It all seems so complicated

Does anyone else get the feeling that everything seems so complicated, yet the same, all at once?

I’ve been thinking of the simplicity of days past. Times when everything seemed rather natural, easeful. Unplanned. Unrestrained.

When I was a kid, it wasn’t a chore to go outside for fresh air. To play. It’s where I wanted to be. So much freedom. Escaping from watchful eyes, I could walk and explore. Look to find someone to come along with me, or meander on my own.

I would walk and jump. Skip down the sidewalks. Come upon the monkey bars in the playground, stopping to hang out for a bit.

I might hum a few tunes along the way or daydream about what I might do tomorrow. Maybe tomorrow I would find some friends hanging about. Perhaps we were lucky enough to have 10 cents to spend after finishing our paper routes. Anticipating all it might buy. Licorice strings that I could practice braiding together. The green ones being my favorite. Powered sugar in long straws. Those crackle-pop things that would burst all at once in your mouth.

I loved to dip my hands in the mud after a heavy rain… looking for unknown treasure. Or place small twigs and leaves alongside the gutter and watch how long they would travel down the street before some kind of obstruction from mud or rock stopped the adventure. Pick flowers. Build tree forts in the yet-to-be-developed suburbs. Throw snowballs. Play road hockey. Always trying to beat my older brothers at their own game, from which I was excluded.

I would play by the light of the day. Navigate the way home by twilight for dinner or bedtime depending on the season. The sun dipping low as my cue for either. That, or someone calling “supper time” in the neighborhood out their front door. It might be my mom, or maybe it was yours. It didn’t much matter as it was still a signal that our time was up.

Today, the day is clocked, watched. Tuned by the rhythm of the pings, alarms, flashes of light so we don’t miss a thing.

These days I’m now wandering rather aimlessly around the neighborhoods, gasping for a little fresh air. Looking for a friendly face to say hello to behind my mask. Some boldly saying hello. Others holding their breath, covering their face as they make room to unobtrusively pass by. This being masked, eyes down, gaze lowered. A story for another time.

The simplest of movements now are so guarded, watched. Complicated. I believe things are changing, opening up again where I live two days from now. Unless of course, they don’t. Stay tuned.

I don’t anticipate normal any time soon.

In the meanwhile I hope some of the young kids I see about the neighborhood these days are dreaming of ways to use this technology at our fingertips to some helpful advantage. At the same time figuring out how we might again disconnect to reconnect. Look up and out. Stir our imaginations towards a more wise, self-sustaining yet uncomplicated future for the ones we love.

Bright Lights, Dim Prospects & Daunting News

One of the basics of sleep hygiene is to sleep in a darkened room. Kind of a no-brainer.

However, what is a common reason people wake up in the night? If you’re like me, it’s often to go to the bathroom. Where are the brightest lights in your whole house? Likely the bathroom. Imagine the signal these bright lights are sending to your sleep systems?

Maybe you wake up for some other reason and next thing you know, you’re scrolling on your phone. Many are aware there’s a way to switch it from Light to Dark mode so perhaps the light won’t interfere with you getting back to sleep – too much.

Yet, what is the content you’re reading? Is it news? Social media? Is it something that might alert or arouse your nervous system or thoughts… late at night? Both, seem to have a way to wind things up for many.

These are a few of the things we will be exploring in Rest & Restore: Strategies for Sleep that begins Feb 16th. Each Tuesday night we’ll dig into some of the research around sleep. Then, explore some practices to help calm your sleep systems or change some unsupportive sleep patterns. Add in some quiet time and finally an opportunity to ask questions, connect with others should that be of interest you.

Though the sessions will be on Zoom, if you’re not a Zoom user or are experiencing Zoom fatigue, everything will be available for you to view on your own schedule, at your own convenience on the Teach:able platform.

The chicken or the egg?

This question about what comes first. The onset of chronic pain (and/or other conditions) from sleep disturbance or the relevance of sleep disturbance due to chronic pain?

