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?
Why should all of this matter to you? Why do you need to pay attention?
The median 1-year period prevalence globally in the adult population is around 37%, so chances are you or someone you know is affected.
And, what’s even more important, is
the way we have been treating people isn’t working.
“Low back pain (LBP) is now the number one cause of disability globally.”
There are a LOT of people who experience chronic or persistent low back pain. On a purely personal note, I would say it is the most prevalent ‘problem’ people tell me about when they turn up at my yoga classes.
“Rarely can a specific cause of low back pain be identified; thus, most low back pain is termed non-specific. Low back pain is characterized by a range of biophysical, psychological, and social dimensions that impair function, societal participation, and personal financial prosperity.”
In other words, it’s complex.
Of course, there is always a need to rule out those cases where there is specific causes.
“but, this is for less than 1% of those presenting with LBP. Known causes may include vertebral fracture, axial spondyloarthritis, malignancy, infection, or cauda equine syndrome (very rare).”
So if any of these are suspected by presenting symptoms, a clinician is well advised to do testing, imaging, etc. for what are often referred to as ‘red flags’.
If these are ruled out or if you’re not suspect for these specific causes, what then?
“Most adults will have low back pain at some point. It peaks in mid-life and is more common in women, than in men.”
“Low back pain that is accompanied by activity limitation increases with age.”
“Most episodes of low back pain are short-lasting with little or no consequence…”
“But recurrent episodes are common and low back pain is increasingly understood as a long-lasting condition with a variable course rather than episodes of unrelated occurrences.”
It’s highest in working age groups so the effect to the workforce is impacted. People unable to work, earn income, the possibility of early retirement. “In the USA, LBP accounts for more lost workdays than any other occupational musculoskeletal condition”.
Then there’s a person’s identity. Consequences such as loss of independence, ability to fulfill expected social roles can be impacted. Common themes of worry and fear are identified, along with hopelessness, the strain on families, social withdrawal, job loss, and there’s the navigating through continual healthcare encounters.
Most studies underestimate the total costs of LBP, but the economic impact is comparable to other high-cost conditions like cardiovascular disease, cancer, mental health and autoimmune diseases.
Most cases are resolved within 6 weeks, however, there are risk factors for recurring episodes. For people with other chronic conditions like asthma, headaches, diabetes. Those with poor mental health are at increased risk, etc. As one example, a study of Canada’s population with 9909 participants, found that “pain-free individuals with depression were more likely to develop LBP within 2 years than were those people without depression”.
Lifestyle factors are also at play. Smoking, obesity and low levels of physical activity are associated, although independent associations remain uncertain.
Which brings us back to it being complex. There are multiple contributors, “including psychological factors, social, biophysical, comorbidities and pain processing mechanisms.”
We can see the complexity when there is a continual increase of those affected, an increase in our health care expenditures and by the recent opioid crisis that is literally taking people’s lives.
It also seems whatever we’ve been doing in terms of treatment doesn’t seem to be working.
Why is that and what needs to be changed?
Tune in next week… where we’ll get to the second paper, “Prevention and treatment of low back pain: evidence, challenges, and promising directions.”
Note: For those interested, all references/studies can be found in the Lancet paper, here.
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.
I’m going to challenge you to change things up this week. Whatever you think you should be doing, (in a movement, in your posture) whatever you’ve been told to do… do the opposite.
As an example, while you’re sitting during the day:
If you have a tendency to hold yourself rigid, perhaps with your shoulders pulled back, chest puffed out front, sitting up nice and tall, as some would say ‘good posture’, allow yourself something different. Perhaps slump a little, let the upper back round a little, feel as if you can soften the area between your collar bones, let your belly be soft and full when you breathe. RelaxI’m not saying this is what you need or you should sit this way all day. But try it for a few minutes and notice what you feel.
If you tend to be someone who is generally in a slumped position when sitting, try the opposite. Feel your sitting bones on the bottom of your chair, perhaps even pushing them into your chair slightly. Think about sitting tall, imagining your head feeling light above your shoulders, it lifting towards the ceiling. Collarbones wide, shoulder blades down your back. Notice what you feel.
Though this is only one example. You might try this way of being, or doing, in a multitude of ways.
In yoga, do you always exhale when forward bending and inhale on the reverse? Try changing it up and see what you feel. What do you notice?
Experiment with doing the opposite of what you think is right for you, what you’ve been told is right for you and see how it goes. If you like, comment below so we can take the conversation further.
The bumper sticker on our last Yoga Tool was to recognize that just as we take a drink when we are thirsty, eat when we are hungry, we need rest when we are weary. All of which requires first, awareness of a particular sensation in our body.
There are signs and signals speaking to us all the time, but are we really listening?
Are you like me in that you eat regularly on a schedule or do you listen to the signal telling you when you’re hungry? Do you sleep only at certain times of the day or are you paying attention to the signs that you need to rest? These are two indicators built into the survival mechanism of our body. Similarly, if you enter a room with a smell so strong it seems toxic you know to immediately step out again. If you are suddenly ill bringing up something you ate, again a signal. Your brain’s number one job is to keep you safe and protected.
Below is a quick and easy Tool to begin learning to sense information your body or your brain, is providing. I often use it in the beginning of a yoga class, to bring some awareness to what we’re about to do.
Lie with your back on the floor. Bend your knees and place your feet hips-width apart. Let your knees gently fall towards each other, resting easy and comfortable.
To sense what you feel in terms of your body’s contact with the floor. What parts of your body are in contact with the floor? Is the surface of the floor hard, soft? Are you comfortable? Do you feel the support of the ground below? Lean in. Feel grounded. Feel supported.
