The Junk Drawer 
by Maggie Myers

Yoga East 2022 200 Hour Training, June 2022

Introduction

In various yoga classes I have taken throughout the years, I have often heard instructors talk about emotions being stored in the hips. Some teachers even describe the hips as “the body’s junk drawer.” They say stretching your hips can cause a release in which suppressed memories or pent-up emotions might bubble up to the surface. Sometimes the release is so profound, it can bring a student to tears. 

I have never witnessed anything like this in a class; however, I am familiar with the uncomfortable feelings that arrive in my own body when practicing a hip opener such as Agnistambhasana. I’ve wondered if there is any truth to this concept that emotions can actually get trapped inside our hips–or, if teachers just use this idea to simply encourage a mind-body connection with the imagination. Luckily, plenty of recent scientific evidence has demystified why a yoga practice can be so cathartic. Basic anatomy of the hips and the muscles that control these joints helps to explain how tension builds up in this area of the body, and recent psychological research shows that emotions are directly linked to this tension. This remarkable link can be explored through the gift of yoga.

Anatomy and Function 

The pelvis plays a crucial role in how our entire body functions. We can consider it as our true core, both physically–since it connects the upper body to the lower body–and emotionally–since it contains our creative, reproductive, and elimination organs (Ishler, 2021). Its shape varies widely from person to person, especially among females. Its uniqueness is determined by genetics and environmental factors. (Swanson, 2019). We depend on our hip joints, which are located on either side of the pelvis, to bear our weight, stabilize our core, and move our legs around (Ishler, 2021). And, the tighter your hips are, the less overall mobility you have. Decreased hip mobility can result in pain and hinder daily activities as simple as walking or climbing stairs. Tight hips can also create an anterior tilt of the pelvis–meaning the pelvic bowl tilts forward out of neutral alignment–which leads to poor posture and a misaligned head and neck (Ishler, 2021). 

The hip flexors are a group of muscles attached to the hip joint. They include the sartorius, the tensor fascia lata, the rectus femoris, the pectineus, the adductor brevis, and the iliopsoas (Kapit & Elson, 2002). The psoas major is a deep postural muscle that is woven through the hip joint on either side, and connects to the lower spine. Much like the pelvis, there are no two sets of psoas muscles alike. A recent scientific discovery shows that some people even have an extra muscle in this area, and it’s referred to as the psoas minor. Approximately 40% of people have this variation (Swanson, 2019). When the psoas or any of the hip flexors become tight, the sensations we feel are not exclusive to the hip area. In fact, one may not even be aware that the hips are tight at all. We typically experience the pain from tight hips indirectly, meaning it isn’t your psoas that is going to hurt, but rather, adjacent areas, such as the back or even the shoulders (“The Psoas,” 2018). Nestled into the psoas muscle are the kidneys, which are responsible for filtering toxins in the body. Moreover, the adrenal glands reside here, and are the command center for the fight, flight, or freeze response. (Ishler, 2021).

Stored Emotions 

The fight, flight, or freeze response is your body’s natural reaction to any kind of threat, whether it be physical or psychological. First, briefly consider your reaction to a physical threat. Think of what you do when you are scared, threatened, or experience something shocking. Our natural response to a physical threat is to draw our knees into our chest and coil up for protection. The action of drawing the knees in, no matter how subtle or dramatic, starts at the hips (“Hips Don’t,” 2018). On the other hand, when you’re under any kind of mental or emotional stress, your psoas muscle tightens up the same exact way it would in response to a physical threat (Ischler, 2021). If we hear some devastating news that brings us to tears, we are compelled to retreat to the fetal position to weep. Even if we don’t actually curl up into a ball, those hip flexors still clench deep inside of us. After the initial stressor, real or imagined, is over and done with, tension will still linger in the hip area, thus “trapping” the emotion there (Ischler, 2021).

