they could go, typically, from a sitting or reclining position, such as their bed, to a standing position without any assistance. And they had to be able to do the reverse, that is, safely transfer from standing to sitting. Obviously, if they could do this from the floor to standing or vice versa, they would be way ahead of most of their peers! I have a 75-year-old student who does just that each week in class with me.

I found this expanded definition of “transfer” at the medical web site medicine.jrank.org:

“"Transferring" is the term used for moving from one condition to another, such as out of a bathtub, chair, or car, or getting into bed. The ability to transfer depends on many factors, including strength, balance, vision, and flexibility.”

Because of the physical benefits of a regular yoga practice, specifically maintaining flexibility, promoting muscular strength, improving balance and keeping the body agile, students who maintain a regular yoga practice are likely to remain independent much longer than their age-matched community, all other factors being equal. And even if they don’t have a vigorous practice like Jane did in her younger years, even a moderate or gentle yoga practice is likely to have the same four categorical benefits listed above.

Many of the standing poses would be likely to help with such daily activities such as getting in and out of the car.  Any standing pose that requires the knees to bend and straighten, such as entering, holding and exiting from Warrior 1 or 2, is simulating the action the knees, legs and hips perform for our car example (see Warrior 1 and Warrior 2 Mini Vinyasas). Even better would be Fierce pose (Utkatasana, also called Chair pose), especially if you added in a twist. One of the more challenging transfers for older people is using the toilet in a standard bathroom. It is usually lower than a typical chair, and so presents more potential challenge for most. Yet, if you continue to practice in an intelligent, age-adjusted yoga class, such situations may be non-issues for the aging yoga practitioner.

In classes designed for seniors with no previous yoga experience, it is quite common to utilize chairs to modify many yoga poses. So, just by virtue of getting in and out the chair in class a few times in class, with mindfulness and attention to detail, the student is again performing a similar movement to other important daily activities. The stress-reducing practices of yoga, as well as the mental sharpening skills of dharana, or concentration practice, are also likely to improve our chances of remaining independent well into our later years. So, let’s follow Jane’s example and keep our body and mind strong and agile via a regular yoga practice, so that we won’t even need an extra thought as we push away from the dinner table, stand and move onto the next activity of our full and satisfying day!

recomended product suport by amazon

New Tricks for Old Dogs: Working with Bunions (Rerun)

by Baxter

It was my first class with Donald Moyer in the new year, January having flown by and February upon us. I checked in with him before class began and mentioned an unusual aching in the lateral aspect of my left foot that I had been experiencing for about two months. It was not bad enough to prevent me from participating in my normal activities, but I noticed it when turning my left foot out to 90 degrees for many of my standing poses. He gave me some pointers for the day’s practice, and then class began.

About half way through the class, while we were in Standing Forward Bend (Uttanasana), Donald had us slip a strap between our big and second toes, and bring the loose end over the top of the big toe and down to the floor to the inside edge of the toe. He asked us to gently pull the strap to move the big toe medially, so that it lined up more evenly with the first metatarsal, the foot bone just before you get to the toe itself (the toe bones are called phalanges, and the big toe has two, the other toes all have three).

In addition to re-aligning these two parts of the foot and toe, the bones of the toe rolled a bit medially on their axis. Donald made an offhand remark about this being beneficial for treating bunions (hallux valgus for you Latin lovers) and then we moved on. But treating bunions! Sweeter words were never spoken. I come from a family of bunion formers, my mom’s mother, my wonderful Grandma Lopresto, had an impressive one on each foot for as long as I could remember. Interestingly, I don’t remember her complaining about them much.

What, you may be asking yourself, is a bunion? Well, a bunion is a condition in which your big toe deviates toward your second toe instead of lining up with your first metatarsal. And although bunions have a genetic component and do tend to run in families, another huge factor is shoes that smash the toes together. While these shoes are often for fashion purposes only, I do teach to one group of students whose shoe wear is all about function and their passion for climbing. And while the shoes these folks wear help keep them on razor thin ledges, they do lots of harm to their impressionable toes and feet.

According to the PubMed Health website, bunions occur more commonly in women and people born with abnormal bones in their feet. Certain kinds of shoe wear, specifically narrow-toed, high-heeled shoes, may also lead to bunion formation. And although it can seem a bit unsightly, it is only when pain develops that most people seek help.

How can you tell if you are developing a bunion? You may begin to see a thickening or actual bump forming where the toe and foot meet on the inner edge of the foot. On the inner side of the big toe, a red callous may form from the big toe and second toe rubbing on one another. Pain can occur in this joint, aggravated by certain shoes.

What is the mainstream treatment for bunions? First off, they often tell you to wear different shoes, ones with a low heel and a wide area for the toes. That alone could do the trick. Sometimes special pads can be placed on the bunion or between the big and second toes, and wearing a toe spacer at night can start to influence the alignment of the toes. If that does not work, there are only a mere 100 different surgical approaches to treat bunions. One of my long time students has had both toes operated on, and says it made a huge difference for her, eliminating the pain. However, it has had an effect on her balance.

So, here was Donald offering up a really simple way to affect the toes! A few years back, my colleague and friend JJ Gormley shared her favorite method to get the big toe back on track, which you can do at your desk. With your feet parallel, place a can of your favorite organic goodies between your inner arches and put a veggie rubber band, one of those strong ones, around the big part of your big toes, so they deviate a bit towards the midline between your feet. You can do this for 10-15 minutes a few times a day, and watch for results.

Obviously, if either Donald or JJ’s techniques result in worsening symptoms, stop them right away! But if not, give it a go. And remember, since a lot of the problem stems from being in shoes, yoga itself can go a long way to help the problem, as you are barefoot and you are strengthening and stretching many of the muscles and other structures that can affect the big toes.

For more information on yoga and bunions, there is a good article by Doug Keller in Yoga + Living Magazine from 2008 that you can find online. I hope the photos of Donald and JJ’s bunion recommendations are helpful in your home practice.

recomended product suport by amazon

Friday Q&A: More About Yoga for Heart Health

Leveil du Coeur by William-Adolphe Bouguereau

Q: Baxter, in your recent post Yoga for Heart Health and Circulation, you mentioned that you were working on an online program on yoga for heart health. When will that be available and where can I find it?

A: Thanks for asking! The online course will be available on yogauonline.com on Tuesday, April 1 and Tuesday, April 8,  2014, 5:30pm Pacific / 8:30pm Eastern. To get an early start, you can download a free interview with me on this topic that is available now via this link. Then, if you wish to sign up for the upcoming webinar, you can do so here.

I hope you find the information I'm presenting on this important topic helpful!

—Baxter

recomended product suport by amazon