Frozen Shoulder, Part 2

by Baxter

Anatomical Studies of the Shoulder by Leonardo da Vinci

For those of you out there who might have missed Nina�s original post on frozen shoulder from a while back (see Yoga and Menopause: Frozen Shoulder), I�d highly recommend it. And while Nina rightly points out a correlation between menopause and adhesive capsulitis (that�s its fancy name), it turns out that men fall victim to this conditions as well. In fact, I developed a case of it in my left shoulder over the fall and early winter months of 2015-16!

Some interesting statistics on and features of frozen shoulder: 

• It usually affects those over 40 years of age, with the peak period being between 40-70 year of age. 
• 70% of cases are women and 30 percent are men. 
• The jury is still out on what causes frozen shoulder. Although there is a connection between menopausal changes in women and the development of frozen shoulder, the other leading contenders are that it is an inflammation problem, an autoimmune problem, or simply a stiffening of the joint capsule problem (a process called fibrosis). 
• Since it does not always show up in isolation, it can be accompanied by other causes of shoulder pain, such as bursitis or rotator cuff injuries, making diagnosis and treatment tricky. 
• According to the Mayo Clinic, you are at higher risk of getting it if you have diabetes, heart disease, Parkinson�s disease, thyroid conditions, or a recent trauma that immobilizes your arm such a fracture or stroke.

When I started getting pain and limited range of motion in my left shoulder and arm last fall, I was not sure what was going on. It came on gradually and I did not have any of the risk factors I had read about, but I had tweaked my shoulder 15 years ago while climbing and had some chronic stiffness that my yoga usually worked out nicely. And then there were two events in September. First, I was swinging on a low trapeze bar for about two minutes, after which I noticed that my shoulder was not so happy with me. And, second, two weeks later I took a trip to an indoor sky-diving place, where a total of four minutes in the wind tunnel with the arms in bird-wing position made my shoulder even more unhappy. I recently came across research that connects direct or indirect trauma to the shoulder joint as a common cause of secondary frozen shoulder, which could explain my case.

When I finally got into to see the orthopedic specialist in late January of this year, initially I was offered a couple of steroid injections to cover both rotator cuff injury and frozen shoulder. At that point I asked for an MRI, since my physical exam could not confirm either diagnosis (it�s good to keep in mind that history and exam don�t always tell you what is going on for sure). And the MRI showed a healthy rotator cuff and definite frozen shoulder, so I only really needed one injection! That very same day, I got into to see an amazing physical therapist, who gave me a set of exercises to begin immediately. From a Yoga for Healthy Aging perspective, I was delighted to discover that some of the exercises were dynamic movements (similar to Arms Overhead Pose), done in sets of 10 repetitions, and others were static movements, held between 2-5 minutes. When I asked about the longer holds, my physical therapist mentioned that the joint capsule, made up of thick connective tissue, requires longer holds to loosen, similar to the timing we�ve discussed for stretching fascia here on the blog.

Now, I had read the studies that the average time for recovery of range of motion was 1-2 years and that really did not fit into my plans, so I asked the physical therapist if he had ever had a patient who recovered faster. He said, yes, one person who had actually taken his advice to do the physical therapist exercises hourly during the day had seen a rapid recovery in just a few weeks! (He pointed out that most patients only do them infrequently.) That was all the incentive I needed, and I started my practice immediately that day. After all, abhyasa (yogic practice) is not all that different (see Practice)!

One of the challenges of rehabbing frozen shoulder is that you actually have to move into far enough into stretch that it is painful. This is in contrast to physical therapy for rotator cuff injuries, where you would not go to the point of pain. I found that my ability to focus on my breath while holding painful stretches for 2-5 minutes was invaluable in staying the course without over triggering my sympathetic nervous system. And although I did not do them every hour, I often got 3-4 sessions in every day for the next few months. By April, my pain-free range of motion in that left shoulder was back to normal, and my physical therapist bid me farewell, with the important reminder to keep an eye on my right shoulder, as 25% of those with frozen shoulder will get a case of it showing up in the opposite shoulder in the 2 years that follow (Nina had this happen).

