Why Internal Rotation of the Legs Is Misunderstood

In yoga, we have a love affair with internally rotating the legs. Down dog: turn the legs in. Standing forward fold (uttanasana): turn the legs in. The list goes on. It goes to the point of where internal rotation of the legs is seen as a panacea--a cure-all for aches, pains, misalignments and imbalances-- and external rotation of the legs, as a consequence, is seen at best as mostly undesirable.

The reality, as always, is quite more nuanced than that. Simply mechanically turning the legs in, which in my opinion has little to do with the muscles of your inner thighs (also known as the adductors), produces a bunch of unintended consequences.

It leads to overuse and tension in the tensor fascia lata and the gluteus minimus (two muscles on the outer thigh and hip) that medially/internally rotate the thigh bone/femur, among other movements. To feel what I am talking about, take your fingertips just below and outside of your hip point (ASIS) at the front of your pelvis and turn that knee in toward the other leg. Regardless of your position, you will feel the muscle jump into your fingertips and engage. If you do it more forcefully, you will most likely produce gripping, which will also move along your hip crease and deep into the groin. Now, imagine doing that faithfully and enthusiastically in your yoga practice on a consistent basis. In essence, you are creating a pinch in the front of your pelvis, in that emotionally charged site of sexuality, digestion, survival, to name a few.

Further, simply turning the legs in like that, from the outside if you will, strains and compresses the femoral triangle--home of  the femoral nerve, femoral artery, femoral vein, femoral ring/canal (lymph nodes, drainage). The femoral triangle is basically the armpit of the thigh. Its boundaries are: the inguinal ligament (your hip crease from hip point to pubic bone), adductor longus (one of inner thigh muscles), and the upper portion of the sartorius (from the hip point to where it meets the adductor longus on its way down and in to the inner knee). Here is a visual:

Femoral triangle (boundaries discussed above pictured with dotted line). From http://home.comcast.net/~wnor/antthigh.htm

Femoral triangle with psoas, iliacus, and pectineus. From http://www.massagetherapy.com/articles/index.php/article_id/417/Danger-and-Excitement-in-The-Femoral-Triangle.

As you can see, there isn't much space for the vascular and nerve contents of the anterior thigh. They are bunched up between the pectineus (the shortest of the inner thigh muscles, which runs from pubis to the lesser trochanter on the inside of the thigh) and the psoas tendon as it crosses over the lip of the ilium (the pelvic bone) in front of the hip joint on its way to the femur where it attaches close to the pectineus. It's Singapore-style population density with prime real estate in there!

Mechanically turning the legs in like this also displaces whole muscle compartments from their intended locations and functions. It basically takes everything in this area in one direction only (down and in), unintentionally taking the quads, especially the rectus femoris, towards the midline of the body, which is not where they are supposed to be. Thus, indiscriminately turning the legs in serves to create less differentiation, and therefore less freedom, between the front of the pelvis and the front of the thigh, which is, in essence, another way of sitting on your desk, in your car, or slouching in front of the TV. I've noticed, for example, that when trying to sit "properly" in my work chair with my thighs parallel to each other (which in a sitting position basically means internally rotated thighs) that I feel much worse (as in tight-groined and tight-hipped)  than when I am sitting in my chair with my thighs in a V shape (not too turned out and definitely not turned in).

I do realize that I might be exaggerating a little bit. Some of you will say that it's not about turning the legs in (and it definitely isn't), but about taking the inner thighs back. I don't disagree. But I would venture to say that when most people hear the instruction to take the inner thighs back, they will turn their legs in from the outside like I described above. In other words, they will simply internally rotate their legs.

It's quite a bit more subtle than that. The inner thighs activate from the ground up, more specifically from the lift of the inner arches of the feet via the tibialis posterior muscle (which starts deep in the foot, goes up the back of the shin bone and connects to the inner thighs), which is another way of saying that the inner thighs are part of the deep core line of the body. When the inner arches activate, the inner thighs, especially the adductor magnus, hug to the femur/thigh bone, only this doesn't adduct the thigh bones (i.e. bring them closer to each other), it actually creates abduction of the thighs from the inside (i.e. moves thigh bones away from each other laterally, which is not the same as rotating them) and creates space in the pelvis and hips.

These days, I rarely, if ever, tell my students to turn their legs in or take their inner thighs back. I tell them to lift the inner arches of the feet up towards the core of the pelvis to activate the inner thighs. To make it more subtle, I tell them to draw from the big toe balls of the feet back towards the high point of the arch (just in front of the heel bone) and lift that energy up into their inner thighs, literally activating the core line of the body. When the inner thighs are activated in this way, then you can tell them to "go back and apart," without actually having to rotate the thigh bones. This feeling of the inner thighs going back and apart is a function of the anatomy of the adductor magnus, which looks like the mainsail of a boat (see image below). Then the armpit of the leg softens, deepens, and feels more open.

Adductor magnus: as seen from the back (left most image). You can see its mainsail shape and its role in stabilizing the pelvis. The sketch in the middle schematizes the magnus and shows you how the muscle twists. The right most image shows you the thigh from the front. From Grundy, John Hull (1982). Human Structure and Shape.

So, for example in down dog or uttanasana, with the feet on straight and about hip width apart, draw from the balls of the feet back towards the high point of the arch right in front of the heel and lift that energy up into the inner thighs and the core of the pelvis. Then, ground down through the outer heels without losing the lift of the arches and resist the inner thighs away from each other without changing the position of your feet/heels. The pit of your belly will probably hollow out and lift by itself, your low back will feel broad and supported, and your hips won't grip.

