Bacon and cheesecake 'alter brain like heroin'

Say no more . . .

Bacon and cheesecake 'alter brain like heroin'

Sleep Apnea: An Alternative Approach

Obstructive sleep apnea syndrome (OSAS) is caused by a disruption to the breathing cycle, often for 10 seconds or more at a time, when you are sleeping. Contributing factors vary -- from narrow or clogged airways to the tongue falling back in the throat cutting off the air supply. If you snore, keep your partner awake at night and wake up tired every morning, you might have sleep apnea.*

Since sleep apnea is a common breathing disorder, and since your breathing is controlled by your brain and breathing muscles, wouldn't it make sense to use breathing exercises as a front-line treatment? After all, Physical Therapists and Yoga Therapists use exercises all the time to restore balance to the body's neuromuscular systems. And, Yoga provides the best system I know of, hands down, for exercising the breathing apparatus -- muscles, lungs and brain. 

Can we then apply this same treatment logic -- of restoring balance to the body with exercise -- with years of documented success, to sleep apnea? It seems we can. Two randomized studies have recently been published in support of using different forms of breathing exercises to successfully treat obstructive sleep apnea.

The first, published in the British Medical Journal February 4, 2006, showed that didgeridoo playing is an effective treatment alternative for moderate sleep apnea. Here 25 patients were randomized between a control group of 11 people and a treatment group consisting of 14 participants. The treatment group practiced didgeridoo playing for 25.3 minutes for 5.9 days per week for four months.

The didgeridoo players showed significant improvements in terms of daytime sleepiness and snoring. The sleep apnoea-hypopnoea index (a measure indicating the severity of the disease in terms of sleep disruption and decreased oxygen saturation in the blood) significantly decreased. Happily, their partners also reported less sleep disturbances.

The second study was published February 20, 2009 in the American Journal of Respiratory and Critical Care Medicine. It was a randomized trial of 31 patients with moderate OSAS. For a period of three months, 15 patients received sham therapy and 16 patients received a set of exercises for the mouth, soft palate, face, tongue and throat.

Not surprisingly, the exercise group showed significant decreases in snoring frequency and intensity, a decrease in daytime sleepiness, improvements in sleep quality and a significant decrease in the severity of the measure of OSAS.

Doesn’t it make sense that yogic breathing exercises might have the same desired effects?

________________

     * To get a good diagnosis, please consult with your primary care doctor, who can refer you to a sleep clinic for evaluation.

References and Resources

Guimarães K, et al, 2009. Effects of Oropharyngeal Exercises on Patients with Moderate Obstructive Sleep Apnea Syndrome. American Journal of Respiratory and Critical Care Medicine Vol. 179: 962-966.

Puhan M, et a,l 2005. Didgeridoo playing as alternative treatment for obstructive sleep apnoea syndrome: randomised controlled trial. British Medical Journal, 332(7536): 266–270.

http://www.mayoclinic.com/health/obstructive-sleep-apnea/DS00968

http://www.webmd.com/sleep-disorders/sleep-apnea/sleep-apnea

http://www.nlm.nih.gov/medlineplus/sleepapnea.html

The Science of Touch

Check out this article on the science of touch

Recommended Reading

The Best Buddhist Writing 2008
  edited by Melvin McLeod
  2008 Shambhala Publications, Inc.

This is a great book of essays by some of my favorite Buddhist writers: Norman Fischer, Joseph Goldstein, Natalie Goldberg, Thich Nhat Hanh, Sylvia Boorstein, His Holiness the Dalai Lama, Pema Chodron.

I especially liked Noah Levine's Learning Forgiveness, Joanna Macy's Gratitude, and Traleg Kyabgon Rinpoche's The Practice of Lojong: Cultivating Compassion Through Training the Mind.

Enjoy!

One Thing You Can Do Today to Prevent Pain

 Look down at your feet. Seriously, take a look at your shoes.

