Fascia Myths and Fascia Facts

Have you noticed that the word “fascia” has become somewhat of a buzzword in the yoga world lately? There have been lots of articles written about this newly-appreciated bodily tissue (I myself have written two of them in the past few years!), and fascia has become a focus in many yoga classes - especially those that include rolling on self-massage tools like balls and foam rollers.

I understand this preoccupation with fascia, because it is a truly fascinating topic. Fascia is a type of connective tissue that forms a continuous body-wide web inside of us, surrounding and interpenetrating all of our muscles, bones, organs, nerves, and blood and lymph vessels. In fact, in addition to forming the architecture that weaves our inner structures together, our connective tissue system as a whole also absorbs and transmits force inside of us, working in conjunction with our muscular system to create smooth, efficient movement. Such insights have the power to expand the way we understand movement, which is very exciting!

In addition to these inherently interesting facts, there are other claims commonly made about fascia that are widely-believed, but reach a bit too far ahead of the research to be actually supported. Today I’d like to address a few of these specific claims in an attempt to encourage our yoga community to embrace a more science-based, productive dialog about the popular topic of fascia and the wonderful practices of massage and rolling.

 

MYTH #1: ROLLING ON BALLS AND OTHER MASSAGE TOOLS BREAKS DOWN FASCIAL ADHESIONS, KNOTS, AND SCAR TISSUE

Every massage therapist knows the experience of finding a tight spot in her client’s body, massaging it, and feeling it “release” or “relax” underneath her hands. It seems natural to assume that through her hands, she physically broke down a knot in her client’s fascia - and that through rolling on massage tools, we can do the same to ourselves too.

But one lesser-known fact about fascia is that its collagen fibers are literally as strong as steel. [Ref] To actually “break them up” would require so much force application that one’s body would sustain serious injury - this is not something that is achieved by a massage therapist’s hands or by a pair of massage balls.

Although you may feel a tight spot in your body change its texture after rolling or being massaged, this change was not due to the architecture of the fascia changing. For fascia to actually change its architecture, many, many inputs are required over a long time - collagen takes about three years in order to completely change and remodel. [Ref] Any instantaneous changes in tissue quality that you experience as the result of a massage are not the “breaking down” of adhesions, knots, or scar tissue - they are instead changes in tissue tone that are mediated by the nervous system. [Ref]

Once we understand that soft tissue treatments like massage and rolling work primarily via neurological communication instead of via physically breaking down adhesions, knots, and scar tissue, we might be encouraged to administer these treatments more gently than forcefully. When we roll and massage ourselves with deep, forceful pressure, this can often increase nervous system threat levels and sensitivity, which can be counterproductive to our efforts. Gentler, milder work is often more successful at decreasing threat levels and coaxing the nervous system to relax our tissues.

Massage and rolling on balls are undeniably wonderful, potent tools that help so many of us feel better in our bodies, but when we understand more about the mechanism for why they work, we will naturally be able to use them more wisely.

 

MYTH #2: WE FEEL PAIN IN OUR BODY BECAUSE OUR FASCIA IS FULL OF KNOTS, ADHESIONS, AND SCAR TISSUE

This is a very common belief, but it turns out that it is based on some inaccurate information about how pain works. I’ve written about the science of pain before [here and here], but one of the most foundational aspects of pain is that it is an output from the central nervous system, not an input from the periphery. It’s easy to be confused about this concept because when we feel pain, we feel it in a particular area of our body. It feels like the pain is in our tissues, and it’s our tissues that are therefore causing it. But the pain doesn’t actually reside in our tissues at all - it is 100% an experience that our nervous system has created for us to perceive - most likely to serve as some sort of protective signal.

