Surgery vs. practice

During our Yatra, we are re-posting some of our top posts from the past 16 or so months. We’ll also try to get new posts up from India, Internet access-willing.

***

First, a little background:

I’ve been in chronic back pain since 1994. The cause of the pain is a prematurely degenerating spinal column: The whole thing, from cervical to lumbar, and including the sacrum and hip joints. Falling apart. “You have the spine of a 60-year-old,” I was told when I 30.

For the past 12 years of that pain, I’ve been practicing Ashtanga. For all of those 12 years, the degeneration has slowed, but continued (my doctor sends me in for MRI updates every now and then). Ashtanga did not made the pain go away, but it has 1) made me feel more in control of it, in a sort of defiant “I refuse to surrender” 2) given me enough strength to lead a normal life. As far as that second item goes, while there are things I can’t do, I don’t spend time prostrated on my sofa, unable to walk from excruciating pain, like I was doing before I began practicing.

Then, last summer, I started to get the idea in my head that I’d like to do Tim Miller’s Second Series Teacher Training, even though I’d been stopped at kaptasana for nearly five years. So I asked him if it would be okay if I came anyway. “I think you need someone to kick your ass,” he said, giving a little kick of his foot to illustrate, “You should come.” So Maria Zavala took me under her wing to get me ready, and taught me second series. From the day my “training for the training” started, to the day Tim’s training ended, the back pain…Well, the back pain virtually disappeared.

 What I'm trying to avoid. Via baerchoropractic.com

I’ve been practicing second (start to finish) for some months now, and always I ask myself, not to be ungrateful but out of curiosity: Why?

It makes no sense, does it? There’s the mudpuddle that is my kapo, often called “the deepest backbend in yoga.” There are extreme twists. My feet go behind my head. Heck, they cross behind my head. Then, there’s the ridiculous moment when I go for a stroll totally folded in half. Some arm balancing. Some mysterious wrapping of legs and arms. Headstands that look like you’re directing an airplane in for a landing, only upside down. Why would these moves make my back pain disappear?

Here is the theory my doctor came up with: For someone with degeneration in the spine, what I’m doing is the total package for spinal range of motion–extremes of back bending, extremes of forward folding (you can’t get much more forward than your knees behind your shoulders). Because these things come quickly after each other, it’s forcing space in my spine, even where the disc is gone (L4/L5–a pivot point).

Also, a number of the poses in second create strength in the muscles that offer support for the spine. And others demand strength in the muscles in the front of the torso. When Maria was adjusting me yesterday in dwipada sirsasana, I could feel the muscles across my mid back and all around my lumbar vertebra broaden–an odd feeling. And bonus: The action of holding my feet behind my head is creating neck strength, supporting my degenerating cervical vertebra.

Now, as I grow older, friends and family are catching up to me–their backs are aging, and naturally I get asked for advice. I never know quite what to say. “Change your life” is never welcome advice, but it’s exactly what the surgeon said to me when I was considering spinal fusion 12 years ago. It was the advice that sent me to Ashtanga. Most chose surgery or injections–it seems easier than years of practice.

I don’t know if this blessed relief will continue. But while it lasts, I practice. And while I practice, I’m usually laughing.

Posted by Bobbie

Advertisements

The mystery of back pain

First, a little background:

I’ve been in chronic back pain since 1994. The cause of the pain is a prematurely degenerating spinal column: The whole thing, from cervical to lumbar, and including the sacrum and hip joints. Falling apart. “You have the spine of a 60-year-old,” I was told when I 30.

For the past 12 years of that pain, I’ve been practicing Ashtanga. For all of those 12 years, the degeneration has slowed, but continued (my doctor sends me in for MRI updates every now and then). Ashtanga did not made the pain go away, but it has 1) made me feel more in control of it, in a sort of defiant “I refuse to surrender” 2) given me enough strength to lead a normal life. As far as that second item goes, while there are things I can’t do, I don’t spend time prostrated on my sofa, unable to walk from excruciating pain, like I was doing before I began practicing.

Then, last summer, I started to get the idea in my head that I’d like to do Tim Miller’s Second Series Teacher Training, even though I’d been stopped at kaptasana for nearly five years. So I asked him if it would be okay if I came anyway. “I think you need someone to kick your ass,” he said, giving a little kick of his foot to illustrate, “You should come.” So Maria Zavala took me under her wing to get me ready, and taught me second series. From the day my “training for the training” started, to the day Tim’s training ended, the back pain…Well, the back pain virtually disappeared.

