Although this is recommended reading, I encourage you to first read the entire Mechanics of Yoga section.

As this website continues to generate responses, I find myself in dialog with many of my readers. Used with permission, these dialogs are here to help you refine your understanding of ExTension and Recovery Yoga; and how and why it differs from most yoga styles being taught today. As always, newer additions are placed at the top of the page. Names are used with permission:

A note to my readers:

If you haven't already done so, please be certain to read The Pain Management section. Part 4 of that section contains an extensive dialog between myself and a yoga student who began his yoga practice because he was in chronic pain. If you are injured, chronically ill or otherwise are in chronic pain, or you are a yoga teacher who works with such students, it is well worth your time and effort to read.

The following dialog concerns a reader's chronic injuries from running and his use of the John Barnes system of Myofascial Release. Steven R from Columbus Ohio, is a 40 year old runner who, as a result of reading my website, purchased my book ExTension Yoga and began practicing.

Steven:
I came across your work after already having discovered that fascia only responds to gentle forces. I first learned that from reading John Barnes’ Myofascial Release Manual. I want to run. I’m a runner and I love it. I believe our bodies, when healthy, are designed to run provided we run properly and softly. But I’m now age 40 and I did not understand that when I was younger … because today, I’m racked with chronic injuries and overall tightness. A brief synopsis of my injures are:

• A severe fall in high school that injured my left side on the ribs, left hip on greater trochander (to the bone), and left lateral knee (to the bone)
  
  
• Severe ankle sprains on both ankles that left them with limited range of motion and permanent swelling.
  
  
• A bike accident as a child that resulted in a deep cut and now a scar on my right side just above my pelvic rim, and
  
  
• I've overtrained to the point of severe soreness countless times (stomach, chest, calves, thighs, hamstrings, you name it). 

1) Can Extension Yoga, done properly with controlled breathing and active extension and never pushing too hard, eventually restore fascia that is badly bound by scar tissue, like in my ankles and hips and left outer thigh and hamstring. I will continue to do Barnes releases on them, but I’m finding that it will take forever without some way of employing my mind and body in movement and stretching in order to re-balance my body. Can that process happen and what will I experience along the way to know?

2) I am very interested in somatic re-education. I’m sure you’re aware of the concept of “sensory-motor amnesia” where we are tight in a certain motion, our minds don’t go there anymore, and we aren’t aware of it. Those chronically tightened areas can’t relax because we’ve lost control of them and don’t use them.

What I’ve read about somatic re-education is that you basically find modes of movement that are painful or difficult, and gently move back and forth into that very movement, being precise about the direction that is most difficult. For example, I find that inverting my ankles on purpose, with no weight on them, induces an uncontrollable shake because my injuries were inversions.

What I’d like to know from you is whether it is advisable to do this while in ExTension Yoga positions. For example, my left hamstring and the region between that and the outside of my leg, is chronically tight. I feel pain when I try to stretch that area. (Your hamstring stretches, the forward bend and lying down with legs up the wall, do not cause pain.)

I sense this as being a key area for my entire body and that if it were to release and be restored, the vast majority of my body would be able to respond. Those scars on my left side are very dense and I can feel them pulling everything to the point of pain.

I find when I’m doing the hamstring stretch on the wall that if I bend my leg maybe 20 degrees and bring my knee toward my chest by taking my left foot off the wall maybe 6 inches, it is uncomfortable to move my leg gently side to side. Is it advisable to do this?

The pain is only slight. It depends on how far I go and how fast I go. When I do it slowly and gently, it seems ok. I don’t know yet how effective it is because it hasn’t been long enough. I’d really like to know your opinion.

Sam Responds:
When you ask: “Can ExTension & Recovery Yoga, done properly with controlled breathing and active extension and never pushing too hard, eventually restore fascia that is badly bound…” My answer is that it’s impossible to predict if ExTension & Recovery Yoga will “eventually restore (damaged) fascia.” That being said, ExTension & Recovery Yoga, when appropriately practiced, will move your body toward restoration. How much fascia releases is impossible to predict, but it will move in that direction.

You ask: “I will continue to do Barnes releases on them, but I’m finding that it will take forever without some way of employing my mind and body in movement and stretching in order to re-balance my body.” My simple answer is that the way to get the Barnes system to work better is to employ the ExTension principles of breath control: Inhale and observe (holding steady, not stretching nor creating “action”), then exhale and explore by moving “toward” the action. This process is discussed in the Pain Management section of my website.

You ask: “What I’d like to know from you is whether it is advisable to do (somatic re-education) while in ExTension & Recovery Yoga positions.” My response is that ExTension & Recovery Yoga IS somatic re-education, except that I refer to it as “neuromuscular re-education.”

ExTension & Recovery Yoga is designed through its logic, and through the understanding and adherence to its various neuromuscular principles and laws, to slowly, over time, re-educate the tighter, more contracted areas of soft-tissue to move “toward” union and balance. The very same logic and principles also addresses the looser and weaker tissues that also move toward balance and union.

Steve, there’s no question that working on your own is difficult, but it’s certainly not impossible. You should read and understand the material in my website, and how its logic and principles directly applies to your body. Then as you do the actual exercises, you should keep at the forefront of your consciousness that “less done correctly gets you more,” that “breathing beats the alternative,” and that “yoga is the movement toward balance and union.”

Finally, you must NOT TRY to do what you can’t do, but instead learn how to pay attention to what you can do without pain or strain. When you talk about ”somatic re-education as finding modes of movement that are painful or difficult, and gently moving back and forth into that very movement, being precise about the direction,” let me say that for you, this is ill advised, because if I were to teach you directly, I would show you how to create “somatic re-education WITHOUT exacerbating your pain.

