Yoga for First Responders

By Heidi Wiegand, NRP

When most people hear “yoga,” they have one of a few responses: “Yoga is for girls,” “I’m not flexible,” “I don’t know how to relax,” “I’m too overweight,” “You won’t see me in a pair of yoga pants!” I thought a lot of the same things. But after six years of training, I’ve learned yoga is so much more than I could have imagined.

The first time someone told me to try yoga, I laughed. I’m your typical adrenaline junkie—I’ve been in EMS for 25 years. I thrive off the rush you get going to emergencies, the thrill of the fast-paced thinking in touchy situations, the high you feel during and after a bad call.

But I’m also a runner, which has resulted in frequent injuries. Following my initial skepticism I decided that if yoga could help me get back to running, I’d try it.

It wasn’t enjoyable for me at first. The practice made me slow down and challenged me physically and mentally in ways I hadn’t been challenged before. Yet I forced myself go back. And while initially it was a way to get me back to running, I soon found yoga was actually changing my life.

Calm in the Storm

The focused practice of yoga goes biologically deeper than just stretching and relaxing. Yoga taps into your nervous system by focusing on mindful, purposeful breathing. After years of compassion fatigue and secondary trauma from my career, it felt as if my nervous system was about to break. Yoga helped bring calm to my storm.

First responders live in a state of hypervigilance. We’re taught to be constantly aware of our surroundings. We are extraordinarily alert, perceptive, and active, and make split-second life-or-death decisions daily.

EMS providers also see more illness, pain, death, violence, and destruction in one shift than the average person sees in a lifetime. As soon as we start out on a call, our sympathetic nervous system is activated. Our heart rate increases, our blood pressure rises, we begin to sweat, our digestive system slows, and stress hormones flood the bloodstream. These hormones are necessary to perform under stress, but if they are released constantly without allowing time for our system to return to homeostasis, we may begin to show a decrease in compassion and increases in  illness, cardiovascular disease, insomnia, and depression. Eventually these physical and mental symptoms can develop into post-traumatic stress.

What if there were a way to proactively teach our bodies to maintain a calm and focused state during these stressful circumstances?

Features of Yoga for EMS

There are many opportunities for EMS providers to practice yoga: at the gym, in a studio, at home, or even at work.  One of these programs, Yoga for First Responders (YFFR), builds resiliency through somatic and cognitive exercises within the foundation of the yoga philosophy. It uses techniques geared specifically for first responders as a tool for stress management.

YFFR focuses on tactical breathing techniques that open the door to access the nervous system. Physical drills are added along with mindful, conscious breathing for releasing stress and building mental and physical stability. Using these techniques, along with cognitive behavioral therapy, changes the mind-set surrounding stressful circumstances.

Designing a yoga program for first responders speaks directly to our needs and supports the skills we require daily. “Prayer hands,” chanting, music and Sanskrit (the classic Indian language used in yoga postures), while often components of other yoga disciplines, are not features of this program. It offers a choice of various poses.

By practicing tactical breathing while in a physical posture and using a technique to mentally reframe your experience, your brain will develop a memory of it and tuck it into a subconscious “file folder” to use later. Continued practice will make it an automatic reset for your nervous system to fall back on after stressful calls.

There really can be a calm in your storm. It’s up to you to take a chance and try it.

Sidebar: 5 Yoga Strategies

Olivia Kvitne, founder and director of YFFR, and a featured speaker at EMS World Expo 2018, offers these yoga tips for EMS providers:

1) It takes just three minutes of mindful breath work to effectively calm the nervous system.

2) If an overwhelming sensation begins to take hold, try this: Begin to breathe through the nose rather than the mouth. Drop the breath down low into the belly. Extend the exhale longer than the inhale.

3) When you begin your yoga practice, there’s often an expectation to feel relaxed, peaceful, or at ease. You may not, and that’s OK. Release those expectations.

4) Move first thing. Simple movements, coupled with breath and an empowering affirmation, can set the tone for your entire day.

5) If you experience symptoms of post-traumatic stress or vicarious traumatization, look for a yoga class taught by a teacher trained in trauma-sensitive yoga.

—Source: Yoga Journal,

Heidi Wiegand, NRP, is an active paramedic and team leader with McCandless Franklin Park Ambulance Authority in Pennsylvania. She earned her yoga teaching certification in 2016, teaches power vinyasa flow yoga, and is an ambassador for Yoga for First Responders.

The 11 Moves That Help Athletes Get Better with Age

Stay in the game longer and stronger with a solid prehab routine, and go harder with a smart recovery routine by Nick Heil

Among the most important things an athlete can do to preserve fitness for years to come is avoid injuries. Sprains, tears, and broken bones can resurface as nagging aches or weaknesses as you get older, preventing you from pushing yourself with the kind of high-intensity interval training that’s so important for older athletes. Enter prehab, pre-exercise routines that prepare your body for the loads and stresses of a workout or race while also helping stave off injury.

“It’s a daily evaluation tool,” says Eric Dannenberg, performance manager at Exos in Phoenix, “a way to make sure you can perform movements before you load your muscles.”

Dannenberg recommends doing each of the following five exercises before every hard workout. They’ll add about seven minutes of warm-up, but the payoff will be huge when it comes to longevity in your sport. “Greatness isn’t one game or race,” says Dannenberg. “It’s consistency of habits over many years.”

The Five Exercises You Should Do Before Every Hard Workout

Half Turkish Get-Up (unweighted)

(Todd Detwiler)

Lie on your back, right leg extended, left leg bent so your foot is flat on the ground. Use your right arm to prop yourself into an upright seated position, with your right arm straight and your left elbow resting on your left knee. Push through the ground with your left heel to raise your hips toward the sky. As you do, raise your left arm so that it points at the ceiling. Repeat by lowering your butt to the ground, returning your left arm to your knee, and driving your hips and arm back toward the ceiling.

Bear Crawl

(Todd Detwiler)

On all fours, crawl forward ten steps, moving your opposing hands and legs forward at the same time. Stay low, with your back straight and your knees just a couple of inches off the floor. Finish by crawling backward the same distance.

Lunge with Twist

(Todd Detwiler)

Step forward in a deep lunge. Plant both hands on the floor inside your forward foot. Keep your back leg straight. Raise your inside hand toward the ceiling so your torso twists upward. Plant your raised hand on the outside of your forward foot and straighten your forward leg to achieve a deep stretch in your hamstring. Finish by returning to the standing position, feet together. Repeat on the opposite side. Alternate for six total reps.

Bodyweight Squat

(Todd Detwiler)

With feet a little more than shoulder width apart, lower your butt down and back as deeply as you can without rounding your back. Keep heels grounded. As you move down, raise your arms so they extend straight in front of you. Your knees should stay over your toes. Keep your head up and your chest out. Do six reps.

Pogo Jump

(Todd Detwiler)

Bounce on both feet in a full upright position, as if you’re on a pogo stick. Continue for 15 seconds, then rest for 15 seconds. Do two sets, adding height or speed to make it more challenging.

The Six Exercises You Should Do After Every Workout

Superstuds like Ned Overend don’t get that way by charging relentlessly through middle age. They understand that at least half the game involves recovering properly, which allows for consistent hard efforts without the detrimental effects of overtraining. A nutrient-rich, plant-heavy diet and lots of sleep are essential, but a recovery plan that includes daily breathing exercises, foam rolling, and mobility work will help you rebound even faster.

