Category: Yoga for Chronic Pain

Research and safe techniques to manage chronic pain from illness or injury.

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The Case Against Stretching

The Case Against Stretching

(from a Yoga Therapist!)

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Plow pose is popular in many yoga classes.

This is one of my favourite poses from the old days.  Hips, back, shoulders and wrists all pulled into severe stretches right to the end of range of motion.  I like this pose.  It’s not hard for me and it makes me feel like I’m super good at yoga.  But I don’t do it anymore.

It’s a common myth that stretching builds flexibility.  This article will attempt to explain the difference between healthful movement in a joint and pushing movement to a potentially harmful point.

When our bodies were new, the connective tissue (ie fascia, tendons, ligaments, pericardium, etc.) was almost liquid in its fluidity.  It slid and glided around all the bones, muscles and organs of the body like Bambi on ice.  As we experienced the physical world, took lumps and bumps and formed movement patterns, the connective tissue began to stiffen, even harden, in order to facilitate more efficient dynamics.  For example, our cervical spine didn’t form its shape until we were old enough as babies to hold our heads up alone.  Our lumbar curve formed as we started crawling and walking.  Those spinal curves create an architectural support for our whole skeleton and serve us well.  But some of the connective tissue adaptations are not helpful. 

One of my teachers (Leslie Kaminoff) tells a story from his youth.  He had a girlfriend for several months.  They loved to stroll around Soho in NYC, his arm around her.  They broke up.  He got a taller girlfriend.  They like liked to stroll around Soho.  His shoulder began to really ache!  Why did he not have pain with the first girlfriend?  His connective tissue surmised that the angle at which he was holding his shoulder joint with the shorter girl was where he needed to be.  The tissue began to stiffen up to reduce the load on the muscles.  The taller girl challenged that assumption, so the joint began to give him pain.  “Really, buddy?  Are you sure you know what you’re doing?  Our experience is such that the first position is the safest one because we know it better.”

Most of your chronic aches and pains have a similar history.  Nothing was inherently “wrong” with Leslie’s shoulder joint but his body was nervous about changing patterns.

Leslie was smart enough and was learning about connective tissue in his yoga practice, so he respected the tissue’s calls for tenderness.  If he had pushed into the stretch pictured above to stretch out the tension in his shoulders, he could have damaged the connective tissue.  This is a common cause of frozen shoulder or more increased pain.

While it is a common practice to use equipment (like straps or weights) or outside assistance (such as a physiotherapist) to push further into a stretch, the odds of creating injury, and more pain down the road, increase dramatically.  This is because it’s not tight muscles that are causing your stiffness, but nervous connective tissue.  How often have you had an adjustment at the chiropractor or a good deep yoga stretch, but then feel even tighter the next day?

What could Leslie do to adjust to the new girlfriend?  Movement!  Movement in new planes of motion and through novel patterning.  But not pulling or pushing the joint.  And lots of movement.  The absolute best way to alleviate stiffness is to move more every day, in ordinary ways.  Walk instead of drive.  Choose to take the stairs.  Bake bread or clean your house.  All these normal duties are representative of the types of duties our bodies evolved to do. 

It’s instinct to stop moving when we experience pain but searching for a range of motion that doesn’t make you gasp is really important.  If you don’t keep the connective tissue sliding and gliding, it will stiffen more.  The movement generates lubrication and educates the brain that this is safe to do.

This video is a great beginning place.  The Joint Freeing Series greets each moving bit of your body in a particular order and in a gentle way.  Try practicing morning and evening for a week.  Let me know how your sore parts are feeling after that time.

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Breathe into a More Joyous Life!

“Our breath is constantly rising and falling, ebbing and flowing, entering and leaving our bodies.  Full body breathing is an extraordinary symphony of both powerful and subtle movements that massage our internal organs, oscillate our joints and alternately tone and release all the muscles in the body.  It is a full participation with life.”    Donna Farhi, “The Breathing Book”  (Holt Publishing, 1996)

                On your last visit to the doctor, he/she may have asked you to take a deep breath.  Here’s what I commonly see in my yoga therapy practice when I observe someone instructed to deep breathe. 

They inhale.  Their nostrils pinch a bit and it makes quite a sound on the intake of breath.  Their arms and shoulders hug into the body.  The shoulders and collar bones lift up.  Neck muscles tighten.  And often their bellies pull in.  Try a deep breath in this manner.  Does it feel liberating or joyous to you?  It feels like a lot of work to me.

