Category Archives: injury

Bad things can happen on a yoga mat.

Taking an alternative route to lower back pain treatment

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

Photo: Donald McGriff in his chiropractic office
Cheerful and caring, even at 6:30 in the morning

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

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

Photo: Howard Rontal in his office
Strong hands and a sharp mind

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.

No yoga class in a month — bummer

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.

What I learned from my hip abductor meltdown

It’s been a while, hasn’t it.

Over the past few weeks, I’ve had a chance to extract some lessons from the pain and discomfort from the meltdown on the mat. I am even hesitant to call it an injury because there was no visible damage or impairment, except that in a few poses it would flare up again:

  1. After my injury, I actually had an increased sense of feeling in my left foot (numbness caused by peripheral neuropathy has a problem for me). Of course, with time, the symptom came back because my muscles and tissues tightened up again; in fact, the symptoms have evened out between my two feet.
  2. I also had more feeling in my lower core, which may just be a consequence of focusing more on that part of my body because of the injury.  I am also aware that I pay more attention to the pitch (tilt) of my pelvis.
  3. A few years ago, I would have freaked out that I had hurt myself doing yoga; I would have taken it as a sign that I was not properly aligned, a “bad” practitioner, and had broken the rules. But injuries sometimes are caused not by what we are doing, but what we did in the past, the accumulation of ingrained neuro-myofascial patterns acquired over a lifetime, and when we may break through some of those patterns, it may leave us “flapping in the wind” because the old rigidity was also a support structure; my muscle and tissues did not know what to do with the new freedom so they went into spasms. I now see that as I loosen up my hips, it’s going to affect other parts of my body so I have to remain alert, aware and sensitive to what my body is telling me. And even then I may not avoid injury.
  4. With an injury to something like the hip abductors, it’s really hard to reach down through several layers of muscle and tissue. I am lucky to have a veteran massage therapist (Howard Rontal) to do that for me.
  5. It’s really touch and go to get back into a vinyasa practice because I did not want to start too soon, but probably waited too long, even though the injury was still sensitive,  and I’m not the kind of guy who believes in practicing through the pain. How’s that for stringing together four contradictions in one sentence. But once I started returning to class, I became less preoccupied and more aware.
  6. When I had this interruption to the intensity of my yoga practice, plus other distraction, I notice that the drop-off in physical exercise had a ripple effect through my body and mind.
  7. Restarting is always disagreeable because I am constantly reminded about how far I have backslid (“Oh, God, I’m going to have sore muscles tomorrow, and I can’t do the jump-backs as well as before, and — this is an order, punk, drop into child’s pose, and give me 20 breaths!” ).
  8. Don’t stop doing yoga even when injured (give it a couple days rest, of course); just modify poses and pick sequences that won’t stress out the problem area.

Well, you get the point. I’ve made it to about five classes in eight days so I am gradually get back to “normal.”

Hip abductor meltdown

With all the web chattering about how yoga can hurt your body (or not), it was only appropriate that I get to experience it first hand.

Graphic: hip abductorsOn Monday, in Jessica Apo’s vinyasa flow class at Thrive Yoga, I was in Extended Side Angle Pose (Utthita Parsvakonasana) with the full bind (under my top hand reaching behind my back and graspoing my bottom hand under my leg). It was the first time I had been able to do the bind since coming back from my knee injury (2009). I could clasp my hands without straining and fumbling to connect my hands (or using a strap); usually I just stick with half bind. In my massage therapy session with Howard Rontal a few days before, we had been working on loosening my shoulders and arms so that probably contributed to the change.

Doing the pose on the right side, I discovered the freedom in my shoulders, and even transitioned towards Bird of Paradise (Svarga Dvijasana), but did not come up to the one-leg balance because I didn’t want to risk an unsteady pose. On the left side, I decided to keep it simple and really sink into the pose, exploring how my body felt with this new range of movement. But the success with the bind that night probably took me into uncharted territory for the rest of my body, especially my core and lower back. When I released the bind to exit the pose, I felt a muscle spasm in my lower core — lower back (left side), groin, left hamstring. It was as if I had been hit by a stun gun. I rested in child’s pose. I did not feel any lasting pain so I continued with the class, modifying or skipping any pose that might overexerted my back.

I didn’t feel the injury at all during the next day or while doing my simple desk yoga. However, I tested my lower back in malasana, going deep into my hips, feet flat on the floor, and releasing my lower back. The injury flares up with a vengeance. I had to fall over on my side to get out of the pose because I could not lift up without severe pain.