“A lot of top athletes come in wanting to improve their movement and speed, but their nervous system is out of whack or they’re broken down,” says Miguel Aragoncillo, a strength coach at Cressy Sports Performance in Hudson, Massachusetts. “There are techniques to help you regenerate between workouts and correct the problems.” Here are six of Aragoncillo’s favorite recovery exercises. Do them immediately following a workout, in the evening before bed, or during a rest day.

90-90 Hip Lift

(Todd Detwiler)

Lie on your back with your feet on a wall, knees bent at 90 degrees. Place a ball or foam roller between your knees. Tilt your pelvis slightly forward. Squeeze the ball or roller, and lift your tailbone a couple of inches off the floor. Repeat five times.

Payoffs: Improved posture; pelvic alignment

Deep Exhale

(Todd Detwiler)

Lie flat on your back. Breathe in deeply using your diaphragm. (Your belly should rise and fall rather than your chest.) Exhale as deeply as possible, holding at the end for a few seconds. Repeat for five breaths.

Payoffs: Deeper sleep; relaxation

All-Fours Belly Lift

(Todd Detwiler)

Get down on your hands and knees and draw in your breath, pulling from the front of your stomach toward your spine. Round your back, breathing into the stretch. Repeat five times.

Payoff: Improved breathing

Plantar Fascia

(Todd Detwiler)

Roll a small, firm ball under the arch of your foot, applying pressure as needed. Hold it against sore spots for several seconds as tolerable.

Payoff: Foot mobility


(Todd Detwiler)

Lie on your stomach. Place a foam roller under the inside of your upper leg. Roll back and forth, from groin to knee, gradually lowering your body weight onto muscles and soft tissue.

Payoffs: Balanced running mechanics; increased blood flow

Hip Flexor

(Todd Detwiler)

On your stomach, place a ball just below your hip bone. Lower your weight onto the ball and roll it around that zone. Hold the ball against sore spots for several seconds

Payoff: Hip mobility


The SI Joint Whisperer Tells All (Part 2)

By Bizz Varty and 


Rehab – How can I be BFFs with my SIJs?

Disclaimer: While I have lots of personal and professional experience helping people heal their SIJs, I am NOT, in fact, a doctor. If these exercises help you, that is wonderful, but if they do not or if your pain gets worse, PLEASE see a medical professional – ideally one who has experience working with dancers.

I’ve provided a number of options for each step because I’ve found that every SIJ joint issue has a personality of its own, and different bodies respond better to different therapies. I recommend giving all of them a try to find which ones whisper the sweet nothings that your SIJs need to hear. The best course of defence against future issues in the SIJs is to do a little work on them every day, from a minimum of 5 up to an ideal-world 20 minutes, either all at once or a few times a day, as needed. Once you become familiar with the exercises and with the difference between the way a functional and dysfunctional SIJ feels, you’ll know what your body needs and when, and you can address any weird twinges before they throw off your alignment and set off a zigzag effect throughout your body.

Step 1: Loosen Up

Since so much SIJ drama is caused by tension, the first order of business is loosening the f#$% up (something most over-achieving dancers prefer not to do) (note from Monika- HAHAHA! So true).

This is as much mental as it is physical – you need to get into your happy place so that you can let go of the anxiety that pain and injury cause. In extreme cases, I often recommend a glass of wine to promote relaxation (you gotta do what you gotta do!).

Bouncing: with your feet parallel and shoulder width apart, bend your knees slightly making sure they point over your second toes, and simply bounce gently up and down, letting go of tension throughout your body. You can let your head roll side to side as you bounce, and try bouncing on one leg at a time while you stack your joints over one another from your feet to your head.

Pelvic Tilt: laying on your back with your feet hip width apart on the floor and your knees bent, gently tilt your pelvis towards your head, rocking your tailbone up off the floor and slightly flattening the curve in your low back. This is a subtle movement that wakes up your deep muscles, so you need to keep it small. Your obliques, transverse abs and adductor magni can rock your pelvis, but only if you relax your glutes and try not to push with your legs.

Step 2: Align

The second most important thing you can do to improve your SIJ function is to embrace inward hip rotation.Turnout is not your enemy, but over-reliance on turnout muscles is, so do yourself a favour and learn to love parallel feet, hip width apart. In yoga, the opposite of turnout is called ‘inner spiral’. A balance of inner and outer spiral appropriate to the body’s position is the key to SIJ stability. A great way to learn to use inner spiral is to use an image I call the “pelvic smile.”


Pelvic Smile: When you activate your pelvic smile, you turn on your deep abdominals and activate your inner spiral while releasing your outer rotators. To do it, imagine that you are able to look at a cross-section of your body, as though you were cut in half just below your navel at the level of your ASISs (the bony points at the front of your pelvis). A top view from here would reveal the two halves of your pelvis connecting at the SIJs in something like a semi-circle.

If you make your index finger and thumb into a semi-circle on each hand and connect them at the tips of your thumbs, you can simulate this image. Without proper alignment, your hip bones can feel (and your hands will look) kind of like a ‘W’. We want to make them into a ‘U’ or smile shape. To accomplish this, there are three main actions:

First, you will imagine widening across the back of your pelvis, pulling your low belly muscles in towards your sacrum (pulling your thumbs out to make a rounder shape) Next you’ll use your deep abdominals to narrow your ASISs (hip points) towards each other in the front of your pelvis (pull your index fingertips towards the centre to make your fingers perpendicular to your thumbs). The third action deals with the body in space. When you are standing, the pelvic smile (fingers and thumbs) should be parallel with the ground, and when you lie on your back the ASISs will point up towards the ceiling. When on your stomach, the pelvic smile forms a bridge from one hip point to the other, with the sacrum at the apex. When you are moving through space, the pelvic smile should move with you, maintaining its position between your head and your feet.

Once I experienced the magic of pelvic smile, I couldn’t help but do it everywhere – in the shower, while washing dishes, grocery shopping…. it works wonder to get you in alignment, and you’ll find that after a little practice, you’ll develop a smirk on your face to go along with it, one that says “bet you can’t guess where I’m smiling right now ;)”.

Step 3: Warm Up

Developing a mental picture of your pelvis by using imagery (such as the pelvic smile) will help you to understand what does and doesn’t work for your body. If the pelvic smile doesn’t work for you, there are lots more options – ask around or check out Donna Krasnow’s dancer-saving Conditioning with Imagery.

Muscles, like people, have trust issues, and when dancers focus all their attention on the outer rotators, the inner ones will weaken and retreat, sulking in a corner and refusing to do their jobs. Being an especially touchy and stubborn kind of joint, the SIJ responds better to attempts at realignment once it’s been flattered with a little attention, so be sure to warm up before you try any of the release techniques.

You will find the exercises below described in my free workout video “The Pilates Quick Fix on youtube (or visit my website to order a DVD). Here is a quick list of the most important exercises to improve your relationship with your SIJs, so if you don’t have time for the 25 minute video, you can choose the exercises you need the most.

Abs: Imprint

Multifidus: Cat/cow

Glute medius and Adductor magnus: Hip release

QL & Latissimus dorsi: Back extensions

Ilio-psoas: Hip fold

Step 4: Release

Retraining involves three things: releasing tense and spasmed muscles, strengthening weak ones, and then stretching and massaging to lengthen the short ones. Because SIJ dysfunction affects so many parts of the body, it would be inefficient to try and strengthen the weak muscles without first putting things back into place.

