A Revolution in Fitness, Yoga and Pilates Revisited Part III: An Interview with Dr. Mark McMahon, DPT, OMT

In the previous installment of this series, we learned that Al can be taught and his mind can be changed. We also learned that I may have been cross pollinating with yoga and Pilates with some of the things that I’ve been using.


This week we talk to Dr. Mark McMahon, DPT, OMT who works with Curtis Cramblett at Revolutions in Fitness in the San Francisco Bay Area. McMahon was great enough to also answer the questions posed to Cramblett, and gave terrific answers you need to read.


So, without further ramblings from your newly humbled host, here you go: A Revolution in Fitness, Yoga and Pilates Revisited Part III: An Interview with Dr. Mark McMahon, DPT, OMT, enjoy!


Given that most endurance athletes sit for 8-10 hours a day prior to running/riding/swimming, what are the potential spinal column structural implications that could be presented in that?

Yoga philosophy uses the model of three Gunas (translated from Sanskrit usually as “threads”), which are elemental shaping forces: Rajas (the energy of activation, movement, heat, speed), Tamas (the energy of inertia, rest, groundedness, slowness), and Sattva (the energy of enlightenment, clarity, balance, wholeness). Too much Rajas or Tamas in your life can lead to serious imbalances and disturbances of body & mind, and can block access to Sattva.


Sitting 8-10 hours/day is a huge tamasic overload (think=rusting cars in the scrapyard rain, they ain’t goin’ anywhere). But consider the additional imbalance of having, usually, a very Rajasic brain, fueled by caffeine, stress, music, work, Facebook – ? Maintaining extreme states over long periods is rarely helpful, and this double/opposite extreme situation can firmly block later access to the body/mind connection necessary for safe, happy, Sattvic workout or athletic performance. Healing means balancing the whole person. Endurance athletics can help achieve balance by easing the negative effects of our tamasic lifestyles; yoga practice can help from the other end, calming the rajasic mind and allowing focused, nonjudgmental attention.


How do endurance activities negatively affect the body? Shoulders? Thoracic spine? Hip mobility? Even though there is constant movement with endurance activities, the movements are generally repetitive within certain fixed parameters – very little activity “outside the box” (the running stride, the bike cockpit, the swimming space.) Hips and shoulders, especially, possess huge 3-D, circular ranges of movement that will be lost over time if not used. If we lose mobility in certain directions, we also lose kinesthetic/proprioceptive feedback and core/proximal stability for that body part in that direction.


How can yoga and Pilates affect this both positively and negatively?

Both practices include systematic ways of using the body’s full range of motion, movement outside the “box.” This has a huge potential benefit for the health of the tissues: for joints, muscles, and ligaments, of course, but also for the visceral organs, and perhaps most importantly, for the mobility of the nervous system. PROPERLY INSTRUCTED, these practices emphasize the necessary proximal stability to ensure safe exploration of range of motion. If attention is not paid to proximal stability, then activities and poses can lead to overstretching, tissue damage, decreased proprioception and a net LOSS of usable mobility.


What elements of the two disciplines do you incorporate into your treatment plans?

1) It is often said that what makes yoga asana (physical poses) different from just stretching is the attention to the breath. Breathing touches every part of the body. Drawing attention to client’s breathing habits and intentions while moving is a big part of helping them restore natural ease. Also, breathing itself is an important Functional Movement Pattern that our client performs during manual therapy treatment, to assist with joint and soft tissue releases especially for the ribs, shoulder girdle, pelvis and spine.


2) When we do a manual therapy technique which restores lost range of motion, we always finish that technique with specific re-education for that body part at or near the new end-range, usually involving a combination of manual resistance and verbal cuing. Proximal stability, often lost due to injury or disuse, can be restored and retrained. We do, at a micro level, what well-instructed yoga & pilates attempts to do on a macro level: we create conditions where the client’s motor system learns (and retains!) how to stabilize the body part and move into the new range with safety.


What should endurance sports enthusiasts be aware of in regard to doing either discipline on both sides of the fence?

Beware of dogma in any form. The world of yoga and pilates is full of well-intentioned instructors who teach as if there was only one way to move, one correct postural alignment. Often these folks mistake the “relative” truth of what works for themselves for the “absolute” truth which should be taught en masse. Real instruction and practice should always include honest assessment of an individual’s needs, and education for the student regarding how to self-evaluate , so the practice can be supportive rather than just trying to fit the practitioner into a dogmatic box.


Don’t do passive stretching: Prolonged PASSIVE stretching of tissue has been shown to be a) ineffective in creating usable mobility improvements and b) possibly detrimental to subsequent production of strength/power for athletics.


Well-done yoga and pilates creates opportunity for ACTIVE stretch/elongation of tissue – that is, the tissue gets to stretch while under mild active contraction, which makes it a safer, more effective process, with the whole area remaining under neuromotor control so the brain and motor planning system can learn from and reproduce the experience.


If they do do yoga/pilates, what questions should be asked of the instructor to make sure they Small classes or individual sessions are best.


Certification: Both yoga and pilates have myriad certification systems, and the instructor should have credentials showing a significant commitment to training (200- or 500- hour teacher training programs in yoga are common). Weekend courses are usually not enough to provide credible certification for teaching.


The instructor should be practicing regularly themselves! Ask! Also, instructors who are involved in endurance athletics themselves in some form will potentially have more insights into how their teaching could impact the student’s athletic goals.


