ANATOMY OF HATHA YOGA A Manual for Students, ‘Teachers, and Practitioners by H. David Coulter Foreword by Timothy McCall, M. D. Body and Breath‘Text and ilustrations ©2001 by #1, David Coulter Foreword ©2001 hy Tianothy BeCall Author's photugraph ©2001 by yee Barone ody and Bresth Inc. 1409 Wosteide Ave, Honesdale, PA 18431 UBA, oy o8o7 op os a4 VBTO5 PRECAUTIONARY NOYE: Phis is not a medical text, but a compendium of remarks concerning how anatomy and physiology relate to hatha yoga. Any medical questions regarding contraindications and cautions or any questions regarding whether or not to proceed with particular practices or postures should be referred either to health professionals iho have an interest in medical problems associated with exercise, stretching, and breathing, or to hatha yoga teachers who have had experience working with medical probleme in « therapeutie vetting: supervised by health professionals, All rights reserved, With certain exceptions enumerated below, no part ofthis book may be repreaced, tore it retrieval sto o transmitted in any form or By any means slectronic, mechanial, photneopying, recording or ctherwise—without written permission frm the publisher There are three exceptions. Fist brief quotations of upto 300 wars that are embedied in eiical articles ned reviews ene ued foe 2 lore ec Uy are prope acknowledged. cond: blanket permission is granted for institutional and ind vidual photoespying, properly acknowledged, of up to ene hundred expres totaling ne more than 25,000 werds foreach copy with accompanying illustrations (approximately ‘one chapter) or alternatively, a series of extracts from the entire book totaling no more than 25,000 wos, for purposes of teaching o for rvcatch und private study, eneepting that no deletions, alteration or exclusions within individual pags are permitted. For ‘ocample: eutting and pacing of Mlustrations for student syllabi expressly forbidden. (Onky incvidunl pages in their entirety are tobe photocopied, including text if any) and all running heads, captions, and labels that are incorporated within each page. ‘Third rermission for scanning af text, halftones, anata drawings, cca, aed bles either in ioltion oF altered as desired is granted only for trials of eketronie or hard copy Publishing layouts; permission must be sughl trom the publisher (Body and Breath Ine) ‘to use such ilstrations for any kind of electric ee meshavial transmission or in other publications Printed in China, Library of Congress Catsleging-n-Publestion Data Coulter, H. David (Herbert David, 1989 ‘Anatomy of Hatha Vogt manual for stadents, tochers, and practitioners hy H. David Coulter ;freword by ‘Timothy McCall Includes hibilogeaphical references and inde: ISBN 0.9707006-6-1 (alk. poper) 1. Yo, Hoth Physologea aspects 2. Human mechanics. 2. Human anatomy: ‘Tite. RATBI.7.088 2001 era 7046-1 2ontnznean‘To my parents, ‘who guided me lovingly, watched my life with joy and enthusiast, supported my academic and personal interests, and always thought the best of me.meemeyerrys eof eoougoryto() “Why de you never find anything written about that iddosyn cratic thought you advert to, about your fascination with something noone clic understand Tore t expel. tes here to caplet Uecase yous Mave never read it EP Recause tt ts up te you. wcthling you find interesting, for a reason hard lo en any page: there you begin, You were made and set here to give voice to this, your o1an astenithment.” — Annie Dillard, in The Writing LifeCONTENTS Foreword ol Preface 13 Introduction 15 Basie Premises Chapter One - MOVEMENT AND POSTURE. ‘The Neuro-mnusculoskeletal System ‘The Nervous System Reflexes. ‘The Veetibular Systom, Sight, and Touch Connective Tissue Restraints . ‘Stretching Three Pustures Putting It All Together Chapter Two - BREATHING The Desi of he Respiratory Sytem ‘Tho Muscles of Respiration How Breathing Affects Posture. ‘The Somatic and Autonomic Systems ‘The Physiology of Respiration ‘Thoracic Breathing 0... = 102 Paradenical Broathing 7 wr Supine Ahdominal Breathing ~ See) Alnlominal Breathing in Sitting Postures mt Diaphragmatic Breathing 7 120 ‘A Traditional Warning _— in Chapter Three - ABDOMINOPELVIC EXERCISES 139 Crunches and Sips wn ‘The Foundation of the Body Supine Leg Lifts Yorn Sit-ups F ‘The Sitting Boat Postures z a7 ‘The Peacock : ITS ‘The Pelvis and The Anatomical Perineum 17 ‘Ashwini Mudra 182 ‘Mala Bandha, 188‘Agni Sara _— ‘Uddiyana Bandha, ‘The Abdominal Lift Nal : Gontraindieations Benefits Chapter Four - STANDING POSTURES ‘The Skeletal System and Movement Anatomy of the Spine Symmetry and Asymmetry Standing Postures Four Simple Stretches, Backward Bending Forward Bonding on Side Bending What Makes Postures Difficult? ‘The Triangle Postures ‘Two Balancing Postures Benefits Chapter Five - BACKBENDING POSTURES ‘The Anatotny of Flexion and Extension Breathing and Boekhending ‘The Cobra Postures ‘The Locust Posture. ‘The Prone Boat: Postures, ‘The Bow Pastures ‘The Knee Joint Supine Backbending Postures peeling Backbend—The Camel indications ofits fer Six - FORWARD BENDING POSTURES . ard Bending: Head, Neck, and Chest bar and Lumbosacral Forward Bending riliae Nutation and Counternutation rard Bending at the Hip Joints tard Bending at the Ankles and in the Feet Jcal Matters and Cations asterior Stretch Dovn-Facing Dog, e Child's PoseBreathing and Forward Bending... a8 Socroiine Flowiility 355 Hip Flexibility i" 361 Benefits. ~ 6 Chapter Seven - TWISLING POSTURES .... 38s ‘he Fundamentals uf Twisting . 84 ‘The Skull the Atlas, and the Axis... 388 ‘Movements of the Head and Ned non 892 ‘Thoracic Twisting : 395 Lumbar Twisting 396 ‘The Lower Extremities 398 Supine Twists 403 Standing Twists 410 Inverted TWists . 424 Sitting Spinal wists 425 Benefits 435 Chapter Light - THE HEADSTAND ast “The Cavdiovascular System 4x7 ‘The Two Headstands 446 ‘The Upper Extremities — 456 Structural Imbalances an Breathing Taswes 474 Developing Strength and Flexibility - av ending und Twisting in the Headstand 488 Extending Your Time 498 enefits 497 Chapter Nine - THE SHOULDERSTAND Anatomy of The Shoulderstand Inverted Action Postures: ‘The Shoulderstand ‘The Plow - ‘The Lifted Shoulderstand and Plow Girculation Respiration ... Sequelae... Benefits —_— =e Chapter Ten - RELAXATION AND MEDITATION Muscular Relaxation . t= ‘Two Relaxation Poetures Breathing and Relaxation‘The Autonomic Nervous System Deepening Relaxation Meditation Posture ‘Maintaining the Geometry Props ‘The Six Postures Mula Bandha Mastering the Situation Knower of the Veil Glossary Additional Sources Acknowledgments Index of Anatomical ‘Terms Index of Practices Biographical Sketch maromoyopry(s ef ougem7o(2) ou 619 623FOREWORD Hate yore. ts teacher and corious students are convinen of ts power to build strength und confidence, to improve flexibility and balance, and to fostor tanita peice and contentment And beyond tx als ibutes as preventive med- era any of us alsa lieve an the power of yop o heal, to ad in recovering frown everything from ow back strain to carpal tunnel syndrome and (0 belp ee eairahvosic probleme Eko arthritis, tiple slerais and infection with the human immunodeficiency virus GV) ‘Dat despite the Teant boom in your's populaity, moet scientists and physi cians have been slow to embrace this discipline. To many of them perhaps, it Cathe ike a myeticel pursuit, 8 quas-religon with hte bass in the modern Seri otcionce na medical profasion now Hal deninated bya nest religious TReorencs for the randval, controled study, Knowledge acquired through TRonands of years of erect chocrvation, introspect nd ial and error may eer quaint ut ue the West has lowly opened in the pst decades to Faster, experientilly sed fics ike scupunctare’as part of grantor necaplanee of alternative tmeticine in gneral_yoen has begun to stake its aim. Concepts lke prana or {EN However are uot warmly recelved by epi! slentnts. Ty win tem over Sint noad ta prewide the kind of evidonce they buy. Studies. Preferably Jublished in peerreview journals. And you need to propose mechanisms of veil (nat conform with scence an they understand i “Asignifeant breakthrough wae provided by Dr. Dean Ornish, a California- tase cariologist who interrupted fis college years to study with Sri Swami Satehidannnda, His work, published in 1990 inthe prestigious British medical Journal the Larect, showed that a program tal combinos hatha yoga with Uetury cluges, exercise, and group therapy can actually revere Bockagos in the bears main arteries-which doctors used to think wasn't possible Tn i998, research led by Marian Garfinkel of the Medical College of Peoruylvanin and. published in the Jourmel of the American Medical Ascocation found that Iyengar yogn coud effectively reduee the symptoms af tape cane! gyro, a nulacy ef cnr epee proportions in this ompular tee Of role, Gorinke’ study lasted only eight otha, ad yet the intervention proved effistsusSericus yoge practitioners realize of corse that although come Fenefit may be noticed after evn a single clas, soa's most profound effects scerue over yeu oven decales-not weeks, Yogh is indeed powerful medicine Thu i is low modicne. ‘Mote studie will be needed to convince the medical establishment, but that rexearch could lea be low n coming. Funding i perennial problem. Unlike the situation with, sa, pharmaceutical, there is no private industry to bankroll the scent investigation of hatha yoga. Given the incredible cnet of Tongerange studies which are more likely Lo demonstrate effectivencse— Tsuopeet that were unlikely to sue any time soon the kindof overwhelming Proof thal skoplicl scientists want, This presents © philosophical question:‘When you have an intervention which appears safe and effeetive—and when its side effects are almost entirely positive—should one wait for proof before tuying it? This value judgment lies at the heart of the rocont debate over many traditional healing methods. Tronically, though, even within the world of alternative medicine yoga seems underappreciated. Two years ago, [attended a four-day conference on alter- native medicine sponsored by Harvard Medical School. A wide range of topics from herbs to prayer to homeopathy were covered in detail. Yet in the dozens of presentations T attended, yora was mentioned just once: In a slide that accompanied the lecture on cardiovascular disease, yogu was one of several modalities listed under “Other Stress Reduction Techniques.” Yous is certainly a stress reduction dovioe but to reduee it to just that misees so much, Given the situation, how welcome then is David Coulter's Anatomy of Hatha Yoga. David combines the perspactives of a dedicated yogi with that of a former anatomy professor and research associate at two major American medical schools. THe has set himself the ambitious youl of combining the modern scientific understanding of anatomy and physiology with the ancient practice of hhatha yoga. ‘The result of an obvious labor of love, the book explains hatha yoga in demystified, scientific terms while at the same time honoring its traditions, It should go a long way W helping yogn achieve the selentifle recognition it deserves. Useful as both a textbook and us u reference, Anatomy of Hath Youa is a book that all serious yoga teachers and practitioners will want on their sholves, If will also be welcomed by sympathetic physiciane—and there are more of us all the time—as well as physical therapists and other health profissionals. Speaking as a doctor who had already studied anatemy in deta (though forgotten more than I'd care to admit) and as a dedicated student af ‘yoga, I can happily report that this book heightened my understanding of both hatha yoga and anatomy and—az a nice bonue improved my personal practice. T realize, however, that to those who lack scientific training Anotoney of ‘Hatha Yoga may seem daunting, Some sections use terminelogy sind concepts that may be challenging on first reading. If you feel intimidated, my suggestion Js to adopt the mentality many employ when reading the ancient and some- difficult texts ofthe you: tradition. Read with an epen heart and ifyou get ‘Ghstreet try another pater como beck toi anather dy. As with yogs eal, t students will be rewarded with an ever-greater understanding. ‘Timothy McCall, MD Boston, Massachusetts January, 2001 ‘Timothy MeCall is a board-certified specialist in internal medicine and the hor of Examining Your Doctor: A Patient's Guide to Avoiding Harmful cal Care. His work has appeared in more than a dozen major publicalions iding the New Englond Journal of Medicine, the Nation and the Los yes Times. He can be found on the web at wwviarmocall.com 2PREFACE The orgies of this bok date from twenty. yen ao when Iwas teaching various neuroscience, microscopic anatomy, and elementary avatomy courses fn the Department of Cell Biclogy and Neuroanatomy at the University of Minnesota. At the same time I was learning about yogs in classes at the Meditation Center in Minneapolis. During those years, Swami Rama, who founded the Himalayan Institute, often lectured in Minnesota, and one of his messages was that yoga was neither exercise nor religion, but 1 science, aad he ‘wanted modern biomedical science to examine it in that light. One of hi ‘in coming to the West was to bring this about, @ purpose which is Teflectad by the name he selected for the institute that he founded—The ‘Himalayan International Institute of Yoga Science and Philosophy. The idea of ‘connecting yoga with modern science resonated with me, and the conviction frew that T onald be a part of such # quest. Soon after I communicated my Interest, Swami called and suggested that T pay him a visit to talk about Writing a book on anatomy and batha yoga. And that is how thie projeet hogan in 1976. ‘Apart from several fulse starts and near-fatal errors, 1 did little waiting on this subject belweon 1976 and 1088, but still T benefited from students’ ‘questions in courses on anatomy and hatha yoga al the University of ‘Minnesota (Extension Division), more comprehensive courses on yoga anatomy for graduate students at the Himalayan Institute in the late 1980s, anatomy fand physiology courses in the mid-1990s for the Pacific Insitute for Oriental Medicino (NYC), and from 1990 to the present, teaching anatomy for students fof Ohashiatsu@, a method of Oriental bodywork. ‘These courses brought me in touch with many telling questions from students interested in various aspecte of holistic medicine; without them, the seed planted by Swamiji would never ‘have matured, ‘And co it went, from a working draft in the smmor of 1976 to 1995, when afler many gentle and not-so-gentle nudges, Swamiji insisted that my time was ‘up, Las to finish the book, nish it now, and not run away. IPT tried to escape, he avowed, he would follow me to the ends of the earth; what he would do upon, finding me is better left unsaid. Happily, he saw an early but complete dralt of the toxt u your before hie passing in November of 1996.(-)eirtualmore for NatahausnuINTRODUCTION A comprehensive statementon the anatomy and physiology of hath yrs fought to have been written years ago. But it hasn't happened, and my sim is to remedy the deficiency. After considering the subject for twenty-five {jus it's clear that euch a work might well interweave two themes: forthe tonefit of completeness, a traditional treatment of how to do yoga postures {yoga asanas) using anatomically precise terminology, and, for correlations swith medical science, au objective analysis of how thore portures are realized in some of the great systems of the body. In that regard, special emphasis is placed here on the musculoskeletal, nervous, respiratory, and ‘ardiovascular systems—the musculoskeletal system because that is where allour actions are expressed, the nervous system hoesnse thats the residence ofall the managerial functions ofthe musculoskeletal system, the respiratory ‘stem because broathing is of such paramount importance in yoga, and the cardiovascular aystein because inverted postures cannot be fully comprehended without understanding the dynamics of the circulation. ‘Most ofthe emphasis is practical—doing experiments, learning to observe the body, and further refining actions and observations. "The diccustion ie intonded for an audience of yora teachers, health professionals, and anyone else who is interested in exploring some of the structural and functional aspects of hatha yogs. The work can also serve as A guide for students of wlertiative medicine who would like to communicate with these who place their faith more strictly in contemporary science. To help everyone in that regard T've included only material that is generally cepted in modern biomedical sciences, evoiding comment on non-physical concepte stich ae prana, the nadis, and the chakras, none of which are precently testable in the scientific sense, and none of which have obvious parallels in turn-of-the-millennium biology "The book begins with an introductory discussion of some basic premises that set a philosophical tone and suggest a consistent mental and physical approuch to postures. Ten ehupters follow, the first three fundamental to the last seven, Chapter 1 summarizes the basic principles of the anatomy And physiology of hatha yoga. Broathing next in chapter 2sines the manner in which we breathe in hatha yoga is important for expediting: movement ‘and posture. Breathing is followed by pelvic and abdominal exercises in chapter 3 for three reasons: muy of Whose exercises use specialized methods of breathing, they are excellent warm-ups for other postures, and the pelvis ‘and ubdomen form the foundation ofthe body. Standing postures will then DDecovered in chapter 4 because these pores are 0 important for beginning 5students, and because they provide a preview of backbending, forward ending, and twisting peatores, which are covered in detail in chapters 5, 6, and 7. The headstand and shoulderstand, including a brief introduction to cardiovaseular function, are included in chapters 8 and 9. Postures for relaxation and meditation are treated last in chapter 10. It will be helpful to experiment. with each posture, preferably in the order given. This approach will lead you logicelly through « wealth of ‘musculoskeletal anatomy, bring the academic discourse to life and pers ‘you to understand the body's architecture and work with it safely. I'some of the sections on anatomy and physiology scem formidable, there is an easy colution. Turn the page. Or turn several pages. Go directly to the next section on postures, in which most of the discussion ean be understood in context. Just keep in mind, however, that knowledge is power, and that to ‘communicate effectively with laypeople who have technical questions as ‘well as with health professionals to wham you may go for advice, it may be desirable to refer back to the more challenging: sections of this book as the need arises. And those who do not find these sections particularly demanding, ‘can look to Alter's definitive Setence of Flexibility, as well us to other sources that are listed after the glossary, i they require more tochnieal details than, are provided here. macomorgnreys of coongonyze(2)BASIC PREMISES "The tact half ofthe brenticth contury mi many schon of hath you ‘uike root in the West. Some are based on authentic oral traditions passed ‘down through many generations of teachers. Some are pitched to meet modern needs unxl expectations but are still consistent with the anciont art, sconce, and philosophy of yoga. Still others have developed New Age tangents that traditionalists view with suspicion, Picture this title placed, near the exit of your local bookstore: Get Rien, Young, an Bewtifl with “Hatha Yoga. V0 not seon it, but it would hardly be surprising, and T have ‘0 admit that I would look carefully before not buying it... Givon human differences, the many schools of hatha yoga approach even the most basic postures with differing expectations, and yoga teachors find themselves facing a spectrum of students that ranges from accomplished dancers and gymnasts to nursing home residents who are afraid to lie down on the floor for fear they won't be able to get back up. That’ fine; it’s not fa.problom to transcend such differanens, heeause for everyone. no matter ‘what their age or level of expertise, the most important issue in hatha yoga is not flexibility and the ability to do difficult, postures, but awareness— awuruuiess of the body and the breath, and for those who read this book awareness of the anatomical and physiological principles that underlie ‘each posture, From this awareness comes control, and from control comes, ‘ace and beauty, Even postures approximated by beginning students can ‘carry the gorm of poise and elegance How to sccomplish these goals is another matter, and we often see disagreement over how the poses should be approached and taught ‘Therefore, ihe guidelines that follow are not set in stone; their purpose is to provide a common point of reference from which we can discuss the anatomy and physiology of hatha yoga. Focus voun aTTENrI0N Lock your attention within the body. You can hold your concentration on breathing, on tissues that are being stretched, on joints that are being: stresed, (x the spadd of your movetnents, or on the relationships between breathing and stretching. You can also concentrate on your options as you Tove in and out of postures. Practicing with total attention within the Dody is advanced yoge, no matler how easy the posture; practicing with Your attontion eetlored is tho pradtica ofa bene ne matter hows dif ‘the posture. Hatha yoga trains the mind as well as the body, so focus your Attention without lapse.88 anarosn ar resis vos BE AWARE OF YOUR BREATH We'll see in chaplers 2-7 that inhalations lift you more fully into many postures and create a healthy internal tension and stability in the torso. ‘You can test this by lying prone on the floor and noticing that lifting: up higher in the cobra posture (Gig. 2.10) is aided by inluslation. Paradoxically, however, exhalations rather than inhalations carry you further into many other postures. You can test this by settling into a sitting forward bend and noticing that exhalation allows you to draw your chest down eloser to your thighs (fig. 6.13). But in either ease you gut two benefits: diaphragmatic breathing