Taking an alternative route to lower back pain treatment

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In the past, I’ve been ret­i­cent to use a chi­ro­prac­tor to treat injuries or other prob­lems because I’ve heard sto­ries about how the pro­fes­sion was allied with ambulance-​​chasing lawyers ready to sue peo­ple involved in acci­dents and their insur­ance com­pa­nies, as well as the charges that chi­ro­prac­tic is not based the sci­en­tific method, espe­cially when com­pared to the con­ven­tional West­ern medicine.

Over the past few months, I’ve been forced to change my mind. I noticed that sev­eral friends vis­ited chi­ro­prac­tors reg­u­larly. I’ve also con­firmed that West­ern med­i­cine does not ade­quately address all health con­cerns. Finally, my iliop­soas spasms made me re-​​examine whether it was worth­while to call in dif­fer­ent opinions.

A new health­care provider

Dur­ing the 40-​​day yoga chal­lenge at Thrive Yoga, Susan and David Bowen brought in Dr. Don­ald McGriff to give a talk to the group about chi­ro­prac­tic and gen­eral well-​​being. I missed the talk because I wanted to take a yoga class at the same time. But Susan and David said that they used his ser­vices so that was high praise.

On April 15, I got an appoint­ment at McGriff Chirprac­tic to see if Dr. McGriff could do any­thing for my iliop­soas spasms. He looks more like a pro­fes­sional wrestler than a doc­tor, a burly build topped off with a shaved head. After an ini­tial exam­i­na­tion and a check of my med­ical his­tory, he sent me off to get an MRI of my lower back. That took a lit­tle longer than expected because of sched­ul­ing con­flicts, but I was back in his office on April 27 with the CD in hand. After tak­ing a look at the MRI, Dr. McGriff came back with the news that I might have a spinal disk her­ni­a­tion (4-​​5 L ver­te­brae), but the MRI was not really that clear. I also seemed to have a dis­placed sacroil­iac (SI) joint on the right side. Since I did not take notes, I can’t be sure three weeks later whether I’ve mis­un­der­stood any­thing. In any case, he pre­scribed 2-​​3 vis­its a week to his office to work his magic.

The nice thing about Dr. McGriff’s prac­tice is that he opens at 6:00 am on three morn­ings a week so I sched­ule my vis­its so that I hop out of bed, get into fit­ness cloth­ing and drive over for a 6:30 appoint­ment, usu­ally on Mon­day and Fri­day. I am out of his office in time to go back home, shower, dress, grab break­fast, and head to the Metro by my usual time. There are also office hours on Saturday.The loca­tion of his office, which is only 10 min­utes from my home in Rockville, sealed the deal.

Treat­ment starts with 15 min­utes of electro-​​stimulation with hot pads on my lower back. There are four elec­trodes sprayed with some kind of liq­uid to increase con­duc­tiv­ity (The spray must come right out of the refrig­er­a­tor because it is cold). Hot pads are placed over the lower back (to com­pen­sate for the cold elec­trodes, I guess). The elec­tri­cal cur­rent goes through vary­ing pat­terns of puls­ing, but can be adjusted to the point where it does not cause dis­com­fort or pain.

After chill­ing for 15 min­utes, Dr. McGriff leads me to his exam­i­na­tion room where he checks my align­ment and then usu­ally has me lie down on my left side and gives me a firm twist of my torso to the right. My SI joint usu­ally pops with the adjust­ment. That’s usu­ally fol­lowed by adjust­ments to my hips, rib cage and upper spine, and upper neck.  He has a firm touch in his adjust­ments that gives con­fi­dence in his skills.

Once he’s done with me, I may get an addi­tional ride on fancy equip­ment: a table that stretches my spine, a vibrat­ing plat­form that loosens my hamstrings.

Dr. McGriff applies more than an exclu­sively chi­ro­prac­tic focus, empha­siz­ing the value of   holis­tic approach that includes nutri­tion, cor­rec­tive exer­cises, phys­i­cal ther­apy, fit­ness and life style coach­ing. His web site has lots of infor­ma­tion to under­stand his approach, the gen­eral prac­tice of chi­ro­prac­tic, and other services.