My takeaways:

1. If stiffness and pain persist in your shoulder, get it checked out by a specialist to get a solid diagnosis.
2. Try to see the best physical therapist you can in your community�it can make a difference.
3. Apply your yogic practice skills and your yoga tools to your rehab. (I was doing all the yoga poses I could do, although with left arm modified, along with my physical therapy exercises, and I believe it helped!).

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Staying Upright: About Our Postural Reflexes, Balance, and Yoga

by Baxter

Playing at Giants by Francisco Goya

In the course of researching agility and balance, I came upon the mention of �postural reflexes.� We humans have a lot of reflexes, so I was not exactly sure what these reflexes were. But I began to do some digging. 

It turns out that you have a couple of reflexes that automatically correct the orientation of your body when it shifts from being up upright. They kick into action when unexpected events throw you off balance so your body can prevent you from falling by quickly attempting to self-correct. Imagine turning and suddenly almost (or actually) bumping into someone, walking down a slick ramp and suddenly slipping a bit, or reaching that darn crack in the side walk that trips you up. They also kick into action during everyday balancing activities, such as when you are standing on a chair in the kitchen trying to reach into the upper shelf or when you are walking on the raised edge of a curb just for the fun of it. 

Our postural reflexes start to develop when we are infants starting to sit up, advance when we are toddlers learning to walk, and continue to be refined through adolescence into young adulthood. In the early days staying upright requires a lot of conscious effort, but with time and practice, our coordinated, muscular responses to being off balance or anticipating loss of balance become more subconscious and reflexive.

These postural responses that keep you upright (or try to!) are a result of information sent to your brain from your inner ears and eyes, the pressure sensors on your feet, and your proprioceptors (the nerves that tell you where you are space). As we age, our postural reflexes may slow down due to age-related changes in one or more of the components of this complex system.

However, in studies of older stroke victims who initially show a decrease in postural reflexes after their stroke there is evidence that practicing agility exercises helps them regain some of their lost function. So although there have been no specific studies of on yoga and postural reflexes, it�s likely that practicing a variety of yoga poses to improve strength, flexibility, balance, and agility would help you maintain and/or improve your postural reflexes. For maintaining postural reflexes, I would particularly recommend strength building practices, as well as balance and agility practices, both static and dynamic variations. 

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How We Age

by Baxter and Nina

"And you may find yourself

Behind the wheel of a large automobile

And you may find yourself in a beautiful house

With a beautiful wife

And you may ask yourself, well

How did I get here?" � from �Once in a Lifetime� by the Talking Heads

All living things age, and every species has a natural, built-in life span. Although a giant tortoise and koi carp can live up to 200 years, the average life span of a human being is around 79 years, a cat lives to around 20, a dog to around 10, a mouse to around 2 years, a worm to only 10-30 days, and the legendary mayfly only a single day. But, no matter how brief, all these living things go through a natural aging process during their life spans (yes, even worms get all wrinkly in their old age), similar to the ones that we ourselves go through.

Life Span of a Worm by Arvind Ramanathan

So what exactly is this natural aging process? Many of us have been able to observe the entire arc of the process as we raised our family dogs. Do you remember something about how it went for Fido?

At the age of two, Fido was a young, healthy adult, with tons of energy, good eyesight, keen senses of smell and hearing, and a shiny coat. He was able to learn and remember quite a few commands, like �sit,� �down,� �fetch,� and �off.� His mind was alert and attentive to you and his environment, and there was an obvious delight in new discoveries and exploration. 

But by the age of five, Fido was already entering middle age, and his energy and vitality were probably noticeably slower. Although he still loved to go on those long hikes with you, you may have noticed that he was bounding less and just focused on maintaining a steady pace. And when he jumped up onto the couch or bed, he wasn�t quite as spry. There were other changes, too, like maybe his digestion wasn�t what it once was or he started having trouble with bladder control. And with his immune system beginning to age, maybe your once super healthy dog started experiencing more illness or infections.