Here’s some of what we know about sleep …

Sleep complaints are present in 67-88% of chronic pain disorders and at least 50% of individuals with insomnia – the most commonly diagnosed disorder of sleep impairment – suffer from chronic pain. Further, both chronic pain and sleep disturbances share an array of physical and mental health comorbidities, such as obesity, type 2 diabetes and depression.” 1

One study found that “women who endorse frequent, “sleep problems,” defined as frequently difficult falling asleep or having a sleep disorder, were significantly more likely to develop fibromyalgia 10 years later.” 2

Also, in another how “sleep disturbance temporally preceded increases in pain, … in “temporomandibular disorder (TMD).” 3

Similar research is being conducted in terms of cancer pain, for depression, PTSD and ageing (including Alzheimer’s and dementia).

I knew poor sleep to be a contributing factor for people who live with chronic pain. What I didn’t know was how it affects not only physical health but mental health.

What’s piqued my interest is in new studies where a trend has emerged suggesting that sleep disturbance may be a stronger predictor for pain than pain of sleep disturbance.” 4

…several longitudinal studies convincingly demonstrate that insomnia symptoms significantly increase the risk of developing future chronic pain disorders in previously pain-free individuals, whereas existing pain is not a strong predictor of new incident cases of insomnia.” 5

Not just a stronger predictor for pain, but also in terms of mental health conditions.

This bidirectionality or said another way, “what came first, the chicken or the egg?”

Lots of studies to examine obviously, but here’s one on the positive side “Quality sleep has also been shown to predict chronic widespread pain symptom resolution over 15 months.” 6

Researchers will continue to find out more and doctors will refer out to specialists in many areas. Pretty much the gold standard for treating insomnia now is CBTi or Cognitive Behavioral Therapy for Insomnia.

Yet, there are things you can learn to do for yourself, that will help.

Curious about this? Exploring some practices, tools and gaining resources that can support you in getting a better night’s sleep. What stress and the nervous system have to do with sleep? Or how you might find rest during the day?

I’m offering a 4-week workshop starting Feb. 16th at 7:30pm ET.

You’ll have some time and space to explore, experience what might be helpful for you all in the comfort of your own home. Online. Change into some comfy clothes, grab a warm cup of herbal tea and join in. Anyone can follow along. We’ll be rolling on the floor a little, expending energy maybe by rocking and swaying, taking some breaths together. And learning “all the things your parents/doctors/friends/colleagues never told you… about sleep.” There’s a lot more to it than just laying your head down on a pillow, each night.

References:

  1. Finan PH, Goodin BR, Smith MT. The association of sleep and pain: an update and a path forward. J Pain. 2013;14(12):1539-1552. doi:10.1016/j.jpain.2013.08.007
  2. Mork PJ, Nilsen TI. Sleep problems and risk of fibromyalgia: longitudinal data on an adult female population in Norway. Arthritis Rheum. 2012 Jan;64(1):281-4. doi: 10.1002/art.33346. PMID: 22081440.
  3. Quartana PJ, Wickwire EM, Klick B, Grace E, Smith MT. Naturalistic changes in insomnia symptoms and pain in temporomandibular joint disorder: a cross-lagged panel analysis. Pain. 2010 May;149(2):325-331. doi: 10.1016/j.pain.2010.02.029. Epub 2010 Mar 31. PMID: 20359824.
  4. Finan PH, Goodin BR, Smith MT. The association of sleep and pain: an update and a path forward. J Pain. 2013;14(12):1539-1552. doi:10.1016/j.jpain.2013.08.007
  5. Finan PH, Goodin BR, Smith MT. The association of sleep and pain: an update and a path forward. J Pain. 2013;14(12):1539-1552. doi:10.1016/j.jpain.2013.08.007
  6. K. A. Davies, G. J. Macfarlane, B. I. Nicholl, C. Dickens, R. Morriss, D. Ray, J. McBeth Restorative sleep predicts the resolution of chronic widespread pain: results from the EPIFUND study. Rheumatology (Oxford) 2008 Dec; 47(12): 1809–1813. doi: 10.1093/rheumatology/ken389

You’re not sleeping either?

woman in red long sleeve shirt sitting on chair while leaning on laptop
Photo by Andrea Piacquadio on Pexels.com

Did you know “chronic insomnia is highly prevalent and affects approximately 30% of the general population?” 1

Or, that “approximately 40% of adults with insomnia also have a diagnosable psychiatric disorder – most notably depression?” 2

That “sleep complaints are present in 67-88% of chronic pain disorders?” 3

I was aware of the third statistic, that sleep can be a contributing factor for people living with chronic pain. But why my interest in sleep, generally? I had (mostly) been a good sleeper yet started to experience disruptions to my sleep patterns over the past few years. Along came menopause and similar to many others I found myself in a cycle of wakefulness around 2, 3, 4 in the morning and went looking for solutions.

