Saturday, November 15, 2014

Yoga and Myofascial Pain

I should start this post by saying that, in the last month, I've learned enough about "yoga for myofascial pain" to write a book. This is somewhat concerning, if you think about it, as both have been a huge part of my life for 25 years.

I'll also add in the obligatory disclaimer about how the degree of complexity involved in understanding and managing chronic pain is matched only by the degree of complexity when it comes to understanding yoga and how it works to heal and strengthen the body/mind.

This post ain't out to change the world, peeps, but to share some of the more mind blowing things that have influenced me lately. And when I say "influenced" I really mean "deeply experienced" because I've been locked in some cult-like therapy session with my pain lo these past 6 weeks.

On the plus side, we're finally talking.

I don't even know where to begin. In the same way my pain is a huge loop that, when it flares, sucks everything into its grip, my increasing awareness of it is circular, like the ripple produced by a stone skipped into water.

How about starting with the elephant in the room: How does a woman (whose fitness, health and spiritual life paths centre around a practice based on listening to the body) develop debilitating pain - likely produced by years of not listening to her body? I cannot tell you how many classes I've taught over the years wherein I've cautioned my students to listen. I cannot tell you how many more classes I've been to (and personal practices I've done), wherein that's the mantra.

How the fuck did this happen?

Well, the origins of pain are not always clear (and this is the complicated subject of another post) - and one can never discount the nature of the practitioner when it comes to adaptation. I have always been the kind of person who throws herself into things passionately - actually, one might say violently. My mind and body don't really understand moderation. This is no secret - especially on this blog. It's what makes me fun to be around. It gives me scope. It exercises a very fast-moving neuro-chemistry. It makes me incredibly productive. It feeds my ego. I love jumping out of a metaphoric airplane as often as possible (which is strange because, in real life, I'm exceedingly cautious with my actions). Sometimes, all that I can see is the outcome. I'm not naturally adept at interpreting the impact.

I started yoga at a very young age - at a very hard time in my life. My parents were moving to another country. I was in Canada alone. I had just left the fold of my high-school, a small, extremely meaningful place where I'd learned how to relate to everything and to truly be myself. Adulthood had begun, but I wasn't ready. I was, in my mind, cast adrift without family, a crushing emotional experience that I recognized all too keenly: I had lived through it once already, in early childhood. I knew, intuitively (certainly not consciously) that I needed yoga to ground me. I can only say I was very fortunate to have found the Iyengar method right off the bat. It worked for my personality (and against it). It was a "safe" practice focused on structural alignment. It came with a community (albeit one I would eventually eschew).

In retrospect, I remember my teacher constantly smacking me (in the yoga way, to bring awareness to a dull part of the body), telling me not to grip. When I wanted to jump, she made me stand still. When I wanted to go further into a pose, she'd stop me half-way. I had the physical confidence of youth and I felt compelled to move, to achieve. For me, deepening my practice was related to improving my physical ability and form. I could do some fancy poses. Mind you, so can lots of people. Even today, in this ridiculous state, I could warm up my body, move past the pain with some heat and breath work, and do a very active practice in such a way that you wouldn't know - more to the point, neither would I - that I'd distracted myself from dealing with injury produced by chronic pain.

The truth is that you can always work any instruction to suit your unconscious desires.

I realize now, as I meditate, in three different styles - to achieve 3 different states - for about an hour each day (30 min morning, 30 min evening), that my yoga has never been as sincere as it is right now. I do everything with the intention of listening to my body, of incorporating its need for release and extremely precise (almost non-) movement. I learned/practiced these techniques (a pranayama method for quieting the nervous system, a biofeedback method and a method of meditative dialogue) in my late teens. Of course, back then, I thought meditative response was something reserved for the very advanced - or else it was a scam. I was doing it, but I wasn't feeling it.

In one of those fortuitous life-ironies, I turned my attention to yin yoga (to the notion of connective tissue release) at just the time I finally began to understand that my pain is based on its utter restriction. It's possible that my return to active yoga practice in the summer led me, 6 weeks ago, to this particular pain "crisis" - a variation on my semi-regular pain bouts (about which I've written all too often here). This one isn't willing to go, though. It's digging in its heels. And honestly, while I hate the pain, I am so incredibly grateful for its message. As my mother likes to say: You pay now, or you pay later. Really people, I am ready to settle up this bill.

