Professional Yoga Therapy: Medical Therapeutic Yoga for ... · 3 + Feeding our Self through the Five Sense Organs Chromotherapy Used by employing the sensitivity of the human eye

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Energy Anatomy as Medicine: The Brain-Body ConnectionModule 12.1Ginger Garner PT, ATC, PYT, DPT-c

+ Provider Disclaimer

• Allied Health Education and the presenter of this

webinar do not have any financial or other

associations with the manufacturers of any products or suppliers of commercial services that may be

discussed or displayed in this presentation.

• There was no commercial support for this

presentation.• The views expressed in this presentation are the

views and opinions of the presenter.

• Participants must use discretion when using the

information contained in this presentation.

+Objectives

1. Review the history and evidence base of light and color based therapies and

how they can improve patient outcomes and your own health and well-being.

2. Discuss the types of meditation found to be responsible for improved

systemic health in the individual.

3. List at least 7 evidence based energy anatomy interventions in order to affect

overall positive change in the Complementary and Integrative Medicine Biopsychosocial Model of Assessment used in the PYT Method.

4. Experience lab simulated environment meditation practices that effect the energy centers of the body in order to develop skills for immediate clinical

application.

© 2012 Ginger Garner. Living Well, Inc. excerpt from PYT Texts ©2001-2012. All rights reserved.

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+What is well-being?

• Individual characteristics

• Physical environmental factors

• Social factors

• Living environment

• Socioeconomic factors

• Personal autonomy factors

• Subjective satisfaction

• Psychological health

• Activities

• Life changes

• Care & support

Castro et al. 2011; Kiefer 2008


+The effect of light on critical illness

The Biological Perspective

Light control over the biological clock

Regulation of hormones through seasonal photoperiods and regular light-dark rhythms.

Circadian pathways

“We shape our buildings, and afterwards our buildings shape us.” ~Winston Churchill


+Beneficial effects of light exposure

Integrative diagram of the visual and non-visual pathways that mediate the biological and

behavioral effects of sunlight exposure in a critically ill patient.Castro et al. Critical Care 2011 15:218 doi:10.1186/cc10000

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+Feeding our Self through the Five Sense Organs

Chromotherapy

Used by employing the sensitivity of the human eye

Visual sense

Electromagnetic radiation (EMR) of light (action + energy)

2000 B.C.

Atmospheric Data Science Center at NASA (2007)

Visible Spectrum = Human eye detects EMR of 400-700 nm

Visible light is essential for both vision and resetting of the circadian clock

Yousuf and Raza 2005, NASA 2007, Cocilovo 1999


+Historical context

Ayurveda

7000 years old of color therapy

Egyptian medicine

Interior design of temples – color and light

Healing & SAD

Chinese medicine

2000 years of color therapy

Middle ages

Paraclesus – music + herbs in healing

1672

Isaac Newton

First paper on color


+19th-20th century

Early 19th century (Graham 1998)

Science overtook Mind/Spirit healing

Medical model as we know it took over

Surgery

Antiseptics

Late 19th century

Return of color therapy

1878 – Edwin Babbitt

The Principles of Light and Color

RED

YELLOW and ORANGE

BLUE and VIOLET


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+Affective meanings of color

Color Affective Meaning & Associations

Red Active, stimulating, strong, jealousy, meaning

of danger, attraction, passion, love, impairs

performance on IQ tests when viewed prior to

test taking (Elliot et al 2007)

Pink Love, compassion, soothing, comforting

Orange and Yellow Weaker stimulus than red; revitalizing,

stimulating

Green Agreeable, introspective,

Blue, Indigo Restful, introspective, agreeable

Violet, Purple Spiritual (divinity) or royal connotation;

authority, prestige

Black and grays Mysterious, death, obstruction or negativity,

dulling, fear, paranoia, lethargy

Brown Grounding, earthy, calming, lethargy in

excess

White Purity, spiritual or divine connotation,

cleansing, virtue, strengthening

Table 4.3 Affective Meanings & Associations of Color (1878)


+Principles of light & color

An excerpt from the 1878 text by Edwin Babbitt, The Principles of Light and Color.