Last fall, however, something else happened. On a Facebook page I belong to, the subject of sleep was brought up. Well, the lack thereof.

I was curious if it was only menopausal women who were struggling with sleep, so I created a random poll. Within an hour or so, there were hundreds of responses.

  • 404 responses
  • 74 comments about issues with sleep.
  • 224 neither menopausal or perimenopausal
  • 95 perimenopausal
  • 51 menopausal
  • 34 ‘other reasons’

Clearly a problem for many but I was surprised to learn that it wasn’t only my age group challenged by this issue. The poll wasn’t scientific and could just reflect the ages of people in the Facebook group. Yet, wow!

Of course people will at times need specific diagnosis, treatment and care from healthcare professionals. Yet, digging into some of the research and after some of the behavioral or environmental factors are addressed with general sleep hygiene information, a lot of what affects sleep has to do with stress and the nervous system (and other systems… circadian, homeostasis, etc.). Which you can learn to influence and modulate.

Would you be interested in exploring this thing called sleep? Safely, gently, with compassion and care you’ll get to experience and learn what might be helpful for you. In your own home, cozy in your pajamas … having some time and space to do so.

A 4-week workshop Rest & Restore: Strategies for Sleep starts Feb 16th!

What are the many factors or contributors that affect sleep? What does the research tell us? What can you do during the day, that will affect your sleep at night? What can you do when waking up from sleep? How might you find some rest in the day, if your sleep wasn’t that great?

If you’d like to join in, registration is now open.

I’ve tried to make it affordable at just $20 each week. If finances are really tight, reach out to me at info@yogatoolsforlife.com. If finances are plentiful, please reach out as well and look to sponsor someone else.

I’d love for you to join in. Experience and learn what might can be helpful, for you.

References:

1. Roth T. Insomnia: definition, prevalence, etiology, and consequences. J Clin Sleep Med. 2007;3(5 Suppl):S7-S10.

2. Roth T. Insomnia: definition, prevalence, etiology, and consequences. J Clin Sleep Med. 2007;3(5 Suppl):S7-S10.

3. Finan PH, Goodin BR, Smith MT. The association of sleep and pain: an update and a path forward. J Pain. 2013;14(12):1539-1552. doi:10.1016/j.jpain.2013.08.007

Showing Up

I’ve been rather absent for the past three weeks, at least in this space. COVID-19 showed up for a close family member so it has been all-hands-on deck for a few weeks now.

Yet, here we are. A new year, another moment in these particular days that we may not be liking so much.

What I don’t like so much now and maybe in the past as well, is there seems to be this one way to be. A particular way to show up in the world, in any given moment. Whether in times of crisis or just the regular days of work, being part of a family, in relationships, or on my yoga mat.

“This, … is the way it’s to be done. This, … is the way to show up.”

Fortunately, or unfortunately for me, I was never much good with the status quo. At times I can tune in to this quickly. On other occasions it takes a long while before I get the sense that what might be well and good for one, doesn’t feel quite right for me. I’m hoping that as I head into my 60th year on this planet the gap between the two is shortening.

There is always a message, a signal trying to capture my attention and act as a guide. The harder part is listening. Even harder is acting on it.

Why is that?

Well, there does seem to be a cultural or societal expectation to go along with the crowd. We look for cues outside ourself. What is the other person doing, saying? How are they responding? From a young age we’re often taught to fit in. Be nice. Say yes. Maybe don’t say anything at all. Grin and bear it. Smile through the pain or discomfort. Do what others do. Again, “this… is the way to show up”.

Yet times are changing. A slow but forward motion allowing for difference. Celebrating it, even. This might be in terms of looks or gender but also a general movement to change other beliefs. That it might be okay to express who we are. What we feel. What we believe. How we see the world, that what we feel in our own uniqueness, matters.