Pass­ing the grade

Has the treat­ment improved my injury? That’s hard to say. My iliop­soas have not been a source of pain or dis­com­fort recently. With a more than a month of rest and avoid­ance of aggra­va­tion (no yoga classes), my hips and lower back may have healed itself. I sim­ply have not been test­ing their lim­its. On the other hand, I do feel the effects of the treat­ment: after a ses­sion, I feel gen­eral mus­cu­lar fatigue by the end of the day, which is usu­ally a sign that my mus­cles are adjust­ing to a realign­ment of my frame. I have noticed that my thighs seem to set fur­ther apart. I can sit in easy pose more com­fort­ably and my knees fall  closer to the ground naturally.

My daugh­ter warned me that I should avoid active yoga classes or gym work on that days that I have chi­ro­prac­tic treat­ment. Dr. McGriff told Howard Rontal, my body­worker, that it’s best if the body­work hap­pen the day before a chi­ro­prac­tic ses­sion to be the best results out of his ses­sions. Finally, Howard told me that I should not have acupunc­ture and body­work done on the same day (within 24 hours of each) since the Ori­en­tal merid­i­ans run through the myo-​​fascial tis­sues. So there are now a whole new slew of sched­ul­ing fac­tors that I have to take into account when plan­ning my healthcare.

With less than a month of treat­ment, it’s far to soon to say that my chi­ro­prac­tic has worked mir­a­cles or oth­er­wise. In the real world, it’s almost impos­si­ble to iso­late the fac­tors  (chi­ro­prac­tic, acupunc­ture, rest, restora­tive yoga, relax­ation exer­cises, body work, pos­i­tive thing, placebo effect) so I have to go with just my gut feel­ing. It has not hurt me.

Thinking about bodywork in self-​​awareness and healing

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This week, I am going to have my first ses­sion with Howard Rontal, my body worker, in more than a month.

Graphic: drawing of skeleton and muscles of the hips

Illi­a­cus and psoas muscles

I stopped mas­sage ther­apy when it became clear to me that I needed to take a step back in deal­ing with my iliop­soas melt­down because the “injury” was not going away and, in deed, seemed to be wors­en­ing. I needed to take a dif­fer­ent per­spec­tive, and also back off my own efforts to get a han­dle on my body. I also stopped going to yoga classes because I felt that my approach to yoga (tak­ing it deeper, find­ing my edge) might be com­pli­cat­ing the con­di­tion even though I was try­ing to be mind­ful when doing my vinyasa prac­tice. My neuro-​​myofascial sys­tem oper­ates at a sub­con­scious level: I don’t explic­itly decide to use spe­cific sets of mus­cles to twist or turn; it’s han­dled by another part of the neural system.

In any case, I felt that I needed to reduce my treat­ments in order to see if and how I was improv­ing and what was hav­ing an impact. I only had so much time and money to throw at the problem.

How body­work changed me

The break from Howard‘s hands allowed me to reflect on how six months of treat­ment (since Sep­tem­ber last year) has affected me.

Work­ing with a mas­sage ther­a­pist requires a sus­pen­sion of per­sonal bound­aries: each ses­sion, I strip down to my box­ers, lay down on the sheet-​​covered table, and allow Howard to rub and probe with his hands, fore­arms, elbows and assorted instru­ments over the sur­face of my body and dig in deep to reach other lay­ers of fas­cia and mus­cle. I sub­mit myself to his expe­ri­ence, skills and apti­tude to some­how trans­form my flesh into some­thing that’s more sus­tain­able, healthy, func­tional. My orig­i­nally inten­tion — that this treat­ment will relieve me of the bizarre com­bi­na­tion of numb­ness and pain (periph­eral neuropathy) — may not be com­pletely attain­able, but it will alle­vi­ate the stiff­ness and lack of range in my neuro-​​myofascial matrix. I know that the expe­ri­ence was trans­form­ing my yoga prac­tice: every time I get on the mat, there are sparks of dis­cov­ery, as I am able to access mus­cles more deeply, over­come resis­tance caused by the years of stress that I’ve stored in my sinews.

Because Howard comes from the Heller­work tra­di­tion, there is a strong psy­cho­log­i­cal com­po­nent in his tech­nique so we can talk about a lot of emo­tional issues that are being expressed in my mus­cles and tis­sues. So as I am tak­ing off my clothes, I am telling him about the aches, pains and numb­ness of my body, the stres­sors of my job and my inten­tions for the ses­sion. I am expos­ing myself to him, but also becom­ing more self-​​aware of my own mind-​​body connection.

