I was feeling too depleted of energy and strength to go to my usual vinyasa flow class with Susan Bowen at Thrive this morning. Although my sinuses have tried up, thanks to the recent rains, I am still hoarse and congested in my lungs. I just have to keep this from developing into something more serious, as it has in the past.
Yesterday, however, I made a point of taking a yin yoga class with Michelle Fry at Thrive. This style of yoga is the opposite of most vinyasa classes: you need to release and relax into pose and hold it for 3-5 minutes. I constantly had to remind myself to pull back my effort, that I did not have to push until I reached my edge. I liked it because it was a kind of yoga lab in which I By the end of the class, I had made up for some of the yoga missing from my life during the week (I had not been able to make it any classes since Sunday).
For the past week, I've been treating myself to 20 minutes of spinal twists before I go to bed. I find that the practice releases the muscular tension that I have built up during the day in my lower back. I've noticed that I am tighter on my left side and have doubled up the time I hold that side to see if I will eventually even out my alignment.
I open my daily Google news alert e-mail this morning and a pattern immediately emerged from the selection.
- WOOD TV8 Yoga for better sleep - informative five-minute video feature on a bedtime routine
- Huffington Post How Laughing Yoga Helped Me Take Relaxation Seriously about this twist. Also see Yogalaff.com
- Globe and Mail Night moves: Sleep yoga may be better than counting sheep- more info about yoga as "foreplay before bed to set the mood before sleep."
- SFGate Restorative yoga for those who want to relax
- Reuters Rwandans reach to yoga as a trauma therapy
I had made a decision to refrain from posting a lot of news items on yoga and meditation unless I could really add something to the content. These short entries were easy to fire off, but others sites, like YogaDorks, do this job well and with a lot more humor that I can muster about the yoga scene here in the States and around the world. I wanted to refocus my blog on my practice, photography, reading, and other assets that a reader would not find elsewhere.
And to contradict what I just said, let me close by pointing to this New York Times article, When Chocolate and Chakras Collide about the trend towards mixing yoga and food. Anything that appears in the NY Times is an indicator of what's happening culturally around yoga.
Labels: life style, news, therapy
I want to spotlight to news items:
- Detroit Free Press Matthew Sanford links yoga's self-awareness and healing about a paraplegic whose experience with yoga sheds light on the mind-body connection. Desirée mentioned Matthew at the workshop. She also recommended his book, Waking: A Memoir of Trauma and Transcendence
. He has a team of professionals working with him at MindBodySolutions. Here's a series of videos at a 2008 Yoga Journal confernce.
- San Francisco Chronicle Restorative yoga for those who want to relax because I'm focusing on this facet of yoga and the reputation of West Coast yoga is usually the opposite: upbeat, intense and driven.
There was some spillover from New Year into today as I could not get to sleep early last night and did not wake up in time for my yoga class. Bummer! So I punished myself by going to the gym and putting in 30 minutes on the stationary bike and 40 minutes on the treadmill, alternating between a brisk walk and jogging. I tried out my new Asics GT-2150 that I had my daughter give me for Christmas. I had been using Brooks Beasts, which are the running shoe with maximum support against pronation, for my running for the past two years, but I wanted to get something that did not get in the way of running. The new shoes are much lighter and fit my feet like gloves so I really enjoy using them. I will have to see how my feet and legs hold up under the renewed challenge of light running. I am not expecting to get back to what I was doing before my knee injury and surgery, but I want the option of jogging and running to supplement my yoga. It will also allow me to back off a bit and take my yoga with more ease and stamina.
On my trip to Miami in late November, a heel spur on my left foot became irritated and inflamed. In fact, I first notice the problem when I was doing savasana (in other words, lying flat on my back), and my legs rolled out and put pressure on my heels. I noticed a shot of pain on the heal and had to avoid putting weight on that spot. It did not bother me after class. But when I went to the airport for my flight to Miami, I wore my Brooks Beasts and those shoes irritated the heel spur even more. By the time I got into the hotel, I was limping from the constant pain. I started taking non-prescription anti-inflammatory drugs and putting ice on the heel and sole when I could. The other lucky break was that for the rest of the week I wore dress shoes that did not allow my heel to move around, and that allowed the inflammation to decline gradually. By the end of the week I no longer had to limp. When I got back to Washington, I decided to see a podiatrist since I could see the little knot on my heel and knew that it could be inflamed again. But the first available appointment was not until December 17 so by the time I got to see him, the worst symptoms had disappeared.
