Dentists, long journeys, work, life. The pause.

sculpture – National Gallery of Canada

A half hour in a dentist chair or a 6 hour drive. Both feel about the same to me.

Why might that be?

Though dentist chairs these days are made to be pretty comfortable, the tension, breath holding that goes on there, remains. At least for me, it does.

A 6 hour drive? Well, though probably not tense I sure can’t move around very much. And for someone with really long legs the cramped space and low seat really does me in.

Now imagine you’re at work, sitting with your laptop in front of you, working on a project that has you so engaged you don’t notice how 4 hours has passed. Or maybe 6 hours. Since you … literally … moved. When you do finally move or stand up your back, neck and shoulders are complaining. A whole lot. You might say to yourself, “ach, this back. Acting up again. When will this pain go away? Probably never. It’s always there, always going to get worse as the years go by.”

Or a similar scenario, but maybe your supervisor is breathing down your back. “Get me those numbers! Why aren’t you finished already? You know how important this is… why is it taking you so long?” I can well imagine those back, neck, shoulder muscles are having a say in how you’re feeling throughout your day, as well.

You might even find it hard to breathe at times. Do you even notice that happening?

What stresses might you have in a day? Why do we call it stress, anyways? Might it be this ‘stresses’ your body, as well as your mind?

What are those little niggly things creating sensations in your body that you’re not really aware of? Not listening to. Paying attention to.

Maybe it’s not the tension, tightness, pucker, hold-your-breath, kind of stress.

It might be more subtle. The slight contraction of your jaw muscles. Shoulders lifting ever so slightly as the minutes are tick, tick, tick, moving along. The gripping of your toes, or perhaps your butt muscles.

What consequences might these create in your body over long – periods – of – time?

This is not to say that all stress is bad. We need to stress the body. That’s why people hit the gym, run for miles on end, love – love – love a sweaty yoga class. Stress can be a good thing. Create a good feeling.

What we don’t want however, is the long – slow – drip by drip – neverending – periods – of – stress.

I bet you notice the BIG periods of stress in your life. Maybe what’s happening right now, for instance. The little, or more subtle ones? Likely not so much.

And if we begin to notice, what might we do to move out of this stress state? Do we have the flexibility, variability to do so?

Pause.

Notice.

Respond.

Repeat. Over and over.

Can we shift, from one state to another? Might we even begin to notice our ‘state of being’?

Difficult. Maybe if we slow down, find some stillness, time or space. Find that pause.

New! Begins May 4th…

A 4-week Workshop to notice what’s ‘Just Right, For You’.

It might feel good to move it!

Anxiety. Worry. Stress. Fear.

These are uncertain times and so many are feeling vulnerable, whether it’s about health, financial security or so many other concerns.

And yes, there are times when it’s helpful to quiet the mind, tame the thoughts, seek some silence, stillness and perhaps peace in all the chaos.

However, that isn’t always helpful. Doesn’t always work.

I know myself when I am stressed what helps me most is to move. Yes, I start cleaning my house when wound up, upset, feeling anxious, or stressed. There is something about burning off energy that might help to bring some space for quiet, relaxation, peace when you’re done. It might help you sleep. Maybe calm your nervous system. After all, when we are in crisis or feel threatened the nervous system is all about getting your attention, mobilization, preparing for action that might be required.

What might be helpful for you? Below are a few ideas, you might like to try:

  • Put on some loud, upbeat music and move in some way.
  • Dance.
  • Clean. Get at those windows and at the same time get some fresh air when you’re opening them or stepping outside.
  • Practice yoga, tai chi, whatever floats your boat.
  • Lift some weights.
  • Get on that ‘dust collector’ piece of exercise equipment sitting in your house and expend some of that nervous energy.
  • If you’ve got a few extra pantry items that you seemingly stocked up with, bake.
  • Cook.

Let me know how it goes. I know after working at my desk today, I am feeling the need to get up and move it!

Take good care of yourself (and others).

**If you’re feeling distressed, please be sure to reach out to a local resource. For those in Ottawa, call the Ottawa Distress Line

613-238-3311

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

 

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.

 

Taming the Beast, that is pain

Professor Lorimer Moseley explains how pain scientists are making amazing discoveries that can help you understand your pain, the first step in taming the beast.

As you’ll see, pain always involves the nervous system and how your nervous system can be retrained.

  • “How do you know if your pain system is being overprotective?”
  • “How do you retrain your pain system to be less protective?”
  • “How do you know if you’re safe to move?”

Learning a little about pain neuroscience education can be helpful. [1]

What complements this is not only learning but experiencing how YOU can change or modulate your nervous system.

Use the tools yoga has to offer; gentle movement, breath and awareness practices… to soothe and calm the system. To ‘Tame the Beast’.