 

• Are you wearing supportive shoes? Our mothers were right on this one. Good shoes are supportive. After all, your feet support all 100 plus pounds of your body weight. Yes, they are an investment; good shoes don’t come cheap.

• Repair worn down heels. Try having your shoemaker place soft rubber taps on the part of the heel that wears down, most often the outside border of the shoe. It’s an inexpensive way to significantly extend the life of your shoes.

• Throw out shoes where the inner soles are flattened and worn out. Similarly, throw out shoes where the outer soles are worn beyond repair. 

If you walk a lot, keep your shoes in good repair. Your feet, and thus your shoes, provide a hopefully stable base of support to your ankles, knees, hips and all of the other joints in your body. It can be only a millimeter or two of an uneven shoe sole that aggravates your foot or knee pain, or causes you to trip and fall. 

Most people haven’t a clue that their shoes are worn out. “But I just got these shoes last year.” For people who walk a lot, and that is most New Yorkers, you need to make friends with your local cobbler. They will save you money on new shoes and doctor’s bills.

Loafers do not provide good support. They’re okay to wear around the office if you are sitting most of the day or if you are blessed with strong feet and arches. (Most people aren’t.)

High heels are great to look at but hell on your feet, knees, ankles, hips and back. The higher the heel, the more the distortion to the entire skeleton. Enough said.

When someone comes to me with foot, ankle or knee pain, I include an evaluation of their shoes. It is surprising how adopting this one simple recommendation can suddenly clear up what seems to be a perplexing problem.

So, if you suddenly -- for no discernible reason -- develop pain in your feet or legs, take a good look at your shoes. 

Tips to Prevent Back Injury

Tips to Prevent Back Injury - The Iliopsoas Muscle

You may wonder why it might be a good idea to avoid double leg lifts, whether your knees are bent or extended, if you have a history of back pain. In yogic terms, this would include boat (navasana) and its variations.

Q: Why would double leg lifts re-injure the back?

A: Because of an unequal and excessive pull on the spine and hips by the iliopsoas muscles, considered to be the primary hip flexors.

The psoas major has its origins on the spine at vertebrae T12 and throughout the lumbar spine on L1 through L5. The iliacus arises on the inside of the hip bone, the ilium. They both attach on the femur on the lesser trochanter. They also serve as important postural muscles.

Let’s look at this more closely. In almost every patient that I have treated for low back pain or injury, including sacro-iliac problems and sciatica, she also shows a curvature, or rotation, of her spine. This curvature may be an acquired scoliosis, from injury or unequal use of the body over time. Overuse of the right side of the body is common -- we live in a right handed world. (Quickly, what hand are you holding your mouse with?) Or, she might have classic scoliosis, called idiopathic scoliosis, which develops in children, usually around adolesence and seems to run in families. This means that the psoas muscles, arising from your low back, are pulling unequally on either side of the curve or rotation in your spine.

Further, the legs have weight. Together, they are approximately 40% of your entire body weight. In a 150 lb. person, if one leg weighs 150 x .20 = 30 lbs., then both legs together weigh 60 lbs. 

In a double leg lift, whether you are lying on your back or in the boat pose, whether your legs are bent or straight, the psoas have to move and hold 60 lbs. This is exerting a pull of at least 60 lbs. directly on your back. 

Think about it. If you lift, or worse, hold in an isometric contraction as we do in navasana, that much weight on an unstable back -- a back which is rotated and uneven on top of an unstable and rotated pelvis -- then does it make sense that you might feel or develop pain in your back? 

Remember, an unequal pull of the iliopsoas muscles will only exacerbate an already unstable situation, leading to back strain, reinjury and pain. And, we haven't begun to mention that the different fibers of the psoas, at its multiple insertions on 5 vertebrae in the low back, pull unequally and different points in the movement cycle.

Free Your Body - Part I

 Free your mind and the rest will follow. 

                                        En Vogue

Free Your Body - Part I

These days I am thinking about freeing the pelvis. I keep coming at the topic from different perspectives. While swimming laps today, I was stimulated to think about it in yet another way.

