Posts In: 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

“You’re missing out on LIFE!” the woman next to me sharply stated as I finished typing a text message into my phone. We were standing at La Jolla Cove where I went for my morning walk before class. 

It was a rude awakening, but she was right. What I missed while staring at my iPhone was a baby whale emerging for a brief moment right in front of where I was standing. I have been swimming in those waters for over 5 years and have never seen whales in the cove! Luckily, he resurfaced and I got a second chance. It was a beautiful moment.

I turned my phone off and continued looking around as I walked. This time I noticed a group of seals huddled together on a rock basking in the morning sun, a family of pelicans cleaning their wings and a hummingbird pausing in mid air as if to say “hello.”

With all our attention being pulled in many directions, it has become more and more difficult to just be present and notice what is happening NOW. Yoga and meditation help bring us back to all we really have: this moment, this life. Staying in the past and worrying about the future only creates stress and dis-ease. The way to peace is PRESENCE and the path to presence is by SLOWING DOWN, one breath at a time.

Join me for my upcoming Advanced Yoga Anatomy Course at Yoga One where we will explore the true healing power of Yoga.

In the meantime, turn off your ringer, check email one less time a day and take a yoga class!

To your well being,

Rachel Krentzman

Here’s a list of our favorite yoga myths. Do you ever hear these “reasons” not to do yoga from your friends? Let us know in the comments!

10. MYTH: You have to be flexible to practice yoga.

FACT: Over time, practicing yoga safely helps increase your flexibility. Maintaining a supple spine and full range of motion in the joints helps prevent injury and may even improve your game if you play a sport.

9. MYTH: My grandmother does yoga so you can’t get a really kick-ass workout from it.

FACT: Yoga is not just about stretching and relaxation! Building muscle strength and endurance through yoga is the key to safely exploring flexibility. There are many different types of yoga for all different body types and abilities and there’s definitely a style to fit your needs!

8. MYTH: My Crossfit-crazy boyfriend does yoga and it sounds too intense for me.

FACT: Some styles of yoga are intense (think: Ashtanga or Power Vinyasa) but other styles, like Restorative Yoga, focus on deep relaxation and breathing techniques to manage stress. If you’re a beginner, start with a beginner class and feel free to explore different styles until you find the ones you like best.

7. MYTH: Yoga is the same as physical therapy.

FACT: Some of the exercises might be the same and yoga does have a reputation for healing – but don’t confuse these two. While yoga is an excellent addition to a healthy lifestyle, if you’re recovering from an injury please listen to your doctor and physical therapist.

6. MYTH: If you practice yoga, then you’re not a real Christian, Muslim, Jew, [insert any other religion or spiritual tradition.]

FACT: For many people, yoga is spiritual, but it is not in and of itself a religion. Yogis of many different religious backgrounds enjoy allowing their beliefs to color and enhance their practice. And many yogis prefer to practice just for the physical and mental benefits.

Check back next week for Part Two!

Wabi-Sabi

One of the highlights of our anatomy training is when we learned about the spine. We looked at each others’ spines standing erect and folded forward. One of the physical therapists teaching us anatomy spotted a student who had scoliosis. We all gathered around to take a look. As the student bent forward, the uneveness in her spine became amazingly prominent. Many of us were so focused on the apparent “wrongness” of her spine that we were gasping in awe.

The therapist looked around and started to point out what we had missed. “Look how beautiful and even her hips are. Look how even her shoulders are.”

It was true. She was perfectly aligned. We had failed to notice all that was right with her pose because we were looking at what appeared to be wrong.

Our anatomy teacher commented on the beauty of scoliosis, marveling that, “The body will do what it needs to do so you are upright in the world.”

This reminded me of the Japanese philosophy of Wabi-Sabi. The idea that the imperfect, impermanent, and incomplete are beautiful. And not just in terms of physical imperfections. Wabi-Sabi goes much deeper and is more of an “aesthetic consciousness that transcends appearance.”

A growing interest in anatomy is one of the reasons I’m in this training in the first place. The more I practiced yoga, the more I became curious about my own muscles, bones, and how they function. The more I saw how body movements affected my state of mind and being, the more I wanted to learn the how and the why.

Every week I have fascinating experiences that confirm my choice to make this investment. We are just scratching the surface of anatomy and how it relates to yoga, but I feel like a clear path of learning is being laid out for me to travel in the years to come.