Releasing is not the same as stretching. While stretching involves pulling on the ends of a relaxed muscle to make it longer, releasing places the body in a position that brings the ends of a tense or spasmed muscle closer together so that the muscle can relax. It’s important to release before you strengthen (and before you stretch), because it will help maintain your alignment as you retrain your body.

Some people hold more tension in their piriformis, while others focus theirs in the glute medius or QL. Releases are best held for 3 minutes, but the longer you stay, the more your muscles will remember what it feels like to loosen the f$%# up.

Outward rotation (releases glute max & piriformis)


Laying on your stomach with feet hip width apart, bend the knee of the affected side so the shin is perpendicular to the floor. Take the bent knee out to the side, about 30-45 degrees from the midline of the body, and place the knee on top of a pillow or cushion. Now allow the foot of the bent leg to drop towards the straight leg, passively rotating outwards. You need to relax the entire leg on the affected side, so you’ll want to prop the foot against something so you don’t have to use your hamstrings to keep the leg bent. I like to do this in a doorframe or near a table, but a chair or stack of heavy books would also make a decent foot-stopper. Once you’re there, focus on breathing deeply and relaxing the outer rotators on each exhale. I also like to reach back and use my hand to give the butt muscles a good jiggle to make sure they’re loosening up. This one is way easier if you get a friend to help, but it can be done on your own when necessary.

Inward rotation (releases glute med & IT band)


Laying on your side (with the affected side on top), make sure your body is in one straight line from head to toes. Bring your top knee forward, at an angle of about 45 degrees to the body and place the entire shin on a pillow or bolster. Roll forward slightly so that your weight rests on the cushion (you might like to cuddle a pillow to your chest as well). Make sure the foot and shin of the bent leg are at the same height as the knee. Once again, breathe deeply and go to your happy place, and add a little jiggle if necessary.

Seated fourth (releases glutes, piriformis and IT band)


This one is a great quick release you can do just about anywhere, no props required. Sit in fourth position with the affected leg behind you (bend the unaffected leg in front of you as though you were going to sit cross-legged, with the unaffected leg curled around behind you near your butt). Align your upper body with the thigh bone of the back leg, and lean away from the leg and rest on your hand or elbow. While relaxing the glutes and thigh muscles of the back leg, massage the piriformis and glute med. I often twist and wiggle around some in this position to find the ideal spot for release.

Bolster release (SI and QLs, etc)


For this release you’ll need a prop that is at least 8-12” in length and not much wider than your SI dimples. A foam roller will do but you can also use a tightly-rolled yoga mat or a bolster if you want something softer. The roll will line up with your spine, and you will lay on it with the bottom at your tailbone. If your prop isn’t as long as you spine, you’ll want to cushion your head and upper body above its end. Once in position on top of your roller, bring the soles of your feet together and your knees out to the side. Place your hands on your hip bones and rock them gently side to side while thinking soft and happy thoughts about your glutes. You may feel a clunk or a shift, or you may not feel anything move, but either way this is a VERY effective release for the SI joint once the muscles surrounding it have chilled out.

Step 5: Strengthen

Now comes the business of strengthening those tense, weak inward rotators so that they feel equal to the outers and start doing their jobs. Don’t skimp on this part – you have probably spent more hours ignoring your inner muscles than you care to admit, and this is your chance to make it up to them. Although joints can be replaced these days, you can’t just trade in the ones you’ve got for ones that trust you more, so you and your SIJs might as well start talking about your feelings and working through your issues now.

Pilates is a very effective way to strengthen your deep core muscles and facilitate neuromuscular repatterning. Make sure to use your pelvic smile! Instructions for the exercises below can be found in my Quick Fix video.

Abs: Tic tocs, Ab curl

Multifidus: Back extensions

Glute medius: Clam shell

Adductor magnus: Butterfly

QL & Latissimus dorsi: Swimming, Arm & leg reach

Ilio-psoas: Hip fold (*try it with a straight leg, too)

Step 5.1 Re-release

In the beginning stages of retraining, old habits could pop up during strengthening and cause a spasm in the outer muscles. If this happens, don’t stress, just go back to step 4 and re-release them before you stretch.

Step 6: Stretch/Massage

Stretching and massaging is about balancing the resting length of your muscles. You need to lengthen your outer rotators to balance them with your inner ones so your SIJs can rest easily between the two. Because the SIJ’s range of motion is small and controlled by deep ligaments, muscles and fascia, stretches won’t be able to get at all the structures that need attention. Massage (using props for those hard to reach places) will dig down into them, basically reverse-stretching them in the way you would roll out a pie crust.

Yoga is a great way to stretch while maintaining proper alignment and activation of your postural muscles. You will find instructions for most of these poses in my Hippy Hippy Shake videos (or see YogaJournal for step-by-step basics). And don’t forget to use your pelvic smile!

Downward dog

Chair pose (with twists)

High and low lunge (with twists)

Warrior 2

Side angle



Fire log


Bound angle

As for massage, a pair of hard rubber bouncy balls are ideal for getting into the deep structures around your SIJs (tennis ball size is good, but I find tennis balls themselves to be too soft and slippery). (Note from Monika- You can get a lacrosse ball for four bucks from Canadian Tire). Place them on either side of your spine and roll up and down against a wall for a nice deep massage. You want to avoid rolling over your spine, instead focus on the muscles and tendons. Make sure you get down into the glutes, and even turn sideways to get the entire glute medius and the IT band.

The SI Joint Whisperer Tells All (Part 1)

by  and By Bizz Varty

The sacro-iliac is quite possibly the most mysterious and misunderstood joint among dancers. As a dancer and a yoga teacher, when I hang around with my dancer friends, I spend a lot of time releasing stuck, jammed and pinched sacrums (they call me the SI joint whisperer). As delightfully satisfying as a recently-released SI joint can feel, (note from Monika- BEST. FEELING. EVER.) I have realized that constantly putting it back where it came from is like using a cup to catch water from a leaking bucket just so you can pour it back into the bucket – that is, rather inefficient. This realization plus my own lengthy history of pain in the posterior hip and spine have led me on a search for long-term solutions in the form of alignment, conditioning and neuromuscular re-patterning.

An injury back in high school began my long journey to understanding my SI joint. I was dancing every night as well as playing soccer, and woke one morning with a pain in my back/hip, a pain that eventually moved into my knee.

For weeks I felt I’d ‘lost my bounce’, because jumping sent a ricochet of pain all the way from my toes to my neck along my right side. Being young and stubborn, I did not seek medical attention or even apply an ice pack. Instead, I just tried to dance it off. Though the intense pain eventually went away, my right hip and knee were never the same. Fifth position and attitude derriere caused pinches and twinges in my back and I constantly had an incredibly tight IT band.

But I continued to dance anyway (See Monika’s article “The Problem with Dancers Today” for more on this).

For three years I was held hostage by the twinges, aches and pains that seemed to move around to a different part my body every week. Then, in my second year at York, a ballet teacher suggested that maybe one of my legs was longer than the other. Intrigued, I went to a physiotherapist who said that they were, in fact, the same length, but my SI joint was stuck on the right side.

That first SI adjustment changed my life – for a few weeks anyway. Not knowing that this was something I would eventually become very passionate (ok, maybe a little obsessed) about, my early efforts to maintain this new and wonderful SI joint balance were half-assed at best. Going to physio each week became more like going for an SI release every week. That is, until my PT got fed up and showed me how to release it myself. Then, she began teaching me how to activate my deep core muscles, which blew my stubborn dancer’s mind.