Regarding your running: I agree with you that the body was designed by Nature to run…especially when the body is young and healthy. That being said, I also believe that Nature doesn’t want the body to run when it is injured. Does an animal in Nature, when injured, continue to run, or does it find a quiet and safe place where it curls up and waits for Nature to do its thing. Animals in Nature that are injured slow down and wait … until they either heal or die.

When we are injured, we human beings will use our will and desire to circumvent nature's proclivity to want us to lay low which will prevent us from starving to death; but instead of slowing down as Nature wants us to do, we will apply that same will and desire to prematurely get back “into the hunt,” and in so doing, we exacerbate our injuries. Does that sound familiar to you?

At your level, ExTension & Recovery Yoga is designed to first address your injuries and without pain or strain, to move your body “toward” balance and union. After that is accomplished (without expectation of how long it would take), the very same program using the very same logic, principles, and laws, is designed to begin enhancing your flexibility, strength, and cardiovascular endurance. But if you move too quickly or try too hard at any stage within the program, you can easily exacerbate your existing injuries, and retard your recovery; or worse yet, you can create new additional injuries.

My position is that we can use Nature’s intelligence to accelerate the healing process. I believe ExTension & Recovery Yoga is an intelligent program that works with Nature to facilitate healing. In fact, when you read between the lines throughout my entire website, you will clearly see that Nature is the thread that ties everything together. ExTension & Recovery Yoga is simply a process that moves us toward balance and union. It does nothing more, and it does nothing less

Steven Responds:
Thank you for your response. Here’s what I’ve learned:

1) It is not clear whether ExTension & Recovery Yoga can clear up my internal fascia scarring, but if I stick to the “less done correctly is more” philosophy, my body will definitely move toward balance over time. I shouldn’t have any expectation of time frame. I should trust nature’s, and my body’s, intelligence. I need to trust the process.

2) Barnes releases can be enhanced by inhaling with a hold, and exhaling while gently stretching the tissue into “action”, always observing and feeling and exploring.

3) I should allow my body to rest, heal, and re-balance before pushing it. (I did push with these injuries in place… many times… but I haven’t done that in about 2 years. I haven’t run in several years. I agree that nature doesn’t want an injured body to run. Nature has been emphatic on that point… with intense pain J I have, however stretched improperly. I will no longer stretch that way).

4) I should not do somatic re-education exercises in modes of motion that would be painful if I were not to do them gently. Rather, I should trust ExTension and Recovery Yoga principles to re-educate my body and movement.
Thanks so much for taking the time to give such a thoughtful response.

The following multipart question from CG, covers many subjects that are important to all yoga practitioners and teachers. They include quesitons on breathing during asana, discipline, depression and spiritualty,

CG:
It has been my experience (I have also encountered the concept in various breathing practices), that the inhalation is for action and the exhalation is for release. You have reversed this in your program, or nearly so. Is that because it is essential for the over stressed person to relax as they begin to move? Wouldn't it make them more tired or are the movements so subtle that it isn't really exertion at all.

Sam Responds:
You are quite correct when you say, “the exhalation is for release.” But release of what?  If in fact, exhalation releases tension, then when we are doing asana, it makes sense to exhale into the action in order to release superfluous tension.
In beginning level yoga, I teach students to focus initially on slowing and softening the exhalation along with easy-to-do body movements (see the page on Pain Management in my website). This is because a slow, soft exhalation promotes quietness of the brain while at the same time, it sharpens the ability to focus on what the body is feeling.

Once the student has learned how to coordinate exhalation during these easy exercises, the student can then begin, slowly over time, to apply that very same attention of breathing and awareness of body to more complex and demanding asana.
If the person is stiff, slow controlled exhalation with appropriate stretching enhances flexibility. If the person is weak, slow controlled exhalation during load-bearing exercises promotes strength. The use of slow, controlled exhalations then, allows the brain to settle while the body activates. The logic that supports this concept is discussed further in my website chapter on Meditation.

Make no mistake about it: The logic supporting slow controlled breathing coordinated with asana that is recommended for chronically ill or injured people, is the very same logic that applies to normally healthy yoga students, as it does for the most advanced practitioner.

CG:
It must take a great deal of discipline, as you know, just to get out of bed if you have chronic pain. All that you have done considering your situation, is tremendously impressive and any one who can practice your method on their own from a book is also quite determined. It is rare. Not everyone has that.

Sam Responds:
I agree that it’s extremely rare for people to discipline themselves, especially when working from books. That’s why it’s enormously helpful for people to initially work with someone who is skilled in both communication and yoga, who can explain the reasoning and logic behind a program, and can motivate students to take personal responsibility for using the program to maintain his or her health.
Patience IS the key. Even though nature wants the body wants to move “toward homeostasis,” the process of change is slow and potentially risky; especially because most everyone in our culture is impatient and wants results NOW.

CG:
Depression and fear add to the load of stress. Physical relaxation would definitely help the body but have you found anything to help the spirit…

Sam Responds:
From my perspective on yoga and from from my experience of what works, yoga when appropriately practiced, at whatever level attainable, helps the body over time, to move “toward” balance and union. In so doing, the practitioner begins to slowly integrate body, mind, and spirit. This process is not magical, nor do we obtain balance and union from the cosmos, or from shaktiput (a peak experience, spirit possession, epiphany, religious rapture, nirvana, clear light, or illumination), but is earned by discipline, again, at what ever level is attainable. As I’ve written extensively throughout my website, the operative word is “Toward.”

CG:
Can you see any way for a therapist to integrate these things using your program. What are your thoughts on this?

Sam Responds:
The very best thing a therapist can do is to personally practice the program thereby developing an experiential understanding of how yoga works. In so doing, the therapist comes from a place of authenticity, which is something that people in distress gravitate toward. Otherwise, whatever the therapist says is just another theory that the patient might or might not relate to, much less practice.