Oftentimes, modern humans do not even realize how stressed they are in the first place. We unconsciously engage the hip flexors all day long, either seated at a computer or behind the wheel (Swanson, 2019). Once one becomes aware of it, this kind of tension is not easy to shake off. In fact, it might have already been there for decades. Michael Lee, who is the founder of Phoenix Rising Yoga Therapy in West Stockbridge Massachusetts, remarked:

Whenever something happens to us as a kid, our body is involved. This is particularly true of trauma. The body comes to the defense of the whole being. In defending it, the body does things to stop the pain from being fully experienced. Emotional pain is overwhelming for small children, because they don’t have the resources to deal with it. So the body shuts it off; if it didn’t, the body would die from emotional pain. But then the body keeps doing the physical protection even long after the situation has ended. (Raskin, 2007)

How Yoga Helps

Undeniably, if something is bothering you mentally or emotionally, it will show up in your body. Yoga has the power to awaken emotional issues within us, allow us to observe them on the mat, and ultimately, with time, release them. Yoga is considered a somatic practice because it puts emphasis on perception (Swanson, 2019). While proprioception is about where your body is in space, interoception is about how you feel inside your body. Practicing yoga can help you cultivate and strengthen this inward awareness. The more sensitive we become, the easier it is for us to understand the link between the body and the mind. 

One can begin to dissipate unconscious muscular tension simply by tuning in to the breath. The diaphragm is situated right near the psoas, and so each breath we take expands the diaphragm and actually massages these postural muscles. Shallow breathing may encourage the psoas to tense up, while deeper breaths can help it start to release (Swanson, 2020). This is one of the countless reasons why conscious breathing is integral to all yoga, whether or not you are practicing the asanas. 

We can begin investigating the hips by shifting our awareness to unexpected places. One scientific study shows an interesting connection between the jaw and the hips–when the jaw is clenched, the hips are gripping as well. When the jaw is released and the tongue softens, the range of motion in the hips increases (Fischer et al., 2009). Another area of the body which is surprisingly linked to the psoas muscle is the arch of the foot (Ischler, 2021). Dr. Martha Eddy, a leading educator in somatics, explained: 

“If you’re massaging your foot and this arch in the foot is collapsed, then you might have an overstretched psoas, or if it’s really held tight, you might have a tight psoas. Working this lateral arch of the foot in reflexology means you’re going to be working with the lower back or down [in the hips].” (Ischler, 2021)

Incorporating asanas which engage the hips will not only help increase mobility and improve one’s posture, but it will also improve their ability to cope with fear and stress (Swanson, 2020). The psoas muscle itself is slightly challenging to target, because not many people can actually perceive it within them. It is recommended to first practice asanas that, in part, engage the psoas, and then focus on lengthening it out (Gudmestad, 2011). 

A suggested sequence could start with Supta Padangusthasana, which will make the psoas contract as it holds the leg up against gravity. Navasana will also create a similar contraction. Once the psoas has become warm and engaged, the hip muscles can then extend. It can be beneficial to first work with one side at a time, such as in Virabhadrasana I and Anjaneyasana. Then one can progress to seated postures such as Baddha Konasana, which externally rotates the hips and gets deeper into the groin and the pelvic floor muscles. Any backbends should come later in the practice, since they require full hip extension on both sides. Setu Bandha Sarvangasana is a great backbend to start with. In this asana, one must take care to set the pelvis to a posterior tilt, which means to tuck in the tailbone, or “spill” the bowl backwards to protect the lower back. Consecutive repetition of this pose may allow one to lift higher each time, which indicates the psoas is lengthening gradually (Gudmestad, 2011).

Conclusion

Though nothing can compare to your own personal, experiential evidence of healing with yoga, there is scientific evidence that the practice can help us process and release trauma by primarily focusing on the pelvis and hips. While yoga may be the ultimate tool to release stored emotions, we must be careful to proceed with caution. Though it may sound obvious to some, forcing the body to release during a yoga practice is counterintuitive. Richard Miller, Ph.D., who is both a yogi and a licensed psychologist, warned that an attempt to conjure an emotional release within the body is, “a subtle form of violence,” because it suggests that “you need to be other than you are,” (Raskin, 2007). The focus should not be on change, but rather self-acceptance. If we meet ourselves on the mat, just as we are, healing and liberation will come naturally. 

