Move. Maybe slowly, softly, gently.

All of this noticing, listening in to your body, your feelings and thoughts might provide some direction or suggestions in terms of movement for the day.

We were built to move yet it seems through all our modern conveniences we don’t have to do a lot of it these days. Like who can recall even having to get up to physically change the channel on the TV? Seems so long ago.

We’re told, we all know, we’re supposed to exercise for good health. That word, exercise, seems to have a negative connotation to it for many. These days, I tend to think of movement instead of exercise and try to frame it as something I get to do. And even not so much what I do as long as I DO SOMETHING.

Yet, especially for people who live with pain, even thinking about moving can be daunting. Often it seems to be the thing that aggravates or brings on their pain. I often wonder if people say, “Yoga, for pain? You must be kidding.” I get that. Particularly in the way yoga is portrayed throughout the media.

Yet, you might begin to move slowly. Softly, gently. You might even just imagine movement to begin with. Consider finding that felt sense of safety I spoke of here. If you can begin from your place of safety, it might just change things up for you.

Listening in to what you notice in your body can be a helpful guide. Today, you might feel unwell, fatigued or overwhelmed so choose do less in terms of movement. Or in ways that feel really easeful. If you happen to feel energized, or perhaps are feeling some anxiety it might feel good to move a lot! The important part is noticing the difference and and learning to respond in a way that best suits your needs.

In our culture, there is often just this push to do more. Not to rest. Conversely, that people aren’t trying hard enough. I wonder if we might just listen in and (re)learn what might be useful to each individual in any given moment, rather than what is often the expectations and judgements placed upon them.

What might serve you best in this moment? On this day?

Warming up

Warm thoughts

As you lay in bed, you might imagine your first cup of coffee or tea. You might prefer warm water with lemon, fresh ginger, a touch of honey. Perhaps a spicy chai. The ritual of running water, filling the kettle, getting out your favorite cup, warming it first with some hot water. Waiting for it to brew. The smell. The first taste. How it warms your hands, your body as it makes its way, particularly on these cold days.

When you go to actually make it in a few minutes, maybe notice more fully and appreciate this very simple way to begin your day. What pleasure it brings. What you notice in your body. Perhaps a feeling of warmth, or of a softening somewhere.

Maybe before climbing out of bed you imagine something else. Taking a few moments to think about a loved one, warms you. Maybe you imagine sitting by the fire with friends. Perhaps you place hand on heart and offer yourself a few minutes of love, compassion… and that warms you.

Warm waters

What about including warmth in the morning in the way of a hot bath, or shower. Really sensing how it feels. The wakening spray of water landing upon you or warm waters, surrounding you. Maybe you notice the sounds. See the steam rising. Feel the water’s cleansing, soft, fluid properties. This warm and tender waking of your body and your senses.

Warm foods

Perhaps, warm foods. Many people these days are into green smoothies and such. I enjoy a light breakfast of crisp greens, bright ripe tomatoes and a boiled egg in the summer. But as we move into the cooler months it might be useful to bring some warmth to food. Just being cooked makes food easier to digest on these slow, sluggish days. Maybe hot oatmeal, toast, biscuits, whatever you prefer. Waffles with the sweetness of local maple syrup, or baked fruit like plums or apples, spiced up as you like.

Fiery, perhaps

Or perhaps your thoughts on any particular morning lean towards the injustices of the world around you and you feel this fiery, hot, anger welling up inside. And that’s what warms you up, gets you moving forward in your day. Who knows?

I get that it’s not always sunshine and rainbows, hot tea, warm baths, clean water that we are privileged to enjoy.

Yet, finding these small moments of warmth, calm, building some resilience to greet the day and whatever that means for you, might be useful.

Or maybe it’s just in the noticing what fuels you, that counts.

Ease, into morning

Hard to imagine what it felt like so long ago… sitting through a long-haul flight, train ride or long drive to go visit far off friends, in far off places. I’m sure so many, miss it a lot. Yet at the same time the trip itself may have been uncomfortable. Feeling constrained. Unbearable at times. You might get a sense of a similar feeling sitting through endless zoom meetings, or just cooped-up wherever you find yourself most of the day.

You might feel stiff. Sore. Boxed in. If you’re a little older like me, it may take more time or effort to get moving easefully after a long bout of inactivity.  