John Billings and I corresponded on the subject of yoga injuries and aging. John studied with me during the 1980's when he was about age 30. I remember him as being remarkably flexible and strong.

John Billings:
I believe health and fitness are different! My new goal is not to do advanced poses, but to do poses at an advanced age…because if you can still do yoga at 80, that's real health, not just fitness.

After reading your web-book and especially the Ages and Stages section, I want to learn ExTension Yoga . The first reason is that I believe it's more healthful than what I'm doing now. For a couple of years, I've been having pain directly attributed to my yoga practice.

The second reason is the alpha-wave phenomenon. I have noticed vinyasa does not lead to that peaceful feeling I used to get as described by Dr. Herbert Benson's Relaxation Response. (Ed. Note: Vinyasa is an aerobic flowing approach to yoga that promotes extreme flexibility and endurance).

My wife, interestingly, is beginning to notice the same thing in her own practice. Vinyasa, at least as we practice it, creates stress. She much prefers the Gentle Yoga I also teach. So I am very interested in your Wright-Patterson experience and anything else on the subject. Yoga should definitely produce waves in alpha range.

I have been in power yoga classes where there is just mass jumping around and it leads me to reflect on your two fundamental questions: “What is yoga?” and “How does it feel?”

I'm now 46. When I was 17, I was able to do remarkable things with my body - things that also feel good. The injuries started when I got into all this Ashtanga jumping around.

Sam's Note: There is nothing wrong with Ashtanga style yoga or for that matter, any style of yoga. On the other hand, it seems to me that all styles of yoga need to be definitely modified when injuries begin to surface; which is the sole purpose of learning the logic behind ExTension Yoga.

John Continues: It will probably help to know what I mean by injuries. Apart from the current pain below both shoulder blades, which goes all the way around to the ribs almost in front, there is sometimes a "sticking" feeling in my left shoulder joint, usually when going into Pincha Mayurasana (the scorpion pose). So I adjust around it.

Also, and of more concern, I have what appears to be chronic medial right knee soft tissue damage. This came from trying to raise my leg overhead in Natarajasana. I can do on left side, carefully, but not at all on right. I also now have to be careful with that knee, because any pose that requires lateral movement or twisting of tibia from knee joint that causes pain. I cannot do advanced Marichyasana, for example. This may change, but right now I'm very careful with that knee.

Sam, I have begun to wonder not only what is the purpose of these poses, but I've also been thinking about the epidemic of yoga injuries

Sam Responds:
ExTension Yoga is a system that honors your current restrictions and pain, and teaches you how to move along without exacerbating your condition. From your description, it appears as if you strained the fascia in and around your shoulder blades and the tendons/ligaments in and around your knees. I'm guessing you need to practice more gently and stretch less deeply. That's not to say you can't continue to do advanced asana; it is to say that you might do them without forcing. 

I want you to review my website's pages on "Ages and Stages," "Fascia," and most importantly, the "Pain Threshold" chapter. They will help to explain why 1) you are suffering now at this time in your life, and 2) why the masses who are now growing older are starting to join you in injury and pain. I also want you to review the remaining pages in the Mechanics of Yoga section. They will further clarify why you are suffering.

As you read through the Mechanics section, always be thinking in the back of your mind, "How do I apply what I'm reading to my personal practice and teaching."

John Billings:
Actually I expected such an answer from you, and you haven't disappointed me. I agree with you, and add that what actually feels good during practice can later be very painful. For instance, a few days ago I started to practice an Ashtanga move which involves pressing and lifting from seated pose into a handstand. Or at least trying to do this, about ten times. Now my back, on both sides below shoulder blades, is so painful it sometimes hurts to breathe. But the lift did not hurt at the time, because of endorphins and what may be called "yoga high".

I have noticed that real injuries began when I started doing "advanced" poses in vinyasa. This is partly the "yoga high", and also the repetition inherent in vinyasa. So it's time to sit and ask what is the purpose of yoga; or, whether I should even try these things. Is yoga health or ego, or something else? I'm rapidly developing new understanding, and you are an important source.

______________________________

Inversions, Menstruation, and Yoga:
A continued dialog with John Billings

John Billings:

We commonly say, "people with thus and so conditions should not do inversions. But what about all those other poses, like down dog and standing forward bends, that definitely put hips above the head? Is the inversion thing just a superstition?

Sam Responds
Inversion cautions are far from superstition. Inversions are known to elevate blood pressure and increase inter-ocular pressure. When I introduce inversions to my on-going students, I always remind them that inversions are not recommended if you have high blood pressure, glaucoma, or detached retina. At that point, I discourage new students with eye conditions from ANY inversions until they have cleared their yoga classes with their doctor.

In most other cases, because dog pose (and standing forward bend) may be considered as "baby inversions" and because their affects are considerably less than full inversions, dog pose is a good alternative to full inversions.

I might be inclined, if a student has high blood pressure for example, to offer a modified dog pose where the hands are on a bench, which minimizes the degree of lowering of the head. Then, if the student reports any feeling of increased pressure in the head, I would immediately offer, as a preparatory exercise, laying on the back with the legs partly up the wall…and extending them higher as is tolerated.

But let's assume for a moment that just laying on the floor with the legs partly up the wall still causes a feeling of increased head pressure, then what? Then, simply add props, such as folded blankets behind the torso, so that the student's head and torso is slightly elevated off the floor, like a wide “V” so the head and shoulders are slightly higher than the hips.

John Billings

That's the best advice I have heard so far. I also think it also has to do with the length of time the pose is held; we typically hold inversions longer than other poses. This may be why the standing forward bends such as uttanasana, prasarita padottanasana, etc. are not contraindicated, especially in the Iyengar school.

