yoga therapy for teachers d1.pdf

7/26/2019 Yoga Therapy for Teachers D1.pdf

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Yoga Academy Romania

Yoga Therapy for Yoga Teachers I with Ann da Silva 1

www.anndasilva.com Copyright 2014 www.paradoxumrealitas.com

DAY 1

Lower back, hips, knees and the feet

Common causes of aches & pains in the lower body:

Lower back pain, knee pain, knee injuries, issues in the hips & feet

YOGA as THERAPY

What role does yoga have in terms of wellness or therapeutic treatments?

From a yogic point of view, problems in the body arises from imbalances of the mind

Undigested emotions / feelings accumulates: depletes prana, the vital energiesLow pranaweakens the body, toxins accumulate both mentally and physically

Disease develops

Mental: Loneliness, isolation, depression, tension, stress, anger, jealousy

Physical: Over-eating, over-working, drugs, alcoholic ways to numb feelings and emotions

Emotional stress / tension = physical- Neck & shoulder stiffness- high blood pressure / heart diseases

Suppressed expression / emotions = physical

- sore throat - heart diseases

How Yoga can help

BODY

Asana physical poses for mobility, strength & stability

BREATH

Pranayama breath modification with mental focus to help facilitate circulation & healing

MIND

Meditation, visualization & chanting to remove

negativity & bring in positive thoughts


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2 Yoga Therapy for Yoga Teachers I with Ann da Silva

www.anndasilva.com Copyright 2014 www. .paradoxumrealitas.com

Physical benefits of Yoga Therapy:

stretches, tones and strengthens the body

- brings nourishment and rejuvenation of the muscles, tendons, ligaments, bones & joints- encourages circulation, stimulates metabolism

- increasing stamina in the body and clarity in the mind; youth & vitality

Assists recovery in common physical injuries

Prepares the body for sports, e.g. marathon, triathlons, golfing etc

Physical & Mental benefits of Yoga Therapy

When the body starts to benefit from the asana practice:- the mind starts to settle down

- letting go of unnecessary burden & thoughts

- relieves tension & stress

- restores mind (mental) & body (physical)

to optimal balance and

well-being

What is Pain?

An indication that something is not right

A perception of pain in the brain, can be mental tension

Not muscle soreness, which is fatigue or giving too much force to the muscles, usually dull

ache esp. when pressed, comes afterwards

Pain usually happens when you are doing it

Back off if it is painful

Pain from stretching should not exist

Pain from Tension /stretching is not right

Tension: tissues are not elastic enough for the bones to move apart,

i.e. not flexible enough can lengthen in time

Pain from Compression may not cause damage but should still be avoided cannot change! Compression : bones hitting against bones, stopping any further movement

Cramps or Spasms: not long term damages, only a protection mechanism of the body- response to sudden movements or out of use: spasms freezes up muscles to protect body

from movements that may hurt the body

-

bad blood circulation or muscle fatigue, dehydration

Can also be caused by lack of minerals such as magnesium, potassium & calcium

Rare, but can be due to nerve malfunction, such as spinal chord injury

! Gently stretch to release the spasm

! Ensure adequate hydration before exercise

!Ensure balanced intake of minerals such as magnesium, potassium and calcium! ease into your practice slowly

! Relax, breathe!


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ACHES & PAINS

Age & hereditary: born with (scoliosis), growing older / degeneration

Pathologies / Illness

Posture / Alignment: habit of sitting, standing, improper alignment during exercise

Injuries: lack of endurance & stability from lack of use & misalignment

Wear-and-Tear: Daily life & exercise

Mental Tension & Anger

Injuries during Yoga

often when going in and / or out of an asana

The 3 most vulnerable areas for injury in Yoga: Neck, lower back, & knees

The 2 main ways of injury:

- doing something wrong fast; hits right away,e.g. over stretching/ tearing hamstrings

- doing something wrong repeatedly, no immediate pain, damage builds up,

e.g. Wear-Tear in incorrect twisting of knee

PREVENTION & TREATMENT OF INJURIES

Maintain proper Alignment at all times

Before any movement of the spine, always activate the Core Muscles to protect lower back

Be Mindful & present during practice

Breathe

1. RICE: Rest Ice Compression Elevation

Rest when there is any Inflammation!!!!

2. REHABILITATION: Yoga Therapy

SAFETY IN YOGA

I can go more, I can go more, I can go more, I can go more..can I?