Read the rest of Monique’s article here.

Not so long ago, I was a half marathon runner, big wave surfer and mountain hiker. At my day job, I supervised large, one-of-a-kind home construction projects. My work placed extraordinary physical demands on my body. But everything changed the day I fell off the second story roof of a construction site.

When I hit the ground, my T-10 vertebrae exploded and my spinal cord got pinched. I was paralyzed and told by some doctors that I would never walk again. The body that was capable of walking and standing all day, lifting heavy materials and going on long runs was gone. But then one day I was able to move one of my toes and I started an eight-month physical therapy program. I had to re-learn how to walk. After 15 months of struggle, I was able to walk using a cane.

Eventually, I was able to go back to work as a construction supervisor. Even though all I could do was walk around the job site, I was happy with my progress. After two years, the doctors told me that I had reached a recovery plateau. I felt as though I could keep improving and that feeling led me to yoga. Four years after my injury, I started to take yoga classes. With enthusiasm I tried the Iyengar, Hatha, Ashtanga and Vinyasa styles of yoga at a studio in Bird Rock. When the studio closed, I continued a home practice for three years, certain that yoga was the key to my continued good health.

In 2009, I heard about Yoga One. By then I was a full time student at City College and their location on 7^th Avenue was perfect. I was impressed by Michael and Amy Caldwell’s knowledge of yoga, teaching style and friendliness. For a year, I attended their classes as well as the Saturday morning Hatha class every week. Eventually, I tried other instructors and took on more classes per week.

I still have nerves that haven’t regenerated. In some poses my body can only go so deep; it might improve, it might not. Either way, I have fun and give it my best effort. I’m still in pain (I call it sensation) of one sort or another every day, but I would rather have the sensation of a long challenging yoga session than the sensation I experience after sitting at a desk or lying around all day. Mindfulness meditation has helped me locate where each sensation comes from, with equanimity I accept them and therefore life is a pleasure not a pain. Gratitude, yoga, mantra, meditation – that’s the morning practice I do before anything else. It’s the way I put my Self first and honor the commitment I’ve made to my health and well being.

Stepping Through the Door 

I had been aware of Yoga One’s studio for six years before I stepped through the door for the first time. My office looked down onto the small businesses along 7^th Avenue, but not until losing a fight with a very heavy piece of furniture would we become acquainted. After numerous physical therapies, acupunctures and injections, I finally found myself sitting in a spinal surgeon’s office faced with the grim reality that my options were running out and going under the knife was looking more and more likely. Reviewing our final options, the surgeon asked if I’d tried yoga before. I hadn’t and immediately my internal Wikipedia pulled up the image of the sign outside the studio that was my only point of reference to this strange-sounding word.

I think it’s part of the curse of being British that we fear embarrassment more than speaking in public or large spiders, but I can honestly say walking to my first class that I was absolutely terrified. Perhaps I had built up an undefined, slightly suspect, pre-conception of exactly what went on behind that door, but it was certainly nothing I had experienced before. The mat, the blocks, the blankets, the belt; all so confusing. I didn’t know it at the time, but I was having a defining life moment. As confident as I might have been in other areas, in this world, I felt painfully self-conscious and overwhelmed. I had no idea what to do or say and I kept looking at the door.

Just at the point when anxiety was getting the better of me and I was getting up to leave, a soft voice spoke. Wren introduced herself and asked me how I was and if I had any physical issues. Her voice was so kind, I couldn’t help but feel that no matter what was going to happen in the next hour, I was in very good hands. And so over the coming months, I was introduced to this undiscovered country; the practice of yoga. Slowly but surely, the omnipresent pain in my lower back left my body. When I think about the alternative route that I might have taken, it reminds me that important decisions in life are sometimes defined by very small moments.

Stepping through Yoga One’s door was really just the start and the subsequent journey over nearly two years has been a joy. Sharing my journey with new friends and fabulous instructors along the way has been the true reward. I am profoundly grateful to Michael and Amy for providing this oasis in my life. 

If you’re reading this and have reservations about trying something new that sounds like a character from Star Wars, then I encourage you not to wait six years before walking through the door. For me, every time I feel the base of my spine and there is no scar I am reminded of why I’m glad I did. I hope you are too.