depression is under-recognized in Parkinson’s

The recent events around Robin Williams’ suicide and the revelation he was battling the early stages of Parkinson’s disease, as well as depression, brings to light the importance of managing the non-motor issues related to neurodegenerative disease.

robin-williams-young-parkinson-depression

Depression is common in PD, and occurs in approximately one-quarter of those diagnosed. More importantly, depression and anxiety can occur up to 10 years before PD diagnosis. Depression is also under-recognized, so these numbers may not accurately reflect the widespread impact of mood disorders in this population. This highlights the importance of understanding how to manage mood disorders in the context of a neurodegenerative disease.

Depression occurs in persons with PD because their brain pathways closely associated with mood, and sleep are also affected by the disease.  The disease starts by affecting certain chemicals in the brain, long before the tremor and movement problems are evident. Depression may also be a side effect of the medication used to manage PD.

A recent article published in Neurology (Aug 15, 2014) by Dr. Weintraub (an expert in non-motor issues in PD) highlights the importance of this issue (article HERE). The study follows a cohort of people from the Parkinson’s Progression Markers Initiative, funded by the Michael J Fox Foundation for Parkinson’s Research. The mission of PPMI is to identify one or more biomarkers of Parkinson’s disease progression and includes cohorts from the USA, Europe, Israel and Australia. The discovery of a biomarker (“a measurable indicator of some biological state or condition” i.e. blood sample) is a critical step in the development of new and better treatments for PD.

423 people with PD and 196 “healthy” controls were followed for 24-months and measured: cognition and symptoms of depression, anxiety, psychosis, impulse control disorders (ICDs), sleep, apathy, and fatigue. People with PD had more depression, fatigue, apathy, and anxiety compared to controls… but more importantly, two-thirds of the people with PD who showed signs of depression were not being treated for depression by their physician.

This highlights that it is important that people with PD notice changes in their mood, and speak to their healthcare professional if they are worried about non-motor symptoms. And know that with Parkinson’s, You Are Not Alone. RIP Robin. much love.

 

 

Fall YOGADOPA classes starting SEPT 11th

Yogadopa and Neuromotion Physiotherapy Victoria are running 12 PARKINSON’S YOGA CLASSES Thursdays from 3:30-4:30pm starting September 11th.

I have some research/conference travel on a few Thursdays, so the dates are as follows:

September 11, 18; October 2, 9, 23, 30; November 13, 20, 27; December 4, 11, 18.

Sessions will focus on posture, balance, strengthening the core, opening the chest, flexibility and range of motion.

Classes are $15/session: sign up for all 12-sessions AND drop-ins welcome (please phone ahead to make sure there is space). All equipment and handouts provided. Both persons living with Parkinson’s and care partners welcome! Looking forward to seeing you there!

For more information or to register (space is limited!), contact Neuromotion at 250.590.7878 or neuromotionvictoria@gmail.com
see you on your mat. much love
yogadopa-neuromotion-fall-2014

summer yoga series: back-to-school desk stretches

For some of us, September still means “back to school”. As a postdoctoral fellow working at a university, September means campus comes alive again with students and so does juggling research and teaching opportunities! As summer vacations wind one, it also translates to more time at my office.

For those of you who spend a significant portion of your day at a desk or sitting, FIRST – read this post HERE about the dangers of sitting, and SECOND, try out a few of these stretches below! They definitely help me get through my day and fend of the dreaded ‘slouch‘, can help with carpel tunnel and low back pain!

A) side-body; B) wrists, fingers, shoulders, neck; C) wrist, fingers, shoulders, upper back

A) side-body; B) wrists, fingers, shoulders, neck; C) wrist, fingers, shoulders, upper back

DSC_6-8

A) chest and shoulders; B) shoulder shrugs; C) gentle spinal twist

A) grip strength; B) wrist extension; B) wrist flexion

A) grip strength; B) wrist extension; B) wrist flexion

 

That tennis ball also feels good when I roll it under my feet to open up the sole, arch, ball and heel! much love

summer yoga series: one-leg balance with tree pose

Vrikshasana or tree pose is a wonderful pose to help you feel balanced and stable on your journey as summer slowly transitions into fall. Tree pose not only helps with balance, but also tones the muscles of the core and legs… and it’s not as easy as it looks! Regular practice over time helps build inner and outer strength and a feeling of accomplishment as you learn to balance on one leg. 

full tree pose

full tree pose

Benefits:
  • Stretches your inner thighs and groin
  • Strengthens your thighs, calves, core, and buttock muscles
  • Strengthens the ligaments and tendon of the feet
  • Improves your posture and develops balance
  • Assists the body in establishing pelvic stability
  • Strengthen the bones of the hips and legs due to the weight-bearing nature of the pose
  • Calms and focuses your mind
  • Increases your body awareness.
tree pose from the side - try to align your foot along the inner seam of your pants and open your hips

tree pose from the side – try to align your foot along the inner seam of your pants and open your hips *engage your core to avoid sway in your lower back!

