4 questions

[Questioner]

I enjoy receiving your questions and answers so much. Thanks for letting me find you in my life. These are four different students looking for help, (thank goodness its not one person with all these things. Yikes!) I feel comfortable dealing with the issues, but since your expertise is so insightful, I would love your opinion:
1. This woman has a slightly rotated cervical vertebra, possibly from incorrect alignment while doing headstands (5 mins). She also does headstand drop-overs to Viparita Dandasana twice a week for a series of backbend variations, which I believe only exacerbates the compression and misalignment of the vertebrae. What do you suggest for a practice to re-align, should headstands, Shoulderstand, backbends be avoided, or modified?

2. When a flare up of genital herpes arises, what is the constitution saying? What diet is suggested, any herbs or oils you might know of?

3. A woman has spinal stenosis (the narrowing of the central spinal canal where nerve roots exit (neuro foramina)). She is resisting her doctor's pressure to have surgery on the area to relieve pressure on the nerve that creates pain from the lower lumbar all the way down the right leg. She is definitely overweight, but seeking to begin a better diet and is very willing to look into changing her life. Obviously, prefers to pass on the surgery. What type of practice is safe in this instance (she is fine in uttanasana, sitting positions, standing poses) but movement of the legs forward as in lunges or walking towards uttanasana from down dog creates pain.

4. (Two) students have damaged their rotator cuff muscles (infraspinatus, surpraspinatus, teres minor and subscapularis). They want to re-begin practice but don't know how to (nor do I without trial and error and creating pain for them). We need a practice that is safe, strengthening, and also encourage healing and not over-doing.

[Mukunda]

1. This woman has a slightly rotated cervical vertebra, possibly from incorrect alignment while doing headstands (5 mins). She also does headstand drop-overs to Viparita Dandasana twice a week for a series of backbend variations, which I believe only exacerbates the compression and misalignment of the vertebrae. What do you suggest for a practice to re-align, should headstands, Shoulderstand, backbends be avoided, or modified?

Slightly rotated cervical vertebrae described 95% of the population. It is not a problem unless there is pain or prior injury that she is working out. If this were the case I would modify and probably get her to drop working on neck strength without cervical weight bearing. So dog pose or wheel, camel are fine and doing cervical range of motion while holding the poses will help to decompress. Realignment of cervical vertebrae is discussed in my book Structural Yoga Therapy, pg. 180-181.

2. When a flare up of genital herpes arises, what is the constitution saying? What diet is suggested, any herbs or oils you might know of?

Herpes is a viral infection, a mixture of pitta condition in a vata region. Vata should be addressed and long-term work is pranayama and meditation. Of course one should also contemplate their ideals of what it means to be in right relationship with yourself first of all then applying that to others. I have found that taking amino acid lysine supplement and foods rich in lysine – eggs, fish, chicken, soybeans, cottage cheese, milk, cheese - and avoid amino acid argenine foods such as chocolate and nuts; helps reduce outbreaks. Medicinal research is currently being conducted on lowered doses of Valtrex and it seems effective at reducing outbreaks.

3. A woman has spinal stenosis (the narrowing of the central spinal canal where nerve roots exit (neuro foramina)). She is resisting her doctor's pressure to have surgery on the area to relieve pressure on the nerve that creates pain from the lower lumbar all the way down the right leg. She is definitely overweight, but seeking to begin a better diet and is very willing to look into changing her life. Obviously, prefers to pass on the surgery. What type of practice is safe in this instance (she is fine in uttanasana, sitting positions, standing poses) but movement of the legs forward as in lunges or walking towards uttanasana from down dog creates pain.

It sounds like the symptoms are due to sciatic nerve root compression. A vastly different answer will come if there is also femoral nerve pain, in the groin or quadriceps. It is unusual that she is comfortable in uttanasana and sitting poses if the pain is in sciatic nerve. Normally these poses aggravate the pain. Tell me more and i will respond again.

4. (Two) students have damaged their rotator cuff muscles (infraspinatus, surpraspinatus, teres minor and subscapularis). They want to re-begin practice but don't know how to (nor do I without trial and error and creating pain for them). We need a practice that is safe, strengthening, and also encourage healing and not over-doing.

I would recommend my joint freeing series (pg. 121-153) in my book, Structural Yoga Therapy. The key is to do the entire series not just the motions related to the rotator cuff motions (147-14. In the ideal way of practicing the series for injuries the student needs to be cautioned to move slowly and thus keep the motions at a slower than regular breathing rate. This will heighten sensitivity and aid in promoting lymphatic circulation.