In the 6 or 7 years since, the amount of attention I’ve paid to the problem has varied in relation to the wide assortment of injuries and misalignments I encountered. I would try to dance (or swim, do yoga or even walk) with my SIJ locked. Then, I would have to spend several days dealing with the after-effects only to have it happen again the very next week.

I learned the hard way that the best offense is a good defence, and began addressing my SIJ with daily re-patterning work about a year ago.The improvement has been magical.

Certain activities (especially if done when tired or distracted) will still throw my SIJ off, but now that I know the symptoms (non-specific pain in my knee and IT band) and the solutions (I live for pelvic smile and seated fourth release!) I no longer suffer daily from the repercussions of poor patterning.

My method may not be the simplest, but I find it very effective, as do many of my students. Stabilizing your SIJ, especially if you are a dancer who expects your body to maintain a large range of motion, should be a daily practice. Tight muscles will pull the SI out of alignment, and the body’s compensatory efforts will keep it stuck there.

If you have SI joint issues, chances are good that they are supported by years of well-intentioned but inefficient movement patterns. (Note from Monika- I agree… the road to dance injury is paved with the best of intentions).

I don’t say that to discourage you, I say it to help you understand that you can’t half-ass this if you want it to work. Trust me on this one, I’ve lived through the drama and made it to the other side. A happy SI joint will improve your movement in a million little ways that you can’t even imagine until you’ve experienced it. It takes some time and effort to find what works for you, and to figure out how your body tells you that it needs attention, but it is SO worth it!

Anatomy: What is the SI joint and how does it work?

The Sacro-Iliac joint is in fact two joints – one on each side of your sacrum where it meets the back of your pelvis – specifically, the inner edges of the ilium. You can find these spots by looking for the dimples at the back of your pelvis (just above the crease between your cheeks). The bump you will feel near each dimple is your PSIS or Posterior Superior Iliac Spine – anatomy-speak for “the bony bump at top of the back of your Ilium.” The SIJs are weight bearing joints that provide shock absorption for your spine and distribute the weight of your upper body onto your pelvis and into your legs and feet.

There is some misinformation out there that states that the SI joints do not move, but in a healthy body this isn’t true. To be fair, the SIJs are not designed for a large range of motion as they are stabilized by many deep ligaments. Especially in the type of loose-jointed (which is to say, long-ligamented) bodies that dancers tend to have the bones do move in relation to one another, and when they do they cause widespread (though usually subtle) shifts in overall alignment. Rather than a ball and socket joint like the hip and shoulder, or a hinge joint like the elbow and knee, the SIJ is a gliding joint, more like those found in the spine, where two relatively flat articular surfaces slide against one another. (You can find out lots more nerdy pelvic anatomy stuff on Wikipedia if you’re interested!).


So, if your loose ligaments aren’t holding the SI joints stable, what is? That would be your deep core muscles, namely the transverse abdominus, multifidus, piriformis and ilio-psoas. But there are a number (some say as many as 35) of other muscles that have a connection with the SIJs including the gluteus maximus and minimus, erector spinae, latissimus dorsi, quadratus lumborum (QL), hamstrings, quadriceps and tensor fascia latae as well as the IT band. You would think with so many supporters the SIJs would be good and stable, however all of these muscles also have other jobs to do when the body is in motion, and when those other jobs take priority over SIJ stability, it can throw all kinds of things out of whack.


Side note: SI joint dysfunction is sometimes called “piriformis symdrome” because the piriformis in one of the primary culprits for malfunction, especially in dancers who overwork their turnout. While piriformis syndrome may well be caused or aggravated by SIJ dysfunction, it is a distinct problem that affects only a small portion of the general population. In less than 20% of bodies, the sciatic nerve runs through the middle of the piriformis muscles (instead of underneath it) and when the piriformis is overly tense it pinches the nerve, causing a radiating pain down the back of the leg. The only way to determine if you fall into that 20% is by cutting your butt open to take a look so you may never know for sure, but if you have a shooting nerve pain that starts in your buttocks, you can bet that your sciatic nerve is being irritated by your piriformis.

Symptoms – What do unstable SIJs feel like?

SI joint instability is a bit of a misnomer. What I see in many dancers are SI joints that have become locked into place by tight, weak muscles. In an effort to protect what is an especially loose joint in dancers, the body tenses up resulting in a joint that is in fact too stiff for its own good.

As I said before, the SI joints should move, not a lot, but just enough to transfer information from the pelvis and legs to the spine and back again. When this doesn’t happen, because the joint has locked into place in the interest of self-preservation, pain can sometimes be felt at the back of the hip near the dimples. But the body is crafty, and in a dancer’s loose body, the spine, pelvis and hips can shift subtly to work around the blockage. In cases like this, pain might not be felt at the SI joint at all. Rather, the over-stability there will cause instability in other locations – typically in the front of the hip, the low back and the knee, but sometimes all the way down to the toes and up into the neck. (For me, I don’t feel anything in my SIJ until after I notice a pain in my knee).

Usually the piriformis, and often the QL and glutes will be very tense, (Note from Monika- Yep. So. Tense.) and could even be in spasm. To make it more complex, a problem with the right SI joint could very well cause pain in the left side of the body, as the brain will just reassign whichever nearby muscle is strongest to cover for the weak ones that are busy tensing up to create more “stability” – essentially, to use the technical term, an “anatomical cluster-f#$%.”

Try this at home: If you suspect your SI joint is locked, you can get a friend to try and help you determine on which side. Standing tall with the feet parallel, have your friend stand behind you and place their hands on the SI joints, just above the dimples. Raise one knee to hip height slowly, then lower. Repeat on the other side. If your friend feels the SI joint lift upwards when you raise your knee (instead of staying still or moving down slightly) the SI joint may be locked on that side.

Causes – What makes dancers so vulnerable to SIJ cluster-f#$%s?

Most people are stronger in the outer hip and weaker in the inner thighs as a result of sitting for long hours and standing with poor posture. Dancers tend to be looser-jointed than the average population, as the dance world has a way of discouraging those less flexible folks. Add to that the dancer’s affinity for overusing the outer rotators to create more turnout as well as a penchant for general over-exertion and you’ve got a recipe for SI disaster. The SI joint was simply not designed with turnout in mind, as most mammals move most efficiently in the saggital plane. But that’s not to say that dancers and their SI joints can’t be friends. In fact, you too could very well become BFFs with your SI if you regularly practice the exercises which will be outlined in part 2.

Here’s a little about Bizz:


Bizz (Elizabeth) Varty has a passion for dance, music and mind-body fitness. While completing her Honours BFA in Dance at York University she discovered her love for dance science and kinesiology. She also studied Arts Management at Humber College and is certified as both a pilates and yoga teacher.

Bizz has studied dance for more than 20 years. She has choreographed and performed across the province including her 2009 work, the Janis Joplin-inspired piece Honey, I Know How You Feel for the BAZAAR dance festival at Toronto’s Opera House. Along with Beth Lifeso, she is co-director of Cocktail Dress Productions, who have performed at Massey Hall and The Rivoli in Toronto.

