In this short article our friends at Minded Institute look at the links between stress and inflammation, and how a therapeutic approach to yoga can help.  

Its worth noting that short term stress is a good regulatory mechanism in out body, telling us to take protective action.  When stress settles in and becomes prolonged – aka chronic stress – then problems start. 

It is also important to recognise that stress is not a fixed condition or entity in itself. Rather, it reflects an ongoing interaction between perception, meaning-making, and physiological response. From this perspective, what we commonly call “stress” arises from how experiences are interpreted and held within the system over time—an understanding that closely parallels yogic concepts such as samskara, where unprocessed experience leaves an imprint that shapes future patterns of reactivity.

The post Chronic Stress and Inflammation: A Yogic Perspective on Tapas, Samskara and the Body appeared first on Yinspire Yoga Therapy.

Knee osteoarthritis: Small change to gait may relieve symptoms

The nub seems to be research showing that retraining walking patterns to turn the toes further in or further out by a small amount was, in some cases, as effective for Knee pain as medication. 

Worth some further thought if you have knee issues.  Its possible, although clearly would need research, that similarly hip pain could be aided. 

Seemingly not explored here is whether freeing up tensions in soft tissue – muscle and connective tissue – to take out restrictions and imbalances acquired over time with the aim to returning to a normal gait from an altered one could achieve the same thing?  Its entirely possible, and this is where a practice like Yoga or Pilates would help. 

Gait however is complex and whilst many of us have variances in gait – including a common one of foot turn out – in some cases this is a natural effect of skeletal variation, and certainly not something to be corrected of changed for the sake of it – I’ve known Personal Trainers who have taken a simplistic view that any turnout is wrong – that’s not supported by studies of human anatomy and variance. 

The post Knee osteoarthritis: Small change to gait may relieve symptoms via Medical News Today appeared first on Yinspire Yoga Therapy.

Knee OA Pain? Yoga, Strengthening Exercises May Help Equally

The research suggests, as the title implies, that for painful knee arthritis Yoga is as effective as strengthening exercises – the latter sis often suggested for knee pain.

The research suggests that Yoga may be marginally better than strengthening exercises, and yoga also gives improvements in quality of life and physical performance.    However, “adverse events” – strains and aches I’d imagine – were slightly higher in the Yoga group, but none of them serious.

One key thing in the headline is “may” – some people take to yoga, some don’t.  Some people take to strengthening exercises, some don’t. 

Not really covered in this report is the psychological effects of yoga – notably tress reduction, mood improvement and improved regulation – which matter a great deal in pain conditions.   This would add to the beneift of Yoga.

The takeaway though is that for a first line treatment for Knee arthritis, yoga is well placed to help.

The post Research – Arthritic Knee Pain? Yoga and Strengthening Exercises May Help Equally appeared first on Yinspire Yoga Therapy.

Only 10% of non-surgical treatments for back problems kill pain, says review

As a Yoga Teacher and Yoga Therapist, and indeed in the latter role with a specialist interest in both Back Health and Pain, you might expect me to be railing against this, and extolling Yoga’s benefits.

Indeed NICE (National Centre for Clinical Excellence) already do a good job of this –  Low back pain and sciatica in over 16s: assessment and management – where although yoga isn’t mentioned specifically, they do say “Consider a group exercise programme (biomechanical, aerobic, mind–body or a combination of approaches) within the NHS for people with a specific episode or flare-up of low back pain with or without sciatica” which sounds like Yoga to me.  They also go on to say “Consider psychological therapies using a cognitive behavioural approach for managing low back pain with or without sciatica but only as part of a treatment package including exercise”, which encapsulates Yoga Therapy very well.

Truth is I’m not surprised by the reports findings as, surprise, our backs are complicated.  

Where reports like this fall down is, in my view, three fold.  

First they look a population based outcomes and tend to ignore the individual – a treatment may not work for a majority of people, even a significant majority, but if you are the one of the minority where it did work, then happy days! In other words, no one model or modality suits everyone.

Second, often interventions are looked at in isolation, whereas the reality is a combination of approaches probably suits most people, eg exercise and some mild pain relief, or as NICE say, as quoted above, “psychological therapies… …as part of a treatment package including exercise”.  There is an additive effect of using a combination of interventions.

Finally, the cumulative protective effect of interventions is ignored.  EG you had a couple of back pain flare ups, so your decide to take up Yoga or Pilates to keep you back flexible and strong, invest in a better office chair and eye level monitor, etc.  The next flare up is a lot less troubling, or maybe avoided all together.

In short they simplify matters and look in the abstract, indeed much medical research does, rather than looking at real life.

Yoga may, or may not, help with an acute back pain flare up or long term chronic back pain.  However when practised, and taught, with care and intelligence, the chances are it will improve someone’s situation, especially when part of a integrative approach with, maybe, massage, input from a Osteopath, Physio or Chiropractor,   some pain relief, and some addressing of causes if known.   The key is an integrative approach; not a one size fits all treatment; not a take-this-pill-and-everything-is-alright approach; not a quick fix, but a nuanced combination that suits the individual.

