November 2010 – Stress, Pain, Injuries . . . and your yoga practice. How to deal?

Stress, Pain, Injuries . . . and your yoga practice. How to deal?

All of us at one time or another are going to be faced with a pain or an injury. It just seems to be a part of being alive! How you deal with it and the methods your choose for healing will make a big difference in your recovery.

First remember attitude is a little thing that makes a big difference . . . we can use our pain to serve us–we can learn a lot about ourselves through pain. Many aches and pains have an emotional root (the issues are in the tissues)–I am not saying it is the emotion that caused the pain, but rather the emotion can create a weakness in certain parts of our body, predisposing us to injury there. For example, money worries and lower back pain; most of us have had to deal with both at some point in our lives–Our back supports us, emotionally it represents support in our life. Lower back pain is connected to a feeling of lack of financial support . . . 80% of the population will deal with back pain at some point in their lives . . . any connection? I think so! Upper back pain is related to lack of emotional support, this is also at the area of the heart–heart problems are connected to long term emotional problems–a lack of joy, hardening our heart. If you are interested in learning more in this area I would recommend Louise Hay’s book “You Can Heal your Life” or any books by Carolyn Myss. And there is the theory that you can heal the emotion by healing the pain . . .

So when you are dealing with a pain, I would first address the emotional attachment to it. Let the healing begin on an emotional level within us.

NO to Ibuprofen or Tylenol!
And until I can share more next week I just want to share that it is best to NOT take pain relievers! They only mask the pain and not solve the problem, also you can further create more injury by not feeling what movements bring on the pain, you keep repeating the incorrect movement further exacerbating the problem. Instead pay attention to what movements heal and what movements aggravate; in this way you will be on the road to healing yourself. And think about the emotional connection to constantly numbing yourself with pain killers . . .

(And just a side note, the same thing goes for fever too! Low grade fever is your body’s next defense when your immune system fails. Many infectious agents do not live in elevated temperatures so fever is your body mechanism for killing the microbes. If you immediately get rid of the fever you are only supporting the microbes . . . Think of the fever as a healing response rather than a symptom of the disease! By the way, this does not apply to infants and toddlers, and if your fever goes above 104 degrees this means the microbe is too much for the body to fight and then (and ONLY THEN!) you may need anti-biotic support.)

When we feel pain our first reaction is usually to immobilize the area. This is not really ideal due to the lack of blood flow. Our body is set up with an amazing capacity to heal and regenerate, but for that to happen we need to get blood flow to the area–it is the blood flow that heals as the blood carries nutrients to the area and removes toxins and damaged tissue. Again we can relate it to the word Prana, prana refers to the energy in our body among other things; but the literal translation of prana is moving always (in Sanskrit, pra means moving and na means always). Wherever there is a lack of movement there is a lack of energy–a lack of energy to repair and heal. For example;

  • post orthopedic surgery now movement is begun less than 24 hours (sometimes easy movements are recommended just hours after surgery) after surgery. Drs. and therapists now understand the sooner you get a joint active after surgery the better and quicker the recovery.
  • Scar tissue, initially your body creates scar tissue to stabilize and protect the injured area for healing. But left there after inflammation ends it cobwebs and restricts blood flow and range of motion. Movement helps the body to break down and remove scar tissue after it is no longer needed.

In dealing with an ache or pain generally there is only one movement that aggravates and many other movements that heal. So you need to move in the directions that do not hurt and avoid moving in the direction that hurts. For example, I have just come through myself dealing with a little back pain, what I learned was that forward bending aggravated it, but back bending, side bending, twisting and movement in general made my back feel good. Even to the point that at night I would wake up and move around in bed a bit as if I did not my back ached when I woke up. And another example, Michelle is dealing with knee pain, her knee was aching so bad for awhile after working all day and trying not to move it that she decided not to come to yoga for a couple weeks. Her knee only got worse. After speaking with me I encouraged her to come and we would modify her practice to accommodate her knee . . . after only one practice she could not believe how much better her knee felt, so she came to practice most everyday after that and each time her knee got better.

So when you are faced with an ache, find the directions you can move in and move!

And in taking this to our mat; if you have poor habits, you will most likely repeat those on your mat. For example, if you sit with poor posture all day, then come to yoga and forward bend with poor posture it will make your back ache. Or if you stand a lot throughout the day without the inner support of your bandhas and let your spine hang in a lordotic position (pelvis tipping forward and lower back arching), then you repeat that in upward dog, it will be achy. This is not bad! This is where you learn life lessons, you correct the habit on your mat, train your body to habitually stand or sit in good posture and you have healed the problem for good. Many people will try a class and aggravate an ache, and then say yoga hurt me. But it was not the yoga that hurt, it was doing yoga with poor form that hurt. If you stick with it on your mat and figure out what is bringing on the pain, and how to heal it, then you will heal the pain both on and off your mat for good.

Remember practice is on your mat, the real game is when you step off it . . .