Let me know what you think and if this prompted any questions. I think my next post will naturally focus on external rotation of the legs, which is equally misunderstood but very under-appreciated in the world of yoga asana.

How to Release Groins of Steel

Short answer: stop digging your heels! I came to this insight as I was riding my bike (which I do every day to and from work). Basically, I realized that when I press more through the balls of my feet (which is what should be on the pedals, by the way, as opposed to your arches or some other part of your foot) as I pedal forward and straighten my leg while biking, my frontal groins release and don't tighten up as much compared to when I press equally through the ball of the foot and the heel. In other words, I plex or floint my feet while biking (without keeping them rigidly in that position) as opposed to overly dorsiflexing my foot (in essence, digging my heels as I pedal).

As you can probably tell, I am a big fan of finding ways to release the groins, since mine are made of steel. There is definitely a structural issue at stake, but that's a tendency in and of itself, which can be either exacerbated or actively coaxed towards a more middle ground.

So I had been experimenting with this idea while biking for some time and then found further to explore at a recent workshop with Doug Keller, who is very often mentioned in my posts. I don't have the opportunity to study as regularly or as much with him as I would like, but our rare encounters lead to substantial explorations, evolutions and insight. In this workshop, I learned the following mantra: big toe mounds = mobility, heels = stability. I know, right? You don't have to be complex to be brilliant!

This idea is borne out by modern anatomy theories, specifically Tom Myers' Anatomy Trains concept and related elaborations such as the work of Doug Keller, Jenny Otto, Megan Davis and others.

Here is how I see it:
The heel is one of the major bony stations or points in the Superficial Back Line (SBL) or the Postural Sutra as Doug Keller calls it. This is the line that runs from the soles of your feet, up the whole back of the body over the head and stops just above your eyebrows. It is the myofascial line in the body that allows us to stand upright and moves us fwd as we walk, and includes the amazing hamstrings and the erector spinae muscles, the latter acting like ropes to keep you erect and also being instrumental in creating the secondary curves of the spine (low back and neck).

Superficial Back Line from http://crossfitsweatshop.com/2012/07/10/superficial-back-line/

The crucial point here is that this line connects the heel to the sacrum. Thus, the heel is instrumental in creating sacroiliac (SI) joint stability. This happens not only through the clear and straightforward myofascial connections of the SBL (sole of foot-heel-calves-hamstrings-sacrotuberous ligament-erector muscles-etc.) but also through the functional connection of the SBL with the gluteal muscles. Myers places the trio of the glutes (maximus, medius and minimus) in a separate Lateral Line, but Keller functionally includes them in his postural sutra because of their central importance to posture, including low back and hip joint stability.

Keller's inclusion of the gluteals, which when properly engaged stabilize the sacrum (and are fascially connected to it, esp. the maximus), is reinforced by another connection, that of the heel and the piriformis.

Priformis in red: under the glutes from http://www.starchiropracticandnutrition.com/chiropractic-symptoms/buttock-conditions/piriformis-syndrome/

Notice how the direction of the fibers of the piriformis is very similar to that of the gluteals and how the glutes and piriformis have a strong fascial connection to the sacrum on one end and the outer top thigh on the other end. The two piriformis muscles join into one across the front of the sacrum, whereas the glutes act on the fascia that covers the top of the sacrum.  So these fasciae in essence sandwich the sacrum from the front and the back.

Consider the most basic human action: walking. At the moment when the heel strikes the ground, the piriformis force closes the SI joint to literally prevent it from dislocating (this is one of the reasons we can walk and not fall apart at the seams!). Then, if all goes well, the weight travels to the pinky toe mound (base of 5th metatarsal), creating the lateral arch of the foot in the process. Then, we move from the pinky toe mound to the big toe mound (creating the transverse arch), at which point we push off the ground with the big toe mound (creating the medial arch of the foot or the spring in your step, basically activating the deep core line in the body) and contract the back line of the body (hamstrings and glutes, for example) to free that leg off the ground, swing it forward and start all over again.

Why all this? To demonstrate that the heel is indeed a fundamental point of stability in the body. However, to paraphrase Jenny Otto, we first need to find release in order to create meaningful (read: optimal, healthy, effective) engagement. If you are already tight, bound and wound up, your attempt to engage will result in over-contraction, gripping and overworking.

This is where the plexing/flointing of the foot comes in and the idea of big toe mound = mobility. If you are having trouble with the idea of plexing and flointing, just think of what your foot does in the push off phase of walking (described above), an action of "stepping on the gas" which translates up through the ankle, the deep posterior compartment of the shin and then onto the inner thighs, pelvic floor and iliopsoas complex, that is, your groins!

How does this translate into practice? The simplest and most efficient way to feel what I am talking about (the idea is courtesy of Doug Keller) is to come into a low lunge with the right foot forward to start and your fingertips in cup shape on either side of the foot (or hands on blocks if the floor is to far away and you are starting to hunch in the back) like this:

Low lunge from http://freretstreetyoga.com/asanas.html

Now, lift your front heel slightly off of the floor, with the weight placed on the ball of the big toe, and feel how this not only activates the inner arch of the foot and lifts the inner thighs to the bone, allowing the thigh to spiral out a bit, but also allows the groins to  release, lengthen and descend. The see-saw principle is at work here (allowing the top of the thigh bone to settle into the hip socket). Here is a visual (in a more advanced version) of what I am talking about demonstrated beautifully by Shawn Parell (look at front foot and leg):

Shawn Parell from http://www.shawnparell.com/#!services/ck0q

To me, this is active release or freed engagement, because it simultaneously activates and releases the deep core line of the body. After you feel that, you can slowly release your outer heel to the floor to create stability. You can experiment with this idea in many other poses: warrior 1, warrior 2, side angle, for example.