References

Fischer, M. J., Riedlinger, K., Gutenbrunner, C., & Bernateck, M. (2009). Influence of the temporomandibular joint on range of motion of the hip joint in patients with complex regional pain syndrome. Journal of manipulative and physiological therapeutics, 32(5), 364–371. https://doi.org/10.1016/j.jmpt.2009.04.003 

Gudmestad, J. (2011). How to Stretch and Strengthen the Psoas. Yoga International. https://yogainternational.com/article/view/how-to-stretch-and-strengthen-the-psoas 

Hips Don’t Lie: How Hip Openers Release Old Emotions. (2019, September 23). Yoga Today. https://blog.yogatoday.com/hips-dont-lie-releasing-old-emotions-though-hip-openers/ 

Ishler, J. (2021, September 16). How to Release ‘Emotional Baggage’ and the Tension That Goes with It. Healthline. https://www.healthline.com/health/mind-body/how-to-release-emotional-baggage-and-the-tension-that-goes-with-it 

Kapit, W., Elson, L.M. (2002). The Anatomy Coloring Book. Pearson Education.

Raskin, D. (2007, August 28). Emotions in Motion. Yoga Journal. https://www.yogajournal.com/poses/emotions-in-motion/ 

Swanson, A. (2019). Science of Yoga. Penguin Random House. 

Swanson, A. (2020, August 11). The Key To Releasing Stress And Paving The Way To Better Poses? Caring For Your Psoas. Yoga Journal. https://www.yogajournal.com/teach/anatomy-yoga-practice/psoas-anatomy/https://www.yogajournal.com/teach/anatomy-yoga-practice/psoas-anatomy/ 

The Psoas Muscle: How it Holds onto Trauma and How to Let it Go, with Yoga. (2018). The Trauma Conscious Yoga Institute. https://traumaconsciousyoga.com/psoas/

 Heart Rate Variability
by Allison Deckel
Yoga East Teacher Training 2022

Heart rate variability (HRV) is a normal occurrence and refers to the slight fluctuations that your heartbeat makes based on the needs of your body at the time (Cleveland Clinic, 2021). Heart rate variability measures how well the autonomic nervous system is working. The autonomic nervous system is divided into the sympathetic (SNS) and parasympathetic (PNS) nervous system. When the body is stressed, the SNS contributes to what is known as the “fight or flight” response. The (PNS) (del parentheses)contribute to functions referred to as “rest and digest.” In summary, HRV measures the balance between the SNS and the PNS (American Psychological Association, 2018). The most accurate way to monitor HRV is with an electrocardiogram, also referred to as an ECG or EKG. This is a machine that measures the electrical activity of the heart. This is done in a medical facility where electrodes (small, plastic patches that stick to the skin) are placed at certain spots on the chest, arms, and legs and hooked up to the machine (John Hopkins Medicine, 2022).

Our respiratory system syncs with our heart through a process called respiratory sinus arrhythmia (RSA). When we inhale, we activate our sympathetic nervous system increasing our heart rate. When we exhale, we activate our parasympathetic nervous system, decreasing out heart rate. The more robust the system the more variation there is between heart rates. The higher the HRV is, the more effective we are at managing our reactions to upsetting events and thinking through our best responses in a calm manner. (Cleveland Clinic, 2021).

When the heart is unable to fluctuate in response to breathing, this will have a negative impact on how the body reacts to stress. Specifically, low heart rate variability increases the likelihood for medical illness such as heart disease and cancer, as well as psychological problems such as depression and Post Traumatic Stress Disorder (PTSD).  Low HRV makes it more difficult to manage emotions and think through how we want to respond in the most effective way to stressors (Van der Kolk, 2014).

What impacts heart rate variability? There is a growing body of influence that early childhood trauma changes the brain and leads to various poor health outcomes, including diminished HRV. The CDC-Kaiser Permanente adverse childhood experiences (ACE) study is one of the largest investigations of how early childhood trauma effects physical and mental health outcomes. The findings indicated that as the number of ACEs increase, the risk for health problems later in life also increase (CDC, 2021). In the book, The Body Keeps the Score, the author, Bessel Van Der Kolk, MD, outlines how repeated exposure to traumatic events causes an over stimulation of the Autonomic Nervous System (ANS), resulting in poor HRV.