Ethically, as Yoga Therapist, I am never going to claim that one Yoga session will cure someone’s back flare up; likewise I’m never going to claim that by itself Yoga does it all; I’m not going to claim Yoga will help everyone. I’ll be honest; in most cases Yoga, done well and carefully, will help rather than hinder.

The post Guardian – “Only 10% of non-surgical treatments for back problems kill pain, says review” appeared first on Yinspire Yoga Therapy.

Mindfulness may be as effective as antidepressant for anxiety symptoms

Researchers assessed the progress of two cohorts with anxiety, one cohort treated with a common antidepressant drug, the other cohort attending a mindfulness course, MBSR.

Results were reviewed at four and eight weeks. 

At four weeks the medicated cohort were reporting a greater improvement than the mindfulness cohort, however at eight weeks both cohorts had the same improvement in their symptoms; interestingly, and perhaps not surprisingly, at eight weeks the mindfulness cohort experienced less side effects compared to the medicated cohort.

So the takeaway is that over eight weeks, mindfulness is slower to act than an antidepressant, but achieves the same outcome symptom wise with less side effects.  Of course taking a pill is easier than carving time out for a mindfulness practice so the ease of the intervention needs to be considered as well.

It would be interesting to see these results over a longer term, and also to see a blended approach with medication given initially alongside a long term mindfulness approach.

However this research does underline what was already known – that mindfulness can be a viable alternative to, or can compliment, medication.

One final thing to add – in this study the mindfulness cohort were using a structured programme known as Mindfulness Based Stress Reduction, MBSR – this is a well known course syllabus which includes yoga based movement practices alongside sitting practices.  As part of my Yoga Therapy training I wrote my short dissertation on the efficacy of general Yoga classes, and different styles, versus courses like MBSR, based on published research.  Where taught in a therapeutic context, there didn’t appear to be a significant difference in outcomes.  So tentatively any consistent therapeutic yoga and/or mindfulness practice should produce a positive outcome for anxiety, however consistency will be the key, alongside working with a teacher who is therapeutically orientated. 

The post Research – Mindfulness may be as effective as antidepressant for anxiety symptoms appeared first on Yinspire Yoga Therapy.

Six Distinct Subtypes of Depression, Anxiety Identified Via Brain Imaging

Of interest is the blurred line between Depression and Anxiety, and the different sub types identified.  Lets unpick that.

First, the blurred line.  Historically Depression and Anxiety have been seen as different things, however experience by therapists in practice shows they often present together, and are often blurred, to a degree feeding off each other.  This doesn’t mean everyone who is anxious is depressed or vice versa, but there tends to be a correlation.  Its good to see this being investigated in the round. 

Second, the different sub types.  Our brains have various networks, think of that as interconnected pathways, and the research looked at in this article has identified that different networks are activated in different people.  This makes sense, as peoples experience of depression and anxiety is very personalised.     Many factors, biological, social and psychological will shape our we respond to, and experience, external stimuli, and how depression and anxiety take root and are experienced, however all to often the treatment and support can be very homogeneous – “one size fits all” – this is a step the other way, as the article says “Depression is a highly heterogeneous disease”.  In practice it will be some time until this more nuanced approach filters down to day to day care.

So what of Yoga?  As a Yoga Therapist you’d expect me to say “Yoga is great for Depression and Anxiety”.   In all honesty, maybe, maybe not.  As this article suggests, depression and anxiety show up differently in different peoples brains, and therefore just as one size fits all medical care doesn’t work, a one size fits all Yoga approach doesn’t work.  It maybe a slower Yoga approach is needed for some, a focus on relaxation; for others a more dynamic Yoga practice; for others a focus on breathing and the nervous system.  For some people a carefully curated Yoga practice may be the only support needed, in other cases Yoga may be part of a range of medical, holistic and complementary interventions.  Being host, in some cases Yoga may not help at all.

What I would say is that Yoga for Depression and Anxiety benefits with working one on one with an experienced Yoga Teacher or Yoga Therapist, and also Yoga is never a quick fix.  Simple Yoga practices, worked with over time will help most people in most cases.

Read more about Yoga Therapy for Anxiety and Depression

The post Six Distinct Subtypes of Depression, Anxiety Identified Via Brain Imaging appeared first on Yinspire Yoga Therapy.

However I came across this article recently, and thought it worth sharing:

‘Landmark’ Trial Shows Opioids for Back, Neck Pain No Better Than Placebo
(https://www.medscape.com/viewarticle/993875)

At one level this is not news – Guidelines from Nice, the UK National Institute for Health Care and Excellence, have long cautioned on the use of Opoids. (https://www.nice.org.uk/guidance/NG59/chapter/Recommendations).

However what is interesting in this latest research is that after 6 weeks there was no difference in the pain scores of those taking Opioids versus a placebo; at 12 months the pain scores were higher for those using Opioids – i.e. the Opioids made the pain experience worse long term. 