I also find this extremely helpful and beneficial in externally rotated poses such as reclined ankle over knee pose (sucirandhrasana or eye of the needle pose):

Eye of the needle pose from http://www.freretstreetyoga.com/asanas.html

The standard instruction here (and one I have given plenty of times) is to flex the top foot so as to protect the knee. However, notice how this locks the groin/inner thigh as well as the outer hip areas and is, in essence, digging your heels but in a different spatial orientation. Now, floint/plex your foot like we discussed (with the inner and outer ankle hugging evenly towards the midline) and feel how the inner thigh releases from the pubic bone towards the inner knee, the thigh bone spirals out, and the outer thigh/hip area is not gripping for dear life. For more advanced practitioners, this idea can really help in your explorations of padmasana (lotus pose). Please note that none of the above in any way implies sickling the ankle like this:

Sickled ankle (green outline)-- a sure way to hurt the ankle and the knee above it. From http://www.womenshealthmag.com/fitness/ankle-exercises.

Finally, here is a video of a supta baddha konasana variation--this is an active groin release, not a passive one. It involves a strap, so go get one (the longer the better; if not, you might need to connect two straps to make a long one). The video will show you how to loop the strap around your feet, shins and thighs. Notice that the heels are not together in this variation, only the toes and the balls of the feet are touching, the heels never touch. Once you get there, anchor your upper arm bones against the floor. As you pull on the tails of the strap, actively press the balls of the feet into each other and resist the heels away from each other (same idea as above). At the same time, lift your heels away from the floor, as if someone is prodding the outer heels and the outer edges of the feet up from underneath. By this time, you will probably feel a stretch from the pubic bone through the upper inner thigh. Don't forget to breathe and keep space between the upper and lower jaw. Also, your buttocks will be working, but don't confuse working with overworking and gripping. If you feel like you are gripping, think of broadening the buttocks away from the sacrum and lengthening the center of the buttocks away from the top of the pelvis in the back. Finally, check once or twice to see that the heels are evenly lifting away from the floor. Often one will be higher than the other, as in the upright version--you  might also be able to discern this from the tone of your buttocks against the floor/mat. Enjoy! Let me know what you think and if this was helpful.

Thank you for reading! A bientôt!!

Levator Scapulae: Perp or Vic?

You can't integrate the pieces until you can differentiate them, and that for most people is a big deal - most people don't even register on a sensory level that there's a distinction between their shoulder blades and their upper back.

-Leslie Kaminoff

This quote appeared in my inbox, just as this post was taking form in my head. How appropriate!

I became acutely aware of my levator scapulae muscle the other day after practicing something (on purpose) that I was going to tell my students not to do in their practice. So I went on a little investigation to see why this muscle can sometimes feel like it was expressly placed there by the celestial design committee (expression courtesy of the wonderful Donna Farhi) to make you miserable.

The levator scapulae as its name implies is the elevator of the shoulder blade. That's the muscle that you use to hold the phone between your shoulder and your ear, when you hands are occupied with doing something else. Here is a visual of how this muscle attaches to the upper inner corner of your shoulder blade at the bottom and the first four cervical vertebrae at the top:

Levator Scapule from http://en.wikipedia.org/wiki/File:Levator_scapulae_muscle_animation_small2.gif

What does it looks like to you? Yes, that's right. The reins of a horse. So in addition to lifting the shoulder blade, the levator scapulae can also quite effectively and painfully contract to keep the top of your neck (those first 4 cervical vertebrae) from going forward, that is, it would pull them down and back, exactly like someone pulled the reins of a horse to stop it from going further.

Now, let me introduce splenius cervicis:

Splenius cervicis from http://en.wikipedia.org/wiki/File:Splenius_cervicis_muscle_animation_small.gif

What is the difference with the levator scapulae? The main difference is that the splenius (which means bandage and plaster) attaches from your neck to your upper back whereas the levator attaches from your neck to your shoulder blade. And this is profound: kind of like of the realization from the quote above.

As Thomas Myers likes to say, stabilization and support of the head are most optimally (not the same as most efficiently or expediently) effected as "an entirely axial event." The axial skeleton consists of the human skull, the ossicles of the middle ear, the hyoid bone of the throat, the rib cage, sternum and the vertebral column. (My understanding of the body tells me that the pelvis should be included in this list too, but I'll stop here and don't go an a tangent.) As you can see the shoulder blades are missing from this list with good reason. They are much more movable than either of the ribs or vertebrae, and have a lot more inherent motion in them by virtue of being connected to the arms and hands, the latter being perhaps unrivaled in their ability for exquisiteness, sensitivity and refinement. So this quite simply makes the shoulder blades an unstable base from which to support the neck/head.

Further, when the levator scapulae gets bullied in supporting the head (for example, when we are tense and hunched over a computer; or when we walk with our head down while checking the latest and greatest on our smart phone, but we still need to look up somewhat; or when we are biking), then a myriad other shoulder muscles get involved compounding the misery for your upper back and neck. Some of these are the upper traps, rhomboids, and pecs, but tension, drag and pull can result along any of the 4 arm lines, which I have described here in conjunction with downward-facing dog. To add to the complexity, bear in mind that these myofascial arm tracks have multiple crossovers among them, which make our arms and hands the miracles that they are, but also augment the task of figuring out what is going on and how to address it.