assists the work of strotching the tissues, and your awareness of those effects directs you to make subtle adjustments in the posture. While doing postures, as a general rule keep the airway wide open, breathe only through the nose, and breathe smoothly, evenly, and quietly Never hold the breath at the glottis or make noise as you breathe except as required or suguested by speetfic practices. BUILD FOUNDATIONS ‘As you do each asana, analyze its foundation in the body and pinpoint the key muscles that assist in maintaining that foundation. the lower extrem ities and their extensor muscles in standing postures: the shoulders, neck, spine (vertebral column), and muscles of the torso in the shoulderstand; ‘and the enlirety of the musculoskeletal system, but especially the abdominal ‘and deep back museles, in the peacock, Focus your attention accordingly on the pertinent regional anatomy, both to prevent injury and to refine your understanding of the posture. ‘Then there is another kind of foundation, more general Ua whith we appreciate from the point of view of regional anatomy—the foundation of connective tissues throughout the body, especially those that bind the ‘musculoskeletal system together. ‘The connective tissues are like steel rein- forcing rode in conerote; they are hidden but intrinsic to the integrity of the whole, To strengthen these tissues in preparation for more demanding work with postures, concentrate at first on toughening up joint capsules, tendons, ligaments, and dhe fascial sheathes that envelop muscles, The | method for accomplishing these aims is to build strength, and to do this from the inside out, starting with the central muscles of the torso and then moving from there to the extremities. Aches and pains frequently develop if you attempt extreme stretches before you have first developed the strength and skill to protect the all-important. joints. Unless you are already a weightlifter or body builder, stretching and becoming flexible should be a secondary concern. Ouly as your practiee matures should your emphasis be changed to cultivate # greater range of motion around the joints.asec presses 19 moving, (To AND OUT OF POSTURES Being in a state of silence when you have come into a posture is eoothing ‘and even magical, but you cannot connect with that state except by know- ing how you got there and knowing where you're going. If you jerk from posture to posture you cannot enjey th journey, and the journey is just ae jmportant asthe destination, So move into and out of postures slowly and consciously. As you move, survey the body from head to toe: hands, writs, forearms, elbows, arms, and shoulders; feet, ankles, legs, knees, thihs, an hips; and pelvis, abdomen, chest, neck, and head. You will soon develop awareness of how the body functions as a unit and notice quirks and iscontinuities in your practice which you ean then smooth out. Finally, as {you learn to move move gracefully, the final posture will ecm lees difficult HONOR THE SUGGES! i NS OF Do you honor or ignore messages from aches and pains? If you have back pain, do you adjuet your posture and activities to minimize it, or do you just tough it out? And do you keep a deferential eye on your body. or do you find that you get £0 wrapped up in some challenge that you forget about it? If ‘you do not listen: W messages from your body you will be a eandidate for pulled muscles, tendinitis, pinched nerves, and ruptured intervertebral disks, ‘To avoid injury in hatha yoga you have to develop a self-respecting awareness Begin your program of hatha yoga with a resolution to avoid pain Unless you have had years of experience and know exactly what you are doing, pushing yourself into a painful stretch will not only court injury, it will also create a state of fear and anxiety, and your nervous system will store those memories and thwart your efforts to recreate the posture. Pain is. gift; it tells us that some problem has developed. Analyze the nature of the problem instead of pushing ahead mindlessly. With self-awareness and the guidance of a competent teacher, you can do other pestures that circumvent the difficulty. ASM, AND CAUTION Try to practice at the same time and in the same place every day. Such habits will make it easier to analyze day-to-day changes. Mornings are best for improving health—stiffness in the early morning tells you where you ‘need the most careful work and attention, Later in the day; you lose that Sensitivity and incur the risk of injury. Cultivate a frolicsome enthusiasm in the morning to counter stiffness, and cautiousness in the evening to ‘void hurting yourself. And at any time, if you start feeling uncommonly strong, flexible, and frisky, be careful. That's when it is easy to go too far.TAKE PERSONAL RE! Study with knowledgeable teachers, but at the sane Gane take responsibility for your own decisions and actions, Your instructor may be strong and vigorous, and may urge you on, but you have to be the final arbiter of what you are capable of doing. Because many hatha yoga postures make use of ‘unnatural positions, they expose weaknesses in the hody, and it is up to you to decide how and whether to proceed. One criterion is to make sure you not only feel fine an hour after your practice, but twenty-four hours later 2 well. Finally, honor the contraindications for each posture and each class of postures; if in doubt, consult with medical practitioner who has had experience with hatha yoga, CULTIVATE PATIENCE Learn from the tortoise. Cultivate the patience to move forward steadily, no ratter how slow your progress. Remember as well that the benefits of Jhatha yoga go beyond gtting strongor and more flexible, and that if you are monitoring only that realm, you may be disappointed. For any kind of beneficial result you have to be patient. The main culprit is thinking that ‘you should be able to accomplish somethings without making consistent fort. That attitude has two unfortunate side effects: first, it diverts your attention from the work before you to what you believe you are entitled to; and second, it makes it impossible to learn and appreciate what is taking placo this minuto, So resolve to practice being with your experience in the present moment, enjoy yourself no matter what, and let go of expectationsCHAPTER ONE MOVEMENT AND POSTURE “Emery yor Felling students inimy fos Cactare that at east Kall of what Fam about to teach them will eventually be towne to be wrong. The trouble cs de not kavw which bal The future isc rough takmaster, Nevertheless, a herd dastinct often grins the imaginations of scientists, Like Aonmings, we are prone to charge over cliffs when a large enough pack of us meves in that dirction.” — Michael Gershon, in The Second Brain, p. 34- Toro frst organizing principle underlying human movement and posture {sour existence in a gravitational field. Imagine its abeence in a spacecraft, where astronauts float unless they are strapped in place, and where outside the vessel little backpack rockete propel them from one work site to another. ‘To get exercise, which is crucial for preventing loss of bone calcium on long voyages, they must work out on machines botted to the floor. They can't do the three things that most of us depend on: walking, running, and lifting. UF they tried to partner up for workouts, all they could dois jerk one ancther hack and forth. And even hatha yoga postures would be valueless; they ‘would involve little more than relaxing and squirming around. Boek on earth, itis helpful to keep recalling how the force of gravity dominates our practice of hatha yoga. We tend to overlook it, forgetting that it keeps us grounded in the most literal possible sense. When we lift Lup into the cobra, the locust, or the bow postures, we lift parts of he Luly away from tho grenind against the force of gravity. In the shoulderstand the force of gravity holds the shoulders against the floor. Ina standing posture ‘we would collapse if we did not either keep antigravity muscles active or lock joints to remain erect. And even lying supine, without the need either to balance or to activate the antigravity muscles, we make use of gravity in ‘other creative ways, as when we grasp our knees, pull them toward the ‘hen, oll from side to side, and sllow our body weight to massage the buck ‘muscles sgninst tho floor Keeping in mind that the earth's gravitational field influences every Movement we make, ve'll turn our attention in the rest of this chapter to 21the mechanisms that make movement and posture possible. First we'll lok ‘at how the ckeletal muselee move the body, then we'll diseuss the way the nervous system controls the operation of the skeletal muscles, and then we'll examine how connective tissues restrict movement. If we understand how these three function together within the field of gravity, we ean begin to understand some of the principles underlying hatha yoga. Finally, we'll ppt it all together in a discussion of three postures. We'll begin with the role of skeletal muscles, THE NEURO-MUSCULOSKELETAL SYSTEM ‘To any informed observer, it is plain that the musculoskeletal system executes all our acts of will, expresses our conscious and unconscious habits, breathes air into the lungs, articulates our oral expression of words, ‘and implements all generally recognized forms of nonverbal expression and ‘communiestion. And in the practice of hatha yoga, tts plainly the musculo- skeletal system that enables us to achieve external halance, to twist, bend, ‘tum upside down, to be still or active, and to accomplish all eleansing and breathing exercises. Nevertheless, we are subtly deceived if we think that. is the end of the story, Just as we see munchkins sing and dance in The Wizard of Oz and do not learn that they are not autonomous until the end of the story, we'll find that muscles, like munchkins, do not operate in ‘isolation. And just as Dorothy found that the wizard kept e tether on every- ‘thing going on in his realm, 50 we'll soo that the nervous system keeps an absolute rein on the musculoskeletal system. The two systems combined form a neuro-musculoskeletal system that unifies all aspects of our actions and activities. To illustrate how the nervous system manages posture, let's say you are standing and decide to sit. First your nervous system commands the flexor ‘muscles (muscles that fold the limbs and bend the spine forward) to pull, the upper part of the trunk forward and to initiate bending at the hips, kknoes, and ankles, A bare moment after you initiate that movement, gravity takes center stage and starts to pull you toward the sitting position. And at. the same time—accompanying the action of gravity—the nervous system commands the extensor muscles (those that resist folding the limbs) to counteraet gravity and keep you from falling in heap. Finally, as soon a you are settled in a secure seated position, the nervous system permits the ‘extensor muscles and the bedy as 1 whole to rela. ‘The musculoskeletal system does more than move the body, it also serves as a movable container for the internal organs. Just asa robot. houses and protects its hidden supporting elements (power plant, integrated Circuits, programmable computers, selérepairing components, and enough fue to function for a reasonable length of time), so does the musculoskeletalsystem house and protect the delicate internal organs, Hatha yoga postures {each us to control both tho muscles that operate the extremities and the ‘muscles that form the container SceLETAL MUSCLE ‘The term “nusele” technically includes both its central fleshy part, the felly of the muscle, and its tendons. ‘The belly of a muscle is composed of individual muscle flders (muscle ells) which are surrounded by connective tivsue fibers that run into a tendon. The fendon in turn connects the belly fof the muscle to a bone. Under ordinary circumstances muscle cells contract, oF shorten, only rcauze nerve impadeee signal them to do so. When many nerve impulses per second travel to most of the individual fibers in a muscle, it pulls strongly on the tendon; if only a few nerve impulses per second travel to a Smaller population of fers within the muscle, i pulls weakly on the tendons and if nerve impulses are totally absent the muscle is totally relaxed. {Technical note: One of the most persistent misconceptions doggedly surviving in the biomedical community that all musce, even thie ol ret always kep receiving fb lout some nerve impulses Fifty years f electromyography with fine-wire needle Sectrodes is at odds with this belief, doeumenting from the 9950s on that i's not Deceserly true, and that with biofeedback training we ea learn to rlax roa! of cour skeletal museles completely] ‘A muscle usually operates on a movable joint such as @ hinge or a ball and socket, and when 1 muscle is stimulated to contract by the nervous system, the resulting tension is imparted to the bones on both sides of the fulcrum of the joint. In the case of a hinge such as the elbow that opens to about 180°, any muscle situated on the face of the hinge that ean close will eercase the angle between the two bones, and any muscle situated on the Ihack sde ofthe hinge will open it up from a closed or partially closed position. For example, the biceps brachii musele lies on the inside of the hinge, so it ‘cts to flex the forearm (by definition, the segment of the upper extremity between the writ and the elbow), pulling the hand toward the shoulder. The triceps brachii is situated on the back side of the arm (the segment of the upper extremity between the elbow and the shoulder) on the outside of the hinge, 20 it acts to extend the elbow, or unfold the hingo (fig, 1. ORIGINS ANO INSERTIONS We use the words “origin” and “insertion” W indivate where muscles are Attached to homes in relation to the most common movement ata joint. The Origin of a muscle is on the bone that is relatively (or usually) stationary, ‘nd the insertion of a musele is on the bone that is most generally moved. Flexion of the clbow is again a good example. Since ordinarily the arm is fixed and the forearm is moved, at least in relative terms, we say that the24 axeronv or wari youn biceps brachii and triceps brachii take origin from the arm and shoulder, ‘and that they insert on the forearm (Fg. 11). ‘The origins and insertions of muscle can be functionally reversed. When the fatissimus dorsi muscle (figs. .9-10) pulls the arm down and back in a swimming stroke, its textbook origin is from the lower back and pelvis, and its insertion is on the humerus in the arm, But when we do a chin-up the arm is the relatively stable origin, and the lower back and ppelvis become the insertion for lifting the body as a whole. In the coming, chapters we'll see many examples of how working origins and msertions are reversed. AGONIST AND ANTAGONIST MUSCLES ‘The muscles surrounding. a joint act cooperatively, but one of them—the ‘agonist—ordinarily serves as the prime mover, assisted in its role by function- ally related muscles called synergésts. While the agonist and its synergists are acting on ane side of the joint, muscles on the opposite side act as antagonists. As suggested by the name, antagonists monitor. smooth, and even retard the movement in question. For example, when the biceps brachii and the brachialis in the arm (the agonist and one of its synergists) shorten to flex the elbow, the triceps brachi (on the opposite side of the arm) resists flexion antagonistically while incidentally holding the joint surfaces in correct apposition (fig 1). ‘Muscles also aet in relation to the force of gravity In the lower extrom- ities extensor muselos act as antigravity muscles to keep you upright and resist crumpling to the floor. Examples: the quadriceps femoris muscle (gs. .2, 3.9, and 8.1) on the front of the thigh (Whe segment of the lower ‘extremity between the hip joint and the knee joint) extends the knee joint 1s you step onto a platform, and the calf muscles extend the ankles as you lift your heels to reach an objeet on a high shelf. Flexor muscles are antag. nists to the extensors. They ean act in two ways. They often aid gravity as when you settle into a standing forward bend and then pull yourself down more insistently with your hip flexors—the ilfopsoas muscles (gs 2.8, 375 34 and 8.13). But they also act to oppase gravity: ifyou want to run in place the iliopsoas muscle complex flexes the hip joint, lifting the thigh and drawing the knee toward the chest; and if you want to kick yourself in the buttocks the hamstrings (fig. 38, 310, 8.10, and 8.2) flex the knee, pulling the leg (the segment of the lower extremity between the kinoo and the ankle) toward the thigh. Even so, the flexor muscles in the lower extremities are not classified as antigravity muscles, because under ordi- nary postural circumstances they are antagonists to the muscles that are supporting the body weight as a whole. For the upper extremities the situation is different, because unless youmcrnaranp nniae 9 ‘are doing something unusual like taking a walk in a handstand with slightly ‘pent clbows (which necessitates a strong commitment from the triceps ‘brachii muscles), the extensor muscles do not support the weight of the ‘bod. In most practical circumstances, it is likely to be the flexors rather ‘han extensors that act as antigravity museles in the upper extremities, as ‘when you flex an elbow to lift-a package or complete a chin-up. ical note: Throughout this book, in order to Keep terminclogy simple andl yet precise, I'l stick with sit anatomical definitions uf ar, forearm thigh, and lg, Pinch means never using ambiguous {erms such as “upper arm,” “lower arm,” aanenr ioe” and "lower ley.” The same goes for the carci use ofthe term “arm” ta ehcompass an undetermined portion of the upper extremity and the careless use tthe tern ley” to encompass an undetermined portion ofthe ower extremity. supraspinalus muscle triceps beach forearm at bow ips brachi ‘as prime mover ee forearr as prime brachiais muscle: synergst or Nexion ol orearr ‘tecranon. bony tip of ‘elton en Insericn of twicers brachit oper part ohterearm Figure 1.1. View of the right scapula, arm, and upper part of the forearm from behind and the side (Irom Sappey; see “Acknowledzements” for discussion of edits rogarding drawings, ilustrations, and other visual materials)And snother technical note: Just to avoid confusion, I'll not use the word flex ‘except in regard to the opposite of extend. Exeryone knows what a first grader ‘means by saying “Took al me flex my museles," but heyeind this childhood expres: sion, it can lead to ambiguity: For example, having someone “flex their biceps” results in flexion of the forearm, but “flexing” the gluteal museles-—the “gluts"— results notin flexion but in extension of the hips, For deseribing voua postures it's better just (6 avoid the usage altogether] [And one more: Until getting used to terminology for movements of hedy parts, often @ puzzle whether it's better to refor to moving a joint through some range of motion, or to moving the body part on the far side of the joint. For example, the choice nid be betwees ssn: extend! Ue knwe joint versus extend the leg, abduct, the hip joint versus abduct the thigh, flex the ankle joint versus flex the foot, extend the elbow joint versus extend the forearm, or hyperextend the wrist joint versus hyporestend the hand. Even though the two usages are roughly equivalent, the con- {xt usually makes one or the ether seem more sensible. For example, sometimes we refer specifically to the joint, as in “flex the wrist.” In that ease, saying “flex the thand” would be ambiguous because it could mean any one of three things: making ‘fist, flexing the wrist, or hoth in combination. On tho other hand, referring to the body part is often more velfexplanatory, as in “lex the arm forward 9o'.” Although the alternative—"flex the shoukler joint 9o°"—isn't nonsensical, tsa litle arcane for the non-professional.] ‘To understand how the musculoskeletal system operates in hatha yous we ‘must look at how individual museles contribute to whole-body activity. The simplest situation, concentric contraction, or “concentric shortening,” is ‘one in which musele fibers are stimulated by nerve impulses and the entire ‘muscle responds by shortening, as when the bicens brachii muscle in the forearm shortens concentrically to lift « book. ‘When we want to put the book down the picture is more complicated. We do not ordinarily drop an object we have just lifted —we set it down eare. fully by slowly extending the elbow, and we accomplish that by allowing the ‘muscle as a whole to become longer while keeping some of its muscle fibers in a state of contraction. Whenever this happens—whenever @ muscle increases in length under tension while resisting gravity—the movement is called “eccentric lengthening. We see concentric shortening and eccentric lengthening in most natural activities. When you walk up a flight of stairs, the muscles that are lifting ‘you up are shortening concentrically; when you walk back down the stairs, the same muscles are lengthening eccentrically to control your descent. ‘And when you haul yourself up a climbing rope hand over hand, muscles of the upper extremities shorten concentrically every time you pull yourself up; as you come back down, the same muscles lengthen eccentrically. In hatha yoga we see concentric shortening and ecventne lengthening in hundreds of situations. The simplest is when a single musele or muscle {group opposes gravity, as when the back muscles shorten concentrically toJift the torso up from a standing forward bend. ‘Then as you slowly lower ‘back down into the bend, the hack muscles resist the foree of gravity that is pulling you forward, lengthening eecentrically to smooth your descent. {soTONIE AND ISOMETRIC ACTIVITY ‘Most readers are already familiar with the terms “isotonic” and “isornetrc. Sirictly speaking, the term isotonic refers solely to shortening of a muscle funder a constant kes, but this never happene in reality except in the case ff vanishingly small ranges of motion. Over time, however, the term {isotonic has become corrupted to apply generally to exercise that involves movement, usually under conditions of moderate oF minimal resistance. Trometrie exorcise, on the other hand, refers to something more precise— holding