Her interest in fitness began at a young age and she has been practicing Yoga and Pilates for 15 years. Her teaching style combines the precision and efficiency of pilates and the philosophy and flow of yoga with the creative expression of her dance background. Bizz’s attention to anatomical detail and her fun, engaging instruction have earned the respect of students of all ages and backgrounds. For more info and free videos, visit

More & More Young People Are Getting Arthritis: Here’s What You Can Do

By Susan Blum, M.D., MPH

Think arthritis only affects the elderly? Think again. By 2030, an estimated 580 million people worldwide, ages 18 and older, will have been diagnosed with the disease. Pretty eye-opening, right?

Conventional medicine tends to treat arthritis with strong, immune-suppressing medications that temporarily relieve the symptoms of the disease. Unfortunately, I’ve seen how these medications can also damage your gut and how they fail to truly address the root cause of the issue. This World Arthritis Day, it’s time to make a change. I’m here to tell you that there’s another way—a way that’s designed to address the underlying causes—in order to reduce inflammation without medication. Here’s how:

1. You can treat all kinds of arthritis with one approach.

There are more than a dozen different kinds of arthritis, and while there are certainly differences in conventional understanding and treatment for each one, they all have common root causes and triggers for inflammation and pain. For example, the two most common diagnoses are rheumatoid arthritis (RA) and osteoarthritis (OA). While RA is considered an inflammatory (autoimmune) disease and OA is typically thought of as the result of “wear and tear” and injury to the joint, both of these conditions are influenced by lifestyle choices such as diet and exercise. No matter what kind of arthritis you have, it’s important to know that it can be made worse by inflammation that starts elsewhere in the body, including the gut. Which brings me to my next point…

2. Heal the gut, and you heal the joints.

You may have heard some talk about gut health—and the gut-brain connection or the gut-pain connection—and you’ve probably heard the word “microbiome,” or the friendly bacteria in your body. Fascinating studies have confirmed that the root cause of your arthritis is most likely lurking in your digestive system, so to heal your joints, you must first heal your gut. But where do you start? The best first step is to take a probiotic daily to help remove the harmful microbes that might be causing your symptoms, but some require a more intensive plan.

3. Treat your terrain with inflammation-fighting foods.

A fresh start for your microbiome means a new chance to influence your “terrain,” or what I think of as the body’s deepest soil, where cells either thrive or wither. There’s a strong connection between your diet, your gut microbiome, and your pain level, so I recommend choosing foods that fight inflammation like organic plants and foods high in fiber and healthy fats, while avoiding refined sugars, dairy products, and red meats. Here are some of my guiding principles:

Increase fiber, micronutrients, and phytonutrients, or, in less-scary terms, eat more vegetables and fruits, and choose organic whenever possible.

Reduce refined sugar, high-fructose corn syrup, and refined grains.

Improve the quality of fat by removing refined oils and hydrogenated fats.

Improve the quality of the animal protein you eat by choosing 100 percent grass-fed and finished beef, free-range chicken, and sustainably farmed, low-mercury fish.

Limit salt, food dyes, and preservatives (which happens naturally when you limit processed foods).

4. Carve out time for daily stress-reduction activities.

Traumatic events and ongoing stress are very real triggers for inflammatory diseases. In our go-go-go world, we’re always rushing; we can’t miss this deadline or that meeting, and we very rarely take the time to sit back, relax, and let our minds reset. Diet and stress are two root causes of a damaged gut, inflammation, and chronic disease, so it’s no surprise that in order to heal your arthritis naturally, you must take time to practice your favorite stress reduction activities daily. I recommend meditation, yoga, long walks through nature, and journaling to ease the mind.

10 Tips for Starting Yoga at 50+

by Amber Burke & Bill Reif

Medical practitioners and health-focused websites are increasingly recommending yoga to those of middle age and up, perhaps because yoga can help make you more flexible and mobile, improve your balance, reduce age-related changes in gait, increase your energy, reduce chronic pain and addictive behavior, decrease the risk of heart attacks and strokes, alleviate depression and anxiety, improve sleep quality, and even slow the effects of aging on a cellular level.

Older adults seem to be listening. According to one large survey, those 50 and up constitute 38 percent of all practicing yogis, making them the second largest group of practitioners (after those 30-49). If you are considering joining this number, it’s important to consider how best to approach a new yoga practice at and after middle age.

Although no single type of practice will ever be appropriate for everyone in any demographic, a yoga practice for those 50 and up is one that understands and works with the differences between younger bodies and older bodies, rather than one that pretends those differences do not exist.

In particular, a safety-focused approach to yoga may be especially valuable for older practitioners, who seem to run a higher risk of in-class injury than their younger counterparts. Yoga, like all forms of exercise, can both cause and exacerbate injuries, and while the rate of yoga injuries for all demographics rose between 2001 and 2014, injuries were most frequent among those 65 and up (57.9 injuries/100,000 practitioners), followed by those 45 and up (17.7/100,000). This may result from the way normal, age-related changes and preexisting wear and tear on our bodies interact with a yoga practice.

Although all bodies are different, in general, our bodies become less resilient as we age. To varying degrees, we experience decreases in muscle strength, connective tissue elasticity, and bone density, the combination of which may make us more vulnerable to injury than our younger counterparts. Older adults may also find that their injuries don’t heal as quickly as they did a decade or two ago.

By the time we reach middle age, it’s also likely that we bring to yoga conditions or injuries—diagnosed or undiagnosed—that affect our practice and can make injury more likely. Kyphosis, frozen shoulder, osteoporosis, and back pain (discussed further here) are among the common conditions experienced by older adults that may necessitate changes in our yoga practice.

Fortunately, by making careful decisions about what type of yoga to practice, and how to practice it, we can decrease the odds of injury. While much of the advice below applies to yoga practitioners of all ages and levels, it is especially crucial for those starting yoga at or after age 50, when safety must take center stage.

1. Seek out the type of yoga class that’s right for you.

There are many types of yoga. A high-intensity practice like ashtanga, vinyasa, or power yoga (in which students often “flow” quickly through poses) usually requires the hands to bear weight. These practices may work for some beginning practitioners, especially those who are athletic and free from competitive urges, and who can easily make adaptations within a group class when needed.

But if you are newer to exercise and/or working with injuries or pre- existing conditions (especially of the shoulders, elbows, or wrists), the fast pace of a vinyasa or power yoga class and the emphasis on weight-bearing with the hands may not suit you. Instead, you might consider choosing a class that moves slowly and focuses on alignment. Hatha classes, Iyengar classes, classes geared specifically toward older adults or billed as “alignment-focused,” and introductory, basic, or foundational classes could all be appropriate. Kundalini classes, which often emphasize seated poses, chanting, and working with the breath, may also be beneficial. Yin yoga and restorative yoga (both floor-based practices emphasizing long holds), and chair yoga, in which many poses are practiced with the help of a chair, are of value to many practitioners, but may be especially valuable for older students who are newer to exercise, find balancing to be a challenge, or have difficulty coming down to and up from the floor.

Teachers of all of these different styles are often happy to teach you privately. A private yoga session is considerably more expensive than a group class, but often far less expensive than an appointment with a physical therapist or doctor.

During one-on-one sessions, a teacher can check your form and help you make adjustments to poses that haven’t been feeling quite right, or about which you may be uncertain.

Yoga International and other yoga sites will give you many of the tools you need to be your own teacher and embark on a home practice. There, you’ll find online yoga videos that offer classes for a variety of different levels that you can practice at your convenience. However, even those who prefer practicing at home often find participating in group classes helpful—both for the instruction from a “live” teacher, and the encouragement from a community of other students.