That experience made me cancel any yoga classes for the rest of the week and call Howard. He managed to fit me in on Saturday for an emergency session. We spent the session working on the hip flexors and lower core. I am really fortunate that I have a therapist who already knows my  body and where my knots are tied. We had an interesting exchange in which he would apply some strokes and then I would test out how my body felt, giving him feedback, and then we’d go back on the table for additional work.

I actually felt more muscular aches and fatigue after the session. Oddly enough, I felt the pain on both sides evenly, as opposed to just the left.

Today I feel fine, a little stiff, but I will hold off on a class until tomorrow.

Yoga injuries, bodywork and a media controversy

I have refrained from commenting on the most controversial topic of yoga in America this year, but it’s time to break my silence.

I am referring to the William Broad’s article How Yoga Can Wreck Your Body in the January 8 issue of New York Times Magazine. it’s a chapter from his book, The Science of Yoga: The Risks and the Rewards (Simon and Schuster) which came out a few weeks later. It resulted in a massive wave of discussion, reaction, even hysteria about the possibility that you could hurt yourself doing yoga. For a representative sampling of the web writing on the topic, see Yoga Dork’s Guide. Really, she’s just scratching the surface. The reaction has been visceral because it also touches on how Americans do yoga, which gets into the evolution of a transplanted and transfigured discipline that started in India and ended up in Manhattan, Hollywood and Dupont Circle.

A personal digression

The short answer is “Yes, of course, you can hurt yourself practicing yoga.” I learned it the hard way when I tore my meniscus in 2008 and underwent surgery to repair the knee. More than the physical damage and the disruption to my practice, the injury shattered my own misplaced faith that yoga was a superior form of mind-body practice that could not harm me. I injured myself and I didn’t even feel it at the time. It was only the next day that the pain hit me. But what injured me was actually not the particular yoga pose that I did in an advanced Anusara workshop, but the patterns of use and abuse that I had locked into my tissues over decades of self-inflicted stress.

Luckily, I did not give up on yoga. As my practice slacked off last year because of the disruptions of my parents’ deaths and my own illness, the experience ended up convincing me that I needed to deepen my practice through increased awareness and self-discovery. It also convinced me that I had to enlist additional help to make sure that I did not harm myself. That’s why I have been treated by a massage therapist since August.

Back to the article

This blog entry got started because I came across an interview with Glenn Black, the veteran yoga instructor that Broad used in his article to wage a finger at the excesses of American yogis. Eden G. Fromberg: Yogi Glenn Black Responds to New York Times Article on Yoga:

EF: What is the best way to overcome injuries from yoga?

GGB: Remedial exercises that overcome the source of the injuries. And people need to get bodywork. Not just any bodywork. They need to look for people who work on really moving the joints and connective tissues.

Well, that just confirmed what I’ve come to comprehend after practicing yoga for nine years. Because my peripherial neuropathy and its repercussions (sleep deprivation, mainly) threatened my livelihood, I was prepared to spare no expense. I’ve been lucky because I can afford the luxury of doing both yoga and bodywork.

And the lesson that we can learn from the “How Yoga Can Wreck Your Body” controversy is that yoga matters in America. It’s reached a kind of critical mass in the American mainstream, and this discussion is about how it can contribute to Americans’  need for wholeness and wellbeing.

Back massage and other tales of balls

I wanted to provide some additional information about how I was using balls for therapeutic massage.

The two Yoga Tune Up® Balls come in pairs for a reason: you apply them to each side of the spline, starting at the neck and gradually working down the spin. They are usually close enough to touch, but they still it into the two grooves along the spinal column. At a seven locations, you apply different techniques to press into the tissues. The most common movement is to raise up the hips and “chug” up and down or “shimmy” back and forth  on the balls. The balls have a lot of give in them so they never really cause pain — unless you happen to hit a knot or trigger point in the muscles. You also incorporate arm movements that extend and contract the rhomboid and trapezius muscles, which in turn press against the balls in different ways.

This self-massage is a valuable learning experience because I am guiding the application of the balls according to the feedback from my muscles and spinal column. I don’t think I could really assess those muscles between my shoulder blades until about 18 months ago. They were frozen in a single block from years of hunching over a keyboard. It’s where I still accumulate tension so regular self massage is both curative and proactive.