How to:

  1. Stand in Tadasana or mountain pose with your toes and ankles touching, your pelvis perpendicular to the floor and your shoulders relaxed and open.
  2. Ground through your left foot, especially focusing on the big toe joint and then bend your right knee to lift your right foot.
  3. Place the sole of the right foot up against the left inner ankle, calf or thigh with the toes pointing downwards.
  4. Make sure your hips are even- avoid the sink into the hip of the standing leg by engaging your left outer hip.
  5. Gently press your right foot into the left inner leg.
  6. Pressing into the inner arch of your left foot and lightly contract your core muscles to keep from arching your lower back.
  7. Once you have established your balance, fold the hands in front of your chest in a prayer position. Repeat with the left leg.
modify for balance issues by keeping your toe on the ground and heel against your inner ankle

modify for balance issues by keeping your toe on the ground and heel against your inner ankle

Modifications:

  • If you have difficulty balancing, place one or both hands on a wall or chair for support or keep the toes touching the floor as the heel rests against the inner ankle.
... and when you weeble and wobble, do it with a smile!

… and when you weeble and wobble, do it with a smile!

… and remember, yoga is a PRACTICE not a PERFECT. Enjoy the journey. much love

 

summer yoga series: vacation and tie stretches

So, you probably know how the story goes… One thing leads to another and here we are thinking about the changing of the seasons and throwing on a sweater and a pair of socks! Well, no, not really. But, it has been a while.

How are you?

After 2 (glorious!!) weeks in Hawaii with friends and family (celebrating a wedding! meeting our little niece! surfing! hiking! swimming in waterfalls!), and another week spent “getting back to reality”, I’m finally getting around to devoting some time to this space. It was a pretty incredible vacation!

beach days!

beach days!

hiking the napali coast

hiking the napali coast

sunset surfs

sunset surfs

Summer begs for permission for flexibility and space for the unexpected (activity! fun! rest!) in our schedules. And, in my case, my yoga practice calls for that too. Mid-July I was wholly focused on shoulder strength and flexibility, working my way into pinch mayurasana (feather) forearm balance … as of late, it looks more like balasana (childs) and tie stretches.

… wait, have you done any tie stretches? It’s a pretty great way to start your day, or finish a long day of sitting. I love the sensation of stretching out one leg… resting… noticing the difference between my two legs, hips, lower back, feet … then starting fresh with my other leg.

So, give maybe give these a try. Give yourself permission to feel how it feels, to feel the differences in our body sides, and maybe permission to take a break too, and let summer happen! much love.

  • lie on your back and place a strap (neck tie, housecoat wrap, belt, long socks, stockings, towel) around the bottom of your left foot.
  • keep your hips rooted into the earth, and press the top of your right thigh down into the ground. lift your left foot straight up (in line with your hip) until you feel a stretch in your hamstring. You can hold here or create small circles to open up the hamstring.
  • take the strap in your left hand and open your left foot to the side, aiming for the floor. creating a stretch in your inner left groin. remember to keep both hips pressing into the ground.
  • take the strap in your right hand and cross your left foot across the right side of your body. keep both hips pressing into the ground to create a stretch in IT band and outer side of your left left, or drop your left leg as far over to the right to twist and stretch into your outer left hip and lower back.
  • take a minute to pause before you stretch out the right leg to notice how it feels.
yogadopa-tie-stretch-1

hamstring stretch

 

yogadopa-tie-stretch-2

hamstring stretch

yogadopa-tie-stretch-3

inner leg stretch

 

yogadopa-tie-stretch-4

outer leg, hip and IT band stretch

summer yoga series: head-to-knee forward bend

Head-to-knee forward fold is a great way to take a few introspective moments during our day. It lengthens our back bodies (spine, hamstrings), and the asymmetry in the pose allows us to focus on the sensations in one-side of our bodies at a time.

