Fifth toe

Thank you to Core Awareness for posting this. I love knowing how all our digits connect to our bodies. http://www.positivehealth.com/article/bodywork/the-little-toe-and-beyond

For my prenatal clients

In class there is usually at least one woman who points to her lower abdomen and tell me about a pulling sensation. I am never one to diagnose anything, but something called "round ligament pain" is pretty common. These ligaments help support the uterus and they get pulled more and more as the pregnancy continues.

Some things to do:

- Stretch and do prenatal yoga

- Drink lots of water

- Make sure you are getting enough calcium and magnesium in your diet

- Try bringing your knees in my your chest, especially if you feel a sneeze or cough coming on.

- Change positions to prevent the ligaments from contracting. Try alternating to both the right and left sides when sleeping.

- Use a pregnancy pillow while sleeping, placing a pillow between your knees and your ankles to stabilize the pelvis

- Try a pregnancy support belt

- Try acupuncture

The IT Band

Here we are at the controversial IT band. Maybe it is only controversial in my household because my husband isn't convinced that it exists. For some of us, it causes such agony that doubting its existence is ridiculous. Many of us feel it after a big workout or if we run, as we increase mileage. Some of us feel it after a long day or week of simply sitting. The iliotibial band is pretty much what it sounds like: a band that stretches from the iliac crest, meaning hip, to the tibia, meaning lower leg. It is a tendon that runs along the outside of our legs from the TFL down and over the knee.

When people ask me why the IT band needs to be so tight, I sometimes answer, "so your leg bone doesn't pop out the side of your body". In other words, it helps with adduction of the leg, but I like the shock effect of the first answer. When track runners run the track counter-clockwise consistently, it is pretty likely that they are going to suffer from a tighter IT band on their left leg which is their inside leg. This is the leg that they are leaning in towards, the leg that is getting a little more of a challenge when it comes to stabilizing the knee. The IT band tightens so that the knee doesn't collapse. If you look at my previous post on quads and hamstrings, you will see that those muscles do a pretty good job of covering the front, back and inside of the leg. The IT band takes care of the side. The IT band will be even tighter for people with "bow legs" where the knees do not come together when the legs are straight and the feet are together.

So what happens when the IT band is tight? It can pull on the knee, tracking it to the outside of the body. It can pull on the hip, not allowing it to move in its full range of motion. It can simply ache, especially if it "snapping" or "clicking" over a bony part of your theigh called a bursa. The inflammation can cause further discomfort and possibly injury. But for most of us it hinders muscle balance.

Remember in Pilates, we are all about muscles sharing in effort. When the IT band is tight, the inner thigh muscles don't work as efficiently, the gluteus medius also checks out. And you already read about what happens when the gluteus medius doesn't do its job. One of the main culprits of knee clicking is a tight IT band. Sometimes it is a tight Rectus Femoris (quad muscle) but often that is combined with a tight IT band. It pulls on the knee cap so that it moves to the outside of the leg. Sometimes the easiest way to retrack the knee so that it moves effortlessly is to roll out the IT band with a roller and then work on strengthening the VMO, the Vastus Medialis Obliquus. This is at bottom of the inner thigh and is crucial for knee rehabilitation.

So when the knee "clicks" when bending I often check if the quads are tight as well as the IT Band. Here is a youtube video demonstrating how to release your IT band. If you look at the picture above you can see how the VMO can balance any pull on the ligaments around the knee including stabilization of the ACL, one of the four major knee ligaments.

Thighs, Legs and j-pegs

When teaching at JCHS from 2003-2009 it was really important to me for my high school students to gain a vocabulary when talking about their bodies. This wasn't only true of the health/sex ed class, but also of the Pilates, yoga and dance classes.

My adult and teenage students often point to a part of their body and say "this hurts" or "this is tight" without knowing the names of those muscles. This is always surprising considering that the people with whom I work are incredibly knowledgeable about so many other things, just not always about body things.