Jill Miller has developed a whole set of routines with the Yoga Tune Up® Balls and types of applications, and that can make it fairly straightforward in applying them.

Other balls

I have also incorporated other balls into my self-massage routines, mainly because my feet were a primary area of concern.  I carry a Foot Rubz Foot Massage Ball around in my shoulder bag so that I can use it while working at my desk. I also acquired Rhino Ballsfor a more extreme kind of foot massage because they are covered with rubber spikes that bite into the flesh more deeply (some would consider it a form of torture). The difference is the Foot Rubz has flat spikes while the Rhino Balls have spikes. I’ve also purchased STX Six Pack of Assorted Color Lacrosse Balls
because I had heard that they were less flexible. I am still trying to figure out when and how I can incorporate them into my practice.

Tying a bow on my birthday present

I’ve now been taking treatment from Howard Rontal for a month now, currently with a frequency of once a week for 60 minutes. As a birthday present to myself (turned 62 yesterday), I took an 90-minute session in which Howard gave me his “ligament treatment” — basically going progressively from soles to neck and stretching out all the muscles and assorted fascia, with special attention to places that were seriously compromised (in my case, hips, sacrum, lower back, neck — Howard was much more specific in naming muscles and ligaments).

A full 48 hours later, I am still feeling the impact of this body readjustment, a different kind of experience than what I had experienced in previous sessions. Rather than just relieving symptoms like numbness, tension, or pain (which I did on Tuesday), I’ve felt as if I’ve been put thorough boot camp. I’ve gone to bed feeling exhausted and sore, and woken up feeling fatigued and sore, especially in my hips, thighs, shoulders, arms, forearms. I almost felt as if I had flu symptoms — or something had gone wrong with the treatment. Obviously, something different is happening; it’s no longer just the “happy talk” of relieving tension and pain. Because of the work done on my core, I am using muscles differently, in new ways, with new lines of tensile stress. I’ve only done one Hatha yoga class (Tuesday evening) and my evening yin yoga sessions, so I’ve not be overexerting myself in a more traditional way (as if I’d gone to the gym for weight lifting for the first time in years). Rather, I am carrying myself (body frame and muscles) in a different way. So the very process of holding myself upright, walking, bending over is more physical exertion for me.

Howard told me that giving me a massage is like stroking a tree trunk: my muscles and fibers are thick, dense, hardened, inelastic, stiff, some more than others.  It takes an enormous amount of energy on his part to get a response, but eventually my body does respond. There’s not a lot of give in my fibers.

I don’t look like someone wound too tightly. I’ve always been slender, un-athletic, and relatively lightly built. At around 40, I put on 25 pounds; when I quit smoking the first time, I added another 10 pounds; and by the time I finished my MS degree, I had added another 15 pounds, pushing me over 210 pounds. So I’ve bulked up over a relatively wiry, tight frame, adding layer over layer.  And for the past seven years, I’ve been trying to reverse that tightness while reducing my weight, with moderate success since I can do a yoga class without looking like a complete klutz. I half joked with Howard that he’s lucky he did not have to work with me when I started yoga.

So what Howard did on Tuesday (and probably in a less concentrated form previously) is to start stretching out some of those sinews, freeing them to movement. Which means that instead of relying on rigidity to hold together and mobilize my body, my muscles are having to work. To use a metaphor, instead of using wooden struts to prop myself up, I am using the tensile strength of wire that has to be adjusted continuously to keep me upright. I may have felt it less before because we’ve tended to focus on a single area (feet and calves, core, shoulders and chest, neck and back). This time we were more ambitious in treatment scope.

Howard explained to me that the model for understanding the body is based on geometric principles — called Tensegrity:  rather than thinking of “flesh hanging off of bones,” it’s better to think in terms of a dynamic tension in which the bones are suspended by the fascia much like a suspension bridge. The concept is fascinating, but right now I am dealing with the discomfort of the transition to being a more embodied form of plasticity from a wooden prototype.

Happy birthday to me

I see the time and money that I now am investing in this treatment as more than just pain relief or injury repair, but as a down payment on future well being in my “seniorhood.” This past year, with my parents’ deaths and all the upheaval and disruption in my personal life, I let my personal care slip and saw a dramatic drop-off in my well-being as my peripheral neuropathy and other symptoms worsened dramatically. With the myofascial release massage, I feel a renewed interest in my yoga practice.

