You’ll Be Ready to Move After This Short Series of Spine Stretches

This was originally published in Yoga Journal. Read the original story and watch the video here.

Dr. Ingrid Yang, yoga teacher, yoga therapist, and YJ’s September/October cover model, shares a 4-minute practice to warm-up your spine.

It’s been said that you’re only as young as your spine is flexible, and there’s some truth to that. The spinal cord holds our lifeforce energy, so warming it up properly before any form of movement—including yoga—not only helps unleash that energy, but also supports your spine’s health (and yours).

In this short practice, Dr. Ingrid Yang—yoga teacher, yoga therapist, and YJ’s September/October cover model—guides us through stretches that move your spine in every direction, so you’ll be ready to flow.

This Doctor Pioneered a Breathing Technique for COVID-19 Patients

This article was originally published in Yoga Journal. Read the full article here.

There’s only one window in the hospital room. It doesn’t open, but it stretches nearly the entire length of the wall, from built-in bench to ceiling, inviting light into the otherwise stark space. A large treble clef sculpture centers a modest fountain in the courtyard outside. On one of San Diego’s classic unseasonably warm April mornings, the air catches and carries the dancing water droplets to the ground. Inside, an orchestral performance of a different sort unfolds.

Here, in the COVID unit of Sharp Memorial Hospital, mechanical whirring replaces the string section, pumping medical devices sub for the woodwinds, and a sharp, irregular intake of crackling breath establishes the bass rhythm. This last instrument belongs to Vernon, a man in his 60s who was diagnosed with COVID-19 two weeks prior. Tubes in his nostrils meet in a V under his chin where they flow to the oxygen tank sitting at his side. His eyes are closed, his maskless face relaxed, hospital sock–adorned feet planted evenly on the ground as he sits in front of the window, the treble clef fountain at his back.

Knee to knee with Vernon sits hospitalist-physician Ingrid Yang, MD. Her hands gracefully carve the space between her and Vernon, gesturing as she conducts a symphony of yoga therapy. “We’re going to inhale through the nose, three, two, one,” she says, drawing her hands slowly upward as together she and Vernon expand chest and belly. “Hold for a count of three, two, one. Exhale through pursed lips—try to depress, use the contraction of the diaphragm—that’s nice.”

There’s a musicality to Yang’s presence, from her bell-clear voice and cadence of speech to the rhythmic way she moves through the world. A trained Reiki healer, she’s a master of shifting energy—almost visibly sculpting it at all times, knowingly or not. She gestures continuously as she speaks, leading Vernon through a pranayama-based protocol she developed that’s so simple it could easily be dismissed. But when dealing with a virus that steals breath from those it infects, where the dominant prescription has been isolation, breathing together creates a life-changing connection for Yang and her patients.

Heart uncentered

After emigrating from Taiwan in the 1970s, Yang’s parents—Christine, an attorney, and James, a physician—settled in Newport Beach, California. As immigrants, they had to adjust their priorities, Yang says, replacing sentiment with success in order to survive—a way of life they instilled in Yang and her older brother as well. “Surviving means having job security, and a title so that you’re indispensable enough to not be marginalized,” Yang says.

Feelings were neither tolerated nor nurtured in her home, so Yang buried hers. She learned to play the role others expected of her as an Asian-American girl, to be “good” and “quiet”—but as a result, an internal disconnect grew: Intellectually, Yang understood her value as a motivated, high-achieving young woman, but she struggled to embody much beyond that emotionally.

At 18 years old, she found herself an anxious, type-A freshman at Barnard College of Columbia University in New York City. She tried a few yoga classes at a friend’s recommendation, but struggled to connect to the practice.

And then, it happened: One day in class, Yang moved into Trikonasana (Triangle Pose). She turned her head to bring her gaze to the ceiling, breathed into the posture, and felt an unfamiliar lightness. A knowing spread throughout her, that she didn’t have to be anywhere or accomplish anything, that she could simply breathe.

“It was the heart expansion,” says Yang, who’s now E-RYT 500 and C-IAYT certified, and who co-authored the book Adaptive Yoga last year. “The actual physical space of my heart, then taking a breath as I expanded the heart and connecting that thought, physical space, and breath. It all suddenly came together.”

At the same time that Yang was exploring this new relationship with yoga, she also developed a bond with her Aunt Shiu-mei, who worked in a lab at Columbia. Shiu-mei brought her niece lunch and helped her with homework. When Yang needed a break from the city, she decamped to Shiu-mei’s New Jersey home for a weekend of cooking, eating, and talking. Where Yang’s parents had been all work and no play, Shiu-mei’s life was full of social outings and travel, of joy and independence. Shiu-mei gave Yang something she hadn’t before experienced—a soft, nurturing kind of love.

Dharma realized

Over time, yoga helped Yang reconnect with the heart she’d been discouraged from nourishing for so long. After completing her yoga teacher training in 2005, she started leading vinyasa classes—something she continued all the way through law school at Duke University and into her first year as a corporate lawyer back in New York City.

In 2005, Yang was 25 years old, making six figures, and killing it by her parents’ standards. But her gut wasn’t sold on this version of success. Then, while in Canada at teacher training, she got a call: Aunt Shiu-mei, who had recently developed idiopathic pulmonary fibrosis—a lung condition that makes breathing incredibly difficult—had suffered a stroke.

Immediately, Yang booked a flight to be at her aunt’s bedside. When Shiu-mei took her final breaths, her niece was there. “Her passing lit both a light bulb above my head and a fire under my ass,” Yang says. Hit by the quickness and fragility of life, she walked away from practicing law, which she’d never truly enjoyed, a few months later. She returned to North Carolina to open a yoga center. “For the first time in my life, I actually followed my instincts,” she says. Her parents looked on in fear, Yang says, believing their daughter was trading in her laudable career to become a gym teacher.

Blue Point Yoga opened directly across from Duke Medical Center in 2006 and was a fast success. The nurses, doctors, and specialists who filled Yang’s classes were curious, posing all sorts of questions about the mechanics of the practice that she didn’t feel equipped to answer. So she researched anatomy and kinesiology in her free time and discussed science in her instruction. Yang loved learning about the intrinsic relationship between yoga and science. She confided in an old friend, who was an oncologist at Duke, that if she could do it all again, she’d be a doctor. “What do you mean, do it all again?” the friend replied. “You’re 27! You still can.” It was all the encouragement Yang needed. In August 2011, Yang entered medical school at Rush Medical College in Chicago.

An inflamed response

The summer of 2020 passed in a haze of disconnect. Uncertainty sat on the shoulder of every decision made, colored by a draining combination of simultaneous information overload and asphyxiation as Yang, in her second year as an attending physician with Sharp-Rees Stealy Medical Group, and her fellow health care workers grasped for any bit of intel that could shift the wind.

Dozens of beds were filled in the COVID unit at Sharp Memorial, hidden behind two sets of doors that Yang could enter only after adorning herself in full PPE. Inside the unit, Yang would stand outside her patients’ doors before entering, watching them gasp for breath, even with the help of a machine. Looking through the door’s window, Yang realized she was mirroring her patients: She had stopped breathing.

Instinctively, her yoga training kicked in. Yang began taking a few breaths to ensure she was present before entering each patient’s room. “Taking this deep breath before I went in was an acknowledgement—that this is really hard, this is all really, really difficult—and then, in that process of caring for myself, being able to let it go and leave it at the door so I could really be there with my patients,” Yang says. It helped. Soon, she wondered whether simple breathing exercises could help her patients, too.

Breathing into Discomfort

COVID-19 starts as an infection in the respiratory system, a nexus that stretches from nose to lungs. Medical experts hypothesize that when your body detects the virus, it reacts with persistent inflammation—a self-healing response that simultaneously throws the body into a constant state of high alert, which in turn wreaks havoc on your organs and tissues, such as those your respiratory system relies on for oxygenation. But yoga practitioners like Yang know there’s a breadth of research to support a different solution.

“Yoga is uniquely suited to assist with COVID-19 recovery,” Yang says. “All the techniques we’re using in pulmonary rehab—comprehensive treatment program for people with acute lung injury—are yoga techniques. We’ve been doing pranayama, we just haven’t been calling it that

Yang is referring to the large body of research supported by the National Institutes of Health on the negative link between yoga and inflammation. A 2012 study, for instance, showed that people with more-regular yoga practices have lower levels of the chemical leptin, which encourages inflammation, and higher levels of adiponectin, which inhibits it. So, Yang hypothesized, yoga ought to be able to help treat the inflammation that causes COVID patients’ most damning symptoms.