Because pain is an output and not an input, adhesions, knots, and scar tissues - which are located in the periphery of our body (if they exist at all - but that’s a whole other topic!) - are not actually capable of creating pain. This concept might be tough to grasp, especially because we know that a massage therapist can touch a certain “knotty-feeling” spot on our body and it might feel tender or painful. But the pain you feel there was not created by the knot - it was created by your brain and experienced in that spot. Additionally, we know that we can have other painful-to-the-touch places in our body that do not actually correspond with a “knot” or tight spot that resides there. The flesh in those painful spots instead feels smooth and knot-free. And there are probably quite a few other locations in your body that definitely feel “knotty”-like when palpated, but are not associated with pain at all. [Ref]

As it turns out, pain and tissue quality are separate entities that sometimes overlap, but oftentimes do not. While it's easy to believe that all tight spots underneath our skin are problematic, the truth is that many of them are probably just normal, healthy variations in our tissue texture. And pain, regardless of where it is felt in the body, has less to do with knots, adhesions, and scar tissue, and more to do with a nervous system that has been sensitized around a particular area. This is a helpful, progressive change in perspective because the less that we pathologize the physical feel of "tightness" and "knottiness" in our tissues, the less likely we are to create nocebos for ourselves or our yoga students and massage clients. (A nocebo is a negative expectation of an otherwise harmless event or action that causes negative consequences like pain.)

 

MYTH #3: OUR FASCIA CAN BECOME DEHYDRATED AND ROLLING ON MASSAGE TOOLS HELPS TO RE-HYDRATE IT

This is an absolutely appealing and intuitive idea, but to the best of my knowledge, we don’t have research that supports this claim. Part of the problem lies in a lack of specificity for how this proposed dehydration/rehydration process would work.

An artist's depiction of connective tissue.

An artist's depiction of connective tissue.

In simple terms, our connective tissue is made up of cells, collagen fibers, and a non-living gelatinous matrix called ground substance. When the claim is made that fascia can be dehydrated, I believe the notion is that its ground substance is dehydrated.

It’s unclear to me how it could be determined that someone’s ground substance is dehydrated, however - can you tell by looking at someone from the outside? Maybe by looking at their skin? Can you tell because they feel pain somewhere? (As we mentioned earlier, pain and tissue quality are poorly correlated.)

Even if there was a reliable way to assess fascial dehydration, it is unclear to me how a massage or rolling on balls or other tools would hydrate it. The ground substance of connective tissue definitely has some water content, but how would the pressure from rolling change this water content? (Water that you drink goes through different channels in your body than water in your ground substance, so that's a different type of hydration than fascial hydration.) Does rolling add new water to fascia (how?), or does it move already-existing water from another part of the body to the deydrated one? If rolling did increase water content, wouldn’t everyone’s glutes be extra hydrated and especially healthy because so many of us squash them with pressure by sitting on them for hours every day?

Most of us believe this hydration claim because we heard it from someone knowledgeable like a smart yoga instructor or an experienced bodywork teacher. But if we actually look to connective tissue biology for some factual basis to the claim, we find that there is little support there. It may be true that massage can hydrate our dehydrated fascia, but research has not yet demonstrated this in a clear way. I believe we would do more of a service to our yoga community by waiting to make claims like this until science begins to produce some solid evidence for them.

 

In summary, fascia is an incredibly fascinating tissue of the body for an abundance of reasons. But we will better serve ourselves and our students if we shed some of our language about fascia that implies that it is full of painful adhesions and scar tissue that need to be broken down and hydrated. Additionally, massage therapy and self-massage tools like balls and foam rollers are absolutely wonderful, helpful practices that offer great results for so many people. But when we recognize and teach an awareness of the often-overlooked role that the nervous system plays in many of these massage benefits, we will be able to utilize these tools even more powerfully for ourselves and our students and clients.

 

(If you're interested in exploring these ideas further, you might appreciate this video from Quinn Henoch, Doctor of Physical Therapy:)

[Microblog] A muscle isn't a muscle to your brain

We tend to think of muscles as the individual, isolated structures that we see in our anatomy books - the biceps, the hamstrings, the psoas (or to be super geeky, *psoai* if we're talking about 2 of them), etc. But did you know that this is NOT how your brain understands muscles?

Your brain doesn't actually know what a "psoas" or a "biceps" is. These are arbitrary names that we give to our parts so that we can learn and communicate about them (which is a good thing!) But the brain doesn't think in terms of individual muscles - instead, it perceives and directs *motor units*, which are tiny subsets of individual muscles.

In this sense, we could really think about each muscle as actually being made up of thousands of smaller muscles, which are where movement truly happens in the body.

Whoa man!

