Yin Yoga: Deep Stretching Of The Body’s Connective Tissues

What is Yin Yoga?

Yin yoga is a less-popular form of yoga which is
 performed to stretch the connective tissues of
the body. Primary connective tissues include
the hips, thighs and lower spinal area. These
types of tissues do not stretch the muscles (as
in the yang form of yoga) but they stretch
and exercise the bone and joints areas of
the body. This type of asana practice is
beneficial to a wide variety of people.

Yin yoga is a perfect match for yang yoga,
and provides a deeper stretch. Although yin
yoga is not as intense as other yang forms of
yoga, its long duration can be difficult to maintain.
The duration of some posture positions may last up
to 20 minutes at a time. Yin yoga is sometimes
offered at eating disorder treatment clinics,
inpatient drug treatment centers, or even for those
seeking pain treatment and trauma recovery.

Yin and Yang Yoga

Most people familiar with yoga, are familiar with yang
yoga, as this tends to be more common in Western
culture. Yang yoga stimulates the muscles in the body,
encouraging strength and great physical health. Over
time however, if yin yoga is not practiced, the body
will weaken and the joints of the body will
become susceptible to injury. As one ages, a lack
of flexible joints in the body increases the risk of pain.

Yin yoga also increases one’s ability to perform yang yoga. By
having lubricated, flexible joints, yang practices will seem
easier. Perhaps the main difference in yin and yang yoga is
each practices affect on the mind. Yin yoga creates a balance
and peace in the mind. In its earlier years of existence, yin
yoga was used in order to improve meditation practices. Yin
and yang yoga may both be helpful in treating those in need
of alcohol rehab and drug treatment as each provides physical
health as well as mental stability.

Practice of Yin Yoga

During the practice of yin yoga, asanas (a variety of positions)
are performed. Yang yoga however, has many more asanas
than yin yoga. No more than 3 dozen asanas are used for
yin yoga. This is due to the fact that in yin yoga, various
positions are held for a long time (minutes at a time) compared
to the short duration of yang postures.

10 Different Yin Yoga Asanas

1. Butterfly
2. Happy baby
3. Swan
4. Caterpillar
5. Lying twists
6. Deer
7. Sphinx and seal
8. Dragonfly
9. Toe squat
10. Frog

Another definition uses in yin yoga is something called
a flow. A flow is a set of asanas designed to be practiced
in a certain pattern, the pattern differs according to each
specific flow. Yin yoga is practiced as a part of a larger
yoga form called Taoist Yoga. The practice of yin yoga
 is performed to regulate the flow of energy in the body.
This energy is called “chi” and when its flow in the body
is strong, a person is healthy.

Benefits of Yin Yoga

Yin yoga improves the body in a variety of ways.
These may include:

• Feeling calm and balanced
• Regulated energy levels (chi)
• Greater strength
• Improved health
• Stress levels lowered
• Greater stamina
• Flexibility of the body’s connective tissues and joints
• Slowed signs of aging
• Improved meditation
• Deeper relaxation
• Improved practice of yang yoga

This type of yoga may be beneficial to a variety of people.
These people may be experienced or beginners of yoga.
Anyone attending drug rehab, eating disorder treatment,
or seeking pain and trauma recovery may find this yoga
form useful in treating their condition. In fact, professionals
at drug and alcohol rehab centers, pain and trauma treatment
centers or at eating disorder residential centers will often
offer classes for yin yoga.

Avoid Runners Knee

If you are new to running you definitely want to be wary of developing runner's knee, an overuse injury that is twice as likely to occur in women than men. Known in the medical world as patellofemoral pain syndrome (PPFS), runner's knee causes pain in and around the knee cap (or patella). The pain is caused by tracking issues with the knee cap that irritate the bony groove the knee cap actually sits in. While there can be many reasons for this annoying and common problem that most often strikes newbies, it is most often caused by tight hamstrings and calves (the muscles in the back of the leg) coupled with weak quads (the muscle at the front of the thigh).

You don't need to avoid running to prevent runner's knee, but you should try to run on accommodating surfaces like dirt paths and asphalt, not concrete. Uneven terrain and hills can aggravate knee tracking problems, so be wary of hills if you are experiencing tenderness around your knee caps. Be proactive and strengthen your quads. And to see how, just read more.

Wall sits are an easy exercise that target the quads.

• Stand with your back against a wall, placing your feet about two feet out in front of you. Feet should be hips distance apart.
• Bending your knees, slide your back down the wall until your knees are at 90 degree angles. Your knee joints should be over your ankle joints, so you may need to inch your feet further from the wall to create proper alignment. Don't let your knees fall in on the midline of your body, or sway outwards.
• Hold for one minute, do three reps.

Treat Me, but No Tricks Please

By GINA KOLATA

I RECEIVED an e-mail message recently from an angry doctor. He’d torn his hamstring running on a beach and spent eight weeks — a total of 20 hours — in physical therapy. Then his insurer said the physical therapy was not covered.

He couldn’t understand it. The therapy cost $150 a session, and he said it was “clearly beneficial and cost-effective.” (He added, though, that after eight weeks he was not yet running again.)

Hmm. I also tore my hamstring running, but my doctor never mentioned physical therapy. Instead he referred me for platelet-rich plasma, an experimental treatment that involves having my own blood platelets injected into the torn tendon. The cost, including the radiologist’s fee, an ultrasound and the plasma injection, was $2,200.

My insurer would not pay, which made sense to me because the plasma treatment is considered experimental. It might work; then again, it might not.