By the age of eight to ten�depending on his size�Fido had become an old dog with a gray muzzle, heading into his final years. His energy and vitality were reduced even more, and though he still loved to go out and sniff things, those long hikes were a thing of the past. And he walked more slowly and stiffly, too, as his strength, flexibility, balance, and agility began to wane, and perhaps arthritis set in. His respiratory functioning diminished, so when he was very active, he became short of breath. And his keen hearing and eyesight also began to worsen (dogs even get cataracts, as do we). 

You might have needed to take Fido to the vet more often at this stage, as he developed more frequent infections or chronic illness, or any number of age-related conditions, such as heart problems, diabetes, digestive issues, obesity, or cancer. Perhaps even Fido�s mind wasn�t what it once was. He may have developed symptoms of cognitive dysfunction, such as confusion or disorientation, restlessness at night, loss of house training, decreased attentiveness, or not recognizing friends or family members.

Eventually the really sad part came, when you had to say goodbye. Fido died while you were still young, probably of a fatal illness, such as cancer, an overwhelming infection, or just heart failure due to old age. Yes, we know, it was a bit difficult to witness, wasn�t it? After Nina�s family dog died, her mother said there would be no more family dogs because the thought of going through that whole thing again was just too painful. But remembering it now will help you understand quite a lot about how humans age, something we�ve been getting into a lot lately on the blog (Your Immune System and Aging, Balance and Aging, Flexibility and Aging, and Aging Changes to Your Brain and Nervous System, among others).

As for why this happens, well, that�s a whole different story. See What is Aging, Anyway?

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Featured Pose: Mountain Pose (Tadasana)

by Baxter

Many yoga traditions consider Mountain pose to be the original standing pose, from which all the other standing poses emerge. So mastering this pose helps you perform all the other poses. This pose is also an ideal, active standing position that supports healthy overall posture, teaching you healthy alignment of your pelvis and spine over your feet, and your head over your torso. It also cultivates strong legs, an even balance between your feet, and an even opening in your chest and your upper back.

Baxter prescribes this for:

• Improving posture 
• Low back pain
• Improving balance 
• Text neck or head forward syndrome
• Weakness in the legs or spine
• Resting between standing poses
• Standing meditation pose

Timing: If you are an experienced practitioner, hold the pose for 1-2 minutes. If you are new to the practice, start by holding this pose for 30 seconds at a time, working up to 1-2 minutes over time.

Cautions: This pose is generally very safe and accessible. If you have trouble with balance, step your feet wider apart and/or practice with your back near a wall. 

1. Classic Version

Stand with your feet hips-distance apart and parallel to each other. Distribute your weight evenly on your feet and actively firm your upper thigh muscles evenly toward your thighbones. From your tailbone, lengthen upward through your spine to the crown of your head, as if you were growing taller. Without squeezing your shoulder blades together, widen the front of your chest so your chest and your upper back are both broadening. Position your head directly over your shoulders, with your chin parallel to the floor. Either relax your arms at your sides or actively reach down from your shoulders into your fingers, with your palms facing your thighs. 

As you maintain these internal actions, gently lengthen your inhalations and exhalations, while remaining active and alert. To come out of the pose, simply relax the physical effort of Mountain pose and notice the posture your body returns to. If desired, repeat the pose one more time.

2. Block between Thighs

This variation strengthens and brings awareness to your legs, especially your inner thigh muscles, which are often weaker than your other leg muscles. 

Start by taking the classic version of Mountain pose. Next, place a block on its narrowest width between your thighs, half way between your pelvis and inner knees. Step your feet a bit closer together. Then firm your legs into the block while lengthening down into your feet. If you tend flatten your lower back, roll your thighs in and push the block back slightly to encourage a normal lumbar curve. If you have a sway back that is painful, squeeze the block and draw your tailbone down slightly towards the block. 

Follow the leg, spine, chest, and head instructions for the classic version, and use the same breathing technique. To come out of the pose, remove the block and relax your physical effort, especially your legs. 

3. Reverse Prayer Position

This version opens your front chest, opens your shoulder joints for taking your arms behind your back, strengthens the muscles between your shoulder blades, and stretches your forearms and wrists.