And what about women practicing yoga during menstruation? I've been exchanging emails with a woman yoga student who said: “Inversions during menstruation should be an individual decision. I have always believed that when a woman listens to her body (nothing teaches this more than yoga) she will know what is best for her. I was happy to see Yoga Journal cover this topic in an article written by an M.D. I have been a Registered nurse for many years specializing in women's health and the rationale behind not doing inversions did not make good science sense to me. Inversions might be fine for some and not for others. The article in Yoga Journal covers this issue well. It is in the April 2004 issue. The bottom line is to evaluate each client individually. What works for one client may not work for another."

I (John Billings) responded to her by saying: “O K, I know that article, but are people ready to drop the ritual contraindications about inversions? You appear to be way up on the subject. I am going to start teaching The Truth , which appears to be that whatever feels good is good, and whatever feels bad is bad! Now we are all enlightened...”

Sam Responds
Having some degree of insight gained from nearly thirty years of practice and teaching, I'm not too sure I totally agree with " The Truth " being "whatever feels good is good..." For instance, (and admittedly this is extreme, but it serves to make my point), certain drugs, both legal and illegal might feel "good," but might have devastating potential repercussions.

The same goes with yoga. Certain sustained inversions for instance, might feel good, but for some people, sustained inversions might create damage. The same goes for backbends. For instance, I've seen hyper flexible women do extreme, spine compressing backbends and love them. Except that over the long run, I've seen that compression of vertebra disks has led to chronic pain in later years.

I think there are basic cautions that should be honored, such as always avoiding compression in the spine, even when there is no pain.

This goes double for the cervical spine. Yes, some students severely compress their spines and don't feel pain. In fact, they might even love the feeling; but my position as both a teacher and practitioner is that the potential for damage by compression far exceeds any temporary "feel good" benefit.

Barbara writes:
I suffer with major depression and panic attacks. I was wondering if you could offer some words of advice as to how you may be able to help me. I've tried yoga here and there, but its hard to even get out of bed let alone have the energy to do a class. I've gone to a few yoga schools, but the classes were too hard and it was clear that all they wanted was to get my money. If you can help in some way I'm desperate for relief.

Sam Responds:
I'm sorry to hear about your difficulties. I know what it is to be depressed because I've been there myself. There is no quick way out of depression but how you will feel when you get to the other side, is well worth the time and effort you must spend to get there.

The very first thing I'd do if I were you is to find a psychotherapist or a professional counselor to help you with your depression. If you can't get a referral from someone you know, then you'd have to do what I did ... go to the yellow pages and find someone in your area. In any event, I believe it's best to seek an older therapist of your own sex. If money is a problem, you must not let that stop you. A good therapist will work with you regardless of your ability to pay.

Regarding yoga: Forget classes for now. The single most important thing you can do is to begin a gentle “walking meditation." That would be taking a ten to twenty minute walk EVERY SINGLE DAY; and while you are walking, start to gently control your breathing with your walking. Start today!

Begin by walking maybe to the end of your block and back. Do not walk quickly, but do not plod along either. Once you maintain a gentle walking rhythm, you can start controlling your breathing with something like "inhale for two steps, exhale for three steps." Or if you're totally comfortable, perhaps you can comfortably “inhale for three steps, exhale for four.” Walk slowly and find your rhythm.

It doesn't matter how many steps you can take with each inhalation and exhalation, except to remember that you always (1) Want to take more steps on exhalation than inhalation, and more importantly, (2) NEVER NEVER try to walk fast, or to try to extend your breathing beyond what is totally comfortable. In other words, you are to GENTLY coordinate your breathing with gentle walking.

You should never get yourself out of breath, nor should you walk so long that you become fatigued. Walk in the morning or in the early evening and avoid the heat of mid-day.

Again Keri, please remember that depression happens to many of us. It's like any other illness that takes us over. We don't ask to get sick, but when we are, the very best thing we can do, is acknowledge our illness, and then “begin taking steps” to get better. Sometimes, we cannot stop illness from invading our bodies, but when it does, we can take charge of how we respond to that illness. Walking meditation and seeking professional help will start you on your path to recovery.

Randy Jellen of Lisle, Illinois, Asks:
What yoga exercises would you recommend for my scoliosis?
I have a small scoliosis, and so, my natural curves in my spine are a little more "flattened" than normal. Not a lot, but there is some. I was wondering mostly about the cervical curve because my chiropractor says I should really try addressing it more with traction and so forth to try restoring a more normal curve to it. I was wondering if there are any asanas (yoga exercises) you could suggest to help restore the cervical spine?

Sam Responds:
There are many variables involved that contributes to your “success or failure” in your quest to deal with your flattened cervical spine, with genetics playing the most pivotal role. However, with that said, I believe yoga is the one very best exercise modality that can help to restore a more natural curve to the spine.

I'm frequently asked the question, “Are there any yoga exercises you can recommend to help my (fill in the blank).” My response is always the same; “The very best way to deal with any problem is to simply and consistently…practice yoga.“

In both my books and throughout my website, I make an argument that when we move through and beyond our 30s, yoga works best when it is practiced without aggression or forcing. When practiced on the level of fascia, the Wiggle and Waggle (as presented in Recovery Yoga and in my website), is to my way of thinking, the one most important yoga exercise we can do. However, it is only one exercise and admittedly, although it feels terrific and give remarkable results when appropriately practiced, it plays only a minor role in helping us move the entire body “toward” balance and union. In other words, my recommendation is not to rely on only one or even a few yoga exercises to address your scoliosis, but to be maximally effective, we need to maintain an intelligent and well-balanced yoga program.

Elizabeth Molfese, Lake Park, FL, is a yoga teacher who recently began studying with me. The ExTension and Recovery Yoga model has challenged her very assumptions about yoga. She asked a series of valuable questions via email:

Elizabeth Molfese:
How to instruct people in a firm and gentle way to stay with the modification best for them, rather than forcing themselves into the moderate and more flexible postures for which they are not ready. I haven't formally introduced yamas and niyamas and am thinking it may be time to emphasize.