Benefits

  • Calms the brain and helps relieve mild depression
  • Stretches the spine, shoulders, hamstrings, and groins
  • Stimulates the liver and kidneys
  • Improves digestion
  • Helps relieve the symptoms of menopause
  • Relieves anxiety, fatigue, headache, menstrual discomfort
  • Therapeutic for high blood pressure, insomnia, and sinusitis

yogadopa-head-to-knee-front

 

How-to:

  • sit on the floor with your sitting bones firmly grounded in the earth or *elevated on a cushion if you have tighter hamstrings.
  • Stretch your legs straight out in front of you.
  • Bend your right knee and rest the sole of your right food against your inner left thigh.
  • *If your right knee is lifted, support it with a folded blanket or cushion.
  • Ground into your sitting bones and lengthen your spine.
  • Turn your torso slightly left to center your chest over your left leg (*line up your navel with the middle of your left thigh).
  • Reach for your foot OR *if you can’t comfortably reach the extended-leg foot with your fingers, use a strap (… or a belt, or a housecoat tie!). Loop it around the sole of the foot and hold it with your arms fully extended.
  • Lift your chest and lengthen your torso.
  • Press the top of your left thigh into the floor and extend through the left heel.
  • Extend forward from your groin, aiming your chest for your thighs and avoid hunching or rounding your back.
  • Repeat other side.

yogadopa-head-to-knee-props

yogadopa-head-to-knee

much love.

summer yoga series: low lunge + twist

Low Lunge twist is a yoga pose that helps to improve the strength and flexibility in your hip flexors, legs, back and knees. The twist helps encourage spinal flexibility and stimulates digestion and internal organs.

Spinal mobility is extremely important as we age for balance and posture. Twisting is great for preserving movements of looking both ways before we cross the road, checking our blind spot and generally looking over our shoulder,  In addition, stretching the front of our hips can counteract all the sitting we do during the day, and address the tightness in the hip flexors from the forward stooped posture that can occur in Parkinson’s disease.

Benefits:

  • It is advisable for people who are suffering from sciatica as it stretches the hamstrings and leg muscles.
  • It is beneficial for the heart.
  • It stretches and stimulates the lower body.
  • It helps to strengthen one’s balance.
  • It stimulates the reproductive organs and helps with digestion as well.
low lunge with toes tucked for stability

low lunge with toes tucked for stability

low lunge with toes untucked to lengthen foot

low lunge with toes untucked to lengthen foot

How-to:

  • start by kneeling on your hand and knees. Exhale while stepping the right foot in front, between your hands. Ensure that the right knee is in alignment over the right foot (90degree angle).
  • Slide the left leg back until you feel the muscles (gently!) stretching in your groin and as well as in the front of your left thigh.
  • You can keep the left toes tucked for added stability or turn the top of your left foot (“shoelaces”) to the floor for a greater stretch along the front of your left foot/leg.
  • Now inhale while lifting your chest forward through your fingertips. Thin about bringing your shoulder blades together while maintaining a long neck and spine.
  • Try to lift your pubic bone towards your belly button and press your tailbone downwards.
  • Square your hips and your pelvis in alignment. Bring your right hip back and left hip forward slightly.
  • Stay here and feel your pelvis sink to the floor. Notice the opening in your hip and legs. If you’d like to take it into a twist…
  • Twisted from the navel and lower belly, bring the left elbow to the outside of the right knee and place the palms together in a prayer position.
  • Pressing the palms together, use the arms to press the right shoulder up and back, twisting the upper back.
  • Aim your gaze over your right shoulder.
  • Eventually, aim to twist your spine enough so that the palms are at the center of the chest and the fingers are pointing up towards the throat.
low lunge: right knee under right ankle, legs hip-width apart, hips square, and chest lifted

low lunge: right knee under right ankle, legs hip-width apart, hips square, and chest lifted

low lunge twisted

low lunge twisted

* if you have knee pain, place a rolled up mat or blanket under your knee to provide cushion.

* if you have balance issues, face your low lunge away from a wall with your back foot pressing on the wall for support.

 

happy lunging and twisting! much love

ps. last week’s summer yoga series posture here: cat / cow

summer yoga series: cat cow

Last summer I did a weekly book review series “summer reads” (life in the balance, the great work of your life, WHOLE, enlightenment for idiots, prions, may you be happy, and poser) and this year I’m going to provide you with a weekly yoga pose. Something simple that you can integrate into your own yoga practice, or maybe inspire you to start a yoga practice of your own.

Simple movements that bring body awareness, improve range of motion and balance can be really beneficial for people with Parkinson’s.

We’re going to start simple – Cat / Cow.

Both the Cat and Cow poses stretch the lower spine, hips, back and core muscles. They also also open the chest and lungs allowing for easier breathing. This is beneficial in Parkinson’s to address stooped posture that may impair balance, and rigidity in the torso muscles that may restrict breath. Practicing the Cat and Cow poses may improve posture and promote a healthy spine.