One of the study authors is quoted as saying “We need to reassure doctors and patients that most people with acute low back pain and neck pain recover well with time (usually by 6 weeks), so management is simple ― staying active, avoiding bed rest, and, if necessary, using a heat pack for short term pain relief. If drugs are required, consider anti-inflammatory drugs,”

This matches the UK Nice recommendations which say:

“Consider a group exercise programme (biomechanical, aerobic, mind–body or a combination of approaches) within the NHS for people with a specific episode or flare-up of low back pain with or without sciatica. Take people’s specific needs, preferences and capabilities into account when choosing the type of exercise” (1.2.2)

“Consider psychological therapies using a cognitive behavioural approach for managing low back pain with or without sciatica but only as part of a treatment package including exercise, with or without manual therapy” (1.2.13)

“Consider a combined physical and psychological programme, incorporating a cognitive behavioural approach (preferably in a group context that takes into account a person’s specific needs and capabilities), for people with persistent low back pain or sciatica” 1.2.14

Note these are extracts from the NICE guidelines, please read them in full: Low back pain and sciatica in over 16s: assessment and management

And this is where, done appropriately, Yoga comes in – addressing both the physical and the psychological in the round.  Yoga is also well placed to help with pain management, short and long term.  

I’ve got to stress done appropriately in the above sentence – Yoga is a broad church, and a very strong physical yoga practice could well make matters worse, likewise the majority of yoga teachers are not trained in the psychological aspects of managing well being nor in the specifics of pain management.  So if you are seeking Yoga help for back or neck issues, you need someone like a Yoga Therapist, or a Yoga Teacher with additional modalities and trainings, to assist.

You can read a bit more on my website about how I use Yoga for Back Conditions and Pain Conditions

Again, to re-emphasise, I am not a doctor or prescriber, so do seek advice if you are unsure, and don’t start or stop taking medications without advice.

The post Opoid Pain Relief for Back and Neck Pain appeared first on Yinspire Yoga Therapy.

Yoga improves cancer-related fatigue, lowers inflammation, research finds 
(https://www.medicalnewstoday.com/articles/walking-and-yoga-can-cut-risk-of-cancer-spreading-or-returning)

The article links to a trio of recent research papers, two around yoga and cancer, one around physical activity and cancer.

The research is no great surprise to those of us in the Yoga Therapy world, but its good to see a wider body of science getting behind how Yoga can help us with health and well-being.

Yoga – or any exercise – will never prevent a cancer, nor cure it.  However used appropriately Yoga will help with cancer, in a variety of ways, such as improved toleration of drugs and treatment; reduction in inflammation; a quicker recovery from surgeries.  Of course Yoga’s benefits are not unique here, any light physical activity will help, however where Yoga wins out is beyond the physical, Yoga can help with the health of our physiology – principally the Nervous System –  and our spiritual outlook.

A stable and well tuned Nervous System will help us in so many ways – better adaptation to stress; better immune response; better resilience; to name but a few,. 

Surprisingly – or maybe not – our spiritual outlook helps.  Positive spiritual beliefs, whatever they may be, are a factor in well-being, so much so that as an extension to the often used BioPsychoSocial (BPS) model of well-being, some people use a BioPsychoSocialSpiritual (BPSS) model.

As always the devil is the detail.  Yoga for Cancer Recovery would need to be delivered in a small group or individual setting, by an experienced Yoga Teacher or Yoga Therapist, and should be a rounded, graded practice, erring on the side of less is more – for most people its not the time for strong physical Yoga Asana (poses).  Restorative and Yin Asana, along with Pranayama (breath work) and some internal enquiry is likely to be the suitable approach.

Finally, in the UK the Cancer Act 1939 rightly places restrictions on people advertising cures for cancer.  Yoga is to help, not treat, in such situations.

The post Yoga, Yoga Therapy and Cancer appeared first on Yinspire Yoga Therapy.

‘Shocking’ lack of evidence on antidepressants for chronic pain

The research being reported on is a Cochrane Review which is a very respectable library of systematic reviews of research – the actual review is at:

Antidepressants for pain management in adults with chronic pain: a network meta‐analysis

The conclusions from the reviews authors show that there is some evidence to support using Antidepressants for chronic pain conditions, but an absence of long term evidence, noting that the research they reviewed covered trials with an average length of 10 weeks. 

There are a few things to pull out of this

First ten weeks, the average length of the research, is not a long time – antidepressants can take several weeks to work, and chronic pain is by its nature a long term condition which is experienced over months or years rather than weeks.

Second chronic pain is a difficult condition to classify – generally it will be presenting without obvious physical cause – maybe no cause at all, maybe pain persisting after an injury or illness has healed.  There are clusters of overlapping conditions – for example Fibromyalgia, Neuropathic pain, Muscular skeletal pain, and these may also overlap with physical and emotional health concerns like ME, trauma or stress related conditions.   There is no one agreed definition for the length of time before pain becomes chronic, although either 12 weeks or pain persisting beyond the expected recovery time for an injury are working definitions.

Thirdly, from a neuroscience perspective, the neurobiology of chronic pain – why it happens, and how it manifests in the brain – isn’t fully understood by science.

However some people do find antidepressants help with chronic pain, which is no small thing.

Making Sense of This

Making sense of these threads isn’t easy.

A modern understanding of pain looks at it from a BioPsychoSocial perspective – thats to say looking at the condition from the perspective of biology, such as tissue damage; psychology, such as how the pain is effecting mood; and social aspects – how the experience of pain effects the persons day to day life including work, relationships and leisure.  These variables feed off each other and often create a negative spiral of decreasing health and well-being.  It also helps to explain how two people with, say, similar injuries, have very different experiences of pain and different long term outcomes.