2. Find the right teacher for you.

Even within each type of yoga mentioned above, classes often vary tremendously depending on the instructor. Some say there are as many styles of yoga as there are yoga teachers. For instance, some vinyasa teachers may move slowly, while some hatha teachers pick up the pace. Shop around. Try different teachers. It is not necessarily important that your teacher be the same age as you, but it is important that younger teachers know how to work with students older than themselves.

Go to class early enough to talk to the instructor, or visit with the studio manager to inquire about various teachers’ styles. Ask about their philosophy and goals. Consider steering clear of teachers who think all poses are uniformly attainable and beneficial for all bodies. Instead, seek out a teacher who seems to care about any needs and pre-existing injuries or conditions you might have, and is interested in making your practice productive for you.
Find someone who gives careful instruction, teaches poses that seem valuable and possible, and who offers directions you can easily interpret. Above all, look for a teacher whose emphasis is not on the “what” but the “how”—a teacher who is more interested in teaching students how to move safely and with awareness, than in achieving a particular pose.

3. Be clear about your goals.

If, instead of accomplishment—like achieving handstand or lotus pose, you see the goal of your yoga practice as improved physical and mental well-being, the poses themselves become less important, a means rather than an end. You will then be less inclined to do anything in the short term that puts you at risk for injury, which would interfere with your long-term goal.

Yoga’s benefits for your well-being do not hinge on the attainment of particularly adventurous or dramatic poses, keeping pace with the person next to you, or practicing a pose just the way your teacher does. Rather, the benefits derive from a consistent and mindful practice of poses that challenge your range of motion and strength to a sustainable degree.

4. If you have any injuries or pre-existing conditions, tell your teacher about them, and share any advice you’ve received from your doctor.

A discussion with your teachers regarding any injuries and conditions you may have is essential, so that they avoid encouraging you to make movements that are risky for you. Sometimes, your teachers can help you modify potentially problematic poses or suggest alternatives. Even if you aren’t seeking advice (because you know exactly which changes you’ll make to your practice to keep yourself safe), it’s also important to communicate with your teachers to avoid hands-on adjustments that could place pressure on a place of injury or vulnerability.

Past injuries and surgeries matter, too, since the area of a previous injury is often the area that’s most likely to be injured again.

Any information your doctor has given you about which movements to do and which not to do can be invaluable to your yoga teacher. Though many experienced teachers will know how to work with practitioners who have certain common injuries and conditions, it’s simply not possible for them to know the particulars of every diagnosis. So if, for example, your doctor has given you instructions not to twist or forward-fold, pass that information on.

5. Take charge of your own well-being throughout your practice.
It can be tempting to assume that whatever poses the teacher suggests will be a good idea for you, especially if you’ve communicated with them about any injuries or conditions you have.

But it’s important not to surrender responsibility for either your own safety or your own good judgment. Sometimes classes are so large that teachers don’t feel they can attend to the particular needs of any one individual. Sometimes your teachers may not know how best to accommodate your needs.

But perhaps most critically, there will be times when only you will know what your needs are. For instance, only you can know when you are on the verge of losing your balance in a standing balance pose. But since, according to one study, falls from standing height are the most common cause of injuries in older athletes, it’s critical that you don’t wait for the teacher’s invitation: Exit the pose before your shaking destabilizes you.

Continually register what you are doing and how it feels. Stay attuned to warning signs like tingling, numbness, lightheadedness, and, of course, pain. These are cues telling you that it’s time to come out of a pose.

6. Move Slowly.

Moving slowly from pose to pose gives you time to both get your footing and to notice sensations in your body. And if you’re not in a rush during transitions, it may be easier to stay mindful of your alignment, as well as of any advice your yoga teacher or your doctor may have given you.

Slow movement can also help build strength. Slow doesn’t mean easy—quite the opposite. Try taking a few steps as slowly as possible. You’ll likely feel that moving slower requires more control and effort, rather than less. Moving slowly can also require mental strength to stick with the challenges it presents, as well as to keep a slow pace even when others are moving faster.

7. Give yourself permission to skip and alter poses as necessary.

Respect your feelings of hesitation. If you look at a pose and think, That looks like a bad idea, don’t do it.

Err on the side of caution. Take all directions as suggestions rather than mandates, and do only the poses you can do without strain and while breathing deep, comfortable breaths. Whenever you wish, take a break in child’s pose or any seated pose that is comfortable for you.

Often, there may be another way of approaching a pose to make it more accessible. Ask for help from the teacher in creating another version of the pose, perhaps using props. Having a wall to touch or lean against can help you with balance, and blocks or straps can arrest the depth to which you go in a pose, lessening strain and lowering the probability of injury.

8. Pay attention to how you feel, both after practice and the next day.

It’s important to take into account how you feel, not only during but also after your practice. Do you feel nothing at all? Do you feel you exerted yourself in a productive way? Maybe you’re sore in a “good way”?

Do you have a lightness in your step and a buoyancy in your mood? Or do you feel exhausted? Or maybe you even feel new pain somewhere?

If you feel nothing at all after the class you took, you might consider upping the intensity of your practice. If you feel absolutely exhausted or in pain, you may conclude that you did a little too much, and tone things down next time.

9. Give up comparisons.

You may or may not have something in common with the person practicing vigorously next to you. Do not expect your poses to look exactly the same way that other students’ poses look. Besides, impressive as some of those demonstrations may be, you don’t know what is going on inside any of those other bodies. For all you know, those yogis have rotator cuff tears, repetitive motion injuries, or pain they are ignoring (and perhaps exacerbating by practicing that seemingly advanced pose). Who knows, some of them may have managed to get into their pose only by compromising their alignment or stability in some way. They may even be holding their breath!

Trust that the more advanced student is one who recognizes their own limitations, and practices the version of a pose that is appropriate for their body while maintaining their personal optimal alignment and breathing deeply. Be that student.

It may also be tempting to compare yourself with the person you were twenty years ago, who could have done the suggested adventurous pose with abandon. You can no longer do anything to help or hinder the person you used to be, but your actions today will have a direct impact on the person you will be tomorrow. Do your future self a service by respecting your limits as they are today.

10. Men: Patience and persistence will pay off.

Researchers have long-noted that women tend to be more flexible than men, a gender gap that is slight in preadolescence but increases toward seniority (when older women maintain greater range of motion in many joints than older men do). This difference may be due to a combination of muscle size, tendon elasticity, hormones, and the kinds of activities that men or women are more likely to engage in.

The fact that aging-related declines in flexibility appear to be joint-specific, with, for instance, the shoulder and trunk experiencing greater losses in range of motion than the elbows and knees, indicates that habitual joint usage patterns play a role in these losses.
Statistically, men tend to participate in more vigorous physical activities than women, do more strength-training activities, and play sports twice as much (or more) than women do. But muscle bulk, the wear-and-tear of repetitive movements, and the scar tissue that results from injuries may contribute to losses in flexibility.

Men’s comparative inflexibility is not a reason for them not to do yoga; rather, it makes yoga even more important. And the good news is that, when embarking on a program of stretching, men seem to make gains in range of motion at a similar rate to that of their female counterparts.

However, it’s important that they take things more slowly than they might be inclined to, and that they don’t expect themselves to be able to do everything their female neighbors in class are doing—at least not right away.