Since I knew that I wanted to get back to running, I asked the podiatrist multiple questions about my feet. First, the heel spur (a calcium deposit at the end of my plantar factia) is not something that will prevent me from running if I keep it from getting inflamed again. Second, I should not fear running because of my knee surgery. Third, my arches had not fallen as badly I thought. Getting fitted with a new pair of running shoes would get ahead of those three points, and he suggested JnR Sports in Rockville. I also learned that I was developing peripheral neuropathy in the sole of my feet. I had noticed some numbness as well as tingling sensations and pin pricks in my feet. This condition can be due to multiple causes -- I can immediately rule out some of the more obvious ones, such as diabetes and side effects from certain drugs. The doctor wanted to see how I respond to increased exercise so I'll be seeing him again this month.
At JnR Sports, I tried on Brook, Saucony and Asics shoes in multiple sizes and support levels, narrowing my choice down to the Asics GT2150. I got them in size 11, double E width, which is the first time that I've purchased a wider shoe. I got them in black because I am a bit tired of how most athletic shoes are decked out in swooshes, stripes and logos, in multiple colors and reflective surfaces. I also learned a couple of useful tricks to ensure that the shoes held my heels snugly, thus preventing any rubbing of my heel spur.
New York Times Mental Stress Training Is Planned for U.S. Soldiers is about how to prepare soldiers for the psychological rigors of war. It's heartening to see that the top brass are finally seeking assistance in dealing with the surge in suicides, post-traumatic stress syndrome (PTSD), depression and other problems in the wake of nearly a decade of conflict in Iraq and Afghanistan:
And in the interview, General Casey said the mental effects of repeated deployments — rising suicide rates in the Army, mild traumatic brain injuries, post-traumatic stress — had convinced commanders "that we need a program that gives soldiers and their families better ways to cope."
The general agreed to the interview after The New York Times learned of the program from Dr. Martin E. P. Seligman, chairman of the University of Pennsylvania Positive Psychology Center, who has been consulting with the Pentagon.
In recent studies, psychologists at Penn and elsewhere have found that the techniques can reduce mental distress in some children and teenagers. But outside experts cautioned that the Army program was more an experiment than a proven solution.
The Philadelphia Inquirer had an article (Penn center to help Army on stress) on this same issue.
Seligman is the lead thinker behind positive psychology and has had a major impact on how people are treated. I recommend that anyone with an interest should visit Happier.com, an initiative to take good mental practices to the masses. Seligman and his crew have developed a series of easy to follow exercises and routines that help you shift your mind set.
Almost Buddhist in nature, the approach aims to relieve human suffering. Although not mindfulness, it asks that you change the story that you're telling yourself inside your head. It asks you to examine your thoughts, which any bodhisattva would appreciate.
Finally, this effort is far better use of psychology than what the idiotic Bush Administration by employing psychologists to develop interrogation techniques that crossed the line into torture. Ironically, the quacks that advised the Pentagon distorted a concept, "learned helplessness" that Seligman (see Wikipedia entry) developed 30 years ago.
TIME plays up Psychotherapy Goes from Couch to Yoga Mat, which is about five years behind the wave of awareness, at least mine:
Since the days of Freud, research into the mind-body relationship has come a long way. Studies show that not only are your mental health and mood dependent in large part on physical factors like exercise, but also unchecked stress, anxiety and depression can affect physical health, increasing blood pressure, heart disease and even risk of death. So it was perhaps inevitable that patients would start bringing their yoga mats into therapy.
The latest conference of the International Association of Yoga Therapists shows that momentum is building for yoga's benefit for both the mental and physical wellbeing. Over at respected World of Psychology blog, Alicia Sparks is also looking at the rise of yoga as therapy. Just a week before, she had laid out her own experience with yoga.