As I think about another year’s passing what is becoming clearer to me is, there is only … right now. Now is the time to show up.

Which doesn’t therefore mean, my way, is the way. It doesn’t mean anyone or anything else is wrong. It’s only that what will be right and well for one, is not the same for another. Funny enough last year I created an online program exploring just that. It’s interesting to notice that often what I teach, is what I most needed to learn for myself.

Here’s what I’m learning these days.

It can be useful to have a place where I can simply show up with whatever I feel, wherever I’m at. Happy smiley faces not required. That in this New Year I don’t have to be better, more enlightened, 10lbs lighter, happy, smiling, fit or always be in a good mood. Trying to sustain all that these days might be quite a challenge.

That I have permission to do, be, what feels most right.

Maybe the same is true for you.

Transitions

I can recall when our son came home to visit after living on his own in Europe for a couple of years and he had acquired a new habit. That being changing from his work clothes to his inside clothes. They were kind of like pajamas, only a bit dressier. It seemed strange at first. I’d not seen him walking around the house dressed like that since, well, a very long time ago. I guess I can relate a little thinking back many years ago and coming  home, changing out of my ‘corporate suit’ and into something more comfortable. At least I think I did. Did I, or did I move straight into doing stuff with the kids, tidying up, cooking dinner? This leaving of one job or role and straight into another?

When practicing yoga it is often the transitions where problems occur in terms of difficulty or even injury. I wonder if it’s because we’re already thinking about the next ‘pose’ rather than giving much thought to how we might get there.

I think it’s where we often face our greatest challenges. Transitions. How do we ‘go across’ from one thing to another.

Child to teenager. To cohabitating with a partner, moving into parenthood perhaps. Then it often feels like 20 years zip by and we’re confronted with children leaving, the possibility of retirement. Other big transitions in the mix like illness, career changes, loss of loved ones, jobs, homes, maybe moving.

But back to even just the simplest of these. How might you transition from your work day and whatever that is for you… into the evening? Does your 5 o’clock look like a big energy crash? A wild and untamed household? Too many demands on your time, yet again?

How might you make it supportive in some way? Less overwhelming?

If you’ve spent your day where conversation is required non-stop, maybe you recognize your need for quiet. If you’ve been working alone where there is no conversation, you may be in need of connection. How might you meet those needs? And if you’ve others to consider during these transitions – how might you somehow meet in the middle?

I surely don’t have all the answers.

It might be worthwhile to consider though.

Creating some kind of ritual might be helpful. We have rituals around big life changes, or at least we used to. Weddings, funerals, rites of passage.

What might you do? Perhaps it is about changing your clothes. Or slowing down, having a cup of tea, or some kind of (prepared in advance) snack so you’re not reaching for the cookies or chips, or whatever’s nearest to your fingertips.

How do you move from one thing to the next? This going across? How do you know one thing is ending and a new one is beginning? It makes sense to first bring some awareness that it’s even happening. From there, perhaps making choices that might support it in some way. So, it’s more easeful. Less frantic.

What ideas do you have, do you use? I’d be interested in your strategies.

We are surely in it

A sense of connection.

The opportunity to be seen, heard, acknowledged. Understood.

Having some agency, a sense of control over what is happening in your life.

The ability to move around in the world. To get up and down, tend to daily tasks at hand.

Do what brings you joy, pleasure.

Nourishes you.

Touch.

To experience community.

Reliability.

Freedom.

Independence.

I can imagine that many of these bring up some kind of sensation in your body as you read through the list. So many we take for granted.

I have a sense you may be missing a few, maybe a lot of these. Feeling loss or grief.

I know I am.

It’s not gone unnoticed by me that many of these are already experienced by the people I see, those I help to support through my work. It is not uncommon for people who have lived with chronic pain, often for years, to feel this sense of isolation, the loss of freedoms, work, connection with others. Well, there is a lot.

This came up up front and center when the hardest hit in our communities were those living in senior or extended care centers. They were already living in such a manner. Already in it.

Many others living with health concerns, disability, low socioeconomic status, new immigrants to our country have this as a part of their ‘normal life’. Not COVID life.

