I’ve been quiet on the class front lately, looking for some help with my nagging aches and pains. Vinyasa would be a joke; even Anusara is no fun. I’ve got a classic zigzag pattern: right foot, left knee, right hip, left shoulder, right wrist. So I’m pretty sure the injuries are related, cropping up due to imbalance. (As you injure one side, you avoid it, and often overwork the other side.) And of course my lower back is getting torqued, too.
It makes me skip yoga practice; there’s too many things to worry about. I know there’s a ton of teachers I could go see, but I have to admit that the money is a concern… I spend SO much money on yoga already. I just go running instead. Not the best solution but at least it keeps me halfway sane. And I found the time to pick up a regular meditation practice again.
But then I couldn’t skip a workshop with Jill Miller, who was in from the West Coast. (I’ve written about her here and here.) She felt my total lack of resistance in an intense side stretch and said that I need some resistance training. (Like with rubber bands. Barf.) But I agree; I am extremely flexible, and not very strong any more. I told her I was overwhelmed. I stare at my mat and don’t know what to do. She recommended Claes Passalacqua: “He’s a genius.” So I met with him yesterday…
A small THANK YOU to Jill Miller and her Yoga Tune Up magic the workshops at Om Factory this week were informative, entertaining, and extremely helpful. The afternoon’s “Hip Helpers” included both massage techniques and strengthening exercises (hello, inner thighs!), while the evening’s “Breathe In, Bliss Out” ironed out my shoulders and neck (again). I slept REALLY well that night.
(It was also nice to see a bunch of old friends Alison from Yoga Union, Brette from Yoga City, as well as Adam, Paul, Kyoko, and T’ai from Om Factory.)
If she’s ever teaching in your area, don’t think, just go. She’s re-inspired my belief in the therapeutic power of yoga. Thanks Jill!
Twice in my life have I wandered into a yoga class where I felt completely fascinated, connected, and at home. The first was with Jhon Tamayo at Atmananda, where I ended up doing my teacher training. The second was this past weekend with Jill Miller at Omega.
Id heard about Jill from Brooke Siler, who runs Re:Ab Pilates here in New York. She said if I liked anatomy and alignment, I would like Jill. Then my friend Tai Jamar, who runs Tai Yoga Therapy, happened to link to Jill on Facebook. And she was leading a retreat upstate the following weekend. Perfect timing!
Today I was thoroughly bruised by a doctor with a butter knife. I have never been happier.
It’s called the Graston Technique, and it might be the most efficient massage I’ve ever had. Six stainless steel tools, just begging for Sweeney Todd marketing partnerships, are rubbed and dragged across your oiled skin in order to break up myofascial restrictions. Aka knots, tightness, and scar tissue. If you bruise easily, you will be left with an enormous hickey across your offended part. My shoulder has never been sexier.
The treatment is good for tendonitis, plantar fascitis, carpal tunnel, etc. Supposedly it’s now used by all the major sports teams. Watch this video to get the gist.
The beauty of the technique is the leverage that the tool provides you’re not limited by the strength of the therapist’s thumbs. The end is used to dig a ditch under your shoulder blade; the long edge rakes out your neck. It was actually less painful than I anticipated. One by one, he called out the muscles and neighbors of my rotator cuff, and attacked them. In twenty minutes, he found and dug into every little knot my last four massages had touched on.
Dr. Minardo at Infinity Sports Medicine did the job; their whole office was strongly recommended by a marathoning friend. Dr. Babiy checked out a little knee puffiness (no drama, just imbalance!), and Stephen Kim taught me some physical therapy. They had a range of suggestions for my chronicshouldertendonitis, including trigger point INJECTIONS (of saline)… but who could turn down “a massage with a special metal device?” (One covered by my insurance, too?)
I felt almost guilty going to a Western office, like there was some Eastern technique I just hadn’t found… but you gotta love German engineering, too. And, I’m telling myself the 8am appointments count as a morning practice. I go back twice next week, but the real test will be for me to keep up w/the homework (ice and stuff for the knee). If I can clear up this shoulder I will be SO happy, cause there’s a time limit on your body’s ability to regain full elasticity; you can’t leave it knotted for too long. It’s time to say goodbye…
I’ve run all over New York City. I’ve raced in and out of subways, ran to meetings, stayed out too late, drank too much, danced all night, but I could always catch up on my sleep and I was never as tired as I am now, as a mother. When you become a mother, 8 o’clock rolls around and you’re ready to get in bed. It sounds crazy, even to me. I look at my past life in Manhattan and I can barely remember who I was.