                Our breathing automatically adjusts to whatever external circumstances require.  It’s brilliant really.  Because we spend more and more time in sedentary activities, during which our brains are concentrating on reading or talking but not movement, our breath just goes into a shallow holding pattern that just keeps the basics going.  No point in investing a lot of energy in breathing deeply when the muscles are relatively stagnant.  Every once in a while, however, the tissues of the body send out an SOS.  FEED US!  And you are prompted to sigh or inhale as described above.

                Breath is literally your life.  As oxygen is brought into the lungs and permeates through the alveoli to the blood stream, hemoglobin molecules shuttle the oxygen to all the cells of the body.  During shallow breathing, not a lot of volume of oxygen is being delivered.  This translates to sluggishness, mental fog and increased stiffness.

                One of the more efficient ways your body can breathe is shown in this illustration.  As the lungs fill with air, the diaphragm descends down toward the abdomen to make more room for that balloon like action.  As you exhale, the lungs deflate and pull all the other bits back into place.

                Maybe you notice that this natural breathing pattern involves letting your belly muscles relax on inhale.  That can be a barrier for many of us who try to look skinny (by sucking in our gut) or think that tight “abs” will keep our backs happier.  Breathing is a whole body experience.  Relaxed breathing means that muscles need to relax as well as contract.  That is a definition of strong muscles – ones that can lengthen and shorten as needed.

Program for Restoring Your Life by Breathing Better

  1. Constructive rest:  (this could be done in bed if getting to the floor is difficult)

Take 2 – 20 minutes here. Use a pillow if necessary and blanket to keep warm. Observe your natural breathing. Where do you feel movement?  No movement?  A lot of movement?  Do you hold your breath?  Is your breath ragged or irregular?  Are there pauses?  Where and how long?  There is no right way to breathe right now.  You are just familiarizing yourself with what you are experiencing today.

2. Cat/Cow Stretch:  Inhale, sit up erect, lifting the chest toward the ceiling.  Exhale, hug the belly muscles in and let the back body stretch.  Repeat 5 – 10 slow breaths, breathing in and out through the nose.

3. Side Stretch   

Lean to one side on exhales.  Lift back upright on inhales.  If your arm gets tired up in the air, tuck it behind your back.  Repeat 5 times to each side.

4. Seated twist    

Inhale, sit up tall, facing forward.  Exhale gently twist to one side.  Repeat 5 times to each side.

5. Down dog with Chair   

Keep knees a little bent, or a lot bent.  Lift buttocks up and backward to length the entire spine.  Take 3 – 5 long, patient breaths.

6. Relaxing Chest Stretch   

This could be done in bed if getting to the floor is too difficult.  Place a rolled blanket along the length of the spine. Buttocks is on the ground. An additional pillow can support the head if needed.  Knees are dropped out to the sides and supported by more blankets or pillows so hips are comfortable.  There should be a pleasant stretch along the inner thighs but no pain in joints.  Let arms drape out to sides, palms up.  More blankets could support the arms if this stretch is too much for tight shoulder or chest muscles.  Rest here up to 15 minutes.

Making these movements part of your daily routine will bring more life to your life!

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The Hidden Muscle that Affects Everything

                What is one of the biggest muscles in your body, crossing three joints, affecting your breathing and every step you take?  Let’s go on a tour of this hidden giant and discover how releasing tension in this muscle can liberate your health and spirit.

                Have you guessed yet?  It’s the psoas (pronounced so-as) and it is primarily regarded as a hip flexor, although, as with most of our anatomy, it’s a bit more complicated than that.

Image result for psoas

  Let’s first look at the geography.  This photo shows an anterior (meaning from the front) view of the left side.  The red is meant to represent the muscle fibres.  See how the muscle starts up on the spine?  It has big, ropey attachments to the front of your vertebrae starting at T12 (just under the bottom of the shoulder blades) to L4/5 (the arch of your low back).  It travels along the inside (anterior) side of the hip bones (those are the saucer shaped ones, either side of the illustration).  It emerges at the groin and finishes on the inside of your thigh bone.  Stop reading and measure this by touching your body from the mid-back to inner thigh.  That’s a long muscle!  Because it is so large, the top and bottom of it are often doing different things.  Which makes it very tricky.

