Doing Yoga Without

by Nina

Yesterday I wrote Cheating at Yoga? about props and how we here at YFHA staff feel it is wise to use them to adapt poses to your body type and/or physical condition. But there are some physical conditions where a prop won’t help. In this case, you can simply modify your poses in certain ways to make them accessible to you.

I was thinking about this because recently a friend told me that she “can’t do yoga” anymore because shoulder injury (as yet undiagnosed). I assured her that she still could because there were a lot of poses that she would still be able to do. She then asked if there were some yoga videos for yoga without arms, and I said that I couldn’t think of any but that most practices (except Sun Salutation practices) could be modified by changing your arm positions or, in some cases, substituting one pose for another. I know all about this because I’ve had two frozen shoulders, which meant even moving my arm was very painful, and I continued to go to a public class and kept up my home practice throughout.

Because lifting caused her pain, I suggested that she avoid all poses where you bear weight on your arms. This would include Downward-Facing Dog, Sun Salutations, and some backbends, such as Upward Bow pose (Urdva Dhanurasana). A modified version of Downward-Facing Dog pose, Half Downward Dog at the Wall, could be substituted for the full pose. Inverted poses, such as Headstand and Shoulderstand, where you bear weight on your shoulders should probably also be avoided. For these, you can do partial inversions, such as Supported Standing Forward Bend and Supported Prasarita Padottanasana (see All About Supported Inversions), where your head rests on a block or other support.

Substitute for Downward-Facing Dog

Even after eliminating those poses, there are still so many other poses someone like her could do, including standing poses, seated twists, seated forward bends, and backbends, such as Locust, where your arms do not bear weight.

But what if even just raising your arms over your head or out to the side causes pain? In this case, in standing poses, you can modify your arm position to one that is more comfortable. For poses where both arms are overhead, such as Tree pose (Vrksasana), Warrior 1 (Virabhadrasana), and Powerful Pose (Utkatasana), bring your hands into Prayer position (Namaste) in front of your heart. You can even take this same arm position in poses such as Triangle pose (Trikonasana) and Extended Side Angle pose (Parsvakonasana), where your arms are out to the side. But you could also practice those poses with just the injured arm alongside your body or with a bent elbow and hand on your hip while your uninjured arm is in the standard position. In other words, just find a position that is comfortable for your injured arm. Feel free to experiment!

Surprisingly, seated forward bends, especially if you are flexible and normally hold onto your feet, can also hurt your shoulder. In this case, for the injured arm, reach it only as far as it can go and use a block underneath to support it. Binding in twists is also not recommended, as it is an intense stretch on the shoulder, but most of us know milder alternatives for the arms in twists.

It’s your practice people, so just make it work for you. Like I said yesterday about using props, this is not cheating! You’re still practicing and that’s all that counts.

Patient Safety and the Man-Machine Interface

We know that humans make errors and we also know that we can eliminate some of those errors through the appropriate use of technology. For example, the computerized order entry system (CPOE) has just about eliminated medication errors due to misinterpreted handwriting or the use of dangerous abbreviations.  
However, machines don’t fix everything and computerization creates new opportunities for error at what is known as the man-machine interface.

An example of a catastrophe created at this interface was the crash of American Airlines Flight 965. The aircraft was a Boeing 757, and it was on a scheduled flight from Miami International Airport to Cali, Colombia, when it crashed into a mountain in Buga, Colombia on December 20, 1995, killing 151 passengers and 8 crew members.

Cali's approach uses several radio beacons to guide pilots around the mountains and canyons that surround the city. The airplane's flight management system already had these beacons programmed in, and could have told the pilots exactly where to turn, climb, and descend, all the way from Miami to the terminal in Cali. Essentially, once the pilots had programmed the computer, the plane could have taken off and landed itself successfully.

Cali's controllers asked the pilots if they wanted to fly a straight-in approach to runway 19 rather than coming around to runway 01. The pilots agreed, hoping to make up some time. The pilots then erroneously cleared the approach waypoints from their navigation computer. When the controller asked the pilots to check back in over Tuluá, north of Cali, it was no longer programmed into the computer, and so they had to pull out their maps to find it.

By the time they found Tuluá's coordinates, they had already passed over it. In response to this, they attempted to program the navigation computer for the next approach waypoint, Rozo. However, Rozo was identified as R on their charts. Colombia had duplicated the identifier for the Romeo waypoint near Bogotá, and the computer's list of stored waypoints did not include the Rozo waypoint as "R," but only under its full name "ROZO." In cases where a country allowed duplicate identifiers, it often listed them with the largest city first. By picking the first "R" from the list, the captain caused the autopilot to start flying a course to Bogotá, resulting in the airplane turning east in a wide semicircle. By the time the error was detected, the aircraft was in a valley running roughly north-south parallel to the one they should have been in. The pilots had put the aircraft on a collision course with a 3,000-meter (9,800 feet) mountain. They realized their error too late and the plane crashed into the mountain. A system designed to make flight safer had been misused by the humans flying the plane and this had resulted in 159 deaths.

Recently, at GBMC, we had a near miss from a human error at the man machine interface. An ED doctor was trying to order a CT scan of the head and neck on a patient and inadvertently clicked on the next name in the list and ordered the CT on the wrong patient. In the old system, the doctor would have taken an order sheet and stamped the patient’s name on it, but in the computerized world, this type of new opportunity for error presented itself.

The wrong patient did not get the scan because our design for safety has a check that worked that day. Jana Sanders, the C.T. technician who was working reviewed the patient’s record and questioned the orders because there was no mention of a fall or head/neck pain. Jana called the physician to make sure he wanted these exams on the patient before doing the scans. At that point, the physician realized the error, thanked Jana for catching it, and put the order in for the correct patient.
 
It is said that in highly reliable systems, operators have a preoccupation with failure. Operators, like Jana, have a questioning attitude because they know that humans make errors, so they follow the design for safety and do the check to make sure they have the right patient. They also realize that computerization prevents many types of errors but creates some new ones at the man-machine interface. Our hats are off to Jana on a job well done!

What opportunities for error do you see in your work at the man-machine interface?