[Microblog] Anatomy Geek Stretching Thought of the Day

ANATOMY GEEK THOUGHT OF THE DAY: We often think of a muscle contraction happening only when a muscle *shortens*. But muscles work just as often as they lengthen - picture your hamstrings and the way they lengthen while they work to control your swan dive into uttanasana (standing forward fold) in yoga. When a muscle works as it lengthens, this is called an *eccentric contraction*, and we move this way all the time in our normal human movements.

One of the core rules we tend to learn in our yoga teacher trainings is that after we've "worked" a muscle or muscle group, we should stretch that muscle group to "balance it out". But because muscles can and do actually contract through all of their ranges (short, long, somewhere in between, etc.), is it skillful to consider the opposite of a muscle contraction a *stretch*? Do these two "balance" each other out? If it turned out that they were not necessarily opposing actions, would this change the way you sequence your yoga classes at all?

Enjoy pondering this one, and feel free to let me know how it goes!

Jumping Back To Plank: What's the Big Deal?

All my life in the yoga world, I have heard the instruction that one should never jump back into plank pose. Instead of landing in plank, this core yoga rule goes, we should land directly in chaturanga dandasana - in other words, we should always jump into the bottom of a push-up and never jump into the top of a push-up. The reasons usually cited for this instruction are that jumping back into plank is injurious for any number of body parts including the wrists, shoulders, low back, knees, ankles, and big toes.

I used to believe and teach this yoga rule as well, but in more recent times I have changed my perspective on the issue. I don't think that there is anything inherently wrong with jumping back into plank pose, and I think the widespread prohibition of this movement mostly serves to create some unnecessary fear and worry about our yoga practice.

Here are my main reasons for this viewpoint - I hope you use them to examine your beliefs and then come to your own conclusion about the "never jump to plank" rule!
 

Reason #1: You can certainly injure yourself jumping into plank, but...

I definitely agree that it's possible to injure oneself while jumping into plank pose. If you lack the ability to engage through your core, press strongly through your arms, and land lightly, some areas of your body may experience a higher-than-optimal level of stress, which could lead to injury. But I fail to see how this is different from so many other movements in yoga that can also be injurious if one lacks proper technique and body awareness - yet we don't make blanket statements about the importance of "never" doing most of these other movements.

If we jump back to plank with no arms, will this protect our shoulders? :)

If we jump back to plank with no arms, will this protect our shoulders? :)

One yoga transition that stands out to me as especially risky for the body if one lacks the proper strength and control is, ironically, jumping straight into chaturanga. Even though chaturanga is traditionally considered the safer asana to jump into, this pose is actually much more challenging to execute skillfully than plank pose. Chaturanga involves much higher loads to the neck, shoulders, and spine than plank pose does, and these loads are significantly higher if we jump into the pose (especially if we slam down with a lot of velocity like many yogis do) instead of lower slowly into it. In fact, so many yoga students lack the foundational skills to practice chaturanga well that I created a whole online tutorial on how to approach this pose with integrity.

I would suggest that contrary to popular teachings, one is at greater risk of injury from performing a sloppy jump-back into chaturanga than they are from performing a sloppy jump-back into plank pose.

 

Reason #2: Jumping Into Plank Is Commonly Practiced In Other Movement Systems Without Concern Or Widespread Injury

The "burpee", a common warm-up exercise that includes a jump-back to plank.

The "burpee", a common warm-up exercise that includes a jump-back to plank.

If you ever visit a gym or other fitness setting, a common movement used for warming up that you'd likely see is something called a burpee. (Yes, I agree that this is an odd name for an exercise, but a fun trivia note is that the burpee is named after the person who founded it - a physiologist named Royal H. Burpee.)

To perform a burpee, one begins in a standing position, lowers down into a squat, jumps back into plank pose with straight arms, often performs one push-up, jumps forward again into a squat, and then jumps up and lands back in a standing position. A typical "set" of burpees is anywhere from 10-15 done in a row, and people typically perform at least 3 sets (and often many more) in one workout. In addition to this classic exercise, there are many variations, such as the one-leg burpee, in which one jumps back into a one-legged plank instead of a traditional plank, the side burpee, in which one jumps into a variation of side plank, and the one-arm burpee, in which the entire movement is performed with one arm lifted.

In addition, multiple research studies have been done by exercise scientists which include the burpee as a movement alongside other classic fitness exercises. (Examples here and here.)