You can find more information and resources at TameTheBeast.org.

[1] Louw, Adriaan & Zimney, Kory & Puentedura, Emilio & Diener, Ina. (2016). The efficacy of pain neuroscience education on musculoskeletal pain: A systematic review of the literature. Physiotherapy Theory and Practice. 32. 1-24. 10.1080/09593985.2016.1194646.

I have chronic pain & you want me to do Yoga? Yes, the two can go together. Learn how.

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
  • breath practices
  • meditation or mindfulness practices
  • awareness 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 info@yogatoolsforlife.com

** Tuesdays and Thursday mornings in Stittsville, starting November 5th.

Yoga and Science in Pain Care

How might we blend yoga with science to provide pain care to people? A new book just released provides a way forward.

“Our vision is for this book to improve care for people living in pain, whether acute or chronic pain. We believe health care professionals and yoga therapists can enhance care through deeper understanding of pain, science and evidence-informed interventions. We also believe that professionals can enhance their work through integrating yoga concepts, practices and philosophies. As such, this book is meant to bridge yoga, pain science and evidence-informed rehabilitation … and will inform those committed to helping people with this largely undertreated issue that causes so much suffering in the world.” –  Preface, Yoga and Science in Pain Care; Edited by Neil Pearson, Shelly Prosko, Marlysa Sullivan

The first chapter by Joletta Belton is about the “Lived Experience of Pain” highlighting to me the need to listen to, acknowledge and consider first, the person and their experience.

“The authors provide an integrated, in-depth understanding of how yoga therapy can be incorporated within a modern understanding of pain as an experience. The book encompasses perspectives from people living with pain, summarises research progress in the field, debates theories of pain and pain management, considers the many different yoga practices, describes pain biology, self-regulation and examines breath, body awareness, nutrition, emotions and response to pain, and above all, integrates concern for practitioners and people in pain as humans sharing an intangible experience together. The authors write about how yoga therapy can provide a uniting and compassionate approach to helping people learn to live well.”

– Bronwyn Lennox Thompson, PhD, MSc, DipOT, Postgraduate Academic Programme Leader, Pain and Pain Management, Orthopaedic Surgery and Musculoskeletal Medicine, University of Otago, Christchurch, NZ

There are a lot of yoga books on shelves these days. Yoga for this, yoga for that. You name it; it’s being written about. The trouble with this and certainly when talking about pain is the approach is about the condition, the problem, the illness or disease. What’s often left out is the person. Which may be one of the reasons why we fail in helping people.

After all, your pain is not the same as my pain. Not only is the physical aspect different, my body different, my genetics, my structure. Almost more important is the rest of ‘me’ that’s different from ‘you’.

My life history is different from yours. My environment is different from yours. My stressors are probably not your stressors. My understanding of pain probably differs from yours. My expectations, beliefs and thoughts about my pain will be different from yours. My social structures, friends, family, work-life will all be different. So how might we believe we can just apply this ‘fix’ to everyone who experiences pain? It just doesn’t make sense, when you think about it. Particularly when we understand that pain… is… complex.

We, therefore, should look to explore and be curious about all the things that might be contributing to your particular experience of pain. Similarly, individualize the care, tools, techniques and practices with what research tells us might be useful, to change your pain.

You may have had pain for years. Like 30+ years or more. Still, there is an opportunity for change based on what we know about pain and how it works. There is much still to learn but we can change the nervous system, We can change the brain. We can change physiology and most likely all three of these have been changed if your pain has been ongoing.

Pain can change. There is hope. I will keep saying this over and over and over again …

If you’re the type that likes read and learn about this yourself, order a copy of the book, here.

If you’re the type that would like to learn from me in person or in a class setting with others, check out my updated schedule for the fall, here. New classes starting in September!

Additional notes:

Joletta Belton, as noted above, writes a blog “My Cuppa Joe” about the lived experience of pain. Among other things, she is a speaker, educator and advocate for people in pain. You can read her blog, here.

Bronwyn Lennox Thompson also writes a blog “Healthskills: For health professionals supporting chronic pain self management.” An exceptional resource for information, research, and discussion. You can check it out here.

Tell me already – what is the thing?

When people want help with a problem (like pain) they most often want to know

  1. What’s wrong
  2. How to fix it
  3. 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 the thing for you?

Maybe. Maybe not. It depends.

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…

“Are we there yet?”

squishedSummer 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?

Which discomforts do we choose to tolerate? 

Little kids fidget, move, express themselves all the time. Until they’re told not to.

How might it feel …

to move and shift, and stretch and dance as you like, when you like? As you feel the need or desire to do so? At any time. Any place. Before, the discomfort pretty much commands that you do so?

When you are uncomfortable, how do you respond? Do you respond?

Hmmmmmm……