Yoga and Hip Pain – The case of “J”

J has been my client for quite some time.  He originally came to see me for left hip pain.  He had undergone a hip resurfacing on his right side, and eventually his left hip began to cause him issues as well.  He was quite active, including playing tennis, running, and biking.  While we originally focused on lengthening his hip flexors, adductors, external hip rotators, quadriceps, and hamstrings, it became apparent over time that he also needed postural integration overall.  His shoulder elevators were overactive, giving him a rounded posture with a forward head and internally rotated shoulders.  In fact,  it turned out that J had a left rotator cuff partial tear, which became the primary issue to be resolved for a time.  All this was complicated by J's intense international travel schedule and drive to be active. 

The rotator cuff issue was resolved through cranial sacral therapy, neuromuscular therapy, and trigger point therapy with me when he was in town and physical therapy when he was elsewhere.  After an absence of several weeks, J called me to resume his yoga therapy sessions.  The shoulder is now resolved and his hip pain is once again the primary concern.  We resumed an intense stretching practice, using proprioneuromuscular techniques (resistance stretching) within yoga poses like hero, the warrior series, pigeon, and lunge.  After our second session, J casually mentioned that his hip is actually more sore for a few days after our sessions.  In his mind, this was a necessary part of improving.  That may be the difference between being a yogi and an athlete.  An athlete may be inclined more toward a "no pain, no gain" mentality.  In yoga therapy we look to the body as our teacher and respect its messages.

I asked Barry Cooper, LMT, to consult on J's pain.  We came to the conclusion that J's entire life tends towards driven – or Yang – activities, causing his sympathetic nervous system to be constantly activated.  This was keeping his body in a constant stress response, resulting in tight, tense muscles all over his body.  Our current yoga therapy approach was only perpetuating the problem and preventing him from healing.  Barry and I agreed that the key to J's healing may be in activating his parasympathetic nervous system – the calming side of the nervous system.  This resonated with J, and I immediately changed my approach. 

In our next session I used a more Yin approach to yoga therapy.  This included supported poses to allow J to surrender to effortlessness (i.e., supported hero) and simple flowing postures (i.e. bridge series in Gary Kraftsow's Yoga for Wellness) to promote postural integration and breath.  The result was less soreness and increased activity tolerance (including tolerating a 4.1 mile slow run) and range of motion in both hips.  J also decided to incorporate massage with Barry Cooper to further activate the parasympathetic nervous system.  When I see J next week I will evaluate how this addition is affecting his healing and will report back.

The conclusion so far in my work with J is that balance is once again the key to everything.  This means muscularly balancing the front with the back, the left with the right, and the top with the bottom to progress the body toward being an integrated structure.  But it also means energetic balancing too – balancing will with surrender, effort with rest, and the sympathetic with  the parasympathetic to progress the being toward integrated wholeness.

Yoga and Scoliosis Pain – It Worked Again for M

Today I had the pleasure of seeing M.  She has an S curve with the dominant curve at the left lumbar.  She has compensatory curves in the right thoraco-lumbar, and left thoraco regions.  She stated that she carries a low back pain of 3/10 all the time and that this pain goes up dramatically with extended standing or stooping.  She had also "tweaked" her left shoulder so that it is painful with shoulder elevation. 

During her assessment I discovered that her feet turned out slightly while her knees turned in.  The result is the knees being centered more to the outside of her big toes rather than over her second toes.  Not surprisingly she has bilateral bunions from how her weight is distributed over her feet.  She also chronically locks her knees.  I first asked her to pay attention this week to how often she locks he knees and to unlock them each time.  The next thing I had her do was stand against the wall in mountain pose with the inner edges of her feet parallel, ground evenly through her feet, unlock her knees, spiral the upper thighs outward to center the knees over the center of her feet, make sure the balls of her big toes remained grounded, engage mulabandha, and externally rotate her shoulders to draw the shoulder blades into the back.  Oh yeah, I reminded her to breathe as well.  While holding this was challenging, this muscle balancing technique resulted in her pain going from 3/10 to 1/10.  I assigned her to do this pose each morning.