still, often under conditions of substantial or maximum resistance. Raising and lowering a book repetitively is an isotonic exercise for the biceps brachii and its synergists, and holding it etill, neithor allowing: it to fall nor raising it, is an isometric exercise for the same muscles, Most athletic endeavors involve isotonic exercise because they involve move- ‘ment, Japanese sumo wrestling between equally matched, Lightly gripped, fend momentarily immobile opponents is one obvious exception. And isometric exercise is also exemplified by any and every hatha yoga posture ‘which you are holding steadily with muscular effort. RELAXATION, STRETCH, AND MOBILITY If few or no nerve impulses are impinging on muscle fibers, the muscle tissue will be relaxed, as when you are in the corpse posture (fig. 1.14). But if a relaxed mucclo is stretched, the situation becomes more complex. Working with a partner ean make this plain. If you lie down and lift your hands straight overhead, and then ask someone to stretch you gently by pulling on your wrists, you will notice that you can easily go with tho stretch provided you have good Nexibility. But if your partner pulls too suddenly or if there is any appreciable pain, the nervous system will resist relaxation and keep the muscles tense; or at the least, you will sense therm {ightoning up to resist tho stretch. Finally, if yon allow yourself to remain hear your limit of passive but comfortable stretch for a while longer, you Tay feel the muscles relax again, allowing your partner to pull more insistently Many ofthese same responses are apparent i'you set up similar eonlitions of stretching on your own, as when you place your hands overhead against wall and stretch the underside of the arms. This is more demanding of Your concentration than relaxing into someone else’s work. however, ‘because you are concentrating on two tasks at the same time: creating the ‘ecessary conditions for the stretch, and relaxing into that effort. But thesume rules apply. Ifyou go too far and too quickly, pin inhibits lengthening, prevents relaxation, and spoils the work. ‘To discover for yoursolf how skeletal muucelos operate in hatha yous, try & warrior posture (warrior 1) with the fect spread wide apart, the hands stretched overhead, and the palms together (figs. 1.2 and 7.20). Feel what happens as you slowly pull the arms to the rear nd lower your welght, To pull the arms up and back, the muscles facing the rear have to shorten concentrically, while antagonist muscles facing the front passively resist ‘the stretch and possibly completion of the pasture. As you lower your weight ‘the quadriceps fernoris muscle on tho front of the floxed thigh resiste gravity and lengthens eoeentricaly. Finally, as you hold still in the posture, muscles throughout the body will be in a state of isometric contraction, Several important principles of imusculuckelets) activity eannot be addressed until we have considered the nervous system and the connective tissues in detail. For now, it is enough to realize that all muscular activity, Whether it be contraction of individual cells, isotonic or isometric exercise, sugonist or antagonist activity, concentric shortening, or cocentre length ning, takes place strictly under the guidance of the nervous system ‘muscles facing the ont resect paling ol the fame to the roar Fight quadticops temons muscle lengirans: conn Figure 1.2, Wartior 1 pase’ THE NERVOUS SYSTEM We experience all—or at least everything pertaining to the material world—through the agency of specialized, irreplaceable cells called ‘neurons, 100 billion of them in the brain alone, that channel information throughout the body and within the vast supporting cellular milieu ef the ‘central nervous system (the brain and spinal cord). This is all acoomplished by only three kinds of neurons: sensory neurons, which earry the flow of sensation from the peripheral nervous system (by definition ull parts of the nervous syetem excopting the brain and spinal cord) into the central nervous system and consciousness; mofor neurons, which carry instructions from the brain and spinal cord into the peripheral nervous system, and from there to muscles and glands; and interneurons, or association neurons, ‘which are interposed between the sensory neurons and the motor neurons, ‘and which transmit our will and volition to the motor neurons. The sensory {information is carnied into the dorsal horn of the spinal eord by way of dorsal roote, and the motor information is carried out of the ventral horn ‘ofthe spinal cord by way of ventral roots. The dorsal and ventral roots join to form mixed (motor and sensory) spinal nerves that in turn innervate structures throughout the body (figs. 13-9) [Technical notes: Because this is a book correlating biomedical scionce with yor, ‘which many consider (o be a science of mind, a few comments are required on a fuject of perennial, although possibly overworked, philosophical interest—the haure of mind vis-a-vis the nervous system. Speaking for neuroscientists, T think F fan say that most of us aoe a tagomatie that neurons are collectively responsible forall of our thinking, cognition, emotions, and other activities of mind. and that the totality of mind ts inherent in the nervous system. But [also have to say as a Iracticing yeqi that according to that tradition, the principle of mind is separate from and more subtle than the nervous system, and is considered to bea life principle that extends even beyond the beds] {ow ana whether these yuestions become reelved in the third millennium isanyonc's ‘guess They are topics that are not usually taken seriously by working scientists, ‘Who usually consider it @ waste of time to ponder non-testable propositions, which fre by definition propositions that cannot possibly be proven wrong. Such state ‘ments ahcund in new age commentaries, and are a source of mild embarrassment ‘to those of us who are trying to examine older traditions using techniques of modern science, This says nothing about the aecuracy of such proposals. It may be true, for ‘example, that “life eannot continue in the abenes of prana." The problem is that Short of developing a definition and assay for prana, such a statement can not be fected it can only be accepted, denied, or argued ad infiniturs {This approceh to experimentation and observation desu't require a lot of brilliance: It simply stipulates thet you must alwagis ask yourself the nature and content of a Statement make it potentially relutable with an experimental approach. IF it’s not, ‘You will be accurate 90% ofthe time if yeu conclude that the idea is spurious, even though it may sound inviting or may’ even appear self-evident, as did the chemical 9 of phleginton in the mid-8th century. To give the benefit of the doubt to the urveyors of such statements, it's rare that they are outright fabrications. On theother hand, one should always keep in mind that all of us (including scientists) have fine capacity fur dexeiving ourselves when iC comes to defending our ideas and innovations. The problem is that it's often impassble to distinguish fantasy, wishful thinking, mild exaggeration, and ampreeise language from out-and-out fraud. What to-do? In the end its @ waste of time to make a enreer of ferreting out errors—one ‘can't get rid of bad idens by pointing them out. On the other hand. if we turn our Sttention to propositions that ean he tested, the creative attention this requires Sometimes brings inspiration and hetter ideas, which in turn disposes of bad ideas ty displacing them. Lavoisier discredited the theory of phlogiston by pointing to brilliant experiments (many of them earried out by others), not by crafting cunning, arguments. {one las concern: if'your complaint is that you can’t understand a particular concept ‘and do not feet competent to criticize it, don’t assume that the problem is your own lack of intelligence or scientific background. More than likely, the idea wasn't presented in a straightforward manner, and it usually happens that this masks one ‘axons of sensory \ ventral neurons nant ight dorsal oot emai fgangton with col badies f sorsory neurons. mixed spinal dorsal ventral reot containing metor nerve (metorand Oot ‘eurenal exons tt Course ‘sonsory lft side) ute the med spral rere ‘gh sce) Figure 1.3. Microscopie section of dorsal root ganglion (above), and thrce dimensional view of the first kimbar segment (L1) of the spinal cord, showing paired dorsal and ventral roots and Iniued (motor and semmony) opinal nerve rom Quoin)‘or more fatal las in the reasoning. One dependable test of a concept is whether Jou! can convingingly explain it, along with the mechanies af how it-gperates, te 3 third party. If you find yourself getting your explanation garbled, or if your listener does nt eoniprehend your argument or is urpersunded, please examine and research the idea more eritically, and if it still does not pass muster, either discard itor putt on the back burner. Tinvite the reader to hold me to these standards. To honor ther, ' Limit inquiries to what we ean appraise and discuss in the realm of | imedern biomedical science, and to refine and improve my presentation, 1 ask for your written input and cordial eritieism.) Returning to our immediate concerns, itis plain that neurons channel ‘our mindful intentions to the muscles, but we still need working definitions for will and volition. In this book Tu arbitrarily defining, will as the decision-making process associated with mind, and I'm defining. volition as ‘the actual initiation of the on and off commands from the cerebral cortex ‘and other regions of the central nervous system that are responsible for ‘commanding our actions. So “will” is.a black box, the contents of which are sill largely unknown and at best marginally accessible to experimentation. ‘Phe nature and content of volition, by contrast, can be explored with estab- lished methods of neuroscience. NEURONS ‘The neuron is the basic structural and funetional unit of the nervous aystem. Although there are other cell types in the nervous eystem, namely the neuroglia, or “nerve gue cells,” which outnumber neurons 10:1, these supporting cells do not appear, as do the neurons, to be in the business of ‘transmitting information from place to place. So the neuron is our main Intorest. It has several components: a nucleated cell body that supports growth and development, and cellular extensions, or processes, some of them very long, that receive and transmit information. ‘The cellular [processes are of two types: dendrites and axons. Picture an octopus hooked na fishing ine. Its eight arms are the derdrites, and the fishing line is the ‘axon. A typical motor neuron contains many dendrites that branch off the «all body. Its single axon—the fishing line—may extend anywhere from a fraction of an inch away fram the cell body to four feet in the case of a ‘motor neuron whose cell hody is in the spinal cord and whose terminal ‘ends in a muscle of the foot, or even fifteen feet long in the ease of similar heurone in a giraffe. ‘The axon may have brunches that come off the main trunk of the axon near the cell body (axon collaterals), and all branches, including the main trunk, subdivide profusely as they near their targets. Dendiites are specialized to receive information from the wavironment from other neurons, and an axon transmits information in the form of Retve impulses to some other site in the body, Dendrites of sonsory neurons “are in the skin, joints, muscles, and internal organs; their cel bodies are sm dorsal root vanilia, which are located alongside the spine, and their axonscarry sensory information into the spinal eord (figs, 13-9). Dendrites of motor neurons are located in the central nervous system, and axons of motor neurons fan out from there (in peripheral nerves) te innervate muscle cells and glands throughout the body: Between the sensory and motor nourons are the association neurons, or interneurons, whose dendrites receive information from sensory neurons and whose axons contact other interneurons or motor neurons that innervate muscles (fig. 4). As a class, the interneurons comprise mast of the neurons within the brain and spinal cord, including secondary and tertiary linking neurons that relay sensory signals to the cerebrum, projection neurons that relay motor signal& from the corobrum and cerebellum to intermediary neurons that eventually ‘contact motor neurons of the spinal cord, and commissural neurons that connect the right andl left cerebral hemisplieres—that is, the “right brain” and the “left brain Interneurons put it all together: You sense and ultimately do, and between sensing and doing are the integrating activities of the interneurons. It’s true, as the first-grade reader suggests, that you ean think and do, but ‘more often you sense, think, and do. "To operate the entire organism, neurons form networks and chains that contact and influence one another at sites valled “synapses.” Synaptic terminals of axons at such sites release chemical transmitter substances that affect the dendrite of the next neuron in the chain (fig. 1.4). ‘The first neuron is the pre-synaptic neuron, and the neuron affected is the post-synaptic neuron. ‘The pre-synaptie axon terminal transmits to the post-synaptic dendrite—not the other way around: it’s a one-way street. ‘Two types of transmitter substances are released at the synapse: one facilitates (speeds up) the activity of the post-synaptic neuron, the other inhibits (slows down) the activity of the post-synaptic neuron. Thousands of axon terminals may synapse on the dendrites of one post-synaptic neuron, and the level of activity of the recipient neuron depends on its pre- synaptic input. More facilitation yields more activity in the postsynaptic neuron in the form of increasing numbers of nerve impulses that travel down its axon; more inhibition yielés diminished activity. For example, the pre-synaptic input of association neurons to motor neurons either facli- tates the activity of motor neurons, causing: them to fire more nerve impulses per second to skeletal muscles, or it inhibits their activity, causing them to fire fewer nerve impulses per second. The peacock posture fig, :24¢) requires maximum facilitation and diminished inhibition of the motor neurons that innervate the abdominal muscles, deep back muscles, muscles that stabilize the seapulae, and flexors of the forearms. On the other hurd, muscular relaxation in the corpse posture (ig. 134) requires reduced facilitation and possibly increased inhibition of motor neurons‘axon terminals af sensory neuron pin endings: ‘synapsing wih denertes of an cal body [aera interneuron otasersory jit capsule coral root ‘sangion ‘axon of sensory neuron in ranst To doveal hom of spinal cord Fermecron {ecrooston wh te ences ant col body tho Sorel reer of the spin cw, snd 7 axon termine ‘synapsing ~ wh dendtes chameter ventral om of the spinal coed ‘axon of motor neuron pasting Gut of spiel ord inte vertral root, Spinal nerve and 1 & meter necro, shevtal muscle ca wih cel bey In vertral nom tthe spinal feud and xen that 2 a = outceniihoe ‘synapse fea aoa sf mts we Figure 1.4. Cross-section of the fifth lumbar segment (L5) ofthe spinal cord, With sensory input from a joint receptor a generic intemeuron, and! motor Sutput oa skeletal muscle cell The small rows indicate the direction of pulses and pre. to post-synaptic inforneuronal relationships. The long, heavy arvowsindicale the locations ofthe generic intemcuron In the spinal Re errr Reet enear ere44 ANATOMY OF MATH 1064 throughout the central nervous system (see fig. 10.1 for a summary of possible mechanisms of muscular relaxation). voUITION: TH .THWAYS TO ACTIVE VOLUNTARY MOVEMENT Exercising our volition to ereate active voluntary movement involves dozens of well-known circuits of association neurons whose dendrites and cell bodiee aro in the cerebrum, cerebellum, and other partions of the brain, and whose axons terminate on motor neurons. A small but important sub- set of projection neurons, the subset whose cell bodies are located in the ‘eerebral cortex auid whose axons terminate on motor neurons in the spinal cord, are known as “upper motor neurons” because they are important in controlling willed activity. These are differentiated from the main class of ‘motor neurons, the “ower motor neurons,” whose cell bulies are located in. the spinal cord. Collectively, the lower motor neurons are called the “final ‘common pathway” because itis their axons that directly innervate skeletal ‘muscles, In common parlance, if someone refers simply to “motor neurons,” they are invariably thinking of lower motor neurons (fig. 15). LOWER MOTOR NEURON ‘The best way to understand how the motor pathways of the serous system operate is to examino the classic neurological syndromes that result from illnesses, or from injuries that have an impact on some aspect of motor function. We'll start with one of the most famous: poliomyelitis, commonly known as polio, which destroys lower motor neurons. Anyone who grew up in the 19408 and early 19508 will remember the dread of this disease. And then a miracle—the Salk vaccine—eame in 1954, putting an end to the fear Poliomyelitis ean be devastating because it destroys the lower motor neurons and deprives the muscles of nerve impulses from the spinal cord, and this results in muscular paralysis. Our power of volition in the cerebral cortex has been disconnected from the pathway of action out of the spinal cord becatise the fini) common pathway has been destroyed. In its most ‘extreme form the resulting paralysis eauses muscles to become completely flaccid, and this accounts for its medical name: flaceid parelysis, ‘The same thing happens in a less global fashion when a peripheral nerve is severed orcrushed, Destruction of the lower motor neurons or their axons at-any site in the spinal cord or peripheral nerves eauses paralysis of all their muscular targets. Will, volition, and active voluntary movement are totally frustrated. RALYSIS: FLAC! PALYSIS UPPER MOTOR NEURON PAMALYSIS. When the upper motor neurons or their axons are destroyed as in an injury or stroke (the interruption of blood supply to the brain) that destroys the ‘motor resion of the cerebral cortex, we lose much of our voluntary control1 movewevranp postin 35 cerebral conex, ‘motor region for thigh masces rear view of spinal cora ‘and paired spiral nerves ‘on each side we see Barca rerves (C18). ‘2 thoracic nerves (11-12), Slumber nerves (LIS) 5 sacral nerves (S18), and small coccygeal nerves "decussate tothe Loppecs cide of the brain inthe motor decussation, ‘vhich ie loose in the lowermost sogment of the brain ctor ho media oblongata) example ofa tower moter euren wth Send tree spinal cord. second imbae (2) ors level, and lower motor feuron whose col boy ¢ shown wth fesr dene turk Figure 15. Upper and er motor Meu. The cell body of an Upper motor neuron is shown above in the left cerebral cortex, adits target the cel body of motor neuron whose Jaxon i destined to fnnervate the right quadricope femoris ‘muscle—is on the right de of the epnal sre ‘axon of a moter neuron tustatec rete a8 passing ‘ut ot the vertebral court by way ofthe nort 26 anaroMy OF HATA 106 ‘of the lower motor neurons, especially on the side opposite to the site of the injury. Our will can no longer be expressed actively and smoothly. The ultimate result of this, al least in severe cases in which a vascular mishap occurs at a site where the axons of othor motor systems are interrupted along with those of the upper motor neurons, isnot flaccid paralysis but spastic paralysis, jn which the muscles are rigid and not easily controlled, A semblance of ‘motor function remains beenuse other parts of the nervous system, parts that have been spared injury, also send axon terminals to the lower motor ‘neurons and affect motor Function. The problom is that these supplemental sources of input eannot be controlled accurately andl seme of ther facilitate the lower motor neurons to such an extent that skeletal museles are driven into strong and uncontrolled states of contraction. Although most of the time the condition does not result in total dysfunction, severe spastic paralysis is only mildly less devastating than flaccid paralyeis; some active voluntary movements are possible, but they are poorly coordinated, especially those that make use of the distal muscles of the extremities (fig. 1.6) SPINAL cono INJURIES If the entire spinal cord is severed or severely damaged at some specific level, there are two main problems. First, sensory information that comes into the spinal cord from below the level of the injury eannot got to the corchral cortex and thereky to conscious awareness. The patient is not ‘aware of touch, pressure, pain, or temperature from the affected region of the body. Second, motor commands from the brain cant get to the lower motor neurons that are located below the injury. Spinal cord injuries at different levels illustrate these conditions: a spinal cord transection in the thoracic region would result in paraplegia —paralysis and loss of sensation in the lower extremities; ula spinal cord trunscetion in the lower part of the neck would cause quedriplesia—paralysis and loss of sensation from the neck down, including all four extremities (fig. 212). Injuries such as these are usually the result of either automobile or sports accidents. REFLEXES So far our discussion has focused on neuronal connections from the top down—from our intentivs, to the cerebral cortex, to upper motor neurons, lower motor neurons, and skeletal muscles. But there is something else to consider, something much more primitive and elemental in the nervous system that bypasses our conscious chuices: e/lexes, or unconscious motor teoponees to sensory stimuli, In this context reflexes have nothing at all to do with the lightning-fast reactions (“fast reflexes”) that are needed for ‘expertise in video games or quick-draw artistry, These reactions refer to unconscious responses eartied out at the spinal level.oper meter nate talon, 4 TOON. Grom Sooper) lance a ste of these 9s. cenronal syste tepreser motor raTecaee ty eae ers turret twonairong ce wet ‘ora skeet 4 oes aa mbytey et, i ‘motor neuron above, than “wpper f se destroyed as 8 motor rors” i fesut