Tag Archives: injury

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.”

Learning to take care of myself again

Sorry for the long silence on this blog.

With the complications arising my injury, my daytime job and a pressing problem of an issue with the IRS, I’ve had little time for blogging. I took my first yoga class on Monday, but didn’t get back to Thrive Yoga until this morning. I had my evening practice to calm my spirit, but I don’t approach it in a way that can substitute my classes.

This year, I set my mind to maintaining a clear boundary between my daytime job and the rest of my life. My strategy was to get into the office at least 15 minutes before 9:00 so that I could get the most important tasks underway before the customary interruptions and distractions started. I also wanted to leave the office at 5:30, 5:45 at the latest, so that I could make it home early and fit in my yoga classes or the gym or running (in good weather) or tackle the obligations of modern life and family. In any case, I did not want my work routine to stretch into the evening.

At least, that was my intention, but it’s been really hard to extricate myself from the office on time. Too many hard-and-fast deadlines, and I don’t trust myself to do some catch-up work at home. On the other hand, I’ve also come to realize that as the day advances, my productivity declines, focus dissipates and energy flags. Part of that decline may be do to my lack of physical stamina, but it’s also a natural process unless something happens that gives me a spurt of adrenaline.

So I’ve had too many days in which I found a ready excuse for staying after quitting time. Add that to the need to dig into my perennially chaotic filing system and spotty record keeping because I had to straighten out the filings of two tax years.

40-day yoga challenge

As might be suspected, the 40-day challenge turned into a 30-day sprint plus rain-check because the injury to my hip flexors cut short my attendance at the studio, which removed a lot of the momentum for yogic discipline. The initial commitment to maintaining a steady, intense practice did allow me to taste the payoff on the mat so as soon as possible I am going to try to pick up the pace.

Lesson Learned

Looking back on the past three weeks, I can see that my physical and mental wellbeing began to slack off once I stopped doing my 40-day yoga challenge and other exercise routines and shortchanging my meditation. This just reinforces the idea that I have to take care of my health, whether that means keeping a strict 8-hour work  day, getting exercise or finding the means to make sure that my head, mind and soul are firmly attached to my body.

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.

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.

Better than the cure

The New York Times is on another yoga binge, putting out stories on Ana Forrest’s niche appeal and former Cornell basketball players doing yoga during off-season, to mention the most recent ones. Jane Brody has a column about Ancient Moves for Orthopedic Problems mentioning the work of Loren Fishman, a physiatrist — a specialist in physical and rehabilitative medicine affiliated with NewYork-Presbyterian/Columbia hospital. I’ve already used the modified triangle headstand posture to get my shoulders aligned. His longer referenced article is available (PDF, 1.76 mb) from a special issue of Topics of Geriatric Rehabilitation (April/June 2011 – Volume 27 – Issue 2, pp. 93-166) on yoga as therapy.

I was even more struck by what Fishman writes in the Foreword of the special issue:

There are few therapies that boast about their side effects. Both medicine and surgery are undertaken because there is a favorable cost-benefit or risk-benefit ratio. The 2 (sic) are placed on opposite sides of the balance of good judgment. In yoga, the side-effects, irrelevant to the actual reasons for its initial adoption, may turn out to be more to the practitioner’s advantage than the primary therapeutic effect! Almost any style of yoga brings with it reduced blood pressure, less obesity, and less back pain, improved range of motion, safe strengthening, reduced asthma and reduced anxiety, better recovery after surgery and chemotherapy and almost stunningly low cost.

Fishman is no stranger to yoga: he practiced in India for three years before going to medical school and has co-authored books on Yoga Therapy. He has a website on sciatica and has several audios of conversations and courses on YogaU.com.

A choice: hard or soft yoga

Photo: yogi folds forward over leg
At Bryan Kest's master class at Thrive Yoga

Last night I went to Thrive Yoga and had two choices: hatha yoga with Marylou McNamara or vinyasa flow 2/3 with Susan Bowen. I’ve been taking Susan’s advanced class on Saturday mornings, but mostly steering towards hatha class to work on the fundamentals. I took Marylou’s class on Sunday. Today, however, I was vacillating. I’ve been getting my evening yin yoga classes in regularly so I am covering the “soft” part of my practice, but I’ve been shying way from more upbeat classes. I know I need to work more on my conditioning, stretch my limits and build up strength.

My friend, Glenn, came into the studio reception, and he resolved my dilemma: “I’m going to class with Glenn to night.” Glenn is a former gymnast who is the kind of yogi that I want to be when I grow up. Hes been practicing about as long as I have, and has been at Thrive Yoga since it opened.