The same might be said when waking from sleep in the morning. Unless you happen to be a big mover while you sleep, I wonder if you’re rather stationary for the most part? If so, what might be a nourishing way to move your body before getting out of bed?

How might you make the transition from laying in bed to being upright in gravity, a little more easeful?

Come along for this short movement practice. Some of which you may like, some of which you may not. But it might inspire you to move just a little…  making the transition from stillness to mobility, ready to begin the day.

I DON’T DO ALL THESE THINGS.

Yet, as a minimum, I do a few movements with my feet. They are where I tend to hold tension so I like to give them some time, space and gentle movement before I step into the day. It seems to be a good thing.  

What might you notice, what might feel Just Right, For You?

#morningpractice #mornings #move #gentlemovement #wrists #hands #arms #legs #feet, #ankles #time #space #goslow #startsmall #JRFU #JustRightForYou #yogatherapy #yogatoolsforlife

To Breathe

Can you bring your attention to your breath? What do you notice?

Immediately following these two questions, your breath is likely to change somewhat. Just bringing your attention to it, is enough to alter it a little.

Walk into most yoga classes and there are often very specific instructions given as to how to breathe. I’ve done this as well when teaching. I still do from time to time, so I’m not saying to never do so. Yet, we might consider when and why it might be useful and appropriate.

Might we begin by just noticing it?

Leave it be.

Allow your breath to respond… rather than consider it is another thing to be fixed. Or regulated, standardized, conformed to. Imposed upon. Being asked to disregard your own natural need or rhythm, during a given experience or situation.

If you’d like to follow along, here’s a 4-min recording you might use to explore your breath early one morning. Or maybe another time during the day. There’s no right or wrong here. Rather, an opportunity to tune in to what might be a place of noticing what we feel, what ‘state of being’ we’re in, what we are experiencing. (Click the link below. You may be directed to another link, or not, depending on where/how you’re viewing it.)

With consistent practice of this checking in with your breath, your body, you might find a pattern. Maybe a baseline of some kind. This might be easier in the morning before you’ve moved or thought too much about the day ahead. But it may be at another time that works well for you.

What does your breath feel like? And then later in the day, notice when it changes. And it surely will from time to time.

Be curious. Check it out. See what you notice. I’d love to hear how it goes for you.

#morningpractice #mornings #breath #breathe #needs #baseline #kindness #compassion #curiosity #feelintoit #feeling #noticing #awareness #time #space #slowdown #yogatherapy #yogatoolsforlife #JRFU #JustRightForYou #startsmall #goslow

Here I am, again

As you wake in the morning, before anything else, can you notice your first thoughts? Before you look at your phone, even open your eyes. Notice what it is, you’re thinking about.

And consider that. How do these initial thoughts begin or influence your day?

Maybe you can catch a glimpse, almost before you’re even fully conscious. Or maybe you won’t notice anything at all and that’s okay too. But you might want to practice this a little.

For some, with a little practice and curiosity you might find a creative spark or some new insight within these early morning thoughts.

Perhaps, to start, you might just notice that… here you are.

“Here I am, again.”

It is morning. I am awake. This is a new day.

Allow yourself a few moments. Some time and space to just be… with whatever, before the rush of the day draws you forward and up.

That might be enough.

You’ve received another day in the world. And that might be something to notice.

#morningpractice #mornings #notice #awake #alive #noticing #thoughts #gratitude #creativity #creativetime #dreamstate #yogatherapy #yogatoolsforlife

Reaching Out

Whew.

Maybe like me, you feel like the last little while has been really hard. This coming back to further restrictions, schools opening up again, the looming winter ahead (where I live) and just the overall increased stress and uncertainty about a whole lot of things, that are likely different for each of us.

I haven’t had much energy for anything other than basic day-to-day stuff and getting outside, which is now a ‘must do’ in my day. Not much else in terms of creating content, writing, connecting with many people outside my teeny tiny circle.

Perhaps this morning it is the cold air, light snow falling and heavy winds that blew in last night that are providing a push to get moving again.  Rather than feeling quiet and contained, I feel a little more prepared to reach out, like these trees. Partially uncovered and extending.

