Proof of the Effectiveness of Reducing Chronic Stress!

by Nina

Joy Sassoon, Age 60, by Tanja Constantine

“the data suggests that mind body interventions should perhaps be instituted as a form of preventative care similar to vaccinations or driver education. Such interventions are likely to be useful in population management and supported self-care, have negligible risk and cost and may help reduce the demand curve in healthcare.” —James E. Stahl, et al

According to a new study “Relaxation Response and Resiliency Training and Its Effect on Healthcare Resource Utilization” by James E. Stahl, et al, published in the journal PLOS one, practicing Relaxation Response techniques, such as meditation and yoga, could reduce the need for health care services by 43 per cent. To me, this was really exciting news (and not just because I’m not very fond of going to the doctor or the emergency room). I feel it’s solid scientific proof that using yoga’s stress management techniques will be very likely to improve your health. The authors of this study decided to do a thorough study of the effects of mind-body interventions on health care services because stress-related illnesses are “drivers” of healthcare use. Here is how they put it:

“In primary care, stress-related illnesses are known drivers of healthcare resource utilization in the US. Health care expenditures attributable to stress-related disorders, such as, depression and anxiety, were over 80 billion dollars/year in 2012. These have been the third highest cause of healthcare expenditures after heart disease and cancer in the US; each of which carries their own substantial stress burden. Over 90% of people suffering from stress or stress-related problems seek help through primary care and tend to be frequent healthcare utilizers. These visits can comprise as much as 70 percent of physicians' case- loads. In addition, more than 80% of patients presenting to general practice evidence lack of resiliency and psychological stress. Common physical manifestations of stress, e.g., headaches, back pain, insomnia, gastroesophageal reflux disease, irritable bowel, chest discomfort, are among the most frequent reasons people seek care.”

To conduct this study, the researchers tracked all 4452 patients who received training at the Relaxation Response Resiliency Program at the MGH Benson-Henry Institute from 1/12/ 2006 to 7/1/2014 for a median of 4.2 years. They then compared the usage of health care resources by this group against that of the control group of 13149. Total utilization of health care resources for patients with Relaxation Response training decreased by 43% compared with the control group. Here’s the breakdown:

• Clinical encounters decreased by 41.9%
• Imaging by 50.3% 
• Lab encounters by 43.5%
• Procedures by 21.4%

In addition, the intervention group’s Emergency Department visits decreased from 3.6 to 1.7 per year (although Hospital and Urgent care visits converged with the controls).

Pretty impressive, isn’t it? Using mind-body techniques to manage chronic stress keeps you healthier in a whole range of ways. And the training that these people received at the MGH Benson-Henry Institute was in using meditation and similar techniques to trigger the Relaxation Response, all of which are similar to, if not exactly the same as, the techniques that yoga provides. (See The Relaxation Response and Yoga for information about the Relaxation Response and how to trigger it with yoga.) 

So my ongoing campaign for reducing or stress levels using yoga (see 6 Ways to Bust Stress with Yoga) is supported by this very thorough study. In fact, the researchers were so encouraged by the study results they proposed that mind-body interventions should be instituted across the board as a “form of preventative care, similar to vaccinations or driver education.” With that, all I can say, is that if you’re practicing yoga solely as “exercise” and not exploring the stress management tools because “relaxing” feels like wasting time, you’re missing out on some valuable health promotion activities (not to mention that peace of mind stuff).

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Featured Pose: Supported Backbend

by Baxter

Supported backbends have always been a bit challenging for me personally, as the part of the spine that attaches to our ribs is a place where I hold a lot of tightness. So, I find it helpful to do this pose regularly, as it is a great pose to create more flexibility in that thoracic spine. 

Besides being an excellent pose for improving the back-bending ability of the rib cage portion of your spine (the thoracic spine), Supported Backbend is also is a great way to stretch the muscles and fascia of your front body, both the long axis of your belly and chest, and the side-to-side axis from your breastbone out to your shoulders. The versions with the arms overhead add even more stretch along your longitudinal length. 

This pose is very versatile, as it can be used to warm you up for a backbend practice, or as a counter-pose for either a forward bend or twist practice. You can also practice it on its own after spending time with a rounded upper back, such as after driving, gardening, or time spent at your desk.

I prescribe this pose for: 

• Stiffness in the upper back
• Tightness in the front chest and belly
• Tightness and stiffness in shoulders (especially version 2)
• Improving breathing capacity
• An antidote for time spent working with a rounded upper back, such as factory work, restaurant work, deskwork, gardening, driving, etc.
• Improving poor posture, head-forward syndrome, or text neck
• Fatigue or depression, as the pose has mild energizing and uplifting effects.