Start by taking the classic version of Mountain pose. Bring your palms together into Prayer position (Namaste) in front of your chest and firmly press your palms together. Next, keeping your elbows bent, bring your hands together behind your back, with your fingertips pointing down. Move your hands a few inches out away from your lower back, and spin your fingertips up toward the your head. With the sides of your hands lightly touching your lower back, wriggle your hands up the line of your spine as high as you can comfortably go or until your palms come completely together. If your palms come together, bring your thumbs together as well. 

Follow the leg, spine, chest, and head instructions for the classic version, and use the same breathing technique. 

Hold your arm position for approximately 30 seconds, gradually working up to 1-2 minutes over time. To come out of the pose, carefully wiggle your hands down your back at least six inches and then release your hands down by your sides. Shake out your hands and arms before moving on.

4. Elbows Clasped Behind Back

 Like version 3, this version opens your front chest, opens your shoulder joints for taking your arms behind your back, and strengthens the muscles between your shoulder blades, but this version more accessible for most people.

Enter the pose like version 3, but instead of bringing your palms together behind your back, bring your just your right arm behind your back. Then bring your left arm back and, depending on your flexibility, clasp opposite elbows or forearms. Follow the leg, spine, chest, and head instructions for the classic version, and use the same breathing technique. 

Hold the arm position for 30-60 seconds and then release your arms. Repeat the arm position on the left side by taking your left arm back first. After finishing both sides, shake out your arms before moving on. 

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Customizing Your Practice

by Baxter

Dancers Practicing At The Barre by Edgar Degas

It is easy for us all to go to a class and be lead through a wonderful, balanced practice, but it�s quite a challenge for most people to come up with a similar practice on their own. However, one of the important advantages of practicing at home is being able to customize your practice for your particular needs and desires on a given day. But if designing a yoga practice from scratch is too overwhelming to consider, a good way first step is to tinker a bit with a practice that you found on our blog, elsewhere online, or in a book. It�s simpler than you might imagine!

In this post we�ll make some basic recommendations for how you can customize any practice to make it:

• More gentle
• More vigorous
• Shorter or longer
• Adapted to your particular limitations

Making a Practice More Gentle

You can make any practice more gentle by:

1. For dynamic poses, do fewer repetitions, for example, do 3 rounds of dynamic Warrior 2 instead of 6.
2. For static poses, use shorter holds, for example, hold Warrior 3 pose for 3 instead of 6.
3. For restorative poses, extend your time in the poses.
4. Leave out the most vigorous pose or poses from the sequence, either just skipping them or replacing them with gentle or restorative poses. 
5. Between active poses, rest in Savanana or another resting pose.

Making a Practice More Vigorous

You can take any practice, other than a restorative practices and make it more vigorous in the following simple ways: 

1. For dynamic poses, add more repetitions, for example, do 10 rounds of dynamic Warrior 2 instead of 6.
2. For static poses, extend your holds, for example, hold Warrior 3 pose for 10 or 12 breaths instead of 6. And instead of doing poses only once, you can repeat them a second of third time.
3. Repeat a series of static pose an extra time.
4. Add in any poses you feel are more vigorous for you, placing them after the warm-up poses and before the cooling down poses.

Making a Practice Shorter or Longer

We all feel the time crunch now and then, and, conversely, sometimes find that we have extra time on a given day. You can easily adjust the length of your practice depending on how much time you have to devote to it on any given day. 

To shorten a practice:

1. For dynamic poses, do fewer repetitions. 
2. For static poses, use shorter holds.
3. Eliminate any poses from the sequence that are less appealing today. Just be sure to keep in at least some of the initial warm-up poses and at least one cool-down pose. 

To lengthen a practice:

1. Lengthen your time in some of the poses, either increasing repetitions of dynamic poses or extending your holds in static or restorative poses. 
2. Repeat your favorite pose or poses a few times.
3. Add in more poses of the same type. For example, in a backbend sequence, add in more backbends, or in a strength building sequence, add in more strength building poses.
4. Add in a short meditation or breath practice that is not in the sequence.
5. Rest in Savanana or another resting pose between poses.
6. Take an extra long time in Savasana.