The fact that the burpee, which involves jumping back into plank pose repetitively, is so prevalent in the fitness world and is also included in research studies suggests to me that it has not been found by fitness professionals or sports scientists to be particularly injurious for the body.

 

Reason #3: Jumping Into Plank Could Actually Have Some Benefits

To be honest, even though I don't believe that jumping into plank pose is inherently dangerous, I don't tend to teach this movement very often in my yoga classes. But I do believe that jumping into plank (and chaturanga for that matter) could have some benefits for the body that we often overlook when we focus on fear and worry about this transition instead.

There is a type of fitness training called plyometrics which utilizes jumping exercises to increase a person's power, or the speed at which they can use their strength during a task. Plyometrics are also known to enhance one's endurance and agility, and several studies have actually shown that they can increase bone density (examples here, here, and here).

There is some debate about whether a burpee (a.k.a. the fitness world's version of "jumping into plank") can technically be considered a plyometric exercise. But I believe there is enough crossover between the two to suggest that they would offer some similar benefits.

An example of a plyometric exercise.

An example of a plyometric exercise.

Additionally, we know that movement variability is important for neural learning, tissue health, and overall graceful aging, so the argument could be made that learning how to jump back skillfully into both plank and chaturanga - and not just one or the other - could be beneficial.

 

Reason #4: There Are No Inherently Bad Movements

You might recall a controversial blog post I wrote earlier this year called Are Some Movements Inherently Bad? (also re-published in Yoga International with a far more angry comment thread here.) In this post, I argued that instead of looking at a movement as inherently bad and damaging for the body, we should reverse our reasoning and instead look at an individual body and ask if it is adapted and prepared to handle the loads of that particular movement.

For example, a beginning yoga student with an office-working, sedentary lifestyle who has never borne weight on her arms might be prone to injury if she tries jumping into plank (and even more so if she tries jumping into chaturanga - yikes!) But because the biological reality of our bodies is that they adapt to become stronger to the loads they experience on a regular basis, most practiced yogis who have a good sense of body control and core stabilization should be able to jump lightly into plank pose without causing injury.

 

CONCLUSION

To be clear, I'm certainly not suggesting that all yoga teachers run out and start teaching everyone to jump into plank during every vinyasa. I'm simply questioning the reasoning behind the ubiquitous "never jump into plank" warning that nearly every yoga teacher learns in their yoga teacher training. Is this transition necessarily dangerous for everyone, and is jumping into chaturanga somehow innately safer? Where do these beliefs stem from? I believe that questioning our biases about these transitions can help us to become more critically-thinking yoga teachers who can serve our individual students better.

4 Basic Pain Science Concepts For Yoga Teachers, Part 1

I recently created a series of social media posts designed to help yoga teachers become better-informed about the complex topic of pain science. Pain science is growing in its reach in the therapeutic, fitness, and movement world, and even though yoga teachers generally don't treat people for pain (unless you're also a physical therapist or other health care professional in addition to being a yoga teacher), pain science actually has many important implications for us beyond the subject of pain itself. As yoga teachers, if we take the time to learn about even a handful of some of pain science's most fundamental insights, we'll be rewarded with a more current and accurate paradigm for approaching and dialoguing about not only pain, but movement, yoga, and bodies in general.

Here is a re-cap of the series of four posts that I shared through my social media channels so that they can be read all in one place together, and I'll follow up with Part 2 of this blog post series with some additional, new thoughts on how and why all of this might matter specifically to us as yoga teachers. I hope you enjoy perusing this info - feel free to share with your networks if you feel that it would be beneficial!


PAIN SCIENCE FACT #1: Pain and tissue damage do not always correlate. In fact, when it comes to persistent pain (often defined as pain lasting more than 3 months), the link between pain and tissue damage is often significantly weaker. (And yes, if you experience a pain that "comes and goes" versus a constant, steady pain that is always there, that is still considered persistent pain if it's been going on for longer than 3 months.)

Reason this is important: just because someone experiences pain somewhere in their body, this does not necessarily mean that there is *actual injured tissue* inside of their body. It might mean that, but it also really might not. (Remember, this is more likely the case when we're talking about persistent pain - not so much with acute pain. Acute pain is the direct result of a recent injury - like stubbing your toe on the door jam or spraining your ankle due to an accidental fall. Acute pain usually lessens and then stops once the injury has healed. Persistent pain, on the other hand, is also often also called chronic pain and is pain that lasts for a longer amount of time.)


