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What Doctors Don't Tell You

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September 2019 (Vol. 4 Issue 7)

Gentle exercises to de-stress and improve heart health

About the author: 
Charlotte Watts

Gentle exercises to de-stress and improve heart health image

We inherently know that 'putting our feet up' is good for us, but putting all of ourselves up can have even greater benefit for heart health and de-stressing, says Charlotte Watts.

Many people associate inversions with the acrobatics of handstands, shoulderstands and headstands common in yoga. But while these more dynamic postures have their benefits, just reversing our usual relationship with gravity so that we don't have to hold up our body weight can offer a soothing and releasing mind-body effect.

Placing the hips above the head aids the lymphatic flow that is so important for immune function and detoxification. This fluid system runs throughout the whole body alongside the bloodstream. But unlike blood circulation, the lymph system does not have a pump like the heart.

Instead, it relies entirely on motor activity in order to flow. Elevating the legs allows fluids that can easily pool into the legs to travel back up the body via gravity, supporting circulation and heart health along the way.

Positions where we are fully supported are often called restorative postures within yoga. They don't just offer renewal and recovery; 'restorative' is a specific practice where props can be used to allow full rest. Many restorative positions are not inverted, but those that are offer even more calming for the heart and nervous system.

These practices are well documented to reduce the stress hormone cortisol, which speeds up the heart rate during moments of fight-or-flight stress.1 They promote a sense of wellbeing and equanimity and invite the slow, deep breathing that brings down high blood pressure and regulates heartbeat.2

These are mindful practices, where we can focus on the sensory experience of the present moment, without expectation or imposition. We are not looking to feel a stretch, but simply to practice attention on the present moment, without judging whether we like or dislike it or attaching to inner chatter.

Research has shown that mindful practices may enhance parasympathetic influences on the heart rate, allowing us to come to calmer states and increasing our ability to adapt to stressful situations.3

The reclining and inverted postures included here are also known to support the baroreflex,4 the body's mechanism for keeping blood pressure stable, which is required for self-soothing. Standing upright inhibits this by exciting the system and raising the blood pressure.

Supported inversions encourage healthy circulation because the heart is below the hips (and sometimes also the legs), where less pumping is needed to bring blood up from the lower body, as gravity allows this effect without effort.

Inversions also allow organs (the heart, reproductive and digestive organs) to drop and shift the position of the ligamentous sheathing holding them in place. This creates movement in and around the organs and their fascia (connective tissues). When organs pull on the sheaths, the resulting subtle sensations draw us into our inner world, creating interoception—how we sense and make sense of our internal landscape.5

New research has suggested that anxiety, depression and irritable bowel syndrome (IBS) are 'interoceptive disorders,' a signal-processing problem where interoception is increased and can seem noisy and overwhelming.6 These states are also correlated with cardiovascular issues.7

This processing is amplified by a racing mind, which can so often accompany stress states where blood pressure and heart rate are elevated. This phenomenon is more obvious in anxiety and IBS, but there is also a stress component to depressive states, in which rumination and difficulty relaxing are very common.

In such states, it is not the interoceptive signaling itself that is the issue, but rather the belief states of the individual, which color the information received. The brain can panic when it cannot clearly sense the internal state of the body, leaving the person feeling unsafe and setting off the chronic stress associated with heart disease.8

Inversions can encourage the refinement of the interoceptive system, helping us develop the embodied awareness that slows down the heart rate. When we also add in the mindful component of such poses, there is great scope to use them for soothing and reducing the negative effects of stress.

Although they're perfect for 'coming down' from anxiety or agitation, restorative positions are more challenging than stronger physical practices as they ask us to stay present without the distraction of things to do or strong bodily sensations. Focusing on the present moment's experience of the breath (mindfulness of breathing) can help to gather our attention to a sense of our body in the here and now.

This helps us feel safety, a state that slows down the heart rate,9 and using the simple guide of observing the inhale up the spine, exhale down the spine can always bring us back from mind chatter.

You can choose several of the poses here for a soothing, meditative practice on their own, or just pick one whenever you need or at the end of a more active yoga, Pilates or exercise session to cool down body and mind. You can stay in one or more of these positions for five minutes or more, depending on how you feel, listening for your body's cues to come gently out of them by lying on your side for a minute or so.

