Posts In: embody physical therapy

Nicole Mullins PT/E-RYT is a physical therapist and yoga teacher with over 20 years experience working in orthopedics and seven years in therapeutic yoga. Currently, Nicole is the clinical director at Embody Physical Therapy and Yoga. She will be leading an Intermediate Anatomy Workshop for yoga teachers and experienced students at Yoga One on June 10-11. For more information and to register, go here. 

Yoga One: Which practice were you introduced to first in your life, physical therapy or yoga? And how long have you been practicing each?

Nicole Mullins: I was introduced to physical therapy long before I was introduced to yoga. Of course I knew yoga existed, I just didn’t have any experience with it or anyone who practiced yoga. I have been a physical therapist for 22 years and have always actively sought out additional training to stay current.

I took my first yoga class 17 years ago, but didn’t really start practicing until about 8 years ago when I jumped into a 200-hour teacher training. From there, I took workshop after workshop to really hone my skills and understanding of yoga.

Yoga made so much biomechanical sense that it soon replaced most of the therapeutic exercise I did with my patients.

YO: How has yoga informed your clinical work in physical therapy?

Nicole: I think the combination of yoga and physical therapy is both revolutionary and uncommon. It is a brilliant marriage that allows me to offer so much more to my patients than I was ever able to before. Yoga is so much more than just asana (the physical exercises). Yoga recognizes the undeniable mind-body connection and how we must address the whole person to affect positive change.

YO: Good alignment is something every yoga student wants to have, but it can be difficult to learn without years of practice or private instruction. If you could teach every yoga teacher and student the biomechanics of one pose, which would it be?

Nicole: There are actually two poses that I think are vital and necessary for everyone! From a purely biomechanical standpoint, I would teach tadasana, or mountain pose. Tadasana is the foundation of all standing poses and so many other yoga poses. Knowing how to find a neutral posture is necessary to be able to safely move into and out of poses and minimize risk of injury or overuse.

From the standpoint of overall well-being, I would choose savasana, or corpse pose. Most of us are unable to truly shut down and let our minds and bodies relax. The purpose of savasana at the end of a yoga practice is to let the nervous system integrate the experience of the physical practice. Learning how to do this properly can be extraordinarily beneficial and healing.

YO: What have you learned recently that really interests you?

Nicole: In addition to studying manual physical therapy and yoga, learning about essential oils and natural healing, I have also been studying osteopathic techniques, including visceral manipulation. “Viscera” refers to our organs. This technique has been around for many years and embodies the concept of treating the whole person. We cannot just address the muscles and joints without considering every other system and structure in the body.

The viscera and their orientation in our body is a crucial component in our ability to move and function with ease. Scar tissue and adhesions from surgery, injury, illness and infection can change an organ’s ability to move naturally. These adhesions are frequently manifested as musculoskeletal injuries, including back and neck pain. Adding this technique to my practice along with yoga and has been truly pivotal.

Learning new techniques and knowledge about the body is what makes me so excited to be a yoga teacher and physical therapist. It’s what makes me even more excited to share what I have learned through teaching so others can grow in their practice as well.

YO: We’re excited you’re offering an Intermediate Anatomy Workshop at Yoga One, can you share one topic you’ll be covering in depth?

Nicole: The workshop will touch on many topics, but one I consider to be the most important is what constitutes a neutral spinal and pelvic alignment. We will explore the biomechanical relationship between the spine, pelvis, shoulders, and hips. You will learn why the shoulders and hips are cornerstones of a healthy spine and you will experience this in your own body via asana in the training.

YO: That sounds amazing! Who would benefit the most from this type of workshop?

Nicole: This workshop will benefit any yoga teacher or student who wants to understand more about how and why the body moves as it does. This workshop is for anyone who wants a deeper, fuller knowledge of biomechanics and how it applies to yoga in particular.

If you want to be inspired to teach yoga more confidently, excited to share what you will have learned, and ready to see the benefits in your students, please join us.

Intermediate Anatomy Workshop

led by Nicole Mullins at Yoga One
10-hour course, eligible for Yoga Alliance continuing education credits

Saturday June 10th 12:30-6:30pm
Sunday June 11th 12:00-6:00pm

Pre-registeration required: $175 by June 1st / $225 by June 8th (last day to register. No refunds.)

 

by Rachel Krentzman, PT, E-RYT

Backbends are an integral part of any Yoga practice. The intention for backbends is to open the chest and rib cage in preparation for pranayama (breathwork). For some, backbends are exhilarating and freeing while for others, they can be somewhat daunting and anxiety-producing. For the first few years of my yoga practice, I would experience back pain in most back bending postures and assumed that it was a ‘normal sensation.’ The truth is, if done correctly, backbends should be challenging but comfortable. If you are not experiencing freedom in your backbends, it is a sign that you may be compressing your lumbar spine instead of increasing your range of motion.

Is it safe for my spine?

When done correctly, back bends help increase extension of the spine, a normal movement that is available to us based on the anatomical structure of the lumbar vertebrae. There are approximately 55 degrees of extension available in the lumbar spine in most humans. As we move up the spine, extension is more limited due to the shape of the thoracic vertebrae.  In optimal alignment, the lumbar spine should rest in a slight arch (lumbar lordosis), to properly carry the body weight and prevent low back issues. When we lose the normal curve due to poor posture or frequent forward bending, there is an increased risk of low back pain, disc injuries and muscle spasm.

