Turn your world upside down

Turn your world upside down - simple inversions to support heart and circulatory health

We inherently know that ‘putting our feet up’ is a restful place to be, but fully changing our perspective on the world can have even greater repercussions for our heart health and stress-coping capacity. In this article we explore supported inversions that can offer a truly calming space in your day.

Many people associate inversions as more acrobatic, like the handstands, shoulderstand and headstand seen in so many yoga pictures. But whilst these more dynamic postures have their benefits, to reverse our usual relationship with gravity so we don’t need to hold up our body weight, offers a soothing and releasing mind-body effect. 

Whichever way we practice inversions, placing our hips above our head, aids the lymphatic flow so important for immune function and detoxification. This fluid system that runs throughout the whole body alongside the bloodstream. It relies on our motor activity for movement as unlike the blood circulation it does not have a pump like the heart. Turning our world upside down allows fluids that can easily pool into the legs to travel back up the body with gravity, supporting circulation and heart health along the way.

Positions where we are fully supported are often called as restorative postures within yoga. They don’t just offer renewal and recovery, but ‘restorative’ is a specific practice where props can be used to allow full rest. Many restorative positions are not inverted but those that are (as recommended here) offer even more calming for the heart and nervous system. These practices are well documented to reduce the stress hormone cortisol that speeds up heart rate for quick physical action in the face of perceived danger (J Diabetes Complications, 2014;28(3):406-12). They are practised to promote a sense of wellbeing and equanimity and invite the slow, deep breathing that brings down high blood pressure and regulates heart beat (Medicine, 2018;97(18):e0639).

Within these positions, it’s not that we need to be ‘doing anything’ or feeling anything in particular. These are mindful practices, where we can focus on the sensory experience of the present moment; without expectation or imposition. We are not looking to feel a stretch, but simply to practice kind attention on the present moment; without judging whether we like or dislike it or attaching to the inner commentary of thoughts. In this way we can let the experience unfold without stress or strain, with space to be fully present for the process of our heart rate slowing down and dropping into calm. Research has shown that mindful practices may enhance parasympathetic influences on the heart rate; allowing us to come to calmer states and increasing how we adapt to stressful situations (Behaviour Research and Therapy, 2013;51(7):386-391).

The reclining and inverted postures included here are also known to support the baroreflex (Indian J Physiol Pharmacol, 1998;42(2):205-13) which maintains the homeostatic mechanism of keeping blood pressure constant, needed to self-soothe. Standing upright inhibits this to excite and raise blood pressure. Conversely, supported inversions calm the whole body and encourage healthy circulation. In these positions, the heart is below hips (and sometimes also the legs), where less pumping is needed to bring blood up from the lower body back to the heart, as gravity allows this effect without effort.

Inversions allow organs (heart, reproductive and digestive organs) to drop and move the position of the ligamentous sheathing holding them in place. This creates movement in and around the organs and their fascia (connective tissues). As organs pull on the sheaths the resulting subtle sensations draw us into our inner world, creating interoception – how we sense and make sense of our internal landscape (Schleip R,‎ Findley TW,‎ Huijing P, Chaitow L. Fascia: The Tensional Network of the Human Body: The science and clinical applications in manual and movement therapy. Churchill Livingstone, 2012).

New research has suggested that anxiety, depression and IBS are ‘interoceptive disorders’ shown to be a signal processing issue where, interoception is increased and can seem noisy and overwhelming. These states are correlated with cardiovascular issues (Int J Yoga, 2015;8(2):142–143).

This processing has shown to be amplified by a racing mind, which can so often accompany stress states where blood pressure is raised, and heart rate increased. This is more obvious in anxiety and IBS, but in depressive states there is also a stress component, with ruminations and difficulty relaxing very common. In such states, it is not the interoceptive signalling itself that is the issue, but rather the belief states of the individual, which colour the information received. The brain can panic when it cannot clearly sense the internal state of the body, leaving a sense of ‘unsafe’ that sets off the chronic stress associated with heart disease (Current Directions in Psychological Science, 2006;15(6):269-272).

Leading fascial researchers have stated that supported inversions can ‘foster interoceptive refinement’ (Schleip R,‎ Findley TW,‎ Huijing P, Chaitow L. Fascia: The Tensional Network of the Human Body: The science and clinical applications in manual and movement therapy. Churchill Livingstone, 2012) helping the embodied awareness that slows down heart rate. When we also add in the mindful component of such poses, there is great scope to use them for soothing and reducing the negative effects of stress.

