 to meet today on Movement Matters. I'm your host Christine Lenders, physical therapist and board certified orthopedic clinical specialist. Today, let's talk yoga. Why do we do yoga for those of us that do it? Why do we want to do yoga? For one, it can promote relaxation, flexibility, that inner mindfulness. It can help us improve our ability and capacity to participate in sports. But one of the biggest reasons that I love yoga is image number one. Let's look at that. It is the feeling that I get taking deep breaths in and deep breaths out and clearing my mind, like what happens when I look at this beautiful photo. When I'm stressed out or when I'm tense or when I can't work through a problem and I do yoga even in my home and I take those deep breaths in and those deep breaths out while I'm moving, it really helps to create a space in my mind where I can process information, make decisions and not have all those things bouncing off my head. In addition to when I used to do Ironman Triathlons, it helped me to avoid injuries. During this COVID-19 pandemic, many folks are trying different methods to get exercise and help their body feel better. Yoga classes are a great way because you can do it on YouTube. You can take a Zoom class. It's not the same as being with people, but you can have a little bit of that camaraderie. A lot of my friends and patients are doing more yoga, but injuries can occur if you don't maintain proper body mechanics or if you try to push your body further than it was designed to go. In this episode, we talk with Paula Lanzara, a yoga enthusiast who inspires us through her own struggles to get the most from her yoga class while feeling confident and injury-free. Welcome, Paula. Thank you so much for coming on Movement Matters today. Hi, Christine. Thank you so much for having me. I'm really excited to talk about yoga today. It's going to be fun. I know, and I'm so excited to talk to you about it. When we were talking on Friday about yoga and you were sharing all your experiences and all your feelings about yoga, it just really hit my heart because yoga is something that provides such a benefit to so many people. How did you get started in yoga, or how long have you been doing yoga for? Wow. I've been practicing yoga for about six years. I had a good friend suggest it to me. I'd never even thought about trying it before that. I wasn't very flexible. I wasn't into athletics. But once I got started, pretty quickly, I grew to love it. I love the fact that it increased my flexibility and my strength. I like the breath work, the guided meditation. Really quickly, I was going several times a week or even there was a period where I would go every day because I loved it so much. Wow. Yeah, I know. I don't do it as much anymore, but I still try to incorporate practices from yoga throughout my day, throughout my life, because I learned a lot from going. I think that's fantastic. I mean, the everyday thing is, I think what they call the practice, right? Going every day, showing up and with the class and combining all the energy. It's giving me goosebumps, combining all the energy of the class while you're doing your own practice, but you're energizing together in that class. I remember doing it every day. This was probably for three months when Core Power Yoga came out in San Diego in 2011 or something. I had shrunk about an inch and a quarter. Back then, there was all these movie stars saying that you could gain your height back in yoga. I'm a physical therapist. I thought, well, I'm sure it stretches things out and you spring back. I remember right before I moved to New York City, I went back to the doctor and they measured me. I'd done three months of five days a week of yoga. I felt fantastic and people were starting to say, hey, you're looking taller. I said, oh, I'm just standing in a mound in the sand when we were playing volleyball. I went back to the doctor and they measured me. I gained a whole inch of my height back just from stretching all those deep spinal rotators for people that have back pain or a hunched upper back. It's really hard to stretch them. In yoga, there's lots of those rotation and breathing positions that really help to elongate those tiny little muscles in the spine. Have you had any spine issues or noticed anything like that with yoga? Definitely flexibility. I was a person who through most of my life, even when I was young, I couldn't touch my toes. Being inflexible was kind of or not flexible was sort of something that I designed to, but yoga really showed me that, wow, through practice and through repetition, I could change that and notice changes in my posture, partly because a lot of the stretches that I was introduced to in yoga, they were stretches I'd never heard of before or done before in my life. They weren't things we did in gym classes as a kid. They weren't things that I knew about from everyday life. So especially things like heart openers, I hadn't really ever done them. I'd never done stretching with blocks. So it was like a whole new world to me. I saw a lot of changes in my body after doing yoga. I love that. I love how you mentioned on posture too, because it's something that I guess I don't really think of that when I'm using some stretches that I learned in yoga with my patients about posture, but that elongation of all those muscles and I'm always harping on people about their posture, it's great to hear that that's one of the benefits that you received from doing these poses. I think that's something that I never, I'm gonna have to use that more for encouraging people with their posture. Yeah, no, it was just a wealth of new information. The posture thing, it actually, it was great because before that it had seemed like such kind of an annoying thing to worry about. You know, posture was such a struggle and a strain to think about. But after doing a lot of the heart opener things, I guess it's just doing it all the time, just a little bit of work. It really made it seem so much easier to me and so much simpler. And now I just, it's a little more automatic. I think, I think that's great. So let me ask you this, now during the pandemic, all the studios were closed and I think they opened a little bit and tried to, and they might be open now, but what have you done over the past six or seven months since the studios have shut down or getting a yoga workout, whether you're doing Zoom or YouTube or on your own practice, how has that changed for you or how do you feel about that now that