Thursday, June 28, 2012

DrRic's Yoga Style


I had been called "Gumby" back during high school track and field (MVP 1984 Bishop Eustace Prep) but as I look at pics in the yearbook, my flexibility was poor compared to what I can do now. As I recall, I had to learn my flexibility routine from previous team captains or coach. So the basis to what I knew as an adult is on the backs of coaches and captains from school days. Fast-forward to present, I had a talk with the guy who runs women’s track at Montini HS, when I volunteered my services to run a clinic on sprinting, he mentioned a study that said stretching is not necessary for competition. What the hell?!!! Is there some vacuum I have been in during my training as a sports medicine doctor? Are the 80's really that archaic? Anyway.....if you are blessed with a great coach, you will succeed in staying injury free as you "get back into exercise to control weight, blood pressure and cholesterol. If you were not an athlete in school or were coached by Mr. Woodcock (Billy Thornton circa 2007) then you are setting yourself up for a non-sustainable reintroduction to living healthy. Had a patient yesterday who said she has done all the diets, been to all the trainers and is exercising 4 days a week with no success. The nutrition review I left to Tom Jordan (the registered dietician/marathoner/trainer) in my clinic. Her maximal effort with movement I trusted, then I did an exam and found limited knee flexibility with severe pop/snap (crepitation) a right shoulder she couldn’t life to 90 degrees, a core that was shaky with ventral hernia protruding out. So what I took for granted as "I guess she really has a good fund of knowledge", was so wrong. Whatever she has been told or taught, she does have regional pathology that may not be surgical and just need the right "coaching/guidance" to gain full, pain free range and strength. So everything she does now in her planet fitness gym is based on very poor body mechanics and instable joint motion. This is bound for injury and failure-this will be non-sustainable. When a lifestyle is embarked on, it should not be for losing weight to fit into a gown, it should be to make a lifestyle change and (as I tell patients) push back the time of death. If a heart attack is predicted at 50 years of age, push it back to 80 years with changing and sustaining a healthy life. What good is a summer endeavor is you can’t sustain it in the winter?

 Here comes the reason I teach my form of yoga: In my opinion, Deepak Chopra and Claire Diab have put together a great yoga teacher training program. It takes the ancient wisdom of Yoga/Ayurveda and defines it in real-world terms and understanding. It is very difficult for an average American to fathom what meditation is. It is hard to "concentrate on breath". There is no formal school introduction to cultivating the relaxation response aside from sitting in the corner for a time out (solitude) or fishing/gardening after school. So most people who pick up a mat and walk into a yoga class for the first time can be intimidated (eesssssspecially my male patients!!) by people who are super flexible, know the flow and can keep their eyes closed and sit in stillness like monks. One bad experience with yoga and the newbie is not going back. I feel a class can go through basic and advanced poses and flow but still be a mixed class of experience levels. If you hit the fullest expression of a pose-go for it! If the knee is too tight, speak to the instructor before class but don’t be embarrassed to practice yoga arthritis-style (it just so happens one of the best treatments for arthritis before prescription meds is tai chi and/or yoga!!!) For a class of 1 or 100 students, true practice is the individual expression of the pose suggested by the teacher. What I learned at Total Body Yoga and The Chopra Center (200 hours each) was to offer a class that imparts to a practitioner the highest sense of success. I feel teaching a pose safely without re-aggravating and old injury is easy. Teaching students that the breath observation and control is more important than flexibility is a challenge. I design my classes to be more breath awareness; you can actually stay in child’s pose or seated in a chair and just listen to the routine cue’s without doing the poses (asana) and leave feeling just as refreshed/relaxed in 60 minutes.

 It ain't about the pose; it's about giving the brain/mind 60 minutes of "stillness" without having to react to every thought, sound, action or feeling.

Friday, June 22, 2012

Ice

My team met with a prominent Orthopedic Surgeon yesterday. "Orthopods" are great, most have a very strong demeanor and emphatic about the doctrines they follow. I too would want someone like that on my side if I was contemplating a life changing alteration of body structure. The good ones will know "their business"down to the "micronutia" of bad outcome, good outcome, randomized controlled trials, failed collegue trials.... Aaahhh! but this comes at a sacrifice. Easily explained in yogic terms, this personality type is referred to as a "pitta" dosha. Hot, light, intense, penetrating, pungent, sharp, acidic.....fiery in nature. http://www.chopra.com/pitta Being a balanced "pitta", is not bad...in fact-many successful people in business and politics fall into this dosha-Donald Trump, Lance Armstrong, Bill Clinton, Denzel Washington. The problem with being in any dosha is when the human gets "out of balance". Then we have the presentation of what we know of in western terms as symptoms of disease. 5000 years ago there were no blood test, mri's, Hamilton Depression Rating scales.....Freud was probably a cat to be reincarnated a few times! So healers relied on community, exercise, meditation herbs and food. Going back to my "orthopod", he is very pitta and I embrace it. Those that are not used to this fiery personality, would immediately conceive-"this guy is too pushy with his doctrines". In a battle, people flock behind this personality; in peaceful times-people move away and seek shelter (especially when the pitta's are out of balance). So, I came loaded for battle-(I too am a pitta!) But with my Chopra Center Yoga Instructor training, I balanced myself out with daily meditation and yogic living...in addition to some acupuncture from Dr Zhu. I let him speak.....at times, I let him erupt while trying to interject some "zingers" back to him so as to keep him on track to why he was meeting us. I feel that in dealing with a high functioning pitta, one has to allow the raging river to erupt at first but then, a precise controlled force will be required to direct how the flow continues. In the end, I saw the innocence and beauty of this man with his genuine desire to help others. I mean, where do you find a "pod" that doesn't want to use prescription medicines to control inflammation!!! He actually believes in allowing inflammation, swelling and heat to go its course stating that "from evolution, the human body was meant to use inflammation to allow the body to heal-signals of pain and swelling tell the injured person to "take it easy" and stop using the extremity especially if surgery is contemplated so fibrous collagen pulls torn muscle fiber together and defects close up. However.......(deep breath in)......for those suffering from "non surgical" injuries where inflammation can be a lifetime, or those that are on "pro-inflammatory diets, or those that deal with stressful events by getting more stressfully "oxidated".....inflammation if allowed to continue will stimulate a casade of poor metabolism that leads us like a dog with a leash to the end product of heart disease, obesity, depression or cancer. (People that attend my Whole Foods Market lectures know I always make reference to get on an "anti-inflammatory diet" for any disease process.) This path of detruction, dna mutation, bad gene expression can blossom and perpetuate even if the initial bad joint is taken care of. This is where my "pod" lacks foresight. A bold statement that inflammation should be allowed is wrong. Every human has to be evaluated in a "whole system" approach. Western medicine is powerful but we tend to get too involved with specific studies and outcomes and details that take us into microscopic views of symptoms, forgetting there is a living breathing complex human with a body-mind-spirit connected to those symptoms. Anyone who chooses to ignore the "whole system" approach to decision making will not have the best interest of the individual in mind. It would be like giving you only 2 choices to contemplate versus empowering you with information to make a decision on your own. BTW-I usually start with Tumeric/piperine (1500mg daily divided), high vitamin D3 (2000-5000IU daily divided with fatty meal), glucosamine sulfate( 1500 mg daily divided if not shellfish allergic), valerian (30-40 mg 3 times a day), magnesium glycinate (400 twice a day if no diarrhea), helicrysum (hourly to affected area), acupuncture (3times a week) and healing visualization maybe arnica montana (low strength 30c) . My prescription pad is always ready to go if everything else fails in addition to physical therapy/hands on healing.