Task 2
You are going to introduce the headstand: What advice would you give to a student who
tells you he/she has high blood pressure?
High blood pressure:
If a student tells you that they have high blood pressure then the teacher should ask if the condition has been
diagnosed by a doctor.
a. if no, the condition has not been diagnosed, then advise the student to seek medical advice.
In the interim the student can attempt headstand, but they should stay aware of any
symptoms. Stop immediately if any dizziness or shortness of breath is encountered. The
teacher should also closely monitor the student to ensure their safety.
b. if yes, the condition has been diagnosed, is the student taking any medication?

if yes, is it working? If it is working, the student can practice headstand. If it's not
working, the student should seek further medical advice and should not participate in
any part of the class.

if no medication is being taken, the student should seek further medical advice if they
are still experiencing symptoms and should not participate in any part of the class.
What advice would you give to an intermediate student who is 3 months pregnant?
The decision to practice yoga during the first trimester is an individual matter; Sri K. Patthabhi Joice advises
women not to practice Ashtanga yoga at all during the first trimester therefore it is advisable to take a
conservative approach. If the student has never practiced headstand before then they should not try it for the
first time if they are pregnant. However, if the student is intermediate/advanced and has practiced headstand
before and are therefore confident of their ability then they are safe to practice, being mindful to take extra
care.
Task 3
Explain why increasing venous return, by doing headstand, is good for the heart.
The heart pumps blood through 2 sequential circuits:
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Pulmonary - from right ventricle to the lungs (to pick up oxygen and drop off carbon
dioxide) and back to the left atrium
Systemic - from the left ventricle to the body (to pick up carbon dioxide from the
tissues and drop off oxygen) and back to the right atrium
Venous return is the amount of blood that is returned to the heart per minute. When standing upright, blood
from parts of the body below the heart is returned to the heart by pumps located in the veins, which each time
the skeletal muscles contract, pump blood back to the heart through one-way valves in the veins, when the
muscles relax the valves close to prevent the blood flowing the wrong way (due to the force of gravity). Inverted
postures increase venous return because the parts of the body previously below the heart are instead above the
heart and therefore gravity is the prevailing force, negating the need for the skeletal muscle pumps. This
increased venous return makes the heart pump stronger and consequently increases cardiac output (the volume
of blood pumped by the heart per minute); as venous return increases, the additional blood stretches the walls
of the ventricles which causes the stretched muscle fibres to automatically pump more strongly, thus increasing
cardiac output. This increased cardiac output has been reported to resemble the cardiovascular activity
achieved during exercise, known as Sterling or Laplace's law.
Assessment of the cardiac output is important in determining the work that the heart is actually performing
with respect to the rest of the cardiovascular system. If the cardiac output is too low, then the body is not being
properly supplied with blood (heart failure), which can and will lead to life threatening problems if left
unchecked. Having an increase in blood flow and circulation to areas of your body helps promote cell growth
and organ function. Your skin also benefits from an increase in blood circulation; healthy skin is better able to
fight off bacteria and infection that it may come in contact with. When your heart pumps at full force, your
heart rate lowers, heart muscles relax and your blood flows evenly and smoothly. An increase in blood flow or
circulation in the body can help benefit the heart and the body's muscles and arteries throughout the body;
increased blood circulation improves oxygen rich blood flow to extremities. If you can remain in an inverted
posture for 3-5 minutes blood will not only drain quickly to the heart from the lower extremities and the
abdominal and pelvic organs but tissue fluids will flow more efficiently into the veins and lymph channels and
this ensures a healthier exchange of nutrients and waste between cells and capillaries.
Task 4
Explain the term ‘essential hypertension'. Can yoga be used in its treatment and how?
‘Essential hypertension’ is high blood pressure for which there is no clearly defined aetiology. From a practical
perspective, it is best defined as that level of blood pressure at which treatment to lower blood pressure results
in significant clinical benefit—a level which will vary from patient to patient depending on their absolute
cardiovascular risk.
Epidemiology
In 2000, it was estimated 25% of the world’s adult population were hypertensive, and predicted that this would
rise to 29% by 2025. By the age of 60, more than one-half of adults in most regions of the world will be
hypertensive
Pathogenesis and pathophysiology
The pathogenesis of essential hypertension is a complex interplay between
(1) genetic predisposition
(2) lifestyle and environmental influences
(3) disturbances in vascular structure and neurohumoral control mechanisms.
Genetic predisposition—blood pressure runs in families, with a remarkably consistent level of correlation of
around 0.2 between first-degree relatives found in many studies. Variants in a large number of genes, involving
virtually all of the main physiological systems affecting blood pressure, have shown association with blood
pressure in one or more studies, but the effect of any individual variant is likely to be modest.
Lifestyle and environmental influences—the exploding prevalence of hypertension in economically developing
regions reflects lifestyle changes, so-called ‘Westernization’, more than anything else, with the most important
influences on blood pressure being sodium intake, obesity, stress and alcohol intake.
Pathophysiology—a characteristic finding in essential hypertension is an inappropriate increase in peripheral
vascular resistance relative to the cardiac output. This is due to remodelling of small arteries (arterioles), which
is characterized by an increase in their media/lumen ratio, but it is not clear whether these changes are a
consequence or a cause of raised blood pressure. The functional integrity of large conduit arteries, i.e. the aorta,
which becomes stiffer, also influences the development of hypertension—especially systolic hypertension.
Task 6
What are the effects of the breath on the spinal muscles during a forward bend?
Breathing and forward bending postures will be experienced differently by those who are relatively stiff than
those who are stronger and more flexible. During self practice it should be possible to feel the movements of
the spine while breathing. If this is not the case you are probably blocking the natural movement by using too
much force and this will compromise the work of the diaphragm and the breath.
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