It is understood that if you can change one aspect of these variables you may be able to reduce the experience of pain.  In that context it is easy to see how ongoing pain can create low mood, so lifting the mood breaks the circle of declining health and enables someone to take steps to improve their overall outlook – maybe get some exercise and fresh air, indulge again in a favoured hobby, or get back to work.  In turn that improved outlook helps the nervous system to stabilise and pain to recede.

Yoga Therapy and Chronic Pain

As a therapist I don’t prescribe medication, so I can only talk in general terms about antidepressants.  And my general thought would be if Antidepressants – or any other medication for that matter – works for you and provide help then that is good – keep in contact with your doctor or prescriber and take their advice on dose, duration and any changes to medications.  They are the experts.

Many people don’t like taking medication long term – due to stigma, side effects or perhaps their doctors reluctance to prescribe it long term.

This is where the BioPsychoSocial model also provides a framework for other interventions like Yoga. 

Done skilfully Yoga can, in a similar way to medication, help to calm the nervous system and help someone regain a balance in life and pain recede.  I’d emphasise the “can” in that sentence though – Yoga won’t work for everyone, and won’t be the complete solution.  Likewise it needs to be done skilfully – not all yoga is created equally, and some yoga practices or routines could easily make matters a lot worse.

A Yoga therapist is trained in using Yoga therapeutically for conditions like Chronic Pain and would be able to suggest where Yoga can potentially help you safely and effectively.    Done skilfully Yoga may help alleviate chronic pain and possibly reduce reliance on medication.

You can read about my approach to Yoga Therapy for Pain Conditions

In conclusion, for someone with a Chronic Pain condition, any help is going to be welcome.  Medication well be a large part of that.  Lifestyle and non medical interventions are part of this as well, and Yoga can be part of the jigsaw here.

The post Antidepressants and Chronic Pain appeared first on Yinspire Yoga Therapy.

Quoting from the article, which reports on research by Dr Clarissa Yasuda, MD, PhD, from University of Campinas, São Paulo, Brazil:

“Even mild cases of COVID-19 can affect the function and structure of the brain, early research suggests.  Some studies have shown a high prevalence of symptoms of anxiety and depression in COVID-19 survivors, but few have investigated the associated cerebral changes”

“On brain imaging, those with COVID-19 and anxiety and depression had atrophy in the limbic area of the brain, which plays a role in memory and emotional processing.  No shrinkage in this area was evident in people who had COVID-19 without anxiety and depression or in a healthy control group of individuals without COVID-19. The researchers also observed a “severe” pattern of abnormal cerebral functional connectivity in those with COVID-19 and anxiety and depression. “

The whole article is worth a read, specially if you have had Covid and are dealing with anxiety or similar conditions.

The article goes on to quote from Dr Yasuda “”The magnitude of these changes suggests that they could lead to problems with memory and thinking skills, so we need to be exploring holistic treatments even for people mildly affected by COVID-19”.

The authors pick up that “Treating these symptoms may induce “brain plasticity, which may result in some degree of gray matter increase and eventually prevent further structural and functional damage”.

We know that a therapeutic approach to Yoga can help promote both Neuro Gensesis – expansion of brain neurons – and Neuro Plasticity – new and reinforced neuronal connections.  Put simply Yoga can most definitely help with brain health.

However it is worth a caution here that not all Yoga – or more correctly not all Yoga teaching is equal.  Yoga for brain health would need to be carefully constructed so it is more than just Asana, and would need to target improvement in the health of the nervous system (via Hebb’s law if anyone is interested in reading further) – this requires a Yoga professional, such as a Yoga therapist, who is familiar not just with yoga but with physiology and mental health.

This is certainly an area I can help with as a Yoga Therapist if you are finding long term mental health problems post covid.

The post Even Mild COVID Is Hard on the Brain appeared first on Yinspire Yoga Therapy.

Psychological Effects of Yoga and Physical Therapy on Low-Back Pain and Disability

It is a US study looking at how Yoga and Physical Therapy may contribute to improving peoples experience of Low Back Pain, by reducing perceived stress.

Its known that psychological health has a tremendous effect on experience of pain.  This is the so called BioPsychoSocial approach to health.

In this research the Yoga intervention seems to have been physically based, using Hatha Yoga classes – a classical movement and posture based yoga approach. 

The conclusion seems to be that improvements in psychological health from Yoga didn’t seem to correlate with the reduction of the stress of low back pain, compared to a control group.

It is a odd set of conclusions.  First, it seeks to separate improvements in back pain from psychological heath versus improvements in back pain overall – in fact we aren’t told whether overall people felt better or worse!  And surely thats the key thing!  It seems a reductionist and simplified approach.  Secondly, Hatha yoga tends to be conflated with physical exercise, borne out by the fact that Yoga and Physical Therapy are compared to a control group, yet a therapeutic approach to back health with yoga is much wider than just yoga postures – the nervous system, accessed through practices like Pranayama (breathing exercises) and mindfulness, as well as via postural yoga, is the emphasis in managing pain – indeed by themselves, without sensitive teaching, yoga postures may do more harm than good.