As the focus of the treat­ment moved away from the neu­ropa­thy issue to the mus­cle spasms, Howard and I engaged in a kind of detec­tive work to find out which were the protest­ing mus­cles, and which mus­cles were merely squeal­ing in sym­pa­thy. We nar­rowed it down to the illi­a­cus and psoas on the left side, and maybe the lig­a­ments con­nect­ing my hips to my sacrum or the SI joint. But these mus­cles may have been over-​​compensating for the right side being over rigid. But these tis­sues are so deep in the body that it’s really hard to access them, but it was amaz­ing to expe­ri­ence how Howard could influ­ence that inner core.

What I learned about body care

There are things that I can do for my body that Howard can’t: in a yoga vinyasa I can employ the whole span of my body and bal­ance it in grav­ity. Howard has to be more focused on sin­gle mus­cles, fas­cia, torso or limbs. In cres­cent lunge, I can engage the full anatom­i­cal chain from my fin­gers down to my toes as I swing through full extension. I can also treat myself to self-​​message, either by using a roller or Yoga Tune-​​Up balls (or other balls of var­ied form and den­sity), with the advan­tage that I can focus on tight areas, deepen or soften the touch at the point of con­tact, or explore at will. Each evening, as a min­i­mum, I roll my rhom­boid mus­cles and it is one of the most deli­cious sen­sa­tion — ten­sion spills out of the tis­sues. I had not real­ized that stress had been build­ing up there, a kind of secret repos­i­tory. I’ve also start mas­sag­ing my feet, espe­cially my arches, dur­ing the day to pre­vent ten­sion from build­ing up in my legs. In other words, I’ve been learn­ing to self-​​heal and self-​​soothe.

I now real­ize that I have to take charge of my own process of heal­ing and well-​​being, but also recruit the inter­ven­tion of other spe­cial­ists to help me take the best path for­ward, which means that I will have to explain what I have learned from under­go­ing treat­ment with a chi­ro­prac­tor and an acupuncturist.

Catching up on the DC yoga scene

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I’ve been so absorbed in my day-​​time-​​turned-​​evening job over the past few weeks that I did not have a chance to point to an arti­cle that appeared May 8:

The strug­gles of D.C. area yoga stu­dios – The Wash­ing­ton Post
Yogis don’t like to talk about com­pe­ti­tion, and most own­ers will deny there’s any ten­sion among local stu­dios. But Schu­macher acknowl­edges that the busi­nesses are vying for stu­dents’ attention.

A few weeks ago, I noted the clos­ing of Ash­tanga Yoga Cen­ter at the end of this month. Yoga has to be com­mer­cially viable in order to have an impact on main­stream cul­ture in the United States. The mar­ket is the medium for sus­tain­abil­ity. The Post scratches the sur­face about the costs of oper­at­ing a yoga stu­dio, and “ameni­ties” like cook­ies are the least of own­ers’ con­cerns. To sur­vive, own­ers need to have a cre­ative, flex­i­ble busi­ness mind with­out los­ing touch with the spirit of yoga. That’s a dif­fi­cult bal­anc­ing act. That can include finindg new ways of offer­ing yoga, like com­bin­ing spin­ning and yoga, although tech­ni­cally it’s a fit­ness cen­ter offer­ing the class. 

Closer to home, my home stu­dio, Thrive Yoga, offers classes for climbers at Earth Treks. But the new twist at Thrive has been the incor­po­ra­tion of Aer­ial Yoga with Silk Ham­mocks - prac­ti­tion­ers are sus­pended from cords hang­ing from the ceil­ing and play a dif­fer­ent kind of lever­age game with grav­ity. The classes seem to be booked up well in advance. I have not had a chance to try it because I’ve been away from the stu­dio for the last two months.   

Oh yeah, May 13-​​20 is DC Yoga Week, as the Post announces, but you can actu­ally read the full details on the DC Yoga Com­mu­nity site, and the tra­di­tional high­light of the cel­e­bra­tion, Yoga on the Mall, will take place on Sat­ur­day, May 19, weather permitting.

No yoga class in a month — bummer

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I have not taken a class since April 7. That day, I was in Susan Bowen’s 2/​3 hot vinyasa class. She led an upbeat ses­sion that had us mov­ing through sun salu­ta­tions and mod­i­fi­ca­tions. I noticed some­thing was wrong: I began feel­ing pain and dis­com­fort in prac­ti­cally every pose and tran­si­tion of the vinyasa, deep in my core and focused on my left psoas and radi­at­ing down by leg, up towards my hip and kid­neys and across my hips. In the ear­lier stages of the injury, it was hap­pened only in cer­tain poses, and I would avoid them or get into them very mind­fully. Now there was no avoid­ing the pain and mus­cle spasms.