 What I'm trying to avoid. Via baerchoropractic.com
What I’m trying to avoid. Via baerchoropractic.com

I’ve been practicing second (start to finish) for some months now, and always I ask myself, not to be ungrateful but out of curiosity: Why?

It makes no sense, does it? There’s the mudpuddle that is my kapo, often called “the deepest backbend in yoga.” There are extreme twists. My feet go behind my head. Heck, they cross behind my head. Then, there’s the ridiculous moment when I go for a stroll totally folded in half. Some arm balancing. Some mysterious wrapping of legs and arms. Headstands that look like you’re directing an airplane in for a landing, only upside down. Why would these moves make my back pain disappear?

Here is the theory my doctor came up with: For someone with degeneration in the spine, what I’m doing is the total package for spinal range of motion–extremes of back bending, extremes of forward folding (you can’t get much more forward than your knees behind your shoulders). Because these things come quickly after each other, it’s forcing space in my spine, even where the disc is gone (L4/L5–a pivot point).

Also, a number of the poses in second create strength in the muscles that offer support for the spine. And others demand strength in the muscles in the front of the torso. When Maria was adjusting me yesterday in dwipada sirsasana, I could feel the muscles across my mid back and all around my lumbar vertebra broaden–an odd feeling. And bonus: The action of holding my feet behind my head is creating neck strength, supporting my degenerating cervical vertebra.

Now, as I grow older, friends and family are catching up to me–their backs are aging, and naturally I get asked for advice. I never know quite what to say. “Change your life” is never welcome advice, but it’s exactly what the surgeon said to me when I was considering spinal fusion 12 years ago. It was the advice that sent me to Ashtanga. Most chose surgery or injections–it seems easier than years of practice.

I don’t know if this blessed relief will continue. But while it lasts, I practice. And while I practice, I’m usually laughing.

Posted by Bobbie

Stern on back pain study: ‘Sliding toward the ridiculous’

First off, I know I said “no more” about the back pain study.

But Eddie Stern has added his considerable two cents, so… just one more. Here’s Stern, and he seems to have come down about where we did (maybe it’s the Ashtangi perspective?):

In yet another yoga study that sounds like it is sliding towards the ridiculous, Jennifer Corbett Dooren reported in the Wall Street Journal on October 25th.

[snip]

1. For someone to suffer pain, they must be cognizant of pain existing.  The cognizance of sensations (whether pleasure or pain) is controlled by what we call the mind – or, at the least, the nerve impulses that are translated into sensation by the brain. If someone complains of pain, it has to be questioned: where is pain experienced? While there may be illness or injury to the body, the mind, which assigns name, form and description to experiences via the sense organs, cannot be considered in isolation from the body.

[snip]

2. These yoga studies need to smarten up. Yoga, as I mentioned in the last post, is not some far reaching ‘thing’ that can be blamed or praised for having particular effects. You can’t just say “yoga” – it is the type of yoga, the teacher, the experience of the teacher, the person who the teacher learned it from, the application of the method that is administered, etc.

To keep using yoga as a blanket description does not do justice to science (which a study, by definition, is part of) – would a peer- reviewed study on a specific type of medication that improves the debilitating effects of Alzheimer’s disease be able to say in a study: “Medicine Helps Alzheimer’s”? No – the type of medication, the doctor, the designer of the study – all these aspects will be measured to gauge the efficacy of the study.

The key thing Stern says (you’ll have to go to his blog to get it all) is this, I think: When a study just focuses on the physical asana, not even the breathing aspect let alone the mental, you’ve removed the yoga from yoga.

Here, here.

I suspect that statement may also give a pretty good idea of where Stern falls on the paddleboard yoga, acro-yoga, etc. My guess, anyway, and I might be judging his judgement too harshly.

Posted by Steve

A roundup of some of the anti-yoga stories this week

Update No. 3 to the study of yoga and back pain relief.

The question: Does yoga have mental benefits? We’ve touched on that here and here.

Now, a few of the stories out there that I’d chalk up as taking a dim view of yoga.

The Seattle Post-Intelligencer (which is web-only now, right?) gets in on the act:

This study disputes previous claims that the act of stretching combined with yoga’s soothing mental components can alleviate chronic back pain. Researchers studied 228 adults with back pain, and found that yoga and stretching alone were equally effective.

In other words, it’s OK to think about what’s on TV while you’re sweating on your mat. Even though your mind is wandering, your body might be getting healthier.