To have an efficient swim stroke, it needs to be relaxed. In the crawl or free style, you let the body roll when you turn the neck and face to get air. You let the spine move side to side, like a fish, when you are stroking and kicking. For a swimming novice, this may seem counterintuitive. You might think that if you hold the body in a straight line, and just turn the head and neck, it would be a more efficient way to swim. If you say "rigid" to your body, you will tend to move that way. And, if you swim that way, what you really might get is a stiff and sore neck.

When I let the body roll from the pelvis, I decrease the cranking on my neck. Today I discovered that if I pushed my face down -- again very counterintuitive -- in the roll, it further integrated my ability to roll in a unit. First, I initiated the roll from my pelvis, which I cued silently to myself as “move the pubic bone.” Then, as I began the turn of my head, I pushed my head into the water. The buoyancy of the water itself facilitated the head turn rather than using my neck muscle to lift and turn the head. It felt great.

I was able to relax into the water, to let my weight drop further into it to allow the water's buoyancy to, well, buoy me.

We can do the same thing in gravity. By pushing down into gravity through our feet, we can engage more directly with the ground reaction force, which travels in an equal and opposite direction from gravity. By pushing down through the feet and releasing the weight into gravity, we can more effortlessly stand taller. We discover buoyancy and ease in our everyday movements, like walking, standing and sitting. I will elaborate more on this topic in days to come.

Holding On vs. Letting Go

Now think about the concept of “holding the body.” When you arae learning a new movement activity, whether it be dance or tennis, there is a tendency to hold tension all over the body, using extra effort to learn the new skill. Movement cuts paths through space. Our bodies move in space. Until the motor pathways are well established in the brain, the movements tend to be inefficient and to take a lot of extra effort. With practice, practice being key here, there are well-established neuronal pathways laid down. Over time, and with lots and lots of practice, the movements become easier. You use less tension to accomplish them. You are able to do more. You have more fun.

We often think of it as kinetic or muscle memory. Really, it is that new motor pathways have been laid down in the brain. Further, if you have aptitude and a good teacher, these movements over time will be increasingly efficient and effortless. Think of the best dancers. They seem to throw away all technique and to move effortlessly.

Practice Practice Practice

After a cerebral vascular accident, also known as a stroke, we can see varying degrees of recovery. Sure the first factor is the severity of the stroke and the extent to which different areas of the brain are damaged. Another significant factor, in my experience, is that those people who had a good fitness level before the stroke did better. It is probable that because they had developed more in terms of quantity and diversity of motor pathways in the brain, that when the brain was damaged in the stroke, they had a head start on recovery. Maybe the motor pathways are deeper, cut in deeper grooves. Certainly, they are more plentiful.

Is it similar in psychological terms? The more one practices anger, say, the angrier one gets. Is this because we have deeply embedded the neuronal processes and pathways that spark anger? Is this why cognitive-behavioral therapies have such a good track record with depression, because they teach the patient how not to just keep repeating the same old patterns -- cognitively, emotionally or behaviorally -- but to establish new ways of thinking and behaving. In essence, beyond the mystical and mysterious results of seeing the changes in one’s thoughts, emotions and behaviors, are we simply establishing new neuronal pathways?

We let go of the tension to have greater freedom of thought and movement. To have greater possibility.

More to follow in days to  come.

When is Less More

Just for today can you tune into what brings you pleasure? No, what really brings you pleasure?

Do you need to rest? Do you need to exercise? If you didn’t sleep well last night, what might you do to help you get a good night’s sleep tonight? Do you feel lonely? Or do you need more alone time?

Do you need to push yourself or lie back a little today? How about food? Take a minute. Check in to see what your body really needs in terms of nourishment. Or relaxation. Or stimulation.

Is it time to take a day off? Or would you feel better abandoning the comfort of procrastination and getting to work on that project you are excited (and maybe fearful) about.