Sam Responds: I can't speak for other teachers. I subtly introduce the yamas and niyamas, not from a classical yoga perspective, but more from a neuromuscular perspective emphasizing how an aggressive practice tends to move one away from “balance and union,” and even more so when the student is chronically ill, injured, or aging.

Elizabeth Molfese:
How to awaken students' self-awareness? How to encourage them to listen and feel their body, rather than encourage forcing? For instance, this is what I now say in class: “Do your yoga with patience, strength and compassion, and by not by pushing the edge”

Sam Responds: Teachers can elicit significant changes in students' perspective by simply changing the words they use, for example “Do your yoga with patience, strength and compassion by intelligently challenging your edge.” I also encourage teachers to use “toward” rather than “to.” And “do” rather than “try.”

Elizabeth Molfese:
How to reinforce students' resisting a personal time out? Is it a reflection on me because I don't want to interrupt the flow taking too many time outs? What can I say or do to establish personal body intelligence and moderation in students?

Sam Responds: During a student's first class, I introduce a couple of “relaxing-active exercises,” which require little energy output, yet they keep the student from cooling-down. I encourage students to do such postures at any time; whenever they have a need to slow down even when I'm maintaining a tempo. I continually reinforce the concept of “it's not how much you do, it's how you do” that matters.

Elizabeth Molfese:
How do I reassure interconnecting body openings with a student fixated on their challenging areas?

Sam Responds: I explain from the very first class that yoga is “all about ‘union' and ‘balance.'” Using the logic as presented in my website, I make a very compelling argument that yoga works better (1) when not being aggressive anywhere within the body and (2) to particularly avoid stressing ALREADY stressed out areas which will only serve to exacerbate “challenged” areas.

Elizabeth Molfese:
What is the best way to introduce new yoga poses? Initially introducing new practices by modeling compromises working the room – is it inappropriate to address students from the front of the room? Anonymously suggesting doesn't always hit its mark. Is there a gentle, nurturing technique(s) eliminating self-consciousness? Should I ask permission – just like touching?

Sam Responds: Teaching, just like yoga, is indeed a delicate balance between demonstrating and working the room. That being said, I believe it's wholly inappropriate for a yoga teacher to teach solely from the front of the room unless there are extenuating circumstances, such as during informal workouts with students. Otherwise, when students are paying, the teacher needs to be totally present and that is impossible while the teacher is doing yoga along with the class.

That being said, it's totally ok for a teacher to demonstrate poses, but when a yoga teacher demonstrates from HIS or HER perspective, the student often TRIES to emulate and either becomes hurt or frustrated by TRYING to achieve what he/she perceives as “the right way to do the asana.” The problem, of course, is that the teacher has been practicing for years and presents an unattainable perspective of the asana.

When personally demonstrating, I often “tone-down” the exercise so as not to present something unattainable. What works better is to work the room and ask permission for students to model exercises, I set the proper environment in the very first class by saying something like, “Hey gang, we're all learning together and it really works well when I sometimes ask you to show the rest of us what you are doing.” After, “trust” is established; I won't need to continually ask for individual permission before I stop the class to “come look here.”

After permission was initially granted, I'll something like, “hey, take a quick look here. See how Sally is rotating her pelvis in dog pose and look how she's keeping her shoulders wide, and her neck soft. See how she's creating extension (ExTension) throughout her entire body.” Establishing such strategies takes a moment and helps enormously.

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How To “Find Your Hamstrings

Jim Sturiale asks:
I've been reading ExTension Yoga and have a question regarding the hamstring stretches in the book - particularly the standing forward bend. It's really more of a problem then a question: I ALWAYS feel the stretch in the tendons behind my knees, NEVER in the belly of the hamstrings themselves. In fact, even with the hamstring stretch against the wall, that you recommend for those who are having problems feeling the stretch in the hamstrings. The results are the same. Either no feeling of stretch at all, or a fairly intense feeling in the tendons behind the knees. I've tried other poses (not in your book), such as Prasarita Padottanasana (Wide-Legged Forward Bend), and that seems to work much better. Is this a good substitute pose? Or would you suggest something else?

Sam Responds: Your inability to feel (isolate) your hamstrings is a common problem and it definitely needs to be addressed. Otherwise, you risk the potential for future injury. This is not to say that you WILL injure yourself, but let's remember that our intention in ExTension and Recovery Yoga is to minimize liability and maximize potential.

Through the years, I've encountered students who have had significant problems in isolating their hamstrings. One most poignant example was an Israeli woman who was exceedingly flexible. When visiting Florida, she wanted to take a class with me, and I was definitely impressed with her yoga ability and became caught up in the intensity of teaching her. After a brief warm-up, I began showing her more and more advanced yoga poses and kept asking her, “Do you feel your hamstrings now?” to which she kept responding, “No!”

Pose after pose, I asked and she responded, “No!” Finally, I asked her the one most important question that I had, in my blind enthusiasm, failed to ask at the beginning of our session, “do you have any previous injuries or operations that I should know about.”

She responded, “Not really, except that when I was in the army, I stepped on a land-mine and although it could have been much worse, I don't really feel my legs much anymore.”

I could have very easily have injured her and was lucky I didn't. The purpose of this story is to impress on teachers and their students that there are many reasons why students don't feel particular yoga exercises. Some of those reasons could indeed be a result of previous injuries. Often, however, the inability of a student to feel an isolated hamstring stretch is simply a result of years of contracted soft-tissue of the posterior side of the body, from the torso down to the heels.

ExTension and Recovery Yoga works so effectively is because we don't TRY to stretch tight soft-tissue. We recognize that tightness and the inability to isolate soft-tissue had taken years and years to develop. Accordingly, we coax soft-tissue to open, we don't force it.