And a note on Ice . . . Ayurveda does not recommend ice for injury. Instead Ayurveda treats inflammation with ginger and tumeric (among other herbs), ginger and tumeric improve blood flow to the area while reducing inflammation. Ice occludes blood flow to the injured area, perhaps this does not promote healing? I am not sure why we are taught to ice immediately after an injury–has anyone heard of any problems with temporary swelling? I think swelling is a sign from our body to protect the area and be careful with it while the body brings in fluids to heal. As we can, we should move the area so the body can remove the fluids when they are no longer needed . . .

Habits in our Practice
All movement carries a risk of injury . . . even on our mats where we are trying to move with awareness . . . beginners especially need to be careful as it takes attention, knowledge of your body and how it moves, and compassion when working with our bodies on our mats and it takes time to develop those qualities! However if you do get a little over zealous about your practice and hurt yourself, it will certainly help you develop attention, knowledge of your body, and compassion! We can hurt ourselves in any form of movement, as well as any form of yoga. It is not the yoga that causes the injury but how we are moving in the yoga form that we choose. With that being said, I would like to review movement patterns I noticed through the years that can lead to pain.

1. Shoulders

  • Overhead reaching– first a lot of overhead reaching can be stressful to the shoulder joints. For some reason, a lot of people have thrown in extra over head reaches when binding . . . with the arm they are working in to the bind with, and then again with the arm thats not bound before forward bending. All this overhead reaching can cause an overuse injury in the shoulder. Reaching overhead is not going to help you bind! time in the practice will. And there is no vinyasa count in all the seated poses that states to inhale and raise your arm/s overhead before you catch your foot! BUT when we do reach overhead for the sun salutes there is a safe way to do this and a way that can aggravate . . . Some teachers like to teach taking your arms wide as you go overhead to “open the heart”, however taking your arms too wide will cause the rotator cuff and/or biceps tendons (the rotator cuff muscles are little muscles that keep your humerus in the socket) to slide over the head of the bones–doing this repeatedly will lead to tendonitis in the shoulder. There are two ways I have found to reach overhead safely
    –the first is to touch your palms together and take your arms overhead with palms together (this is the safest and best to do in crowded classes)
    –If you feel like your shoulders are too rounded and you like to take your arms wide to work on shoulder flexibility, then you need to experiment, take your arms way wide and feel in your body how the tendon slips over the bone as you do that; now take your arms not as wide and see if you still feel the tendon slipping over the bone. Play around with how wide you can go without the tendon slipping over the bone–that is your safe area.
  • Chaturanga – many people dip their shoulders in the push up position. Usually this is done because it is easier! but done repeatedly it will lead to pain in the fronts of your shoulders where the brunt of your body weight is dropping. When we dip our shoulders in chaturanga we are internally rotating the humerus and rounding our upper back. When we internally rotate the humerus it makes our elbows wing out and places more stress on our upper back, shoulders, and neck. To safely lower into chaturanga your hands should be VERY LOW, by your lower ribs and waist. This hand position allows you to roll open your collar bones broadening your collarbones and “lift your heart” or extend your upper back instead of rounding it down. It is also helpful to keep your head lifted looking forward instead of down. This position will also disperse our body weight more evenly into our hands offering better support for our back. Although be-aware, this hand position will change your upward dog 🙂 but for the good.

2. Lotus and knees – Lotus requires open hips, if we have any tightness in our hips (common for us westerners who have toilets and chairs) and we work into lotus the knee joint must twist to accommodate. So first thing is to sit on the floor as much as you can (instead of chairs), when you do have to sit on a chair, don’t sit like a lady–sit like a yogi! Sit with your legs up, crossed, folded back, etc. And keep practicing your yoga to open your hips. NEXT is how your work into lotus; many people grab their foot and twist away . . . the knee is safest when it is fully bent or fully straight–anywhere in between is risky. Grabbing the foot to get into lotus twists the knee and ankle–instead first bend the knee completely, then hold your shin and place your ankle on top of your thigh.

3. lower backs and upward dog and chaturanga – if you find yourself with an achy back after practicing most likely it is from sagging in upward dog. You need to engage your deep abdominal muscles (bandhas) in chaturanga–this will produce a slight tuck of your tailbone (posterior tilt of the pelvis), then keep this tuck as you move into upward dog. This requires mental attention (more than strength) as when back bending (as in upward dog) our habit is to tip our pelvis forward putting more compression in the lumbar spine, if you mindlessly move into upward dog your back will sag, so try to make the mental effort to give a little tuck of your tailbone, contract your quadriceps then inhale into upward dog arching your upper spine while you keep your tailbone tucked. This is also good posture for most movements off our mat!

4. Swinging on joints – jump throughs are fun 🙂 however many people just swing on their joints when jumping through putting the soft tissues around your shoulder girdle at risk. If you are working the jump through you need to be able to control it the whole way through, that means at any given point in the pull through you can stop and hold yourself mid-air, and you should be able to stop yourself mid-air before you land, then with control you can safely set yourself down on your mat instead of landing with a thud. We also need to be aware when jumping back in sun salutes; before you jump you need to ground your body weight in your hands, if you jump your feet off the floor without having grounding anywhere else you will crash to the floor. To control your landing carry your body weight in your hands and arms–shifting your body weight forward before you jump and then while mid air pulling with your lats so you land with your hands closer to your waist supporting your spine–don’t jump your feet too far back, you want a short jump so you land with your hands at your waist, not under your shoulders. Too many people jump and go mid-air without having any grounding, then crash to the floor with their hands too far forward where you can not support your spine. This impact is hard on our joints and lower back.