PAIN SCIENCE FACT #2: Pain is an output of the brain. This is an often-cited pain science insight - but what does it actually mean? Remember that pain science involves a major perspective shift in how we see the body, so we really have to wrap our minds around some new concepts here. Typically, when we experience pain, we tend to think of the pain as being located "in our tissues", and our brain then senses it there and THEN we feel it. In this view, pain is an INPUT to the brain because it first exists "out there" in the periphery of our body, and then we sense it centrally (in our brain).

As intuitive as this "input" idea seems, it's actually the opposite of how pain really works! In reality, there is no pain *anywhere* in our tissues that is inputted to our brain. Instead, pain is a creation OF the brain that is meant to signal us to take protective action against a perceived threat. If you feel pain in your shoulder, for example, it's because your brain is *outputting* a warning signal to you about that area for some reason. Pain is therefore not an input from your tissues to your brain - it's an output from your brain to your tissues! How mind-trippy is that?

Now your brain might be correct that this painful area is under threat (especially if you recently injured that spot - too many sloppy chaturangas, anyone? Heh heh...) But your brain might also be wrong in its conclusion that the area is under threat - especially if there is no recent tissue damage there. And pain without tissue damage (and vice versa - tissue damage without pain) happens ALL. THE. TIME. Refer back to Pain Science Fact #1 to review this concept, and then see if you can put Fact #1 and #2 together to start to build your new pain science-informed paradigm.


PAIN SCIENCE FACT #3: We've already covered (in a very simplified way) the fact that pain is an output FROM the brain, not an input TO the brain. Pain doesn't exist in one's tissues to be sensed by the brain - it is instead a creation OF the brain to be sensed in one's tissues. But why and when does the brain choose to create pain?

We used to believe that all pain experienced in the body was the result of tissue damage somewhere inside of us - in other words, we thought pain was always the result of some structural problem. But we now understand that tissue damage is just *one input* that the brain considers when deciding whether to emit a pain signal. In addition to tissue damage, the brain considers inputs like past memories, emotions, expectations, beliefs, one's environment, things that health professionals say, and more when deciding whether to output a pain experience in any given moment. All of this information processing happens unconsciously, and in just a fraction of a second.

Now that you know this, think about someone who experiences a persistent pain in their low back (like 80% of us will at some point in our lifetimes). Here is a list of common reasons given when someone has back pain: your spine is out of alignment, you have a herniated disc in your spine, you have poor posture, you flex your lumbar spine too much, your SI joint is dysfunctional, you sit in a chair too much, you have SI joint instability, your core is weak, you have a vertebral subluxation, you lack core stability, your back muscles are tight, etc., etc.

This is a really long list of commonly-cited reasons for back pain, but the interesting thing is that they are ALL structural reasons - meaning that they all have to do with the physical structure of the body. But remember our new Fact #3 from today: the brain takes MANY inputs into consideration before deciding to output pain, and structural inputs are just ONE category of inputs. Combine Fact #3 with Fact #1 (the link between persistent pain and tissue damage is often quite weak), and your paradigm for how you think about someone's back pain might begin to shift and expand.


PAIN SCIENCE FACT #4: We often believe that our body is naturally vulnerable in certain movements or postures, like lumbar flexion, forward head posture ("text neck"), etc. We believe that these positions will injure our tissues and create pain, often blaming someone's low back or neck pain on these "bad postures".

What this viewpoint (that I used to share too!) overlooks is the fact that the tissues of our body are adaptable and become stronger when they are loaded (as long as the load isn't too high). Any movement that you desire to do is a "good" movement as long as your tissues are adapted to withstand its loads. (This is a super oversimplified explanation, but for more info, check out my blog post Are Some Movements Inherently Bad? (which was also re-printed in Yoga International).

Additionally, recall Fact #3 of this series - *many* inputs contribute to pain, not just structural ones. Recent research has strongly suggested that our *beliefs* about pain can directly influence our pain. For example, if we believe that a certain movement is bad for us, this can create what's called a nocebo - the creation or increase of pain or dysfunction based solely on negative expectations and beliefs.