When Yang first brought breathing exercises to her COVID-19 patients, she wasn’t intending to treat the virus specifically, but to help her patients feel better generally, to enjoy and benefit from some sense of connection (to Yang, to an activity, to their breath). But the more she incorporated pranayama into her rounds—encouraging her patients to take a mindful pause and a series of deep, diaphragmatic breaths—the more her lens shifted and the practice evolved from an exercise into a protocol. By applying a yogic scope to diaphragmatic breathing, Yang realized she would have two rich bodies of work to reference—her yoga training and her medical training—the marriage of which could guide others in working with COVID-19 long-haulers, as she writes about in the winter 2021 issue of Yoga Therapy Today.

“Diaphragmatic breathing exercises can work to strengthen weak respiratory muscles,” writes Yang about pulmonary complications. “After all, the diaphragm is a muscle, and people often experience global weakness post-COVID. Exercising and strengthening the diaphragm will benefit any postviral syndrome or inflamed physiology. … The primary goal is to strengthen the lungs and their supporting musculature; the secondary benefit is relaxation and activating the parasympathetic nervous system.”

More recently, Yang has been meeting with the hospital’s physical therapists to discuss how to implement the breathing practice more widely, and regularly lectures via webinars to help educate yoga therapists when it comes to aiding their patients with recovery.

Yoga therapeutics for COVID-19 go beyond breathing-related manifestations, Yang says. Movement helps ease vascular blood clots caused by virus-caused tissue damage and inflammation; the lung expansion that comes with Salabhasana (Locust Pose, also called “proning” in the medical field, and a favorite recommendation of Yang’s) soothes musculoskeletal complications; and mindfulness meditation or yoga nidra serves as a powerful therapy for the emotional trauma and disconnect that COVID-19 leaves in its wake.

Underlying each therapy, no matter the symptom or cause, is connection, and in this way, yoga serves one of our most basic human needs.

“In some ways, it’s my job to save lives, which is a little hyperbolic—most days I’m just helping people get through their chronic medical issues. But if I can give them a piece of what saved my life, my self-worth, my heart…” Yang trails off. “We underestimate the degree to which connection and heartfelt love and permission to feel can affect people’s healing, and yoga gave me that permission.”

Not Just a Pain in the Brain: Yoga Therapy and Headache Disorders

Originally published in Yoga Therapy Today, a publication of the International Association of Yoga Therapists (www.iayt.org). Shared with permission.

Headaches are a universal human experience. According to the World Health Organization’s (WHO) 2016 Fact Sheet on Headache Disorders, 50%–75% of people over 18 suffered from a headache within the previous year. Of the people reporting, 30% described their headaches as migraines—and migraines rank sixth in the world for losses due to disability, from productivity and wages to quality of life. More painful to note: As many as 4% of people worldwide are estimated to have 15 or more “headache days” per month. Finding relief for patients suffering headaches has been the goal for Western medicine as well as holistic care. 

Headache Types and Pathologies 

The limbic system is involved in the emotional, behavioral, memo ry-storage, and fear responses to pain. The ventrobasal (front-lower) portion of the thalamus sends projections to the somatosensory cor tex, where pain discrimination (sensing of contrasts) and localiza tion are thought to occur. The medial (closer to the center) thalamus projects to the frontal cortex, where the affective and motivational responses to pain are believed to be mediated. In addition, evidence from positron emission tomography (PET) scans shows that the medial thalamus may participate in the transmission of both dis criminative and affective components of pain.1 This complex network demonstrates the importance of the thalamus in the prop agation of headache pain. Nonetheless, there are many causes of headache pain that should be understood by the yoga therapist—I will delineate below based on the type of headache. 

Headaches fall into two cate gories, primary and secondary, with the assigned category relating to the underlying pathology. By definition, pri mary headaches are not associ ated with any type of preexist ing medical condition and comprise the overwhelming majority of recurring head aches. Given their high preva lence, this article will focus on primary headaches. There are three main types of primary headaches: migraines, tension type headaches (TTH), and cluster headaches. 

Particularly in primary headaches, meditation has been found to decrease headache intensity and frequency with no associated side-effects. 

Under normal physiological conditions, the brain itself is large ly insensate. Head pain occurs when nociceptive nerves (inflamma tion/chemical damage receptors) within the trigeminal, vagus, and glossopharyngeal cranial nerves (three of the cranial nerves) or the upper cervical roots are stimulated.1 To describe this phenomenon in scientific terms, from the trigeminal nucleus (the cell origin of the largest cranial nerve), nerve fibers transmit information that projects into deeper brain sites and further into the brainstem and thalamus (the sensory-system “hub” of our brains). From the brainstem and thalamus, information carrying pain sensations from the body is transmitted to other areas of the brain, such as limbic areas. 

For most people, migraines arise from a complex genetic disor der with susceptibility that depends on specific genetic variants. The details of these genetic predispositions for migraine disorders are not entirely understood. What we do know is that, with migraines, cere brovascular (the blood vessels in the brain) and meningeal (the membrane that protects the brain and houses a vast network of nerves) pain stimulation may predominate. 

Traditional theories of the cause of migraines fall into two cat egories: vasogenic (blood-supply based) and neurogenic (nerve based). With vasogenic migraines, the theory is that intracranial vasoconstriction (reactionary narrowing of the blood vessels within the brain resulting in a change of blood flow) is responsible for the aura portion of migraines, and the subsequent headache results from rebound blood-vessel dilation, distention of vessels within the brain, and inflammation of the sensory neurons that line these 

hyperexcitation of the neurons moves across the brain’s cortex after chemical or mechanical disturbances. This hyperexcitation then causes a series of reactions that result in meningeal irritation and changes in the intracranial blood flow, precipitating migraines. 

Tension-Type Headaches 

Tension-type headaches are the least understood in headache pathology. These are the most common of primary headache disor ders, yet TTHs continue to defy a single pathophysiological expla nation. The importance of muscular and myofascial structures is acknowledged in many, but not all, cases of this type of headache. Given the focus on muscular and myofascial input in TTH, it is helpful to understand that myofascial stretching with yoga can help in this condition, as discussed below. 

Cluster Headaches 

Historically, little was known about the cause of cluster headaches. New speculation suggests that cluster headaches are caused by pathophysiological events that activate the trigeminal-vascular sys tem. (The trigeminal, cranial nerve V, is the largest cranial nerve, with projections through the face, head, and neck.) In this syndrome, pain is manifested in the first and second trigeminal division, causing sympathetic activation (usually represented as sweating of the forehead and face), sympathetic dysfunction (Horner’s syndrome, which is a droopy eyelid and constricted pupil on one side), and parasympathetic activation (tearing and nasal congestion). This array of symptoms is thought to be due to abnor malities at the point where the ophthalmic and maxillary trigeminal nerves converge. 

Medical Management of Headaches 

Headaches have traditionally been managed with medications. With that in mind, it is important to note that only half of people with headache disorders actually obtain relief with medications. Furthermore, those treated with medications often discontinue their treatment because of unwanted side-effects. Even worse, over use of medications in an attempt to manage headaches can often lead to a phenomenon called “medication-overuse headaches,” in which the quality and duration of headaches actually worsen. Another unfortunate paradox of headache management is that discontinuing medications after regular and frequent use may lead to rebound headaches. Because of these poor outcomes, side-effects, and sequelae due to medication use, complementary and alternative medicine has become common practice in headache management.2 

Yoga Therapy for Headache Management 

Yoga has been reported as a safe and cost-effective intervention for managing headache pain.3 A growing body of evidence supports the belief that yoga benefits both physical and psychosocial health through the mechanisms of downregulation of the sympathetic nervous system and the hypothalamic-pituitary-adrenal axis.4 As a result, yoga can play a vital role in reducing sympathetic activity, increasing parasympathetic activity, improving the quality of life, and decreasing pain levels when managing headaches.5 

To support headache sufferers with yoga therapy, the practi tioner must start with a specific and detailed client history. This his tory needs to contain information about the client’s headaches, including frequency; duration; character; severity; location; quality; and the factors that trigger, aggravate, or alleviate the symptoms. With yoga therapy, a significant change in the nervous system demonstrating improved vagal tone and reduced sympathetic (fight or-flight) activity has been observed.6 This further resulted in improved cardiac autonomic balance. These findings indicate that adjuvant yoga therapy may be effective for people with migraines. 