With all this in mind, it is important to increase the extension in our spine in order to maintain back health and mobility and combat the constant effect of gravity that pulls us forward. In addition, back bends help increase lung capacity, prevent arthritis, alleviate depression, build stamina and energy as well as improve circulation, digestion and immune function. Backbends are said to help us move from the past into the present, and to help us open our hearts and let go of fear.

Backbends are safe for most individuals (contraindicated for those with spinal stenosis or spondylolisthesis) as long as the body is warmed up appropriately and there is close attention paid to proper alignment and actions in each pose. The beauty of yoga is that detailed instructions can be given to help one attain ideal alignment so a greater sense of opening is experienced. When we have pain in backbends, it is because something is breaking down in our execution of the pose. Discomfort is an opportunity for us to practice more awareness and find a new, pain free way to work in the posture.

Common limitations

Individuals who have difficulty in backbends can be categorized into two main groups: those with tight muscles and ligaments and those who are naturally loose and highly flexible. In every body, there is a dance between the qualities of stability and flexibility in the musculoskeletal system. There is a myth that being more flexible is a sign of better physical health, however, the more flexible a person is, the more prone their ligaments are to injury in yoga because they lack stability. Conversely, those who are stiff are less likely to suffer an injury due to over-stretching, but these individuals need to increase their flexibility so the pelvis and spine can move freely and avoid compression during activities of daily living.

Common restrictions for tight individuals include decreased range of motion in the chest, shoulders and hips (primarily in the hip flexors and external rotators). These areas become restricted from prolonged sitting at a desk, driving, frequent forward bending and lifting and can even occur from overtraining the anterior chest musculature. Runners, cyclists and avid athletes are prone to tightness in the hip flexors and external rotators as well. These individuals need to focus on increasing flexibility in the chest and hips to prepare for backbends.

Hyper flexible people experience different difficulties in back bending postures. They often have tight hip flexors but compensate with over-extension in the low back. Core strength is usually lacking in these individuals, so they tend to ‘hinge’ at one segment in their spine over and over again instead of dividing the extension throughout the length of the spine. In this case, the hyper mobile segment becomes more mobile while the tighter segments in the spine stay tight. Years of ‘dumping’ into the low back without awareness can lead to injury as the segment bears all the work. These individuals need to focus on stability and strength in their backbends, which may mean backing off a little to maintain the integrity of the pose and length throughout the entire spine.

How to practice correctly 

Here are some important tips to help you achieve success in your back bending poses:

• Warm up! In order to be ready for back bends, you must practice poses that open the chest, hip flexors, quadriceps and external rotators of the hip. It is also important to practice a couple of poses that encourage strength in the arms and legs to prepare for certain backbends.
• Keep the front body long. “Back bends should really be called front body lengtheners,” says Jo Zukovich, a well known Iyengar Yoga teacher from San Diego. While we are extending our lumbar spine, it is important to maintain length at the same time so there is more space and equal movement between each spinal segment. The common mistake that leads to pain and injury is collapsing in the spine at one segment while in the backbend.
• Internally rotate your hips. Internal rotation in the hips is essential in all backbends to avoid compression in the spine. If we allow our hips to externally rotate (which will cause the knees to splay out), our stronger muscles, namely the gluteus maximus and external hip rotators, will contract. By internally rotating the thighs, we turn off those stronger hip muscles and activate the deeper gluteal muscles which help to create more space.
• Avoid gripping! The tendency in backbends is to contract the buttocks strongly which creates more compression and less freedom in the spine. In addition, ‘tucking of the tailbone’ creates shortening instead of increased length in the spine.  Instead, think about lifting the lower belly to help the tailbone descend. This creates length while maintaining the integrity of the spine and core strength in back bends.
• Don’t fight the backbend, GO FOR IT. Most people try to resist the back bend while they are doing it. It is safest to work on helping your lumbar spine move into extension at every level. Focus on moving each vertebrae into the body as if it were sinking into quicksand in order to safely increase extension in the lumbar spine. Remember that we are lengthening as we are extending to maintain a full lumbar curve free from compression.

Rachel Krentzman PT, ERYT 500 combines 18 years of Physical Therapy experience with more than 15 years of Yoga studies. Her treatment methods involve a highly effective approach to healing the whole person. Rachel received her 2000-hour certification from the College of Purna Yoga™ with Aadil Palkhivala and has studied Yoga therapeutics. She is the founder and director of Embody Physical Therapy and Yoga in San Diego, CA. For more details and/or questions contact: 619-261-6049 or rachel@embodyphysicaltherapy.com

How many hours do you spend typing in front of a computer screen? If you’re like many Americans, you’re spending a significant amount of time every day with your fingers on a keyboard. Over time, repetitive movements like typing or clicking on a mouse can cause wrist pain or even carpal tunnel syndrome.

Our friends at Embody Physical Therapy and Yoga (who lead the anatomy portion of Yoga One Teacher Training) have created a short video showing three poses to reduce and eradicate wrist pain and carpal tunnel symptoms. To find out more about Yoga One’s award-winning studio and yoga teacher training, go here or send us an email: info@yogaonesandiego.com