BIG TAKEAWAY: The issue isn't that we need to *avoid* certain "bad" postures and catastrophize them - it's more that we want to move our body in a *wide variety of ways* so that we can be strong and adapted to many different positions. Movement variability is more important than fear of movement!


That concludes the series of posts that I shared through social media, but keep your eyes out for Part 2 of this series, which will attempt to address why all of this matters specifically to us yoga teachers. In the meantime, I also wrote a helpful introduction to pain science in Yoga International earlier this year (see "Yoga & The New Science of Pain"), and at the bottom of that article I included a lengthy list of links for further reading for those interested. Enjoy exploring this topic further if you feel so compelled!

Three Alternatives to Pigeon Pose & A Brief Discussion About Stretching

I know I might be in the minority amongst yoga teachers, but even though yoga students tend to looove their pigeon pose, I have consciously chosen to forgo this pose in my classes for the past several years now. While I do teach variations of pigeon pose like reclined pigeon and standing pigeon chair, I don't generally teach the traditional version of this pose in which you lie in a passive, unsupported forward fold over the front leg.

 

WHY I SKIP PIGEON POSE - REASON #1

I have two main reasons for skipping pigeon pose in my classes. The first is that it doesn't offer much in the way of positive change for the tissues of the body. We generally tend to think of pigeon pose as a stretch designed to increase the flexibility of the hips. But we've actually learned quite a bit more from scientific research in recent years about how stretching works (although there is still a ton that we don't know!), and thanks to my brilliant mentor Jules Mitchell, much of this new information is making its way to the yoga community.

One of the biggest realizations that I've learned about stretching is that flexibility is a much more complex topic than we've generally learned from our yoga teacher trainings, workshops, books, and other studies. The prevailing approach to flexibility in most yoga classes (and in much of the health/fitness world in general) is that if someone lacks range of motion in a joint, the solution is to stretch the muscles and fascia that cross the joint to lengthen them out. Then we get longer tissues and voila! - we can stretch further in that direction. By this reasoning, the solution to the ubiquitous "tight hips" that many people claim to have is to simply stretch one's hips out in pigeon pose for a long time at the end of every yoga class - a practice that we yogis are quite familiar with!

But the assumption that in order to solve all inflexibility issues, tissues simply need to be stretched out does not take into account the many other likely factors that could be causing the inflexibility - factors that passive stretching does not actually address. It reminds me of pain science and how easy it is to attribute pain simply to structural factors like tissue damage, poor alignment, or dysfunctional movement patterns, when the bigger picture of pain is truly so much more complex than this. The brain's decision to output a pain experience is multifactorial and completely unique to each individual - and in the case of persistent pain, is actually rarely due to a single structural reason like tissue damage.

Similarly, if someone experiences what they would call "tight" hips ("tight" of course being a vague, subjective word with no single definition for all bodies), the possible reasons for this tightness are many and varied, from a restriction in the capsule of the joint itself (which would not be addressed by passive stretching) to issues in how the brain is coordinating muscle activity (more of a motor control/neuromotor issue that is also not solved by passive stretching). Therefore, when we as a yoga community assume that the solution to all inflexibility issues is to stretch our tissues out in poses like pigeon pose, we are missing a much larger picture of how flexibility, performance, and joint function works.

This image of pigeon pose that I found online makes me feel weird. :)

This image of pigeon pose that I found online makes me feel weird. :)

WHY I SKIP PIGEON POSE - REASON #2

With all of that said, this isn't the only reason that I choose to skip pigeon pose in my classes. Even though passive stretching is not the universal solution to inflexibility issues that we yogis tend to believe it is, it still has some nice benefits, and I certainly include some passive poses in my classes. But pigeon pose also happens to incorporate some precarious joint positioning for the front knee and hip with the added weight of the torso and upper body lying on top of them, which isn't necessarily beneficial for these joints. Although there are ways to modify the pose to support these joints in a healthy way, these options are rarely offered or taught in detail in most yoga classes. And even if they were, most yoga studios don't have enough props to support every student the way they would need to be set up for optimal loading of the front knee and hip.
 