So had the authors of the report used a therapeutically taught yoga approach, ideally with a Yoga Therapist, then the outcomes would likely have been different.

Put simply not all Yoga is the same.  And thats no bad thing, as at different stages in life we have different needs.  The trick is to know what is right for this time.

To read a bit more about how I approach Back Care and Back Pain, read here

I’d like to think I achieve a bit more with my clients than this report suggests!

The post Psychological Effects of Yoga and Physical Therapy on Low-Back Pain and Disability appeared first on Yinspire Yoga Therapy.

Yogic Breathing Affects Cerebrospinal Fluid Dynamics During Breathing Practice

It is a write up of some research done around cerebrospinal fluid movement.  CSF movement has a different rhythm during deep sleep, which is believed to correlate with removing cellular waste from the brain.  The cellular waste is linked to some dementia conditions such as Alzheimer’s and other neuro-degenerative conditions which negatively effect the health of the brain and nervous system.

The hypothesis was that Yogic breathing may create similar changes in CSF movement.  Tentatively this was found to be the case, and whilst it is certainly precipitous to say that Yogic breathing is a preventative measure for these conditions, certainly the evidence points to Yogic breathing having a beneficial effect on brain and nervous system health.

It is likely that Yogic breathing is only part of the story in improving the health of our nervous systems, and regular practice would be needed over a period as part of a holistic approach to well-being.  As part of a bigger picture, these are, of course, positive findings and point to the benefit of a nurturing and supportive Yoga practice over a period of time.

The post Yogic Breathing Affects Cerebrospinal Fluid Dynamics During Breathing Practice appeared first on Yinspire Yoga Therapy.

The original paper by Zubin et al in 1977 looks at vulnerability in the context of schizophrenia.  Vulnerability: A new view of schizophrenia

What I found more interesting was some contemporary writing from 2010 by Goh and Aguis – The stress-vulnerability model how does stress impact on mental illness at the level of the brain and what are the consequences?  (here is a unpaywalled version)

If you are someone who struggles with stress, then this may be worth a read. 

Its quite a dense article, and addresses amongst other things how stress impacts the HPA axis ( hypothalamic–pituitary–adrenal axis), the main physiological moderator of stress in our bodies via the “stress hormone” Cortisol, and brain areas which may be impacted.  Interestingly although the neurological presentation of various stress conditions may present differently in the brain – for example the authors report that in Post Traumatic Stress Disorder and Borderline Personality Disorder the Amygdala, part of the brain which modulates threats, are seen to reduce in size, yet in Bipolar Affective Disorder they increase in size – there is a commonality in how all Stress conditions, eg Schizophrenia,Bipolar Disorder, PTSD, Depression, impact the HPA axis with an prolonged increase in levels of Cortisol (Hypercortisolemia), and attendant down stream impacts.

Another area considered is the genetic patterns of different stressors, and how their neurological, endocrine and physiological patterns interplay with genetic coding, which the authors identify as a “constitutional genetic vulnerability to particular illnesses”.

Nature Loads the Gun, Circumstance Pulls the Trigger

However the old saying is “nature loads the gun, circumstance pulls the trigger” – so put simply whilst we may have a inherent, genetically coded, response to stress, we have the ability to control how we respond to stressors.

And this, of course, is where Yoga, alongside modalities like CBT and Psychotherapy, can help us to change the inner experience.

A carefully crafted Yoga practice is known to protect and strengthen the nervous system; at first it may simply be a case of grounding us and helping us to regulate – basically emotional First Aid – then Yoga may help us to develop coping strategies to improve how we respond to stressors and thus head off our vulnerabilities.  Longer term neuro-plasticity can help us mould new and more resilient brain health – look up both “Hebb’s Rule” and “Neuro-genesis” but these are something for me to write about another day.

As part of my training as a Yoga Therapist I looked at Stress Vulnerability in the context of Psychological Overwhelm – the “stress of being stressed” – for my final Dissertation project.  Interestingly research suggests the type or style of Yoga practised is less important than both the intention to do something, and the skills of the Yoga Teacher/Therapist in holding space.  But these aren’t quick changes to make, and will require some effort and consistent practice to both effect change and to prevent relapse.

Stress, Anxiety and Low Confidence is one of the areas I specialise in as a Yoga Therapist, and I am able to work with people one on one or in small groups. 

The post Stress Vulnerability Model – Zubin et al 1977 appeared first on Yinspire Yoga Therapy.

Minded Institute have published an interesting review on the topic:

Irritable Bowel Syndrome is a widespread issue. In the UK, between 10 to 20% of people live with this chronic health condition, which causes frequent digestive discomfort and causes symptoms like stomach cramps, bloating, diarrhoea and constipation. These symptoms, while they tend to come and go, may last for days, weeks or months, and appear in periods of particular intensity known as “flare ups”. 

Unfortunately, the medical community is yet to identify either a cure or a cause for IBS. It is theorised the experience of IBS could be linked to oversensitivity in the gut, food passing too slowly or too quickly through the digestive system, or hormonal changes – with people who menstruate often reporting a worsening of symptoms around their period. There is also a strong suggestion that IBS is exacerbated by stress and anxiety, and symptoms may be related to disturbances in the gut-brain axis. 