What can be done to relieve the levator scapulae of the unwanted burden of keeping the neck/head from going forward? Simply, we learn to differentiate between it and the splenius cervicis and its brother, splenius capitis. However, a few other issues need to be addressed first before we attempt to do that.

First, we need to bring the head back from its forward position (reason #1 for the levator scapulae overworking). For this, you can read my post on neck smiling. You can skip to the third to last paragraph.

We also need to ensure that the chest is opened properly. For clear and intelligent instruction on that, check out Doug Keller's article for relieving upper back and neck pain. The quick and easy is that the habitually tight pec minor needs to be released and lengthened so that the low traps can draw the shoulder blades down the back and away from the base of the neck. The shoulder blades also release down the back with external rotation of the arms (for example, warrior 2 with the palms turned up, so that the whole arm is externally rotated).

When we have that knowledge and awareness—Is the head jutting forward of the spine or is the neck smiling and extending? Is the chest closed and shoulder blades creeping up towards the neck or is the chest open and broad and the shoulder blades releasing the down the back?—then we can turn to the task of differentiating between the levator scapulae and the splenii brothers that prevent the head from going forward.

The splenii muscles are part of the lateral and spiral lines in Anatomy Trains speak. In yoga terms, these are the lines that are stretched and strengthened with lateral poses like trikonasana, parighasana, parsvokonasana, vasistasana, side bends and the like, and twists or revolved poses. I won't go into detail, but here is a visual of both (note: yes, there is overlap between these two myofascial tracks):

Lateral line from http://www.sportsrehabexpert.com/public/472.cfm

Spiral line from http://www.sportsrehabexpert.com/public/472.cfm

In addition to keeping the head from going forward, the splenii assist with head rotation. I think that a good way to feel the splenii and see how they work is with a twist. I shot the video below this morning to help with the description.

Sit on the edge of a chair with the thigh bones mostly off the chair seat, fairly parallel with each other. Remember to take the top of the throat up and back (neck smile) and keep your chest open and broad. Take your right fingertips at the base of your skull—under the occiput and a bit to the side such that your fingertips are under the lateral part of the occipital ridge and the mastoid process (you'll see in the video)—with the elbow pointing forward and slightly higher than your shoulder. With your other hand, nudge the lats and the teres into engaging to take the outer edge of your right shoulder blade onto your back. Keep your gaze diffuse (i.e. more peripheral vision than staring somewhere in particular) and direct it slightly down and to the right as if  you are trying to look at your right elbow crease. You will feel the splenii muscles contract under your fingertips and start turning your head to the right, at the spot where your skull and your spine meet. Follow the twist from the top of the spine down through the upper back, keeping the right shoulder blade down the back by reaching out and slightly up on the diagonal from the elbow as you draw the shoulder blade onto the back (if it starts creeping up, the levator scapulae has probably kicked in and you might feel that your neck in no longer smiling). Twist to the best of your ability, keeping the eyes soft, reaching up through the crown of the head, having space between the upper and lower teeth. If you feel this around and under your shoulder blade, as well as the sides of the torso (see lateral line photo above), you are probably on the right track. Also remember to keep both collarbones broadening and the opposite shoulder blade releasing down the back. Come back to center and go to the other side (when I turn away from the camera, you will see that my right shoulder blade needs a lot of convincing to stay on my back):

 http://youtu.be/mrvGfflT5Js

I have called the levator scapulae a villain, but as Jenny Otto once said, it is the victim that screams not the perpetrator.

Thank you for reading! Let me know if you have any questions and please share if you found this helpful in any way!

The Butterfly in Your Head

We all know the expression: "As Above, So Below." Nothing is more so in the human body. And certainly the reverse is true too: as below, so above. This post is about the sphenoid bone, which came about first as an observation of another human being, and then formed as an idea that wanted to be expressed while I was semi-awake on a weekend morning and very vividly felt how the subtle adjustment of my head on my pillow produced an equally subtle (but very felt) adjustment in my sacrum.

The sphenoid is an amazingly beautiful bone inside your skull, which makes up the anterior base of the cranium, and sits just above the upper soft palate. It is shaped like a butterfly or a like a bat or a small bird with outstretched wings. Here is a visual:

Rotating sphenoid! From http://commons.wikimedia.org/wiki/File:Rotation_sphenoid_bone.gif.

Impressive? Mind-blowing? I thought so... Here is a video of animated skull anatomy if you are further interested in visualizing.

This bone is amazing on many levels: it articulates with all the other bones in your cranium, holding them together like a keystone in an arch (but upside down). It is the center of gravity in the head and its position and ability to rock gently (more on that in a moment) are critical to overall health and well-being. The sphenoid—which means a wedge; and is another way to think of a keystone—is the area where the nerves leave the brain to connect with the spinal column and the lower spine. This bone also houses the pituitary gland, is close to the ears and has the nerves of the eyes passing through it. The pituitary controls the functions of all other endocrine glands.

On a skeletal and fascial level, the sphenoid connects to the sacrum first via the the sphenobasilar joint (the joint of the sphenoid and the occipital bone, i.e. the base of your skull), then through the atlanto-occipital joint where the atlas (first vertebra) and your skull meet, down through all the other vertebrae of the spine to the sacrum. Through these links, the sphenoid and sacrum function as unit.