THREE ALTERNATIVES TO PIGEON POSE

And so, without further ado, I present to you... three alternatives to pigeon pose! These are three excellent ways that a pose like pigeon pose can be practiced, but with the added benefit of positive change for the tissues of the hip and a more efficient path toward increased flexibility. You'll notice that all three examples incorporate some degree of muscle activation (versus assuming the poses passively). This is because research has suggested that strengthening muscles through their full range will result in more flexibility gains faster than passive stretching alone. This is likely because when we actively contract our muscles during a stretch, this signals our nervous system that this range of motion is safe, and our nervous system will therefore be more likely to allow more range of motion in the future. Additionally, when we contract our muscles during a stretch, we load our connective tissues via muscular force, which increases their load-bearing capacity (i.e. their strength) over time. Strong connective tissues equals strong, efficient movement, functional joints, and decreased risk of injuries in the future.

Consider offering these options as an alternative to traditional pigeon pose in your yoga classes, or if you find yourself in a yoga class in which pigeon pose is taught, consider trying one of these "pigeon-ish" poses instead. (Just for the record, I don't think pigeon is an absolutely terrible pose, and I would certainly not "judge" a yoga teacher for including it in their class - pigeon is extremely ubiquitous in our yoga community and it sometimes feels like our students almost expect it. But once you learn a bit more about current stretching science and the connection between strength and flexibility, you might be inspired to change up what you offer to reflect these new understandings.)

If you decide to experiment with these pigeon alternatives, notice how it feels to strengthen your hips instead of passively stretch them in this classic pose, and enjoy the benefits that these new movements offer to your body and mind! (Also be sure to check out the further reading resources listed below these videos...)

 
 
 

Further Reading & Exploration

Blog Post: Resistance Stretching with Charlie Reid & Jules Mitchell

Related Online Workshop by Jenni: Re-Imagining Hip Openers: A Yoga Anatomy Workshop

Related Online Class by Jenni: Hips-Focused Practice #2

Related Blog Post by Jenni: Stretching Is In Your Brain: A New Paradigm of Flexibility & Yoga

Can A Simple Sitting Test Predict Your Mortality? I Have My Doubts!

You may have heard about the Sitting-Rising Test for Mortality. This test is said to predict your mortality based on how well you perform the task of sitting down onto the floor and rising back up to standing. I’ve seen news articles and video segments about this test passed around an abundance of times on social media with headlines like “Simple Sitting Test Predicts How Long You’ll Live” and “The Exercise That Predicts Your DEATH”. (Scary!)

Now I am definitely a proponent of the importance of skill in functional movements like sitting and rising from the floor, and I teach yoga and movement with this as a guiding principle. But I was curious about the bold claims and dire warnings I was seeing associated with this sitting-rising test, and I also didn’t love the idea of someone scoring a point or two below perfect on the test and then worrying that certain death was nearly upon them. I decided to examine the original research study on the sitting-rising test to find out what the researchers actually did and what their results truly suggested. I discovered that the research does show that this test can be a helpful assessment tool for a small percentage of the population (namely elderly people), but that the study’s results have been largely misinterpreted by news articles and the health and fitness world in general.

 

WHAT IS THE SITTING-RISING TEST?

For those not familiar with the sitting-rising test, it’s very simple to perform. From standing, lower yourself into a seat on the floor and then rise back up again to standing, using the minimum amount of support that you can (i.e. try not to use your hands or knees to help you.) You’re awarded 5 points if you can sit down without support and 5 more points if you can stand without support for a total possible score of 10. For each hand, knee, or other form of support that you use on the way down and up, 1 point is deducted from your score.

According to the study, lower sitting-rising scores were associated with higher mortality among its subjects. This seems quite suggestive on the surface, but let’s examine a few details about the study that are often overlooked in news and media reports.

 

1) The title of the study, “Ability to sit and rise from the floor as a predictor of all-cause mortality”, is very easy to misinterpret. To most of us, the term “all-cause mortality” is foreboding and seems to suggest that if you score lower on the test, you have an increased risk of dying from all possible causes - i.e. cancer, heart disease, stroke, diabetes, etc. How worrisome indeed! But what this term truly means is that the researchers did not control for type of mortality in their study because they did not know how their subjects died. This is actually the exact opposite of the way that most readers would interpret the meaning of the title.