Beginners: The posterial stretch in the forward bend causes compression in the
abdominal organs; each inhale will lift the torso as to the dome of the diaphragm
descends and each exhale lowers the torso forward and down
Intermediate students not in the final position: It is likely that the student is holding
onto the lower extremities with the hands to maintain a deep forward stretch; this
position makes it difficult for the diaphragm to lift up the torso during inhalation.
Consequently there is increased tension during inhalation as the diaphragm presses
down against the abdominal organs and a release of this tension during exhalation
but they are still lifted up and down by the pneumatic system.
Advanced students in the final position: If the posture has been completed and the
torso is flattened against the thighs, this prevents the posture from lifting and
lowering during inhalation and exhalation. This offers the most stability in the
posture and this position can be used to increase capacity.
How could you take advantage of this effect?
The pattern of breath and movement has consequences for both the practice and the adjustment. When
working towards the final position, the inhale should be used to lift and lengthen the spine and the exhale
should be used to move deeper into the asana. If in the final position then the breath can be used to increase
capacity:
-
Come into forward bend, with knees extended, shoulders and arms relaxed and
hands resting on the ankles or feet
Breathe in and out normally, noticing that the inhalation lifts you up and creates
tension in the trunk
In one sequence, breathe out to your full capacity and at the end of the exhalation
pull your torso forward with the rectus femoris, iliacus, psoas and rectus abdominis
muscles. Grip the lower site firmly and hold the posture, inhaling and exhaling
several times until the body has adjusted to the new stretch. The hands are not
pulling you into the stretch, rather they are just holding the body in the position
established by the torso and proximal muscles of the lower extremities.
This sequence can be repeated several times.
Regardless of flexibility, if the forward bend position is reached in which the breathing cannot lift you out of the
posture you will notice that tension from inhalations, especially from deep inhalations, spreads throughout the
body and is redirected into stretching the calf muscles, hamstrings and deep back muscles as well as joints and
muscles throughout the upper extremities. During exhalation the diaphragm permits a release that lulls the
stretched muscles into submission.
For passive adjustment, pressure should be applied during the exhale and released during the inhale; if the
pressure is not released during the inhale then the adjustment becomes a resistant adjustment in which PNF can
be utilised when the back muscles are contracting during the inhale.