When recording the history, it is important to ask about specific lifestyle habits, such as diet, caffeine use, sleep habits, work, or personal stress. Any contributing factors should also be uncovered during history taking such as associated sleep disorders, depression, anxiety, and/or other underlying medical disorders. If any contributing factors are revealed at this time, consider referral to a qualified medical professional for further workup and evaluation of these underlying conditions. Be sure to also ask about relevant family history because, as mentioned above, some individuals have a genetic 

Science for the Yoga Therapist 

vessels, may help in reducing migraine attacks.8 NO plays a key role in regulating brain metabolism, cerebral circulation, and blood vessel function. It is one of the factors for modulating cerebral blood flow in response to changes in oxygen and carbon dioxide levels within the blood vessels. Repeated exercises that increase NO and sustain its levels within the blood have been demonstrated to decrease migraine frequency, severity, and duration.9 Thus, pranaya ma may be particularly beneficial for headaches, and in particular, for migraines, because studies have shown the improvement of NO levels due to pranayama practices.8 

Breathwork 

The conscious breathing of pranayama is known to have a calming effect on the nervous system and emotions, such as reduced fear and anxiety.10 Pranayama may further help to diminish tensions that have accumulated around the forehead, temples, neck, and shoul ders.11 Studies have shown that pranayama can lead to more oxygen delivery to the whole body, including to the heart and brain.12 As a lowered blood oxygen level is one of the risk factors of migraine, learning to efficiently use oxygen with pranayama can be a potential solution. Pranayama has been offered as a method for balancing the autonomic nervous system and has a powerful influence on stress release, as stress is a significant risk factor for vascular dysfunctions.11 

I will not be so bold as to offer specific pranayama techniques for relief of migraines; the choices of technique will largely depend on the individual and on your history-taking, as stated above. I will note, however, that one specific study mentioned using kapalabhati (skull-shining breath or breath of fire) and demonstrated improve ment in NO levels and lessening of migraine severity with this technique.8 

Mechanical Stretches of Muscles and Fascia 

If done correctly, yoga can significantly release tensions accumulat ed around the areas of pain (often the forehead, temples, neck, and/or shoulders).9 For headaches specifically, yoga postures can tar get stretching of the neck, shoulder, and back muscles, followed by relaxation. Teaching correct posture (ergonomically speaking) and the stretching of cervical spine muscles can also be helpful, especial ly for TTH.13,14 As tight muscles can trigger headaches, yoga could potentially assist in alleviating symptoms of TTH. 

predisposition for migraines.7 Above all, as always, yoga therapists must remember to stay within their scope of practice and refer patients to qualified medical professionals for support with any issues that will not or should not be addressed by yoga therapy. 

The Role of Nitric Oxide 

It is thought that the practice of yoga may increase nitric oxide (NO) levels in the cardiovascular system and even in specific parts of the body (see “Nitric Oxide & Mouth Breathing: Physiology You Want to Understand,” by Heidi Dickerson, DDS, at www.lviglobal.com/wp-content/uploads/2017/06/NitricOxideMouthBreathing.pdf ). 

The theory behind this is that NO, a crucial and global signal ing chemical made in and excreted from the lining of the blood. Studies also demonstrate that specific stretches and manual therapies for the neck can be helpful in headache relief.15 

Again, I will not opine upon exact postures to practice with clients, as every individual’s anatomy will be different, and again, your history-taking may reveal contraindications to head and neck stretching to end ranges. As always, working with clients one to one to determine appropriate practices will be the key to efficacy and safety.

Yoga as Exercise 

The use of exercise as a prophylactic treatment for headaches has been researched and is recommended by clinicians more regularly for headache prevention. Studies have shown that exercise has a therapeutic effect on migraines by increasing blood levels of endor phins and pain-relieving hormones. However, it is important to note that intense exercise also paradoxically triggers increased calcitonin gene-related peptide (CGRP) and lactate levels, which may be a sign of increased inflammation,14 and thus sustain an environment to induce headaches. Therefore, although exercise may be indicated to increase pain-relieving hormones, a balance must be struck regard ing the intensity and duration of exercise. 

This is where yoga may play a particularly helpful role in headache relief. Because yogic postures can be performed slowly and mindfully, along with breathing and relaxation exercises and pranayama, this type of physical activity may prevent an increase in CGRP and lactate levels. Thus, yoga, as a measured form of exercise with individualized pacing, may be particularly well-suited for headache prevention, with performance causing the release of pain relieving hormones and neurotransmitters while avoiding the release of potentially pain-inducing substances. 

Meditation 

Meditation is known to reduce headache duration and disability while increasing self-efficacy and mindfulness. Particularly in pri mary headaches, meditation has been found to decrease headache intensity and frequency with no associated side-effects.16 Moreover, meditation has been shown to significantly improve self-efficacy,

which is the ability to motivate, follow through, and complete tasks unaided. When self-efficacy is elevated, people have a better quality of life. The studies are varied regarding meditation techniques; cur rent guidance is simply to incorporate mindfulness-based exercises into yoga therapy for headaches.17 Similarly, positive effects of headache reduction have been found in other relaxation exercises, such as Yoga Nidra and guided relaxation. 

A Case for Yoga Nidra 

Although there is currently no specific published research 

Yoga nidra meditation has been associated with increased endogenous dopamine release in the brain.21 (Dopamine is current ly seen as a neurotransmitter closely tied to our ability to think, plan, act, and experience pleasure.) As practitioners ourselves, we know that Yoga Nidra can cause us to feel ease and pleasure by decreasing our overall feelings of stress. And if generalized stress reduction can decrease headaches symptoms in clients, it is always worth a try. 

Yoga Therapy—A Frontier in Headache Treatment? 

As yoga therapists have long known, a sustained and continued yoga practice can contribute to a state of calm alertness and an increase in parasympathetic activation.22 This tones the stress-response systems and releases hormones that improve feelings of happiness and well being. In addition, yoga asana also improves physical and mental processes and helps relieve stress and anxiety, factors known to intensify migraine onset, severity, and frequency. 

The system of yoga is a powerful tool that helps to build a com prehensive skillset of synergistic processes to improve function and quality of life. Within these processes, headache symptoms can be alleviated, lessened, or prevented. Yogic practices facilitate bidirec tional feedback and integration between high- and low-level brain networks. This makes yoga a unique therapy for balancing the auto nomic nervous system and influencing physical, psychological, and stress-related disorders, such as headaches. Introducing yogic tech niques to clients with chronic conditions of all kinds could mean symptom relief, and helping them to keep an open mind could be life-changing. YTT 

 