When “trying” to pull taffy, it will oftentimes just snap. Instead, it's better to lightly and repeatedly pull and release until it slowly begins to give way.

You haven't been able to isolate your hamstrings YET, but don't give up hope. Other than that Israeli woman, although it might take a while, there hasn't ever been another failure in my teaching career to help students' isolate their hamstrings. That being said, I want you to go back to the wall and follow the instructions in the ExTension Yoga book. I want you to be certain that you are working on only one leg at a time. That's why you need to bend one leg and place it's foot directly vs. the wall. You must keep the leg you want to isolate BENT throughout the exercise. How much you bend it is a function of your overall tightness. Without me looking at you, I can't really advise you how much to bend it, but you must bend it enough so that the tendons behind the knee are totally and absolutely not engaged.

Then, in order to activate your hamstrings (NOT really your hamstrings, but the fascia surrounding your hamstrings), you MUST totally understand the material in my website about the differences between fascia and muscle. You must understand the concept of working TOWARD, not TO. You must understand the concept of BACHIN ALIGNMENT, because you must keep your foot active, but not tense.

Then, you must not TRY to stretch your hamstrings. You must take a deep inhalation and then, ONLY on the exhalation, begin to subtly, and I mean SUBTLY, begin to lengthen, minutely lengthen, your leg WHILE at the very same time, you begin moving both sitting bones MINUTELY downward (you do this by anchoring your other foot directly vs. the wall and keeping that knee directly in alignment with its foot and hip-socket (maintaining Bachin Alignment).

Only create lengthening during your exhalation. Repeat only three times and then give it a rest. Then repeat 3x during three exhalations.

You probably won't feel anything for a while. Don't despair. If after several attempts, give it up and do something else. It will eventually come, but remember, the harder you try, the less you will get it. But once you do get it, your entire yoga practice should transform, because you can (and should) use the very same technique while doing all your yoga exercises, from the most basic to the most advanced.

Jacqui, M.D.:
Please comment on when to practice yoga after an acute injury.

Sam Responds: From my clinical experience as a neuromuscular therapist in dealing with acute injury, I find that fascia rarely responds to intervention, be it extrinsic (therapist facilitated) or intrinsic (patient facilitated i.e., yoga). During the acute phase of injury, it seems to me that over-stimulated fascia can not properly respond to appropriate stretching...In essence; fascia simply wants to be left alone until nerve stimulation subsides.

Until stimulation subsides, I find a therapeutic intervention rarely works. However, if I wait a week or so after the traumatic incident, fascia, in most cases quickly responds to therapeutic intervention and specifically the more yoga a patient has done using techniques similar to ExTension Yoga concepts, the quicker the response.

As an interesting aside, my therapeutic interventions first consist of manual fascia stretching followed by a trigger-point like therapy as pioneered by Janet Travell, MD (Myofascial Pain and Dysfunction; Janet G. Travell, MD & T Davis G. Simons, MD, Williams & Wilkins, Baltimore, 1983). The major difference in technique, of course, is that Dr. Travell used injection therapy and I use manual therapy. It is interesting to note that during my trigger-point therapy, (consistent with ExTension yoga concepts), less pressure appropriately applied always promotes quicker and more long-lasting results than application of a deeper and longer-held pressure. This is totally consistent with the ExTension Yoga concepts: Appropriate stretching is done on the level of fascia which, by definition, necessitates doing less; which gets you more.

In my practice, a therapeutic intervention is merely a "jump-start" for yoga exercise. In other words, before and during the sub acute phase, the patient usually feels "tight as a drum." Stretching exercises are difficult to execute and are potentially dangerous as injury exacerbation is omnipresent. My conclusion: Until the patient becomes sub acute, neither my therapy nor yoga-exercise is can be effective.

Linda of Orlando, Florida:
More "ex-tension" details
I loved ExTension Yoga and read it through and applied the concepts immediately. Do you have more materials that cover proper "ex-tension" of more of the poses. In any event, I am glad to see some people are questioning the "traditional" yoga poses and safety.

Sam Responds: I'm not questioning traditional yoga poses as much as wanting, through my books and website, to give you tools for making your yoga work best for your particular body-style and age.  

With hundreds, if not thousands of yoga "poses" along with their variations, it's obviously impossible to offer specific instruction for them all. On the other hand, by understanding the mechanisms of yoga, you can do virtually any pose while "maximizing your potential and minimizing your liability." 

In essence, my intention is to help you become your own best teacher whether practicing at home or when enjoying the camaraderie of others in yoga classes and seminars. I'll always encourage you to take classes, but to always remember that no one knows what is better for you than you - especially when you pay attention to the two most important questions in yoga: What is yoga? and How does it feel?

Sheri Kauhausen, of Vancouver/Burnaby, Canada:
Why is shoulder stand contraindicated in shoulder stand?
I have been trying to find out why, in yoga, the shoulder stand is contra indicated for people with high blood pressure, but the downward dog is okay.  Could you explain how, exactly, BP is affected by true inverted positions.   And, again, why the downward dog is okay for people with high BP.

Sam Responds: As the heart pumps blood throughout the body, each subsequent beat causes another "shot" of blood to move into the arterial system, which "pushes" the previous "shot" along its journey throughout the body and eventually back to the heart. But what prevents all your blood from pooling in the legs during the blood's journey from the heart? After all, cardiac output isn't nearly strong enough to push any given “unit” of blood all the way to the legs and back to the heart on a single contraction. To resolve this problem, nature has created an arterial system with an array of one-way valves that keeps the blood from pooling. In other words, after each cardiac contraction, each “shot” of blood moves along and is trapped by a one-way valve until the next contraction pushes the blood along. Eventually, the blood is circulated all the way back to the heart and the entire process begins again.
 