Just as the sacrum rocks forward (nutation; into the body) and back (counter-nutation), the sphenoid exhibits a subtle pulsing that can be quietly experienced and resembles bird's or butterfly's wings flexing forward and back. Here is a video of this mesmerizing motion. This connection between the motion of the sacrum and the sphenoid is the basis for craniosacral therapy. Further, this approach talks not only about a fascial and skeletal connection between the sphenoid on top of the spine and the sacrum at the base of the spine, but of a deeper connection via the membrane system surrounding the brain and the spinal cord and the cerebrospinal fluid. The movement of the cerebrospinal fluid and the membrane system can be felt as a tidal motion, a kind of welling and receding which is called the craniosacral rhythm.

What does any of this have to do with your everyday well-being and your practice? Here it goes.

I often tell my yoga students to stop clenching their teeth and stop doing the pose with their face. Besides being funny, the above makes it clear that if your teeth are grinding and your jaw is tense, not only can this lead to TMJ and other neck issues, but the sphenoid and everything all the way down to the sacrum will be gripping as well and you are quite effectively locking yourself out from your core intelligence. Being tense in the eyes, jaw, throat and neck, and having poor head posture (such as forward head, rigidly holding the head still as in meditation or in front of a computer) disrupts the pulsing of the sphenoid and cuts/disconnects your head from your spine and the rest of your body.

Simply, clenching your teeth means you are clenching your butt, which can explain your low back pain, sacroiliac (SI) joint issues, and the like. The sphenoid and the sacrum quite simply mirror each other.

What can you do? One would be to soften. Close your eyes and let go of the mask of your face, softening your skin, your hair, making space between the upper and lower teeth, quieting the hands and the feet. Once you access that space (and I mean this literally), I think you will be surprised to feel the subtle movement of your head as it tries to balance on top of your neck and the internal movements of being human (heart beat, breath, gas, etc.). Remember, the more you hold yourself physically still, the more you are grasping. As you sit quietly, do mini horizontal figure 8 (or infinity signs, if you wish) movements with the tips of your nose, as if with a tiny paintbrush.

Breathe! As you inhale, imagine and allow the inside of the mouth to expand, the soft palate to widen and broaden. As you exhale, think of the soft palate gently drawing in and up, gently massaging the sphenoid above it and coaxing it to resume its pulse.

Finally, smile with your neck (follow the link for detailed description)!

Becoming aware of your sphenoid and integrating this knowledge into your life and practice is reorganization of your embodiment from the core outwards!

Thank you for reading!

What Knife-Hand Strike Can Tell Us About Hand/Wrist Alignment?

One of the things that we are concerned with in yoga is creating space: space in the flesh body, space in the mind body, space in the emotional body, space for being... It is also taken as a given that the more space, the better.

I am certainly a space enthusiast. I love to spread my toes, for example, and have found that the more I am able to do funny things with my toes, the more ease I find in my hips. The same attitude is largely applied to our hands, regardless of whether we weight-bear on them--as in down dog, handstands, or arm balances--or not, as in warrior 1 or 2 and related poses. We hear over and over again: spread the fingers!

And that's fine, but up to a point. As with anything, yoga is about striking a balance--neither underdoing, nor overdoing. And I think that the finger spreading tends towards the overdoing, especially on the pinky finger side of the hand. What do I mean by that?

Overspreading the pinky/little finger actually creates compression in the outer wrist and enough repetition (i.e. regular yoga practice) can lead to injury in the TFCC (triangular fibrocartilage complex). Say w-hat? Said simply, the wrist is a complex structure, as delicate and exquisite as it can be lethal depending on how you choose to use it. The wrist joint is actually a collection of many bones and joints. Here is a nice visual of the TFCC:

TFCC from the excellent http://classes.kumc.edu/sah/resources/handkines/ligaments/wvsartgroup.htm, showing the major structures in the wrist that can be affected by overspreading the pinky. This is palmar perspective: as if you are looking at someone's palm. The thumb is to the left of the screen, the pinky to the right.

Here is a visual of what I mean by overspreading:

This is my hand. It's as the image above, but the palm is turned down. If I flipped my palm up to face you, the thumb side will be to the left, the little finger to the right.

To me, I've overspread my pinky finger, when it is not lined up with my 5th metacarpal (the outer fleshy part of my hand, also known as the knife edge). So, when I spread my little finger in the this manner, I am actually taking space away from the outer wrist and causing pinching around the articular disc, meniscus homolog, and ulnar collateral ligament; in a sense, the ulna (the forearm bone on the little finger side of the hand) rubs against the triquetrum carpal bone. Here another image to help you locate the triquetrum, where it is labeled:

Triquetrum, shaded in blue from http://classes.kumc.edu/sah/resources/handkines/bone/triquetrum.html. This is palmar perspective: as if you are looking at someone's palm. The thumb is to the left of the screen, the pinky to the right.

How can you know whether you are overspreading the pinky? To me, it's all about awareness and paying attention. With your hand in the air, spread your pinky as much to the side as you can and pay attention to what you feel in your outer wrist but also in the back of your neck and top of the shoulder blade. Do you feel less space in your outer wrist and a tightening in your upper back/neck (I think that would be your levator scapula muscle, quite the villain if you ask me). Also, if your outer wrist is too bunchy and wrinkled in comparison to the rest of your hand/wrist, you are probably overspreading the pinky.

So, what is an optimal spread of the pinky? This is where the knife-hand strike comes in, or more commonly known as the karate chop. (As a caveat, here is an article on why the karate chop is a useful tool to have in your bag of tricks.) In a karate chop hand, the knife edge of the hand and the pinky are lined up in a straight line (as far as anything in the human body is straight), which creates stability along the back line of the arm. We've all seen bricks being shattered with a knife-hand strike.