I don’t have the answers but my hope is that we bring some awareness to these issues, some path forward for the long term. Not just now.

Everyone waiting for things to get back to normal. Talk today of vaccines and yes, one can hardly wait. There is so much on hold at the moment. Much fear, uncertainty. I can feel that. Sense that.

But might we also learn from and change in some way, what is often normal for many.

Think back to when this first began and the heightened state of everyone around you. I can surely remember what it felt like walking through the grocery store as everyone was scrambling for Lysol wipes and toilet tissuse. Nervous systems all on high alert, seeking some sense of security and groundedness.

Perhaps we can begin to imagine what that feels like for so many when these big life events or ‘transitions’ happen. Injury, illness, aging, loss, grief. Can we learn ways to help with that, to sit with that, bring some care and ease to the person in need.

We’re all going to be there at some point.

Something will happen. If not before, we will grow old. We will struggle. Lose independence. Freedom. Ability to do things.

Might we provide for, care for, those who are already ‘in it’.

Who Attends Yoga Classes for Chronic Pain? All kinds.

hearts croppedMost people I talk to wonder how yoga might help with their long-term, persistent or chronic pain. So, I thought I might tell you this week a little about who comes to these classes, what we do and why, or the outcomes experienced.

Let’s begin with who attends.

Most people in these classes (or private 1-to-1 sessions) have never done yoga before.

Classes tend to consist of people who don’t turn up in yoga studios, who probably never thought of doing yoga to help with their pain. After all, most of the marketing and imaging around yoga is out of reach for many people, let alone people who have difficulty or experience pain when they move.

Most, are around mid-life; perhaps 45 or older.

The oldest student who’s attended is 78. Most are about 50 – 65 years old. Once in a while someone younger will attend, perhaps in their 30’s. Currently, my youngest client is 13.

What are some of the conditions, or diagnoses they have?

The most common condition is people with persistent back pain and/or those with fibromyalgia. Most often, those with fibromyalgia have had it 20 to 30 years or more. Others have osteoarthritis, rheumatoid arthritis, sciatica, other musculoskeletal pain (hips, shoulders, feet, and neck seem to be the most common). Chronic pelvic pain, is another. Or those who are currently going through cancer treatment, or recovering from it.

What are some of the conditions or diagnoses that often accompany persistent pain?

Most often it’s either (or both) anxiety and depression.  Many suffer from irritable bowel syndrome (IBS), chronic fatigue, sleep issues (insomnia, sleep apnea, etc.), incontinence.

You can see there is such a wide variety and it’s not really ‘yoga’ people coming to these particular classes. Again, from what I know about most, they are people who have tried many other things that haven’t worked for them over the long term or are using yoga as complementary to or integrated with other aspects of their personal comprehensive pain management or treatment plan.

Up next on the blog, we’ll dig into what we do in these classes. I hope you’ll join me.

 

 

Yes, we are connected

skeletons

Though I’ve been focusing on the feet these last few weeks, if you’re having problems with your feet you may also want to make some other connections. Yes, similar to what we’ve been exploring there are things you can do physically that will help. But our feet are connected to our leg bones, our leg bones are connected to our hip joint. Our hips are connected to our spine and further it goes, up the whole body.

We tend to look where pain expresses itself… and think we will find the solution there.

Some people may have knee problems and look to ‘fix’ the knee when really what’s happening (or not happening) is at the hips or at the feet. Or elsewhere.

Imagine you have a cast on your ankle and how it might feel when you walk. How your body might compensate. You may end up with a sore back or shoulder muscles as you try to move as best you can with a stiff, unable to bend, ankle. We’re not usually walking around with a cast on, but many people don’t really use a lot of their ankle flexion for a whole host of reasons. Shoes, patterns of movement, previous injury, etc. Pain may be expressed in your back or shoulders when what’s really going on is down at your feet.

People will often say, “yes but I had an x-ray or ultrasound and they found this (insert condition here) is wrong with my feet”. Yes, I’ve been there too. Diagnosed with chronic plantar fasciitis in both feet, osteoarthritis in both big toes. Basically, I was told to wear rocker shoes, orthotics, and live with it.