Adapting a Practice to Your Limitations

Injury. You can still practice with an injury by adapting the individual poses to your limitations. For example, with shoulder injury, you can keep your arms down at your sides in many standing poses or practice the wall version of Downward-Facing Dog pose instead of the full version. For those poses you cannot adapt, you can simply skip them, for example, skip Plank pose with a shoulder injury. When you�re in the acute and recovery phrases of an injury, floor sequences and chair variations are good substitutions. 

Illness. When you are ill or recovering from an illness, focus on gentle, restorative practices until you recover. When you�re ready for a gentle practice, use our recommendations above to make your first active practice days easier.

Disability. If you�re working with a longer-term disability, adapt your practice as we described for an injury. Because you'll be practicing this way for a long period of time, it may also be worth getting special guidance from a skilled teacher for creative ways you can adapt various poses to your condition.

Have fun practicing! And don't be afraid to get creative.

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Aging Changes to the Brain and Nervous System

by Baxter

Book, Pipe and Glasses by Juan Gris

We have recently shared some basic information about what the brain and nervous system are and what they do (see Your Brain is More than that Thing in Your Skull). And we�ve also shared with you how yoga can help with healthy aging of these essential parts of our bodies (see How to Foster Brain Health with Yoga). Yet we have not been clear on what the normal aging changes are for the brain and the nervous system, so today, I will address that deficiency!

The Brain and Central Nervous System

As your brain ages, certain areas shrink in size, and as a result, the empty spaces deep in the brain, called the ventricles, expand a bit. As the volume of the brain gets smaller, the neurons�the specialized cells in the brain�also shrink, as do the number of neuron-to-neuron connections, called synapses. On top of this, some of the neurons die and are not replaced by new ones. 

As nerve cells break down, waste products can collect in the brain tissue, leading to new and unwanted growths called plaques and tangles. Growing both inside and outside of the brain, these growths can disrupt the communication network between the neurons. All of these changes can cause your brain to slow down and work less efficiently. You can mitigate some of these changes through practices that foster brain health, including exercise, sleeping well, and continued learning.

Inflammation. As we age, we tend to produce more free radicals, which can lead to inflammation in the brain as well as the body (see Chronic Inflammation and Yoga: An Update for information about aging and inflammation). Inflammation in the brain can increase rates of cell death, and unchecked, can lead to more severe brain issues, such as Alzheimer�s and Parkinson�s. Although we don�t know for sure that you can prevent Alzheimer�s and Parkinson�s this way, you can prevent inflammation in general by focusing on stress management, meditation, and gentle exercise.

Blood Supply. The gradual decrease in blood flow to the brain due to arteries shrinking and changes in the blood brain barrier may decrease your body�s ability to transport nutrition into the brain and keep toxins out. All of this may contribute to overall decrease in brain function over time. To maximize your vascular health, focus on exercise, such as a well-rounded asana practice or even a gentle asana practice as well on meditation, which have have been shown to reverse clogged arteries.

Cognitive Abilities. As a result of all these structural changes, the brain and central nervous system�s ability to function also changes. For example, structural changes to the prefrontal cortex and the hippocampus may cause decreases in learning, memory, planning, and decision making, as well as altering personality. This leads to a decrease in general mental abilities, such as troubles learning new things, recalling information efficiently, and keeping up with technological advances. 

Although all this often leads to older people performing poorly on complex tasks of attention, learning, and memory, all is not lost. It turns out that if older adults practice these tasks, they often perform as well as younger adults. Additionally, older people often continue to improve in certain other cognitive tasks including vocabulary, verbal knowledge, and information analysis. This explains why my grandmother could whoop me at Scrabble when she was 88! And we also know that when we are engaged in learning new activities, skills, and creative projects, the brain will continue to grow and build new neurons and neural synapses, a process neuroplasticity. In addition to continued learning, regular exercise, managing stress levels, and participating in a community will all help foster cognitive ability as you age. 

The Peripheral Nervous System

Aging brings natural changes to the nerves of your peripheral nervous system causing them to shrink and the insulation around them to be reduced. As a result, nerve cells may pass messages more slowly between the body and the brain, causing your body to respond less rapidly and reducing your overall agility. This slowing can also affect your senses, leading to reduced or even lost sensory feedback from your body to your brain, including:

• Diminished response to touch, and to sense where you are in space and what types of surfaces your body is touching (this affects your ability to balance) 
• Decreased eyesight
• Decreased hearing
• Decreased sense of smell
• Decreased sense of taste
• Changes in perception changes, so in some people there is a decrease in pain sensation and sensitivity, while in some others, there is an increase.