Can you pause right now to tune into what you’re really feeling and thinking. Then, can you do just one thing that will make you happy. Just one little thing -- whether it’s indulging in a 10-minute nap in the afternoon or putting 15 minutes into the project you keep pushing to the side.

Just for today, maybe less is more.

The Role of Posture in Pain

I've discussed before how important your posture is to preventing and treating pain. Posture is how you hold your body up against gravity. It's the picture of your body in space, sitting in the chair, standing up or lying down. It is how you move your body to get from one place to another. Posture is dynamic.*

Most of my clients' physical therapy goals are simple. First and foremost, they want to get rid of pain. They also want to be able to get back to doing everything they did before the onset of pain, injury or surgery.

How we go about doing this is the interesting question. It varies with each patient with whom I have the privilege to work. In physical therapy, the overarching principle is to bring the body back into balance, with itself and within the gravitational field, the constant force within which we all live. We seek to strengthen weaknesses, to relax tense muscles and to open tight areas of the body.

Since the body is a dynamic structure, it is changing all the time. It changes with activity and even with our thoughts, especially the habitual ones.

Learning how to move with ease is a challenge, mostly because of inefficient habits. It usually is not the case that we stand, walk or sit with too little muscular effort, but with too much effort. We habitually hold tension in our muscles, partly in reaction to stress, but also in reaction to gravity pulling on body parts that are out of alignment with gravity. It really is a mind-body thing. Muscles that should be working may become weak and out of balance because of habitual patterns and chronic tension. Chronically tense muscles typically become tight, thereby creating muscle imbalances in a joint or even an entire area of the body.

Finding the weak areas in the movement chain is the therapist's job. There can be some surprising discoveries along the way. Everybody has a unique posture and a unique walk, as individual as her fingerprints. She also expresses varying degrees of composite, predictable movement patterns -- forward head and rounded shoulders with compressed breathing, for example.

Because we sit at chairs, desks and in front of computers all day, we might develop neck, back, shoulder or forearm pain. When the back of our necks and trunks are slumped forward, those muscles become overstretched and weak. The muscles may develop too much tension in them in their chronic effort to hold the head and trunk up from falling over and into gravity. We might develop shoulder impingement problems because of slouching forward at the desk. Our forearms may become sore and painful because of working on the computer. (Did you know that we see more cases of tennis elbow (aka lateral epicondylitis) from overuse of the mouse and keyboard, combined with poor ergonomics, than we ever have from people playing tennis?)

Besides poor posture, things that contribute to dynamic functional weaknesses are too little exercise, the wrong kind of exercise, fatigue and stress. In New York, most of us walk quite a bit, so footwear is important. (This could be the topic for another blog.) Walking on hard concrete, rather than loamy soil, may keep us pointed in the right direction, in a beeline for work and home, but this moving in 2-dimensions on concrete, may create weaknesses in our core muscles, especially the pelvic stabilizing muscles of the gluteus medius and minimii.

What are the core muscles? Are they only the abdominal muscles? Or, does the core also include the lateral and posterior hip muscles? Answer: yes, the core includes the abdominal as well as the surrounding hip musculature.

Did you know that your flat and fallen arches might be the primary cause of your neck pain?  Or your knee pain? Your hip and back pain? The weakness in your core? Or that your shoes, slightly worn down on their outer edges, may be causing your knee or hip pain? Did you know that either having the heels of your shoes fixed or buying a new pair of shoes can immediately give you relief? Sometimes the fix to your problem actually may be that simple!

There are many ways to improve your alignment, but standing up straight with your shoulders back may not be one of them. Learning Mountain and Tree poses in Yoga are wonderful tools to breathe in upright alignment. Ideokinesis is a wonderful tool for learning alignment. Ballet and other dance forms are excellent ways to learn about developing strong posture. Tai chi not only improves balance and posture, but teaches you how to move from your center (your core), as well.

*For purposes of this blog, I will alternately and interchangeably use the words posture and alignment, which essentially mean the same thing.