As does Reuters:

Finding that yoga and stretching had about equal effects means it was probably the stretching in yoga, and not the relaxation or breathing components of the practice, that helped improve functioning and pain symptoms, researchers said.

Time takes time to blog about it:

Chanting “om” might help ease your aching back, but only if it comes at the end of yoga practice. A new study finds that the physical act of doing yoga — but not its meditative aspect — may help reduce symptoms of chronic back pain.

Feeling panicky yet? Well… let’s let Yoga Journal ride (on horseback of course!) to the rescue:

Buzz asked Loren Fishman, MD, of Manhattan Physical Medicine and Rehabilitation and  Columbia College of Physicians and Surgeons, who prescribes yoga to his patients.

“That is an excellent finding because it shows scientifically, and again, what we believed from our own experience all along–that yoga helps patients with non-specific back pain. And stretching does too,” he says. However, what the study didn’t measure–the psychological and behavior benefits of regular yoga–is what yoga practitioners know is unique about the practice. “It often takes more time for these types of positive changes to take hold.”

More time? I can attest to that… because I’m still waiting! (Hopefully we now are done with this study.)

Posted by Steve

A more positive take on the ‘yoga for back pain’ study

My initial take on the study released this week that determined yoga and stretching both relieved back pain at about the same levels was, I suppose, relatively pessimistic. I wrote:

What’s that mean? Well, according to this story in the Wall St. Journal, it means the study “didn’t find any evidence that yoga provided broader mental benefits.” Researchers had thought that some mental benefit — stress relief, relaxation — from yoga was part of what helped reduce back pain.

I do think there is something to that perspective, especially if researchers were expecting yoga to do more than just stretching.

But I don’t want to discount the positives from the study. Here’s a key quotation from a New York Times blog post about the study:

“This is good news for yoga,” said Karen J. Sherman, lead author of the study and senior scientific investigator at Group Health Research Institute in Seattle. “The smaller studies which hinted that yoga might be helpful all had problems one way or another. This is a much larger study, and the findings are robust.”

So, in that sense, this study suggests that the physical benefits of yoga are significant. And that’s nothing to sneeze at, right?

I also note this:

As an alternative to yoga, stretching may be a viable option. Dr. Sherman recommended taking an intensive stretching class, then establishing a routine at home. But she cautioned that her study looked specifically at deep stretching that is far more involved than the brief, light stretches most people do before or after a workout.

“It’s not like stretching each leg for 30 seconds,” she said. “It’s much more intensive. You might spend two minutes stretching each leg before moving on and stretching other parts of the body, so you’re really getting in there.”

That makes the stretching exercises sound a lot more like asana poses than a quick reach for the toes.

Of course, all of this reflects a pretty narrow view of yoga, right? Just Hatha, from the sounds of it. And, as a commentator on my earlier post notes:

In its crudest form, hatha yoga IS nothing but stretching, so just labeling some arbitrary class “yoga” means about the same as closing one’s eyes and chanting “one” while watching the breath and calling it “meditation.”

In beginning that comment, the writer asks the key question: “What does ‘yoga’ mean?” I suspect the answer in mind is something that is not quite so easily measurable, but is that feeling you get when everything does unite.

Posted by Steve

More on injuries, from someone not too injured

I’d like to add a tad more to Bobbie’s post on injuries below. She’s — unfortunately, fortunately, however you might look at it — much more familiar with practicing while injured than I am.

That said, thanks to my tight quads, I’ve built up a pretty respectable case of tendinitis in my right knee, which is rendering any significant flexion of that knee pretty painful. Out are lotuses and even Janushirasana B.

I’m working on it. And Tim Miller gave me some things to do to try to loosen up those stubborn quads.

David Swenson has this to say in response to someone asking about practicing with a bulging disc and related back problems:

I think that Ashtanga is so special because it is whatever we want it to be. We can make it difficult and dynamic or soft and easy. We can make it into an external display of prowess and physical strength or an internal journey of self-awareness. There are also myriad possibilities between those diverse perspectives. When Pattabhi Jois says “Yoga is not easy” I think this is what he is speaking of. I really do not think he is referring to getting into postures but rather to the internal struggles that manifest within us. These challenging mental and emotional battles many times are triggered from our physical challenges. When we are confronted with bodily pain it is not only that we feel the sensation and discomfort in our body but it is the resultant inability to do what we once could where the deeper pain and frustration resides.

That pretty well sums up my experience with the practice, which — physically at least — comes from a place where finding the full expression of the poses is never easy. And it provides some food for thought when reaching the edge, beyond which lies injury and dis-integrating pain.

Posted by Steve