For those who missed it from eight years ago, the TIME article The Power of Yoga was a milestone for yoga's emergence into the American mainstream. The article used to be buried in a pay-to-see archive.
Labels: mind health, news, therapy
New York Times Musical Pharmacology - Concerto in the Key of RX gives some interesting insights in efforts to marry music to the healing sciences. Most of this stuff is in the early stages of investigation and trial, but it all rings true.
Stefan Koelsch, a senior research fellow in neurocognition of music and language at the University of Sussex in Brighton, England, agrees, and is working on participatory musical treatments for depression. But in the long term, he sees broader possibilities. "Physiologically, it's perfectly plausible that music would affect not only psychiatric conditions but also endocrine, autonomic and autoimmune disorders," he said. "I can't say music is a pill to abolish these diseases. But my vision is that we can come up with things to help. This work is so important. So many pills have horrible side effects, both physiological and psychological. Music has no side effects, or no harmful ones."
One discovery is that if the music is too familiar or has identifiable words it does not have the same effect as "anonymous music." I suspect that's one of the reasons why kirtan chants and Sanskrit lyrics are so appealing.
Labels: brain_science, mind health, news, therapy
I am slowly working my way back to practicing yoga. My orthopedic surgeon has given me a thumbs up on my recovery, and does not need to see me again. I have been putting in a daily average of 30 minutes walking and 30 minutes stationary bike for about a month. I've gone back to climb the eight flights of stairs of my office building. I've been doing some of the rehab exercises. I had a session of acupuncture on my knee today, and I'll get a massage tomorrow, so I've been lavishing care on my body.
If I do a lot of walking, I will have a little discomfort in my knee the following day and it will feel stiff. I've also noticed recently that I have a lot of discomfort in my right sit bone, probably due to the hamstring. I can't take sitting down for a long time.
I am aiming to start up yoga class again next Tuesday at Thrive Yoga. Pierre Couvillion will teach that evening. Although it's a relatively advanced, all-levels, vinyasa flow class, I would prefer to have the watchful eye of a yoga therapist watching as I move through the poses. He told me he could indicate modifications of those poses that might be risky for me.
I really miss the community of the yoga studio, and also the disciplined structure that a regular practice builds into my life. Even though I should have more "free time," I don't seem to get a lot more done. I really miss the big muscle movements from the vinyasa. Aerobic exercise or weight lifting does not provide the same kind of satisfaction.
I sought out a conversation with Pierre Couvillion, a wandering yoga instructor and bodyworker, about my knee injury. Pierre has been filling some teaching holes at Thrive Yoga due to the August vacation absences. I wanted the opinion of someone who understood yoga and bodywork with a non-medical outlook to balance against what my doctor and acupuncturist told me. He recommended going ahead with the surgery because Western medicine deals more effectively with meniscus tears than other health alternatives.
Although I can trace my injury to the Rumbaugh workshop (part 1, part 2) a month ago because that's when it started to hurt, I can not say that it was the cause of the injury. At no time did I sense a jab of pain or feel that I had gone too far. It was only the next day that I notice a minor ache in my knee. It was two weeks after the event that the injury got in the way of my yoga practice. Pierre told me that injuries often happen at workshops because the "glow of a extraordinary teacher" frequently blind us to the limits of our bodies. I know that I was physically tired towards the end of the weekend, which is a double edge sword: the fatigue breaks down resistance in the body, but it can make me insensitive to the natural limits.