Really one of the best ways to avoid injury is to keep an internal view of the posture. When we have an external view we are forcing our body into someone else’s idea of what the pose is. With an internal view we are going for a feeling in the posture (and the breath), a good feeling of release and stretch while still being able to breathe deeply. The postures should feel comfortable–even if you are stiff.

And as always, come back to the breathing! Breath is the tool we have to calm our minds and relax our bodies. It is our breath that heals; and if we focus more on the breath during our practice we will have a lower risk of injury, injury occurs when we are holding our breath.

The best way to remain injury free – Lifestyle, preventative maintenance or way of living

Pain which has not yet come is avoidable (Yoga Sutra 2:16)
This is what the sutras say when speaking of karmas and suffering; this pain that is still in its seed form can be rooted out of our mind and tissues before sprouts.

Your body, it talks to you, we have to learn to listen to it. At first our body will whisper to us that something is wrong, something is out of alignment or something is not functioning properly. If we learn to listen to our body when it is gently speaking to us we will save ourselves a lot of suffering. If we ignore the body it will eventually scream at us . . .

Alternative therapies are best when used as a preventative medicine, once pain or disease has taken hold of your body it is much harder to treat. This is why an Ayurvedic Dr. looks at your tongue, fingernails, eyes, skin, checks your pulse, etc. The body will show symptoms of disease before it takes hold. If you can catch the dis-ease at this point it is much easier to treat! Awareness of your body, your emotions, your energy levels, etc. will help you know when something is out of balance or alignment in your body, with this knowledge you can bring yourself back into balance before pain or disease sets in. This is where a daily practice is beneficial, when you are everyday on your mat “inside looking” you will notice when something is out of balance, and then you can take the steps necessary.

If you can do Ashtanga yoga, then you have one of the best tools for preventing disease and injury in your body. Ashtanga yoga covers all the bases! Which is why we do so many postures, we are working systematically through our body, from our musculoskeletal system to our organs, to the lymph system, to the endocrine system, to the nervous system . . .

The number one factor–especially in chronic pain is stress. Learning how to deal with dis-stress and keeping your life as stress free as possible will go a long way not only in reducing pain but being healthier as well.

Tips for reducing stress in your life

  • K.I.S.S. – Keep It Simple Sweetie – Arrange your life to live simply. This may take some time, simplify your life one little thing at a time. I learned a lot about this while traveling through Europe–especially in the communist countries. Not only is there a simpler way of living but a need for less. I was surprised to notice that many homes in Europe do not have furniture–yet they are very comfortable. People use big pillows on the floors with little tables around. And most people in Europe just put their mattresses on the floor–no bed frame. Most refrigerators in Europe are very small, like the type we would see in a camper or efficiency–when you buy fresh food daily to cook and eat you don’t need to store so much! In Prauge where it does not get too hot many people don’t even have a refrigerator, if they need to keep something cool they put it on their windowsill outside! And even other simple little ways I noticed like how they make coffee . . . just put some grounds in the bottom of your cup, pour hot water over and let it set for a few minutes, then drink it, just don’t drink the grounds . . .
  • Find a practice to release stress daily . . . ashtanga yoga is a good one but not for everyone, especially if you are worrying about how good you are at it, whether or not you can get a pose, etc, this will create more stress in your life! Then you need to find a practice to relieve your yoga stress . . .
  • Routine of healthy behaviors (especially important in fall and winter when vata is strong). For example I learned from my Ayurvedic dr. a morning routine that includes neti, nauli, etc. These practices help to ward off colds, allergies, sinus problems, etc.
  • Thought Patterns – In sutras it says to replace negative thoughts with positive thoughts. Or when you catch yourself thinking negative thoughts, sing a song 🙂 Our mind creates a lot of dis-stress over things that will never happen. Our mind starts working on something and spins a story, we then actually start to believe it! This is where a meditation practice is helpful, you learn to laugh at your thoughts! After some time you begin to catch yourself before you turn some thought in your head into drama! And you will catch yourself sooner and sooner with practice.
  • accept your obligations and do them cheerfully (your dharma)
  • and that is a big one–ACCEPTANCE. I love how AA teaches acceptance:
    And acceptance is the answer to all my problems today.
    When I am disturbed, it is because I find some person,
    place, thing, or situation — some fact of my life —
    unacceptable to me, and I can find no serenity
    until I accept that person, place, thing, or situation
    as being exactly the way it is supposed to be
    at this moment.
    Nothing, absolutely nothing happens in <This> world
    by mistake.
    Until I could accept life completely on life’s terms,
    I cannot be happy.
    I need to concentrate not so much
    on what needs to be changed in the world
    as on what needs to be changed in me and my attitudes.
    c. 1990 AAWS, Alcoholics Anonymous, pp. 417
    With permission, Alcoholics Anonymous World Services, Inc.

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