Regarding her left shoulder, I discovered that due to the convexity of her scoliosis at the level of her left shoulder, she was predisposed to internally rotating the left shoulder.  This is likely causing impingement during shoulder elevation.  Her left shoulder blade was no longer integrated onto the back body which interrupted her scapulo-humeral rhythm. I instructed her in ways to begin to integrate her blades onto her back both in her daily life and in her yoga practice.  This namely involved external rotation of the upper arm to draw the shoulder blades into the back.  I showed her how to do this in table, plank, and downward dog.  I also encouraged her to not plow through the pain in her activities to give the inflammation a chance to heal while we get muscles around the the shoulder blade more mobile again to do their job.  To increase the mobility of the shoulder girdle muscles I showed her a 5-step rolling routine to release teres minor, subscapularis, serratus anterior, and the pectorals.

I look forward to hearing about her progression when I see her on November 3 in the scoliosis class.
 

October 18 Gratitudes, Intentions and Affirmations: Back Pain is Gone!!!

Ok my back pain is completely gone.  I knew there was an energetic component to it, but even I was amazed at my rapid return to normalcy.  It occurred the very next day after completing my last work day for _______________.  The funny thing is, I enjoyed the patients, my coworkers, and my supervisor.  I was sad to leave.  There were tears.  And yet my back pain disappeared immediately upon leaving.  I have told people for years, "The body never lies."  My body was telling me something was wrong.  Yes I was working exorbitantly long hours, and that was getting me down.  But my new job is going to be the same.  Why is my back pain gone when I still have so much potential stress ahead of me.  Maybe the disappearance of it is signalling an inner knowing that despite starting a new job – AGAIN – everything is going to be alright.  Remember it also felt normal when I was spending the day packing up my house I have lived in for the last 13 years.  It also didn't bother me during intimacy with my boyfriend.  The longer I live and do healing work, the more sensitive I become apparently.  My body really is my teacher.  It is ok to be starting a new job, it is ok to be leaving my old life, it is ok to be with a new partner.  This is what my body seems to be telling me.   And the body never lies.

Today I am grateful for a sobering but needed meeting, the studio mortgage being paid, having good food to eat today, starting the day with walking and yoga with Barry, making up after our disagreement, getting all my paperwork and CEUs turned in to my new company, good yoga sessions tonight, Barry driving back tonight from Orlando.

Tonight I intend to sleep well, long, and peacefully.

Affirmations:
I can hold on by taking one step – or even one breath – at a time.
I have everything I need – food, shelter, love, higher consciousness.
I am always divinely guided and looked after.

Healing my Low Back Pain

I was clipping along pretty well there for a few months, getting chiropractic adjustments every two weeks, doing lots of yoga, enjoying a relatively pain-free existence.  Then I started my new job, which kicked my stress level up 200%, put my body in awkward positions, precluded me making it my chiropractic appointments, and limited my time for yoga practice.  Not surprisingly I worked myself into an episode of acute back pain that has lingered for several weeks. 

I started with chiropractics again with full faith this would resolve the issue.  It has not.  On Sunday as I was writing my pain course I realized I had not used my own methods!  I began to breathe from inside the pain in various positions.  I began to remind my back it is strong.  I began to practice back bends.  I began to stretch all the muscles around the back that have drawn up in protection.  I began to acknowledge all the energetic components of my pain – mourning my divorce, mourning leaving my marital home, leaving my pets, anticipating a move, moving forward in a new relationship to a new level of commitment.  My back began to heal that day and is continuing to do so.

I learned a lesson here.  Healer heal thyself!  Do everything for myself that I would do for another.  Be detached enough from my own stuff to see my own stuff.  Do my practices.

September 16 Gratitudes, Intentions, and Affirmations – Breathing into my own pain

I am busy writing my course of using breath and meditation for pain management as I myself am experiencing low back pain.  It only hurts when I am bending forward at the very lowest point of my back… and it is amazing how many times a day one has to do that!  And on top of that, I have the dropsies…and then I have to bend over and pick up what I've dropped!  Even using my legs I cannot avoid that bending forward to reach the floor.  Sigh…. This is very humbling.  But alas I am not writing to complain!  I am writing because I am amazed at the effect just writing out the pain management scripts is having on my being.  As I write the words I have so often shared with others I am filled with well-being myself!  I feel spacious, expansive, light – everywhere but my low back!  Now I am moving the feelings of well-being up and down my spine and imagining my whole spine is breathing, especially my low back….I feel peace there… so now I will try to stand and reach something from the floor….As I do it I feel pain, but instead of tensing and getting emotional I pause there and allow my spine to breathe….  I allow the pain to be there and just allow my spine in that spot to breathe.  Yes, the pain is still there but my lack of resistance to it makes it less so…. I will continue this practice today….