At this point, my methods for working with pain are numerous (again, the zillions of inter-related processes would require a full post of their own). But in terms of yoga, when I wake up in the morning (feeling like I've been hit by a truck, if you must know, and afraid of how my body will last the day in an incredibly stressful job), I meditate. Then I do about 15 minutes of yoga postures that don't look a damn thing like yoga. I prop my body with, say, my dining room table and other furniture. My goal is to stress connective tissue in my left hip, low back and upper thoracic. Gradually, the ridiculous morning stiffness (I've recently developed) abates.

Cut to the evening. I begin by using props very carefully and lying in poses to undo the physical damage of the day. (Note: Yeah, I do realize I've got to find a way not to take it all into my body. But one fucking thing at a time! This is the topic, not of a post, but of a long conversation over dinner and a bottle of wine.) Depending on what's up - and lately it's been pretty fucking hard core - I do very simple, non-weight-bearing poses which I hold for very long periods. These aren't simply yin asanas, though I bring that awareness into the poses via intention. I also do many of the Iyengar supported poses I loathe. Ah, my latent pain (in the early days) knew even then how to avoid things.

Eventually, for the sake of endorphin-release, I may opt to bring some flow (heat) into the work - but not your average vinyasa. My trapezius and related muscles are SO hair-trigger, that one weight-bearing movement can throw everything into a literally nerve-wracking spasm. I use my head stander (have I mentioned how I love this thing) to allow me to get neck and shoulder traction, while also calming my nervous system and regulating my (ever so taxed) endocrine system. Man, I spend a long time hanging upside down.

I can do this because I have the knowledge and the years of technical experience. I own the (expensive) props. I have a yoga studio. I have access to information. I can only imagine how someone without these resources struggles to function. I'm calling on years of mudra - those poses I've done all my life have been saving my ass for decades. The roots of this pain have been in my body for as long as I can remember.

If you are in terrible chronic pain and you haven't done yoga before - please, find yourself a good teacher. When you most need support, don't try to learn something complex on your own. Of course, practice as often as you can in your home, but invest in private classes or a good Iyengar therapeutics class. The teacher, whatever her method, must be knowledgeable, sensitive, able to communicate - and she must be able to see the pain in your body in order to help you to fix it. You wouldn't go to a mediocre chiropractor or physical therapist. Don't take yoga risks when you're managing pain.

When I look at people with my "yoga eyes", I often see their physical (and mental) pain. The very pain I haven't been able to access in myself is writ large in others and it's much less complicated than my own because I see it objectively. I understand how it can leave. When I teach a person in pain, I tell her to listen to her body, to make her actions minute, to hear the feedback of those actions and to face the untenable.

Now onward.


  1. Hi, K. I'm across the lake from you, in western NY. For now, I just want to send encouragement in your quest for relief. Your blog is unique, interesting and informative. For me at least, your pain posts are especially enlightening;I don't feel you have discussed it "too much".

    1. I so appreciate this comment, Sanmarie. And I hope y'all are recovering from that hideous snow storm.

  2. I am a real yin yoga lover. May your practice bring forward the healing that you need and want. Woohoo!

  3. Ironically, I have time to read a lot of blogs because I am recovering from surgery 10 days ago. I really wish I had more time every day because you really write some interesting stuff. I have been so anxious to get back into my yoga (I just use a few DVDs - such a novice compared to you) because it helps me sleep, which is my big challenge. When I was waking up from anesthesia and felt like I couldn't breathe, I used my yoga breathing (fill the belly, then the ribs, then the chest) and it sustained me. They told me not to do any yoga for 6 weeks after surgery, so ... well, a few days ago, I just did some really easy-going mountain pose and super conservitive side bends and such, and guess what I had MAJOR bruising within a few hours afterwards. That was when I realized, ok, all this stuff is way more powerful and complicated than I realized and I am just going to follow doctors orders and go out for a short walk today and suck it up. Your post validated my experience. THANK YOU and I SINCERELY HOPE YOU FEEL BETTER. You are a great writer who just keeps getting better and better. Hang tough sweety.

  4. Robin: I hope you're feeling better day by day! The meditation will no doubt help with post-op pain and healing. Envision those affected areas being nourished with breath. When things tense up, let the breath work remind you to release. Definitely walk if that's doable and indicated and know that you'll be able to return to your active asana over time. You might just have started a bit too soon. :-) Thanks so much for your comment. xo