The full article is worth a read if IBS is of interest to you.  Can Yoga Therapy Help IBS (Irritable Bowel Syndrome)?

The post Can Yoga Therapy Help IBS (Irritable Bowel Syndrome)? appeared first on Yinspire Yoga Therapy.

A Single-Session Pain Management Skills Class Benefits Patients With Chronic Low-Back Pain

The summary is that “A single 2-hour pain self-management skills class is no less effective than an 8-week, 16-hour cognitive behavioral therapy (CBT) program for reducing pain catastrophizing, pain intensity, and pain interference in adults with chronic low-back pain, according to a new Stanford University study.”

They go on to say “Three months after receiving one of these treatments, participants in both the single-session pain class and the CBT program showed clinically meaningful reductions in pain catastrophizing scores. The reduction in pain catastrophizing score in the group that attended the single-session pain class was not significantly inferior to that in the CBT group. Both treatments were superior to health education for reducing pain catastrophizing scores. The single-session pain class was noninferior to CBT and superior to the health education class in reducing scores for pain intensity and pain interference (the extent to which pain limits or interferes with a person’s activities).”

“The findings from this study indicate that a single pain management skills class can have meaningful benefits for patients with chronic low-back pain. The researchers who conducted the study said that this new intervention may improve access to care because it is adaptable to medical or community settings and may be offered at low or no cost. They cautioned, however, that their study participants were mostly White and of high socioeconomic status. It’s uncertain whether similar results would be obtained among participants of different socioeconomic status or in racially/ethnically diverse populations. “

I’m always cautious as a practitioner about promising too much to people from one session, but previously have had a client experience a considerable improvement in back pain after one Yoga Therapy session.

This research finding underscores that back pain is complex – is not just physical, its also psychological, emotional and social.  Therapeutically we consider it using a BioPsychoSocial model which looks at both cause and effect of back pain from a physical, psychological and social basis.  It can be hard sometimes to accept that back pain is more complex than just physical tissue damage (the Bio in BioPsychoSocial) but we all know how a long term injury can effect mood – we tend to appreciate less how mood can make our experience of pain worse.  Add in the social impact if we cannot work or enjoy our social lifes, and we end up stuck at home.  What research of this nature shows is that a targeted session can help change our experience, expectations and outlook.

However as a note of caution, this doesn’t mean that quick fix remedies are all thats needed.   With something as complex as ongoing back pain a regular programme of exercise and mind body work will always reap benefits.  It would have been interesting to see the longer term outcomes from this research of a single session versus an eight week course. 

Although the initial outcomes were similar, I would expect, long term, the eight week participants to enjoy more in the way of ongoing improvement in their experience of back pain.

Read more about how I work with Back Complaints

Image by Robystarm from Pixabay

The post Research: A Single-Session Pain Management Skills Class Benefits Patients With Chronic Low-Back Pain appeared first on Yinspire Yoga Therapy.

What is the Molecular Signature of Mind Body Interventions? A Systematic Review of Gene Expression Changes Induced by Meditation and Related Practices.
https://pubmed.ncbi.nlm.nih.gov/28670311/

Mind Body Interventions (MBIs) cover a broad category of disciplines like Yoga, Tai Chi, Qigong, Mindfulness, breathing practices, Relaxation Response.^1,3

It’s reasonably clear that these all have positive effects on our physical and mental health. Often, however, we tend to look at these effects through the lens of obvious mechanisms like gross anatomy – changes to muscle and tissues – or psychology and neuroscience – changes to brain function or structure.

However the human body is much more than the sum of the parts, and one of the many areas of expanding knowledge in recent years has been genetics.

In this review paper the authors are looking at how Mind Body Interventions change our genetic coding, in particular how genes are expressed – that is to say which genetic traits are dominant and which suppressed. The genes themselves are inherited, but their expression or suppression is variable – as has been said “genetics loads the gun, lifestyle pulls the trigger”

There is a distinct genetic coding for chronic stress. In this context chronic equates to a long term stress response to adverse events – the authors define stress as “Stress can be regarded as a bodily response to events that are perceived as a threat or a challenge”. When we experience chronic stress our genes adapt to reflect this, especially promoting pro inflammatory genes, and downstream inflammation has a significant effect on our health and ageing – everything from arthritis to dementia via heart disease and digestive complaints have a inflammatory trait to them.⁵

Put simply our genes reinforce the stress, and state becomes a genetic trait. It’s an adaptive function of old which hasn’t kept place with modern life – when stress was life or death, such adaptations made sense; in modern times they are less useful, a ongoing spat on Facebook is unlikely to be life or death.⁴  Likewise when medicine and medical care was primitive, inflammation may have been the best medicine – not in the modern world.

This review paper looks at a cross section of research showing how MBIs potentially reverse these genetic changes and downrate these inflammatory genes. That in turn makes us less susceptible to the negative effects of inflammation.

Tentatively this suggests we can counter some of the stresses we face by our preferred MBI. As the authors say in conclusion “This research opens the doors to the development and testing of a multi-level theory of MBIs, which integrates the biological, psychological, and environmental levels” although rightly they also acknowledge that more research is necessary.