This potential for release, although the perfect situation for ‘coming down’ from anxiety or agitation, also creates the space to feel vulnerability. For many, restorative positions are more challenging than stronger physical practices as they ask us to stay present without the distraction of things to do or strong bodily sensations. The experience may be subtler and bring up difficult feelings. Focussing on the present moment experience of the breath (mindfulness of breathing) can help to gather in attention to a sense of our body in the here and now. This helps us feel safety that slows down heart rate (Int J Prev Med, 2012;3(7):444-58), and a simple guide of observing the inhale up the spine, exhale down the spine can always bring us back away from the mind chatter that takes us away from the experience.

You can choose several of the poses here to do for a soothing, meditative practice on their own or just pick one whenever you need or at the end of a more active yoga, Pilates or exercise session to cool down body and mind. You can stay for 5 minutes or more, depending on how you feel, listening for your body’s cues to come gently out by laying on your side for a minute or so.

Legs up the wall sequence

Simply lying with legs supported up a wall is highly smoothly, but adding in the element of hips raised above the heart adds in two aspects - on top of the inversion - that support cardiovascular and other body system health. There is a backbend effect where the chest can fully open and diaphragm move for breathing where it can get collapsed with hunching or stress; supporting slower natural breath patterns. Also, space is create at the base of the skull which soothes via the vagus nerve that begins there and signals relaxation to the whole mind-body.

1. With a bolster or folded blankets against a wall (with a 2-3 inch gap for your tailbone), bring your right hip up onto the right side of the bolster and swing your legs up. Shimmy on if you need, to position all of your lower back onto the lift with tailbone just over the edge - for tight hamstrings have the lift further from the wall. Settle into the weight of the legs, arms wherever the shoulders can most easily drop and rest.

2. Taking the legs wide in an inversion helps relieve stress in the pelvic floor, which can stay stuck in protective contraction up to the spine and mouth. The pelvic floor, tongue, palate and upper throat can all stay contracted, holding us in stress patterns. Widening and inverting the pelvic floor signals permission for this whole channel to release.

3. Drawing the knees into the chest then draws the tailbone under to create gentle length in the lower back and the safety of the foetal position.

4. Moving into a forward bend inversion supports the lower back, so we can gauge the level of leg extension the whole back body is ready for. Opening the hamstrings with conscious breath helps create vagal tone, our ability to self-soothe via the vagus nerve; stress often comes with tightness there.

Come back through the sequence before rolling off to the side and laying for a while in a foetal position on your side, feeling fully supported by the ground.

Supported bridge pose

This pose is a simple way of letting gravity help heart rate slow down; from the knees to the head.  From lying with knees bent, walk the feet in towards your bottom and raise heels enough to lift the pelvis and slide a bolster (or firm cushion) under. Bring the heels back down slowly and find the foot position where you feel grounded through all four corners, this support allowing release through lower back, belly and inner thighs. Spend some moments finding the most comfortable arm (and therefore shoulder and neck) position to be able to soften space between the back teeth and around the eyes, from where safety and calming are signalled to the whole body.

Forward bend on chair

This is one of the simplest inversions you can do at any time, for instance if you feel stressed or overwhelmed at a desk. Sitting to the front of your chair seat and with your feet wide (legs open about a 90-degree angle) drop your torso between your thighs to where feels comfortable and safe. you may need to place your hands on something (yoga blocks or books) to raise the height or start with elbows resting on your thighs.

Shoulderstand – variation to chair

This is the most active of the postures here but is still soothing to the heart and a great alternative to a shoulderstand in yoga – the angle on the neck is less intense and we are not supporting the whole weight of the body.  The head and neck positioning soften the musculature around the neck and upper back, which tend to get hypertonic with stress, where breathe up into the chest and shoulders, rather than more restfully into the belly and diaphragm. 

Start with bottom on the ground, close enough to the chair to take hold of its front legs. Bring the heels onto the very front of the seat and keeping them hip-width apart, lift up the pelvis on an inhale, opening the chest. Soften face and jaw, opening your heart with soft breath, rolling down to rest with shins on the chair seat when your body signals. It may feel right to come up and down a few times, as you will stay lifted for less time than in a full support.

Simple lying inversions – savasana variations

Within the yoga system, corpse pose or savasana is always recommended to practice at the end of a session. This is the place where the previous moving practice (however strong or soft) is able to be assimilated into body tissues and we come back down to a cooling state.

Whether you are a yoga practitioner or not, this is highly balancing habit, which can always be practised as a simple alternative to a meditation position if you are tired.  Any supine (lying) position relieves muscular tension and therefore slowing of heart rate - we don’t need to hold ourselves up and neural excitation is reduced. For those with lower back issues, laying with legs raised above the hips may be more restful to stay for up to 20 minutes, where you can also listen to a calming practice such as a body scan or other mindfulness meditation. 

1. Legs raised to a chair (also the position to come down to after the shoulderstand variation above)
2. Legs lifted over three bolsters (as shown) or cushions lifting a large tightly rolled towel under the knees.

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