Orthotics absolutely serve a purpose in many cases but I’m not sure of any other body part we are willing to cast or brace for a lifetime. We might need a collar brace, but not forever. We may need to wear a special boot to help with a foot injury or after surgery. The point is we work hard, physiotherapists and others work hard with us, to remove these external or artificial supports. Our feet and some orthotics, in my opinion, should be no different.

After my own diagnosis and subsequently learning that our body will most often adapt to what’s asked of it, I figured there must be another way. I have put some effort and focus on my feet in many of the ways shown last month but what was happening in my hips (lack of strength and stability) also played a part.

There are often many pieces to the puzzle of long-term, persistent or chronic pain.

For instance, why was it my feet didn’t always hurt? Why only sometimes? Some days?

Paying close attention I came to notice that when under stress, under too much ‘load’, my pain was likely to arise or increase.  If I was out enjoying myself, not a care in the world, doing something fun or even necessary perhaps, I didn’t seem to have pain. But at other times, it most definitely kicked in.

The biggest a-ha for me now is to realize that structural degeneration or tissue damage is likely to show up for me and everyone else at some point (Note: Brinjijki et al 2014 study as shown in the table below). Particularly by the time you’re my age (56). I need not ‘fear’ this, or fear making things worse, but rather utilize all the things I know I can do, that might help with the pain I sometimes experience in my feet.

  • Strengthening
  • Stretching
  • Keeping my feet soft, supple, agile
  • Adding load, good stress, to keep the bones healthy
  • Wearing appropriate footwear; allowing for space, mobility, flexibility
  • Keeping my overall ‘weight’ in a manageable range
  • Knowing that my levels of stress, fatigue, diet and a range of other factors may also play a part.

degenerative spine issues

In the month of November, we’ll explore our HIPS (Yes, I switched my focus this month from shoulders to hips. We’ll get to shoulders in December). This is where load and/or gravitational forces are primarily distributed through the body so how well we manage this, matters.

Along the way, I’ll throw in a few morsels about chronic pain that might help you make sense of your own personal experience with persistent pain in the hips, or elsewhere.

I hope you’ll join me.

 

The Evolution of a Practice

SimplifyWhen I used to write about yoga for a local magazine, the numbers of Americans practicing yoga was about 20 million. Today, about 6 years later, that number has nearly doubled, edging up towards to 40 million. Globally, the estimate is about 300 million and the number of over 50s practicing yoga has tripled over the last four years.

People often wonder what this thing called yoga actually is. Difficult to answer in just a sentence but to me YOGA is the exploration, awareness, and response that informs how I (might best) relate to the world inside myself and to the larger world around me.

A large part of this doesn’t involve the physical yoga postures or asana practice, but that’s usually where people begin. It is a good way into the wider exploration. Most, practice on a mat and typically in a group class. Certainly, it’s where I began.

Not knowing anything about yoga when starting out, I first practiced Ashtanga yoga and then when I began teaching it was a somewhat modified Vinyasa practice. Both involve strong, physical, almost gymnastic-like movements linked with the breath. Ashtanga, in particular, is meant to be practiced for 1.5hrs each day, 6 days of the week.

My practice today no longer resembles this in the least. Today, my physical yoga practice is interweaved throughout the day, with broader concepts in the background.

  • Most often it does not take place on my mat.
  • Most often it is less than 30 minutes at a time.
  • Most often it’s a response to whatever I feel might best serve me, at any given time.
  • No special place, clothing, or time.

Which I think might be a helpful way to practice for many who don’t have the time, money, or perhaps ability to get to a studio or gym.

What does this practice look like?

Join me over the next few months and we’ll look at little snippets of yoga, movement, breath practices that can be done in a couple of minutes or combined to make your own personal practice. On your own time, in your own space, that fits into whatever your life demands of you.

Most important to me is to teach people what they can do for themselves. Provide agency. The ability for you to have the tools and the freedom to make choices that enhance your wellbeing and your life.

  • In October we’ll focus on the feet.
  • November will be all about the shoulder joint.
  • In December, we’ll get into the hip joint.

I’ve chosen these particular areas to focus on as they tend to be where problems, pains, issues show up for most people I talk and work with.

You can find me talking about this on Facebook, and Instagram, if you want to follow along.