Well, 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.
What if you could learn how to move safely? To live your life again, with more ease.
What if you could learn how to tune into your body’s signals in a way that can best guide you?
Pain is definitely complex and there can be a whole range of contributors to your individual experience of pain. It’s usually not just one thing which is why looking for the ‘thing’ to fix the pain doesn’t usually work. Particularly over the long term.
What if you had a safe place to practice what yoga offers?
gentle movement practice
meditation or mindfulness practices
What if you had a community of others to be with who face similar concerns, uncertainty and questions, while you explore this?
What if you could learn that you are capable of changing or modulating your pain.
What if you could learn a little more to understand pain, what might be contributors, and what might best help to change your experience of pain?
What if you could learn how to work with your breath to help modulate your pain?
What if you could learn to notice stress and muscle tension which may contribute to your pain? Often, these lay just under your current level of awareness.
What if you could learn ways that might help you to sleep, as we do know sleep is often a factor in the experience of pain.
What if you could learn more about your nervous system and your brain and how adaptable these are? What part they play and how this means your pain is adaptable as well.
If any of this is of interest, resonates with you or you’re curious to find out more there is still time to register for the next series of Pain Care Yoga Classes. You can find more information here, or feel free to send a question here or by emailing me at email@example.com
** Tuesdays and Thursday mornings in Stittsville, starting November 5th.
Similar to the current biopsychosocial model used in the medical community when working with people suffering from chronic or persistent pain, yoga therapists utilize a comparable framework or philosophy, that being the panca maya kosha model.
The felted model above (by my colleague @meyogalune) beautifully illustrates how we might look at, explore and peel back the many layers of our existence when working with someone therapeutically. We are, after all, more than a body of tissue and matter.
What does this mean, exactly?
Let me provide a very general, simplistic idea of what each represents:
Annamaya kosha. You can think of this generally, as the physical layer.
Pranamaya kosha, or the energetic layer.
Manomaya kosha, or the mental/emotional layer.
Vijnanamaya kosha, or the mind. We might also refer to this as intellect or wisdom.
Anandamaya kosha, or the spiritual, blissful layer. What I prefer to call the meaning and purpose of someone’s self, or life.
What happens sometimes in our current medical system is the person is looked at, evaluated by and treated in terms of the physical layer only or from a biomedical model, rather than a biopsychosocial model. This can be due to a multitude of reasons but I’ll highlight just a couple, below.
One, that may be surprising to you, is how many of our medical professionals are provided little training, specifically, in pain. (1) “In a review of 10 Canadian Universities across 7 provinces… 68% of programs were unable to specify any designated hours for pain educationand veterinary students were shown to receive 2-5 times more pain education than that of health science students (Watt-Watson et.al., 2009). Educational content also typically lacks integration of biological aspects with the psychosocial factors that contribute to the experience of pain (Wideman et. al., 2019b).”
Another reason might also be lack of time that’s allocated to people given our over-burdened system and/or accessibility into “self-management programs that educate people about their condition and build their capacity to take action.” (2)
What is now understood about pain and as stated in the IASP definition, pain is “An unpleasant sensory and emotional experience associated with actual or potential tissue damage, or described in terms of such damage. ” You might think of it as an ‘actual, or potential threat to the system’, that system or organism, being YOU. Your whole person.
And often these threats to the system are just under your level of awareness. Or as David Butler says “DIMs and SIMs can hide in hard to find places”. Referencing DIMs as being the Danger in Me, while SIMs as being the Safety in Me. (If you want a brief explanation of this concept, here’s a link.)
We will experience pain when our credible evidence of danger related to our body is greater than our credible evidence of safety related to our body. Equally we won’t have pain when our credible evidence of safety is greater than our credible evidence of danger (Moseley and Butler 2015, pp14).
People sometimes think that their pain problem is, or must be, something physical. Or, sadly, they think or are told, that its all in their head. Pain is complex and by bringing a sense of curiosity to explore many areas, layers or koshas and how they might be affecting you either positively (perhaps a SIM) or negatively (maybe a DIM) we might just change this human experience, we call pain. Your experience of pain.