The pinky is associated with the Deep Back Arm Line, which includes your triceps and rotator cuff muscles. The rotator cuff muscles do contribute to movement of the arm bone, but they have the important function to stabilize the head of the armbone in the shallow socket of the shoulder blade while the armbone is in motion. You can feel this stability simply by taking your arms out to the side but still in the front plane of the body (with the palms facing forward and the hands slightly above shoulder level; the latter helps with releasing your upper traps), so that the knife edge of your hand and your outer forearm are pointing down toward the floor. Experiment with overspreading the pinky towards the floor (so that your outer wrist bends or kinks if you wish) and lining up the pinky with the knife edge of your palm, so that the outer wrist is stable and smooth. Although overspreading the pinky does create engagement, it feels more like gripping and muscles along the arms either overwork or underwork. It's kind of like creating a kink in a hose, the energy stops flowing smoothly. When the pinky lines up with the knife edge of the hand, there is space, but there is also stability, and you can pulse the energy along the deep back arm line: drawing from the pinky through the triceps and into the rotator cuff muscles, as you extend out from the shoulder blades through the pinkies. Further, when the pinky overspreads to the side, it's more likely that the mound of the index finger will have trouble connecting with the floor, which by definition will put pressure on the outer wrist.

Let me know what you think and share your experience. Thanks for reading!

Here are a couple of photos of what is an optimal spread of the pinky for me. Do you notice the difference with the image above? The little finger and the fleshy outer part of my palm are on a nice continuous line.

 

How Are Your Groins Connected to Your Humanity?

"The groins are of great importance for humans because their full extension creates the upright posture unique to our species. In a sense, when we are not balanced and stable through the groins, we're not fully human."

-Arthur Kilmurray

The groins are fascinating territory in the human body. Not technically an anatomical term, the groins are broadly the area in the body where the legs and the torso meet or fold into each other, a juncture where we like to keep our junk. It's an area of great hoarding, a veritable junkyard, a treasure basement to rummage through with glee and fascination.

Anatomically speaking, the groins are broadly described to include the 5 adductor or inner thigh muscles (lower inner groin); the iliopsoas complex (upper inner groin); and the part of the quads (rectus femoris) that acts on the knee (as in straightening it) and the hip (as in flexing it) as well as the sartorius and the tensor fascia latae. To me, the groins can be broadened to include any myofascial structure involved in the articulation or interaction between the leg bones and the pelvis, and therefore, by proxy, the sacrum and the spine. So, for example, the hamstrings can be thought of as the back groin--they cross and act upon the hip and the knee joints and are the antagonists to the quads mentioned above.I would include the glutes and the piriformis too.

Opening and balancing the groins is a lifelong practice, which requires utmost patience, gentle dedication, thoughtful awareness, less teeth grinding, less sitting (or should I say slouching), a willingness to do exactly the opposite of what you think you know or should do, an explorer's mind, to name but a few qualities. I am sure you can add to the list based on your experience. 

What does it mean to have open or balanced groins? According to Kilmurray, a body is open when it allows bodily fluids and energy to flow freely through, in, and out of it. This means that the bones must be centered in relation to each other, so that they can channel the energy of gravity and allow the various bodily systems to function efficiently in conjunction with the force of gravity. This also means that muscles will work optimally without unnecessary tension and the organ body will be supported rather than encumbered or collapsed.

What does this mean in practice? The short answer to this question is that to cultivate balanced and spacious groins we must do the work of separating the legs from the pelvis and differentiating these areas on a psychosomatic level, so that we can quite literally allow for the free flow of information between the legs (our connection to the earth: a fundamental and non-negotiable connection) and the rest of the body; in other words, so that we can be grounded, which is what allows freedom in movement and in self. 

Groins often feel anything but open. They feel bunched up, gummed up, glued, stuck, tight, gripping, sore, bulging, thick, dense, insert appropriate groin descriptor here.

But what does this concretely mean in practice? Below are a few examples of ideas that you can work with in a variety of poses:

• In any pose, think of allowing the very top of the thigh bone, where it feeds into the hip, to settle into the back of the leg/hamstrings. If you try to this muscularly, you will achieve the opposite effect. Think of your hamstrings broadening, like a hammock receiving the thigh bone. It's more about becoming aware of that area and realizing if you are holding any (residual) gripping (for example in the gluteal fold, where the hammies and buttocks meet; also affectionately known as the butthigh or thass area), which might prevent you from releasing the thigh bone into the back of the hip socket. It's not about pressing with the front of the thigh into the back of the thigh, it's about mindful direction. You can do this in constructive rest position (see image below), in lunge (for both legs!), any of the warrior poses, etc.