So I thought I would break it down. The big leg muscles are the hamstrings and quadriceps. The hamstrings and the quads are both muscle groups, not actual muscles. The QUADriceps are made up of four muscles*, and the hamstrings are made up of three muscles** (or it could be four if you consider the biceps femoris two muscles, short and long). The quads are the muscles in front of the upper leg and the hamstrings are the muscles in the back of the upper leg.

The thing that both of these muscle groups do that is so amazing is that they work on the same two joints, the hip and the knee. The quads are all very important in knee extension. The middle quad muscle, the rectus femoris, attaches to the ilium hip bone, so it flexes the hip. The hamstrings are involved in knee flexion and hip extension.

Both these muscle groups cross over the knee joint, so they are really important knee stabilizers. The quads cross over the front of the knee to the patella (knee cap). When the quads are tight, they often pull on the patella, sometimes moving it out of alignment. This sometimes causes clicking or pain but can be managed by rolling out the quads with a roller or pinky ball as well as through stretches. The hamstrings affect the knee from the other side and can be stretched and massaged. Be aware that pain in the back of your knee is something to you should heed. Those are tendons that are asking for attention. Tendons don't stretch like the big part of the muscles. Stretch the big part of the muscle first and you will probably find that your tendons will quiet down.

The other big reason to stretch your hamstrings is, because as I mentioned before, they attach to your hip. When the hamstrings are tight, they can pull on your pelvis, which in turn can cause lower back pain.

The front and back of your leg should balance one another, agonist and antigonist muscles. When walking the quads lift your leg and bring it in front of you. The hamstrings pull the leg behind you. When each muscle is doing its job effectively the other muscle gets to stretch.

So proper gait actually balances the muscles! We will focus on that one another time, in addition to the lower leg muscles and the IT band.

So remember, quads - front of the legs, and hams - back of the legs. Now go for a walk in sensible shoes or no shoes at all. Allow your arms and legs to swing. Let your legs pull the ground underneath you and push the floor away. Then stretch.

*The muscles in the quads are: Rectus Femoris, Vastus Lateralis, Vastus Intermedius, Vastus Medialis. When rehabilitating the knee, we focus on strengthening the Vastus Medialis

**The muscles in the hamstrings are: Biceps Femoris, Semitendonosus, Semimembranosus

Jewish Yoga?

I just got off the phone with the Marin JCC. I can't get specific with my frustrations because the internet is not private. Here is my take on Jewish yoga:

As modern Jews, particularly those of us who live in the Bay Area, we are very aware of our physical health. Many of us find peace and inner strength from exercise and movement. In my classes I hope to convey that this sense of calm is not separate from Judaism.

Granted, working out, doing yoga or dance, is not the same as going to synagogue or studying Talmud. But Jewish life has never been ONLY about studying holy texts. It has been about taking care of your family, passing on traditions, living an ethical life and celebrating community. In a world where we have become more individualistic it can feel like Judaism just doesn’t fit.

For me yoga is a great place to start thinking about mindful movement. Yoga means union. The definition of that union has different interpretations. I think it is the union of the divine spirit inside us and the physical world. It is a time to reflect about how you stand, how you sit, how you breathe. When brought into a Jewish context, one can start asking questions like: where did that first breath come from? We can acknowledge that our bodies are absolutely incredible creations. We can start to appreciate the Divine context in which we live life.

This past summer I visited Sri Aurobindo’s Ashram as well as Auroville, a community that is dedicated to living out Auribindo’s teachings, creating an ethical community that is mindful, environmentally conscious and diverse. I was expecting to find a community that practiced yoga in the way that I knew it – on a mat. However, Sri Auribindo called mindful living Yoga. When one was doing organic farming, that was Yoga. When one was preparing food for others in the community, that was Yoga. When one was contributing to the community by being a security guard or artist, that was Yoga.