To feel your breath moving through your body. Where do you first notice your breath? In your chest, your lungs? Your nostrils? In your belly perhaps? Does the air feel smooth flowing in, and out? Does it feel forced, soft, cool, warm? Can you sense movement, in tune with your breath, elsewhere in your body?
To notice the tone of your muscles. Are your muscles at rest, tense, or sore? Where in particular do you notice any tension? Where might you find softness? Can you soften the areas around your eyes? Let your jaw, feel relaxed. Your tongue loose and soft in your mouth. Can you contract a muscle somewhere and then for contrast, let it go?
To pay attention to your heartbeat. Can you sense it? Can you feel it? Where do you feel it?
Going even deeper, can you feel or sense the blood flowing through your body?
If you can’t feel a particular sensation, just notice that. Without judgement. Just let it be.
Body / Breath / Musculature / Heartbeat / Bloodflow
*Note: If you’re typically a doer, go-getter, Type-A, cannot sit still type of person, consider doing this AFTER a workout, brisk walk, end of your day, when you’re more likely to be at ease with the sense of quiet and stillness this exercise asks of you.
Life is not easy. For any of us. There is more than enough to do, day in and day out. Stressors at work, at home or elsewhere.
So cut yourself some slack. Give yourself permission to rest.
Start with just 5 minutes. Do this at least once a day. Do it twice if you like. But do it consistently.
You might want to set a particular time for this. Perhaps at mid-day, or early evening. It’s not often you need to rest first thing in the day and this 5 minutes isn’t meant for sleeping, so not too close to bedtime either.
Either lie down or sit in a comfortable position (*see below for specifics). It’s preferable to lay on the floor but if you’re unable to do so, a bed or sofa is fine.
Set a timer for 5 minutes.
Close your eyes or soften your gaze.
Begin to breathe in and out through your nose (close your mouth).
Be here for 5 minutes, just breathing naturally. Don’t try to change anything about your breath.
Notice where you feel your breath. It might be most noticeable in your nostrils, maybe in your chest or perhaps your abdomen.
Notice how your breath is moving. If there’s any particular quality to it such as smooth, interrupted, easy, strained.
Then just breathe. And just notice.
If your mind wanders, as it’s likely to do, just bring your attention back to your breath. Feel where it’s moving through your body, where you notice it. Try not to judge the wandering of your mind as anything either good or bad.
And just breathe. And just notice.
When the timer goes off, slowly open your eyes. Roll over and stand up.
Notice what you feel. Mentally or physically make a note of what you experienced or noticed.
Keep practising for a week.
Check in with me next Tuesday and we’ll expand on this practise.
If… you can’t find 5 minutes in your day? You might want to look at that.
If you have any questions or comments, post them below.
* Positioning if seated
Sit forward on a chair so your back is not touching the back upright portion of the chair.
See if you can feel your ‘sitting’ bones (ischial tuberosities) and let your weight be supported there.
Have your feet planted on the floor, hip-width apart.
Hands comfortably on your lap.
* Positioning if lying down
Lie on the ground, perhaps on a carpet or mat if available. If you have back pain, you may want to use a rolled up towel, yoga mat, etc. to slip under your bent knees for support.
Hands can be by your side or placed on your belly.
Notice the parts of your body supported by the hard surface of the floor (heels, hips, shoulder area, head).
I’ve also learned it seems we may have been ‘wrong about stretching‘ insofar as we’re not really stretching or lengthening muscles. At least not as much as we once believed. Rather, we’re changing our response to a stimulus via the nervous system.
Our brain is naturally going to respond in a protective manner to anything it perceives as dangerous. If we are trying to re-train flexibility or just movement in the body and do so with strong, forceful pressure or stimulus … the brain/body will react by saying … stop! No! Don’t go there. It will send a (pain) signal to safeguard our movement.
However, if we move in small incremental ways within a safe and pain-free range of motion, the nervous system will react by saying … this feels okay. Safe. I’m happy to explore this.
This is a somewhat simplified way to explain all that’s going on, but it’s a starting point we can work from. We can even begin by just imagining movement and still create changes in the brain and our nervous system. So we can, really, start anywhere.
By learning to pay attention, moving in a way that allows your nervous system to adapt and create new patterns while it feels safe, you will make progress.
Why is it you sometimes need to visit a doctor, chiro, physical therapist, massage therapist, etc. time and time again for the same problem? They adjust you, work with you in a manner that seems to provide relief but within a few weeks or months, you’re back in their office again. I have been to them all and credit is due in helping with immediate pain or to fix something.
Sometimes it works long term.
Sometimes, only temporarily.
I want to speak to the temporary fix.
Until you figure out what’s creating the problem, it will likely return.
For example, if you are overweight you understand that eating too much, moving too little or a combination of both is likely creating the problem. You can go on different types of diets, you might do a fast, you might work out for the first two months in the New Year but if you don’t change those first two factors, over the long term your body’s weight remains the same.
You’re experiencing pain. Not able to move well. Feeling restricted perhaps in what you’re trying to do or you may be the type to just power through, get an ‘adjustment’, chow down on ibuprofen for months on end … but until you learn what’s creatingthe problem you won’t find long-term change or well-being.
If you suffer from an addiction, you may quit ‘the addiction’ but it will probably show up again and again unless you figure out what lies beneath.
The weight, the pain, the addiction … and so it goes …
The problem is(and we all know this) if you keep doing the same thing you end up with the same result.
However, if you can first, pay attention you will actually learn to sense, see and feel signals your body provides that can guide you to what’s below your current level of awareness or understanding. Those signals are signposts that can lead to healing and wellness.
It’s not easy to do but with practice, information and support, we can most often, figure it out.