you can't go somewhere to do it? One thing I really feel grateful for is that I learned so much in person in the classes because now I have this feeling of slight independence where I can do certain things on my own or I can watch a video and not feel confused. I know that, okay, the instructor on the Zoom video or the YouTube video is showing down dog and I heard so much personal instruction in real life that I feel like, okay, I can follow along, I can do this. So I incorporate things here and there when I feel like I need it, but I do just feel really grateful that I got the in-person instruction. I feel for people who are starting their journey now because you're alone. I mean, even if the person is there in the Zoom, they can't see your body as well or they can't come over to give you an adjustment or a YouTube instructor can't respond. So I feel really grateful and lucky that I started before this, but I think it's not bad to start now. I feel really impressed by people who started exercising more in quarantine or started doing more yoga practice because that's fabulous and I am impressed with that motivation and that drive to continue even now with this difficult situation. Yeah, that feeds in right to a question I have from a viewer which is, can you get a good yoga workout from YouTube videos or do you insist that people should get a yoga instructor? So Paula kind of just hit on that point and you can get a good yoga workout from YouTube videos and Paula had a great benefit from being instructed because the instructors can come over there and help you fix your pelvis because it's hard to, even if you're looking in the mirror, unless you're like a physical therapist or you're very body aware, it's hard to see that, oh, wow. Oh, that's crooked. Oh, wow. That's now the teacher moves you and you say, oh, that's straight. Wow. That's just insane. I really felt straight and so the guidance of a yoga instructor is great, but if you're going to do YouTube videos at home, you can get a great workout. I think you just have to be careful or do it in moderation so that you don't strain something. There's beginner yoga classes and I think, Paula, actually you told me you were doing eshtanga, wait, no, you were doing ayangar yoga, right, which is a lot of alignment. So do you know much about the difference between ayangar yoga and say like flow yoga? I don't think I've ever done ayangar, although you think I should, I'm a physical therapist, but what do you, do you know the difference between the two or what does ayangar tend to focus on? I'm not an expert, but to my layman's perception, I saw that ayangar was really focused on alignment and the use of things like props so that if you couldn't do certain stretches as deeply as other people, you were still aligned correctly by using a block or using a bolster or it was really focused on not injuring yourself, which is funny because I did get injured, so it just goes to show you all the best intentions, sometimes things can happen, but you still do a flow though, you know, I still did some salutations and all of the typical poses that you would see in a vinyasa class. I think the studio I went to was great because they tried to incorporate all different types of yoga so that you as the student got a chance to see a lot of different styles and I would recommend that to anybody, you know, really checking out as many different styles as you can so that you can have a more informed idea of what works for you. That's a very good point. I remember doing yoga and bali when I was living at this Gandhian ashram. I know late 20s, I kind of fell into it. I did a trip after working as a PT for three or four years and I saved my money and I took off for four or five months and I ended up by a blessing at this Gandhian ashram where every morning they woke up at sunrise and did a chanting ceremony and then we did yoga for an hour and that was my real introduction to yoga and it was, I said stretch yoga, we held poses for long periods of time, you felt like a million bucks afterward, it got rid of my plantar fasciitis and then when I moved back to San Diego afterward, I did another stretch pose class where you kind of went against the wall and you held poses for long periods of time but they weren't holding poses standing up. They were holding poses on your back or on your side with big Mexican blankets and things to help open up your chest and I loved it. You almost wanted to fall asleep afterward and then I got introduced to flow yoga and I, after 15 minutes of my first class thought, when do we get the final shavasana? When can I lay in my back and relax? But that, it was work because you have to work on your core strength to hold the poses for this period of time but also as you're flowing, you need to be able to engage your core and that's something that I wanted to talk about having, talking with you last night again about you having some back pain during some yoga poses and I wanted to have you tell our viewers like what was your story? How did you hurt your back or when did your back hurt and what did you do? Did you do anything to modify it during your classes? So pretty quickly I started going to yoga fairly often and one of the things I noticed very quickly also was that certain poses gave me back pain but you know I'm not sure what to attribute my mindset to but even though the teachers were saying don't compare yourself to other people, everyone has their own process, you can be in child's pose at any point even though I was hearing that in my mind I was still sort of thinking to advance in my practice I should be able to do these poses and I should be able to go more deeply into them, increase my flexibility. So certain poses such as bridge or camel pose, anything where I had to arch my back, I felt pain but I was trying to ignore it and work through it. You know there's the difference right between just feeling muscle fatigue and that sort of exercise pain and then feeling this pain of wow I stretched something too far and I would still work through that and I think slowly over time it just built up to this head of where it was too much it was like the straw that broke the camel's back and no point it ended and I woke up one morning and I couldn't even bend over to put my socks on I was in so much pain. I actually had to take time off of work. At the time I was even tired to tell myself oh I don't think it's the yoga maybe it's all the driving I have to do for my job because I sat in my car quite often