Today I am grateful for the Hicks Quotes that show up in my inbox daily and how right on they are, my approval as a CE provider, my imagination which I have learned to use for good and not evil toward myself, my gratitude partners, sleeping well and long, getting the massage menu completed cooperatively with Barry, getting more books sorted through, faith that my back will be up for the move, getting more writing done this morning.

Today I intend to work on my pain course throughout the day, taking breaks to do other things as my brain needs a rest, eat well and light, move my body, breathe into my low back.

Affirmations:
I imagine my new life into being.
I imagine all my responsibilities into completion.
I imagine my back full of light, well-being, strength, stability.
I receive the love flowing to me.
I love freely and easily all those in my life.

Yoga for Anxiety/Neck Pain

Anxiety and neck pain go hand in hand.  Anxiety results from lack of grounding.  And especially with a history of a neck injury, lack of grounding causes  tension to gather at the neck to cause neck pain. 

Today I had a client with both anxiety and neck pain.  In the assessment we discovered that he locks his knees constantly (an ungrounded way to stand), has a diminished sense of energy in his lower 4 chakras, and stands with his left leg turning out to the left.  His first assignment was to become aware of when he locks his knees and unlock them.  In terms of yoga, first I had him roll his feet on a tennis ball.  Then I had him practice mountain pose, spiraling his left thigh inward to stand with his feet parallel.  In mountain pose I instructed him to engage mulabandha, externally rotate the shoulders, and lift up on his breastbone while drawing the shoulder blades into the back.  He held this position for 10 breaths.  Next I had him practice warrior 1, warrior 2 (both done with hands on the hips), and lateral angle.  He reported at this juncture that his anxiety level had decreased from 6/10 to 2/10 and his neck pain from 5/10 to 3/10.  Next he did supta padagusthasana in a doorway, discovering his left hamstring, inner thigh,  and outer hip were tighter than his right.  After this series he reported that both his pain and anxiety were at 0/10.  The client had stated that he sleeps only 2-4 hours per night.  I gave him a tissue with Yland Ylang on it for savasana and lead him through whole body breathing.  The client was completely at ease when he left. 

Yoga for Anxiety/Neck Pain

Anxiety and neck pain go hand in hand.  Anxiety results from lack of grounding.  And especially with a history of a neck injury, lack of grounding causes  tension to gather at the neck to cause neck pain. 

Today I had a client with both anxiety and neck pain.  In the assessment we discovered that he locks his knees constantly (an ungrounded way to stand), has a diminished sense of energy in his lower 4 chakras, and stands with his left leg turning out to the left.  His first assignment was to become aware of when he locks his knees and unlock them.  In terms of yoga, first I had him roll his feet on a tennis ball.  Then I had him practice mountain pose, spiraling his left thigh inward to stand with his feet parallel.  In mountain pose I instructed him to engage mulabandha, externally rotate the shoulders, and lift up on his breastbone while drawing the shoulder blades into the back.  He held this position for 10 breaths.  Next I had him practice warrior 1, warrior 2 (both done with hands on the hips), and lateral angle.  He reported at this juncture that his anxiety level had decreased from 6/10 to 2/10 and his neck pain from 5/10 to 3/10.  Next he did supta padagusthasana in a doorway, discovering his left hamstring, inner thigh,  and outer hip were tighter than his right.  After this series he reported that both his pain and anxiety were at 0/10.  The client had stated that he sleeps only 2-4 hours per night.  I gave him a tissue with Yland Ylang on it for savasana and lead him through whole body breathing.  The client was completely at ease when he left. 

Yoga Therapy and Hip Pain – The Case of “D” and Why I Love My Work

D had been having right hip pain for about four months.  Not only was it affecting her gait, but she was unable to tolerate sleeping on the right side of her body and often awakened in pain.  She had been getting chiropractic treatments for quite some time without results.  In fact, she was often in more pain after her chiropractic treatments.  She was unable to walk great distances, and grocery shopping had become quite painful for her.  She works as a PT Assistant and the amount of mobility required of her in the day often resulted in a lot pain at the day's end.  D had lost her mother just before her hip pain began, and is still grieving the loss.  She is also trying to comfort her father, who is also grieving.  During the assessment D became emotional about the competing demands on her emotions and energy.