If you’re interested in exploring this further, I offer both private sessions or group classes utilizing this approach. Along with awareness, exploratory and gentle movement practices, I always add in an educational aspect or some yoga philosophy in line with what we know about pain and how you can learn to be your own best resource. Click here, to see my current schedule.
References above are from ‘A Report by the Canadian Pain Task Force, June 2019’. You can read the full report here, if interested.
(1) “…the current state of pain education in Canada remains inadequate across disciplines, with significant knowledge gaps in both pre- and post-licensure contexts (NASME, 2019; Thompson et. al., 2018).” On page 21 of the report.
(2) “Research in 2005-2006 indicated the median wait time for a first appointment at a MPTC was 6 months….. In a recent update to this work, researchers found little change in the wait times, noting in 2017-2018 the median wait time still hovered around 5.5 months, with some people waiting up to 4 years to access to multidisciplinary pain care (Choinière et. al., 2019).” On page 18 of the report.
When people want help with a problem (like pain) they most
often want to know
How to fix it
How long it will take
My last few Instagram posts were shoulder movements that you
might have found helpful. So, if you came to me asking for help in regards to
shoulder or perhaps neck pain, would I choose to have you do them as thething for you?
Maybe. Maybe not. It
You see, the thing for you is likely not to be the thing that helped me or someone else for that matter.
Which is why looking to find the thing or the fix for chronic pain often leads to frustration. Or further
along the line, a sense of hopelessness.
There are variables between you and I not only in our
physical structure, but also other areas that affect what we might feel or
experience in any moment, on any given day. Particularly when it comes to pain.
And most often, it’s usually not just one thing.
Over the last couple of months, I offered up some movements specific to feet, hips and shoulders that you might have found useful. Whether you’re seeking greater mobility, ease, gaining more awareness or perhaps you’re trying to overcome some issues with regards to chronic or persistent pain that you experience. It can take some time to make progress, or it can actually be rather quick in learning what does, or does not provide relief for you or at least the ability to move with more ease.
I find it most hopeful to know there many things we can try along the way.
And no, it’s not just cherry-picking, or somehow blindly choosing, either. What’s been learned over the years in regards to pain is quite different from our understanding of the past in terms of causation and most important, what might be effective treatments.
It’s now understood that long-term pain is poorly correlated to tissue health and science shows us that it is both complex and often has a multitude of factors. We do feel pain IN our body. However, it is often a nervous system issue… which often increases our sensitivity to pain. We can affect our nervous system. We can affect change. We can affect our physiology. Which is what makes this a hopeful message.
For the most part, any movement you add into your day and into your life will be of benefit. What’s key while moving is for you to build awareness of what works and what doesn’t for you. What feels right and what doesn’t, for you.
If you learn to pay attention to even the most subtle of sensations, you’ll begin to notice and learn all kinds of things about your body and your self which will lead to the other things, that often play a part in your unique experience of pain.
So it’s not just one thing. Or the thing. Or your thing. Or my thing.
What are the other things, that might be contributing to your experience of pain? More to come…
When 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.
Summer has officially begun and soon many will be on their long-anticipated holidays. Most likely, it will involve some travel. And at some point the dreaded ‘are we there yet?’ You might think it to yourself or maybe your little travel companions repeat the phrase. On the hour. Time seems to drag. on. forever.
Why is it we dread the getting to, and coming back from, our trips?
Sure there can be unexpected delays or surprises that inevitably happen. But typically it’s the thought of sitting in our vehicle driving for 4, 8, or 12 hours to our destination. Or being crammed into the airplane for hours on end. Uncomfortable, to be sure. Not only being seated for so long but also waiting to eat on someone else’s schedule or getting to the bathroom when the need arises.
Most of us sit, for hours, all day long. Why then, does it feel different or more noticeable when we’re traveling? In an airplane, it’s not so easy to move around, to shift in our seats, when discomfort arises. In our cars, perhaps it’s a little easier with more room and not so many eyes watching us.
On most any day, we tend to listen to the hunger and thirst signals our body sends us, while other ‘discomforts’ such as simply moving, tend to be ignored. Why do we respond to some and not to others?
I’ve written about this before, here. But I think it’s important to talk about again.
People associate yoga with flexibility.
I do associate the word flexibility with yoga, but it’s in how we apply flexibility to our life.
That is, we have lots of choices available to us.