too so I was I was actually trying not to see that my yoga practice could be part of it until yeah but it continued you know in yoga class I would have pain and I started to talk to my instructors and ask them what can I do here what can I do there and I really started to focus on doing things in a way that didn't cause pain and that really changed things for me because that's when I really accepted the idea that it's an individual practice so what if I'm the only one who can't do bridge so what if I'm the only one in child's pose it's okay if one person tells me a certain technique and it doesn't work and you know I don't have to be implied about it but I just have to say well that didn't work for me and I have to try something else and just keep continuing so actually that's the point where I think it really became a journey to learning about my body and accepting that I'm not necessarily going to have the same outcome as everyone else in the class and and really accepting that that message that had been said to me before was which was you know this isn't about being a gymnast it's about that mindfulness so yeah I was actually in a way it was about kind of a good thing that I learned a lot about myself through this that's a wonderful point thanks for sharing that I think that's huge to come to the awareness and and I haven't been injured all my life have had to battle with accepting that my body can't do what other people's bodies can or my body can do it but once a week or once a month because if I do it more than that I'm down with an injury and you never of course you said you didn't want to attribute it to yoga because you love yoga and so you don't want to attribute the pain to something that you love and you know is good for you that you enjoy doing so you think oh I must have lifted something or maybe I was in my car the wrong way it's too much sitting and all those things can cause your back pain but it was so mature of you and open of you to modify your positions and learn that hey my body can't do this that way I do that all the time in my yoga classes and I think it's a huge point for people to hear that we are all unique and we all have our own body types our own sizes and flexibilities and we're each great some people are never going to touch their toes or I think you told me you were able to stretch your hamstrings more in doing yoga because you were never flexible and that's good you don't have to go flat and kiss your knees you're trying to gain flexibility right and if you hurt to kiss your knees then you don't kiss your knees but if you get a little inch further then you're a little bit more flexible and that's just something that's hard not to do is compare yourself to everyone around you in the room and then you see all these beautiful straight bodies and you're and I'm kind of like bent over one way you just try to do the best that your body can do while you're breathing and not push it too far too fast I love what you said Paula yeah and I think it it is really like you said a process of maturing and and recognizing that in life like the biggest competition you have is just yourself to just better yourself not to be competing with other people but trying to be the best version of yourself and I think when I started seeing it that way it actually just improved my yoga practice so much because I was getting more out of it like it wasn't helping me so much when I'm hurting myself and it's actually that's sort of putting me in this state where I'm less flexible I can't do as much I have to take time off and you know taking time away from it I saw you know all the gains I had in other areas sort of withered away a little because I can't practice at all so you know practicing minimally is more beneficial to me than trying to go 110 which of course they the instructors never advocate for you to try to do that but I think for me in the beginning since it was something that I was intimidated by I was trying to do that you know that that factor being afraid of not being good at it was there in the beginning yeah yeah that's that's so true oh I've been there I've been there so so we have a question speaking we're talking about back pain and pushing yourself too hard and then having to take a step back from something you love like yoga one of the questions is can yoga be a replacement for physical therapy and I think it's funny I have two of my great colleagues who were students of mine when we have to do an internship and they have beautiful combined yoga physical therapy practices and I do not believe that yoga is a replacement for physical therapy and Paula probably proves it right because you had to back off but it's such a great adjunct to physical therapy I use it all the time and my two dear friends who are yoga instructors and physical therapists have built their practice about integrating yoga and physical therapy into their treatments and and one of the things with on the back pain front that I was asking Paula last night was when you bent forward did you suck it in or did anyone ever tell you to suck it in and Paula what did you tell me about that did somebody ever tell you to suck it in so you know we were talking and I was thinking indifferent in some poses yes and then others no and I think you were kind of talking about um sort of generalizing that skill and using it more throughout the day and I thought oh yeah I guess sometimes they'd say it but I'm sure I'm not doing it all the time and I'm not doing it as often as I could be and I don't think I generalized it to lots of different situations because I do get back pain when I bend over and I don't think I was using that as a technique nearly as much as I could and I you know I tried it after you said it I tried it and I was like oh yes she's right you know she's totally right and I was like oh this is really helping me out right now I need to put a little reminder on um somewhere I don't know just to be like suck it in when you bend over to see it everywhere on the wall maybe just like post it around my apartment because it would do it yeah these little bands that say suck it in I just gave it to a page yesterday this one says sit up straight but uh he came in he was he was 87 years old and his back was still bothering him and he said he was really trying to work on his posture but he just was forgetting to suck it in and I said I hate to say this to you because this is my big mission right to get the low back pain percentage down and to spread the word about so I can