Constructive Rest Position from http://alexandertechnique.com/constructiverest/

• Partial "supported" squat: You can do this with a chair without arm rests (such as a folding chair). Sit at the edge of the chair, with the thigh bones forming a comfortable V shape: not too wide, not too close together. Track your toes and knees in the trajectory of your thigh bones (and subsequently adjust if there is any discomfort in the knees), have your shins vertical with the floor. From there, take your hands behind you on the chair and lift the pelvis away from the thigh bones, as you let them drop away from the frontal surface of the thighs (see bullet point above). See if you can maintain this sense of separation as you sit back on the chair. From there, with the hands holding the edges of the chair seat and supporting you, you can take the pelvis away from the edge of the chair and slowly and repeatedly squat down towards the floor, becoming aware of the tops of the thighs descending and the pelvis ascending, imagining and feeling tremendous space between the surface of the hip crease and the thigh bone. If you get into it, it can be quite profound. It will also make you realize why "regular" sitting (excuse me, slouching) is so detrimental to our health and well-being: it literally cuts off communication between the lower and upper body.
• In poses like baddha konasana (bound angle) and supta bada konasana (supine bound angle), please stop thinking of your knees getting to the floor. Rather, think (again) of letting the thigh bones move into the backs of the legs in addition to moving them away from each other laterally (you can also think of the inner surface of the pelvic bones—the ilia—expanding and broadening).
• In poses like parsvottonasana (pyramid), parivrtta trikonasana (revolved triangle) and urdhva prasarita ekapadasana (UPEP or standing splits) the inner thighs tend to collapse onto each other. What I find very helpful here, especially in the back (or lifted) leg) is to create space between that side of the pubis and the upper inner thigh.
• This is a fun one and will help you with differentiating your thigh bone from your hip point in any number of poses (for example, vrksasana or tree pose, padangustasana B or extended hand to foot pose, baddha konasana, and the like): from standing, take your hands on your hips, then lift one foot off of the floor and look at the bottom of this foot as if to see if you stepped on gum, while keeping that hip point facing straight ahead and taking care not to hike it up.
• Sitting on tennis balls: the possibilities here are beyond the scope of this post. Everything I learned about tennis balls and how to use them for myofascial release and space creation I learned from the fabulous Megan Davis and Jenny Otto. 

The above just scratches the surface of how you can begin to have a meaningful relationship with your groins. There are a myriad of ways to do that. If you have a specific question, feel free to drop me a line. If you have a tip, I would love to hear it. If this was helpful, spread the word. If you are interested in a topic and would like me to write about it, I would love to hear from you. 

Groinfully yours,

Anna

Downward-Facing Dog Exploratorium

Downward-facing dog is one of those ubiquitous yoga poses, spanning styles, methods, disciplines, and approaches. It is a defining (visual) symbol of contemporary yoga. I am a bit tempted to go on a bit here and talk about down dog as a concept deserving its rightful place in yoga's ever-evolving polysemic lexicon (meaning a vocabulary of words which have many and different meanings depending on the context, courtesy of the always thoughtful and thought provoking Matthew Remski), but I'll confine myself to what usually fascinates me in my practice and that is the alignment of the human flesh in this pose--a pose that is as basic as it is wildly advanced.

In particular, the front end of the pose is where it gets especially interesting: the arms and the hands. Practicing down dog in particular and asana in general requires using your hands and arms and weight-bearing on them. This coupled with contemporary lifestyle habits and patterns is often a recipe for sore wrists, misused shoulders, and jammed necks, to name but a few abominations.

Tom Myers puts it very well when he says that "the arms have to control the finest instrument the world has ever known—the human hand—at one end, and are anchored into the head, neck, upper spine, ribs, low back, hips, sacrum, and even arguably the femurs at their other end." (Myers 2012). In other words, a lot is at stake when we practice down dog or any other pose that derives from it (plank, low pushup, handstand, arm balances, side plank...). Further, "the arms are highly complicated bits of machinery, very handy accoutrements to our body’s repertoire, and amenable to the poetry of bird’s wings and nonverbal haiku" (Ibid.). Whereas the legs lead us to the world and into our environment, our arms and hands bring the world to us.

Tom Myers identifies 4 arm lines, presented very schematically below:

• Deep Front Arm Line connecting pec minor (tight chest, anyone?)-biceps-supinators (radius bone rotators)-thumb muscles
• Superficial Front Arm Line connecting pec major-latissimus-teres major-hand/wrist flexors (undersides of forearm in down dog)-palm surface of the fingers
• Deep Back Arm Line connecting rhomboids-levator (pesky villain)-rotator cuff muscles-triceps-pinky finger muscles
• Superficial Back Arm Line: traps-deltoid-hand/wrist extensors (tops of forearm in down dog)-back/top of the hand

Myers further compares the arms lines as the four aspects of a bird's wing, with the superficial and deep front arm lines being the bottom of the wing and the superficial and deep back arm lines being the top of the wing. In this cute video on How Wings Work, we are told that extending the wing fully creates a smooth surface for flying. We are also told that the bird's first finger allows it to fly slow speed without falling out of the air.

Where am I going with this? What I am trying to say is that the arm lines (especially the front arm lines vs. the back arm lines) need to be balanced for down dog to be an integrated pose rather than overusing the back arm lines at the expense of the front arm lines. The underside of the wrist—where a lot of us collapse in down dog—is called the volar surface of the wrist, which means the hollow of the hand and it is etymologically rooted in the Latin for "fly."

In terms of the lines above, my take is this:

• The Superficial Back Arm Line is the line that tends to overwork and grip in down dog, starting with the upper traps, the deltoids, the tops of the forearms and hands. The one part of this line that is often asleep and needs to be nudged is the mid and lower fibers of the trapezius muscles which have the wonderful function to take the inner edges of your shoulder blades down your back and thus create a lot of freedom at the base of the neck/tops of the shoulders. But we'll get to that in a moment.
• The Superficial Front Arm Line is your flying line: if the undersides of the forearms and palmar surface of the hands engage isometrically (you think of the action but you are not actually doing it), this will keep the tunnel in your carpal tunnel, will give space for the ligaments that maintain the arch of the hand to do their work and also begin to take the outer edge of your shoulder blades up (away from the floor), like bird wings spreading and getting ready to fly (with the help of the lats and the teres major).
  (This is a good place for a caveat: in many yoga classes, students are instructed to take the outer edges of the shoulder blades toward the floor in down dog and wrap them towards the outer armpits with the idea of lifting the inner armpits; what I am describing here disagrees with this instruction. I feel that this "wrap" is what the wonderful Barbara Benagh calls "borrowing" without giving back: like shortening your bottom ribs in parsvokonasana (side angle pose) and bowing out the top to allow your hand to reach the floor or like using the mobile T12-L1 juncture in your spine and pretend that your top chest is open. Further, if you take your blades off your back in this way, how can you then take them down your back?)