Eating the Rainbow Correlation http://www.gingergarner.com/2012/07/18/eat-the-

rainbow-a-quick-guide-to-eating-well/


+ Birth of “chromopaths”

Babbitt as “father of color therapy”

US and GB

End of 19th century

Treat pathophysiologies

Sunlight and UV therapy for TB

“Modern medicine” gives nod to early therapies (Martineau et al 2007,

Wilkinson et al 2000)

Vitamin D

Jaundice

TB


http://www.gingergarner.com/2012/07/18/eat-the-rainbow-a-quick-guide-to-eating-well/

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+20th Century

Yerkes-Dodson Law (1908)

Color affects ANS

“Strong universal trends in the attribution of affect in the color domain.” (1942, 1947, 1957)

21st century support

Elliot et al (2007)

Longer wavelength colors (red and orange) -arousing

Shorter wavelength colors (green and blue) –calming

Lubos (2010)

Stress reduction – (blue > pink)


Goldstein 1942, Krakov 1947, Gerard 1957, E l l i o t e t a l 2007 , Lubos 2010, Elliot et al 2007, Adams & Osgood 1973

+20th Century

Theo Gimbel

“Hygeia Studios and the College of Color Therapy

Great Britain

Based on work of professor Rudolph Steiner

Luscher Theory

Continuation of Gimbel’s work

Hypothesis?


Graham 1998

+Ayurvedic Medicine: Advent of a Link Between Ayurveda and Modern Health Science

First International Congress on Ayurveda offers insights on how

Ayurveda has acquired an important role in the understanding and

management of disease in the modern world:

Ayurveda analyzes the

person apart from the disease

Ayurveda emphasizes mind

and the individual psychological

state in prevention and

treatment of disease

Ayurveda - “the health of the

individual, the society, and the

environment are intricately

connected”

Ayur – life

Veda – science

of knowledge of

Morandi et al 2011


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+Constitutional vs. disease examination

CE vs. DE

Inherent to individual rather than the general process of a disease, which does not define a person or their individual nature

Disease presents differently based on individual constitution

CE

Systems-based evaluation

Three dimensional view

“Whole person and whole health” Identification of precursors of disease = effective preventive medicine

DE

System-based evaluation

Single dimension “snapshot” Person as diagnosis

Diagnoses of disease states, not potential disease states.

Critical for handling acute medical emergencies and crises


It is more

important to know what

sort of person

has a disease

than to know

what sort of disease a

person has.

~ Hippocrates

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+Content Review

Compare and contrast the idea of “constitutional” vs. “disease” examination. How can you begin to employ the use of

“constitutional evaluation” in your practice of prevention and wellness therapy?

+Personalized medicine

Prakriti (constitution)

Sub-categories (doshas)

1. Vayu/vata (vah-you/ vah-tuh)

2. Pitta (pit-tuh)

3. Kapha (kah-fuh)

Vata/Pitta

Pitta/Vata

Pitta/Kapha

Kapha/Pitta

Kapha/Vata

Vata/kapha

Tridoshic (equal measures)

Recent research correlates the prakriti sub-types with:

Specific alleles

Biochemical correlation

Genome expression

Rastogi 2010, Patwhardan et al 2005, Prasher 2008, Godhke2009


The concept of input-output ,

throughput and storage as three basic functions of an

open system resemble

functions of vata, pitta and

kapha, respectively, as

proposed in Ayurveda ~ Hankey 2005

+Higher evolution in humanity?

5000-7000 year old practice of “personalized medicine”

Yogic methods – 8 limbed practice

Ayurvedic methods – 8 branches

Internal medicine

ENT

Toxicology

Pediatrics

Psychiatry

Aphrodisiacs

Rejuvenation

Surgery

9 year old theory of “Personalized Medicine”

In 2003, after more than a decade of research, the Human Genome Project was

completed by the U.S. Department of

Energy and the National Institutes of Health.