Yoga has been shown to have positive effects on physical and emotional well-being. Understanding this, Dr. Bessel Van Der Kolk and his team at the Trauma Center in Boston, MA, decided to study if regular yoga practice increased heart rate variability specifically. They selected thirty-seven women with severe trauma histories who had tried traditional psychotherapy but had not received much improvement. Half of the women took the yoga class, while the other half participated in dialectical behavior therapy (DBT), which is a well-established type of therapy that focuses on mindfulness. Their classes consisted of breath work (pranayama) and classic poses, with an emphasis on mindfulness, or being aware of the sensations that are happening during class within the body and in the mind. The results indicated that HRV improved with the yoga participants and did not change with the other group. These findings motivated them to incorporate yoga class as a treatment modality at their trauma center.

There are many ways to help students connect with their breath in a yoga class. A commonly used technique that is simple and effective is coherent breathing. In coherent breathing, the goal is to bring awareness to, as well as, extend the length of the breath itself. Students take a comfortable seat, keeping a straight spine, and asked to inhale through the nose for 6 counts and exhale through the nose for 6 counts. One may have to start with 4 counts and with practice work up to the full 6 counts. This is usually done at the beginning of class to bring awareness throughout the practice (Verywell Mind, 2020).

In the journal, Applied Psychophysiology and Biofeedback, a comprehensive search of multiple databases was conducted and all studies that reported a measure of HRV associated with any yoga practice were included. Studies were categorized by the study design and type of yoga practice. A total of 59 studies were reviewed involving a total of 2358 participants. Most studies were performed in India on relatively small numbers of healthy male yoga practitioners during a single laboratory session. Of the reviewed studies, 15 were randomized controlled trials. The reviewed studies suggest that yoga can improve HRV. Regular yoga practitioners were also found to have increased vagal tone at rest compared to non-yoga practitioners. However, they were unable to draw any firm conclusions about yoga and HRV as most studies were of poor quality, with small sample sizes and insufficient reporting of study design and statistical methods. While there is convincing evidence that yoga does improve HRV, more quality studies are needed to state this definitively (Posadzki, Kuzdzal, Lee, & Ernst, 2015).  

References:

Heart Rate Variability (HRV). Cleveland Clinic, 2021, retrieved from http://my.clevelandclinic.org/health/symptoms/21773-heart-rate-variability-hrv

Stress effects on the body. American Psychological Association, 2018 retrieved from https://www.apa.org/topics/stress/body

Violence Prevention. Centers for Disease Control and Prevention, 2021 retrieved from

https://www.cdc.gov/violenceprevention/aces/about.html

Bessel Van Der Kolk, MD (2014). The Body Keeps the Score: Brain, Mind, and Body in the Healing of Trauma. Penguin Books.

Posadzki, P., Kuzdzal, A., Lee, MS., Ernst, E., 2015. Yoga for heart rate variability: A systematic review and meta-analysis of randomized controlled trials. Applied Psychophysiological Biofeedback, 40, 239-249.

Health. John Hopkins Medicine, 2022, retrieved from https://www.hopkinsmedicine.org/health/treatment-tests-and-therapies/electrocardiogram

An Overview of Coherent Breathing. Verywell Mind, 2020 retrieved from

https://www.verywellmind.com/an-overview-of-coherent-breathing-4178943

 

People with Knee Osteoarthritis
Can Practice Yoga Safely
by Janet Cuthrell

Yoga East 200hr Teacher Training, June 2022

 Global aging, sometimes referred to as the “Silver Tsunami” or the “Age Wave”, has become one of the greatest sociological shifts in history ^[1]. Americans ages sixty-five and older, make up the fastest growing sector of the U.S. population; this diverse group are living longer, practicing yoga and even running marathons ^[1]. Furthermore, according to the CDC, 41% of these older individuals report that they are in good or excellent health ^[2]. However, although a large percentage report back positively, seniors are often faced with a variety of adverse health conditions which can have detrimental effects on overall quality of life ^[2].  Among these conditions is osteoarthritis ^[2]. 

The most common form of arthritis worldwide is Osteoarthritis (OA), a progressive disease that destroys cartilage and joints, is a frequent cause of pain, functional limitation and disability ^[3].  Osteoarthritis of the knee is a common form of arthritis, and affects nearly 12.4 million seniors, the majority of which are women ^[3]. 