However, when a person goes upside down and as the blood is no longer "secured" by these valves, blood pressure in the legs drop and pressure builds toward the head. (This is why beginners usually feel leg tingling and a “full” head during inversions). However, this is most usually an insignificant problem because the body has mechanisms during inversions that: 1) prevent blood from excessively pooling in the head, and 2) sense when blood is not appropriately moving into the legs. Accordingly, in order to counter the reduction in blood in the legs during inversions, there is an increased cardiac output.  

Hence, a regular inversion practice creates a subtle form of cardiovascular enhancement because the heart must beat stronger in order to get the blood back up into the legs.
 
Notwithstanding these built-in safeguards, there is a minor increase in interoccular and intercrainial pressure during inversions, which is basically why people with detached retina or high blood pressure need to avoid full inversions.

But dog pose is not an inversion because the legs are not inverted. Accordingly blood from the legs doesn't flow in opposition to the one-way valves and even though the head is lower than the torso, interoccular or intercrainial blood pressure doesn't appreciably rise. Well, because the torso is partially "inverted"," intercranial and interoccular blood pressure does increase slightly, but usually not enough for major concern. In any event, as a teacher, I don't recommend that students with high blood pressure or detached retina do full dog poses right off. I like to do other things first, like supported dog poses with the hands higher than the floor, beginning with the “wiggle and waggle,” as shown in Recovery Yoga; and also doing the on-the-back exercises with the legs up against the wall, as shown in ExTension Yoga.  

Elizabeth Martin, of Westford, MA:
"Ages and Stages" concept:
Do you mean to say that every ten years our practice may become more limited, and we should just accept it? I've talked to so many people at Kripalu about pain. The conclusion has always been that I have to figure it out for myself. Do you have any information about arthritis? I would greatly appreciate any direction you could give me about it.

Sam Responds: NO, we don't have to just accept pain and NO, we don't have to accept that our bodies will contract as we grow older and NO, we don't have to accept that arthritic pain is inevitable. When appropriately practiced, yoga can offer us some very important tools that can help manage or even reduce chronic pain. 

As we grow older; how do we want to go about the aging process? If we do nothing as we pass through those "ten year thresholds," there is every tighter and less mobile as we age. However, that "normal" propensity for contraction does not have to take place. Using yoga as a tool, we can intervene through appropriate stretching and strengthening. By understanding and applying the principles given in www.extensionyoga.com, we can slow down or possibly even reverse fascia's propensity to contract.

As a person in chronic pain, you did the right thing to seek appropriate medical advice. With that said, let's talk about your arthritis. Chronic pain is caused by nerve stimulation (in your case, a diagnosed arthritic condition). Because of Hilton's Law, that stimulation will contract most, if not all of the proximal soft tissue. But, because ancillary soft tissue
(fascia in particular), distal from the principal stimulus will also contract, even more pain is created.

When yoga is appropriately practiced, it is possible to reduce contraction of ancillary soft tissue (primarily fascia) and thereby reduce pain. These mechanisms are fully discussed in my website so there is little need to go into detail here.

I hope my response has given you some degree of hope. As we discussed at KYTA, I have been developing these ideas and concepts as a result of studying with some amazing people through the years and from paying attention and learning from my own experience with chronic illness and chronic pain.

Adhisthana Ellen Pfeffer, The Yoga Connection, North Caldwell, NJ:
About Spirituality:
I understand that you're working on the page regarding spirituality. So far, what you have so eloquently said about yoga is more about the physical practice than anything else. However, it's not the physical practice that keeps me coming back to yoga, it's the deep stillness and experience of SELF, and PURE AWARENESS (Perusha) that keeps me in it. Yoga, in the final analysis, is an experience that is always available; one only needs to become aware of it. You have not fully addressed the fact that the entire system of yoga comes out of the basic inquiry of all humanity: WHO AM I?  And the desire of humanity to transform and transcend to a higher state of awareness, consciousness, functioning. Yoga is a complete evolutionary path, not just an ancient system of exercise.

Sam Responds: I've had a few other responses such as yours but not nearly as well-expressed. I feel it is important to note that as a Westerner "living" in a western body, it might benefit us to think of yoga asana as a system designed to: maximize physical potential; minimize physical liability, and maximize our spiritual awakening and awareness. In other words, understanding asana's effect on the human body in its minute detail teaches us how the physical exercises of yoga can both benefit and harm us. 

Speaking from both personal experience and from being a teacher for 25 years, when we injure ourselves or just experience the smallest discomfort during asana, we are at risk of minimizing yoga's spiritual influence. With full respect for your feelings, I am not willing to take that risk. What may seem like a physical program on the outside, is extraordinarily spiritual on the inside.

Shoosh Crotzer, Mobility Limited, Morro Bay CA:
Another View of ExTension Yoga
In your description about the theory of why extension makes the limb feel lighter, I have a different thought on that. I agree with the concept and the movement, but my studies have led me to believe  that by extending, the musculature is resisting gravity more, and therefore creates the lighter feeling.  You said that it causes a release of tension in the limb being extended.  Let's use an example.

By holding the arm out in front, with a bent elbow, it becomes heavy with time.  If you then lengthen and extend out to the fingers, we both know that the arm lightens.  However, you say that the reason is a release of tension from the bent arm.  My bent arm was not tense, though.  Some might even say it was more relaxed, hanging loosely.  To me, it wasn't the tension that caused the weight, it was gravity pulling it down because the center of energy became the bent elbow, and the energy pulled down.  By extending, the energy moves all the way out to the fingers, causing more resistance to gravity, and therefore the lighter feeling.  What do you think about this?