Human Genome: Our Blueprint

Goal: Learn order of the 3 billion units

of DNA that go into making a human

genome, as well as to identify all of

the genes located in this vast amount

of data. Current counts indicate that

the human genome contains 22,000

to 23,000 genes.

Personalized medicine: the future of

medicine


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+Content Review

How will the evidence base on the effects of light and color

on an individual’s health affect your professional practice? Your personal well-being?

+Chromotherapy of the chakra system

Figure 4.4 Chromotherapy using the Chakra System

Red - root

Orange - pelvic

Yellow – solar plexus

Green/Pink –heart

Blue - throat

Indigo – third eye

Violet - crown


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+Environmental analysis


+Review of Methods for intervention

1. Light Therapy

Full spectrum lights in the winter season

Blue-enriched white light in health care and critical care considerations

Office/workspace lighting

2. Nutritional Therapy

3. Environmental Analysis Vastu or Feng Shui

Clothing

4. Chromotherapy Meditation

Chakras

Visualization and Imagery

5. Ayurvedic assessment for medical pros


+Contemporary Interpretation of 8 Limbs

http://lucidpractice.com/category/ashtanga/

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+Using Yoga in Rehab: MTY

PHYSICAL

• Anti-Inflammatory Lifestyle (nutrition, movement, thought)

• Focus on Stability & Safety

ENERGETIC

• Three Diaphragms

• Gut-Brain-Body Axis

PSYCHO-EMOTIONAL-SOCIAL

• Meditation

• Polyvagal Theory

INTELLECTUAL

• Patient-Provider

Interaction

• Therapeutic Landscape

SPIRITUAL

• Allostasis

• Introspective Analysis

Empowering patients to take responsibility for their

health depends on focused, biopsychosocial

assessment.

+Risks of dysregulated cortisol

High cortisol Diabetes/prediabetes Obesity/increased body fat/Metabolic syndrome Depression/Suicide/Hippocampal shrinkage/MS Delayed wound healing

Infertility, PCOS Insomnia Bone loss

Low cortisol PTSD Fibromyalgia

Dr. Sara Gottfried, presentation “Stress Resilience: Functional Medicine and Yoga.” 2012 Mountain Pain Medicine and Yoga Symposium


+Breaking the stress response

Meditation is beneficial for:

Stress resilience

Neuroendocrine regulation - facilitate normal circadian rhythm

Reduce stress arousal and induce positive arousal effects

Promote telomere maintenance

Longevity

Deep, focused breathing – HRV

PVT

Cognition & Focus

Increase awareness of your surroundings without distraction (i.e. pain management)


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+Meditation

Seventh Limb:

• “a family of self-regulation practices that focus on training attention and awareness to bring mental processes under greater voluntary control…foster general mental well-being and development and/or specific capacities such as calm, clarity, and concentration” – Walsh and Shapiro 2006

The breath

is the

vehicle

Concentration

precedes

meditation

Meditation

is energetic

medicine

Emancipation

from the

senses =

Concentration


+Meditation Techniques

• Vipassana Technique (Buddhist) – “insight meditation”; self transformation through self-observation and introspection. Body scan Meditation object focus – senses, elements Focus: to see past impermanence and to discover seeing

self with wisdom

Mindfulness-Based Stress Reduction (Jon Kabat-Zinn) Characterized by dispassionate, non-evaluative and

sustained moment-to-moment awareness of perceptible mental states and processes.

Continuous and immediate awareness of physical sensations, perceptions, affective states, thoughts, and imagery.

Mindfulness is non-deliberative: observation only that arise during waking consciousness.


+Meditation Techniques

Transcendental Meditation Technique (Vedic) – settling the mind inward beyond thought to experience awareness (transcendental).

Peaceful consciousness

Restful alertness

Deep rest

No specific thought or focus i.e. mantra, object of visual focus, images, etc.

Others associated with major religions – Christian & Jewish meditation/prayer, Bhagavad Gita and Hindu study, Islam prayer 5x/day; Chinese Zen (Taoism/Daoism)


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+Consciousness

Eighth Limb:

State of active rest bringing consciousness as a result of meditation and concentration

Loss of duality or oneness

Place where you have moved beyond words

State of alertness and wakefulness, not sleep

Place beyond distraction


Rosenzweig et a l 2010 – Journal o f Psychosomat ic Research

+Starting to meditate

Your meditation should be suitably conjoined with your belief system. Yoga does not ask you to follow a spiritual path that is not your own.