I've made major changes to my life style in the past five years. When I finished my Masters degree in May 2003, I was in sad shape. Working full time and getting a graduate degree, I smoked, ate poorly and was sedentary during work hours and at home. I was at least 30, maybe even 40 at times, pounds overweight. This blog documents my long slog back into a healthy life style. I've only been running since October last year. I've tried to increase my exercise regime's intensity gradually, both with the practice of yoga and running. That's why I adopted Chirunning, because it tried to reduce the heel's impact on the ground. But I could have abused my meniscus over the past year or worn it down over the past five years, or it could have been a problem that was just waiting for the right trigger to set it off, like a piece of paper that had been folded repeatedly in the same place and finally tore apart. Although I've tried to prevent myself from doing harmful things, like fit into lotus pose before my body was ready, I am still laboring with the body with tight hips that has sat in front of a computer for 20 years (if I had sat crosslegged on the ground all my life, I probably would not have this problem). My tight hips are going to stress my knees automatically, and I noticed that as my legs gradually moved closer to resting on the ground in easy pose, it increased the torque on the knees. I am one month short of being 59 years old, after all, and the body starts breaking down at this stage.
There are lots of adjustments that can be done to protect the knees, but when you have a torn meniscus, there's no way around it.
What I am trying to say is that my injury did not happen because I was a bad yogi who was misusing his body. It's not my fault. I think I was especially at risk because my tightly wound muscles were loosening a different speeds.
It's now confirmed: I have a torn medial meniscus that requires surgery. The debris poses a medium-term risk to the integrity of the knee, and Dr. Connell recommends cleaning up the knee by the end of the year, at the latest. He did not leave open a medical option for wait-and-see. The arthroscopic surgery is an outpatient procedure and requires three days of post-operative rest at home. It would then mean 4-6 weeks of recovery and physical therapy before taking up physical exercise. I could expect full recovery within three months.
Curiously, my knee was feeling fine today, with no pain or stiffness, so the news surprised me because I was imagining that I was recovering. If I had felt like this last week, I would never have gone to a doctor. The main problem of the meniscus is that it does not heal. It's a piece of cartilage that has no blood flow, and once it gets torn it becomes a piece of debris that can mess up the rest of the knee. Some people actually have their knees lock up on them because the meniscus moves between the bones and impedes movements.
But Dr Connell is in the business of solving problems by surgery so he has a professional, business and scientific bias to using surgery to fix injuries. He does have a reputation for not automatically prescribing surgery, which was one of my reasons for consulting him.
I already had an appointment with Kelly Welch, my acupuncturist, and so I asked him about the best course of action. He suggested waiting to see how my knee felt. He's had problems with both knees, at least one of them due to overaggressiveness in yoga poses. His biggest reservation about operating is that once part of the meniscus is removed, the knee can never return to its normal state.
He advised against future running because it put so much stress on the knee, even with the best technique. That's a kind of hypothetical questions because I don't have enough confidence to even jog. We closed out the session with acupuncture and electrical stimulus to the knee (so he's got a professional bias, too).
I woke up this morning and felt a big relief in my knee. The relief of tension that I had felt yesterday after treatment had continued after a night's rest. Yesterday, I was really sore, and felt tired from the difficulty of walking and climbing stairs. I could feel the strain building up in my shoulders as I clinched with each step with my right leg. I have started icing down my knee this weekend. I previously thought that my knee did not show any signs of swelling, but today I did detect some puffiness above my knee, which may be a sign of inflammation. Another symptom is that I get pain relief from ibuprofen.
In other words, I am treating it as if it is an injuruy, not just a nick or ding that will go away with a little rest and time.
Another consequence is that I've gone up five pounds over the past four weeks. I have to cut back on my calorie intake due to the drop-off in my physical activity.
Acupuncture chart from Hua Shou (fl. 1340s, Ming Dynasty). This image from Shi si jing fa hui (Expression of the Fourteen Meridians). (Tokyo : Suharaya Heisuke kanko, Kyoho gan 1716). Courtesy of Wikipedia.
My knee bothered me more each day as the week went on. Ibuprofen has become an essential intake several times a day. Last week, I could still feel capable of taking a yoga class. This week, it's out of the question because of the increased pain and the sensation of instability. I was lucky to already have a Friday appointment with my acupuncturist, Kelly Welch, only three blocks from my office. Kelly also practices Ashtanga yoga and had two bad knees so he has first-hand experience about dealing with the problem.