Cautions: Those with lower back pain can usually do this pose, but if you notice pinching or discomfort, then bend your knees and have your feet on the floor as in Constructive Rest position. Those with arthritis in the neck will likely need to do the versions with the head elevated on props. For those with shoulder issues, you may want to skip the arms overhead variation if it causes worsening pain in your shoulder joints. People with severe kyphosis (upper back rounding) may need to use much smaller roll under the chest and use lots of head support. 

1. Classic Version

To set up for the pose, place a bolster or thickly rolled blanket crosswise on your mat, about 2/3 of the way towards the back of your mat. If you like, you can add in a folded blanket to support your head. Then, sit down in front of the bolster about one to two feet away from it (depending on your height), with your knees bent and your feet on the floor. 

To come into the pose, use your hands to guide yourself back and down onto the bolster, arching your spine to bring your head down onto the floor just beyond the bolster. The bolster should support your upper back, with the lower tips of your shoulder blades on the center of the bolster. The tops of your shoulders should hang towards the floor but not rest on it. If necessary, shift yourself forward or backward to achieve this alignment.

Next, bring your arms straight out to your sides, just along the top edge of the bolster, so the back of your hands, and maybe your elbows, rest on the floor. You can keep your arms straight or bend at the elbows into a Cactus position (as shown in the photo). Finally, straighten your legs along the floor. Firm your leg muscles and draw the balls of your feet back towards the tops of your shins. 

When you have finally aligned yourself in the pose, release the weight of your upper body onto the support and bring your attention to your breath. Breathe comfortably for 6-12 breaths and then try to deepen your breath for 6 additional breaths. Gradually work your way up to longer holds, eventually holding the pose for up to 3 minutes.

To come out of the pose, bend your knees and place your feet on the floor. Then roll off the props onto your side, and slowly come up to sitting.

2. Arms Overhead

(Sorry, no photo) 

This is a great version if you want to get even more opening of your thoracic spine and the long axis of your front body, as well as improving the range of motion of your shoulders. It is especially helpful for warming up for backbends or standing poses where your arms are overhead.

Come into the classic version of the pose as above. Next, take your arms straight up towards the ceiling and actively reach upwards. Then slowly take your arms overhead, reaching more for the wall behind you than for the floor. Press your heels forward and reach your hands back at the same time.

Take 6-8 breaths in this extended position, gradually working your way up to longer holds, eventually holding the pose for up to 3 minutes. Then on an exhalation, bring your arms back up toward the ceiling and then out to your sides and to the floor. Exit as for the classic pose.

3. Block and Head Support

This is a great variation because the block is firmer than the bolster and typically invites more opening of your thoracic spine. And the blanket under your head is helpful if your neck is sensitive or painful when dropping back (the blanket could be used in the first two versions as well). 

To set up for the pose, place the block on its lowest height crosswise on the mat, about where the bolster is in the classic version and place the folded blanket where your head will be. From here, move into the pose the same way as you do for the classic version, with the lower tips of your shoulder blades resting on the center of the block. You can make the blanket thicker or thinner as your neck requires. 

While you are in the pose, work with your breath and timing as in the classic pose. Then exit the same way.

4. Two Blocks

I really like this version for focusing on increasing the flexibility of the spine and stretching of the front body, while completely eliminating the backbend of the neck and head. And with your head actually raised higher than your heart, you work more deeply with your breath or even use the pose as a more restorative, meditative position. 

To set up for the pose, place the first block on its middle height lengthwise on the mat, about where the bolster is in the classic version and place the second block is on its highest height, about 6 inches behind the first. 

Now, sit down in front of the first block about one to two feet away from it (depending on your height), with your knees bent and your feet on the floor. Arch your spine a bit and use your hands to guide yourself back and down onto the first block. Rest your spine onto the block so the block is between your shoulder blades and rest your head on the second block. (If the block isn’t between your shoulder blades and/or your head is not resting comfortably on the second block, come out of the pose and move the blocks to better position.) Finally, take your arms out to the sides and straighten your legs. 

While you are in the pose, work with your breath and timing as in the classic pose. Then exit the same way.

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Video of the Week: Handless Half Moon Pose

This week Baxter is playing with Half Moon pose (Ardha Chandrasana). There is a version using a block and one without—something for everyone. We dare you to lift your hand off the floor!

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