References 

  1. Warfield, C. A., Bajwa, Z. H., & Wootton, R. J. (2016). Principles and practice of pain medicine (3rd ed.). McGraw Hill Education/Medical. 
  2. Sang-Dol, K. (2015). Effects of yoga exercises for headaches: A systematic review of randomized controlled trials. Journal of Physical Therapy Science, 27(7), 2377–2380. https:// doi:10.1589/jpts.27.2377 
  3. Brummer, M. (2005). Yoga and ayurveda for headaches and migraines. Positive Health Online: Integrated Medicine for the 21st Century, 110, 45–48. Retrieved from www.positivehealth.com/article/yoga/yoga-and-ayurveda-for-headaches-and migraines 
  4. Sharma, M. (2014). Yoga as an alternative and complementary approach for stress management: A systematic review. Journal of Evidence-Based Complementary Alternative Medicine, 19(1), 59–67. https://doi:10.1177/2156587213503344
  5. Evans, S., Subramanian, S., & Sternlieb, B., (2008). Yoga as treatment for chron ic pain conditions: A literature review. International Journal on Disability and Human Development, 7(1), 25–32. https://doi.org/10.1515/IJDHD.2008.7.1.25
  6. Kisan, R., Sujan, M., Adoor, M., Rao, R., Nalini, A., Kutty, B., . . . Sathyaprabha, T. N. (2014). Effect of yoga on migraine: A comprehensive study using clinical pro file and cardiac autonomic functions. International Journal of Yoga, 7(2), 126–132. https://doi:10.4103/0973-6131.133891
  7. Rizzoli, P., & Mullally, W. J. (2018). Headache. American Journal of Medicine, 131(1), 17–24. https://doi:10.1016/j.amjmed.2017.09.005
  8. Boroujeni, M. Z., Marandi, S. M., Esfarjani, F., Sattar, M., Shaygannejad, V., & Javanmard, S. H. (2015). Yoga intervention on blood NO in female migraineurs. Advanced Biomedical Research, 4, 259. https://doi:10.4103/2277-9175.172995
  9. Narin, S. O., Pinar, L., Erbas, D., Oztürk, V., & Idiman, F. (2003). The effects of exercise and exercise-related changes in blood nitric oxide level on migraine headache. Clinical Rehabilitation, 17(6), 624–30. Boroujeni, M. Z., Marandi, S. M., Esfarjani, F., Sattar, M., Shaygannejad, V., & Javanmard, S. H. (2015). Yoga intervention on blood NO in female migraineurs. Advanced Biomedical Research, 4, 259. https://doi:10.1191/0269215503cr657oa
  10. John, P. J., Sharma, N., Sharma, C. M., & Kankane, A. (2007). Effectiveness of yoga therapy in the treatment of migraine without aura: A randomized controlled trial. Headache: The Journal of Head and Face Pain, 47(5), 654–661. https://doi:10.1111/j.1526-4610.2007.00789.x
  11. Dabhade, A. M., Pawar, B. H., Ghunage, M. S., & Ghunage, V. M. (2012). Effect of pranayama (breathing exercise) on arrhythmias in the human heart. Explore, 8(1), 12–15. https://doi:10.1016/j.explore.2011.10.004 13. Hammill, J. M., Cook, T. M., & Rosecrance, J. C. (1996). Effectiveness of a physical therapy regimen in the treatment of tension-type headache. Headache: The Journal of Head and Face Pain, 36(3), 149–153. 
  12. https://doi:10.1016/j.explore.2011.10.004 Amin, F. M., Aristeidou, S., Baraldi, C., Czapinska-Ciepiela, E. K., Ariadni, D. D., Di Lenola, D., . . . European Headache Federation School of Advanced Studies. (2018). The association between migraine and physical exercise. Journal of Headache Pain, 19, 83. https://doi.org/10.1186/s10194-018-0902-y 15. Castien, R., & De Hertogh, W. (2019). A neuroscience perspective of physical treatment of headache and neck pain. Frontiers in Neurology, 10, 276. https://doi:10.3389/fneur.2019.00276 
  13. Gu, Q., Hou, J. C., & Fang, X. M. (2018). Mindfulness meditation for pri mary headache pain: A meta-analysis. Chinese Medical Journal, 131(7), 829–838. https://doi:10.4103/0366-6999.228242 
  14. Wells, R. E., Burch, R., Paulsen, R. H., Wayne, P. M., Houle, T. T., & Loder, E. (2014). Meditation for migraines: A pilot randomized controlled trial. Headache, 54(9), 1484–1495. https://doi:10.1111/head.12420 
  15. Kropp, P., Meyer, B., Dresler, T., Frische, G., Gaul, C., Niederberger, U., . . . Straube, A. (2017). Relaxation techniques and behavioural therapy for the
  16. treat ment of migraine: Guidelines from the German Migraine and Headache Society. Schmerz, 31(5), 433–447. https://doi:10.1007/s00482-017-0214-1
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  18. Ferreira-Vorkapic, C., Borba-Pinheiro, C. J., Marchioro, M., & Santana, D. (2018). The impact of yoga nidra and seated meditation on the mental health of college professors. International Journal of Yoga, 11(3), 215–223. https://doi:10.4103/ijoy.IJOY_57_17 
  19. Kjaer, T. W., Bertelsen, C., Piccini, P., Brooks, D., Alving, J., & Lou, H. C. (2002). Increased dopamine tone during meditation-induced change of conscious ness. Brain Research: Cognitive Brain Research, 13(2), 255–259. 
  20. Kumar, A., Bhatia, R., Sharma, G., Dhanlika, D., Vishnubhatla, S., Singh, R. K., . . . Srivastava, M. V. P. (2020). Effect of yoga as add-on therapy in migraine (CONTAIN): A randomized clinical trial. Neurology, 94(21), e2203–e2212 

The Mindful Yoga Journey of Dr. Ingrid Yang

This article was originally published in LA Yoga – read here.

Sharing a Mindful Yoga Journey as a Mindful Life Journey

The path to a meaningful life is far from straight and narrow. My professional career began as a stressed-out prelaw student-then-attorney, before I made the career leap to yoga teacher/studio owner in my mindful yoga journey.

While stepping away from law was a difficult decision, I realized that practicing medicine was my true calling, and the place where I could contribute most to the world. Even before I entered medical school, I knew in my heart that incorporating yoga could, and would be, beneficial and integral to how I would practice medicine.

Today, in my practice, I meld the wisdom and therapeutics of yoga with rigorous scientific investigation, creating the space for deeper healing and wellness.

Now, I am a physician and yoga therapist and two-time author. I use my skills as a former attorney to advocate for my patients. I am also an advisor for the tech wellness company obVus Solutions, where I design the breathing exercises featured in the award-winning minder® posture corrector + breathing coach app, lead health coaching, and host continuing education webinars for health professionals. It is an honor and a thrill to contribute to the world in such a unique and exciting way. And I have to say, gratefully, that I love my life. But a mindful yoga journey, or any journey, was not an easy path… It never is, is it?

The Path to Living my Purpose

Having participated in a few different careers, I feel I am truly living my purpose as a physician, advising and educating people on their health. I started practicing yoga because I needed it on a very personal level. Along this path, I had to ask myself really hard questions at times when the “right” answer seemed impossible to find.

In college, I was a type-A go-getter in New York City, full of ambition and energy. Yet, the stress and pressure I put on myself felt suffocating. I was anxious and rigid, both physically and spiritually. Luckily, a friend recommended yoga to help ease my emotional inflexibility. Yoga taught me that I could just breathe in each moment: I did not have to prove or accomplish anything. I could just breathe and exist. I had never felt so relieved.

In my medical practice, I have found that a blend of ancient and modern healing methods have proven to be highly effective as the Covid-19 pandemic crisis unfolded in 2020. As a frontline healthcare professional, my patients benefit from a unique blend of mindfulness, breathwork (pranayama), and yoga asana in ways that counter their unique challenges. I find that these techniques greatly benefit those who are suffering and recovering from the alarming effects of the virus and help create a deeper sense of calm, which facilitates healing.

A Mindful Yoga Journey Includes Breathwork

I believe that all my patients benefit from the inclusion of mindfulness and breathwork, and have observed that people generally experience more ease in recovery, both during their hospital stay and after they are discharged home. My hope is to see more of this type of awareness introduced to the general public, which is why I’ve taken on the role of advising tech-wellness company obVus Solutionson the breathing exercises featured on the minder app. It brings awareness to the general public on the importance of better posture and breathing, two components which are crucial to helping improve overall health. My mission is mindfulness, not just in fields of medicine and yoga, but for the wellbeing of our entire population.

My path as a physician and yoga therapist has allowed me to witness how a dedicated yoga practice, when made accessible to everybody, can truly change one’s path to wellness. My latest book, Adaptive Yoga, highlights a variety of physical and physiological conditions in populations who have historically felt that their disabilities precluded them from practicing physical yoga. The book illustrates variations and adaptations to poses, which provide therapeutic comfort and increased confidence to all yogis.

To that end, I teach weekend-long trainings on Adaptive Yoga, including at Prana Yoga Center in La Jolla, for both yoga and medical professionals. A highlight of the training is that it outlines the biomechanics of altered anatomy and physiology of numerous conditions and shows how best to adapt poses for these populations. The training also provides trauma informed mind-body principles and practices, which have been shown to help those with students lead healthier, fuller lives.  I am also presenting at the Global Yoga Therapy Conference, virtually, in August.

Cultivating Work/Life Balance

Despite all my responsibilities, I hold a healthy home/work balance high on my wellness checklist. As a yoga therapist, I understand first-hand how important a personal yoga practice is in helping to maintain this sometimes precarious balance. I like to get away to the LA retreat staple, Terranea, to practice yoga on the beach, commune with nature, and get away for quiet meditation while listening to the ocean waves. In my free time, I also turn to surfing, where I find solace in the mindfulness and presence of riding the waves.

“Surfing is simply another form of yoga practice, and the uncertainties and challenges of wave-riding mimic those experienced in everyday life; we breathe and flow in each moment, and as life presents itself to us and we allow ourselves the time and space to be aware, we can see that we flow in sync with nature’s intentions.”