Yoga was not something that was done on the mat. In some ways, that community had a different challenge: getting on the mat.

So many of us practice yoga on the mat. So many of us practice mindful movement in Pilates or dance or maybe even on the treadmill. The challenge for us is to take the yoga off the mat. I’m not saying that these followers of Auribindo were perfect – far from it. But they got the idea right. Wouldn’t it be great if everyone who did yoga on the mat spent equal amount of time contributing to the community? One could argue that meditating, praying and mindful movement IS giving to the community. But I would argue that your personal experience is only one part of the puzzle. (I am married to King of Giving and Community Outreach, Rabbi Mark Asher Goodman.) In modern Judaism, you can't get away from Tikun Olam (Fixing/Healing the World) as a core principle.

This experience in Auroville made me feel more confident to take some of the Hindu out my yoga teaching. It is not the core of Yoga. With Judaism as a viable option, we don’t need to use Hindu god stories to explain our purpose in life. We have hundreds of our own stories that are rich and confusing.

We can breathe and think about our ribs expanding, what it means to give a rib to create another being (story of Adam and Eve). We can reach our heels back into the ground and imagine Jacob tugging at our heels (story of Esau and Jacob’s birth). Jewish folktales share the wisdom we have gained through the ages, often with humor. Sometimes we take it all way too seriously.

I often need to remind my clients that there is not pot of gold on the other side of that stretch. Judaism is all about the journey, not the destination. So much of the Torah focuses on wandering, not on living in a homeland. This is something to which so many of us can relate.

So now I need to write a description of a Jewish yoga class. I think I needed to get all that out before I market myself to the JCC’s of the South Bay and North Bay Jewish community. I am putting it out there that I would like to have some offer from SF. So much more convenient.

Butt Trilogy

So we are finally on the most famous of the three glut (pron. gloot) muscles, the Gluteus Maximus. In Pilates, we call the Gluteus Maximus an "on-off"muscle because it doesn't need to be used all the time. Meaning, the GM is not essential for stabilization like the psoas muscle or even the Gluteus Medius. We can stabilize our spine and pelvis without squeezing our butts. Butt squeezing might be a way of toning the muscle but it is not the way one should live life.

The Gluteus Maximus is used when we get up from a sitting position, climb stairs or simply extend the leg in front of us. It is the largest and most superficial of the three gluteal muscles, meaning it is furthest from the spine (so not a part of the "core") but it still important to keep it strong.

When the Gluteus Medius gets weak, it can often affect the piriformis and the TFL, and press on the sciatic nerve. When the Gluteus Maximus gets weak, it too can affect the piriformis, causing it to work overtime and press on the sciatic nerve.

When the GM gets too tight, it can affect the deep rotator muscles underneath it, called "The Deep Six." The Deep Six muscles, which include the piriformis, rotate the legs and stabilize the pelvis and leg. It is important to stretch and massage the GM so that all the rotator muscles that lie underneath the GM can work effectively.

Remember I mentioned the psoas earlier? That's the muscle we need to lift the leg. If that muscle is tight then we can't do the exercises we need to do to strengthen the GM, like climb stairs or run with correct form. This often causes the hamstrings to do the work instead of the GM, causing tight hamstrings that can pull on the pelvis and lower back.

So stretch those psoas muscles (also known as hip flexors)! Stretch those piriformis muscles! Climb some stairs and then stretch your hamstrings and piriformis muscles again!

Gluteus Minimus

The gluteus minimus is another overlooked butt muscle. It is the smallest of the three gluteal muscles. It often works together with the tensor fasciae latae (TFL). My high school students used to comment "There's a latte in your leg?". I will get to the TFL another day.

In Pilates, when we do side leg series, we sometimes feel this muscle as we lift the leg away from our midline in abduction. The gluteus medius also works when we internally rotate. If this muscle is tight, it can interfere with rotation in the hip. One very effective way of loosening the muscle is through massage with a foam roller or with a pinky ball.