Find our potential for improvement AND Accept that we do have limitations


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THE SPINE

Four major sections:Cervical C1 to C7

Thoracic T1 to T12

Lumbar L1 to L5

Sacrum fused S1 to S5

Vertebrae

joints & disks

Curves

Vertebra

Multi-segmented structure

Vertebral Body

Lamina & Pedicle

Spinal Canal

Spinous Process

Transverse Processes x2

Facet joints x4

Separated by Intervertebral discs

Intervertebral Disc

Made of water, collagen, & gel

Annulus

-hard, tough

-rotational stability

-compressive stress

Nucleus

-soft, moist, gel-like

-transmits stress & weight from vertebra to vertebra


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Curves of the Spine

Spring-like, shock absorber

Allows the spine to bend and give Weight bearing Strength

Better muscle attachment for flexibility,

momentum & stability

Flat spine = harder working muscles

Big range of normal curve angles

Exaggerated curves of the spine

Kyphosis

-over curvature of the thoracic

-hunchback

-rounded shoulders, tight chest

Lordosis-over curvature of the lumbar

-swayback

-hypermobility = risk

Planes of Spinal Movement

Flexion -forward bend

! Restricted by soft tissues, can bend too deep

! Risk of compressing nerves

Extension -backward bend

! Restricked joints & bones, generally safer

! No nerves to compress

Lateral Flexion / Extension

! sideways bend

Rotation

- twists

Cervical

curve Thoracic

curve

Lumbar

curve Sacral

curve


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Flexion and Extension

Side bends & Rotation

side bends almost always involve rotation stretching 50% and unloading of the other 50% fibers of the Annulus

Strain on the Intervertebral disc

Intradiscal Pressure raises during sleep due to water uptake = risk!

95% of disc prolapse caused by repetitive Flexion esp. with Rotation

Neutral Spine

Key concept in modern sports rehab

not too curved and not too flat

Weight load is distributed evenly along the whole spine

Maximum force to go forward in sports

Performance & safety

No 100% perfect shape of spine

Common spine problems

Usually in the Lumbar spine as it supports the entire spine = stability!

Also common in Cervical spine as it supports the weight of the skull = stability!

Less frequent in the Thoracic as it is less mobile due to rib cage = mobility! May or may not manifest in pain along spine

Pain/numbness can extend down arms/legs

Common causes

Usually chronic, keeps coming back & triggered by a particular traumatic incident

Age & Lifestyle: lack of exercise, diet, smoking, causing degeneration, prone to injuries

Injuries from lack of endurance & stability

Poor posture: misalignment, repeatedly

Stability & Mobilizationwith Alignment is the key to prevent & rehabilitate back

problems


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Common treatment for Back Pain

Anti-inflammatory pain medication (NSAIDS)

Injection of cortisone into the spine

Rehabilitation: Yoga Therapy, Physical Therapy

Chiropractic treatments

Change of habits / lifestyle

Correct posture

Surgery rare: incontinence, weakness or numbness, to relieve compression & pain

Strengthening the Spine Muscles

Strengthening is protective

Stretching is releasing, feels good and helps to prevent immobility BALANCE between the two!

Strengthen = weight bearing

Endurance & Stamina = lower weight, reps

Erector Spinae

Abdominal Muscles

Key Muscles for Spine Stability


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THE LUMBAR SPINE

Supports the weight load of the whole Spine

The largest segments of the vertebral column

very mobile, needs Stabilization

Most problems appear here

Interconnected to Sacro-illiac joint problems

Sciatica

most common pain and discomfort caused by a problem in the lumbar region

Pain, weakness, numbness or tingling sensations, usually one side

Injury or pressure on the sciatic nerve A symptom of another medical condition, not a condition on its own

Causes of Sciatica

Disc Herniation

Spondylolithesis

Spinal Stenosis

Piriformis Syndrome

Sacroiliac Joint Disorder Pelvic injury or fracture

Tumors

Usually only one-sided

Worsen after standing, or sitting,

or when sneezing, coughing

DamagedSciaticnerve

Weakenedknee (pain

running down

back of legs to

toes)


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Disc Herniation

Slipped disc

Disc protrusion

Most often in Lumbar spine

Tear in the Annulus

Bulging out of the Nucleus

Pain due to inflammation/nerve

May cause nerve compression

Can cause Sciatica, but not common

Therapy for Disc Herniation

Pain-free, neutral spine

Extension from neutral

prevent immobilization

Core stability

Movement that extend the pain away spine

- big NO as nerve compression is more severe

Avoid deep ROM in morning due to IDP

Numbness, bladder & bowel control problems

Spondylolysis & Spondylolisthesis

Spondylolysis: fracture of Pars Interarticularis

Spondylolisthesis: forward slippage of the vertebra due to breakage of this boney ring

Usually L5 and Sacrum, sometimes L4


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Spondylolysis & Spondylolisthesis

Hypermobility Can be Hereditary

Stress fractures typically due to repetitive load

Hyperlordosis gymnasts, dancers

Can be caused by Disc Hernation

Spondylolysis can usually heal on its own

Spondylolisthesis may require surgery

Therapy for Spondylolisthesis

Stabilize

Avoid Hyper-extension (over back bend)

Core Strengthening!