Presently, if I go to bed at midnight, I think to myself, “Oh no! My baby has 5 hours on me already and I have to wake up at 7! He is going to run me over tomorrow!” When I lose sleep or don’t get enough of it which is often I make excuses to skip yoga class.
On top of this, my baby is a big boy and I started getting terrible shoulder pain from holding him all day up and down the stairs, in and out of the car, dancing (we dance everyday). It was so uncomfortable that for a while, I was sleeping with a heating pad on it my husband would roll over in the middle of the night and Id be on fire! I thought yoga would put too much pressure on my shoulder and make the injury worse.
This yogi knew she had missed too many classes, and so I went to yoga class yesterday. I always feel worse when I don’t practice regularly. So I said to myself, “You see more clearly after yoga. You feel better. You are stronger and leaner. This is the one place where all you have to do is be on your mat and breathe.”
I told my yoga teacher that I’d been having terrible shoulder pain. She told me to monitor my responses to the poses. If my shoulder pain seemed worse after class, Id need to make the appropriate modifications. But after class, as always, I felt like a new woman and my shoulder was not hurting. I told my teacher and she said, “If you only have a little shoulder pain, yoga can help the healing process and keep the shoulder joint stable.”
It is possible I just found more reasons to practice and love yoga.
So. Myshoulderthing is still going. Lots of crunchy noises (which the sports medicine guy said are no big deal, unless there’s also pain) and the occasional sharp pain (which is moving from the top of the arm to the inside of the shoulder blade). It’s lessening and lessening, but still not gone. I know this stuff takes forever to heal, so I’m trying to be patient. But I’m also trying to keep my practice habit intact. I was already struggling with slacking, and then the injury confused me almost to the point of inaction (much like a muscle in spasm). I’ve been wondering how much rest my shoulder needs, how much work and what kind, how much stretching / massage / release, and, most of all, what is up with my Down Dog? (My left shoulder doesn’t feel anything like the right one now.) I’ve been unable to distinguish pain that is strengthening my shoulder from pain that is further aggravating it. So, I’ve been looking for some specific guidance on what poses to practice, and what poses to avoid.
A friend who also has a left shoulder injury (from a skiing accident, much more glamorous than my sleeping accident) recommended Beth Hinnen at Integral Yoga. She studied Structural Yoga Therapy, an Iyengar-based system of individualized therapeutic yoga, and wrote her final paper on rotator cuff injuries. (Note: I don’t know any other teacher training that makes you write a thesis.) The class is general Hatha II, with a mix of men and women, young and old. We did some gentle warmups, three rounds of Sun Salutes with variations, some standing poses and inversions, and closed with pranayama and meditation. (Warning: there is chanting, for those of you who can’t take it.)
I’ve been three times now, and been helped greatly by each class. In the first class, after I introduced my injury (not that it’s a separate being…), she gave me some great adjustments in Down Dog. She really emphasized the external rotation of the upper arm bones, while keeping the inner rotation of the forearms, until my shoulder blades simply couldn’t wrap around the side of my ribs any more. She eliminated my overarched back by waking up my abdominal lift and containing my flared lower ribs. I felt strong in the pose again, and not scared to practice it any more!
The second class started with the Joint-Freeing Series, a sequence of wrist, elbow, and shoulder movements that’s also great for arthritis. She also gave us shoulder tips in each and every pose. But I had a flashbulb moment at the very first instruction. From sitting, she had us bring our arms straight out in front of us, and stretch them forward. “Now pull the shoulders back, into their sockets, and feel them relax downward.” Well, mine were the opposite: relaxed when stretched forward (out of the socket), tense and awkward when drawn back home. So I’ve been working on that adjustment for three weeks now, and noticing crazy subconscious postural habits. (I really think injury is 90% posture, and 10% irritant.)
In the third class, the Cobra instructions were really helpful. Lying on the belly, palms under the shoulders, relaxing the lower back and butt. Keep them relaxed as you raise the forehead an inch off the floor. Try again. Try again. It’s amazing how much we overuse our lower back. This method helps release the lower back, and strengthen the upper. We also did Locust with arms by the side, out perpendicular, and in front, for three more levels of strengthening.
Beth was also kind enough to bring me the handouts from the shoulder workshop she teaches: anatomy articles from Yoga Journal, diagrams of the rotator cuff bones and muscles, and instructions for the Joint-Freeing and Shoulder Strengthening Series. She taught me Cat Bow, a short pushup from Table Top (with the shoulders in front of the wrists) that helps strengthen the serratus etc. These two series take about 15 minutes total, so I’m trying to practice them every day.