What are the biggest weak spots you’ve seen in endurance athletes, and how can yoga/pilates benefit them?

Endurance athletes tend to be very strong and smart about movements within their chosen discipline, but weak/undertrained in movements of real life! Yoga & pilates require attention to core function in many planes of movement, providing access their strength and spread it throughout the body. Again, I believe the goals of yoga involve being a more balanced, whole person, a state which can be lost somewhat through overtraining one endurance activity.


What is the best way for someone to incorporate yoga/pilates into their weekly training program? How would this blend in with lifting weights?

First of all, there are as many ways to practice yoga! Doing a little each day is generally considered better than doing a blowout class once or twice a week. Mostly it should be seen as a practice in its own right, and not just the latest crosstraining option you’re thinking about getting into – so it should fit into your schedule nonviolently. But within the context of taking a nonviolent, balanced approach to life and training, it still pays to remember: we need REST between bouts of (any) exercise to reap the benefits. So if your yoga practice was heavy on planks, arm balances, sun salutations, then I’d consider going easy on the chest press later in the gym – ? Luckily a full classical yoga practice includes both opportunities for “good” fatigue and aerobic exertion, as well as time in deep relaxation, in restorative or supported poses. But think of active part of each yoga or pilates practice session as an opportunity to wake up, or facilitate, the quality of core stability. Practicing well should leave one relaxed, energized, ready for life – including weight lifting, if that’s what’s up next for you in life.


What are your thoughts on Dr McGill’s take on spinal flexion as it pertains to yoga/pilates?

“There are only so many bends or a ‘fatigue life’, in your spinal disks,” says Stuart M. McGill, a professor of spine biomechanics at the University of Waterloo. “Inside each disk is a mucus-like nucleus, and if you keep flexing your spine and bending the disk over and over again, that nucleus slowly breaches the layers and causes a disk bulge, or a disk herniation.”

This is all too true, from a materials science perspective, and supported by irrefutable research; repeated or prolonged PASSIVE uncontrolled) flexion of a vertebral segment will contribute to the overstretching of posterior support structures and leave the disc wall more vulnerable to herniation. This is true for any spine – the stooping farm worker, the humpbacked dentist, the slouching teenager, as well as the bendy yoga practitioner who pushes into deep forward bends repetitively.


The question itself seems to imply or assume that yoga/pilates will necessarily create this excessive flexion – which is not universally true. It’s true that many overzealous, goal-oriented practitioners, who may have the natural physical ability to flex their lumbar spines that far, have gotten into trouble. Good instruction and mindful, nonviolent practice should always include self-verifiable criteria for avoiding suffering due to yoga practice! In performing forward bend poses, most people who overflex the lumbar spine do so because they are relatively inflexible at hip and pelvic articulations, or are limited by tightness of “hamstrings” (posterior chain, including neural structures i.e. sciatic trunk). Yoga poses which help open these hip and soft tissue restrictions, performed as preparation for forward folding, can actually improve overall “folding” ability while actually decreasing the flexion moment on the lumbar spine. Additionally, a well-rounded yoga practice will include serious time spent dynamically strengthening the lumbar extensor system (backbends = not just doing Cobra passively!!!), targeting both local/segmental musculature (multifidus, interspinales, rotatores) as well as global (erector spinae), which are key to protecting the lumbar spine from overflexion in forward folding movements.



But research also shows that flexion itself is not the only predictor of disc pathology. What circumstances keep a disc healthiest? Disc tissue is notoriously poorly vascularized, which means that it gets most of its nourishment and waste removal from movement.


Which movements? 1) COMPRESSION/DECOMPRESSION: Discs imbibe fluid and nutrients while in gravity-unloaded positions (REST), then expell fluid and waste products as we load ourselves upright in the gravitational field. 2) Rotation: The arrangement of the annular fibers of the disc wall (up to 9 layers of fiber sheets layered in alternating diagonal bias, like a radial tire) indicates that they are there to resist (and are therefore strengthened by) ROTATION. In a spinal segment that doesn’t get its requisite dose of these 2 movements processes (i.e. in the sedentary worker or single-position endurance athlete!), there will be both buildup of tissue waste products, and general weakening of the disc wall – both of which can contribute to degeneration of the disc and increase vulnerability to herniation if excessive force is applied (especially in flexion). So maybe a practice (like yoga), which takes the spine into multiple novel combinations of these helpful movements, wouldn’t be such a bad idea?





Al Painter, National Academy of Sports Medicine Performance Enhancement
Specialist, Corrective Exercise Specialist is the President and Founder of INTEGRATE Performance Fitness. He has also been named the “Bay Area’s Best Personal Trainer” by CitySports Magazine, and he has also received a “People’s Choice Award” from the Palo Alto Daily News.


Al is also the Fitness Editor for VeloReviews.com and TwoSpoke.com as well as a contributor to FitApproach.com. 


INTEGRATE Performance Fitness has also been named “Northern California’s Best Fitness Facility” by Competitor Magazine as well as a “Top 5 Bay Area Fitness Facility” by the SFGate.com. 


He also holds a degree in Journalism from Santa Clara University.



Never attempt any new exercises mentioned in the Fitness411 blog without a thorough evaluation from a physician, personal trainer, strength coach, athletic trainer, physical therapist or sports chiropractor.