In the mid­dle of the class, I shut myself down. I did poses to soothe my core mus­cles, hip abductors/​flexors and lower spin, lay­ing or seated on the mat. I rested on my back with my knees propped on blan­kets. All the while my friends were sweat­ing away in an active class.

For two month, since the first instance of the injury, I had rested the injury, mak­ing reg­u­lar vis­its to my body worker, Howard Rontal, and then started tak­ing yoga class after two weeks being very mind­ful in my poses and flows. Dur­ing my daily rou­tine, I was not con­scious of any dif­fi­cul­ties. At the gym, I did not feel any prob­lem doing aer­o­bic exercises.

Obvi­ously, that approach did not work, because the injury (?) has flared up in a more gen­er­al­ized pat­tern. I decided to stop yoga classes again, see a chi­ro­prac­tor and check in with my acupunc­tur­ist, Kelly Welch, who had helped me in the past. More in future entries.

Another DC yoga studio bites the dust

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My friend and ded­i­cated Ash­tangi Don­a­van Wil­son sent me a mes­sage today:

David Ingalls is shut­ting down AYC (Ash­tanga Yoga Cen­ter, for those not in the know). The doors close on May 31. The stu­dio space near Amer­i­can Uni­ver­sity is too expen­sive. Keith Moore (long-​​time AYC teacher) found another loca­tion. The new loca­tion is unof­fi­cially in the MacArthur Boule­vard area (DC). The ten­ta­tive new name is the Ash­tanga Yoga Stu­dio. Moore has not signed a lease. How­ever, the odds pretty good to solid­ify this new loca­tion. All of this (new space and loca­tion) is up in the air. AYC clos­ing is not.

What a bum­mer! And to think, I have not had a chance to take a class there — though I do have until the end of May. What did in AYC was what made it a con­ve­nient place to prac­tice yoga — it was right next to the Amer­i­can University/​Tenlyetown Metro sta­tion, right across from Whole­Food. You could fit in a Mysore class before pick­ing up a bagel and head­ing to work. But eco­nom­i­cally, the rent got too high at that prime loca­tion. Let’s hope that all the instruc­tors and stu­dents find an appro­pri­ate space for their practice.

I should also under­score that the AYC web­site dis­tin­guished itself for exquis­ite pho­tog­ra­phy of yogis and yogi­nis absorbed in their prac­tice. As some­one who has dab­bled in that dark art, I know how dif­fi­cult it is to cap­ture the instance, but when you do, it’s magic.

Post­script: I should also note that DC is not the only place where yoga stu­dios can become unvi­able com­mer­cially: In New York City, Om Yoga will shut down at the end of June because the lease was not renewed. Om Yoga was founded and run by Cyndi Lee, a high-​​profile yoga instruc­tor and pio­neer in fus­ing yoga with Bud­dhism. The owner of the build­ing did not want a ygoa stu­dio on the premises.

Confirmation of meditation’s impact on the brain

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I’ve been keep­ing my head down lately, but I just noticed the fol­low­ing news item that rein­forces the find­ings of more sci­en­tific research into the impact of med­i­ta­tion on the brain:

The unique brain anatomy of med­i­ta­tion prac­ti­tion­ers: alter­ations in cor­ti­cal gyri­fi­ca­tion appeared in mid-​​March and Sci­ence Daily also did an arti­cle, Evi­dence Builds That Med­i­ta­tion Strength­ens the Brain The work was done at  UCLA Lab­o­ra­tory of Neuro Imag­ing by Eileen Lud­ers and col­leagues. The LONI’s lat­est news announce­ments shows the range of their investigations.

I should also point you to The Mind­ful­ness Research Guide which fol­lows the prac­ti­cal appli­ca­tion of med­i­ta­tion to many human are­nas. There is a monthly newslet­ter that has nearly 5,000 subscribers. 