Choose your object of meditation carefully, for this will permeate all of your thoughts and actions.


Out beyond ideas of wrongdoing and right

doing, there is a field. Meet me there.~Rumi

As a result of contentment, one gains supreme

happiness.~Yoga Sutras

+Attitude of gratitude

Choose a practice you can sustain, a posture you can sustain

for an extended period of time, without distraction.

Meditation is an individual path. Your teacher’s path may not necessarily coincide with your own. You must constantly

reassess if your meditation practice is beneficial.


You must learn to be sti l l in the midst of

activity and to be vibrantly al ive in repose.

~Indira Gandhi

Hell is the place where nothing connects.

~T.S. Eliot

Lack of true knowledge is the source of

al l pains and sorrows. ~Yoga Sutras

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+Practice

Vipassana

Body Scan

MBSR

Observation

TM

Quiet consciousness

Chakra

Awareness


+Resources

1. Light Therapy Full spectrum lights in the winter season

Blue-enriched white light in health care and critical care

considerations

Office/workspace lighting

2. Nutritional Therapy

3. Environmental Analysis

4. Chromotherapy (M15)

5. Ayurvedic Assessment (M15)


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Energy Anatomy as Medicine: The Brain-Body ConnectionModule 12.2Ginger Garner PT, ATC, PYT, DPT-c

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+Objectives

1. Identify therapeutic applications and contraindications for

using the “locks” system.

2. Practice the system of “locks” taught in the Professional Yoga Therapy (PYT) Method in order to affect

musculoskeletal, neuromuscular, and sensorimotor patient

outcomes.

3. Identify the affective impact and clinical evidence that

supports energy anatomy methods in order to effectively

practice Complementary and Integrative Medicine through

the evidence based lens of both conventional and Ayurvedic

(yogic medicine) medicine.


+MTY Locks System

“Bandhas” – anatomical and energetic locks

used as functional medicine

Protective restraint mechanism

Energy medicine (7 locks)

“prana” & “ojas” Neuromuscular control & postural

awareness

Musculoskeletal endurance

Safety net for movement-based practices

Physiological

Differs from traditional yoga bandhas/locks


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+MTY Locks System:Three Diaphragms & Six Locks

©2016 Ginger Garner. Medical Therapeutic Yoga. Handspring Pub Ltd, Scotland.

+Cervical spine

Chin Lock

Mild jalandhara bandha (MJB) (top photo)

Pure planar movement of retraction

Forward head

C shear

Approx. 10 degrees between the cranium

and the atlas

Full jalandhara bandha (FJB) (bottom)

Movement which remains after performing

MJB

Flexion from the remaining C2-7 plus T1.

FJB facilitates partial closure of the glottis (as

in victorious/ujyaii breath)


+Chin lock practice & Indications

MJB

Cervical retraction

Postural NM re-training

Correct anterior shear in cervical spine

Protection or reestablishment of cervical lordosis

Turn “off” SCM during yoga postures i.e. boat pose at right

C1 and C2 mobilization

Meditation

Partial closure of glottis for some ujyaii pranayama


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+Cautions for Chin Lock Use

Full or Mild Jalandhara bandha

Cervical fusion

Poor body awareness

Poor breathing habits

DDD

DJD


+Abdominal Lock

Mild uddiyanda

bandha (MUB)–“abdominal grip or literally, flying up”

Energy from

abdomen to head

Redefined as TA

contraction

Not TATD breath

– combination of

locks C, D, & E


+TATD Breath

TalaszH, Kofler M, Kalchschmid E, Pretterklieber M, Lechleitner M. Breathing with the pelvic floor? correlation of pelvic floor muscle function and expiratory flows in healthy young nullipa rous women. In

2010;21(4):475-481.