Alongside what we know about MBIs helping promote positive changes in brain and nervous system functionality and structure, and other factors like telomere² length, we start to see a pattern regarding taking control of our health and well-being.

Notes

¹ https://www.yinspire.co.uk/relaxation-response-and-coherent-breathing-a-review/

² https://www.yinspire.co.uk/book-telomere-effect-blackburn-epel/

³ https://www.yinspire.co.uk/book-relaxation-response-herbert-benson/

⁴ https://www.yinspire.co.uk/book-zebras-dont-get-ulcers-robert-m-sapolsky/

⁵ Although, paradoxically, not all inflammation is related to stress, and not all inflammation is bad.  We demonise inflammation at our peril.

The post The Molecular Signature of Mind Body Interventions appeared first on Yinspire Yoga Therapy.

Historically I’ve always been cautious about recommending Yoga for Weight Loss – this is because Yoga is much more than merely a physical practice, and whilst a vigorous physical Yoga Asana practice may raise the heart rate, often Yoga practices do just the opposite slowing both our heart rate and energy expenditure down.

However in the research programme referenced in this paper, it was found that, as part of a structured weight loss programme, Yoga helped with the weight loss.  What is particularity interesting is that it seems Yoga was the only physical activity in the programme, and the weight loss was found regardless of whether a more vigorous style of Yoga was followed or a more relaxing style – classically in the latter, the relaxing style,  we would expect to see heart rate and energy consumption decrease so weight loss effects being limited.

It would have been useful to see a comparison of both Yoga and the individual Yoga styles on their own against the structured programme, because we don’t know how much the overall programme which included dietary advice and group support contributed to the weight loss.

However this certainly shows that Yoga has a part to play in an integrative weight loss programme, and that the Yoga style isn’t as important as may be thought.

I would speculate myself that, whilst activity and diet are seen as the key components of weight level, stress and psychological well-being is also an often overlooked factor, and that Yoga, especially the more relaxing style, contributed by a reduction in stress levels and a down rating of Sympathetic nervous activity with attendant downstream effects like a reduction in Cortisol and inflammation.   As part of my Yoga therapy training I investigated Yoga Therapy for Psychological Overwhelm, and in that context research also showed that the style of Yoga was less important than the manner it was taught and the group support – so its not surprising to see a similar effect here, which demonstrates that the overall programme and delivery environment are an important factor. 

Yoga Therapists are, of course, well placed to support clients on such a multi faceted journey. 

The post Beneficial Role of Yoga for Weight Loss appeared first on Yinspire Yoga Therapy.

We’ve Got Depression All Wrong. It’s Trying to Save Us – New theories recognize depression as part of a biological survival strategy

For anyone affected by depression – maybe as someone susceptible to it; maybe as a family member; or maybe as a professional – this is worth a read.

The thought is that Depression may be an adaptive response to adversity, and part of a somatic process of protecting us.  The author considers how Polyvagal Theory may help us understand depression better. 

Polyvagal Theory emanates from the work of Stephen Porges, and postulates that rather than the classic Sympathetic v Parasympathetic split in our nervous system, and the well known “Fight and Flight” v “Rest and Digest” there may be a further response of “Fear and Freeze” coming from the older dorsal branch of the Vagus nerve, creating an extreme Parasympathetic response to major stress.  Its not an easy set of concepts to grasp, and I like Deborah Dana’s writing on the topic for an accessible way in to it.¹

I don’t think this creates a universal theory of Depression by any means, which is best considered as a complex response to multiple physical, emotional and psychological inputs, however certainly these thoughts help us to see new treatment options for Depression, and also help to remove some of the stigma of “its all in your head” – maybe its not.

Yoga Therapy can help look at health in the round, not constrained by divisions between physical and psychological, and there is good evidence supporting Yoga’s use with Depression. ^2,3

Yoga Therapy can also help us by giving a perspective to conditions like Depression away from the rigidity of the Western dominant BioMedical model – for example the mapping Polyvagal Theory to the various energetic qualities that Yoga recognises within the three Guanas – Tamas, Rajas and Sattva. ⁴

1 – Book: The Polyvagal Theory in Therapy: Engaging the Rhythm of Regulation – Deborah Dana (2018)
https://www.yinspire.co.uk/book-the-polyvagal-theory-in-therapy-engaging-the-rhythm-of-regulation-deborah-dana-2018/

2 – Yoga for Depression: A Systematic Review and Meta-Anaysis
https://onlinelibrary.wiley.com/doi/abs/10.1002/da.22166

3 – Positive therapeutic and neurotropic effects of yoga in depression: A comparative study
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3768221/

4 – Yoga Therapy and Polyvagal Theory: The Convergence of Traditional Wisdom and Contemporary Neuroscience for Self-Regulation and Resilience
https://www.frontiersin.org/articles/10.3389/fnhum.2018.00067/full

The post Depression – Some Alternative Thoughts appeared first on Yinspire Yoga Therapy.

Effects of yogic breath regulation: A narrative review of scientific evidence

It’s a comprehensive review of research and papers on Yoga breathing techniques – Pranayama – published in 2019 by Saoji et al.

It’s quite a read, but if you are interested in what research says about Pranayama then it’s worthwhile.