Back in the spring I ran my first online program called Just Right, For You. Part of it was bringing awareness to the many things we do in a day. What nourishes us. What depletes us. What might be needed at any given time, on any particular day and responding to that in some way. Looking at the patterns and habits we have formed over a lifetime and noticing if they serve us well, or maybe changing them up a little might be useful.

What I’d like to do this month, each day, is offer some of the tools and practices explored in the program to consider. Try them out. See if they ring true for you, or not. Definitely not to do ‘all the things’ but rather just a few. Start small. Go slow.

What feels right for me, might not at all feel what’s Just Right, For You.

Which is often why providing someone ‘a simple fix‘ for overall wellbeing, pain, sleep issues, maybe just navigating this wild, world of ours doesn’t seem to work. I have found in working with people, and for myself personally, that what might be right and true is very individual. Personal. My life is probably nothing like your life. What’s that new covid-related saying? “We are in the same storm, but not in the same boat.”

So, follow along if you’re interested. I’ll be posting on Instagram, Facebook and Twitter using the hashtag #JRFU, #JustRightForYou, #dailypractice, #startsmall, #goslow. My hope is these practices will be of benefit to you in some way and that we can remain connected. We’ll begin tomorrow.

What outcome, or benefit might you expect from attending Pain Care Yoga classes?

don't lose hope picWell, much like anything, it depends. The answer is rarely straightforward and definitive.

As mentioned in the last post everyone comes in with their own experience of pain,  history,  individual, unique life circumstances. What might be helpful for one, will not likely be the same for another.

Below are a few comments made during a recent class, which illustrates this difference, for each person.

“I slept so much better all last week.”

“I’m not really using my cane anymore. My leg feels stronger, and I have no pain.”

“My back went out last week for a couple of days. I was flat on my back, so I used one of the (breath-awareness-distraction) practices and it really helped me get through it.”

And your back now? – Me

“It’s fine, now.”

“I’m so surprised. Normally I cannot walk around without my shoes on.”

Did you feel pain, while we were doing this (walking exploration, practice)? – Me

“No, I had no pain at all.”

I can’t say what will happen for you, or for another. Most often though, people will begin to experience feelings of calm, safety, less or no pain during class. And, some will begin to transition those responses and feelings into their daily lives.

Like most things in life, what we do, what we practice, we get better at. I would say the same, in this case. If you only practice during our class, for an hour a week, you may not see as much progress, notice as much difference. However, if you do a little, each day, I bet your experience will be similar to these others.

What I highlight to people, from both their comments and experiences is that something changed. To get curious about that, and realize they created the change.

It wasn’t something done to them.

From there, they begin to feel some hope. Perhaps a little empowered and more able to start exploring and learn to self-manage or resolve their persistent pain.

If you’re interested in how this might work for you, the next 6-week series of Pain Care Yoga classes begin at the end of February. I’m also available for one-to-one in-person or ‘zoom’ online sessions and would love to hear from you.

 

What do you do, in yoga classes for people living with chronic pain?

one thingThe second question people often ask me about Pain Care Yoga classes, after “who is it that comes to these classes” described here, is “what do you do in them”?

Pain is never just about one thing. You want to know what’s wrong. How you’re going to fix it. And how long it’s going to take. And rightly so, as having long-term pain often changes everything for you and how you live your life.

When it comes to pain, however, it is usually not that simple which is why searching for ‘the thing‘ usually doesn’t work in the long-term. Particularly if you’ve had pain for a long time. Which doesn’t mean to say that it can’t change. It can. We know what can help to bring about change, the best practices research points to.

Two key aspects, education … and movement, are important. So that’s what we do in these classes.

EDUCATION

Some kind of education piece, usually at the start of the class, is provided. I only spend a few minutes on this, but it’s important to do so. One of the most common things I see with people in pain is the fear of moving. If I can help you to understand why it might be safe to move and why it’s important to do so, that’s a good place to begin.

“Current evidence supports the use of pain neuroscience education (PNE) for chronic musculoskeletal (MSK) disorders in reducing pain and improving patient knowledge of pain, improving function and lowering disability, reducing psychosocial factors, enhancing movement, and minimizing healthcare utilization.” [1]

PRACTICE

Then, you practice. You get to experience how you might move, with guidance and guidelines, to learn what’s right for you. Which often won’t be the same as others in the room.