What all these tips encourage is viveka: a Sanskrit term for the prized quality of discernment and discrimination. Although certain physical aspects of yoga may be more challenging as we age, discernment may also be easier to come by.

At middle age and beyond, we may have an easier time discerning our goals, the kind of practices and teachers that are right for us, and the speed at which we may safely proceed. We may be able to better discriminate between the poses and movements that are of benefit to us and those we would be better off skipping, between what is right for another and what is right for us, and even between what was right for us 20 years ago and what is right for us now.

If we apply this earned wisdom to our yoga practices, it will not only help to keep us safe, but it will also serve as a signal to others.

Every time we stay in a less extreme version of a pose, or take a break when we need it, we model to younger, more ambitious practitioners a kinder way of practicing. We tell another story about what yoga can be. Through the self-awareness and self-care that infuses our actions—and at times our inaction—we become arrows that point inward instead of outward.

Finding Flow

By Michael Shapiro. Photo by Ali Kaukas

I don’t envy the newlyweds who picked this week for their Hawai‘i honeymoon.

The Turtle Bay Resort is a swarm with the lithe, and all their painted-on Lululemons and Lycra pants aren’t helping things. Tatted and pierced and dreadlocked, they radiate vitality as they fairly prance between classes, their bodies toned by thousands of vinyasas and their smiles sculpted by preternatural optimism. And little wonder: Four days of yoga, meditation, ocean sports, rainforest hikes, healthy food and live music would boost anyone’s luminosity a few candelas. But with hundreds of vibrant people powering up together on one of O‘ahu’s most spectacular coastlines, it’s all positively blinding. Distraction enough for the newly-minted marriage, but heaven help the couples here to celebrate a fortieth anniversary.

Two things you learn right away at a yoga festival: Everyone is intensely blissful, and there are no decent yoga clothes for men. My 50-year-old dad-bod is long past Lycra friendly, so I wear the most form-obscuring clothes I have—my pajamas—and search for a class befitting my lack of fitness. “Aging Gracefully” seems promising until I read the description and discover that the acquisition of grace requires ninety minutes of “intense and sweaty” yoga. “You Are a Spiritual Warrior” hardly calls to my innate passivity(in yoga they call it, charitably, “yin”). “The Core of You” will “challenge me to dig deep within” myself, which I’m reluctant to do because of the challenge part. Then I find it: “Deep Snooze with AIReal Yoga,” which consists of lying suspended in a silk hammock for half an hour, a “guilt-free napping experience” and a “floating savasana.” Ah, savasana—the pose where you lie on your back and let it all go. Usually it follows an hour or more of intense movement, but this—it’s like bypassing the entrée and going straight for the crème brulée. Maybe I’ll dig deep tomorrow; after all, I’ve got four days to find the core of me, which I’m pretty sure will be dozing in a silk hammock, wondering why I’m bothering it.

Still, with all these yogis and yoginis opening themselves physically, intellectually and spiritually—with meditation classes, “culture walks” sharing the ancient mo‘olelo (stories) of this stretch of the North Shore, surfing lessons, poi-pounding workshops and talks on self-realization (my favorite: “Make Your Life Feel Like an Orgasm,” which, while enlightening, turned out to be blatantly false advertising)—I feel lame for being lame. So I decide to push myself by stretching as far outside my comfort zone as I can—by signing up for the “HoopDance Fundamentals Playshop.”

I know I’m in the right place when I see the stack of hula hoops and note that I’m the only male within a hundred yards. I’m also prepared to fail embarrassingly: The instructors demonstrate what we’ll learn with such sinuous grace that even the women seem intimidated—and their hips are made to do that, while mine have all the mobility of a cinder block. Stationed at the back of the group, I fail as anticipated, evoking that solicitous expression reserved for the kid who gets an award for participation. But watching the women sustain the hoop’s rotation with the slightest rocking of their hips—they barely move—I realize I’m going about it all wrong. Instead of hacking my hips in choppy circles, I close my eyes and feel the hoop, connecting to its rotation from within, a flow found not by pushing the hoop but by following it. Turns out my yin isn’t so passive after all. Once I tune in, it becomes easy, and I feel like a child at play, unaware. that what he’s doing is difficult. Because, for the moment, it isn’t. When I stop, the instructor, who’s been playing at this for years, gives me a look that says, “See? You found it.” HH


Three rules of thumb: The Body is a Machine

by Jonathan FitzGordon

Just like a car the body is a machine designed to work in a specific fashion. Nothing in the body works in isolation—every part has an explicit function meant to work in harmony with other parts. Our skeleton is like the chassis of a car and the quality of our posture determines whether all of the moveable parts can work effectively. Many of the body’s muscles though far away from each other are meant to work in synch and require proper posture to do so. Our body follows a mechanical model—it is a series of arches, hinges and pulleys, and learning about and understanding your body’s mechanics will allow you to effectively utilize the genius behind the body’s design.
You have to learn how the body works in order to use it correctly. A question I am often asked is—Don’t we just know how to walk? There are so many things we teach babies and young children— how to eat with a fork and spoon, how to tie your shoes and zip a jacket, but when it comes to walking, we all take our first step somewhere between ten and eighteen months old, get a big clap and a cheer from our parents and are then left to our own devices.
The fact is we are designed to walk in a specific way. Bones hold us up; muscles move us; nerves tell the muscles to move the bones. The foot is meant to fall very near to parallel with a distance of two or so inches between each foot. Our arms are meant to move in opposition to the legs with each step—when the left leg moves forward the right arm should move the same distance at the same pace. Our head is meant to be level so that the eyes can best communicate with the spine.
Some people are born strong. Look at your ancestry. Where did you come from? If your forefathers were strong like mine, you likely have a reserve of strength stored away in your DNA. Our level of childhood activity goes a long way to determining the strength you carry into adulthood as well. An active child who played a lot of sports or just ran around a great deal will have a lot more core strength and body awareness than someone who spent more time indoors and avoided the playing field. There are many mitigating factors to movement as well, including illnesses, accidents, and traumas both physical and emotional.
Core Power is a very popular cultural buzz phrase. My approach to the core is about creating strength to support the muscles and bones of walking. Without the proper tone in the muscles of the pelvis and trunk, the body is a machine that is not free to move effectively.
Our society’s aesthetic focus is on the surface and the extremities. When most people go to the gym they work the muscles that people can see—they build strength in the arms legs and the surface of the belly. While tone in these muscle might look good, if it is pursued at the expense of the muscles responsible for holding us up and moving us we will run into trouble in the long run. The muscles of the inner thigh, the pelvic floor and deep low belly are the key core muscles for the FitzGordon Method. These three groups of muscles tend to be weak dues to imbalances with their opposite more external counterparts. Pay attention to your mechanics and learn which muscles need building for a more finely tuned tuned and balanced body. The body is a machine that likes to function efficiently but you have to show it the way how.

The Science Behind Miracles

By Erik Vance

How our minds push our bodies to defy expectations, beliefs, and even our own biology—in short, to make miracles
Imagine a man who could endure near-freezing water for 45 minutes at a stretch. Imagine if that same man could run a barefoot marathon in the Arctic or swim 50 meters under the ice of a frozen lake. Imagine that man said the secret to his abilities not only allows him to climb Himalayan mountains wearing shorts, but also eases everything from chronic pain to Crohn’s disease and even Parkinson’s. What would you call that man? A savant? Guru? Prophet of God, maybe?