of oxygen eprhaton ve to F ‘upture ofa smal {hod vessel ata te terowheae) twough wien the axons of E aAltivee systems ‘motor neurons on the sous fonts ofthe spa ord til eceive put—__ ftom the 3 neuronal Systems represented by the soba ine Figure 1.6. A hypothetical scheme itstrating how injury to a small Fegion of the brain could interrupt Pathways important for the precke Control of skeletal muscular activity and cause spastic paralysis. The dotted fepresents the systorns thal have bbeen interrupted, and the solid line eprescots the remaining systorse that ‘Cannot control muscular activity the final Gommon pathway (the cobeciun pool of ‘ower motor neurons) i stl aaet, butte conscious ‘onto is problematicye anaroawy or naTHA YOR Reflexes ure cimple. That is why they are called reflexes. They always include four elements: a sensory neuron that receives a stimulus and that ‘carries nerve impulses into the spinal cord, an integrating center within the spinal cord, a motor neuron that relays nerve impulses back out to a ‘muscle, and the muscular response that completes the action. More explicitly, the sensory neurons carry nerve impulses from a muscle, tendon, ligament, joint, or the skin to an integrating center in the spinal cord. This intesrating ‘enter might be as simple as one synapse between the sensory and motor neuron, or it might involve one or more interneurons. ‘The motor neuron, in its tun, innervales muscle cells that complete the action. By definition, the reflex bypasses higher centers of consciousness, Awareness of the ‘accompanying sensation gets to the cerebral cortex after the fact and only ecause it is carried there independently by other cireuits, There are dozens of wellknown reflexes, We'll examine three, all of which are important in hatha yogn. THE MYOTATIC STRETCH REFLEX ‘The myotatie stretch reflex, familiar to everyone 8 the “knegjert,” is actually ound threniphout the body, but is especially active in antigravity muscles (Bx. 13). You can test it in the thigh. Cross your knees so that one foot can bounce up and down freely, and then tap the patellar fencon just below the kneecap with the edge of your hand. Find just the right spot, and the big set ‘of quadriceps femoris muscles on the front of the thigh will contract reflexly ‘and cause the foot to fly up. You have to remain relaxed, however, because it js possible to override the reflex with a willed effort to hold the leg in place, "The receptors for the myotatic stretch reflex are located in the belly of the muscle, where the dendrites of sensory neurons are in contact with muscle spindles—specialized receptors barely large enough to be visible ‘with the naked eye. Named for their shapes, each of these muscle spindles contains a spindle-shaped collection of specialized muscle fibers that are loaded with sensory receptors (ig. 17) "The reflex works this way: When you tap the patellar tendon to activate the roflex at the knee joint, the impact stretches muscle spindles in the ‘quadriceps femoris musele on the front of the thigh. ‘This stretch is as fast san eyeblink, but it nevertheless stimulates the specific sensory neurons Aihoce dendrites ond in the muscle spindles and whose exons terminate directly on motor neurons back in the spinal cord. Those axon terminals strongly facilitate the cell bodies of the moter neurons whese axon terminals stimulate the quadriceps feraoris muselo, eansing it to shorten and jerk the foot up. The myotatic stretch reflex is specific in that it feeds back only to the musele in whieh the spindle is located. van with all veflexco, thie one takes place a fraction of a second before youdorsal ret (sorsory) corsal root ‘gangion (sensory) mixed (motor by impact ‘qudticops feronis f ‘one of two muscle cats (greatly triaiged in rotor muscle Lumbar opine! ord (Sepyey) Spine), ane neuromuscular muse inurosssecten iuncton (+) sora Figure 1.7. The myotatic stretch reflex. A'3-foot vertical jump momentarily slretches muscle spindles in all the extensor (anti-gravity) muscles of the lower ‘extremities, The spindles then provide direct (monosynaptic) and almost immediate facilitatory input (+ in ventral horn of spinal cord) to extensor motor Creamers, repli hr stuns seflen conse attiun ef tre individual maaches.‘are aware of it consciously. You feel it happen after the fact, after the reflex hhas already completed its circuit. And you notice the sensation consciously only because separate receptors for the modality of touch sen meesagee to the cerebral cortex and thus into the conscious mind. ‘You ean feel the myotatie stretch reflex in operation in many sports in which your muscles absorb dynamic shocks. For example, when you are ‘ater ekiing on rough water outside the wake of a boat, the muscle spindles in the kneo extensors of the thighs are stretched by the impact of hitting each wave, and absorbing one bump after another would quickly collapse ‘your posture wore i not for the myotatic stretch reflex. Instead, what happens je that cach impact nctivatos the reflex for the quadriceps femoris muscles in a few milliseconds, thus stabilizing the body in an upright postion. You ean also feel the reflex when you attack moguls aggressively on a ski slope, run down the boulder fie of « mountain (fig. 1.7), oF simply jump off a chair ‘onto the floor—any activity in which an impact shocks the muscle spindles. ‘The reflex is therefore a major contributor to what we interpret as strength” in our dynamic interactions with gravity. Athletes depend on it far more than most of thern realize. ‘Stimulating mayotatie stretch reflexes repetitively has another important effect: it shortens muscles and diminishes flexibility. We ean see this most “obviously in jogying, which only mildly engages the reflexes each time your front foot hits the ground, but engages them thousands of times in a halfhour. This ean cause problems if taken to an extreme, and if you tend to be tight you should always do prolonged slow stretching after a run. On the other hand, if the muscles, tendons, and ligaments are overly loose from too much stretching and too few repetitive movements, joints ean become destabilized, and in such cases an activity that tightens everything, oven is one of the best things you can do. Tn hatha yoga we usually want to minimize the effects of the myotatic stretch reflex because even moderately dynamic movements will fire the receptors, stimulate the motor neurons, shorten the muscles, and thereby limit stretch. Any dynamic movement in hatha yora activates the myotatic stretch reflex—houncy sun salutations, jumping in and out of standing postures, and joints and glands exercises carried off with flair and toss ‘These are all fine, especially as warm-ups, but if you wish to lengthen ‘museles and increase flexibility it is better to move into postures slowly. ‘The clasp hnife reflex acts like the blade of pocket Iife when it resists closure up to a certain point and then suddenly snaps into its folded position. Lis another streteh reflex, but this one causes the targeted muscle to relax suthor than contract. The stimulus for the reflex is not dynamic stretch of1 MovewenT ann posteRe 4 ‘a mucele spindle, but contractile tension on a sensory receptor in a tendon. ‘This tension reflexly causes the muselo attached to that tendon to rela and the joint to buckle (ig. 8). ‘The sensory receptor forthe clasp knife reflex is the Golgi tendon organ. ‘Most of the receptors are actually loeated near musculotendinous junetions, where they link small slips of connective tissue with their associated muscle fibers. The Golgi tendon organ is therefore activated by the contraction of muscles cells that are in line (in series) with the receptor. Recont studies have clarified that the Golgi tendon ongun is relatively insensitive to passive strotch, but that it boxins to fio norve implies back to the opinal cord a soon as musele fibers start tugging on it ‘And then what happens? This is the main idea: unlike the myotatie stretch reflex, here the incoming sensory axons do not terminate directly ‘on motor neurons (which would increase their activity and stirmalate = ‘muscular contraction), but on inhibitory interneurons that diminish the activity of motor neurons and thereby cause the muscle to relax. If you stimulate the receptor, the reflex relaxcs the muscle (fg. 1.8). It is.a precise feedback loop in which the contraction of rauscle fibers shuts down their own activity. This feedback loop works something like a thermostat that shuts off the heat when the temperature rises, Anecdotal reports of super hhuman strength in which a parent is able to lift an automahile of her child might be due to a massive central nervous system inhibition of this reflex, like a thermostat that stops working and overheats a house. In ordinary life we see the clasp Inife reflex in action, at leaet in @ gross form, when ‘bvo unequally matched arm wrestlers hold their positions for a few seconds, and suddenly the weaker of the twa gives way (fg. 1.8) Whether intentional or not, we constantly make use of the clasp knife reflex while we are practicing hatha yora. To eco it most effectively and to begin to gain awareness of its utility, measure roughly how far you ean come into forward bend with your knees straight, preferably the first thing in the ‘morning, Then bend the knees enough te Natten the torso against the thighs. Hold that position firmly, keeping the arms tightly wrapped around the ‘highs to stabilize the back in a comfortable position in relation tothe pelvis. ‘Then try wo straighten the knees while keeping the chest tightly m place, and hhold that position in an intense isometric pull for 30 seconds, ‘This is tho hamstrings-quadriceps thigh pull (fig. 116), and ve'll examine it in more Aetail later inthis chapter. Release the pose and then check to see how much furthor you can come into a forward bend with the knoos straight. The difference will be a measure of how much the Golgi tendon organs “stimu Jated” the hamstring muscles to relax by way of the clasp knife reflex. ‘The Golgi tendon organe are sensitive to manual stimulation as well as to muscular tension. If you manipulate any musculotendinous junction in2 away or naTuA v0GA the body vigorously, its Golgi tendon organs will relexly cause their aseo- ciated muscle fibers to relax. This is one of the reasons why deep massage is relaxing, This is also why body therapists wanting to reduce tension in a specific musele will work directly on its musculotendinous junetions. It's ‘an old chiropractic trick—manual stimulation stimulates the clasp knife reflex almost as officiently as contractile tension, Surprisingly the results last for a day or two, during which time the recipiont of the work has a chance to correct the offending musculoskeletal habit that gave rise to the ‘excess tension in the first place. “Although you can test the effects of manual stimulation on tendons any here in the body, let's experiment with the adductor muscles on the inside of the thighs because tight adduetors, more than any other muscles, lirit, Your ability to sit straight and comfortably in the elassic yous siting pos ‘ures. First tost your ubility to sit in either the auspicious or accomplished posture (figs. 10.11 and 10.14) Then release the pose and lie with the hips butted up firmly against 2 wall with the knees extended and the thighs spread out as much as possible for an adductor stretch, With the help of a partner to held your thighs abducted, try to pull the thighs together jsometrcally, engaging the adduetors as much as possible, and at the same time stimulate the Golgi tendon organs in the adductor muscles with vigorous rubbing. Some of the adductor tendons are the cordlike structures in the inner thighs near the genitals. Others are more flattened and are located further to the rear. All of them take origin from pair of bones, the inferior pubic rami (fig. 112), that together form the rear-facing V which accommodates the genitals. ‘As you massage the adductors for a minute or so while keeping them under tension, you will feol them gradually release, as evidenced by being fable to abduct the thighs more completely. Then sit up and check for improvement in your sitting posture. The combination of messaging the adductor tendons plus making an isometric effort with stretched adductors powerfully inhibits the motor neurons that innervate these muscles, and this allows them to release and permits you to sit straighter and more ‘comfortably. "The hamstrings-quadriceps thigh pull and the adductor massage give us obvious examples of how the clasp knife reflex operates. It is len invoked {in a milder form any time you are able to stay comfortable in an active posture for more than 10-15 seconds, which is what we often do in hatha Joga. In this case don’t bounce unless you want to induce the myotatic ‘trctch reflex, and don’t take a posture into the discomfort zone unless you fare prepared to trigger Hexion reflexes, which we'll discuss next1 MOVEMENT AND FOSTERE 4 dorsal root anc cal body of Ssereory neuron ‘ntitnry reuwon, and ice ane tnceps brachil radial nerve; branches innervate egies —_—_& tree nea oftresps rach triceps ‘as well as Golg tendon organs bach mast Golg “tendon” organs fre actualy found at or near musculoterdknaus junctions lateral head of ticens brachi— ‘common tendon f insertion for {cops brachi muscle medial hoad of triceps tract ‘xoes-section of exricl spinal co (C7) neuromuscular syranse i, ss, mixed (motor fan sensory) ‘spinal nove ‘0° of inhibitory intemeuren, with Cola tendon organ, in series minus sign sigraung wsptery eect with the fve skeletal muscle (60 eel body of motor neuron cells shown above Figure 1.8-The clasp kif reflex: Muscular fr stimulates Gol tendon ‘organs, whose sensory input to the spinal cord activates inhibitory interne (Grin dorsal hom; the inhibitory interneurons then inhibit motor neurons (in in fewer nerve impulses per second to the skeletal mur- le cells (+ effects at the neuromuscular synapse are minimized). Final result is relaxation of the muscle. or in this case. lass of the atmuresting match (Sapper)FLEXION REFLEXES ‘The flexion reflexes (fig. 1.9) are pain reflexes. Ifyou inadvertently touch hot skillet you jerk your hand back reflexly. You don't have to think about it, itJust huppous. As with the other reflexes, awareness comes a moment lator Flexion reflexes are more complex than stretch reflexes, but they are ‘easier to comprehend because pain is such an ebvious part of everyone's conscious experience. Even if it is no more than a fecling of strotch that ‘went too far while you were gardening, a pain in the knee or hip that devel- oped after 2 strenuous hike, or a neck problem you didn’t notice until you Marted to tum too far in a certain direction, with rare exceptions your ‘automatic response will be Hexion. You may be only vaguely aware of the reflex itself, but you will certainly be aware of the fear and tension that accompanies it "The sensory neurons (including their axons) that carry the modalities of pain and temperature conduct their nerve impulses more slowly than those that activate the myotatic stretch reflex. What is more, flexion reflexes are polysynaptic—that is, they involve one or more interneurons in addition to the sensory and motor neurons—and each eynapee in the chain of neurons slows down the speed of the reaction. You can estimate the conduction time for temperature by licking your finger and touching a coffee pot that is hot ‘enough to hurt but not hot enough to cause injury. I wall take almost a second for the sensation to reach consciousness from a finger, well over a second from a big toe, and, for the adventuresome, about a tenth of a second from the tip of the nose. Such slow conduction times from the extremities would not serve the myotatic stretch reflex. If for that reflex it took a full seeond for nerve impulses to reach the spinal cord, you would be in serious trouble {jumping off a platform onto the floor with bent knees—you would collapse ‘and chatter your kneecaps before the extensor muscles could react enough to support your weight. Like the two stretch reflexes we have just considered, the motor reflexes {for flexion are spinal, not cerebral. So even if the spinal cord were cut off from the brain, the flexion reflex would otll withdraw a foot from a toxic stimmulux. That's why neurologists have little reason to be encouraged when the foot of a patient with a spinal cord injury responds to 2 pinch. RECIPROCAL INH! Flexion reflexes not only activate flexor muscles to pull the hand or the foot toward the torso, they also relax the extensors, which then allows exion to take place freely, Thio is done through the agency of inhibitory inter neurons, While facilitatory interneurons impinge on motor neurons that Tnnervate flexors, thus causing them to contract, inbibitory interneurons tupingees motor neurons thot innervate extensors, causing: them to relax.Incoming sorcery Srna tro bation of lotttoce ws) motor Gupur To flexars for ‘exon retex relaxation of torsos (Fociprocal inhibitor) oa »\ ne toLs——e and este: Figure 1.9. Flexion reflex on the left, and crossed extension feflex on the right Incoming, Sensory input from bottom of left foot (U5) spreads to lower ‘motor neurons from L2 theough Ft er cere (Copper) | woveuexrasn poste 45 cross-section Step core tit iunbor level (5) moter inmibitea |, motor out putat ts Son ight Stuer crossed ‘extensor motor neuron retlex fetvated on right sige spinal cord seoment. Lt sera let toot Gspiral reve) nro, lett ice: al flexen refi wth ‘eciprocst inhibition: flexors ae simulate relaxed from t2 through tenth thoracic spiral nerve SS (HO) night side 111 opinal m2 fest mbar Spinal nerve yesh lower extremity, ht sce crosses, ‘enonsion reflex extensors are fered pana musdes Ste relaxed frormta ANjs an integral ‘The phenomenon ix known as reciprocal inhibition, and it part of the flexion reflex (fix. 1.9) Unlike stretch reflexes, flexion reflexes create effects well beyond the site of the stimulus, We can eee this when # nurse pricks a child’s index finger with a necdle to draw blood. ‘The child's entire upper extremity reacts, not just the flexors in the offended finger. A vehement jork back- ward shows that the flexion reflex facilitates flexor motor neurons and inhibits extonsor motor neurons for the entire upper extremity. THE CROSSED-EXTENSION REFLEX "The crunsed-extension reflex ads yot another ingredient to flexion reflexes— ‘a supporting role for the opposite side of the body. Through the agency of this reflex, as the extremity on the injured side flexes, the extremity on the olher side extends. This would happen i you stepped on a hot coal near = ‘campfire, You don’t have to think about either reflex; you lift your injured foot in a hurry, contracting flexors and relaxing extensors on that side—- everything at the seme time—toe, ankle, knee, hip, and even the torso, And '5 the injured foot lifts, the eroseed-extension reflex contracts the extensors ‘and relaxes the flexors on the opposite side of the body, strengthening your stance and keeping you from toppling over into the fire (fig. 1 "The croseed-extension reflex is uecomplished by interneurons whose ‘exons cross to the opposite side of the spinal cord and innervato motor neurons, ina reverse pattern from that seen on the side with the injury—motor neurons for extensor muscles are facilitated, and motor neurons for Nexor muscles are inhibited. ‘The flexion reflexes also serve many other protective functions. For example, ifyou sprain your ankle badly, the pain endings become more sen- sitive. ‘The next time you start to turn your ankle, the higher eentors in the brain ascociated with volition and consciousness allow the spinal flexion reflexes to act unencumbered and collapse the limb before your weight drops fully on the vulnerable joint. This prevonts re-njury. A “tick” knee demonstrates he same mechanisme—an old injury, a sudden physical threat, unresistant higher centers, and unconscious flexion reflexes. Your bad knee buckles quickly, and you are saved from more serious injury. RECIPROCAL INHIBITION AND A STIFF BACK Since they restrain movement, flexion reflexes usually influence hatha postures negatively, but there are certain situations in which we ean wee Them to our advantage. Ifyou tend to be stiff and not inclined to forward pending, try this experiment early in the morning. First, for comparison, slowly lower into a standing forward bend with your fingers extended. Notice that you hecitato to came forward smoothly: This may happen even1 Movesuexranp postiRe 47 if you are in excellent condition but not warmed up. The deep back muscles are extensors of the back; they lengthen eccentrically as you bend, resisting forward movement and only allewring you come into the post swith creaks and wariness, Come up. Next, holding the elbows partially flexed, flex your fingers tightly, making fists. Holding that gesture, come forward again. You will immediately notice that you do this more easily and ‘smoothly’ than when your fingers and elbows were extended. Come up, and repeat the exercise to your capacity. ‘Making your hands into fists reciprocally inhibits the motor neurons that innervate the deep back muscles. If you are in good condition this merely helps you come forward more smoothly and confidently, but if your back is tense from excess muscle tone in the deep back muscles you will be ‘amazed at how much the simple act of flexing your fingers into fists eases you into a relaxed bend, Why might your back he stiff from excess muscle tone? It is usually because of pain that causes the back museles to become taut and act as a splint to prevent movement. This is Fine for a while sa proteetive measure, Dut at some stage it becomes eounterproductive and leads to other problems. When stiffness and mild back pain emerge, you need enough muscle tone to prevent re-injury, it is true, but you do not need enough to lock you up for months on end. The reciprocal inhibition caused by making your hands into fists helps relax the extensor muscles in the hack and allows you to ease further into a forward bend. If your back is chronically stifT, but not in seute pain, you can bonefit by doing this exercise several times a day: THE VESTIBULAR SYSTEM, SIGHT, AND TOUCH So far we have seen how m0 1 