Benefits:

  • Stretches muscles of the hips, back, and abdomen
  • Stimulates organs including gastrointestinal tract
  • Aids breathing by stretching chest and lungs
  • Relieves lower back pain and sciatica

 

cat-cow-neutral

neutral spine

cat pose

cat pose

cow pose

cow pose

How to:

  • Start by kneeling on your hands and knees, and gaze at a spot on the floor about three feet in front of you. Place your knees under your hips and wrists slightly forward of your shoulders.
  • Inhale and slowly round your spine toward the ceiling. Drop your head toward the floor but do not force your chin into your chest. Make sure you keep your arms and legs perpendicular to the floor. This is “Cat Pose”.
  • Exhale and slowly bring your spine back to starting position returning your gaze to the original spot.
  • Inhale and lift both your chest and tailbone to the ceiling while curving your back down towards the floor. Raise your head up and look to where the ceiling meets the wall, but do not force your head back and stress your neck. Keep your knees down and make sure your weight is distributed evenly in hands, placing a bit more weight into the base of your index finger and thumb. This is “Cow Pose”.
  • Exhale and slowly bring your spine back to starting position returning your gaze to the original spot at which you started. Repeat this alternating Cat and Cow pose with each inhale and exhale.  Do this10 to 20 times.

* If you have wrist pain and are unable to place weight on your wrists during the pose, you can drop down to your elbows and rest your forearms on the floor as you do the poses.

wrist-free cat pose

wrist-free cat pose

wrist-free cow pose

wrist-free cow pose

* If you have neck pain, keep your head in a neutral alignment with your spine during the poses and do not raise or lower your head.

* If you have knee pain, you can roll up a yoga mat or towel and place it under your knees for support. This can alleviate pressure and pain in your knees while on the ground.

rolled up blanket to avoid knee pain

rolled up blanket to avoid knee pain

* You can also perform these postures seated or standing.

seated cat / cow

seated cat / cow

 

standing cat / cow

standing cat / cow

A great start to your summer yoga! Much love.

yogadopa summer workshops!

I’m excited to announce that Yogadopa and Neuromotion Physiotherapy are running TWO YOGA FOR PARKINSON’S SUMMER WORKSHOPS!

Thursday July 17th will cover some core (abdominal) work, focus on postural alignment and gentle opening of the chest... Great for anyone with a stooped posture and will provide some take-home tips!

Thursday August 21st will focus on finding our feet on the floor, work on activating the leg muscles, and building a solid foundation to help with balance… This session will really address balance issues and provide some advice for practicing at-home! 

If you’re unsure, here’s what people have to say about past Yogadopa classes:

“Kate’s classes are targeted directed at PD’ers. Her knowledge base, instructional and empathetic nature make the course fun and beneficial”

“Kaitlyn is a born teacher. She integrates her knowledge of movement, yoga and Parkinson’s into her sessions directly and meaningfully. Creating a positive feeling in the mind and body.”

Please contact Neuromotion Physiotherapy to register or with any other questions! Looking forward to it. Much love.

yogadopa-neuromotion-workshops-summer-2014

yoga for parkinson’s kripalu retreat with the national parkinson foundation

Hey everyone! Sorry for the radio silence around here! My schedule has been full of yoga, research and visitors 🙂

I was grateful to be included as a speaker at the latest A Wellness Retreat for People with Parkinson’s and their Care Partners. The retreat was hosted again at the Kripalu Centre for Yoga and Health in partnership with the National Parkinson Foundation.

We had Dr. Nina Brower discussing Parkinson’s 201. Her talk focused around how therapies (pharmacology, surgery, exercise) manage the production of dopamine, which is like the gas for your car. Dopamine also works in conjunction with other cells that tell it when to increase or decrease production.

The wonderful Susan Imke gave a really insightful talk on relationships, communication, sexuality and how care partners can start caring for themselves.

The staff at Kripalu, including Aruni, Maria, Megha, Annie and Steven Cope, enabled us to integrate the material, feel it in our bodies, and create healthful adaptations to change and lasting transformation.

Yoga teaches you to use breath as an anchor and be in the moment, making each of the moments joyful. Enjoy the picture below!

yoga-parkinson-kripalu-npf

kripalu-centre

yoga-parkinsons-npf-kripalu

 

berkshires-yoga-parkinson

 

kripalu-lake

yoga-parkinson-meghayoga-parkinsons-class-megha

let-your-yoga-dance-parkinsons

let-your-yoga-dance-megha

npr-parkinson-joyce

parkinson-relationships-susan

The staff at National Parkinson Foundation was incredible, and I was grateful to be included in discussing how people with Parkinson’s can be informed about exercise and how the body moves. If you are interested in attending the retreat in October 19-23, check out the link HERE! And, see my previous posts on NPF-Kripalu retreats for more pictures, descriptions and schedule ideas: June 2012,June 2013October 2013 (click on dates for links).

And don’t forget to check back later next week when I kick off my “summer series”! … much love.