I gave him the background on the injury, which I have already laid out here in excruciating detail. He asked about where the pain was felt, zeroing in on medial side of the knee. He really did not give me a "diagnosis" in a medical sense, leaving that for a Western physician who could use MRIs and other tools to rule out things like arthritis, torn ligaments and other nasties. He gave me some pointers about how to keep up with my yoga while not injuring it further by using a rolled-up towel or blanket between my thigh and calve behind my knee whenever I have to go into hero's pose or similar poses that put pressure on the joint. He gave me the name and phone number of his orthopedist, who handles a lot of sports related cases. He also gave me the name of his massage therapist who has worked with people with knee issues, too.
Kelly did acupuncture on my right knee and left elbow (China medicine is into the yin-yang thing so a Chinese doctor would always treat the opposites to restore balance). He also applied some electrical stimulus, a slight sensation of being shocked. He adjusted it so that it did not reach discomfort or pain. And then he left me to simmer for 20 minutes. The treatment seemed to release a lot of muscular tension that had built up by the pain -- and the anticipation of pain. As always with acupuncture, the treatment seems to wash me clean of tension and compressed energy. I feel lighter, more clearheaded.
Finally, Kelly set me up for three more weekly appointments for follow-ups on the initial treatment.
As soon as I made it back to the office, I shot off an e-mail to the optometrist's office assistant and set up an appointment for next Wednesday afternoon, the soonest that he could see me.
This is not an xray of my knee, but it will serve to illustrate my plight.
My previous entry about my nagging knee injury brought two comforting comments: Mary suggested that I see a sports specialist/orthopedist, and Melissa mentioned that a yoga therapist might help and pointed me in the direction of Doug Keller. Keller is based here in the DC area, but spends a lot of time traveling to yoga workshops and teacher training around the United States and the world so he is not immediately available. His site does contain an archive of about dozen articles that he wrote for Yoga+ magazine, and one did deal with knee issues. I have downloaded several to apply them to my multiple aches and pains.
The helpful responses reminded me that the yogic path should not be isolated, that we can reach out to others for advice, support and commiseration. That's why we have yoga studios where like-minded practitioners can share their experiences. The Internet itself opens up the whole world, both for giving and receiving. Sometimes, injuries and other obstacles get me all wrapped up in the tangles that my mind gets trapped in.
I think my concern was three-fold: first, my yoga-empowered changes have been altering the way that my body parts are moving and changing at different speeds due to variable flexibility, strength and awareness. Second, the injuries themselves can engender changes in the body, compensations for a gimpy knee that may jeopardize my gains of the past four years. Or at least, that's what my neurotic mind was telling me, which just amplified the repercussions of the injury. Third, my ego was telling me that a good yogi would not be hurt himself so I must be failing in my practice in some respect.
Alternatively, I could also take this incident as an opportunity to learn more about how my body works, how it heals, and how it changes in the face of handicaps and stimuli. Greet it as a kind of anti-vinyasa that I have to recognize, accept, deal with, learn from and then assimilate into my yogic path.
I should note that Melissa Garvey and is based here in Washington, DC where she freelances as a writer and editor, and has her own website and YogaPulse blog. Following a link from her blog, I found a fascinating, even-handed article in June 2007 issue of Self, Bad Karma, about the risks of injury in yoga practice. Mary is "anonymous."
Labels: injury, knee, reading, therapy, yoga_resource
For the past week, I have not done any running, jogging or used elliptical trainer, or other gym equipment. The only yoga has been some light, simple stuff at home, except for a Flow I class with my daughter Stephanie at Flow Yoga. This weekend, I did not jump out of bed to get my yoga time in first, as I usually do.
Why? My right knee has continued to bother me, giving me a troubling sensation of instability. Three weeks since the injury first appeared, the day after the Thrive Yoga workshop ended. Probably the most striking complaint is that the knee cap is making a popping sound with a lot of regularity, especially after sitting cross-legged for a while. It has gotten marginally better this week, but not enough to feel that it's healing. I can do yoga without any problem, but I may aggravate the injury in half pigeon or easy pose without even realizing it, even though I never try to push beyond my edge and I flex my foot so that it stabilizes the knee. I have a sneaking suspicion that the injury has more to do with my hips than my legs.