Avoid SLR (straight leg raising) psoas load

Explore Flexion with awareness

Neurological deficits (paralysis, weakness, numbness, or increasing pain)

Spinal Stenosis

Aging: enlarged joints, Thickened ligament

Disc Herniation

Facet joint fracture

trauma

Vertebral slip - Spondylolisthesis

Can be hereditary narrow spinal chord

Pressure on the spinal cord or nerves

Can cause neurological deficit:

Pain, numbness, tingling or loss of mobility

Lumbar: when nerve roots in lower back is compressed, can cause sciatica, affects walking,gait & distance

Cervical: dangerous as spinal cord is compressed, serious symptoms, major body weakness& paralysis

Therapy for Spinal Stenosis

Emphasis on flexion, may decrease pain

Laminotomy to increase space by removing a bit of the bone / disc

Post surgery:

o -Stabilize

o

-Maintain neutral Spine

o -Regain normal function


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Sacroiliac Joint Dysfunction

Pain in the SI joint

Cartilage damaged or worn (degenerative arthritis/osteoarthritis)

pregnancy (hormonal)

Stress of joint (repetitive)

Trauma (missed step)

Common: leg length discrepancy, back pain

Therapy for SI-Joint Dysfunction

Stabilization, strength, endurance of surrounding muscles, e.g. glutes, core

Mindful self mobilization may help to reposition the SI-joint

Reduce / correct load in daily habits

Avoid asymmetric FWD bends, and end range

Warm oil Avoid too frequent manual adjustments!

Severe cases: surgery to fuse the SI-joint

The MUSCULAR SYSTEM

Three types of muscles tissues:SKELETAL, SMOOTH, CARDIAC

- elastic, flexible, stretches

Three types of connective tissues:

TENDONS, LIGAMENTS, FASCIAE

less flexible, only gradual lengthening

They make up about half of the weight & bulk of the body

TENDONS connective tissues

Bundles of fibrous connective tissue, collagen

Tough, flexible, gradual lengthening

Dries, shortens, becomes brittle if not used

Connects muscles to bones

Body movement

Example: Achilles tendon, hamstrings

LIGAMENTS


Tough, flexible, gradual lengthening

Dries, shortens, becomes brittle if not used

Connects bone to bone

Stabilizes, supports & controls movements of the joints

overstretched, double-jointed, risk of injury Example: Anterior Cruciate Ligament (ACL),Medial Collateral Ligament (MCL)


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FASCIAE


Bands or layers of stringy elastic tissues, stretches

Dries, shortens, becomes brittle if not used Surrounds muscles to muscles, covers bones, blood vessels, nerves, everywhere

Some binds structures for stability or protection

Some layers on to allow smooth gliding movements

Example: Plantar fascia

TENDINITIS / TENDONITIS

Inflammation of a tendon, e.g. Achilles

Common in the limbs, not often hips /torso

Repetitive strain injury, mostly wear & tear

Aches & pains, joint stiffness

Burning sensation around joint or inflamed tendon

Can have swelling

R.I.C.E.

MUSCLES OF THE HIP


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The ILIOPSOAS & PSOAS

The Iliopsoas: two muscles

Iliacus: main hip flexor Psoas: only muscle thatattaches leg to spine

Short psoas: tilts the pelvis, look of shorter leg, knee &back pain,

Wear-tear, over holding

Mindful stretching

The ILIOTIBIAL BAND

fibrous reinforcement of the fascia lata muscles

Assists in moving the hips

Stabilizes the knee inextension & partial flexion

Used constantly in walking, running etc

Overuse = ITB Syndrome

ILIOTIBIAL BAND SYNDROME

Pain in outer knee

Possible pain in hip

Training /overuse

Anatomical (arches, foot supination/strike)

Muscle imbalance

R.I.C.E. then: stretch

The HAMSTRINGS

group of three muscles on back of the thigh, connects the hip to the knee, walking

Biceps femoris, Semitendinosus, Semimembranosus

Extension of the legs

Flexion of knee

Stretches over time

Can be torn

Takes time to heal

R.I.C.E. then stretch


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JOINTS

When two or more bones come together

There are three types of joints:

FIXED JOINTS

Held together by a tough fiber that doesnt allow movement, also called Fibrous Joints

e.g. the skull

SLIGHTLY MOVABLE JOINTS

Separated by cartilage, allowing small range of movement, also called: Cartilaginous Joints

e.g the joints between the vertebrae

MOVABLE JOINTS

With lubricating synovial fluids inside a

synovial membrane that wraps around the joint great freedom of movement

Two main types: Hinge, Ball & Socket

Also Synovial Joints

HINGE JOINTS

Allow movement in one direction

E.g. the knees, elbows & fingers

BALL & SOCKET JOINTS

Allow the greatest freedom of movement, the round end of one long bone fits into the

hollow of another E.g. hips and shoulders

OSETOPOROSIS

Progressive bone disease, Porous bones

Production of new bones cannot keep up with the loss of bone mass

Risk of bone fracture, even from sneezing, coughing, falling!

