Archives for February 2015

Dr Terrell: “Women 40+ Need Yoga!”

This post is brought to you by  our own Yoga HotDisher, Top Doc,  and now,  Minnesota Monthly CoverGirl,  Dr. Carrie Ann  Terrell, MD, University of Minnesota (UMN). Thanks Carrie for contributing to our blog!


The evidence for yoga improving various health problems is deep and varied.  I recommend the website for an overview of the benefits of yoga as presented by the National Institutes of Health.  The evidence is solid as is my experience.

My most common patient scenario presents with a litany of concerns that reads something like this:

  • Fatigue, low energy, difficulty completing the umpteen tasks before her
  • Low libido
  • Inability to focus, memory loss, distractedness
  • Mood swings, irritability
  • Weight gain, digestive problems
  • Dissatisfaction with life

These women are 40-60 years old, often partnered with a significant other of varying participation in the relationship/housework/child rearing/care taking/cooking/shopping, have busy/successful/demanding careers, are the primary caretaker of the house/parent(s)/children/pets, and have unwieldy expectations for what they “should” be doing to take care of themselves.

These patients are essentially working every hour of their lives.  If and when they sleep it is erratic and interrupted and they wake without having rested. Or they “rest” while watching TV, iPading, gaming, texting, Facebooking. These activities are not restful, rejuvenating, nor replenishing. As if this isn’t enough they are also constantly talking to/bombarding themselves with negative or expectant commentary that translates as “not enough or not good enough.” In fact, the incessant loop of streaming thought these women live with is exhausting.

These women often come in seeking a magical hormonal cure.  They read that estrogen or bioidentical hormones or compounded hormones will resolve all of their issues; that their issues must be related to menopause or perimenopause. Now, I’m not underestimating menopause. Estrogen deficiency causes hot flashes.  Hot flashes can disrupt thought, the work day, the physical body. When hot flashes occur at night, sleeplessness results and irritability, mood swings, memory problems can follow suit. However, in many many cases, estrogen deficiency is not the problem. These women need a break, a time out, a mini-retreat, a respite.

Many women have found their solution. Some have found it in running, others in meditating. However, for many the potential solutions are untenable, unreachable, or add to the never-ending list of shoulds. Or, the options are so overwhelming women cannot begin to decide what to do or how to perform self care.

For me, this is where yoga comes in. When taught well, with attention to the philosophy and teachings, Yoga provides peace, quiet and a chance to observe ourselves.  Some know yoga to be an exercise; a physical activity leading to fitness, improved health, increased heart rate, etc etc. The secret is that asana practice (the poses are called asana) is solely meant to allow us to sit comfortably enough,quietly enough to see and feel clearly. Undoubtedly, the physical practice feels good. “Doing” yoga feels good, but, what feels even better is being able to look at my thoughts and see, ‘huh, those are my thoughts. I am not my thoughts.” Or, “look, this awful thing happened to me or someone said this awful thing to me and gee, I don’t have to be affected by that. I can still be me.” Or, “This pose sucks. I hate this pose. My muscles are shaking. This is dumb. I’m way too important for this pose. Why did I come? I have better things to do.” Which over time can become, “This pose sucks. I hate this pose. I’ve gotten through this pose before. I am stronger. My resilience is better.”

After 14 years of practicing yoga I can honestly say it makes me a better person. I build better relationships. I think more clearly. I know my limitations and know what I need to care for my self. I can separate myself from my wrongdoings, my suffering, my awards, my rewards, my family and my thoughts. With this ability I am able to set my work and personal goals in alignment with my deepest beliefs. I am able to achieve lifelong goals and hold positions of leadership with a sense of love and responsibility. I get to choose how I will react to incoming stimuli (if at all) and I can readily access a place of peace and serenity within myself.

Beginner Yoga: 5 Things New Students Should Know

Hands on assists are key for beginners

Hands on assists are key for beginners

1) The wellness and health benefits of yoga (physical, mental and more) will probably trump anything else you’ve ever done.  Beginners can not only expect to be stronger and more  flexible, but sleep better, stress less and fight bad bugs better with yoga-strong immunity.

2) Your success in performing the physical postures/exercises is determined more by your unique body and bone shapes, and ranges of motion facilitated by those shapes.  For instance, if you have a narrow pelvis, aspiring to do the splits is a bad idea!   45 degrees of extension in your spine on a good day?  Then Wheel Pose may not be for you.  It’s not a big deal–there are tons of poses that WILL suit you.

3) All yoga instructors are not created equally, nor are they interchangeable,  as some mass marketeers of yoga would like you to think.  Would you pick a hair stylist based on who’s closest? OK, for some of you, yes, — but, hair grows back!  Hurt your rotator cuff and the recovery time will be longer than getting over a bad hair day. Read teacher bios carefully and look for instructors w/ at least 5 years teaching experience, though 10 preferred.  Also, figure out how long they did yoga before they decided to teach it.  Did they think because they were a naturally flexible dancer or gymnast that they were magically endowed to teach a deeply inwardly-focused, mental practice?  Watch out — they might not understand how less fit bodies work, nor have command of anything beyond the physical postures flashing you back to phys ed!   Ideally, find a teacher who trained in an immersion program (lived yoga 24-7).  The Yoga Alliance certification used to carry weight, but one could argue it is less meaningful nowadays.

4) Treat your yoga like a doctor’s appointment and try not to miss class early on.   The practice of yoga can be overwhelming at first with lots of moving parts — how to perform the postures, breathing exercises, meditation techniques.  The biggest hurdle I find when beginning adults miss a class is more memory-related than anything else.  They forget all the coaching I gave them one-on-one, how I came over and guided them into poses in those first classes.  Then, they miss a week and “poof!” — I have to go back and re-teach it all. This can get a little tedious for the other students.  So, don’t be self-conscious about showing up and not knowing anything, but don’t let down the rest of the class by not taking your commitment seriously. Most of you wouldn’t cancel a doctor appointment due to less-than-perfect weather or a social engagement, then why cancel your Wellness Appointment?  Plan on disappointing people in the short-run with your new-found commitment to yoga–better than disappointing yourself in the long-run.  Look in the mirror and pretend telling someone demanding your time, “I’m sorry, I have an appointment.”  Deliver this line a in hushed tone with a serious face and I promise, they won’t ask!

5) Give it 3 months before you evaluate and avoid The Classic Beginner Mistake.   Authentic yoga practiced as “relaxed exertion” is the epitome of the Japanese concept of “kaizen,” or barely noticeable, continuous  improvement over time.  Subtle, sure, but it’s a big part of how Japan industrialized itself into a superpower.  Once you start coming to yoga 1-3 times per week, your body, mind, mood, outlook –everything launches on a slow trajectory of change.  While some people notice early on, for most, it sneaks up on them–maybe one day lifting a bag of groceries with   new-found upper body strength.  Then, at a party, you’re the only adult limber enough to sit on the floor!  So what’s The Classic Beginner Mistake? Thinking that you’re not really getting that much out of yoga and dropping it for a couple of weeks.  Before you know it, you’re the one who needs to sit in the chair and you realize how much you’ve lost!  Excuses in hand, you come groveling in to class (see number 4).  Yes, of course, we’ll take you back…and try not to judge.