Legs up the wall sequence

Simply lying with legs supported up a wall is highly soothing, but adding in the element of hips raised above the heart adds in two aspects that support cardiovascular health and other body systems. There is a backbend effect to support slower natural breath patterns, where the chest can fully open and the diaphragm, which can get collapsed with hunching or stress, can move freely. And when space is created at the base of the skull, it soothes the body via the vagus nerve, which begins there and signals that the entire mind-body can relax.

1) With a bolster or folded blankets against a wall (leaving a 2- to 3-inch gap for your tailbone), bring your right hip up onto the right side of the bolster and swing your legs up. Shimmy on if need be, to position all of your lower back onto the lift with the tailbone just over the edge. For tight hamstrings, move the bolster farther from the wall. Settle into the weight of the legs, with arms positioned wherever the shoulders can most easily drop and rest.

2) Taking the legs wide in an inversion helps relieve stress on the pelvic floor, which can stay stuck in protective contraction up to the spine and mouth. The pelvic floor, tongue, palate and upper throat can all stay contracted, holding us in stress patterns. Widening and inverting the pelvic floor signals permission for this whole channel to release.

3) Drawing the knees into the chest then draws the tailbone under to create gentle length in the lower back and the safety of the fetal position.

4) Moving into a forward bend inversion supports the lower back, so we can gauge the level of leg extension the whole back body is ready for. Opening the hamstrings with conscious breath helps create vagal tone, our ability to self-soothe via the vagus nerve—stress often comes with tightness there.

Come back through the sequence before rolling off onto your side and laying for a while in a fetal position, feeling fully supported by the ground.

Supported bridge pose

This pose is a simple way of letting gravity help the heart rate slow down—from the knees to the head. From lying with the knees bent, walk the feet in toward your bottom, raise the heels enough to lift the pelvis, and slide a bolster (or firm cushion) underneath. Bring the heels back down slowly, and find the foot position where you feel grounded through all four corners, allowing release through the lower back, belly and inner thighs. Spend some moments finding the most comfortable arm, shoulder and neck position to be able to soften the space between the back teeth and around the eyes, from where safety and calm are signaled to the whole body.

Forward bend on chair

This is one of the simplest inversions you can do at any time, for instance, if you feel stressed or overwhelmed at a desk. Sitting to the front of the seat of your chair with your feet wide apart (legs open at about a 90° angle), drop your torso between your thighs to a point that feels comfortable and safe. You may need to place your hands on something (yoga blocks or books) to raise the height or start with elbows resting on your thighs.

Shoulderstand with chair

This is the most active of the postures here, but it's still soothing to the heart and a great alternative to a shoulderstand in yoga—the angle on the neck is less intense, and we are not supporting the whole weight of the body. The head and neck positioning soften the musculature around the neck and upper back, which tend to become hypertonic with stress, where we breathe up into the chest and shoulders, rather than more restfully into the belly and diaphragm.

Start with the bottom on the ground, close enough to the chair to hold onto its front legs. Bring the heels onto the very front of the seat and, keeping them hip-width apart, lift up the pelvis on an inhale, opening the chest. Soften the face and jaw, opening your heart with soft breath, rolling down to rest with calves on the chair seat when your body signals. It may feel right to come up and down a few times, as you will stay lifted for less time than in a full support.

Simple lying inversions

Within the yoga system, corpse pose or savasana is always recommended to practice at the end of a session. This is the place where the previous moving practice (however strong or soft) can be assimilated into body tissues, and we come back down to a cooling state.

Whether you are a yoga practitioner or not, this is a highly balancing habit, which can always be practiced as a simple alternative to a meditation position if you are tired.

Any supine (lying) position relieves muscle tension and therefore slows the heart rate—we don't need to hold ourselves up, and neural activity is reduced.

For those with lower back issues, lying with legs raised above the hips may be more restful. You can remain in one of the following positions for up to 20 minutes, where you can also listen to a calming practice such as a body scan or other mindfulness meditation.

1) Legs raised onto a chair (also the position to come down to after the shoulderstand variation above).

2) Legs lifted over three bolsters or cushions supporting a large tightly rolled towel under the knees.

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