People often get stuck and then their choices become smaller, and smaller, and smaller… until they feel something a little like this; boxed in.
What I’m really looking for is this:
Do you have freedom, to do what you want in your life?
Do you have the freedom to BE you?
Skills that may aid in this might be strength. Physical strength if you want to move around in the world. Be able to go jogging, walking, cycling. Even to simply pick up and play with your kids/grandkids.
Maybe you are an office worker or writer and need to sit a lot of the day. What skills might be useful to do that?
A skill may be the ability to voice your opinions at work?
Or the skills required to get a good night’s sleep, so you have the energy for the coming day.
A useful skill may be noticing what creates tension in your body.
Try sitting in a dentist chair for any length of time and notice how you feel? A sore jaw, perhaps, makes sense. But what might your shoulders feel like? Or your leg muscles? Imagine doing this, unknowingly creating tension throughout the day, and what it might create? Pain, fatigue, stiff or sore muscles.
Yoga, is all about the noticing.
Which helps guide our life, …
out of the box, and toward spaciousness and freedom.
Most of the time I’m not sure where I’m at with my practice.
(I tend to substitute ‘my practice’ at any given time with ‘my life’, to get to the bigger picture).
Am I doing enough?
What should I be working on?
Is there enough time in the day?
What comes first?
What’s most important?
I used to get, oh, so bogged down in the details. I would be stuck because there were so many areas I needed to work on, I didn’t know where to start.
What I’ve learned over the past 3-4 years in looking at the research, the evidence about movement, manual therapy, yoga, etc. it’s become clear to me it’s not so much what I choose to do
… but that I choose to DO something.
Today I will go for a skate. Hopefully, I will remember to do a few useful stretches / movements before I begin. I know that doing these will be of benefit to me. Particularly in the cold weather and, well, because I’m getting older.
When I feel the muscles in my back, shoulders, and face tighten from the cold I will try to remember to release some of the tension there. Soften.
I will try to remember that LESS is MORE.
I’ve only been skating once this year, so it probably doesn’t make sense for me to skate the WHOLE canal.
Listen to the whispers that tell me when I’m feeling fatigued.
It is enough.
Sit back down. Unlace my skates. Grab some hot chocolate and call it a day, … well done.
Consider the ways you need to use and move your body every day.
Depending on your life, how much you move throughout the day may be fairly limited or alternatively, you might go through a whole range of movements.
Do you work in an office? Sitting, walking, reaching, writing might be some of the things you do in a day. I suspect sitting, is a primary one. Do you work as a plumber? Your movement needs are different than the office worker. As are what a doctor, teacher, hairstylist, service worker, etc. will be, who are often on their feet much of the day.
What you need to ‘train for’ is different than what anyone else needs to ‘train for’.
What a person needs who sits at a desk all day, is different than what a parent with toddlers needs, versus what a teacher might need.
We sometimes get into trouble when we’re doing exercises, that don’t always or altogether correlate so well to what’s actually required in our life. If you’re exercising for basic fitness and enjoyment, that’s fantastic. That in itself is an achievement. But perhaps you might consider adding more to the mix if you’re someone who also experiences pain, fatigue, etc.
This is important:
If you’re hitting the gym every day, building strength and stamina but suffer from low back pain because you’re also sitting in a chair for 8 hours a day, perhaps you need to train differently or add something to your training routine.
If you are the most amazing yogi but suffer from hip strain or other pain symptoms because during the rest of the day you’re standing on your feet, perhaps you need to look at what you’re training for.
If you’re out on the golf course getting your exercise and fresh air daily, but cannot ‘do, or manage’ the rest of your life, perhaps you need to do something else as well.
What happens all too often is the hour of exercise we get at the gym, yoga studio or out on the golf course doesn’t quite support all the rest of what we need to do in our day.
If you need to sit, train as best you can so your body can adapt for this.
If you need to stand, train what’s required in order to stand a lot.
If you are the golfer, train for whatever it is you need to do, besides golf.
But how can you do this and where to find the time?
It’s not always easy, but you can learn to build it into your day. It doesn’t always have to take another hour going to the gym, paying for a babysitter, driving through the snow. There are simple tools, you can use. Anywhere, really. That don’t take up a lot of time.