What is really surprising is that the therapy seems to have more than transitory effect (relieving pain or loosening up muscles). You would think that “moving around muscles and ligaments” would eventually mean that they fall back in place. I suspect that if I might slip back into old patterns if I did not do yoga (or exercise or stretching) to lock in the new range of movement.

Healing the body with expert hands

Drawing of a left human footI have to apologize for how I left my previous entry hanging ominously on the diagnosis of having idiopathic peripheral neuropathy and my doctors’ seeming inability to determine the cause or prescript a treatment that could relieve my pain. I already knew that I had more options for treatment and even the prospect of  a happy ending.

After I meet with my neurologist, I had already lined up an appointment with Howard Rontal who practices myofascial release therapy. He is a certified Hellerwork practitioner, a  Certified Myoskeletal Therapist, a Certified Structural Integrator SM, and am licensed as a massage therapist by the Board of Chiropractic Examiners, State of Maryland. More importantly, he’s been at this vocation for more than 20 years, and currently teaches around the country.

Drawing of the humna leg musculature
And the foot in intrecately bound to the calves, the knee, and the hip.-- and so on

I had contacted Howard because I wanted to work with an experienced bodyworker who is aware of yoga, comes out of the currents of  structural integrators that include Ida Rolf, Joseph Heller, Moshe FeldenkraisTom Myers and others. It’s safe to say that Howard is not just a massage therapist. I told him that I had multiple problems that included plantar fasciitis, peripheral neuropathy and assorted body tightness. Howard was very honest up front and said that he could not guarantee anything in terms of the neuropathy, but he could certainly help my plantar fasciitis. Another reason that I picked Howard is that he is located about 15 minutes from my house and could treat me in the morning.

I’ve now had six sessions of bodywork, one hour each, with Howard, and the results have been jaw-dropping. As just an initial example, the first two sessions focused exclusively on my feet, ankles and calves. Howard does intense stretches of the plantar ligaments (soles of the feet) that are sheer torture.  In the first session, I could just barely tolerate the pain on my right foot; I could not feel anything on my left foot. It was as if a local anesthetic had been applied to my left foot.  On the second day, I could actually feel the ligaments on my left foot being stretched. By the end of the session, the sensation of relief in my lower legs was overwhelming, but was even more surprising was that it seemed to ripple up my whole body. I could tell that I was in the right hands and was on track to managing the pain and even healing my body.

Over the next four sessions, I found that even working on another part of my body (say, shoulders and neck) could end up relieving the tension in my lower limbs. The pin pricks that had been keeping me from sleep at night are much less intense, and only distract me at times. Other symptoms, like numbness or blunted feeling, do tend to come back gradually between sessions, but each time with less intensity. It might even be a case of new circuits of sensation that I am feeling and interpreting as being symptoms, but are actually a new phenomenon.

The bodywork has also changed my yoga practice as I find that my body is pulsing with more sensory feedback and awareness in muscles that I had not been able to access fully. In one session, Howard dramatically freed up my diaphragm and made my breathing smoother and fuller. The experience has made clear to me that any mature adult (45 or older) who starts doing yoga should also seriously considering using a structural integrator because there are so many issues that have been “baked into the muscles” (bad posture, trauma) over the decades. In the past, I’ve frequently felt as if I’ve been fighting against myself, and now I know I have been struggling against some real resistance.

This treatment has been eye-opening for me, and there are so many lessons in it that I could not possibly give a full account in one sitting. I am going to come back to this facet of my mind-body experience because of its transformative power.

A bloody nose gets in the way of pranayama

The last two days I’ve been handicapped by having a bloody nose. It started late on Monday evening after a shower, and kept me from getting a good night’s sleep. The next day, I seemed to be doing OK, except when I started to do  bas­trika breath, my left nostril started to bleed again so I cut short my pranayama practice. These episodes have been controlled fairly easily, but I plan t consult a physician about this problem.

I’ve tried to trace my bloody nose to a change in diet, supplements or medication but have not found a good culprit to blame. Since I’ve revived my pranayama practice over the past week, that may be the cause because the vigorous air stream may dry out and irritate my nasal passage. In the past, I’ve probably gone over the edge in pushing and pulling air, but this time around, I’ve been staying more controlled.

I’ve never had a problem with nose bleeds until this year. I had one in April at work, but that seemed to be connected to the use of an antihistamine nasal spray for allergy season. I no longer use it.