It feels really good to have a strategy now. I really appreciate all the tips Beth gave me; I have a path back into my poses. If you have a rotator cuff injury, a slipped disc, a bad knee, or really any kind of confusing pain, I urge you to check out the research papers on the Structural Yoga Therapy site. It will give you an amazing introduction to the field of individualized yoga therapy, if you haven’t encountered it already.
This morning I went to a free class at Om Factory, schlepping over to the Garment District at 10am. (Still better than the 7am call time when I used to teach there.) I was puffy-eyed and groggy from some gluttony the day before, but knew that three hours before breakfast wouldn’t work for me, so I had a quarter-cup of coffee with cream en route. (I had to save the rest of my daily coffee allotment for a meeting at everyone’s favorite coffee place, Grumpy’s.)
The class was slow vinyasa, a perfect pace to guard my shoulder from any aggravation. (I saw a sports medicine MD on Tuesday, who assured me my shoulder was no big deal and would heal without problem. Tendonitis is a really common yoga injury. But weight-bearing will stress it, I have to be careful to strengthen and not stretch too much. I have ligaments “like rubber bands.”)
I felt so alive and awake afterward, I wondered why I don’t practice in the mornings any more?? Then I remembered: the hump. I don’t make it past the first 15 minutes. If I plow through it I have an amazing, creative, fulfilling solo practice, but I have issues with plowing through yoga. Aren’t we supposed to listen to our intuition? What if that body awareness is saying “I don’t want to move! I want to lay back down!” How do we know if it’s actually tamasic (heavy) energy that needs to be burned up?
This is the weird dialectic that is my practice: I have to force myself through the beginnings, but once I’m going it’s an easy flow.
On Friday I went to see my anatomy teacher Leslie Kaminoff, who noticed my blog posts bemoaning my injury and kindly invited me to come in to his clinic. Yay for blogs! I sit in class every week and watch him fix people, but I kept thinking my shoulder would be better tomorrow, or tomorrow, or maybe tomorrow…
I did my little demo of snap-crackle-pops around the left shoulder blade, which he said was probably tendonitis (inflammation of the tendons). I told him about the pinch in the upper arm, and how I’d tried to treat it according to my trigger point book, which pointed me to a big painful knot on the back of my shoulder blade. He said that the spasming muscle was probably the teres minor, more than the infraspinatus, since I felt the knot better with the arm over my head. He asked about my job and computer use, so I described my work station… turns out that elbows on the desk is “really, really bad. There’s your problem.” Villain!
Then came the treatment. It’s like a bit of chiropractics, a dash of Thai yoga massage, and a pinch of Shiatsu all mixed up as a breathing lesson. He found a rotated vertebrae in my neck and fixed that. He found all the “stuck” vertebrae in my back, and popped them. He stabilized the center of my diaphragm (aka “pushed on my tummy”) to force my ribs to expand upwards as I breathed. And he cranked me into this one twist that I swear popped the fused vertebrae in my tail. Then he stretched out my hip flexors, my hip extensors, and my neck. We hadn’t even gotten to my shoulder yet.
All these adjustments were like adding an extension onto my house. When I sat up, it was like I had a third lung; I just kept inhaling. He said that when we have an injury, we have to look at what’s supporting it. So, a neck or shoulder condition can result from tightness (or collapse) in the ribcage. When we have good support below, we can have full mobility above.
Then we adjusted the shoulder a bit. He pressed his thumbs into my back as I moved my arms from side to side, up and down. I felt the knots underneath squirming and trying to escape. He popped the humerus back into its socket a bit, I don’t know how. And then we were done!
I can’t get over the fact that the solution to this is breathing better. It makes sense; if I loosen up my ribcage, I can stretch my shoulders from the inside, too, 24 hours a day! But it seems so easy. As with my meditation, and asana practice, I’m going to have to beat myself over the head with the “secret”: it’s all about your breath! Maybe I’ll take it literally, Monty-Python-style. That’ll convince the masochist in me. I will still be squelching the knots under my neck with my tennis ball; it’s a new favorite sport, and I have to undo all my computer poses. But it’s amazing how posture the way we align ourselves in the 22+ hours OUTSIDE of yoga practice will make or break our health.