neurons drive Uhe musculoskeletal system, hhow association neurons channel our will to the motor neurons, and how ‘Sensory input from muscles, tendons, and pain roeeptors participate with ‘Motor neurons in simple reflexes. But that’s only the beginning. Many other sources of sensory input also affect motor function. Some of the most important are the vestibular sense, sight, and touch. THE VesTiuLan SENSE We have little conscious awareness of our vestibular sense even though it is ‘titical for keeping us balanced in the field of gravity Its receptors lie close to the organ of hearing—the inner ear—in little circular tubes called semi: Gireular canals and in # little reservoir called the utricle, all of which are ‘embedded in the bony region of the skull just underneath the external ear. ‘The semicircular canals and the utricle are all involved with maintaining ‘ur equilibrium in epsee, but within that realm they are sonsitive to. different stimuli—the semicircular canals to rotary acceleration, and the“utricle to linear seceleration and to our orientation in a gravitational field ‘They also participate in different reflexes: the semicircular canals coor: dinate eye movements, and the utricles coordinate whole-body postural adjustments. ‘Except for pilots, dancers, ce skaters, and others who require an acute vwareness of equilibrium, most of us take the vestibular system for granted. We don’t notice it because it. dues almost all of ite work reflexly, feeding ‘sencory information into numerous motor cireuits that control eye and body movements: Because the semicircular canals are sensitive to rotary acceleration, they respond when we stort oF stop any spinning motion of the body. One of their several roles is to help us maintain our equilibrium by coordinating feye movements with movements of the head. You can experience these 1¢ {you sit cross legged on a chair or stu that can rotate, tip your bead forward Shout 30%, and have some assistants turn you around and around quickly for 30-40 seconds. Make sure you keep balanced and upright. Don’t lean to the side or you will be pitched off onto the floor. Then have your assistants stop you suxidenly. You eyes will exhibit little jerky movements knovn = nystagmus, and you will probably feel dizzy. Children play with this reflex ‘when they spin themselves until they got dizzy and fall down. the sensation they describe as the world “turning” is due to nystagmus. The perception is disorienting at first but it slows down and stops after a while. "The receptors in the semicircular ennals stop sending signals after about 30 seconds of spinning, which is why you have your assistants rotate you {or that period uf time. It is also why the reaction slows down and stops in yo seconds after you are abruptly stopped. Third-party observers obviously ‘cannot observe nystagmus during the initial period of acceleration while ‘ou are being spun around. To observe these eye movements in a practical setting, we must roly on what we call post-rotatory nystagmurs, the eye movements that occur after you have been stopped suddenly. "The neurological cireuitry for nystagmus is sensitive to excessive alechol ‘and this is why highway patrol officers ask suspected drunks to get out of the car and walk a straight line. If the suspect is suffering from alcohol jnduced nysiaginus, the ensuing dizziness is likely to make walking ‘traight impossible. Spontancous (aud continuing) forms of nystagmus {hat ere not induced by drugs or aleohol may be symptomatic of neurological problems such a a brain tumor or stroke. ‘Occasionally students in hatha yoga classes are sensitive to dinsines= when they do neck exercises, ‘They may have had such problems from Childhood or they may just not be accustomed to the fact that they are Stimulating their semicircular canals when they rotate their bead. And cnet utherive healthy students who are just getting over a fever may be1 Movrunevranp Pose 49 sensitive to dizziness. In any case, anyone who is sensitive should always do neck exercises slowly. ‘Tho second component of the vestibular anyin, the utricle, detects two ‘modalities: speeding up or slowing down while you are moving in a straight line, and the static orientation of the heed in space. The rush of accelerating, or decelerating a car io an example of the first eace. As with the semicicular canals, stimulation ends after an equilibrium is established, whether sitting slill or going 100 miles per hour at a constant rate on a straight road. The ‘utricles also responé to the orientation of the head in the earth's gravitational fiold—an upright posture stimulates them the least and the headstand stimulates them the most. The receptors in the utricle adapt to the stimulus of an altered posture after a short time, however, which is why it Important for pilots of small planes to depend on instruments for keeping, properly oriented in tho sky when visual feedback is absent or eonfusinst Forexample, a friend of mine was piloting a small plane and flew unexpectedly {nto a thick bank of clouds, Instantly lost and disoriented, and untrained in flying on instruments, he calculated that he would just make s slow 186” turn, Unfortunately, after having made the turn and exiting the clouds, he ‘was shocked to see that he was headed straight toward the ground j Fortunately, he had enough airspace to pull out of the dive. In ordinary circumstances on the ground, the receptors in the utricle do ‘more than sense the orientation of the head in space: they trigger many ‘whole-body postural reflexes that maintain our balance. 'This is the source of the impulse to lean into eurvos while you are running oF eyeling sround a track. We also depend on the utricle for underlying adjustments of hatha, _Yoga postures that we triggor when we tlt the head forward, backseard, or ‘to one side, Every shift of the head int space initiates reflexes that aid nd bet many of the whole-body postural adjustments in the torso that we take for granted in hatha yous. ‘The well-known righting reflexes in cats can give us a hint of how the ‘vestibular eystem influences posture in humans. If you want to ece these ‘eflexes operate, drop an amicable cat, with its logs pointed up, from as litle 4858 few inches above the floor It will turn with incredible speed and land on all four fect, even if it has been blindfolded. Careful study reveals « definite Sequence of events. ‘The utricle first detects being upside down, and then it detects the falling sensation of linear acceleration toward the floor. Tn ‘Tesponsse to this the eat automatically rotates its head, which stimulates neck ‘nuscles that in turn leads to an agile twisting around of the rest ofthe body ‘and a nimble landing on all four feet. The eat does allthis in a fraction of a ‘second, Comparable reflexes also take place in human beings, although fre not refined! ss in eatssight When we are moving we are heavily dependent on vision, as anyone can attest who has stepped off a curb unawares or thought erroneouely that fone more step remained in a staircase, This is true toa lesser extent when, tre are standing still. you stand upright with your feet together and your tyes open, you ean remain still and be aware that only minuscule shifts in the muscles ofthe lower extruuities are necessary to maintain your balance ‘But the moment yeu close your eyes you will experience more pronounced ‘muscular shifts, For an even more convincing test, come into a posture such ts the treo or eagle with your eyes open, establish your balance fully and then close your eyes. Few people will he ale to do this far more than a few seconds before they wobble or fal. Visual cues are especially important while coming into a hatha yo pos ture, but once you are stable you can close your cyes in most poses without losing your balance provided your vestibular system and joint senses are healthy. On the other hand, if you want to study your body's alignment chjectively you ean do it only by watching your reflection in a micror. Tis nl tov wany to deveive youreelf if you depend purely on your muscle- and joint-sense to establish right-left balance. ‘he SENSE oF TOUCH ‘The vonse of touch brings us awareness of the pleasure and luxury of com- fortable stretch, and because of this it is the surest authority we bave for telling us how far to go into a hatha yoga posture. The vestibular reflexes and vision help with balance, and pain tells us how far not to go in « stretch, But the sense of touch is a beacon, It both rewards and guides. ‘The modality of touch includes diseriminating touch, deep pressure, and ‘inesthesis, All three are brought into conscious awareness in the cerebral ‘cortex, and along with stretch reflexes, vision, and the vestibular sense, they make it possible for us to maintain our balance and equilibrium. Diseriminating touch is sensed by receptors in the skin, und deep pressure is sensed by receptors in fasciae and internal organs. Kinesthesis, which i= the knowledge of where your limbs are located in space, as well as the awareness of whether your joints are folded, straightened, stressed, or comfortable, is sensed mostly by receptors in joints. If you bft up in @ posture euch as the prone boat and support your weight only on the hdomen, you ean feel all three aspects of touch—contact of the skin with the for, deep pressure in the abdomen, and awareness of extension in the spine and extremitios ‘Touch receptors adapt even more rapidly than receptors in the vestibular system, which means that they stop sending signas ty the central nervous jotemafier a fow seconds of stillness, That's why holding bands with someonegets boring in the absonce of occasional squeezing and stroking. Without ‘movernent, the awareness of touch disappears. Rapid adaptation to touch is extromely important in hatha you postures, relaxation, and meditation. If ‘your posture is stable, the receptors for touch stop sending signals back to the brain and you are able to focus your attention inward, but as soon as you move the signals return and disturb your state of silence TOUCH AND THE GATE THEORY OF Ps Ifyou bump your shin against something hard, rubbing the injured region ‘lloviatos the pain, and if your knoe hurts from sitting for along time in a ‘ross-legeed posture, the natural response is to massage the region that is hurting. ‘There is a neurological basis for this—the gate theory of pain, according to which the application of deep wuch and pressure closes a “gate” to block the synaptic transmission of pain in the spinal cord. Although it has rot been possible to substantiate this theory as it was initially proposed, we all know experientially that somehow it works. So even though the ‘mechanism is still uncertain, the general idea i widely accepted as self evident-—somewhere betwoen the spinal cord and the cerebral cortex. touch and pressure pathways intersect with the ascending pathways for pain au either block or minimize its perception. We use this principle constantly in hatha yoga. ‘To illustrate, interlock your hands behind your back and press the palms together. Pull them to the rear so they do not come in contact. with the back, and come into a forward bond. Ifyou are not warmed up you may notice that you feel mild discomfort from the stretch. Now come up, press the forearms firmly ‘Against the back on either side of the spine, and come forward again. The ontrast will be startling. The sensation of deep touch and pressure against the back muscles stops the discomfort. immediatoly Ts this good or bad? That is a vital question, and one of the challenges of Thatha yoru is to learn how far this principle can safely be taken. If you Underestimate tho importance of the signals of pain, and diminish that Pain with input from touch and pressure, you may injure joints and tissues, But if you baby yourself, you'll never progress. The answer, unfortunately, Js that you may not know if you have gone too far until the next morning, Hyou are sore you know you misjudged CONNECTIVE TISSUE CONSTRAINTS Our bodies are made up of four primary tines epitheliuo, muscle, nervotes “issue, and connective issue. Epithelia form coverings, linings, and most of fhe internal organs. Muscle is responsible for movement, and nervous tissue Fesponsible for communication. That leaves connective tissue —the ome binds all the others together. If you were able to remove all theconnective tissue from the body, what was left would flatten down on the floor like a hairy, lumpy pancake, You would have no bones, cartilage joints, fat, or blood, and nothing would be left of your skin except the Spidermis, halt, and sweat glands. Muscles and nerves, without connective {eeue, would have the consistency of mush, Internal organs would fall apart. ‘To understand epithotia, muscle, and wervous tissue we have to under- stunt their cells, because itis the cells that are responsible for what the tissue does, Connective tissues are a different matter, With the exception of fat, the one connective tissue that is mado up almost entirely of cells it is the extracellular (outside of cells) eubstance in each connective tissue that gives it its essential character. The extracellular materials impart hardness to bone, resilience to cartilage, strength to tendons and fasciae, and liquidity to blood. And yet the extracellular components of onnetive issuus are entirely paseive. Trying to relax a ligament or release fascine ‘with our power of will would be Tike trying to relax leather. ‘So are the eonnective tissues alive? Yes and no. Yes, in that living ells in the various comnective tissues manufacture its extracellular components and organize the tissue. Also yes, in that the extracellular space in connective wis teeming with electrical activity. But no, in that the extracellular materials are nonliving. And one more no, is that the only way we earn decors: them is through tho ageney of living cells. Only through neurons sand their commands to muscle cells can we release tension in a tendon. execute weight-bearing activities that add bone salts to bone, and stimulate the laying down of additional connective tice fbors in tendons and fasiae. ‘And only with cells derived from epithelial tissues ean we accomplish the ssbeorption, manufacturing, and eliminatory functions that are needed for supporting the tissues ofthe body in general. tn the end, our aim of molding fand shaping the extracellular components of our connective tissues can ‘only be accomplished indirectly. “The fact that the various connective tissues are 60 unlike one another ‘areflection of the foct that their extracellular materials are diametrically dlfferent. Bone contains bone salts; tendons, igments, and fasciae contain dense accumulations of ropy fibers; loose connective tissue contains loose ccuraulations of the same fibers; elasti connective tissue contains elastic hers, and blood contains plasma. So we can't work with connective tissues in goneral; we have to envision and work with each one individually Connective tisues not only give us shape, they’ also restrain activity. Bone butting ayninst lone brings motion to = dead stop. Cartilage constrains vrotion, but more eofly than bone. Ligaments constrain movements according a theld architecture arrangements around joints. Shoets of fisciae, which are vocally nycrne'eonnestivo Hane, enolase and argunive muscles and nerves1 soveuENTaNo PosriRe 5) sometimes more retrictively than we would ike. Finally, ease eannective tissue Jplps bond the entire body tovether, conctraining movement between fascine ad skin, adjocent muscle groupe, and internal ongan. BONY CONSTRAINTS Ligaments, muscles, und the joint capsule itself all uid in holding the elbow Joint together, but underlying these supports, bony constraints ultimately Timit both flexion and extension, Flexion is limited when the head of the radius and the coronoid process of the ulna are stopped in the radial and eoronoid fossae in the lower ond of the humerus, and extension is stopped ‘when the hooked upper end of the ulna—the olecranon process—comes to ‘a stop in & matching olecranon fossa in the humerus, Even though thin layers ‘of cartilage soften the contact between the radius and ulna in relation to the humors, the architectural plan limits flexion and extension as certainly as doorstops and provide us with clear examples of bony constraints to move- ‘ment. It is not something we would want to alter (fig 1.10). In the spine we ace another example of how one bone butting up againet ‘another imits movement. The lumbar spine can extend and flex freely, but ‘matching surfaces of the movable intervertebral joints in this region are ‘oriented vertically in a front-to-back plane that severely limits twisting (Gg. 1.1). Because of this, almost. all the twisting in a xpinal tacit takes Place in the neck and chest, where the matching surfaces of comparable Joints are oriented more propitiously (chapters 4 and 7). As with the elbow, e would not want to alter this design. If the lumbar region, isolated as it ‘is between the pelvis and chest, could twist markedly in addition to bending forward and backward, it would be hopelessly unstable. CARTILAGINOUS CONSTRAINTS Cartilage bas the consistency of rubber or soft plastic. It gives shape to the fand external ears, and it forms « cushioning. layer at the ends of long ‘Our main concern in this discussion, however, is nol with these but with the joints called symphyses—the intervertebral disks ‘adjacent vertebral bodies (figs. 1m, 410b, 4.11, and 4.13b), 28 well the pubic symphysis between the two pubte bones (figs. 1.12 and 3.2). At Of these sites symphyses restrict movement, something likw sat but ‘rubber gaskets glued between blocks of wood that allow alittle move- it but no slippage. Yo that end the pubic symphysis is secure enough to the two halves of the palvie bowl together in front and yet permit shifts and deviations; intervertebral disks bind adjacent vertebrae tightly and yet permit the vertebral column as a whole to bendoy axeroMv or narnia v06A mela ew of ight bow cnt ina colster! ) gare wo > pares racial fossa faciot collateral ligament dk Ua humerus ‘olecranon fossa — olecranon process Figure 110. Bory stops for elbow flexion and extension, with the joint capsule ceetred above, font views ofthe disarticulated right and left ethow joints Ptah the middle, and a longitudinal cut through the joint and two ofits Test bones shown below. Extension is stopped where the olecranon process Tene ootgainer ite fossa. and flexion is stopped where the head of the radius eo era roves butt up against the ronal and coronols fossa (Sep).1 movewexrann posroRe 55 TENDONS AND LIGAMENTS By definition, tendons connect muscles to bones, and ligaments conneet bone to bore. They are both made up of tough, ropy, densely packed, inelastic ‘onnective tissue fihers, with only a few cells interspersed between large skets of fibers. Microscopically, tendons and ligaments are nearly identical, although the fibers are not packed as regularly in ligaments as in tendons, Jna tendon the fibers extend from the belly of a muscle into the suhstance ‘of @ bone, lending continuity and strength to the whole complex Ligaments hold adjoining bones together in joints throughout the body, ‘often permitting sinall gliding motions, and usually becoming taut at the end of a joint's range of motion Ligaments and tendons can accommodate no more than about a 4% {increase in length during stretching, after which tearing begins. This can Je a scrious problem. Because the extracellular connective tissue fibers in tendons and ligaments depend only on a few scattered living cells for repair and replacement, and because the tissue is so poorly supplied with blood vessels, injuries are slow to heal, The most commun of these is fendinitis, which is eaused by tears in the fibers at the interface between tendon and frmeverse processes superior atesing spinous process ofL1 inferior oflt | process of Lt 2 articulating : process of Ero Eo superior artculating process of Cogn sic). ofnght process of t etspneus D) prosess of te Inferior aniculsting spa enertstion of articulating Process of LS Processes provorts lumbar tasting fire 1.1 tua writ a he ont ila hind The vert frontback orientation ofthe artlting processes and thei races lx a bony stop that prevents lumbar twisting, Spaces that represent the fete fortieth ik Between L2 and ate cal by anonsé anarosiv oF usin VOGA one. If someone keeps abusing this interface with repetitive stress, ‘whether typing at a computer keyboard, swinging @ tennis racket, or trying compulsively to do a stressful hatha yogn posture, the injury can take & year to heul, ur even longer “The main purpose of ligaments is to restrain movable joints, and this becomes & major concern in hatha yoga when we want to streteh to cur ‘maximum, We might at first think of loosening them up and stretching, them out so they do not place so many restraints on hatha postures. But ligaments don’t spring back when stretched and lengthened (at least not beyond their 4% maximum), and if we persist in trying to stretch them beyond their limits we often do more harm than goed. Once lengthened ‘they become slack, and the joints they protect are prone to dislocation and injury. Ligaments have their purpose; let them be. To improve ranges of motion and flexibility, itis better to concentrate on lengthening muscles. somnt CAPSULES ‘Joint capsules aro connective tissue encasements that surround the work: {ng surfaces of the class of joints known as synovial joints, including hinse joints, pivot joints, and ball-and-socket joints. Joint capsules for synovial sant tet ube pubic Bore boro ight superior pubic ras Jot superce pubic ramus enorpuan nies / isthia! tuberoaties (iting bores) Tigure-1.12. Pubic symphysis sown where it joins the two sides ofthe pels. Tnsenlegement of the to pubic Bones and shia ont view) is taker from Fe sarhich shows the entre pete in psrapective (Espp=y)joints bave several roles: they provide a container for the slippery synovial fluid that lubricates the mating surfaces of the opposing bones; they house the synonial membrane that secretes the synovial fluid: they provide & tough covering of tissue into whieh ligaments and tendons can insert; and of special interest to us here, they and their associated ligaments provide about half the total resistance to