A few points jumped out at me:

First, the authors stated “The practice of Pranayama is generally considered safe and we could find only one case report reporting an adverse effect of yogic breathing during our review of literature”.  They went in to report that one adverse effect was from Kapalabhti, which non coincidentally is the one technique I am cautious around teaching – it’s got a lot of benefit, and it’s a near daily practice for me, but it’s a difficult one to learn and not for beginners.

Second, and again quoting the authors “We observed that, most yogic breathing techniques are found to have profound effects on autonomic functions. Most yogic breathing practices lead to parasympathetic shift of the ANS activity, except high frequency Yoga breathing (Kapalabhati)”.  It could be generalised that autonomic regulation – the shift between sympathetic and parasympathetic activity is impaired in many people, certainly it is in many clients I work with, and likewise many people experience sympathetic dominance, and hence Pranayama presents many simple opportunities to improve wellbeing.

Finally, it’s gratifying to see in one place the weight of evidence supporting the benefit of Pranayama, and the number of conditions that can be assisted, although to those of us working in Yoga Therapy it is no surprise.  The authors do note, as is often the case with Yoga research, limitations in the quality of some of the papers.

It is worth quoting directly from the authors conclusions:

“Pranayama or yogic breathing practices were found to influence the neurocognitive abilities, autonomic and pulmonary functions as well as the biochemical and metabolic activities in the body. The studies in the clinical populations, show the effects of yogic breathing in modulating cardiovascular variables in patients with hypertension and cardiac arrhythmias, relieving the symptoms and enhancing the pulmonary functions in bronchial asthma, as an ancillary aid to modify the body weight and symptoms of pulmonary tuberculosis, to enhance mood for patients withdrawing from cigarette smoking, to reduce the reaction time in specially abled children, to manage anxiety and stress in students, to modulate the pain perception, improve the QoL and sympathetic activity in patients with diabetes, reduce the cancer related symptoms and enhancing the antioxidant status of patients undergoing radiotherapy and chemotherapy for cancer. Thus the cost effective and safe practices of yogic breathing could aid in prevention and management of various non-communicable diseases. They may also play a role in management of communicable diseases such as pulmonary tuberculosis.”

Full access to the paper is available via this link:

Effects of yogic breath regulation: A narrative review of scientific evidence

Quotations taken from paper under principles of fair use, (c) acknowledged 

The post Research: Effects of yogic breath regulation: A narrative review of scientific evidence appeared first on Yinspire Yoga Therapy.

Study Provides New Insights Into Changes in Brain Function in Fibromyalgia

Its a commentary on a recent study into how a functional set of connections in the Brain called the Default Mode Network adapts in people with Fibromyalgia.
Default mode network changes in fibromyalgia patients are largely dependent on current clinical pain

The study showed that where someone with Fibromyalgia was currently experiencing pain, the Default Mode Network had strong connections to the Insula cortex.  To translate this the Default Mode Network is the set of connections the brain defaults to if it is not focused on something else – hence, literally “default mode”.  The Insula cortex is a brain structure responsible for an assortment of brain functions, but most notably interoception – the sense of how the internal state of the body – and the sensing of emotional states, including anger, fear, disgust and happiness.

So there are a couple of interesting things to note from this:

First, that part of the brain that is activated when Fibromyalgia is flared up is not only the pain register, but the area of the brain that deals with the sense of how we are and our emotions – no wonder a Fibromyalgia flare up can leave people exhausted, emotional and unable to cope.

Second, these senses feed of each other.  We know that pain causes us to feel fearful and anxious, and in turn fear and anxiety will intensify the experience of pain.  Again, explaining a little of how a Fibromyalgia flare up becomes all encompassing. 

Third, other studies show growing consensus that Yoga practices can improve the functioning of the Default Mode Network:
Greater Anteroposterior Default Mode Network Functional Connectivity in Long-Term Elderly Yoga Practitioners
Meditation’s impact on default mode network & hippocampus in mild cognitive impairment: a pilot study
Changes in Neural Connectivity and Memory Following a Yoga Intervention for Older Adults: A Pilot Study
Yoga Effects on Brain Health: A Systematic Review of the Current Literature

So, bringing this together starts to explain how Yoga helps with conditions like Fibromyalgia.  If the Default Mode Network can be enabled to work more effectively across a number of brain areas rather than getting caught up in the areas that focus on pain, the the person with the Fibromyalgia flare up may be able to contextualise the pain and cope with it more easily.

Of course, thats not to say that Yoga is the only option here, and doubtless similar results may come from Tai Chi, Pilaties or other disciplines – Yoga doesn’t have a monopoly on brain health!  However  when taught by an experienced Yoga Therapist then Yoga has a lot of supporting evidence behind it in terms of brain health.

Equally it needs to be said this is simplifying complex issues around both Fibromyalgia and Neurological Function considerably.

However, all said and done, some interesting links arising. 

Fibromyalgia and Pain Conditions are an area I specialise in as a Yoga Therapist, and good results can often be achieved when someone sticks with Yoga over a period of time.

Image by VSRao from Pixabay

The post NIH: Study Provides New Insights Into Changes in Brain Function in Fibromyalgia appeared first on Yinspire Yoga Therapy.