Sam Responds: Of course your bent arm was tense...you just didn't perceive it as being so. Assuming you are keeping a limb elevated; then in order for the limb not to succumb to gravity, soft tissue has to "fire" in order to keep the limb from falling. Whenever soft tissue activates, it contracts and tension is created. The longer it is held, the more "tense" the limb becomes. Maybe extension is just a feeling but the result is the same ... extension releases tension.

Shoosh Crotzer continues
In your hamstring test, on pages 32-3, you are holding behind the knee.  Doesn't this inhibit the stretch?

Sam Responds: Holding behind the knee does not need to inhibit stretch. In fact, a person has a better chance of invoking an appropriate response when APPROPRIATELY extending the leg. What the person does is to hold the bent knee and then (on exhalation) begin to extend an ACTIVE foot toward the ceiling while at the same time grounding (in the most subtle way) sitting bones downward. The intention is to activate biceps femoris and avoid tendon activation.

I've recently taught a 24-year-old woman with abnormally enhanced flexibility, yet she couldn't isolate her hamstrings in any mode forward bending. The only way we could get her to isolate hamstrings was when I facilitated a unilateral hamstring PNF stretch with a bent knee. (Why is it better to work unilaterally when the client has difficulty isolating an appropriate response?) After experiencing the correct feeling, she was then able to easily and accurately isolate the appropriate hamstring response in all modes of forward bending.

Shoosh Crotzer continues:
One area that I have begun working on intensively over the last 2 years is pelvic alignment.  On the same hamstring pages (32-3), I agree with all that you explain, except that you don't mention the pelvis.  If a person did this, imitating figure 7, they could conceivably have rolled or tilted their pelvis to accommodate the knee lift without really knowing it.  They would have the false sense of length, but only because they were working from the pelvis rather than the hamstring. 

I know that you know this, as a teacher, but I have become a real taskmaster about it lately. Of course, it has stemmed from 25 years of my doing things incorrectly and only recently realizing, as a result of new-found problems, that I am a symptom of this lack of pelvic awareness. Imagine my shame and sense of failure that during all these years I never understood this correctly, nor was any teacher ever able to point it out to me! My apparent flexibility overshadowed the fine-tuning and hid my weaknesses. All your work discusses this indirectly.

By pointing out lengthening, for example, in forward bends, don't you think that it also must come from a core awareness of the position and balance of the pelvis for people to be able to create the proper angles that you so beautifully point out?

I know that this book was written in 1994, so we have both learned a lot since then.  I would like to hear your comments. 

Sam Responds: You are absolutely correct. Your observations and comments are totally valid and “pelvic awareness” was not adequately addressed in my book and therefore needs to be addressed in more detail here:

Let's assume you wish to stretch a rubber band between your index fingers from being flaccid to an average stretch of a factor; let's say to a “three or four” on a level of one to ten (with one being flaccid and ten being close to busting the rubber band). In order to stretch it, you could stabilize your right index finger and pull away two inches with your left. The rubber band stretches.

Or, you could stabilize your left finger and pull away two inches with your right index finger and the rubber band stretches.

Or, you could pull away with both index fingers and the rubber band again stretches, BUT, you ended up with a more “balanced” stretch within its fibers and you moved each index finger LESS in order to achieve the desired stretch.

When stretching hamstrings, we want to consider the same concept. What we don't want to do is to just lengthen our legs. That would be analogous to pulling the rubber band with only one finger. What we want to do is create an appropriate response by “doing less to get more” which is done by stabilizing the pelvis (at minimum) or by learning how to appropriately move sitting bones downward simultaneously when the leg extends. In so doing, the student quickly discovers that hamstrings stretch not only quicker, but the feeling becomes much more balanced than by just lengthening the leg.

Anna Billingham, Dip. B.W.Y. Worcester, United Kingdom, writes:
In several of our past email exchanges, you talk about the ExTension approach to aerobic yoga.  Is there anyway I can find out about it?

Sam Responds: You've taken some aerobic yoga classes, I'm sure. So have I. But I've often come away feeling as if my body was abused, rather than appropriately used. Well, I like to refer to the ExTension approach to aerobic yoga (EAY) as simply a pumped up version of ExTension Yoga. As always ... it's designed to do what you CAN do, not what you CAN'T.

You can try it yourself. Just begin with a couple of slow, concise, appropriate ExTension Yoga Sun Salutations, paying strict attention to your breathing and each and every movement within the twelve positions. Then, keeping each movement coordinated with your breath, begin moving through the positions a little more quickly, but still strictly adhering to the detail. Then, as your body accommodates to the increased speed, speed it all up again ... until you've done UP to 108 cycles. Before I became ill, I used to do 108 Sun Salutations twice weekly and it would take between 23 and 24 minutes. Because of my illness, it's no longer advantageous for me to heat myself up; so I might do ten or twenty Sun Salutations and stop before my body heats up.

During my recent seminar in Ashville, I did about thirty minutes of EAY with a handful of more advanced students before a couple of the classes. Even though I had not done 30 consecutive minutes of EAY in years, I even surprised myself by not being even the slightest bit sore or winded afterwards ... which is a strong testament to the appropriate character of ExTension Yoga.

Nancy Freedom from Berkeley, CA  writes (responding to my request for comments or questions):
I may have misunderstood who your audience is. You say it's for students and teachers. (Would not) a simpler presentation ... help ... beginners who are unwisely using the instructions without a live teacher not to injure themselves.

Sam Responds: My work has been to provide resources for both lay persons, yoga "professionals" as well as for the healthcare community. Accordingly, I recognize that no vehicle can appropriately reach all audiences. My website is intended to be a continuation of both my books and is intended for the more inquisitive mind. I intended the footnotes to go beyond the text in order to provide substantiation for many of my assertions. I know that I sometimes get lost in the minutia of detail as well as my "erudite" writing style and this is exactly why I wholeheartedly welcome any feedback you can offer regarding repetition and clarification within the pages of the website.

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