In her assessment we discovered that D was actually quite weak through her left hip and leg, tended to externally rotate her left leg, and had fallen arches bilaterally.  She was also experiencing diminished energy in her 1st chakra and had a habit of locking her knees.  I told D that her first assignment was to become aware of how often she was locking her knees throughout the day and to correct this habit, since this was associated with a diminished first chakra.  I also taught her mountain in which she stood with feet parallel and hip width apart, internally rotated her upper thighs and at the same time pressed outward through her hips to create arches, engaged the pelvic floor,and externally rotated her shoulders.  The goal here was to fully engage the legs in an aligned way to bring energy down.  She expressed amazement at how tiring this was, but noted that it "felt good" and that her pain was less.  Next I taught her Warrior 1 ( with feet hip width apart instead of in a straight line) and Warrior 2 allowing the front leg hip to rotate back to avoid misalignment of the SI joints.  Very little emphasis was placed on the arms with much energy going into engaging the legs.  At the end of the session D exclaimed that she had no hip pain and that she felt much better overall.

I saw D two days later.  She reported she was faithfully doing those three simple poses and as a result had no hip pain.  She was even able to sleep on her right side without it waking her up.  Yep, I love my work!

Doing God’s Work – The Case of “M” and Severe Knee Pain

Toward the end of my workday Monday I was feeling like I might have a handle on my real job now that I am in one location only instead of running between properties … then I got a text to adjust my Tuesday to see a patient on another property.  Once again, I felt out of control of my schedule and like I was being taken advantage of – my commitment of working 6.5 hours a day has turned into 8-10.  Angry thoughts were running through my head as I headed to work today at 6am.  When I arrived and was wheeling my cart of supplies to the front door, I was greeted by the "regulars" hanging out on the porch.  One was at the ready to open the door for me while the other asked if I could advise him about his knee.  When I asked how long his knee had been bothering me, he said, "It just started when I saw you."  As I realized he was flirting with me I smiled.  I felt my anger already waning.  I belonged here.

I was to see a patient, "M"  for self-care training (bathing and dressing), but when I got to her door, I heard her moaning loudly inside.  I went inside and found her sitting on the side of her bed complaining of terrible pain in her legs.  She has severe arthritis, especially concentrated in her knees.  I had her lie down and felt her legs.  They were burning hot.  I immediately began cranial sacral therapy to balance the meridians.  The words, "This is why I'm here – to do God's work", ran through my head.  I was no longer thinking about my anger.

I started with kidney points and progressed to liver, gallbladder, spleen, stomach, and bladder.  As her legs became cool to the touch, M said, "I felt the pain drain right out of me."  M was confused and kept expressing concern that she was keeping me from sleeping.  I was able to assure her that I had gotten plenty of sleep.  Finally she was able to rest.  There is nothing as humbling as taking away another's pain.  Nothing.

“I have had this pain for 50 years” – The Case of B

B was referred to me by another client I have written about here.  B had a disk herniation as a teenager and has scoliosis.  While the herniation eventually resolved, she ended up with gradually increasing back pain over the years that became chronic, unrelenting, and impactful on her quality of life.  When she came to see me she was quite fearful of moving and was complaining of back pain of 8/10.

The first thing we did was correct a misalignment of her thighs over her feet and fallen arches with a mindful mountain pose.  She squeezed a block between her knees while pressing her outer hips into a strap around her upper thighs.  We also "de-rotated" her rib cage by placing a strap just under her breasts and tractioning her ribs to the right.  Next I had her unlock her knees, engage the pelvic floor, lift up through the sternum, externally rotate her shoulders, and retract her chin (yes, this was a lot to take in!).  But her pain decreased from 8 to 4 right away.

Next she did the sphinx pose on the wall which brought her pain to 0/10.  We finished with lunges and leg stretches up the wall in all planes of motion.  Her assignment was to make sure she kept her knees unlocked at all times and to practice the poses. 

When I saw her yesterday she confessed that the only thing she really did was keep her knees unlocked and focus on her upper core by drawing the shoulder blades into the back.  Her pain had settled at about a 3/10 during the week until she did yard work.  Her current pain was 6/10.  We repeated what we did the first day but added "de-rotation" of the hips to the left.  Again, she left with 0/10 pain.

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