                So what does the psoas do for you?  It flexes the hip, for starters, which means in bends the leg up into the body or pulls your body down toward your leg.  So walking involves lifting a leg which means the hip flexor is active.  It also deeply influences the curve of your low back.  In cases of non-specific back pain, I always suspect the psoas.  It typically presents as tightness in the thoracic or lumbar area that responds well to gentle stretching and relaxation but gets worse with prolonged standing or sitting.  Typically, an exaggerated lumber curve means a tight hip flexor, but flattened back curves can mean psoas malfunction too.  As I said, it’s a tricky character.  The muscle also acts as a bit of an external rotator, which means it turns your thigh bone out a bit.  If the external rotator muscles are overused (if you tend to walk a bit duck foot like, this might be you), this can create hip pain and other conditions such as sciatica.

                The psoas crosses the hip joint, sacro-iliac joints and the spinal connections.  It is the only muscular connection between the leg and the spine.  Misalignment and tension can affect knee, pelvic and shoulder function.

                As the psoas travels through the torso, it weaves in amongst all your digestive and reproductive organs.  Malfunction or tension in the muscle can contribute to acid reflux, constipation, IBS, fertility problems, menstrual irregularities and cramping, among many other issues. 

This charming fellow is showing the position of the diaphragm.  It’s that big dome shaped muscle under the lungs and heart.  Look at the fibres right at the spine where we noted the psoas starts.  They interdigitate, which means they hook up quite intimately every breath.  Which brings us to the biggest insight into getting a healthier psoas muscle.  Breathing!

                Moving a bit deeper into our investigation, think of the basic job of the psoas.  Hip flexion is called for in fight or flight.  We are either going to lift the leg to run or fight, or we might pull the body into the legs to protect our belly.  We are deeply hard wired to initiate a psoas reaction to any environmental irregularity or threat.  So did someone criticize your report today at work?  That’s an environmental threat to your psoas.  Did someone pass you too fast on the highway?  Did you feel disappointed that you weren’t invited to lunch?  Did you worry about making budget?  Was it really loud or too bright?  You get the picture.

                Many clients ask about stretches for the psoas.  It may make much more sense to begin to release the tension of the last few decades a bit first.  Aggressive stretches  (isn’t this one fun?) 

 can cause damage in the groin and take a long time to heal. 

                Let’s look at a more patient plan that is safer, quite pleasant to undertake and provides ripples of benefits to all systems of the body.

  1.  Legs Up The Chair Pose : This video demonstrates the pose (https://www.youtube.com/watch?v=a1dvKsv39tY&t=17s).   In this series, plan to spend 5 – 10 minutes here.  Get comfortable.  Begin breathing in and out the nose, slowly and rhythmically.  Gradually take as full breaths in and out as you can without straining.  After the first few minutes, let go of actively breathing and just let nature take its course.  Deliberately day dream about pleasant thoughts, like a favourite vacation memory.  If an emotional charge comes into your relaxation, gently set it aside, promising to revisit it later.
  • Half Knee to Chest Pose:    Start with both knees bent.  Inhale.  As you exhale, hug one knee gently to chest, not too tightly.  Gradually straighten out other leg to form this shape.  Feel the bones of your straight leg as they might be made of iron …. sooooo heavy!  Take a few active nostril breaths.  Repeat other side.
  • Gate Pose:    Place a folded blanket under the knee for cushion.  Modify to stand on the left leg here if weight bearing on the knee is painful.  Inhale, reach left arm up and exhale to side bend.  Move in an out of the posture a few times and then hold for 3 – 5 breaths.  As you use your diaphragm fully to breath, see if you can start to sense the influence that has on the psoas.  Repeat other side.
  • Active Bridge Pose:  Place a yoga block, or full roll of toilet paper, between knees.  Inhale to lift hips and arms.  Exhale to lower.  Keep block or toilet paper roll firmly hugged between knees.  Repeat 10 breaths.
  • Savasana (or Relaxation Pose):  Lie back on mat, using a pillow under head or rolled blanket under knees for comfort if necessary.  Stay as supported by the floor as much as possible for about 2 – 5 minutes.

As you slowly stand up and move about, notice if there is a lightness in your step.  The psoas muscles act as guy wires between the leg bone and spine.  When they are relaxed and receptive, they conduct the electricity more fluently.  These exercises may also be accompanied by a feeling of light heartedness as they release deeply held stress.