In all of my years working with people on yoga mats and in hospital beds, I have seen firsthand that burnout and exhaustion are one of the major causes of physical illness and disease. I believe in the restorative power of stepping away from the chaos of our daily lives and the power of mindfully setting the intention of self-care; on a physical, mental and spiritual level.

Retreats with Dr Ingrid Yang

Over the past few years, I’ve led yoga and meditation retreats in various destinations, incorporating wellness and healthy living practices on all levels. I hope LA Yoga readers will join me for either or both of two upcoming destination retreats currently scheduled: One in Portugal, September 2021, and one in April 2022 located in beautiful Playa del Carmen, Mexico.

If there is one thing that makes us feel more alive, it is travel. I find travel takes me out of my comfort zone and helps me connect with nature, as well as old and new friends. I love to experience different cultures, which is why I lead yoga retreats in different countries around the world.

 

Yoga Is the Best Way to Feel Less Stress From Work

This article was originally published by VeryWellMind – view here.

Feeling stressed out about work? You might want to find some time to spend on a yoga mat. New research has found that yoga is particularly effective at reducing work-related stress.

A report published this month in the Journal of Occupational Health reviewed the findings of 15 trials on healthcare workers that involved various types of physical relaxation for stress relief. The analysis showed that while all physical relaxation techniques reduced work-related stress, yoga seemed to provide better results than other methods.1

Here’s a closer look at the findings, along with ways you can use yoga to relieve stress from your job.

Understanding Yoga and Stress Management

For the study, researchers from Nevada and Florida reviewed 15 randomized controlled trials that explored the use of physical relaxation methods for work-related stress among healthcare workers. The techniques studied in these trials included yoga or yoga-like exercises (tai chi and qigong), massage therapy, progressive muscle relaxation, and stretching exercises.

The trials involved a total of 688 healthcare workers, including mental health professionals, nurses, and staff at a Department of Veterans Affairs hospital. While not all studies included data on gender, those that did involved a majority of women participants.

The results showed that healthcare workers who tried any of the physical relaxation techniques experienced a significant reduction in occupational stress compared with control groups.

The researchers also conducted a network meta-analysis (a research technique used to compare multiple treatments in randomized controlled trials at the same time) to see which relaxation method was the most effective at easing work stress. They found that yoga was probably the best for stress relief, followed by massage therapy, progressive muscle relaxation, and stretching exercises.1

“This study reinforces the previous findings that yoga is a highly effective stress management practice for improving tolerance and resilience to stress and prevention of burnout,” says Sat Bir Singh Khalsa, PhD, assistant professor of medicine at Harvard Medical School and director of research at Yoga Alliance.

This study reinforces the previous findings that yoga is a highly effective stress management practice for improving tolerance and resilience to stress and prevention of burnout.
— SAT BIR SINGH KHALSA, PHD

Overall, this study offers a jumping-off point for further study on the potential for yoga to treat stress in people’s lives. Future research could help determine if one type of yoga is more beneficial than others, suggests Cheryl Albright, OTR/L, C-IAYT, an occupational therapist, yoga therapist, and owner of Soul to Soul Yoga in Lakewood Ranch, Florida.

“The analysis did not state which type of yoga was performed. The physical postures are only one limb of yoga—there are seven others, including breathing, singing mantra, meditation, and guided relaxation,” she says. “We have got to get out of the mindset that yoga is only physical postures.”

It could also be interesting to look at how yoga compares to primarily physical practices, such as aerobic exercise and dance, adds Dr. Khalsa.

Benefits of Yoga for Healthcare Workers

The findings of this study come at a particularly important time, considering the extraordinary amount of stress the pandemic has placed on healthcare workers. Research from May 2021 shows that nearly half of healthcare workers in the U.S. were experiencing burnout.2 Yoga could become a key part of a larger intervention aimed at providing relief to healthcare workers.

“As physicians, we have been trained to cure illnesses and heal our patients’ maladies. When it came to this novel disease, we felt completely helpless and loss of control over what we used to be able to offer remedies for,” explains Ingrid Yang, MD, JD, a physician, certified yoga therapist, and medical advisory board member to the wellness tech company obVus Solutions.

She continues, “Yoga is unique in that it allows us to sit with the discomfort of uncertainty and helplessness. Yoga’s connection with the breath and yoga’s underlying philosophy of being in the present moment allows us to let go of a predictable outcome and be open and ready for whatever any outcome, whether it is welcome or not.”

Furthermore, yoga can be a source of connection for healthcare workers who have felt isolated from colleagues, patients, and loved ones over the last year.

“Yoga, on its most basic level, is about connection. The actual translation of the word yoga in Sanskrit is ‘union,’” says Dr. Yang. “Union is our connection to all—to our breath, to our hearts, to nature, and to others. Yoga brings us back into connection when we feel lonely and disconnected.”

While this study was conducted on healthcare workers, experts believe that yoga can be beneficial for people in just about any other field, as well.

“There are many studies demonstrating the effectiveness of yoga on reducing stress for workers and people living with health conditions or chronic pain,” says Michelle R. Zechner, PhD, assistant professor in the department of psychiatric rehabilitation and counseling professionals at Rutgers School of Health Professions. “Yoga offers an integrated strategy to address stress that includes other physical relaxation techniques, including stretching, slowing down the breath, and relaxation practices.”

Getting Started With Yoga

The accessibility of yoga makes it a viable form of stress relief for people across the country. Data from the industry research group IBISWorld shows that there are more than 42,000 Pilates and yoga studios in the U.S.3

“It is usually best to take in-person yoga classes with an appropriately trained and qualified yoga instructor to ensure safe and effective yoga practice,” advises Dr. Khalsa. “Because there are many different styles, schools, and traditions of yoga practice, beginners should take some time to identify a yoga style and yoga teacher that are appropriate for their goals, interests, and personal life circumstances and limitations.”

Yoga is unique in that it allows us to sit with the discomfort of uncertainty and helplessness. Yoga’s connection with the breath and yoga’s underlying philosophy of being in the present moment allows us to let go of a predictable outcome and be open and ready for whatever any outcome, whether it is welcome or not.
— INGRID YANG, MD, JD

If you’re not near a studio, can’t afford to pay for a class, or simply prefer practicing at home, you can also learn yoga through free videos online, such as those from Yoga With Adriene.

Experts say it’s important to keep in mind that yoga doesn’t require you to be flexible, or engage in any movement at all. Tapping into different parts of a yoga practice can allow you to access its benefits in whatever way works for your body and preferences.

“Even if you cannot perform the physical movements, most people can benefit from yogic breathing for anxiety or stress relief,” says Dr. Zechner.

With all the changes the pandemic has brought to the workplace and our lives, many people are facing high levels of stress right now. Yoga may provide some relief, but if the stress feels overwhelming, it can also be helpful to connect with a mental health professional for additional support.

What This Means For You

If work has become increasingly stressful during the pandemic, consider starting a yoga practice. New research shows that yoga is better than other relaxation techniques at relieving work-related stress.

You can get started with yoga through an in-person class at a local studio or at home with a free online video. Even if you can’t or don’t want to participate do yoga poses, you may be able to reduce stress through other elements of yoga, such as breathing exercises and meditation.

The 6 Best Face Masks for Yoga – My Feature in Yoga Journal

The original article was posted on Yoga Journal – view here.

Spring is in the air, and after an unprecedented year, our communities are beginning to open back up. While we may be ready for new beginnings, we also acknowledge that the COVID-19 pandemic has left us reeling from the loss of health and connection. We know that attending an in-person yoga class can alleviate many of our stuck-in-a-rut maladies. But many of us have questions on how to do so safely.

Most yoga studios are taking enhanced cleaning precautions and ensuring that all mats stay 6 feet apart. Some allow practitioners to remove their masks once they are on their mats. But is that enough to keep ourselves and others safe during this ongoing pandemic?

The Centers for Disease Control and Prevention (CDC) recently published an analysis on the increased relative risk of transmission at group exercise facilities. They point out that high-intensity activities increase risk, but also specify that yoga might be a lower risk, because of its reduced intensity. Nevertheless, they recommend that everyone, even people who are fully vaccinated, should wear masks at all times while in the facility—no matter if you’re on or off the mat.

While it may feel awkward wearing a mask while practicing Ujjayi breathing, the right mask can make all the difference. Here, we offer tips for how to make mask-wearing more comfortable, plus our six favorites to don during your practice.