That’s the character Scott Carney describes in his new book, What Doesn’t Kill Us, about legendary survivalist and icy-water swimmer Wim Hof. The 57-year-old Dutchman, often referred to as the Iceman, has devised a series of breathing techniques and conditioning exercises—mostly various types of hyperventilation and other ways to purge the body of CO2—that he credits as being the key to his extraordinary abilities. Hof, for his part, sees the whole thing in a much more spiritual light—getting back to a purer, more primitive version of ourselves.

The book is a fun read because, at first glance, Hof does seem superhuman. He claims that by slowly conditioning oneself to low-oxygen states (through breathing exercises) or extreme cold (through full-body muscle-clenching exercises), one can channel their spiritual energy and tap into all kinds of hidden powers. Carney is at his best when he tries to explain Hof’s abilities through science. For instance, he suggests that Hof has tapped into a specific type of fat cell called brown adipose tissue that is found in human babies but mostly disappears in adulthood; through his body training, it’s possible that Hof has encouraged this vestigial fat to play an increased role in trapping heat. But the tone of What Doesn’t Kill Us occasionally implies that we should worship the guy. And honestly, it’s hard not to.

Hof is one of those extraordinary characters who pops up occasionally throughout human history seeming to be nothing short of miraculous. For thousands of years, humanity has occasionally glimpsed man’s capacity to do the seemingly impossible or the miraculous using only force of will: walking on burning coals, healing the sick, enduring lethal temperatures for hours. And for all that time, we have been left to our own devices in guessing how such things are possible.

But today, modern science has revealed a number of fascinating mechanisms for how the brain influences the rest of the body, forming a string of enticing bread crumbs leading toward a more satisfying understanding of some of the limits of the human body—and how people like Hof cheat them.

Take one fascinating lead: the effect certain expectations have on bodily functions. The mind has a propensity to make predictions, and then ensure those predictions come to pass through internal “pharmacies” that, when lumped together, are also called placebo effects.

In my book, Suggestible You, I talked to scientists around the world who investigate placebos, internal pharmacies, hypnosis, and the power of belief on the body and mind. One of my favorite quotes came from Alia Crum, a psychologist at Stanford. “I don’t think the power of mind is limitless,” she said. “But I do think we don’t yet know where those limits are.”

In his book, Carney points to Wof’s ability to heal things like Parkinson’s, asthma, chronic pain, and digestive problems, giving us the impression that the mind can do anything it wants. As it happens, all of these diseases are also highly susceptible to the influence of placebo. Contrary to popular belief, not all placebo effects are the same, and not all conditions respond to them equally. That’s because a big part of placebo effects are chemical, employing things like dopamine, endogenous opioids, serotonin, and an untold number of other chemicals your brain idly keeps on hand in case it needs to adjust what’s happening in the body.

That’s what’s at the center of almost every “miracle” I’ve encountered: chemicals that have incredible effects but still follow the rules of biochemistry, even if we don’t yet fully understand what those rules and mechanisms are. Hof claims that one of the secrets to superhuman strength and healing is specialized breathing techniques. Fair enough. But I can introduce him to a healer in Beijing who says it’s about balancing spiritual heat with cold or a witch doctor in Mexico who says it’s about channeling spirits. What do they all share? The chemistry of expectation and belief—which, writ wide, is the world of placebo. A better definition for placebo might be to call it a measurement of the effect of one’s belief on their body.

Belief and placebos don’t just affect disease. They also boost athletic performance, as Hof demonstrates when he swam under 50 yards of ice. This is where scientists have begun asking some really interesting questions.

Placebo effects have long been studied in medicine, but Christopher Beedie, a sports psychologist at the Canterbury Christ Church University in England, is among the few scientists who study it in athletics. His work often examines how elite athletes perform under intense fatigue when they think they have some kind of performance enhancement. The interesting question for Beedie isn’t what can the human body do, but rather, what more can the human mind add to that?

“I don’t think there’s anything surprising about people who exist at the end of continua,” says Beedie. “[Hof] is an extension of the classic example of a unique athlete optimized on nearly all variables who’s also probably learned to capitalize on every component of placebo responding he can.”

One of the most studied mechanisms of placebo in medicine is that of pain relief. Scientists have documented an extensive network of self-medicating pathways in the brain involving internal opioid stores that kick into gear when our bodies expect a treatment—from aspirin to acupuncture—and don’t get one. And there’s a lot of overlap between pain and athletic performance. Because what is intense exercise but extended pain resistance? In fact, pain relievers like morphine are strictly regulated in athletics for their performance-enhancing powers.

In addition to painkillers, there may be a whole network of internal chemicals our bodies can dip into for increased performance. In one mind-boggling study from 2008, legendary Italian placebo scientist Fabricio Benedetti told weightlifters that they were getting performance-enhancing drugs when they were actually getting placebos and, secretly, lighter weights to lift. Once they believed the drugs were working, as perceived by the lighter weights, the loads were surreptitiously returned to their normal weight. The force the athletes were able to produce with their muscles increased while perceived fatigue stayed the same.

Beedie has done a lot of similar placebo performance experiments—consistently demonstrating their ability to give an impressive edge to cyclists, runners, and many other athletes—to the point where the athletes at his school don’t always believe what he says. He claims belief taps into “headroom” that every athlete has in their potential—or the idea that that athletes can push themselves to operate between their perceived maximum execution and the maximum that physics and their bodies will allow. By either removing energy-wasting anxiety or tapping into chemicals like opioids or as-yet-undiscovered internal performance drugs through one’s expectations, the brain can coax the body into that magical zone.

In fact, Beedie is convinced this headroom is the same space filled by performance-enhancing drugs. (Indeed it’s not even clear that some banned drugs, like erythropoietin, can outperform placebos.) He’s just finished the largest (not yet published) placebo study ever done in athletics—600 subjects in all—and found that the people most likely to respond to placebo were the ones experienced using supplements. Perhaps the previous supplements the athletes had taken primed them to have a placebo response. Perhaps people who naturally respond to a sports placebo are also likely to have taken performance enhancers. Either way, it suggests that artificial boosted performance and boosted performance from expectation produce similar effects.

“This [whole idea of expectation-based bodily responses] is an evolved mechanism that allows us to capitalize on untapped resources at critical points in our existence,” Beedie says. Belief is belief, so it’s possible that drugs—real or placebo—fill the same space that superstitious baseball pitchers fill by wearing mismatched socks or dirty underwear and the same space filled by Hof and his breathing methods. None of this is to say Hof isn’t incredible. His feats of endurance are astounding and perhaps even scientifically significant, like his ability to control his body temperature so well. But he’s not magic, and we should be careful about trusting important health decisions to any belief-based technique—even one that allows a person to swim under ice.

Perhaps the most interesting question is what can people like Hof really tell us about the effect of our mind on our bodies? Scientists already know that Parkinson’s disease, pain, and depression all respond very well to all kinds of beliefs, whether through special breathing, secret pills, or magic crystals. But could that same belief fuel unprecedented feats of athleticism? Beedie says that, especially for elite athletes, there’s a limit to the benefits of both psychological and pharmacological performance enhancers, so why not just use belief in place of drugs?

“We’re trying to educate athletes into the idea that the headroom is there to be filled, and drugs are not necessarily the only way of filling that headroom,” he says. “Confidence is the drug of champions.”

Erik Vance is the author of the new book Suggestible You. Reporting for this project was supported in part by the Pulitzer Center.