A healthy sarvangasana requires a strong opening of the armpits and a rolling of the shoulders back and toward each other to allow the neck to release properly. A good way to prepare for this is to stand with your back near a table, interlock your fingers, place your hands on the table, and bend your knees while lifting your chest. This replicates the movement necessary in the full pose but places no weight on the head or neck, allowing you to cultivate flexibility without risk.
Setu Bandha Sarvangasana (Bridge Pose) is another good preparation, because it distributes weight between the feet and upper body while protecting the neck. While in this pose, you can check to see if you've developed the necessary flexibility in your shoulders for Sarvangasana: Lift your pelvis, leave your shoulders on the floor, and notice your seventh cervical vertebra (C7), that big bump at the bottom of the neck. If it's pressing into the floor, you are not yet ready for the next step, or you will need firm blankets or foam pads to support your body. If you use blankets or pads, they should support your body from your elbows to your shoulders and upper trapezius muscles, which cover the upper-back part of the neck and shoulders. If you have stiff trapezius muscles, C7 will also rest on the pads. Eventually, your chest will touch your chin, indicating that your neck is mobile enough for you to practice Sarvangasana.
If you feel you are ready to move on, try Ardha Sarvangasana (Half Shoulderstand). This is done with the pelvis lifted off the floor, the feet on the wall, and the shoulders rolled under with two or three carefully folded blankets or firm pads under them to ensure that the neck is pain-free. The pads should be in the same position as described above for Setu Bandha Sarvangasana. In time, you will feel ready to do full Sarvangasana by lifting one leg at a time from Ardha Sarvangasana.
While pads are unnecessary for perfect bodies, for the rest of us, they are necessary. Ultimately, the shoulders themselves become the pads and no part of the spine touches the floor. In the meantime, the stiffer the shoulders, the higher the pads need to be. Though many instructors teach this pose without pads, I value my students' necks and consider pads to be an indispensable part of the posture.
After you come out of Sarvangasana, sit up and notice its effects. Your eyelids should feel heavy and your facial muscles soft and weighted, as if your jawbone is going to drop off. If you feel agitated, angry, or tense, you may have stayed in the pose too long or may need assistance with your alignment; in that case, consult a trained teacher.
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