So. Next step is to rearrange my whole computer setup, ugh. (And up my olive oil intake, it’s the best anti-inflammatory and that should help my tendonitis… along w/the icy New York weather.) I guess I need a higher chair, or a lower desk. But I already went today and bought one of those ugly laptop stands, so my computer is floating six inches above my desk (like a good yogi) with a new keyboard underneath. My big head is no longer looking down at my screen, pulling on the back of my neck. My elbows are opening downward, and my wrists are flat. And my shoulders are relaxed.
POSTSCRIPT I forgot an interesting part. Leslie said that the infraspinatus (or was it subscapularis?) and rhomboid muscles work in opposition, and while we do a lot of rotator cuff strengthening in yoga (chaturangas and other “pushing” movements), we don’t have a lot of poses or movements where we “pull” our arms back or shoulder blades together and strengthen the rhomboids. So he said I could loop a strap around a door handle, hold it with straight arms, lean back, and pull from the shoulder blades in little pulses to strengthen the rhomboids. Without overdoing it, of course. I think I might try to get myself back onto an erg…
I’m trying to watch the inauguration replay, but CNN.com Live is not loading… the Facebook sidebar is giving me more info than CNN.
I haven’t posted since last week… it’s been same old same old with my shoulder. It feels better for a day, then worse in another way. I should probably see a doctor, but I’m worried that my superbasic freelancers’ insurance won’t cover much. I don’t know a sports medicine specialist, and my GP is a kind old grandpa who tells me incorrect information about my prescriptions. The knot on the back of the shoulder blade is much better, and the pinching feeling around the top of my arm is reduced but still there. I’ve been going to my regular vinyasa and hatha classes, but taking it easy and just holding basic versions of the poses. My guess was that I should keep warming up and gently strengthening / stretching the infraspinatous and teres minor… but is a week too short a time to expect it to be better? Patience is not my virtue. I kind of forgot to keep massaging the knots, though.
The cool part about an injury is that you get to study one part of the body in detail, and understand what that part is doing in each pose. It actually inspired me to practice at home more, since I wanted to explore poses for the shoulder. It put me back into beginners’ mind for my studio practices, since I had to reconfirm how I wanted to approach, hold, and exit each pose. And it gave me an excuse to do more gentle stretching and breathing practices. It might also give me an excuse to get a massage with this woman who works on the New York Ballet dancers… I’ve heard her sessions are INTENSE.
One other lesson: be kind. I think I instigated the problem (tension and knots) when I realized that my left side is weaker than my right, and promptly tried to fix the problem by putting more weight and flexion into my left side during Down Dog, Mountain, whatever. I still think strengthening is probably needed on that side, but maybe I went at it more aggressively than I realized? Can’t think what else would have caused a non-dominant side injury. Unless it’s my computer pose: elbows on the desk, leaning slightly into my left arm…
I’ll keep you posted on this issue that is transfixing the nation. Back to the webcasts now.
A few nights ago, I slept funny and woke up with a tweaky shoulder. Shooting pain when I moved my left arm in certain ways, and a few new snap crackle pops when I rotated my shoulder. This is my second sleep-related injury; I need to do a public-service announcement.
Finally, I remembered julstro.com. The website of Julie Donnelly, it saved me the last time I was hurt. Julie is a massage therapist who works mostly with triathletes. She’s identified all sorts of conditions that are actually caused by muscle tension, and teaches a system of trigger point massage to release the knots and thus the pain. The crazy part is that these knots are not always located at the source of pain my knife-in-the-back shoulder pain was caused by a spasm under my collarbone! The spasming muscle can impinge nerves or other muscles, and cause pain at the other end of the system, similar to pulling someone’s hair. So Julie has mapped out where to look for knots when you have pain in various areas.
The website has a great forum (be sure to search the archives) where you can find dozens of people asking your same question. Julie is amazingly generous with her time on the forum, and will recommend treatments that you can do at home. (Like rolling around on a tennis ball, using pressure to force the spasm to relax.) She used to live in New Jersey, and I actually had the masochistic pleasure of a massage with her a few years back. She’s since moved to Texas, so I finally broke down and bought her eBooks: Pain-Free Living and The Pain-Free Triathlete. They are full of diagrams and photos to make treatment easier.
So the answer to the pain shooting down my arm? The outside of my left shoulder was a little knotty. Underneath my collarbone, and towards the armpit, was too. But when I raised my left arm, on the back of my left shoulderblade I found a big ropy knot that hurt like hell. So I get to hold this monkey pose and torture myself for a while now, talk to you later.