Tips for mask wearing

The best face mask is one that allows you to follow the CDC’s recommended “consistent and correct” mask usage. So, if we are consistent in wearing our masks, what does correct mean? Correct mask usage means:

  1. It completely covering the nose and mouth
  2. It offers a snug fit without gaps around the face
  3. The wearer handles it only by the ear loops or straps, not by the surface of the mask.

A good fit is important both so your droplets don’t escape around a poorly fitted mask, but also so you are not constantly fidgeting with it, and thus inadvertently touching your face.

The CDC also recommends trying your mask at home before wearing it out to ensure you can tolerate it for the intended activity, so don’t be shy about using the mask during your next online yoga class!

Selecting the right mask

When selecting the best face mask to wear during yoga, there are two important factors to consider: the mask structure and care.

Mask Structure

Per the CDC, the key is many layers (two or more) with high thread counts. Specifically, the CDC states that “multiple layers of cloth with higher thread counts have demonstratedsuperior performance.” Additionally, nose wires can be particularly helpful to hold the mask in place and reduce the risk of contamination from adjusting the mask.

Care

Choose a mask that is easily machine washable. This is important after prolonged wear and sweating because bacteria can become caught in the cloth of your mask. Over time, the mask can become a cesspool for bacterial growth—so make sure to wash it after each use.

Our picks for the best face masks for yoga

The all-around favorite: The Under Armour SportsMask

This mask is made with movement in mind, so it’ll stay in place while you practice your inversions and backbends. It’s made with polyurethane open-cell foam, which Under Armour states lets air through, allowing for safe ventilation while keeping your droplets to yourself. And if your yoga session happens to be outside, you have an added benefit—this mask is infused with UPF 50+ sun protection. $30, two for $50

For simplicity and function: Outdoor Research Mask Kit

If you want to check all the CDC’s boxes for cloth masks without making a fuss, this may be your answer. Outdoor Research’s mask has a double layer, which is important for catching droplets emitted from your own nose and mouth. An easily adjustable nose-bridge wire allows for a snug fit, thus minimizing air leakage that often clouds up glasses. It also has a filter pocket (and comes with a three-pack of removable filters) adding extra protection. And bonus: it’s easily machine washable and maintains its structure out of the dryer. $10

For hot yoga: The Nathan Run Safe Mask

Wearing a mask to protect others (and yourself) while practicing yoga is cool. But hot yogais, well, hot, which makes the idea of wearing a mask during class quite stifling. The Nathan Run Safe mask is made to sweat in and features a “Quick-Flip” function to allow for easy and efficient hydration, with minimal time to uncover your mouth for a sip of water. The mask also wraps around your head instead of your ears for secure placement and is made with quick-dry, machine-washable material. $14.99, on sale

For comfort and style: The Proper Cloth EveryDay Mask

Proper Cloth, a custom menswear brand in NYC, has poured its tailoring expertise into an elegantly designed mask for everyone. This mask is made from premium shirting fabrics sourced from Europe and Japan to create its inner and outer layers. This five-layered mask includes a three-layer polypropylene filter for the inner layers, which the CDC suggests may enhance droplet-filtering efficacy. $20, on sale

For paying it forward: Beyond Yoga In This Together Mask

Beyond Yoga, known for its comfy yoga apparel and clean designs, has made the natural transition to creating face masks to wear while practicing yoga. This mask is made with the same fabric as their clothes (read: soft, comfortable, and flexible) and comes in a variety of lovely designs. The straps can be fastened into ear loops or tied behind the head, allowing for easy convertibility and fit. But the best feature? When you purchase the two-pack, Beyond Yoga donates a mask to essential workers who need them. All you have to do is email [email protected] to request masks for your organization. That’s some Karma Yoga for you. $25 for two

The ideas offered in this article are for informational purposes only. They are not intended as medical advice, professional diagnoses, opinions, treatments, or medical services to you, or any other individual. It should not substitute for the advice of your physician or healthcare provider. If you have any concerns or questions about your health, you should always consult your physician directly.

Ingrid Yang, MD, JD, E-RYT-500, C-IAYT has been teaching yoga since 1999 and is a physician specializing in Physical Medicine and Rehabilitation. Her expert grasp of anatomy and human physiology bring a unique, thoughtful and joyful experience to the practice of yoga. Ingrid is also a certified yoga therapist under the International Association of Yoga Therapists (IAYT) and a Reiki master of the Usui tradition.

Read Dr. Yang’s Feature in The Healthy – I Tried a Back Posture Corrector—Here’s What Happened

This article was originally posted by The Healthy.

I used a back posture corrector for two weeks to improve my posture and alleviate my back pain while sitting. This is what it was like.

Sit straight, shoulders back

Growing up, my mom would tell me to stand tall, sit up straight, shoulders back, chest out, and face forward. After all, this is the key to maintaining good posture and looking confident. And this was before you could wear a discreet back posture corrector. Today, I still heed that advice, but working remotely full-time has led me to slouch more. (Sorry, mom.)

At the beginning of the Covid-19 lockdown, I would find myself hunched over with my back slightly rounded. When I noticed, I would correct myself. But, of course, shortly after I’d reassume the hunched position. As lockdown restrictions were extended, I started to do more sitting than standing (no commute wait times or crowded subways to add to my “stand” goal). Soon, the aggravating lower back pain started to kick in. (Here’s how to improve posture for back pain relief.)

If you use a computer for work, chances are you’re guilty of “sinking into” your work activity and starting to slouch like me.

A small study, published in 2013 in the Journal of Back and Musculoskeletal Rehabilitation, found musculoskeletal pain is common among laptop users. Shoulder pain was the most common (75.7 percent) and elbow pain the least common (37.3 percent). Those who reported the most musculoskeletal pain also used single-strap laptop bags.

The shift from being out and about on a day-to-day basis to leading a sedentary life (minus the at-home workouts and short 10-minute walks) took a toll on my back. Desperate for a quick fix, I decided to do what any millennial would do: I browsed Amazon for a good product. Enter the back posture corrector.

What is a back posture corrector?

A back posture corrector is a wearable device that typically comes in the form of a cross-back brace with adjustable straps, a long line back brace, a lower back belt, or an electronic option with built-in sensors that aim to provide better spinal alignment.

“It can help alleviate muscle tension by reducing pressure on the spine, thereby reducing the amount of strength needed in the muscles to support the spinal column,” says Ingrid Yang, MD, an internal medicine physician in San Diego.

“Back posture correctors sometimes use straps in order to create a force to pull you into what the [manufacturer] perceives as the ‘correct’ posture,” says David Perrotto, a physical therapist at Prehab Network in New York City. They act as constant feedback for how it feels to be in a proper posture position. However, Perrotto cautions, the alignment that the posture correctors bring you into may or may not agree with your body.

He urges you to seek a physical evaluation from a physical therapist first before you buy.

Choosing a back posture corrector

Due to overwhelming curiosity and an Amazon Prime Day deal, I decided to act with haste and get a back posture corrector without consulting a medical professional. (Don’t try this at home.) I opted for a Gearari posture corrector on Amazon that has more than 21,000 reviews and is Amazon’s “#1 Best Seller.”

The major selling point: It was on sale for $7.20 (original price $21.99). Not only was it a good deal, I saw it as  an important investment for my health.

Before I started, I read there’s an adjustment period called the “14 Days of Evolution,” according to the manufacturer, during which your posture is expected to improve. For two weeks, you’re supposed to wear it for two hours every day—you can’t wear it for too long in the beginning.

Perrotto agrees you should introduce the back posture corrector gradually. This is so you don’t “introduce too much of a different stimulus to your body, as it can lead to extreme soreness or pain,” he says.

In other words: Your body needs to adjust to it.

His recommendation is to start 30 minutes three times a day on an eight-hour workday. “As long as you do not experience any adverse effects, gradually start to increase the time it’s being used,” Perrotto suggests.

After my back posture corrector arrived, I tried it out for the recommended two weeks. This is what happened.

What it’s like to use a back posture corrector

Week one

The first day using my posture corrector, I was eager and ready to improve my spinal alignment. This back posture corrector was confusing to put on at first. I had to adjust the straps for a few minutes to get it to a setting that was comfortable for me. It almost seemed as if it was my first day of school with a JanSport backpack. The adjustable straps on the back brace are designed so that if you slouch, you’ll feel some tension on your shoulders because the straps tighten.