Long feature about an old story

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Where have I been for the past two weeks? I did not even notice that my home­town paper pub­lished a long arti­cle detail­ing the upheaval in the Anusara and broader yoga scene because of John Friend’s misadventures: 

Scan­dal con­torts future of John Friend, Anusara yoga: “Friend’s empire — an inter­na­tional net­work that claims more than 1,500 teach­ers, includ­ing 25 in the Wash­ing­ton metro area, and 600,000 stu­dents — is in cri­sis now, tee­ter­ing under the strain of a sex scan­dal that has split its most loyal prac­ti­tion­ers and prompted an astound­ing vent­ing of emo­tions, from rage and recrim­i­na­tions to com­pas­sion and sadness.”

The Wash­ing­ton Post piece was so long that I could not fin­ish — I’m at work right now so I’ll have to come back to it later.

Good news on the political front

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Mind­ful­ness turns into a pol­icy option in Wash­ing­ton, thanks to Rep. Tim Ryan (D) from Ohio (and oth­ers), and there’s now a book to spread the word.

The Wash­ing­ton Post In med­i­ta­tive mind­ful­ness, Rep. Tim Ryan sees a cure for many Amer­i­can ills:

For Ryan, the raisin was the begin­ning of a trans­for­ma­tion. The retreat, con­ducted by Jon Kabat-​​Zinn, founder of the Stress Reduc­tion Clinic at the Uni­ver­sity of Mass­a­chu­setts Med­ical School, led Ryan on a search into how the prac­tice of mind­ful­ness — sit­ting in silence, los­ing one­self in the present moment — could be a tonic for what ails the body politic.

The book is A Mind­ful Nation: How a Sim­ple Prac­tice Can Help Us Reduce Stress, Improve Per­for­mance, and Recap­ture the Amer­i­can Spirit. Catchy title. Also see the Hays House descrip­tion.

 

Yoga hits Washington baseball team

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The Nation­als are my home town team so I guess I have to link to a story that appeared in the Wash­ing­ton Times:

It’s not a stretch to say yoga gain­ing pop­u­lar­ity with Nation­als “Stephen Stras­burg, Drew Storen and Bryce Harper also are among yoga devo­tees, with Harper and Storen big believ­ers in Espinosa’s pre­ferred Bikram yoga — a class that’s held in a room kept at 115 degrees.

Ryan Zim­mer­man, Jayson Werth and Steve Lom­bar­dozzi also par­tic­i­pated in a once-​​weekly class at Nation­als Park this off­sea­son with strength and con­di­tion­ing coach John Philbin and a pri­vate instructor.”

Every sea­son we get a fresh crop of sport news about a pro­fes­sional (uni­ver­sity or high school) ball player tak­ing up yoga to improve his/​her per­for­mance. It doesn’t mat­ter what sport. I turned the TV on the other evening and the Ten­nis Chan­nel was show­ing a fea­ture on a ten­nis camp that included “mind­ful” in prac­ti­cally every instruc­tion to the trainees. The sci­ence is pilling up so high now that an ath­lete may actu­ally feel that not includ­ing yoga and related dis­ci­plines in the train­ing regime puts him/​her at a disadvantage. 

Learning something from my daughter

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Photo: Stephanie Smith

My daugh­ter, the yoga teacher

I had a spe­cial plea­sure today in my hatha yoga class at Thrive Yoga: the class was led by  my daugh­ter, Stephanie. We’ve been going to classes together since 2004, and she went through teacher train­ing in 2006-​​2007 at Flow Yoga and then took addi­tional train­ing at Thrive this past year. She’s been teach­ing com­mu­nity and kids classes and sub­bing at Thrive. She’s been bug­ging me for months (or a year) to take one of her classes, but her teach­ing oppor­tu­ni­ties and my sched­ule always seemed out of sync. Finally, she filled in on a Sun­day morning.

I think that the biggest com­pli­ment I could give her was that after the first five min­utes, I for­got that she was my daugh­ter, and just cursed under my breath that she was kick­ing my butt in high lunge and War­rior II. It was still a hatha classes, strong on fun­da­men­tals and focused on breath­ing and body aware­ness, but it kept up a good flow so that I felt touched in my whole body at the end. It cer­tainly was a test for my ego, allow­ing myself to be guided by my daugh­ter through a yoga rou­tine and hold­ing back from tak­ing a pic­ture of her in the class.

Stephanie’s been teach­ing a lot over the past week or so because there have been a lot of class open­ings. Susan and Dave Bowen, the Thrive Yoga own­ers, led a group on a retreat in Hawaii (and tak­ing some leisure time while they’re out there). Hope­fully, there will be many other oppor­tu­ni­ties for Est­eff (as she prefers to be called — it’s a long story).