By improving blood flow to the special sensory nerve receptors (the nerves that shuttle information back to the brain) and increasing space around your nerves, regular exercise can help support healthy senses. In addition, maintaining good nutrition and regularly resting your senses regularly with restorative practices can also help. 

Slower responses from your nerves to the muscles involved in conscious action affect coordination and speed of movement, as well as strength of muscle response. Of course, this can in turn lead to movement and safety problems. You can counteract this slowing with regular well-rounded exercise, such as a well-rounded asana practice that focuses on strength, flexibility, balance, and agility.

Aging also causes a decline in blood flow in the nerves and the ability of nerves to regenerate after an injury. Regular exercise, such as a well-rounded asana practice, will help with this by improving blood flow and releasing holding patterns around your nerves, allowing them to function them better.

In your autonomic nervous system, the slower messaging of nerves affects how well your brain communicates with your cardiovascular system, as well as the other organs and systems whose functions it coordinates, such as the digestive system and bladder. Slower communication can lead to less efficient functioning of all those systems, causing, for example, sluggish digestion or trouble with urination. To preserve good autonomic functioning, both regular exercise, including a well-rounded asana practice, and managing chronic stress can be helpful. 

To summarize, there�s quite a lot you can do to maintain the health of your brain and nervous system as you age, including:

1. Exercise regularly. Exercise been shown to be one of most important things you can do for keeping your brain and nervous system healthy as well as your body. 
2. Maintain good nutrition. Good nutrition is as important for brain health as it is for physical health.
3. Meditate. This not only improves mental functioning, such as the ability to focus and maintain willpower, but it has been shown that meditation actually strengthen the brain.
4. Sleep. Good sleep is necessary for the brain to function properly and also to keep it healthy. 
5. Manage Chronic Stress. Reducing chronic stress helps reduce inflammation and reduces the likelihood of developing chronic conditions that negatively impact the nervous system, such as Diabetes and Hypertension. Allows healing time for nervous system as well as brain.
6. Keep Learning. Ongoing learning stimulates neuroplasticity and the growth of new brain cells. 
7. Join a Community. Socializing and belonging to a community improves cognition as well as emotional health.

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Appreciating Your Entire Cardiovascular System

by Baxter

The Heart of the Circus by Marc Chagall*

Sometimes it�s easy to equate your cardiovascular system with its engine, the heart. But, as we shall see, it is so much more than that. It�s also common to think of the cardiovascular system as the part us we �exercise� when we do aerobic activities, such as running, biking, and active hiking. But this system is just as essential for quiet times as it is for active ones. And understanding a bit about how your cardiovascular system works will help you realize how important it is to use your yoga practice to keep this system�as well as its related systems�functioning optimally. Fortunately, yoga can help keep the heart and blood vessels strong and responsive, and give you tools to quiet the engine down to a purr when resting. See Techniques for Improving Cardiovascular Health for information on techniques.

Heart. At the center of the cardiovascular system is the heart, a unique muscular structure whose strong contractions send blood throughout your body. The heart has a built-in electrical system that sets the rhythm of the contractions of the heart, which can work independently if necessary. But in normal situations this electrical system is in constant communication with your brain via nerves and hormones to adjust to your changing activities moment by moment. Finally, the heart has its own blood vessels that feed it continuously. Yoga is a great tool for exercising your heart muscle, and for helping to balance and regulate its electrical system. And studies show that yoga can also help keep your heart�s blood vessels open and flowing. 

Blood. The liquid that flows through the cardiovascular system contains red and white blood cells, platelets that help form scabs, proteins, glucose, minerals, and hormones. This is provides the fuel needed by all parts of your body and moves the waste effectively to the kidneys and liver for processing. A well-rounded asana practices supports the efficient flow of blood throughout your cardiovascular system.