movement. ‘The shoulder joint reveals an excellent example of a joint capsule. Like the hip joint, the shoulder joint is.a ball and socket—the ball being the head of the humerus and the socket being the glenoid eavity of the scapula (is 149). The joint capsile surrounds the entire complex and accommodates tendons that pass through or blend into the joint capsule, as wel as ligaments that reinforce it on the outside. To feel how it restricts movement, raise your arm overhead and pull it to the rear as far as possible: within the shoulder you can fecl the joint capsule and its ligaments tightening up. EXTENSILE LIGAMENTS. Extensile ligaments are not really ligaments; they are skeletal muscles held ‘at relatively static lengths by motor neurons firing a continuous train of ‘nerve impulses, They have greater elasticity than connective tissue ligaments, Because of their muscular nature, but other than that they function to ‘maintain our posture like ordinary ligaments, What they don't do, by definition, ‘is move joints through their fll range of motion, which is what we usually ‘expect from skeletal muscles, According to the eonwentional definition, extensile Tigaments are mostly postural muscles in the torso, but itis arguable that for ‘maintaining a stable meditation posture, every muscle in the body (excepting, ‘the muscles of respiration) becomes an extensle ligament. Unlike connective tissue ligaments, the length of extensile ligaments ‘can be adjusted according to the number of nerve impulses impinging: on ‘the muscle. And since every muscle associated with the torso and vertebral ‘column is represented on both sidee of the body, the matehing; muscles in “each pair should receive the same number of nerve impulses per second on ‘tech side, at least in any static, bilaterally symmetrical posture. If that umber is unequal, the paired muscles will develop chronically unequal that result in repercussions throughout the central axis of the In hatha yoga, this condition is especially noticeable because itis the ‘source of right-left musculoskeletal imbalances. Asal imibalamees ean be spotted throughout the torso and vertebral column, they are especially noticeable in the neck, where the tiny suubocrpitat function as extensile ligaments to maintain head. position (fg 20). If your head 1s chronically twisted or tipped slightly to one side, it ‘mean that you have held the matching muscles on the two sides ut lengths over a long period of time. Motor neurons have becomesf ANATOMY OF HATHA YOGA ‘of scapula leno 2 ony: coroco1d N _— process ot scapula articular head of homens smecial border —6r scapula ‘ront surface of scapula (aces Deck side of chest longheedot ‘weeps brachi device subecapuloris muscle fakes origin from the ma > tort surface tthe capsu scapula (behind the ‘Shoulder joe chest) ad Helps hold ‘the head of the tendon of ongn, humenis againat the ong head of the slencid city biceps brecrt—— tendon of insertion ofthe ssubscapatais muscle, one ofthe rotator cuff muscles site of tachment of endon of eign. ora forous eapstie of head of triceps Brachi the shoulder jot 10 the rear border ofthe flenoid cau —— tendons af incertion of Sotator cut muscles: —suprespintus inftagpinatus, and teree miner thoes ‘muscles stablize the shoulder joint and keep it om being elocated ‘capsule of should joint — A tendon of origin ong oad t eps bro =o ——— neck of humenss: Figure 1.13. Disartculated right shoulder joint as viewed from the front top Frage), ght shoulder joint with its capsule, also from the front (middle image): eee achoulder joint with is capsule as viewed from bhind (bottom image) a ie he chest as being located in front of the scapula and to the observer's Fight in the top two images te surface ofthe scapula shown here faces the Fen or the chest In the bottom image, envision the back of the scapula 2s pasnatlnuated to the observer’ left: except for being a much deeper and more pentined! dissection, this view is similar to the one shown in figure 1-1. Asterisks Fane esti ligaments, and arrows inckcate rotator cull tendons Geppey-1 MONPMENT AND PONTME 99 habituated to long-established firing patterns, the bellies of the muscles ‘themeelves have become shorter on one side nnd longer on the other, aud tho connective tise fibers within and surrounding the muscle have adjusted to the unequal lengths of the muscle fibers, Correcting such jmbalances requires years of unrelenting effort; neither the bellies of the muscles or their connective tissue fibers can be lengthened or ehortened quickly. FASOIAE Foseiae are sheets of connective tixene that give architectural support for tissues and organs throughout the body, holding everything together and providing for a stable infrastructure. They are crudely like leather gloves hat for. a boundary around your hands. Underneath the ckin and subcutaneous connective tissue, fasciae organize and unify groups of muscles, individual museles, and groups of muscle fibers within each ‘muscle. ‘hey form a tough envelope around all the body cavities, and they furround tho heart with a heavy connective tissue sack—the fibrous ‘pericardium. We have superficial fascia just underneath the skin, and deep fasciae overlying muscle groups. The singular and phural terms are almost inlerclungeabble—we can say deep fascia of the back, fascia of the body, or fascine of the bod. Fascia is flexible if we keep moving, stretching, and breathing, but if we allow any part of the body to remain immobile, its fasciae become less flexible ‘and ovontuslly restrict our movements, like gloves that fil so tightly that yon ‘can't bend your fingers. LOOSE CONNECTIVE TISSUE AND GROUND SUBSTANCE Toose connective tissue is composed of ground substance, scattered fibers, ‘and coll. IL fills in the spaces between the three primary tissues that are ‘mostly cellular—musele, epithelia, and nervous tissue—and between all ‘the other connective tissues, inchiding bone and cartilage, Hood and ph, tendons and ligaments, joints and joint capsules, fascine, fat, and tissue. But loose connective tissue is more than a filler. Its substance is crudely comparable to glycerine—it lubricates and ‘movement throughout the bods. The ground substance permits of adjacent structures as well as slippage of individual connective ‘ers relative to one another in tendons and ligaments. Wore it not the connective tissue fibers and their submicrascopic attachments to fibers, nerve fibers, and epithelia, ground substance would let ing slip and slide apart. ‘This would be as unwelome—by itelt—as spill on an iey road jund substance is normally fluid, but it eongeals and loses moisture60 anaroMn OF MATIN ¥0CA if the eurrounding tissues are inactive. And as it loses moisture it loses its Jubricating properties. The entire body tightens down. Tendons, ligaments, ‘and joint eapsules become brittle, sauscles lose much of their elasticity and ‘bility to fiction smoothly. and the tissues become susceptible to injury. ‘These reveesals are the main reasons for morning stiffness, and they are a compelling argument for beginning every day with a session of halla yous. ‘Turehydrate the ground substance « short, lazy practice is not as effective ‘as a long and vigorous one, and you get what you pay for. The benefit is well-being; the payment is work and stretch. STRETCHING Ifyou esk most people what it takes to lift a barbell overhead they will say ‘muscles, bones, and joints, If you ask them what is needed for running & marathon they will eay heart, hinge. and legs. And if you ask them what is required for dance or gymnastic performance they will say strength, grace, ‘and agility. But if you ask them what is most important for increasing flexibility they will probably just give you a blank look, And yot those of tue who practice hatha yoga know that improving flexibility is one of our greatest challenges. Even the simplest postures are difficult when one is stiff, and that is why instructors are always encouraging us to stretch. But ‘whut exactly do they mean? Given what we have discussed so far, we know that we should be wary of increasing flexibility by trying to free up bony stops or loosening up cartilaginous restraints, joint capsules, tendons, and ligaments, What we can do is lengthen nerves and the hellies of muscles, the two kinds of ‘extendable anatomical structures that run lengthwise through limbs and ‘across joints. ‘Muscles have to be lengthened only a little to permit a respectable improve- ment in a joint’s range of motion. But when we are stretching thom and looking for long-term results, are we dealing with their individual muscle fibers or with their associated connective tissue fibers? The answer is both, ‘The individual musele fibers within a muscle can grow in Jength by the addition of little contractile unite called sarcomeres, We know this from studies of muscles that bave been held in casts in stretched positions. And by the same token, if a musee is held by a cast in a foreshortened state, sarcomeres are lost and the muscle fibers become shorter Tt is not enough to inerease the length of muscle fibers alone. A mateh- ing expansion of the connective tissue within and around the muscle is also heeded, including the overiying fascia, the connective tissue thot eurrounds paskets af musele fibers, and the wrappings of individual fibers. And this is LLIES OF MUSCLES1 MoM ann postiRR 6 what happens during programs of prolonged stretching. ‘The connective tiseue gradually follows the Tead of the muscle fibers, the muscle as a whole gets longer, and flexibility is improved. Hatha yora stretches are a safe and effective way to bring this about, And in the occasional cases when we want to tighten everything down, all we have to do is stop stretching so much ‘and concentrate on repetitive movemonte and short ranges of motion, ‘The ‘muscle fibers will quickly got shorter, and the connective tissues will soon follow suit. weaves ‘The issue of peripheral nerves is another matter. Nerves are sensitive to stretch but are not robust enough to limit it; they can accommodate to stretch only because they don’t take a straight course through the tiseuee that surround them and because their individual nerve fibers meander back and forth within the connective tissue ensheathments of the nerve itself, During the course of stretching a limb, the gross path of a nerve through tho surrounding tissues is first straightened, and as the stretch continues, the serpentine course of the individual fibers within the nerve isalso straightened. And even after that, the enveloping connective tissue Iias enough elasticity to accommodate about 10-15% additional stretch without damaging the nerve fibers. Without their connective tissue ensheathments nerves would be hope- lessiy vulnerable, not only to stretch but sls to tranuma and compression among tense muscles, hones, and ligaments. The protection is not failsafe, however, because in extreme eases these ensheathments can accommodate ‘toeven more stretch than the 10-15% that is safe for their enclosed nerve fibers, The carly warning signs are numbness, sensitivity, and tingling, and ‘if these are ignored, sensory and motor deficits may develop. Your best ‘Protection is awareness and patience—awareness of why nerve stretch is & ‘tential problom and the patience to work slowly when and if mild symptoms. ‘emerge. Ifnerve pain keeps turning up chroniealy, seek professional help, Wine Last anaursis Research has shown beyond question that the length of muscle fibers ean ‘be increased as a result of prolonged stretching, or decreased as a result of ie foreshortening, Iti also clear that the conneetive tissue ensheath- of either muscles or nerves can be stretched too much, But there is factor in the equation: the nervous system plays a pivatal rol in muscles to either relax or tighten up, and this either permits stretch Timits it. So is tthe active role of the nervous system or the pave role of connective ticues that ultimately restruins movement? Since nerve keep stimulating muscle cells during ordinary activities, there is62 ANATOMY oF HATHA YOGA ‘only one way to find out for certain: to check someone's range of motion. ‘when they aro under deep anesthesia, when the nervous system is not stimulating uny skeletal muscle cells except thove needed for respiration ‘This has been done, inadvertently but many times. Any operating room attendant ean tell you that when patients are anesthetized, their muscles ‘become so loose that care has to be taken not to dislocate the joints, and ‘his will happen even if the patient is extremely stiffin waking life. So why can't therapists take advantage of anesthesia-induced flexibility to increase the range of motion around joints? The answer is that without the protection of the nervous system the tissues tear muscle fibers, connective tissue fibers, and nerves. And this proves that even though connective tissues provide the outermost limits to stretch, it is the nervous system that provides the practical limits in day-to-day life. When we lave reached those limite the nervous system warns us through pain, trembling, or simply weakness that we are going too far, and most important, it warns us before the tissues are torn. ‘THREE POSTURES ‘Three hatha yogu postures illustrate the principles of movement we have been discussing. They are all simple to analyze and study because they ‘exhibit bilateral eymmetry, in which the two sides of the body are identical in structure and perform identical movements. Each one presents different challenges. We'll begin with the corpse posture. THE CORPSE STURE “The corpse posture reveals several common problems that arise when people try to relax, Lie supine on a padded surface withthe knees straight, the feet apart, the hands out from the thighs, and the palms up. Relax completely ‘llowing your body to rest onthe floor under the influence of gravity (fig 114) When you firt lie down most of the motor neurons that innervate the skeletal muscles are still firing nerve impulses, but your breathing gradually ‘becomes oven snd regular, and the number of nerve impulses per second to your museles starts to drop. I'you are an expert in relaxation, within a rminute or two the number of nerve impulses to the muscles of your hands and toes goes to zero. Then, within five minntes the motor neuronal input to the muscles of your forearms, arms, legs, and thighs diminishes and also approaches zero, ‘The rhythmical movement of the respiratory diqphrag hulls you into even deeper relexation, finally sinimizingt the nerve impules to the deep postural muscles of the torso. The connective tiswes are not restraining you. Pin is not registered from any part ofthe body—the posture ts entirely comfortable. This is an ideal relaxation, In the early stages of practice any numbor of problems can interfere‘with the ideal, First let's say you hurt your right shoulder playing basket- ball earlier in the day: Tension in that region is still high and stands out painfully in contrest to the relaxation in the rest of the limb snd on the cther side. In addition, you have an old back injury and the museles around the vertebral column are holding it in a state of tension. You would like to Iift-your knees to relieve the stress, but you do not sigh to ecem unsporting. So you override the impulses of the flexion reflexes and continue to suffer ‘with your knees straight. “This Is absurd. All problems in the body tattle on themselves in one way ‘or another, snd you cannot relax your body beeause it is rebelling. You ‘would not be in so much pain if you were walking around the block because ‘the movement would keep you from noticing it, but when you try to relax ‘you are aware of nothing else. The posture becomes inereasingly iritating, ‘and your mind, far from being still is oscillating between awareness of the discomfort and longing for escape. If your instructor holds you in this pose for more than a minute or two you are in the wrong class. You are not yet rrenuly for this work You need to heal, move, and stretch—not lie still ‘Those who are uncomfortable can sometimes improve the situation by simply moving into partially flexed positions—bending the knees, placing, the hands on the chest, and supporting the head with a thick pillow Por restful sleep, it is not surprising that most people lie on their sides and curl ‘up in an attitude of flexion. THE PRONE BOAT ‘The prone boat posture demonstrates the simplest kind of movement ‘against gravity. To experience this lie face down on the floor. Stretch your farms toward the feet, straight out to the sides, or overhead, as you prefer. Raise the arms, thizhs, and head away from the floor all at once, keeping: the knees and elbows extended (fig. 1.5). You are lifting into the posture ‘with the muscles on the pastertor (back) side of the body. ‘The neck, back, hamstring, and ealf muscles are all shortening concentrically and drawing, the body up in an are. Figure 1.14. The corpse posture, for whole-body relaxation,fy axarosn OF HATHA voGA ‘Although by most standards the prone boat is an easy posture, especially with the hands alongside the thighs, it can be challenging if you are in poor physical condition. A set of muscles is being used which ie rarely exercised ‘s.a group in daily life, and if you keep your elbows and knees extended you ‘may not be able to lift your hands and feet more than an inch or s0 off the floor The combination of inflexibility and unfamiliarity keeps the antagonist muselea on the anerior (front) side of tho body active, and this in turn restrains the lift. Whole-body extension is the essence of the prone boat, but the pull of gravity, lack of strength posteriorly, muscular resistance anteriorly, an abundance uf flexion reflexes, and various connective tissue restrictions in the spine may all iit you. For beginners the activity of the nervous system is the main impediment to the posture. Fascia is the main obstacle for intermediate students, ‘The nervous system is commanding the posterior muscles to contract strongly and the anterior muscles to relax, but connective tissues and the design of the joints prevent marked extension. With time and practice the anterior ‘muscles will relax and permit a full stretch, Finally, advanced students confidently lift to their maximum and play with the edges of neuronal control, tugging on their connective tissues with an educated! awareness “while at the same time keeping the breath even and regular without straining or faltering. ‘THE HAMSTRING! ‘This standing forward bend demonstrates the interactions among agonist ‘muscles, their antagonists, gravity, and the clasp Knife reflex. Stand with the feet about 12 inches apart. Flexing the knees as necessary, bend forward ‘and press the torso tightly against the thighs, which Keeps the back rela- lively straight and prevents etrain. Now, holding the chest and abdomen. firmly in place, try to straighten the knee joint. The quadriceps femoris ‘muscles on the front of the thighs try to accomplish this, and the hamstring igure 1.15. The prone boat. As you ft up into the posture, muscles on the back Tree Sette body shorten concentecally, as you slowly lower yourself down, they lengthen eceentricaly. Tension in muscles and connective tissues on the Wak Se en inc body increases a you Ht up aind dexieases a» you come downs1 MOVEMENT ann Paste 65 muscles on the back side of the thighs resist, but you can undereut the hamstring resistance by activating their clasp knife reflexes, Just massage the musculotendinous junctions of the hamstring muscles behind the knee Joints while you are trying to press your hips up (ig. 116). [At this point the quadriceps femoris muscles are shortening concentrically, stmightening the knces, and raising the body up against the force of gravity ‘At the same time the hamstring muscles, which are antagonists to the quadriceps, ae actively even though unconsciously resisting. Ifyou are in 00d condition your nervous system allows you to press upward to your personal maximum, but if yeu have recently hurt your knee or sprained ‘your ankle, flexion reflexes responding to pain will limit you, As you press Lup you are making an isotonic movernent. Ifyou go to your maximum but then keep pressing, you are exercising isometricaly. Ifyou were to bounce, which we do not want here, you would stretch the ‘muscle spindles dynamically and stimulate the myotatic stretch reflexes, you move slowly, you willbe stimulating the Golgi tendon ongans and clisiting the clasp Knife reflex in both the quadriceps femoris und the hamstring museles. Although this will tend to relax both sets of muscles, the focus of your wil is tostraighten the knee joint, with the result thatthe higher centers ofthe brain foverzide the reflex in the quadriceps ferori and allow it Fuller reas in the hhamstrings Neurological circuits for reciprocal innervation also probably inhibit the motor neurons whose axons innervate the hamstring muscles, ‘The main resistance to lifting up comes from the hamstrings, Ifyou are ‘an advanced student and not feeling any trace of joint pain, you can try to relax the hamstrings and extend the kneo joints more completely, contracting the quadricops as much as your strength and health permit. ‘This posture is different frum the prone bout, in that your attention is ‘more restricted. In the prone hoat you are trying to relax the entire front side ofthe body; here you are trying to relax only the hamstrings Figure 1.16 tanding hamstrings- ‘quadriceps thigh poll The fst priority placing the torso solidly agains the thighs inorder to protec the lower back. Under those circumstances, trying to it the hips forceably fn combination with massaging the Golgi tendon organs inthe hamstring terslons encourages dep relaxation tnd eventual lengthening ofthe Tamir nari trIryou are relatively healthy, as you reach the limits of nervous system ‘control, the fascine begin to play an important role in limiting your efforts to straighten the knees and raise up. You reach & point xt which the connective tissue Aburs within and surrounding the hamstring muscles will nt allow any sore lifting. They are now like wires pulled taut, stretched to their limit. The nly way to get more length in the system isto patiently lengthen the muscles ‘and nerves with a longterm program of prolonged stretches. PUTTING IT ALL TOGETHER “We have covered a great deal of territory in this chapter, Dut in #0 doing we have lid the foundation for everything that ix to come. To sum it up: sensory input to the brain and the power of will both ultimately influenee the motor neurons, which in turn preside over the actions of the musculo- skeletal system. ‘The reflexes are in the backgroune! and out of our immediate ‘awarencee, but withont them we would be in dire slraits. Without the ttretch reflexes our movements would be jerky and uncertain, like film portrayals of Frankenstein's monster. And without pain receptors and ffexlon reflexes ave would soon be a battleground of burns and injuries, Without the reflexes ftom our vestibular system we would teeter about, ‘uncertain of our balance and orientation. Without sensation from touch and pressure pathways we would love most of the seneory input that given tus plenstre—and along with its loss, its guidance. In the end, the nervous system drives the musculoskeletal system, and these two in combination maintain and sculpt connective tissues, which in turn passively restrict movement and posture. All of this takes place within the field of gravity under the auspices of will and ereates the practice of hatha youn. Fortunately scare isp correcting. Whatewer the herd ss ding, truth eventually acces frst end taps the tanpues ~ — Gershon, in The Seeondl Drain, p35CHAPTER TWO BREATHING “The tangs ane placed tne recess to sacred and Kidden hat nature would sem to have serially withdrawn this pat Goth from the eyes aud oom the intellect: far, beyond the with, tt has nol yet lecn granted to any one te fit a window 00 the bovast andl redeem from darkness the profeunder secrets Oo wtere, For of all off the Parts off the body, the bangs alone, as if sheishing foam obierwation, evase form thei movement and collapse at once on the fst entrance of light and self revclation. Hence such an ignorance of Respiration and a sert of holy wender, Hide tet me dram near to the eamost vitals, and concerning so obscure 0 matter, make at Basta guess,” —sohn Mayow, in Tractatus Quinque (1674), quoted from Proctor's A History of Breathing Physiology, p53. Yaris new nothing of physiotuy at least in terms that would have been elpful to 17th and 8th century Huropean scientists and physicians like Mayow, but for a long time they havo mado extraordinary elaime the value of studying the breath, ‘They say flatly, for example, that ‘the breath is the link between the mind snd the body, and that if we can they tll us, that begins with simple hatha yoea breathing exercises. aspect of our being? That's a lot, by any standard. No matter: even Such comments may stimulate our curiosity their pursuit is outside l scope of this hook. Our ohjective here is to pursue studios in breathing far 9s they can be tested objectively and experientially, and then to uss some of the relationships between yoga and respiration that can be correlated with modern biomedical ecience: how different patterns of hing affect us in different ways, why this is 60, and what we ean learn practice end observation, hing usually operates at the edge of our awareness, but will und ‘are always at our disposal. Just as we can choose how many times Wy:66 aNaTOM OF HATHA v0GA to chow a bite of food or adjust our stride when we are walking up a bill, so cean we choose the manner in which we breathe. Most of the time, however, ‘we run on “automat,” allowing input from internal organs to manage the rato and depth of eur breathing, Youis emphasize choice. They have discovered the value of regulating respiration consciously, of breathing evenly and diaphragmatically, of hyperventilating for specific purposes, und uf suspending the breath at will, But even though these eims might seem laudable, readers should be made aware that the classical literature of hatha yora generally ‘warns students against experimenting intemperately with breathing exercises, Verse 15 of Chapter 2 of the Hath Yoga Pradipiha is typical: “Just as lions, dlephants, and tigers are gradually controlled, so the prana is controlled through practice. Otherwise the practitioner is destroyed.” This sounds like the voice of experience, and we ought not dismiss it casually. We'll rev the issue of temperance at the end of the chaptor after having examined the anatomy and physiology of respiration. There are reasons for caution. "To understand the henefits of controlled breathing we must procecd step by step, beginning with look at the overall design of the respiratory cyetem, and then at the way skeletal muscles draw air into the hungs. Next we'll see how breathing affects posture and how posture affects breathing. ‘After that we'll explore how the two major divisions of the nervous systen—somatic end autonomic—interact to influence breathing. Then we'll turn to the physiclogy of respiration and examine how lung volumes and blood gases are altered in various breathing exercises. That will point tis toward the mechanisms by which respiration is regulated automatically ‘and at how we can learn to override those mechanisms when we want to. Finally we'll examine four different kinds of breathing—thoracie, paradoxical abdominal, and diaphragmatic—and the relationships of each to yous breathing practices. At the end of the chaptor we'll return to the issue of ‘moderation in planning a practice ‘THE DESIGN OF THE RESPIRATORY SYSTEM. Every coll in the body needs tei breathe—taking up oxygen, burning fuel generating energy, and giving off carbon dioxide. This process, known as cellular respiration, depends on an exchange-—moving oxygen all the way from the atmosphere to lungs, to blood, and to cells, and at the same time moving earbon dioxide from cells to blood, to lungs, to atmosphere. The body accomplishes this exchange in two steps. For step one we draw aur into the lungs, where it comes in contact with a large wet surface area—the collective hundred million alveoli—into which oxygen ean dissolve and from which carbon dioxide ean be eliminated. For step two oxygen travels in the pulmonary circulation from the lungs to the heart and in the ‘ystemio circulation from the heart to the eells of the body. Carbon dioxide2 nnexranes 69 travels in the opposite direction, first from the cells of the body to the heart in the systemie circulation, and then from the heart te the lungs in the pulmonary eivenlation (Fig. 2.1 and chapter 8). Everything about the respiratory system is accessory to the movement, of oxygen and carbon dioxide. Airways lead from the nose and mouth into the lungs (fig. 2.2). Air is pulled backward in the nose past the hare! and soft palates, where it makes a 90° turn and enters a funnel-shaped region, top: the pulmonary circulation ‘of blood to and from the lungs "= umonary capitan He Initiate appostion to the ‘leo they transport carbon ‘once from the blood into the ave! and oxygen fom he alveol ito the blood airways mosphere: > oyger in > scarcer dence —— ut anoot mee foray ‘ein comes Blood es oon ahr owen ‘Sona tothe i carbon ing te et Sone” cater — sina of he eat geste Soe suc forthe ayatemic thereat ration, he telunge soa cron the vena cava let venice ot ‘caries bicod that the hoot to the IS high in carbon booy asa ene alo in whole ‘exygon from the capillary beds of the bod back ight atrium of the heart is 6 cots of the syserse the body venous return” VW the copies ofthe systersc ereulation he In close apposition to Seer pacman od ‘to the cells and sate rene soumns eget blood to and from the body as a whole Figure 21. Cardio-espratory system. As indicated by the arrows, oxygen is irom he stmonphere tothe cells ofthe body: om airways to lungs 40 the pulmonary relation, Beart. nd finaly tothe sytoric tears Caron Ahoxide is transported in the fer direction: from the ces to the systemic eR bella oajo. ANATOMY OF MATIN YoCA ‘the pharyns. From there it continues downward into the larynx, which is the organ for phonation and whose vocal cords vibrate to create sound. Below the larynx air posses into the trachea, the right and let primary bronchi, and then into tho two lang, ecch of which contains 10 branchopulmenary segments that ‘are served individually by secondary bronchi. ‘The secondary bronchi in turn. divide int tertiary bronchi and smaller subsivisions (bronchiotes) that colec- tively compose the bronchial tree (fig. 23).'The terminal bronchioles of the ‘bronchial tree in turn open into the tiny alveoli, giving a microscopic view ral conchae asl messes {bite bones sinuses (or paasooes foveed by mci inet eneath ber TG = fo faen ENT muse, and =. ce epigiotta body, Cs 9 ff fs disk between Te to lary. VE “ vocal cord vertebral cael esophagus ‘niet side Tube reusing (paeay for trachea (pathway ef ary Gira! cord)” feed between forairbetween and gltis Srphanne leryra and and stomach paimry bronchi Figure 22. Nearly mid-sagittal cut (ust to the left of the nasal septum) showing, Ties nlf ol the head and neck, and revealing the crossing pessageways for red (sod line Rom the oral cavity into the esophagus) and air (dashed lines {fem ther nasal passages into the trachea). Gren Sappey)-of the lungs the appearance of a delicate lacy network. The trachea and other large tubes in the airways are held open by incomplete rings of eartilage, and the alveoli remain open because special surfactant on their walle limits their expansion during the course of full inhalation and yet prevents surface tension from collapsing them during the course of a full exhalation. ‘The pharynx is 2 crossroads for the passage of air and food. Air passes down and forward from the nasopharynx into the laryngopharyns: and then, into the larynx and trachea. Food is chewod in the mouth, and from there it is swallowed backward into the oropharynx and ueross the pathway for ‘ir into the eeophagus, which is located behind the trachea just in front of trachea. wth apex, right ling apex let ung eas pgs a tertiary bronchus seconaary , bronchus for " superior obe A deahting tot fight privy pirary Brenchus Sronehus tet ty ght petronary paroneey tery gs . ‘tery aibon ‘cron onde to ‘Sov to the ot therght ne ting | ht tionary Pulmonary eins cay poner ‘onoen oxygen user mane fet ung ght ang 4 backto forean the heat Feary trove er va! con ee Bae envicle onto Yen ‘Segments ofthe infer fobe of te et ung Figure 2.3. tolated heart-lung pre aera eee ee ce tranches into right and left primary bronchi, 5 secondary bronchi (forthe Fight lng and 2 forthe lil and 20 tertary bronchi to the bronchopulnronary Seamenis (10 for each ung) Branches of the pulmonary arteries and vein ae Bras casa gter sicay of une tioechsopahors ary agrees earthe vertebral column (fg, 2.2). The glottis, which is the narrowed aperture in the larynx at the level of the vocal cords, closes when we swallow. You can feel that happen if you initiate either an inhalation or an exhalation find then swallow some saliva. You will find, ne matter what part of the breathing eyele you are in, that swallowing obstructs breathing. IF it doesn't food may “go down the wrong way,” as children put it, and we choke. "The lungs are mostly composed of air: 50% air after full exhalation and ‘0% air after full inhalation. Ifyou slap the side of your chest you'll hear @ hellow sound; contrast this with the lower-pitched liguidy sound that comes from slapping your hand against your abdomen. A slippery mem: brane that i tse impervious lo air covers the lungs, which enn in turn be likened roughly to blown-up balloons that fill the rib cage, excepting that the “balloons” are not tied off at their necks, So why don’t they deflate just like loosed balloons that fly away’? ‘The answer is fundamental to: the design of the respiratory syetem. ‘The lungs have an inherent elasticity, and they remain inflated inside the rib cage only because they faithfully track Changes in the volume of the chest as it gets larger and smaller. How can this be? It is because nothing ies between the outer curfaces of the lungs ‘and the chest wall except a potential space, the pleural cavity. ‘This cavity sontains no air, only a vacutim which holds the lungs tightly against the inner surface of the chest wall, along with a small amount of Jubricating ffuid that permits the lungs to expand and contract a8 the chest expands and contracts through the agency of the surrounding muscles of respirution (figs. 2.4, 2.6, and 2.9). ‘TWO EMERGENCY SITUATIONS ‘Two emergency situations will put all this in perspective. First, if your rib cage were penetrated on one side in a traumatie injury, alr would rush into the pleural exvily and cause the lung on that side to collapse, This is ealled pneumothoras. Flow quickly it develops depends on the size of the injury: With a large enough opening, the lung collapses almost like letting the alr out of the neck of a balloon, as might be surmised from Mayows astute ‘observations more than 300 years ago. ‘More perilously than pneumothorax for one lung, if both sides ofthe rib ‘cage are grosely penetrated, both lungs collapse to their minimum size and Shrink sway from the chest wall, With the pleural cavities filed with air, the muscles of respiration cannot get purchase on the external surfaces of the lungs to create an inhalation, and unless someone holds your nose and plows directly into your mouth to give you artificial respiration. you will die 1 few minutes, technical note: There is one other alternative, Ifyou were thinking fast enough Treat riatracted HY tie injury yom eel Balloon aut your eheets and qsiekely(two kimes per second) “wallow” air ito your lungs 10-15 times for inhalation, (ing the flotts after cach swallow To exhale you simply open the glti, For an Snereting exercise in awareness, and to feel for yourself how the lungs effortlessly get smaller when you open your gletis to exhale, hold your nose and brvathe this Seay for 2-3 minnie] ‘The remedy for pneumothorax in a hospital setting also illustrates the architecture of the system. It's simple, at least in principle. Tubes are sealed into the openings of the chest wall, and the air is vacuumed out of ‘tho ploural cavities This pulls the external surfaces of the Lungs against the inner wall of the chest and upper surface of the diaphragm, and the ‘muscles of respiration can then operate on the inflated lungs in the usual ‘A second emergency situation involves an obstruction in the airway, perhaps a big chunk of food that has dropped into the larynx instead of the esophagus. If itis too big to get all the way Uirough into the trachea, the obstruction may get stuck in the larynx, block the airway, and prevent you from breathing. In such eases the natural reaction for most people is to try ‘sntn rion ereetor spinous vertebral vertebral body intenorlobe —nightside singe process, 76 of Teveriebra eS Inferior abe ft kingza aNaToMe OP HATHA YOGA to inhale more forcefully, but this will almost certainly reinforce rather than relieve the obstruction. ‘Trying to exhale may be more productive. OF fa second person, someone who knows first aid, could try the Heirolich ‘mancuver, pulling sharply in and up on the abdominal wall from behind to create enough intra-abdominal and intrathoracic pressure to force the ‘object from the laryngopbarynx back into the oropharynx, where it- can either be auzlied out externally or evallowed properly. ‘The emergency surgical remedy for a complete obstruction of the larynx is a tracheotomy, making 4 midline incision between the larynx and the pit, of the throat, quickly separating the superficial muscles, and opening the expoced trachea with another midline incision just below the thyroid gland. ‘This allows inhalation and exhalation to take place below the obstruction. In the ease of pneumothorax, when the chest wall has been penetrated and the lungs are collapsed, the muccles of respiration can expand and con- ‘tract the chest, but the effort is all for nothing since the requisite contact ‘between the inner surface of the chest wall and the outer surface of the Tungs has been lost. It’s like a car stuck in the snow—the wheels turn but they can’t move you forward, The second case is like a ear with its drive ‘wheels immobilized in concrete—the blockage in the airway completely frustrates the action of the muscles of respiration. In both situations we fare trying to pull air into the lungs by using our foree of will but we are tunable to support our inner needs with our external efforts. ‘THE MUSCLES OF RESPIRATION Inhalations ean take place only asa result of muscular activity Exhalations are different: the hungs have the capacity to get smaller because their elasticity eer palling them, along with the rib cage, to a smaller size, And as alrenly rmenticned, the size of Ut: kung follow the size ofthe chest in lockstep: any’ thing that expands and contracts the chest also expands and contracts the tungs, whether it is lifting or compressing the rib cage, lowering or raising the dome of the respiratory diaphragm, releasing or pressing inward sith the abdominal muscles, or allowing, the elasticity of the hangs to dravr in the chest wal. "The way in which the muscles of respiration accomplish breathing i ‘more complex than the relatively simple way a musele creates movements freund a joint, Three main sets of muscles are active when you breathe ‘normally: the infereastad muscles, the abdominal muscles, and the respiratory Giophragm, We'll start our diseussion with the intercostal museles ‘THe INTERCOSTAL MUSCLES When we breathe, and in particular when we emphasize chest breathing, ‘the short intanonatal (between the ribs) muscles operate as a unit to expand2meanune 75 and contract the chest (figs. 2.5 and 2.9). Two sets of these muscles, one under the other, act on the rib eage. The external indercostal muscles Tun betwoon the ribs in the same direction as the mast external sheet of abdominal muscles (figs. 27, 2.9, 311-13, and 8.8); they lift and expand the rib cage for inhalation, like the movement of an old-fashioned pump handle as it i lifted up frou its resting position. The internat intercostal muscles run at right angles to the external layer; they pull the ribs closer together as well as down and in for exhalation (usually a forced exhalation). If you place your hhands on your chest with the fingers pointed down and medially (toward the midline of the body), this approximates the orientation of the external intereostal museles, and if you place your hands on your chest with the fingors pointing up and medially, this approximates the orientation of the internal intercostal muscles (lig. 25). The external intercostal muscles do not always act concentrically to lift the rib eage: during quiet breathing they entrance to frst thoracic ‘ower border of nb cage to tatlomber wich espraony arog ort Figure 25, Surface view of chest. The internal intercostal muscles are visible in front near the stemum where they are not overlain by the external interenstaly and they are also visible laterally where the external intercostals have been dissected away (between the fifth ane! sixth ibs) Aca group, the extemal intereaxtal muscles it the rb cage up and out to suppor inhalation, and the internal intercostal muscles Dall it denen el ts compote 2 ll echalatinn (eon Rotelalso act isometrically to keep the rib cage from collapsing inward when the respiratory diaphragm (see below) creates the vacuum that draws air into ‘the lungs. ‘THE ABDOMINAL MUSCLES In breathing, the abdominal muscles (figs. 3.1143, 88, 8.1, and 83-14) function mainly in deep and forced exlialations, as when you try to blow up ta balloon in one breath. For that task the muscles shorten eoncentrically, pressing the abdominal wall inward, which in turn pushes the abdominal organs up against the relaxed (or relaxing) diaphragm. In combination With the action of the internal intercostal muscles, this forcibly decreases the size of the chest cavity and pushes air out af the igs. You can also feel the action of the abdominal muscles by pursing the lips and forcing the breath out through the tiny opening, Tn youa the abdominal muscles are important for what yoris refer to as even breathing, and they are also key elements for many breathing exercises. THE ANATOMY OF THE DIAPHRAGM Recause the respiratory diaphragm is eompletely hidden inside the torso, ost people have only a rudimentary notion of what it looks like or how it ‘operates, The simplest way to describe itis to say that itis a domed ehest fof combined rauscle end tendon that spans the entire torso and separates the chest cavity from the abdominal cavity figs. 2.69). Its rim is attached to the base of the rib eage and to the lumbar spine in the rear. ‘The diaphray is shaped like on umbrlla, or an upsidedown cup. ‘xcept that it is deeply indented to accommodate the vertebral column. I consists of a central tendon, a costal portion, and a erural portion. Tae central tendon forms the top surface of the douse, which floats there freely tttached only to the muscle fiherx of the costal and erural portions of the diaphragm, ICs thus the only “tendon” in the body which does not attach directly to the skeleton. The largest part of the diaphragm is its costal fomporent, whose muscle fibers fan down from the central tendon and attach all around to the lower rim of the tib cage (Gigs. 27-9). The erural portion of the diaphragm eonsiste of the right rus and left crus, which Bttach to the forward arch of the lumbar spine (Ggs. 27-8). These are separated from one another by the aorta as it passes from the thoracic ceviy into the abdominal cavity. The architecture of the diaphregsm thus {femite it io move the contral tendon ofthe dome, the base of the rib cage, the lumbar spine, or any combination of the three. "You can note the site of the costal attachment of the diaphragm by hooking {your fingect under the ribcage and tracing its lower margin. Iekshigh in front Mime itatuacheo to the storym, and lower where vou trae it laterally (to the2 anesrnnss 7 side), but you can’t feel it behind because the deep back muscles are in the ‘way. You can also occasionally feel the region where the crura (plural form) of the disphragm attach ro the lumbar vertebrae, especially in someone slender who is lying flat on the floor, because the lumbar region sometimes arches forward to within an inch or soof the surface of the abdominal wall. ‘This vividly illustrates how far forward the diaphragm ean be indented by