Continue reading A choice: hard or soft yoga

Relieving human suffering among U.S. service men and women

New York Times Mental Stress Training Is Planned for U.S. Soldiers (August 18, 2009 – MLS: No longer online.) is about how to prepare soldiers for the psychological rigors of war. It’s heartening to see that the top brass are finally seeking assistance in dealing with the surge in suicides, post-traumatic stress syndrome (PTSD), depression and other problems in the wake of nearly a decade of conflict in Iraq and Afghanistan:

And in the interview, General Casey said the mental effects of repeated deployments — rising suicide rates in the Army, mild traumatic brain injuries, post-traumatic stress — had convinced commanders “that we need a program that gives soldiers and their families better ways to cope.”

The general agreed to the interview after The New York Times learned of the program from Dr. Martin E. P. Seligman, chairman of the University of Pennsylvania Positive Psychology Center, who has been consulting with the Pentagon.

In recent studies, psychologists at Penn and elsewhere have found that the techniques can reduce mental distress in some children and teenagers. But outside experts cautioned that the Army program was more an experiment than a proven solution.

The Philadelphia Inquirer had an article (Penn center to help Army on stress, July 31, 2009 – MLS: No longer available online) on this same issue.

Seligman is the lead thinker behind positive psychology and has had a major impact on how people are treated. I recommend that anyone with an interest should visit Happier.com, an initiative to take good mental practices to the masses. Seligman and his crew have developed a series of easy to follow exercises and routines that help you shift your mind set [No longer available].

Almost Buddhist in nature, the approach aims to relieve human suffering. Although not mindfulness, it asks that you change the story that you’re telling yourself inside your head. It asks you to examine your thoughts, which any bodhisattva would appreciate.

Finally, this effort is far better use of psychology than what the idiotic Bush Administration by employing psychologists to develop interrogation techniques that crossed the line into torture. Ironically, the quacks that advised the Pentagon distorted a concept, “learned helplessness” that Seligman (see Wikipedia entry) developed 30 years ago.

Progress report – fourth class

I went to my fourth class on Tuesday evening at Thrive, with Pierre again. I kept trying to throttle back on my practice, to keep from overreaching and getting ahead of my recovery. For the first time, I did some jump-backs and jump-forwards in my vinyasa, but only after warmly up thoroughly. I did notice a touch of stiffness and discomfort in my injured knee. I have to be careful when getting into kneeling positions, like hero’s pose (Virasana) and even child’s pose (Balasana) because my body weight rests heavily on my knees.

Pierre will not be back at Thrive for a while. His nomadic journey will bring him back to the DC area in February. He’s helped me feel more at ease with my injury and inviting me accept the healing process as a renewed exploration of my body: “With the breath, everything you do can be yoga.”

A second class on the mat

I went to Thrive again this evening, after giving myself 48 hours to recover from my first yoga session in four months. Tonight’s class was with Elizabeth Pope, a new teacher for me, who joined the studio after I hurt my knee. She’s been exposed to a range of teachers, from Kasthaub Desikachar to Ana Forrest. It was a good solid class for all levels so I modified most of the poses to concentrate on my knees. Where I really felt it was in my shoulder and upper arms: all the chararungas in the vinyasas were punishing me for wimping out during my convalescence and not maintaining my core strength. Elizabeth confirmed this conclusion by making us do multiple sets of abdominal exercises that left me barely able to lift my head and neck off the ground. I sweated profusely and had to take child’s pose on several occasions because my conditioning has lagged far more than it should have, especially in the last few weeks when I was struggling with resistance to going to the gym and the studio.

At long last, in class again!

I was finally able to fit in a yoga class at Thrive with Pierre Couvillion this evening. My first class since mid-August and almost two months after my knee operations. I forced myself to go by packing my kit and rolling up my mat this morning before I left for work and giving my wife instructions to take it to the studio when she went to her class in the afternoon. I knew I had to put some kind of imperative in the formula because I was building up all kinds of resistance to the yoga class and even going to the gym, even though I can feel the adverse effects that their absence is having on my body and temperament.

Pierre led a pretty straight forward class that was good for me because it was am all-levels class that emphasized grounding in the basics of good form and breath. I did not do anything crazy — no jump-backs or jump-throughs, no wheels or advanced inversions. I just wanted to feel easy and comfortable in my asanas, and focus on my knees to make sure that they were solid and fully engaged. Pierre led us through some fundamental variations in standing poses that reinforced the tracking of the leg muscles. I think the factor that had deteriorated the most during the break was balance.

In preparation for the class, I had a session of acupuncture in the morning that was supposed to help break up some of the scar tissue in my knee.