Because the study did not control for type of mortality, and because the sitting-rising test assesses musculoskeletal health qualities like balance and strength, the most likely explanation for the deaths reported was that they were from falls. Therefore a lower score on the sitting-rising test probably does not suggest that you might die sooner from cancer, heart disease, diabetes, or a host of other frightening possibilities. A lower score instead probably simply suggests that you lack balance and strength skills, which indicates that you’re more likely to take a fall. We know that falls are an unfortunately common cause of death among older populations, which leads us right into the next point:
 

2) The majority of people who received low scores on the sitting-rising test were between the ages of 76-80. And the study itself also only looked at people between the ages of 51-80. This means that the sitting-rising test was most meaningful for elderly people (and again, this could be explained in large part because of the high incidence of falling as a cause of death among the elderly.) This also means that despite news reports that this “simple test predicts how long you’ll live”, if you are younger than 51 years of age, the results of this study do not actually apply to you.
 

3) The study showed no difference in mortality between those who scored an 8, 9, and a 10 on the test. This means that if you use one hand for support on the way down to your seat and one hand on the way back up (a score of 8), your mortality risk is no different from someone who uses no support at all and scores a perfect 10. This seems counterintuitive and is not the way the sitting-rising test is generally presented to us in the health and fitness world. We are usually told that using one or two hands and knees is significantly worse than using no hands or knees at all. But this is a misinterpretation of what the study found.
 

4) The magnitude of the effect becomes most worrisome at scores lower than 6 (using 5 or more hands and knees), and is largest with a score of 3 or less (7 or more hands and knees). And because the majority of people who received these low scores were elderly, the effect is really much more relevant for this age demographic (and is likely explained by falls.) This isn’t to say that this test is meaningless for people in their early 50’s. But in all likelihood, if a 51-year old has to use 7 or more hands and knees to lower to the floor and rise back up (just picture for a moment what that would like), this is probably indicative of obesity or some other fairly obvious health factor that is impeding their function and affecting their mortality that this study did not control for. (While the researchers did control for body mass index, this is not the same as controlling for obesity.)

 

In conclusion, I definitely believe there is value in learning to sit and stand with as little support as possible, and I do teach this skill in my yoga and movement classes. But unless better research comes out in the future, I would hesitate to suggest based on this study that people should assess their own mortality by using the “sitting-rising test”. I believe that doing so could cultivate unnecessary fear, stress, and discouragement in people who don’t score a perfect 10, and it could also encourage a false sense of security in people who do. This test appears to be statistically significant for elderly people only, and even then, the mortality likelihood predicted could be driven entirely by falls. The “sitting-rising” test is probably best utilized by medical doctors as a general screening tool for their patients in combination with other routine health assessments like measuring blood pressure and taking pulses.

Super Cool Anatomy Fact #53

 

(This is a little factoid that I shared on my yoga FB page, and I thought I'd also share it here on my blog because it's a pretty important concept for yoga teachers to understand. It's not a full blog post like my usual ones, but I have some more of those coming soon. :) )

SUPER COOL ANATOMY FACT #53: You probably know that your muscles move you around, but did you know that your connective tissue plays an important role in moving you around too? It's harder to picture because we know that our connective tissue doesn't actively contract like our muscles do. But our connective tissue actually stores what's called *potential energy* when it lengthens.

Think about this frog here. When this frog decides to jump, it first moves into a crouch, which stretches its tendons & other connective tissues, loading them with potential energy. When the frog releases this position, it certainly uses its *muscles* to propel itself forward, but its jump is hugely enhanced by the stored potential energy that was loaded into its connective tissues. It would never jump as impressively far if it didn't have its spring-like connective tissue to propel it much further than its brute muscle force alone could.

We humans rely on properties like this when we move too. It's therefore important to keep our connective tissue healthy for optimal energy storage and force transmission. One great way to cultivate healthy connective tissue is to integrate active stretching into your yoga/movement practice. When we strength-train our tissues at all ranges, we signal our connective tissue to grow stronger and stiffer ("stiff" being a good thing when we're talking about connective tissue!) We don't create healthy, efficient tissues by pulling on them and trying to make them longer - we create strength and resiliency in our tissues by making them stronger at all ranges.

Try thinking less about "length" and more about strength and efficiency in your yoga/movement practice and see if your flexibility magically improves anyway! My new hamstrings-focused online yoga practice is a great place to start if these ideas are newer to you. :)