Ready to start my workday, I made sure my feet were flat on the floor, my chair and computer screen height adjusted, and my hands and arms positioned correctly on the armchair and keyboard.

I was mindful of my posture and ready to reap some benefits. Instead of using it for two hours consecutively, I divided it up into four 30-minute intervals over an eight-hour workday to gradually get my body accustomed to it. (Here are some desk ergonomics to learn.)

After a full workday and taking it off after use, I did notice my concentration and my posture seemed better while wearing the corrector. I was, however, relieved whenever I took it off because it felt like I was wearing a backpack. I felt the straps underneath my armpits.

During the week, I wore the back posture corrector every day and felt different when I wore it versus when I didn’t. I felt I could breathe better. The rest of my body also felt “linear” and alert.

Week two

One week later and I felt the same. I felt great when I wore the posture corrector because I was mindful of my sitting position during the day. I was able to focus more, breathe better, and I also felt my digestion improved after I came back from eating lunch or having a snack. (Here’s what you need to know about sitting disease.)

A plus: My neck and lower back didn’t hurt as much as before. This is likely due to not putting much strain on those muscles. I was relieved for the relief.

However, once I took it off, I slowly started to morph into my standard and “comfortable” slouch position. I would start to notice after working on a story and immediately sit up straight again. But, without the posture corrector, I eventually slumped back down. (Here’s how bad posture can affect your health.)

The truth is the back posture corrector alone is not enough. It’s a temporary solution to a bigger issue. Disappointed, but not surprised, I realized the back posture corrector only works when I wear it. Science agrees.

What the science says

In a small study of 38 healthy overhead athletes (for instance, baseball, volleyball, and tennis players) prone to poor posture, researchers found the use of a compressed shirt and shoulder brace during upper body exercises led to an improvement in shoulder posture and muscle activity. The study was published in the Journal of Athletic Training.

It seems a posture corrector brace does provide the benefit of self-awareness when you wear one, making you more likely to maintain good posture.

The type of back posture corrector experts recommend

When it comes to using back posture correctors, experts vary on what they do and do not recommend.

Preston Brown, a Milwaukee-based board-certified clinical specialist in geriatric physical therapy and owner of Prestige Therapy and Wellness, says you should consider body height and body weight when shopping for a posture corrector. “This is to ensure proper fit and support.”

He adds that it’s important to look for comfort because some posture correctors are a challenge to put on and take off, not to mention uncomfortable to wear. A healthy price range to look for is between $10 to $50, according to Brown. (These are the best posture correctors back experts recommend.)

Meanwhile, Perrotto does not advise the use of these devices. “I don’t use back posture correctors,” he says. “In my clinic, I train people to teach their body to find the position on their own. People need to work on their body and not rely on an outside source. Only if they are forced to sit down for a while will I use something to give them feedback on when they fall into poor posture.”

Dr. Yang agrees, saying she doesn’t believe in back brace use except in an acute situation under the instruction of a doctor. And even then, she says, “I do not recommend the use of back braces for longer than a few days. They are only meant to be helpful in reminding us to maintain good posture.”

If you experience increased pain or discomfort, skin irritation/breakdown, onset of numbness or tingling, or no improvement in posture, Brown advises to stop using immediately.

Ways to improve your posture

If you do not want to opt for a back posture corrector, there’s good news: You can work on improving your posture naturally.

Strength and conditioning exercises

“Conditioning yourself and gradually strengthening the areas that are weak, imbalanced, or overworked with spine-strengthening exercises, is the better way to go,” says Dr. Yang. She suggests doing these exercises when you take your regular breaks throughout the day to stretch and strengthen. “This will help counteract the effects of sitting at a computer for hours at a time,” she says.

Brown also agrees that stretching your lower and upper back along with gentle stretches will promote good posture and help decrease stress or strain on the entire spine. “Make sure that the exercises you want to do are correct for you and that you are doing them correctly by consulting a physical therapist.” (This is the best time to work out.)

Resistance training

“Movement is the best medicine,” says Perrotto. “Where the work needs to be done is through exercises like mobility and motor training, because your brain and your muscles have to remember how to stay in that position. They need to be trained in that position.” He uses resistance training, motor control training, and yoga to maintain good posture.

“Reverse-posturing”

Reverse-posturing involves going into the opposite position that you spend the most time in. For example,  “standing up, bringing your arms overhead, opening up your chest, getting your shoulder blades moving, and getting your hips extending” if you’re sitting most of the day, says Perrotto. He adds that walking is a great counterbalance to sitting.

Set an alarm

You can set an alarm, Perrotto suggests, but he cautions that the success of this depends on how well trained you are. “If you’re disciplined, you can set an alarm for every 20 minutes to bring yourself to a correct posture.” Eventually, the goal is to recognize how long you can hold a good posture.

The takeaway

Back posture correctors are a good start to improving your posture. But I learned that they’re not a permanent fix. When I took mine off, my brain and body lost the feedback it was getting.

Posture correctors “start to speak to your body and brain (about) what a good position is,” Perrotto says. But “a posture position that may be good for you may not be good for another person.”

Also, a back posture corrector won’t be able to teach your nervous system and your brain how to support itself, which is the long-term goal, he says.

All of our experts recommend speaking with a physical therapist or doctor before trying a back posture corrector as a fix to a medical problem.

Next, learn how going braless can affect your balance and posture.

Women In Wellness: Dr. Ingrid Yang on the Five Lifestyle Tweaks That Will Help Support People’s Journey Towards Better Wellbeing

 

Article originally published via Medium – view here.

Travel- if there is one thing that makes us feel more alive and at the edge of our comfort zone, it is travel. It can be travel to connect with nature, see old friends, meet new friends, try new foods, experience foreign cultures. That is why I lead yoga retreats in a different place every year — so that people can come and have new experiences with me, step out of their comfort zone, but all with the grounding of yoga and breathwork.

Asa part of my series about the women in wellness, I had the pleasure of interviewing Dr. Ingrid Yang.

Dr. Ingrid Yang is a physician, certified yoga therapist, Reiki master and an advisory board member at wellness company obVus Solutions, where she contributed her expertise to the breathing exercises featured in the new minder® posture corrector + breathing coach app. When not practicing medicine, Dr. Yang leads yoga trainings and retreats all over the world, with a special focus on kinesthetic physiology and healing through posture modification, breathwork, meditation and mind-body connection. Dr. Yang has authored two books: Hatha Yoga Asanas and her latest release, Adaptive Yoga, published in November 2020.

Thank you so much for doing this with us! Our readers would love to “get to know you” better. Can you share your “backstory” with us?

Iam a physician, former attorney, yoga teacher, Reiki master, author of two books including my latest, Adaptive Yoga, and medical advisory board member at wellness company, obVus Solutions. Having had many different careers, I feel I am truly living my purpose as a physician, advising and educating people on their health. I started practicing yoga because I needed it on a very personal level. But my story is far from straight and narrow, and I’ve often had to ask myself really hard questions at times when the “right” answer seemed impossible to find.

In college, I was a type-A go-getter in New York City, full of ambition and energy. Yet the stress and pressure I put on myself felt suffocating. I was anxious and rigid, both physically and spiritually. Luckily, a friend recommended yoga to help ease my emotional inflexibility. Yoga taught me was that I could just breathe in each moment; I did not have to prove or accomplish anything. I could just breathe and exist. I had never felt so relieved. It was the best gift I could have ever received.

During law school at Duke I taught a lot of yoga, both to relieve stress and hone my skills. I took hours to prepare for each class scouring through yoga books, drafting outlines, and practicing in front of the mirror until I had the plans memorized. Yet it didn’t feel like work because I loved it so much. It was a process, but the hard work paid off as my weekly classes grew from 10 to 60 people within a year, and close to 100 by the end of law school. It was rewarding to have so many students benefit from a practice that I held so close to my heart.