Exercise therapy, including mind-body exercises, yoga, and mental focus along with controlled breathing, have become key elements in the treatment for knee osteoarthritis ^[3]. Additionally, yoga has proven itself to be the superior form of exercise therapy, not only because of decreased pain and improved function, but yoga’s inclusion of meditation and standing exercises has helped seniors decrease anxiety and fear of falling ^[3].

 Sharon Kolasinski, MD, a professor of clinical medicine and a rheumatologist at the University of Pennsylvania in Philadelphia, produced a study on the impact of yoga on those suffering from knee osteoarthritis ^[4]. Kolasinski’s study demonstrated that people who participated in a 90- minute Iyengar yoga class, once a week, for 8 weeks, using props and pose variations, had decreased pain, increased physical function and less joint stiffness ^[4].

Because of yoga’s gentle movements, people with osteoarthritis are increasingly drawn to yoga for a safe and gentle form of exercise along with a way to lower stress, improve mobility and balance. Additionally, yoga is fun and presents people with arthritis a type of exercise that can be done on a regular basis ^[4]. Practicing with an experienced yoga teacher, modifying poses and using props, help to promote knee joint safety and provide a beneficial practice ^[4]. Iyengar yoga, is recommended for people with knee arthritis because it allows the use of props ^[4].

People with knee arthritis should modify yoga poses and use props to protect the knee ^[5]. In poses where the legs are straight, such as Trikonasana (Triangle Pose) hyperextending the knee should always be avoided ^[5]. To prevent knee hyperextension, a slight bend in the knees and keeping weight evenly distributed in the four feet corners is recommended ^[5].

Avoiding deep knee bends and maintaining proper knee alignment in poses like Virabhadrasana II (Warrior II) is another way to protect the knee and avoid knee injury when practicing yoga ^[5]. The bent knee should be aligned over the ankle and in line with the second toe ^[5]. If the knee should go beyond the ankle, the stance should be widened ^[6]. During Warrior II a frequent, but destructive, misalignment is for the thigh to fall inward turning the knee towards the big toe, placing too much stress on the knee ^[6]. Likewise, allowing the thigh to turn outward shifts the knee towards the little toe creating knee stress ^[6]. Pointing the knee in line with the second toe, making sure that the knee and the toe are on the same plane as the sit bone will protect the knee ^[6].

Finally, a common pose where props should be used to alleviate pain and to make the pose achievable is Virasana (Hero’s Pose) ^[7]. Many people with knee OA cannot perform Virasana by sitting upright, with hips in between the feet and knees together ^[7]. One solution is to raise the floor with props, like a sitting on a folded blanket or one - two blocks under the hips ^[7].

Today, “sixty is the new forty”, someone celebrating a sixtieth birthday can expect to live two decades or more, yoga presents the potential for making this chapter of life truly the golden years ^[1]. As a holistic practice that intersects body, mind and spirit, yoga can be a deep and transformative practice during this cherished time, even for those with knee osteoarthritis ^[1].

Bibliography

1. Relax into Yoga for Seniors, Carson, Kimberly MPH, C-IAYT & Krucoff, Carol, C-IAYT, (2007). p. 7-11.
2. Top 10 health concerns for seniors: ASC blog. ASC. (2021, November 17). Retrieved May 23, 2022, from https://www.asccare.com/health-concerns-for-seniors/ 
3. Conservative treatment of knee osteoarthritis: A review of the literature. Lim, W. B., & Al-Dadah, O. (2022). World journal of orthopedics, 13(3), 212–229. https://doi.org/10.5312/wjo.v13.i3.212
4. Yoga Benefits for Arthritis, Susan Bernstein, Arthritis.org
5. Avoid Knee Pain and Injury with Yoga, August 28,2007, Catherine Guthrie, Yoga Journal, yogajournal.com
6. Yoga Therapy for Your Knees, Doug Keller, Yoga International
7. Yoga for Health Knees, Hips and Ankles: 3 Ways to prop Virasana, September 18, 2020, Allison Ray Jeraci, Yoga U Online, yogauonline.com