But the letter the angry doctor had received from his insurer made me wonder whether physical therapy was different from the plasma treatment. Is there rigorous evidence showing it works?

Unlike the doctor’s insurer, my health insurance companies have always covered physical therapy for sports injuries. Yet their willingness to do so is not necessarily an indication that the therapy is effective. The orthopedists in my town seem reflexively to write a prescription for physical therapy whenever I or any of my friends go to them with sports injuries. That, of course, is no indication, either.

When I’ve gone to physical therapy, the treatments I’ve had — ice and heat, massage, ultrasound — always seemed like a waste of time. I usually went once or twice before stopping.

My doctor at the Hospital for Special Surgery in New York, Joseph Feinberg, seems to share my opinion. “Very often, I think the hot packs, cold packs, ultrasound and electrostimulation are unnecessary,” he said, adding, “For sure, in many cases these modalities are a waste of time.”

So has physical therapy been tested for garden-variety sports injuries like tendinosis? Or is it just accepted without much question by people who urgently want to get better?

It depends, says James J. Irrgang, a researcher in the department of orthopedic surgery at the University of Pittsburgh and president of the orthopedic section of the American Physical Therapy Association.

“There is a growing body of evidence that supports what physical therapists do, but there is a lot of voodoo out there, too,” Dr. Irrgang said. “You can waste a lot of time and money on things that aren’t very helpful.”

Sometimes, manual stretching by a physical therapist can actually eliminate a sports injury, he said. His two examples are manual stretching of the shoulder for shoulder impingement syndromes, in which the shoulder blade rubs on a major tendon, the rotator cuff, and manual stretching of the ankle for ankle sprains.

They are the exceptions. More common are the “voodoo” treatments, he said. And what might those be? None other than ice and heat and ultrasound, Dr. Irrgang said. Also, he said, there is no evidence showing laser and release — a massage technique — to be effective in helping injuries heal.

Ice and heat, Dr. Irrgang said, “can control pain a little bit” but “are not going to take care of the problem.” The underlying injury remains.

When I asked Dr. Irrgang for studies showing what worked, I was a bit surprised. To put it kindly, they left much to be desired.

Researchers would mix treatments — stretching and massage and orthotic shoe inserts, for example. If patients said they felt better, it was impossible to know why. Some of the studies involved as few as four participants. And the researchers did not always assign subjects randomly to one treatment or another to see which one worked better.

In addition, researchers routinely failed to follow a standard method of data analysis called intention to treat. It means that when you look at results, you include even people who dropped out of your study. After all, people are dropping out for a reason. Often it is because the treatment is not helping, or is making them feel worse. Those remaining might be having a placebo effect or might be getting better despite, rather than because of, the treatment. And even if those remaining are actually being helped, when the dropouts are not counted, the treatment will end up looking better than it really is.

It is hard to defend such work, Dr. Irrgang said. “There are limitations,” he said. “There is room for improvement.”

To help physical therapists identify the best treatments for specific conditions and to minimize variations in practice, the orthopedic section of the American Physical Therapy Association is trying to put together clinical guidelines that assess and grade the evidence for treatments. So far, one review of evidence for treating a common sports injury — heel pain, or plantar fasciitis — has been published. Others are in the works on knee ligament instability, knee meniscus and cartilage problems, Achilles tendinopathies and low back pain.

Dr. Irrgang was part of the group that assessed the treatments for heel pain. The doctors concluded that for plantar fasciitis, physical therapy treatments like massage, stretching and taping have little evidence to support them. There is some evidence, not particularly convincing, that stretching can provide short-term pain relief.

But the best treatment for plantar fasciitis, orthotic inserts for your shoes, is the only one with a body of consistent (though not definitive) research behind it, and it may not even require a physical therapist. It does not even require a doctor. And, the studies indicate, off-the-shelf orthotics are just as effective as custom-made ones.

Even orthotics, though, provide only temporary relief. There is no evidence to support the use of prefabricated or custom foot orthotics for long-term (a year) pain management or functional improvement, the review concluded.

Dr. Irrgang, who has also been involved with the reviews that are in progress, gave a preview of some of the strongest findings.

Stretching, he said, appears to help sprained ankles heal faster, especially if is combined with exercises — strengthening and range of motion. And studies have found that a common treatment, taping an ankle to immobilize it, may slow healing.

There are good studies showing that Achilles tendinosis heals faster if patients do eccentric muscle contractions, like calf raises. Hamstring strains and pulls may heal better if patients do strengthening exercises.

Why go to a physical therapist for as many as 20 sessions, though, in order to do strengthening exercises? Why not just go to a gym?

Good question, Dr. Irrgang said. You can do exercises on your own at a gym, he said, but if you go to a physical therapist first, the therapist can do an evaluation and tell you what muscles are weak or tight, can design a personal exercise program and can teach you the exercises.

“If you have access to a gym, you might go to physical therapy for one or two sessions, learn what to do and then return to physical therapy in a few weeks to check on your progress,” Dr. Irrgang said. “Often, you don’t need to go to physical therapy three times a week or five times a week.”

With all that voodoo physical therapy out there, though, how can you tell if what you are getting is helping or useless?

It’s not easy, Dr. Irrgang said.

“You just have to be very inquisitive,” he said. “The physical therapist should be able to explain the various treatment options. You should ask about the benefits and risks, and ask what is the evidence that it will work.”

And if the therapist can’t give you good answers, he added, you might want to rethink your choice of therapist.