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+EBM in TATD

Hung et al 2010

RCT; 90% “cure” rate Sapsford (2004) first suggested

synergistic training, described as “new” approach; As of 2010, only 1 RCT had

addressed abdominal muscle training

effect on SUI

Myofascial effects of upper

diaphragms tension on pelvic floor

function

Hyoid, Masseter, Glottis, Respiratory

diaphragm

+TATD Level 1

From hook-lying, have the patient clear the throat. There should be no:

No “Rectus Loafing” No adverse PF tensile force

that causes leakage or pelvic pain

No EO domination

No adverse fascial tension

Tips:

Try with Ujyaii/Overcoming

Advanced – progress to upright extended foot pose

Expiratory Flow:Involuntary TATD Response Screen via

Cough –Throat-Clearing Test

Upright Extended Foot Pose

Modification is shown to illustrate proper TATD function (but perform

in hook-lying)

+Root Lock (PF)

Identify the pelvic floor

Anterior triangle

Posterior triangle

Sit on firm surface or floor

1. Verbal cuing

2. Imagery

3. Self-palpation

4. EMB biofeedback

Module 15 Lab

Identification

Sequencing

Progression

Prescription


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+Indications for root lock

MMB

Pelvic floor proprioception, strength,

endurance, neuromuscular, and

musculoskeletal function

Synergistic lumbopelvic strength and function

Strength, safety, and energy retention during movement therapies and ADL’s

Beginner yogis should practice mild mula

bandha in the following order:

1. Anti-gravity postures (i.e. supine lying)

2. Postures conducive to performing mild mula

bandha.

Therapeutic applications,

such as incontinence, post surgical, POP, or post partum.

In these situations, 3 different

applications of MMB need to be

taught (Module 15 Lab)


+Root Lock Action

TATD (Locks C, D, & E) must

be isolated without valsalva

1. Elevator holds (from 0%

to 100% MVC and back

down)

2. Long sustained MVC

holds (up to 20 seconds)

3. Quick flicks (short, burst

contractions of 100%

MVC typically functionally

used to precede a cough,

sneeze, or lift to prevent

incontinence)

+ “Flying Up”TATD breath (locks C-E)

Full abdominal lock uddiyanda

bandha (FUB) plus root locks

(ant/post)

Abdominal organ massage

Out of spinal neutral (flexion

spine)

Between exhale and inhale

Not taught with breath hold

2ndary modern demographic

and valsalva contraindications


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+Indications for locks C-E

MUB “TATD Breath”

Without breath holding

Medically or anatomy based yoga practices during all postures which require stabilization of the spine

Facilitation or maintenance of energy or strength in a pose

Synergistic lumbopelvic support and strengthening

Udana vayu, or upward ascent of life force energy


+ContraindicationsAbdominal lock (other than TATD breath)

Abdominal lock/MUB

Post-surgical, abdominal

Inability to isolate the

transversus abdominis (TA)

without spinal flexion

Inability to isolate the TA without

valsalva

Inability to independently isolate

the TA on cue within the context

of asana performance when

needed

Pregnancy & postpartum

Could be performed for lumbopelvic stabilization and to lend strength and endurance during labor and delivery and in prevention of diastasis recti; however, the lock should never be performed in its full state, or FUB

Immediate postpartum without consent of physician or midwife.

Hypertension (FUB only)

Hernia(s)

Any contraindications for valsalva (FUB only)

Avoid flexion for beginners during abdominal lock. Work in neutral first.


+Contraindications for root lock

Root Lock/Mula bandha

Beginners who cannot perform all other bandhas without breath holding

MMB can be performed without valsalva to MVC, and in graduating, or

elevator stages

Post-surgical, abdominal

Hernia(s)

Anxiety or panic disorders


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+ In Review…

Proper posture, breathwork, and trunk stabilization via gentle work of

the TA in conjunction with PFM recruitment can:

Maintain spinal, core, diaphragmatic, and pelvic floor

strength

Protect against low back pain, pelvic pain, and low back

injury

Synergistically act to prevent or resolve bowel or stress or

urge bladder incontinence that is non-neurogenic

In women’s health Treat pelvic organ prolapse (POP)