I now believe that I am going to need a professional evaluation, but I am not sure who I should turn to. I have an appointment with my acupuncturist, but I am not convinced that he will be able to address this particular problem. Should I go to my personal doctor, since it's about time for my annual physical? Go to a chiropractor? Go to a professional doing bodywork (Trager, Hellerwork, Rolfing)? Should I find a bodyworker who is familiar with yoga-type injuries? Should I find a sports specialist? I've spent several evenings mulling over the options, Googling and trying to narrow down the options.
Washington Post A Breath of Hope: Walter Reed Tries Yoga to Counter PTSD picks up on the use of mind-body techniques to heal the psychological and physical suffering of war veterans at Walter Reed Army Medical Center:
The yoga that Carnes teaches, a form of guided meditation known as yoga nidra, was added to the program in 2006 after she helped conduct a feasibility study at the medical center... The results of the study were overwhelmingly positive, she said, adding that the service members appreciated learning skills that they could continue to use after they left... However, it's difficult to document the program's impact. Participants, who evaluate their own progress, often say they feel better after sessions, Carnes said, but there's little scientific evidence to back their anecdotal reports.
When Bush unleashed war on Iraq, his administration failed to put a dollar cost on the invasion and occupation of a Middle East country for five years. Now we know that the psychological cost may be even heavier than the financial, maiming a generation of soldiers. Their suffering will linger for decades. Yoga and other disciplines have been identified as key components of any treatment strategy, but it's been hard to pin down the statistical evidence (anecdotal accounts abound) to back this up to the full satisfaction of Western science.
My friend and infrequent yoga teacher, Rachel Permuth-Levine, is one of the organizers behind 2008 NIH Yoga Week: Exploring the Science and Practice of Yoga. NIH is the National Institutes of Health, for those not up on Washington acronyms. From May 19 to May 23, there will be guest speakers, reports on NIH's own research on yoga and meditation and yoga practice on the NIH campus lawn (weather permitting). Most events are to take place from 11:00 am to 3:00 pm so I will probably not be able to attend.
Among the speakers are Timothy McCall, M.D., Medical Editor of Yoga Journal Magazine and author of Yoga as Medicine: The Yogic Prescription for Health and Healing
Thrive Yoga will be holding an event outside the NIH daytime schedule. Sat Bir S. Khalsa, will speak on " Yoga and Meditation in the Management of Stress" on Thursday, May 22, 6:00 - 8:00 pm. There is limited space so you will have to register Sign up online..
Labels: brain_science, dc_yoga, meditation, therapy
Mindfulness and Psychotherapy: Cultivating Well-Being in the Present Moment is offered by UCLA Extension and Lifespan Learning Institute in collaboration with the Center for Mindfulness and Psychotherapy and InsightLA on October 5-7. If you're not going to fly to California on 24 hours notice, you might want to check out the speaker handouts page because the convergence of interests is stirring up a lot of heat and insight. Some of the handouts are more detailed than just an outline. As mentioned here before, I am plodding my way through Sharon Begley's Change Your Mind, Change Your Brain, and this conference offers similar material.
One speaker, Sarah Lazar from Harvard, has a site with her research information on meditation, called Meditation Research (catchy title). She has a link to New Yorker cartoons on yoga, always good for a yuk.
Labels: meditation, therapy
New York Times: The Yoga Therapist Will See You Now underscores the recent growth of yoga therapy, but also carries a warning:
But experts inside and outside the industry say yoga therapy should be approached with caution. In general, a person can practice as a yoga therapist after 200 hours of yoga teacher training, which might include basic training in anatomy, breathing, meditation and giving adjustments.
At the end of the article, there is a paragraph about NY-based designer Donna Karan "sponsoring a 10-day Well-Being Forum in Manhattan to bring together doctors, yoga therapists and yoga teachers..." That may explain why the article got commissioned in the first place. The event is organized by UrbanZen with Rodney Yee, Christy Turlington and a host of big names serving on the board. Karan is pushing integrative medicine that combines alternative health with conventional medicine following the death of her husband from lung cancer.