As I said above, my take is that the Superficial Back Arm Line tends to overwork in down dog due to tight/overused extensors (the tops of the forearms, i.e. the hairy part of your forearm; these are the muscles that help you gesture stop with your arm and hand, which is the same position as in down dog but in a different spatial orientation if you think about it).

Further, modern humans tend to have weak/underused hand/wrist flexors (the underside of the forearm; these are the muscles that help you make a fist).

To add to all this, very often when we go to yoga class, we are told to take the chest down towards the floor or towards the thighs and to aim to touch the floor with our forehead. (I know, I am maybe exaggerating a bit, but I sometimes think that to make a point, it is sometimes helpful to exaggerate, and no, I am not saying that the chest should not be open in down dog.) This, however, tends to disengage the front arm lines and collapses the whole endeavor towards the floor and you are quite literally subsumed by gravity and stuck to the floor with any number of unpleasantries such as achy wrists or elbows, a pinch in your shoulders around the tops of the deltoids, and a neck that feels heavy and hard like lead. Further, if we go with the bird wing metaphor, you have to lift from below (the front arm lines or bottom of wing) in order to be able to fly.

What about the other two lines:

• The Deep Front Arm Line is your stabilizing/weight-bearing line in the front, in the sense that the thumb connects to the radius (that's the forearm bone on your thumb side), which in turn connects to the humerus (upper arm bone), which connects to the ribcage in the front via the pec minor. The front needs to engage and draw up so that you don't fall.

• The Deep Back Arm Line is your stabilizing line in the back, in the sense that the pinky finger connects to the humerus (via the ulna—that's the forearm bone on your pinky side), which connects to the shoulder blade via the rotator cuff, which connects to the spine and neck via the rhomboids and the levator scapula respectively. 

Further, for your down dog to "fly" out of gravity's lovingly smothering embrace, your wings need to be fully extended and lined up as per the bird wing video above. In a human, lining up your joints helps muscles to work optimally with/against gravity, decreases drag and inefficiency along the myofascial lines of the body, and facilitates the flow of energy between the joints (not to be confused with hyper-extension at the elbow joints though: locking your elbows stops the conversation between your hands and your shoulders for example in the same way that locked knees destabilize your hips because they have no feedback from the feet and the earth beneath them).

How does this all work in asana? Please read this first, reflect on it, and then try it in action.

Have a block handy. Start on hands and knees. Come down onto your forearms and place the block wide-side between your elbows on the floor. Then, position your forearms in such a way that you are not holding the block with the fleshy part of your forearms but really with the bony protrusion at the elbow (which is really the inner rounded end of your upper arm bone, the humerus). If you do this well, your forearms will be parallel with each other, rather than narrower at the wrists. Hips will be over your knees (or a bit behind to keep the torso long), low belly lifting towards the spine, torso long, fingers spread, head/neck neutral so that the back of your neck is not shortened. Press down through your palms to lift your elbows and the block just a couple of inches off of the floor (leave the knees on the floor for the first round and then experiment with lifting the knees off of the floor and pressing back through the hips like you would in down dog). Now, the arm lines, which are cumulative (in the sense that the actions build on each other and don't cancel each other out). 

• First, press down through the thumb pad and index finger knuckles and draw energy up along the inner forearms, the biceps and right where the biceps disappear under the deltoids to create a lift in the inner armpit and stability in your pose. (Deep Front Arm Line for establishing your base and stability from the front/bottom)
• Second, draw up from the entire palmar surface of your hands: the more you spread this action, the better; hopefully, you will feel the undersides of the forearms begin to engage and the arches of the hands begin to emerge and create an energetic lift away from the floor. Remember, the knuckles of the fingers--where what we perceive as fingers meet the palm--are rooted to the floor. The more you direct the weight into the front of the palm, the more space and lift you will create in the bottom of the wrist/carpal tunnel. Now, think of taking the outer edges of your shoulder blades away from the floor and onto your back (Superficial Front Arm Line, or lifting your wings)
• Third, draw energy up into your triceps from the fleshy part of your pinky "finger" (5th metacarpal) while keeping it firmly grounded, and think of plugging/connecting your triceps into/with the muscles connecting your shoulder blade and your arm bone (the rotator cuff). Hopefully, you will feel the bottom tips of the blades start telling you things as a result :). (Deep Back Arm Line for establishing stability from the back/top)
• Finally, think of length and space in the Superficial Back Arm Line (or spreading your wings). Lift your collarbones away from the floor to free the upper traps, then lengthen from the deltoids through the tops of the forearms and fingers, like you are exhaling from under your finger nails. At the same time, think of the inner edges of the blades sliding down your back (or up towards your hips if you are a spatial person) to awaken the mid-low traps. You are still doing 1-3 and holding the block, right? :)

Come down and rest and repeat a couple of more times, progressively straightening the arms in the process, without ever locking your elbows (yes, it can be done even with the block). Can you feel how this is creating more balance between the undersides and the tops of the forearms? One way to gauge if you are on the right track is to bring your attention to your elbows and create an energetic balance between the elbow crease and the elbow point, so that the crease is not overstretched and the point is not digging in. Keep space between the teeth and your tongue relaxed. Then, of course, try this in full down dog, plank, handstand, your choice :).

Questions? Feel free to drop me a line or leave a comment!