the spinal column. “The diaphragm has to be one of the most interesting and complex muscles jn the body. Because itis a thin sheet, its shape bears the impressions ofits Jmmediate survoundings-—the rib cage, the heart and lungs, and the abdominal organs, and i is dependent on the existence and anatomical arrangements of these structures for its function. The diaphragyn's extensive relationship with faye Von phrenic nerve (wnte profile) _ let clavicle (out) onic arch pulmonary _— rial trunk ‘abdominal muses ttrarversus abcominis) Figure 2.6. Front view ofthe chest, with the first sx ibs, lavils, and sternum cut “aay to revel the internal organs, which include: the laryn, trachea, lunge and ‘Bleal caviins the heart, great vessels aorta, vena cava, pulmonary artery, and imonary vein, not all show, pericardial cavty, and fibrous pericardium the tom portion othe respiestory dlaphragm: and the right ar lft pirenie “The pleural cavities are represented by the thin white spaces between the fe and tes bedysnll-and hereon the hangs ane laphapm (Sapnes)the chest wall is a case in point, Even though the costal portion of the diaphragm extends to the base of the rib cage, the lungs are never pulled that far inferiorly (toward the feet), and for much of ito area the costal portion of the diaphragm is in direct contact with the inner surface of the rib eage, with only the potential space of the pleural cavity separating the two. This region into which the lungs never descend is ealled the zone of ‘apposition (fig. 2-9); without its slippery interfaces, the outer surface of the ciaphragm could not slide easily against the inner aspect of the rib cage, ‘and the dome of the diaphragm could not move up and down smoothly when we breathe. costa foots ofthe diaphragm esoptans ious Staehng a carlage atthe costa bers ofthe e forvera base ofthe stemum ephsagm alot hiatus inthe cava. bt N cceriral tendon ot SGiaphraar ah ide) ff tower bord of oe on eartiages ~~ left crs of sight oni of oupbragr Geptragm intercostal muscles treo lyors Crebdorneal ee muscles: tered clover boomed ecco {toaing) eral ‘Shamil i " i tet quadrats oblique, tbo fansverus muscle abdomns lembar ire 2.7.A view of the respiratory diaphragm looking at its underneath side saan cons It like a rejected upside-down bow! that a potter pushed in on Eee side, The pushed-in place is the indentation for the vertebral column, and eee ee a of the bowl contains hiatuses (openings) for the esophagus, aorta, are valerior vena cava, The central tendon of the diaphragm is represented by Heese iyntly contrasted central arch. The msee Aber ofthe diaphragm are Uisposed radially from the ceniral tendon: the costal fibers attach to the base of tard cage mow of the way around (approaching the viewer inthe third the halon and the tight and left crura attach to the lumbar vertebrae below Cine ai ut the origin of the peoac muscles) (erm Morrie)2 enamine 79 ‘THE FUNCTION OF THE DIAPHRAGM ‘fo analyze the origins and Insertions of 1 muscle that is shaped like an indented umbrella is a hit daunting, but that is what we must do if we want to understand how the diaphragm functions in breathing and posture. ‘We'll begin with the simplest situation, which is found in supine postures. ‘Here the base of the rib cage and the lumbar spine act as fixed origins for the diaphragm, and under those circumstances the central tendon has to scales isering onic cavcle let forearm prorated subscepuis PO me Grote clove fen ereugh fer ie Cort respiratory ation of ddiapireom: forearm suprated (facus ené ran atalls eonkgiaton) ER feito eg ae pcre aneBo AxATOMY oF MARIA ¥0G ‘act as the movable insertion. ‘The dome of the “cup,” ineluding the central tendon, descends and flattens during inhalation, putting, pressure on the contents of the abdomen and creating a slight vacuum in the chest that ‘draws air into the lungs. By contrast, the dome of the diaphragm is drawn upward during exhalation by the inherent elasticity of the lungs, and as thal happens air caeapes into the atmosphere. ‘Whenever the chest and spine are fixed, as typically occurs during relaxed breathing in a supine position, the top of the dome of the diaphragm is pulled straight downward during, inbulation, like a piston, with the chost wall acting as the eylinder. During a supine inhalation the fibers of the diaphragm shorten concentrically and pull the central tendon inferiorly. During a supine exhalation its fibers lengthen eccentrically «: the central tendon is both pushed from below and pulled from abovo— pushed by gravity acting on the abdominal organs and pulled hy the elas recoil of the lungs. ‘The abdominal wall remains relaxed. It stretches ou: the ver and its improssion of heart is located here espiatory diaphragr lange mipressicn _~ con he inlenor Stitace of the sith ot ‘diaphragm —_ —its impress external an one of _ reer eppostion y-— intercostals pera eauty ‘Shown as _—soleen andi a eubstartial imoression space tor erty _— eleventh ‘aphagn Stine ote 3 layers of ‘Sacualy abdomns facie muscles, ‘pposton to inti 27 “ descendin exten lower end of severing — ‘colon - sian) bate greater (Greing ‘semach) ane in place. with the diaphragm and lower half of the fe extensive one of apposition, into which the lungs ing the course of a maxim inhalation GSappey) Figure 2.9. Abdominal rib cage cul to illustra Barat iarerlinss2 eerie 8 anteriorly (forward) as the dome of the diaphragm descends during, ‘inhalation, and it moves back posteriorly (toward the back of the body? as the diaphragm relaxes and rises during exhalation. Only in supine and inverted postures do we sce the diaphragm act with such purity of movement. This kind of breathing is carried out in its entirety by the diaphragm, but it is often referred to as abdominal breathing, or belly breathing, because this is where movement can be scen and felt. It s also known as deep diaphragmatic breathing in recognition of its effects in the lower ‘abdomen, Finally, we can call it abdomino-diaphragmatic breathing to indicate ‘hat the downward movement of the dome of the diaphragm not only draws ‘ir into the lungs, it also pushes the lower abdominal wall anteriorly. Another type of diaphragmatic breathing operates very differently. Amazingly, ils principal mechanical features were accurately described by Galen (a first century Roman physician and the founder of experimental physiology) almost two thousand years ago, even though his concept of why ‘we breathe was pure fantasy. During inhalation the primary action of this ‘ype of breathing is not to enlarge the lungs by pulling the dome of the iaphragm inferiorly, but to lift the base of the chest and expand it laterally, posteriorly, and anteriorly. It works like this Ifthere is even mild tension in the lower absiominal wall, that tension will impede the dowaward smo of the dome of the diaphragm. And since the.ahdominal organs cannot be ‘compressed, they can act only as @ fulerum, causing the diaphragm to cantilever its costal site of attachment on the rib cage outwardly, spreading the base of the rib cage to the front, to the rear, and to the sides, while at the same time pulling air into the lower portions of the lungs. In contrast to the pump handle analogy for intercostal breathing, diaphragmatic Sreathing hes been likeued \o lifting « bucket hundle up and out from its resting position alongside the bucket (see Anderson and Sovik's Yoga. ‘Mastering the Basies for illustration and further explanation). Without the Fesistance of the abdominal organs, the diaphragm cannot create this Femult. ‘The intercostal muscles serve to support the action of the diaphragm, not so much to lift and enlarge the chest but to keep it from ‘collapsing during inhalation. (echnical note: Precise language does not exist, at least in English, for describing Jn g single word or phrase haw the respiratory diaphram operates to expand the ‘hb cage in diaphragmatic breathing. A “cantilever truss,” however, rom evil engi Aeering, deeerbos a horizontal truss supported in the middle and sustaining: lod at both ends, and this comes close. In the special case of the human tors, the ‘hdominal organs and intra abdominal preceure provide horizontal wujqurt for the ome of the diaphragm, and the lt and outward expansion ofthe hace ofthe ib (age ine led ousteined at the perimeter of the hase ofthe ri cage] ‘The origins and insertions of the diaphragm for abdominal inhalations different than for diaphragmatic inhalations, and understanding the ment2 axarow oF HAIHA YOGA subtleties of these functional shifts will further clarify the differences between the two types of breathing. For abdominal breathing in the corpse ‘and inverted postures, both the costal attachment to the rib enge and the crural attachment to the spine act as stationary origins; the only part of the diaphragm that can move (the insertion, by definitian) is the eentral tendon. in the dome, which moves inferiorly during inhalation and superiorly Goward the head) during exhalation. By contrast. for diaphragmatic breathing, the central tendon is held statie by the relative tautness of the abdominal wall and serves mainly asa link between the spine! attachments of the crurg, whieh now act as the stationary origin, and the costal attachment to the base of the rib cage, which now aets as the movable insertion ‘To summarize, diaphragmatic breathing occasions an expansion of the ri ‘cage from its lower border. To differentiate it from abdomine-diaphragmatic breathing, in which the rib cage remains static, we can call it thoraco diophragmatie breathing. It should be mentioned that the terms abdomine! breathing, belly breathing, deep diaphragmatic breathing, and diaphragmatic breathing have all been in casual, although generally noncritieal, use for ong time, but the terms “abdomino-diaphragmatic” and “thoraco Giaphragmatie” have not appeared in the literature before now. HOW BREATHING AFFECTS POSTURE ‘The way breathing affects posture and the way posture affects breathin swill be continuing themes throughout the rest of this book. The importane of these issues have long Leen recognized in yoga, but most commentaric are vague and imprecise. Here I am aiming for simplicity: photograph’ records of exhalation and inhalations, and superimpositions of computer generated tracings of inhalations (sine these are always larger) on th ‘exhalations. As secn in both this chapler and in chapters 3 and 5, suc images provide a source of raw data not only for bow inhalations result ‘movements of the chest and abdomen but also for how they affect the bod from head to toe. The single most important key to understanding all suc effects is the operation of the respiratory diaphragm, and to introduce th subject, we'll explore two exercises that will help you become aware of i ‘anatomy and understand two of its main roles in movement other the those for respiration iteelf. AVARIATION OF THE COBNA Lie face down un the floor and interlock your arms behind yor back grasping your forearms or elbows. Or you can simply place your hands i the standard cobra position alongside the chest. Strongly tighten all the ‘muscles from the hips to the toce, and use the neck and deep back muscles tollift the head, neck, and chest as high as possible. You are not making any2 onexrrae 8 particular use of the diaphragm to come into this position. Now inhale and exhale deeply through the nose. Notice that euch inhalation raises the upper part of the body higher and that each exhalation lowers it (Fig. 2.10) Because you are keeping the hack muscles engaged continuously during oth inhalation and exhalation, the lifting and lowering action is due entirely to the muscles of respiration. In this variation of the cobra pose we hold the hips, thighs, and pelvis firmly, which stabilizes the lower back and the spinal attachment of the rus of the diaphragm. Inhalation erestes tension at all three of the iaphragm’s attachments: one on the vertebral column, one on the base of the rib cege, and the third on the central tendon. But because the hip and thigh muscles have been tightened, the spinal attachment is stabilized, excepting only a slight lifting effect that is translated to the hips. What happens in the torso illustrates clearly how respiratory movements influence posture: with the abdomen pressed against the floor, the contents of the abdominal cavity cannot easily descend, and this restricts the downward movement of the central tendon, which now aets asa link batweon the two ‘muscular portions of the diaphragm. With the erural attachments stabilized, ‘the only insertion that ean be mobilized without difficulty is the ono at the thase of the rib cage. This attachment therefore expands the clist from its ‘base, draws air into the lungs, and lifts the upper body. If you are breathing ‘smoothly and deeply you will fel a gentle, rhythmie rocking movements ‘the head, neck, and chest rise and fall with each inhalation and exhalation. ‘This is a perfect illustration of thoraco-diaphragmatic breathing. In this exercise the action of the diaphragm during inhalation reinforces ‘the activity of the deep back and neck muscles and thus deepens the back- yard bend. During exhalation the musele hers of the diaphragm lengtben ecventrically as they resist gravity. When they finally relax at the end of exhalation, the backward bend in the spine is maintained only by the deep 2.10. Cobra variation with tightly engaged lower extremities, 12{ymatic inhalation (dotted line) its the upper hall af the hedy over and ‘what can be accomplished by the back muscles acting alone (halftone), fal utth the dlapteragrnatic rote it in figs 7 #1Ay aNArOW OF HAT YOGA muscles of the back and neck. This isan excellent exercise for strengthening the diaphragm, because after you have lifted to your maximum with the deep back muscles, you are using the diaphragm, aided by the external intercostal muscles acting as synergists, to raise the upper half of the body even higher—and this is « substantial mass to be lifted by a single sheet of ‘musele acting as prime mover. Furthermore, if you keep trying as hard as ‘possible to inhale deeply without closing the glottis, you will be creating the mast extreme posible isometric exercise for this muscle and its aynorgists, the ‘oxtornal intercostals. But be watchful. If this effort creates discomfort in the upper abdomen on the left side. plenze read the section in chapter 3 0n hiatal hernia before continuing. [Next try a posture that we ean aptly call the diaphragmatic rear lift. Again lie face down, placing your chin against the floor, with the arms along the sides of the body and the palms next to the chest. Keeping the chest pressed firmly against the oor, relax all the muscles from the waist down, including: the hips. Take 10-15 nasal breaths at a rate of about one breath per second, With the thighs nd hips relaxed, and with the base of the rib cage fixed ‘against the floor, the action of the diaphragm during inhalation ean. be translated to only one site: the spinal attachment of the crus. And because the deep back muscles are relaxed, each inhalation lifts the lower back ane hips, and each exhalation allows them to fall toward the floor (fig. 2.1 Make sure you produce the movement entirely with the diaphragm, not by bumping your hips up and down with the gluteal (hip) and back muscles Because the inhailations increase the lumbar curvature, this exercise will not be comfortable for anyone with low back pain. Inhalation Diaphragimatic rear fit. With the ib cage anchored against Osc en ecg forte lartragrs eather han an iMvortion (as happens inthe cobra posture in fig. 210) lf the gluteal region Sinton extermitcs remain completely relaxed the crural attachments wag then lit the hips duting inhalation and lower them back Ciealation.2 retnune —%5 ‘You can feel the diaphragmatic rear lit most eaxily if you breathe rapid ‘the quick inhalations whip tho hips up and away from the floor and the sudden exhalations drop them. But if you breathe slowly and smoothly you will notice that each inhalation gradually increases the pull and tension on the hips and lower back, even though it does not create much movement, and that each exhalation gradually eases the tension, When you are breathing slowly enough, you can also feel the muscle fibers of the diaphragm shorten concentrically during inhalation and lengthen eecentrieally during exhalation as they control the gravity-induced lowering of the hips toward the floor ‘The origins snd insertions of the diaphragm are reversed in the diaphrag- ‘matic rear lift in comparison with the cobra variation, and this ereates reper ‘cussions throughout the whole body. In the cobra variation we fix the hips and thighs, allowing the costal attachiuent of the diapluragis Uo lift the rib) ‘cage, and with the rib cage the entire upper half of the body. In the diaphragmatic rear li. we do just the opposite: we fix the rib cage, relax the hips und thighs, and allow the crural insertion of the diaphragm to lit the lumbar spine and hips. ‘These two postures also show us how important it is that the diaphragm is indented s0 deeply by the vertebral column that it almost encircles the spine. This enables it wo act Lou from above and behind to accentuate the Jumbar arch during inhalation, lifting the upper half of the body in the cobra ‘ariation, and lifting the sacrum and hips in the diaphragmatic rear lift ‘THE SOMATIC AND AUTONOMIC SYSTEMS, ‘The way we breathe affects far more than our posture, and we ean best ‘explore those ramifications by looking at the two great functional divisions, of the nervous system—somatic and sutonomie—and at the tissues and ‘organs they each oversee, The somatic nervous system is concerned with “everything from the control of skeletal muscle activity to conscious sensations ‘such as touch, pressure, pain, vision, and audition. For the autonomic nervous “‘Wslem, think first of rogulation of blood preseure, viscera, eweat glands, ‘Aigestion, and elimination—in fact, any kind of internal function of the ‘body that you have little or no interest in trying to manage consciously. “This system is concerned with sensory input to the brain from internal 1s—generally more for autonomic reflexes than for inner sensations — well as for motor control of smooth musele in the walls of internal eruians and blood vessels, cardiac muscle in the wall of the heart, and (igs. 10.42-b). Both systems are involved in breathing, Ireathing draws air into the lungs, and since the kings are internal ‘we might suppose that the muscles of respiration are controlled byte anarow oF narHa YOGA the autonomic nervous system. But they're not, The act of breathing is a somatic actof skeletal muscles. In chapter 1 we discussed the somatic nervous system, although without naming it, when we discuseed the control of the skeletal muscles hy the nervous system. Respiration makes use of this system. ‘whether we want to breathe fast or slow, cough, sneeze, or simply lift an ‘object while going “oomph.” When we participate consciously ist any of thie activities we breathe willfully to support them, and we do so from the ‘command postin the cerebral cortex that influences the lower motor neurons for respiration. If you are consciously and quietly using the diaphragm as ‘you breathe, you are activating the lower motor neurons whose axons innervate the diaphragm hy way of the phrenic nerves (figs. 2.6 and 212). If ‘you are eight months pregnant the diaphragm can’t function efficiently, ‘and in order to breathe you will have to activate lower motor neurons ‘whose axons innervate the intercostal muscles by way of the infercostal nerves, And if you are trying to ring the bragging bell at a state fair with » sledge hammer, you will make a mighty effort and a grunt with your ‘abdominal muscles, again calling on molor neurons froma the thoracic cord to transmit the cerebral emmands to the muscles of the abdominal wall, ‘The call bodies for the phrenic nerves are located in the spinal cord in the region of the neck (the cervical region), and the cell bodies for the interest! nerves ure located in the spinal cord in the region of the chest (the thoracic region). In the neck the spinal cord contains eight cervical segments (Ci-8) ‘and in the chest it contains twelve thoracic segments (Ti-12; figs. 1.5 anc 212), The diaphragm is innervated by the right: and left phrenic nerves from epinal cord segments C3-5; the intercostal and abdominal muscles ar innervated by the intercostal nerves from spinal cord segments Ti-12 (igs 15 and 2.12). Both the phrenic and intercostal nerves are necessary for the ful ‘expression of breathing. If for any reason the intercostal nerves are nol functional, leaving only the phrenic nerves and a functioning diaphragn intact, the diaphragm will support respiration hy itself (fig. 2-12, sited). Be! in that event tho oxternal interenstal muscles will no longer maintain shape of the chest isometrically, and every time the dome of the diaphrago descends and creates a vacuum in the lungs and pleural cavity, the ches aval will be tugged inward. On the othor hand, if for some reason the phrenic nerves are not functional (see asterisks fig. 212), but the inter ostal nerves and muscles are intact, the vacuum produced by activity © the external intercostal muscles will pull the dome of the laceid diaphram higher in the chest during the course of every inhalation. Like all typieal somatic motor neurons, those for respiration are cor: trolled from higher centers in the brain, and life cannot be supported by spinal rord transeetions above C3 (fig 2.12, site e). A transection at Cé is 7this nevton represents ll 2 alesion Infuonees on brearg moter ffor above the pons and aways recta eove the pore leaves feepration is pene and Taste Breen ae ey the pening em ana mecutary tespiato the med and a cel foun nts cones feat conta comer 'b) a complete transection of = tetsu a ie oe Se srenean tre ete pon ves fhetet se ot resp ers cet posable cont lhe the daphragm: its col bocies “ar located in Spel core ‘seoments C35: ‘ating these nares a thes “complete Data of the ‘Gaohraom eculary corto! center ‘alcne ') a lesion that destroys motes pathways ee ries tion between the meduiary Ccoritolcantes and 3 rests In immediate cassation of freathing, and death sel tercceta eres (ore el

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