Manage a pathologic diastasis recti


+Shoulder Lock: Prayer Hands “Plus”

Shoulder Lock

4 joints

Not traditionally defined

Transcendental “icing on the cake”


+Indications for shoulder lock

Shoulder Lock

Scapulothoracic stabilization

Scapulohumeral rhythm

Cultural or spiritual sensitivity for those averse to yoga

A dynamic version of prayer hands pose

Co-activation of scapular , chest, and upper extremity musculature

Biofeedback mechanism to facilitate either abdominal (diaphragmatic) breathing or TATDbreath

Inhibition of compensatory action such as use of the secondary muscles of respiration

Focus for meditation or therapeutic imagery


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+Contraindications shoulder lock

Shoulder Lock

Active or acute carpal tunnel syndrome

Poor body awareness, although this is also a reason to work toward teaching the lock

Poor postural awareness could reinforce pectoralis group dominance, thus contributing risk factors for shoulder injury

Inability to selectively isolate or relax the upper trapezius

Acute cervical spine injury, sprain, or strain

Post-surgical myofascial restriction, anxiety, or functional limitation preventing relaxation of the upper extremities, neck, or mask of face

Poor breathing habits, although this is also a reason to work toward teaching the lock


+Integrative physical therapyHip lock

Not traditionally defined

Synergistic action

Lumboplevicstabilization


+Femoracetabular/Hip Rainbow RTC

Gluteals

Piriformis

Gemellus superior

Gemellus inferior

Obturator externus

Obturator internus

Quadratus femoris

©2014-2016. Ginger Garner. No part of this may be reproduced without express permission from the author.

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+Deep Gluteals

+Indications for hip lock

Hip Lock

Lumbopelvic stabilization

Accessory action or method for creating awareness to initiate pelvic floor for other root locks

Safety in movement therapies i.e. dynamic yoga postures requiring integrity of the hip and spine

Hip strength and joint stability

Contribution to the cylinder theory for trunk strength

Assistance in inversions for increased stability and confidence in postures

Protection of spine in standing postures requiring spinal flexion and/or rotation

© 2012 Ginger Garner. Living Well, Inc. excerpt from PYT Texts ©2001-2012. All rights reserved.©2016 Ginger Garner. Medical Therapeutic Yoga. Handspring Pub Ltd, Scotland.

+Contraindications – hip lock

Hip Lock

Inability to isolate or maintain TATD breath or (MUB), which would also preclude the individual from performing dynamic yoga postures, such as in standing, inversions, or advanced spinal extension

Poor body awareness, which would also preclude the individual from performing dynamic yoga postures

Poor posture


Revolved triangle – advanced

posture example

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+Locks in Action

Regional Lumbopelvic Stability

Hip Strength and Integrity

Safety in Posture Performance

Functional ADL completion

Isolation of hip synergists

Dissociation of gluts vs.

hamstrings vs. rotators

Tools for assist

Strap, chair, wall, bolster

Manual/tactile input by therapist for

co-contraction


Triangle with internal support

Shoulder Lock

TATD – Abdominal & Root Locks

Hip Lock

Chin Lock

+Resources

www.proyogatherapy.org - M15/YAM III Companion Lab

Meditation

Lock practice for all pppulations

Music & Sound lab

Chromotherapy lab

Ayurvedic modalities for your therapy toolbox

Additional yoga postures and breathing techniques

Sequencing for 10 orthopaedic and 9 GI conditions

www.proyogatherapy.org

Registered member Toolkit resources

www.gingergarner.com

Ayurvedic resources under Patient Portal

© 2012-16 Ginger Garner. Living Well, Inc. excerpt from PYT Texts ©2001-2012. All rights

reserved.

http://www.professionalyogatherapy.org/

http://www.professionalyogatherapy.org/

http://www.gingergarner.com

Documents

Professional Yoga Therapy: Medical Therapeutic Yoga for ... · 3 + Feeding our Self through the Five Sense Organs Chromotherapy Used by employing the sensitivity of the human eye