Often in hips, wrist or spine

Stooped posture, loss of height, collapsed vertebrae, fractures Age, race, sex, family history, menopause, bone reserve from youth

Hormonal and /or glandular issues

Dietary: low calcium, eating disorders, nutrient absorption problems

Medication: long term corticosteroid use can interfere with bone-regrowth

Lifestyle: lack of exercise, alcohol & tobacco use can reduce calcium absorption

Calcium supplements

Moderate & mindful weight bearing, e.g. Standing poses, warriors etc

Lifestyle changes: avoid smoking & alcohol consumption

Being present,

avoid falling!


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OSETOARTHRITIS

Degenerative joint disease, most common type of arthritis, Wear-and-Tear arthritis

Cartilage in the joints are worn down

Often in lower back, knees & hips

Pain & stiffness, loss of flexibility, tenderness

Gradually worsens, no real cure

Can only slow down deterioration, relieve pain & improve function

Glucosamine, supplements

nourish the joints with gently cycles of moderate weight loading & unloading

Mindful rotation & movements to encourage circulation & range of motion

Gentle stretching / pulling of the muscles

ANATOMY OF THE HIP

ISSUES OF THE HIP JOINT

Osteoporosis

Hip Fracture

Osteoarthritis in the Hip:


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THE KNEE JOINT

Femur: Thigh bone

Tibia: Shin bone

Fibula: Calf bone Patella: knee cap

ACL: Anterior cruciate ligament

PCL: Posterior cruciate ligament

LCL: Lateral collateral ligament

MCL: Medial collateral ligament

Knee cap (Patella): protects the interior parts of the knee joint

Patella tendon: also known as Patella Ligament connects from the quadriceps, through the

Knee cap to the tibia, the shin bone (bone to bone),

it provides and controls extension of the knee joint

Anterior cruciate ligament (ACL): connects the thigh bone to the shin bone in the centerof the knee. Limits rotation and forward motion

- most commonly injured or torn, resulting

in instability of the knee

- E.g. falls that caused the knee

to twist or pivot: skiing, soccer

- In yoga, fast, forceful twist ofknee, or forceful overextending such as lunges

- Immediate symptoms

- Slow healing, or, surgery

Medial collateral ligament (MCL): runs down the inside of the knee, connects the thigh

bone to the shin bone

Lateral collateral ligament (LCL): runs down the outside of the knee, connects the thighbone to the calf bone

Together they limit and stabilize sideways movement of the knee

Injured by sideways force to knee Slow, timely healing process

All soft tissues around & nearest the knee joint, tendons &ligaments, are for stabilizing and

protecting the knee

Meniscus:two pads of cartilaginous tissues in the knee joint, to disperse the weight

of the body & reduce friction during movement

Injured either by acute tearing fromsudden trauma in sports, or a Slow Wear-and-

Tear

In Yoga: misalignment, e.g. hyper-extension or hyper-flexion of knee, esp. when

weight bearing Symptoms slow or recurring


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OTHER ISSUES IN THE KNEE

Patellar Tendinitis:

Jumpers Knee repetitive overloading

& extending of the knee

Osteoarthritis in the Knee

ISSUES IN THE CALVES

Gastrocnemius Muscle

tearing of inner calves, or Tennis Leg

A pop, sharp pain

Slow healing, depending on severity, surgery

R.I.C.E. stretching & strengthening

ISSUES IN THE ACHILLES TENDON

Calcaneal Tendon

A pop, sharp pain

Slow healing, according to severity, surgery

R.I.C.E., then stretching & strengthening

PLANTAR FASCITIS

Progressive, degenerative damage to Plantar Fascia Ligament, may not have inflammation Weight bearing, overuse, inadequate arch support in shoes, esp when running/ flip flops

can cause, possibly caused by Flatfeet


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R.I.C.E.

Stretch Achilles Tendon & Plantar Fascia

Ligament

Strengthen Calves Orthotics (shoes) with arch & foot support

Surgery (detaching the Plantar Fascia

Ligament from the heel bone) = Flatfeet!!

FLATFLEET

Collapsed Arch in the feet

Related to Plantar Fascitis, age, weight bearing,

improper shoes

Feet Pronation

Can cause pain in back, knees, hips and neck

same treatment as Plantar Fascitis

FEET PRONATION

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