get in I said to him I hate to say this but your back pain will never go away if you don't suck it in it won't because when you suck it in you engage your deepest abdominal muscle which fires with your deepest back muscle and gives you an anatomical girdle and when you have back pain that mechanism has been disrupted and definitely the deepest back muscles with one episode of back pain have been disrupted so I told him that and I gave him the band and he came back and said I was I did this weekend was focused on sucking it in and he goes it does feel better it does feel better and I told Paula that last night hey make sure you suck it in before you bend over make sure you suck it in before you reach for your refrigerator door be sure you suck it in before you bend to wash your face or when you're brushing your teeth because you're activating that mechanism that has been disrupted that is not working for you during your daily activities it's consciously activating a mechanism that was designed to function automatically and the more you activate it consciously the more you're prepping it and strengthening it to get back that brain generated mechanism where it'll start to operate automatically again so and I told you I told you the last night that when you suck it in I promise you one thing you're either not going to have back pain or it's definitely going to be less yeah and you know what you said about the automatic like that was really helpful to me because I always had this question of you know I've been told before oh suck it in but I always thought well they don't that one that lady over there doesn't have to suck it in or I never had to suck it in before or it's so hard to remember but I think when you said well it was automatic at one point and you're trying to you know retrain your brain and your nerves you know I was like oh okay that it makes sense to me because I'm kind of a why person and when I understand the why a little better it helps me just follow through I'm not sure what's going on there but when I understand why I'm like okay now I'm I buy in more or something you know that's helpful for me to hear too is to help people understand the why so let who wants to learn how to suck it in I've got two videos they're quick to show you it's uh video number two let's play that so you can learn how to suck it in to learn to engage your trans versus abdominis correctly and engage your anatomical girdle I'm going to show you how to do it in standing first so you're going to stand up and I'll visualize that for you you're going to put one hand on your diaphragm here one hand on your belly button below and you're going to pull your belly button in like that so you just suck it in suck it in you don't want to pull it in from here too because then you stop your diaphragm from breathing you can hear how it changes the sound of my voice when I do that you just want to pull it in from here your trans versus abdominis and if you see it from the front the fibers run this way so when you pull your belly button in you see it shrink my waist belly button in belly button in so practice that in standing first that way you can use it pull your belly button in bend to pick something up pull your belly button in reach for the car door pull your belly button in put your short on up over your head enjoy so that teaches you how to engage it in standing just so that you can get an idea of what to do but if you go to video number three I'll show you how to engage it in your neutral spine position to find the position of your neutral spine you want to lay on a firm surface so if you can't get to the floor you can use your bed but I'm going to explain to you why it's better to do it on a firm surface if you can get down to one so I'm going to show you on the ground here so I'll move my arm so you can see so you want to have the point of contact with your tail bone and your rib cage here but not in your lower back right here so you don't want to pin your back flat by tucking your buttocks under and you can see as I roll my pelvis like that and you don't want to arch your back up all the way like that you want to find a position that's in the middle where you're resting on your tailbone and to engage your anatomical girdle you want to suck it in so you want to pull it in from your belly button and blow like this here pull it in you can see it narrow in my waist right here suck it in what you don't want to do is you don't want to pull it in like this and stop your diaphragm from moving either you want to pull in your belly button so that you can still breathe here and use your diaphragm while you keep this in so learn to pull your belly button in and then breathe how you could go wrong is if you pull your belly button in and you tuck your buttocks under like that because what that does is it uses the big six pack muscle your rectus abdominis that's not what you want to do that's more for just range of motion if you need to get your back moving when you learn to engage your anatomical girdle you want to be in neutral spine point of contact with your tailbone and your rib cage small space between your low back and then you pull your belly button in and you enjoy a lot more information I have a link that I can post for you to an article that I published last year it's free it's open access it has illustrations and explains to you more in detail about the transverse abdominis so Paula we have about a minute left and I know that I was so inspired with talking to you Friday and I was so inspired talking to you last night about your experiences with yoga and how you modified your body and your positions after you'd hurt yourself is there anything that else that you want to share with everyone about yoga and your experiences I just like to say you know thank you so much for having me and I totally agree with you that yoga is a wonderful addition to your physical activity and you should also you know consult a physical therapist or doctor for having pain and it's not okay to be having pain you don't need to work through it you can just talk with someone about it and everyone's going to be different and but still yoga is great and it's a wonderful thing to add to your daily routine that's great and I agree 100 I love it thank you so much Paula for coming out and sharing your time with me and thank you thank tecawaii and all our sponsors and donors for allowing us to bring this to you today everyone stay safe aloha and life is better when you listen to your physical therapist