Blood Vessels. The tubing that the blood moves through to reach all parts of the body goes by different names according to function and size. They include:

• Arteries and Arterioles: Transport blood from the heart to capillaries to distribute fuel-rich blood to all parts of the body and takes blood to the lungs to get oxygen and release carbon dioxide. These vessels assist in maintaining steady blood pressure by either relaxing or contracting the tube walls.
• Capillaries: With walls only about one-cell thick, they allow fuel and waste products to move in and out of the cardiovascular system throughout your body. 
• Veins and Venuoles: Return blood from the capillaries back to the heart, first through the smaller venuoles and eventually through larger veins. Veins are not as thick as the arteries and rely somewhat on physical activity to contract and relax the muscles they pass through and between to squeezes blood back to the heart. So active asanas and inverted poses can assist with the efficient return of blood to the heart.

Chest Cavity. Your heart physically resides in your chest cavity, and is cradled by your lungs to its right and left side, the diaphragm below it and your spine and ribs behind it. So the overall health of your chest cavity has a general supportive role in heart and cardiovascular system health. For a healthy person, a well-balanced yoga practice will help you maintain optimum functioning of your chest cavity. For a person who has gained weight, been sedentary or inactive, or has poor posture, you can use your asana practices to improve the strength and flexibility of your chest cavity and restore your posture to a healthier state and support your heart. 

Now we�re going to turn our attention to certain organs and systems that the cardiovascular system interacts with, so you can understand how using your yoga practice to support those systems can help your cardiovascular system. But keep in mind that the cardiovascular system interacts with everything in body! No cell in your body is more than a few millimeters from a capillary, as blood supplies nutrition to all the cells, removes waste from all the cells, distributes hormones throughout the body as chemical messengers, and distributes white blood cells for immune system and repair jobs. 

Brain and Nervous System. Depending on your activity levels, your brain and nervous system make moment-by-moment adjustments to your heart rate and the force of your heartbeat as well as to your blood pressure. And because your brain and nervous system are so important to the overall health of your body, the cardiovascular system supplies your brain with blood via four different arteries�more than any other organ or system of the body�to almost guarantee that it gets a continues supply of food and quick clearing of waste. See How To Foster Brain Healthy with Yoga.

Respiratory System. The cardiovascular system circulates blood through your lungs to pick up oxygen that you�ve inhaled, and then transports the oxygen-rich blood to the rest of your body. And when the blood is returning to the heart (after being cleansed by the liver and kidneys), the lungs receive carbon dioxide from the blood so you can exhale it. Healthy lung function is an integral part of your cardiovascular system, which is why some anatomists refer to the two systems together as the cardiorespiratory system. See Techniques for Supporting Respiratory Health. 

Digestive System. Your cardiovascular system circulates through your intestines to absorb digested food in the form of sugar, fat, and protein molecules into capillaries and then transports it to other organs for processing. For example, the cardiovascular system delivers sugar from the digestive system to the liver, which then converts it into storage particles for future use. See How Yoga Helps Your Digestive System.

Liver. In addition to storing glycogen, your liver filters your blood to remove toxins and clean it before the blood is returned to your heart. Without a healthy liver, the blood and body gradually become toxic. Practicing yoga to support your immune system (see Techniques for Supporting Your Immune System) as well as circulation (see Techniques for Improving Cardiovascular Health) will support overall liver health.

Urinary System. Before your blood returns to your heart, your kidneys filter it, clearing many kinds of waste molecules and extra salt molecules, such as potassium and sodium, and moving them into urine for removal from your body. Without healthy kidneys, your blood and body will gradually become toxic and lead to serious illness. Practicing yoga to support your immune system (see Techniques for Supporting Your Immune System  as well as circulation (see Techniques for Improving Cardiovascular Health) will support overall kidney and urinary system health. 

Spleen. This organ, which sits in the upper-left of the abdomen, clears out old red blood cells, recycling the iron of those cells, and helps clear the blood of bacteria. It also provides a reservoir of about a pint of blood for release if blood levels suddenly drop, such as with a laceration to a major artery. Practicing yoga to support your immune system (see Techniques for Supporting Your Immune System) as well as circulation (see Techniques for Improving Cardiovascular Health) will support overall spleen health. 

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