After graduating, I moved to NYC to practice law but quickly realized that a corporate life would not fulfill my desire to make an impact in others’ lives. When my closest aunt passed away that year, I saw that our time on Earth is too short to live a life unfulfilled. So, I packed up my things and moved down to North Carolina to open a yoga center. It was scary. I was leaving a promising career as a corporate attorney at a large, reputable law firm to follow this “pipe dream” to found and run a yoga center. Without question it would not be the most lucrative path, but I decided to take the leap, based on gut instinct alone. Little did I know that, despite all the fears that I had and all the uncertainty ahead of me, this decision would put me on the path towards realizing the life I was born to live. So, I opened up Blue Point Yoga Center and, using money I saved from practicing law, built it from the ground up — no walls, no floors, just a vision. I am proud to say that Blue Point still stands today, a thriving multi-location yoga center in Durham, NC. And while there were hiccups along the way, the right opportunities and people — investors, contractors, teachers — always presented themselves at just the right moments. And I witnessed that — the minute that I would start to stress about something — the solution would come naturally and elegantly. It just goes to show that when you are on the right path, the entire universe aligns to clear the passage for you.

While running the center, I began to realize how connected yoga is to physics, kinesiology and human physiology. The way that we practice pranayama speaks fluently with our respiratory mechanics, and the transitions between postures logically connect to the biochemistry of our brains. As a child I had always wanted to be a doctor; however, I never believed I was smart enough. During my tenure at Blue Point I became more interested in medicine and devoured books and videos on our physiological inner workings. I started to teach through that lens, and because my yoga center was near to the Duke Medical Center, many of the doctors and nurses that attended my classes encouraged me to consider a career in medicine. Although I initially shrugged it off, I began by dipping my toes into pre-med classes at a local college and, after multiple applications, was finally accepted at medical school. Though medical training was grueling and exhausting, yoga provided much needed balance and kept me grounded.

Can you share the most interesting story that happened to you since you started your career? What were the main lessons or takeaways from that story?

I think the most interesting thing about my career is that, while it may appear to be a success, it was also riddled with failure. At times, it felt like every turn in the road brought about obstacles to challenge me, leading me to tough questions: How much did I want this? How dedicated was I?

It took me three tries to get into medical school. Then, I failed the first step to my medical certification boards (by one point). My med school threatened to hold me back a year, but I powered through, retook the test, and achieved a great score. Then, halfway through residency, I realized I had chosen the wrong specialty, and switched to Internal Medicine, where I had thrived previously. There was a lot of crying and feelings of disappointment and inadequacy. But I was so sure in my heart this was the right path.

After each hurdle, I continued to forge ahead, despite feelings of self-doubt. I felt like I had no other choice — this was my destiny. But today I am in the specialty that is perfect for me (I work as a hospitalist), with a medical group I love, in La Jolla, a city that I hope to always call home. Each failure taught me an important lesson: failing does not mean you are a failure. What defines us are the actions we take after the failure. Do you reflect and learn from the failure, get back up, and keep moving? Or do you take on the victim role and give up? There is always a choice. And I can guarantee you that the most successful people you know and admire have failed over and over again until they succeeded. Failing is all part of the process, and we must choose to take it in stride.

Can you share a story about the biggest mistake you made when you were first starting? Can you tell us what lesson you learned from that?

My biggest mistake was believing that if I just muscled through something that it would turn out the way I had envisioned. When you are a student, if you study harder, put in longer hours, then you can achieve the outcome you want. I was used to that because I had spent so much time in school. But the most important lesson I learned from that is to follow your instincts and pay attention to what the signs are telling you. Did a challenge arise to signal you to take a different direction to get to the same place? Or to ask you to turn around altogether? Often, the key is to sit still in order to know your heart’s greatest hopes and receive the answers. Remaining rigid would have caused me to stay in a medical specialty that was not the right fit for me. Instead, taking a step back in order to think about my values and goals led me to the right decision.

None of us are able to achieve success without some help along the way. Is there a particular person who you are grateful towards who helped get you to where you are? Can you share a story about that?

I am going to name someone I’ve never met: Michael Alan Singer. He is the author of The Untethered Soul, a book that unquestionably changed my life. The book allowed me to be courageous enough to ask myself difficult questions during what felt like impossibly challenging times. It allowed me to examine the limitations that I placed on myself and decide whether I would move past them or remain imprisoned by them. It taught me to be bold and brave about sharing my vulnerabilities and connecting in a real way with myself, with others, and with nature.

Ok perfect. Now let’s jump to our main focus. When it comes to health and wellness, how is the work you are doing helping to make a bigger impact in the world?

I consider myself first an educator, then a physician. My job is to educate patients so that they can make informed decisions based on their personal value systems. I am a huge fan of knowledge acquisition because knowledge is power. And if I can empower others by sharing knowledge, I feel that I have done my job. But in all, my patients teach me so much more than I can ever teach them. I have sat aside dozens of people on their death beds and they never say: “Gee, I wish I’d been in the office more instead of seeing my kids,” or “I wish I’d bought that expensive purse.” They say, “I wish I had reconciled with my estranged son,” or “I wish I had apologized to my wife for making her feel unseen during our marriage” or “I wish I had traveled to my parent’s homeland before it was too late.” These are the lessons I have learned from them. What is life really about? Where do we, as humans, find meaning In our connections?

Can you share your top five “lifestyle tweaks” that you believe will help support people’s journey towards better wellbeing? Please give an example or story for each.

  1. Travel- if there is one thing that makes us feel more alive and at the edge of our comfort zone, it is travel. It can be travel to connect with nature, see old friends, meet new friends, try new foods, experience foreign cultures. That is why I lead yoga retreats in a different place every year — so that people can come and have new experiences with me, step out of their comfort zone, but all with the grounding of yoga and breathwork.
  2. Stay curious — having a curious outlook will help your mind stay young and resilient. Asking questions of yourself, your spouse, your parents, strangers — staying curious about the world around you will allow you to experience the world in a manner which feels fresh and new every day.
  3. Move and exercise! — it is the number one (and only proven) way to delay Alzheimer’s dementia, improve your cardiovascular health, decrease your risk of cancer, and improve your overall quality of life.
  4. Use technology to your benefit, not your detriment. Tech tools like the minder® app (to which I contributed my expertise) can help track wellness goals and prompt healthy habits including good posture and proper breathing (essential for lung health, so important during a pandemic). But know when to turn off technology. Use it to benefit health, but put it away when done for the day.
  5. Sleep! — the brain needs time to rejuvenate, so be sure to make sleep a priority. Try to go to sleep and wake up at the same time every day, even on weekends. Try to get at least a solid 8 hours every night. It’s the #1 guaranteed way to make you more efficient, productive, and stress-free.

If you could start a movement that would bring the most amount of wellness to the most amount of people, what would that be?

We are in the midst of an unprecedented global pandemic. Now more than ever, we need to look to natural, proven methods to build our lungs, relieve stress, and improve emotional health. As a medical doctor and yoga teacher, I understand the benefits of how both good posture and proper breathing can not only build our lungs, but also alleviate stress, increase self-esteem, and improve positive mood. My advice is to take big deep breaths regularly (that alone improves your posture and brings oxygen to your muscles, which helps you feel invigorated). Technology can be our biggest ally here: studies show that people who wear wearables such as minder are more likely to take steps towards achieving their health and wellness goals by adding encouragement and motivation.

What are your “5 Things I Wish Someone Told Me Before I Started” and why?

  1. Haters gonna hate. But seriously — there will ALWAYS be nay-sayers. They may feel threatened by you, jealous, or maybe something about you triggers them. Whatever it is, it is not about you. Keep doing what you’re doing and don’t pay any mind to those that have nothing nice to say.
  2. Know your values. Be very clear about your values and you can then more easily make important decisions when you are coming from a place where you can remember your purpose and values.
  3. Maintain healthy boundaries. It is impossible for you to be everything to everyone all the time. In order to do well at what you are focused on in the present moment, you must be able to take a step back and not be pulled in every direction. That links back to remembering your values and staying on the path that helps you maintain these values.
  4. Surround yourself with those that support you and believe in you. Because in the moments where you doubt yourself (and there will be plenty of those moments), those people will sense that and share their belief in you, and by proxy, allow us to believe in ourselves again.
  5. Do only what you love! There are so many things in the world that you CAN do, but what MUST you do? I have been asked how I’ve been able to accomplish “so much”; it does not feel like that much to me, but the only reason I have accomplished anything is because I have only done what I love doing in the moment. In this moment, it is practicing medicine and spreading the good word of mindfulness and breathwork. And when you are doing what you love, it truly does not feel like work at all.

Sustainability, veganism, mental health and environmental changes are big topics at the moment. Which one of these causes is dearest to you, and why?

Mental Health. We are the masters of our own destiny. If you suffer from anxiety, there is a way out that is not just about pills. You can use breathwork, mindfulness techniques, connection to others. And none of those things have side effects!