Movement

This is not a typical yoga class with sun salutations, downward dogs, lunges, forward folds, backbends. It is not even what I would call a ‘gentle yoga class’. Yes, we use slow, gentle movements. Yet, sometimes you might begin by just imagining the movement if you don’t yet feel safe to do it. Or you might practice it in your mind, plan out how you might go about it and if it feels right for you. It is always your choice to do or not do anything presented in class. You always get to decide how to move, how far to move, by using a slow, mindful exploration along with guidelines and principles utilized.

Most movements are fairly simple and modifications are always available. You’ll experience a lot of repetition, and rhythmic movements. Movements that cross the midline of the body. Movements that challenge your brain as well as challenging your body.  You, anyone, can really begin wherever you’re at. With what’s right for you.

Breath

There will always be some kind of breathwork or a breath awareness piece in the practice. Again, it’s not so much about controlling the breath, rather what you might notice about your breath. How breath can be an indicator of your physical and emotional state at any given time. Also, learning how breath can help to bring about change to your nervous system, physiology, which can then change your experience of pain.

Awareness

Like breath, awareness is key. So often when you are in pain the last thing you want to do is pay more attention to your body. But in fact, this paying attention is your guide to changing pain. It is in this noticing that you can begin to explore what the signals (or sensations) you feel might be indicating, what might be your unique contributors to pain, what might be the reasons for flare-ups. This practice is not only about noticing your body in class but then also paying attention to your whole self in your environment, in the larger world you live in.

Relaxation

There are many reasons, purposes and benefits to practice relaxation techniques. In most yoga classes this is done at the end of class. Though we’ll also do some kind of formal relaxation practice at the end, relaxation or creating a state of calm is facilitated right from the start.

It is when you are in a place of safety, when you are calm and relaxed, that change is likely to occur. It is this place of calm (a parasympathetic state) when you might first experience a change in your pain. Without this, it’s no different than trying to stretch, exercise, push through and strengthen your pain away, which seems not to work out so well.

If you’re interested in learning more, have any questions or would like to sign up for the next series of classes starting at the end of February, please get in touch here. I’d love for you to experience, how you might learn to change your pain.  Or, if you prefer a one-to-one session, information can be found here.

[1] Adriaan Louw, Kory Zimney, Emilio J. Puentedura & Ina Diener (2016) The efficacy of pain neuroscience education on musculoskeletal pain: A systematic review of the literature, Physiotherapy Theory and Practice, 32:5, 332-355, DOI: 10.1080/09593985.2016.1194646

 

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.

 

 

Let’s Get You Moving Again

Back facts

The Editorial in the British Journal of Medicine (BJM), begins

“Low back pain (LBP) is the leading cause of disability worldwide, and is often associated with costly, ineffective and sometimes harmful care.[1]

I’ve written about this before, here.

What drives disability and poor care?[2]

Unhelpful beliefs about LBP are associated with greater levels of pain, disability, work absenteeism, medication use and healthcare seeking. Unhelpful beliefs are common in people with and without LBP, and can be reinforced by the media, industry groups and well-meaning clinicians.”

The purpose of the editorial (made free due to popular demand, read it here) and the infographic is to “identify 10 common unhelpful beliefs about LBP and outline how they may influence behavioral and psychological responses with pain”.

The authors are also “calling on clinicians to incorporate these into their interactions with patients.”

This is so important. It’s why I always include a touch of education and information as part of my Pain Care Yoga classes. When people are in pain, it’s difficult to understand why it might be safe to move, how important it is to move and how movement “doesn’t mean you are doing harm – FACT #5”.

I hope these FACTS will bring some curiosity to your beliefs. I hope you might consider what you believe and how they might influence your experience of pain, either positively or negatively.

Sometimes, however, information is not enough. I, we, can give you all the ‘FACTS’ but often until you experience that you CAN move without pain it’s difficult to change beliefs.

As called for in the editorial, I am personally committed to bringing evidence-informed information and education to the people I work with and hope to provide a new experience to get you moving again, with confidence.

  1. Foster NE, Anema JR, Cherkin D, et al. Prevention and treatment of low back pain: evidence, challenges, and promising directions. The Lancet 2018;391:2368-83.
  2. Buchbinder R, van Tulder M, Oberg B, et al. Low back pain: a call for action. The Lancet 2018;391:2384-8.