Practicing Through Pain. ~ Elayne Robertson Demby

Via on Apr 3, 2012
Photo credit: Flickr Commons—By caitlin marie♥

I have not done a downward dog since July 2011.

I have not done a chaturanga (plank) in over two years. I had to give up doing cobra in early January, and my surya namaskara A (sun salutation) now consists of me raising my bent arms over my head and then bending from the hips to touch my hands to my mat.

I used to have a pretty decent practice. I could not put my leg behind my head, but at one point I was able to hold sirsasana (head stand) with the best of them, fly in bakasana (crow) and flip back and over in chakrasana (back flip) with ease.

Two years ago, however, a consistent throbbing pain developed in my left shoulder. Initially, I applied ice and heat, took some Motrin, and cut back on vinyasas, as well as any asanas (yoga poses) that put pressure on my shoulder.

It was the start of a routine. First pain would develop, I’d take steps to ease the inflammation, the pain would subside, I’d try to resume my normal routines, and the pain would return worse than before.

After several months with no relief, I went to an orthopedist, who immediately diagnosed the problem—bursitis caused by shoulder impingement syndrome. Because I have narrow shoulders, I have bone rubbing up against tendons, bursa, the rotator cuff, etc., inflaming tissue in the process. The more it rubbed, the greater the inflammation and swelling, which in turn caused more rubbing—a pretty vicious cycle.

My orthopedist gave me cortisone shots, recommended physical therapy, and prescribed a prescription strength anti-inflammatory. Eventually acupuncture and therapeutic massages were added to the mix. My orthopedist also instructed me to avoid any yoga posture that put even slight pressure on my shoulder. The treatments, medications and abbreviated practices helped, but only for a short while. The cycle continued, with the pain subsiding for just a short while then returning worse than before.

The pain eventually developed to a point where I could not laterally raise my left arm more than fifteen degrees from my side and even the slightest pressure on my shoulder caused pain. Not only could I no longer raise my left arm to gaze up at it in Utthita Trikonasana (triangle pose), but just putting my left hand on the floor to adjust my sitting position sent currents of pain from my shoulder down my arm.

 My doctor ordered an MRI to determine the exact nature of my condition, and when the results came back, I learned that no amount of rest nor any anti-inflammatory drug, acupuncture treatment or massage would make the pain go away. I had to have surgery.

I was considering my options, and trying to find a good time to schedule surgery, when another health issue arose. Last September, I was diagnosed with invasive breast cancer. Pain or no pain, shoulder surgery had to be put on hold while I underwent an extensive lumpectomy, partial removal of lymph nodes, partial reconstructive surgery of the breast, and six weeks of radiation therapy five days a week.

My last radiation treatment was on December 23rd, and in early January, I was back at my orthopedist’s office in excruciating pain. Many of the activities daily life, from opening a car door to carrying groceries, had become torture. I was vocalizing a stream of profanities anytime I put on a coat or slipped a shirt on over my head.

I needed the surgery immediately, but the timing was just not right. I had just gone through cancer, and both my family and I needed a break before I went under the knife again. I scheduled the surgery for late March, and went home to deal with the pain for a few more months.

I sit here writing this story as I prepare for my shoulder surgery later this week.

Yet, through all the pain and the cancer treatments, I have maintained my consistent and steady Ashtanga practice. I never took a day off except when I had my cancer surgery and was back on my mat practicing at my local Shala within a week—swollen lymph nodes and all.

Do not get me wrong. I never gritted my teeth and forced myself to do handstands or anything likely to cause further injury. I practiced, but avoided anything in my practice that caused pain, and even avoided asanas that do not cause pain, but which I think might be too stressful for my shoulder. That means no sarvangasana (shoulder stand), no sirsana and no vinyasas between seated poses in the Ashtanga sequence. I have stopped doing many asanas and modified everything from sun salutations to  trikonasana to accommodate my injury.

I have had many people, and even fellow yogis ask, “Why not just take a break from yoga?” The attitude seems to be that if I cannot go full throttle and do everything from jump backs to balancing on my hands then somehow yoga is not worth practicing.

The reason for my persistence and not quitting, I initially explained, is that my yoga practice grounds me, and even though I cannot do a headstand, I am still making constant improvements in areas such as opening up my hips. In the two years since my shoulder started aching, I have developed the flexibility to get my hand on the floor on the outside of my foot in Parivritta Trikonasana (reversed triangle pose), my head to my knees in the janu sirsasana (head to knee posture) series, and even though I have not been able to do jump backs in Surya Namaskara I can now get my hands flat on floor when I fold forward.

But, more importantly, as time went by, as I did less and less to accommodate my injury, I realized that my practice became more internal. My injury forced me to become less attached to the purely physical aspects of my practice, and focus more on breathing, bandhas (internal locks), and what exactly was going on with my body when I strike a particular pose. I like to say that my injury has made me a better yogi.

I, like many attracted to the Ashtanga practice, had always had a bit too much attachment to the physicality of the practice.

It was, after all, the sweat-dripping, muscularity of the practice that attracted me to Ashtanga. I had taken yoga classes before, but always left somewhat bored.

Seven years ago, I walked out of my first Ashtanga class invigorated, and had sore muscles for days afterward. I was hooked, and five years later I could get through the entire sweaty primary series without skipping a single vinyasa.

Yet, by taking a step back physically, you realize that doing less allows you to, in a way, do more. Prior to my shoulder pain developing, I never just sat and breathed. I also never really focused on holding my bandhas throughout my practice. Every few poses I’d think “bandhas,” and applied the locks, but now, I am thinking about them much more consistently throughout the sequence. I still have a long way to go in controlling my breath and bandhas, but the last two years have given me the opportunity to focus my practice more on breath and bandhas than I would have otherwise.

Being forced to do fewer vinyasas also allowed me to focus on exactly what was going on with my body in each pose because I was less tired.

I discovered that by going back in some of my asanas, I can actually move forward. My shoulder prevented me from pressing all the way into Urdhva Dhanurasana (wheel), so I had to revert back to half-bridge. But, once I took the struggle of pushing all the way up into the full expression of the pose out of the equation, I discovered something: I was actually better able to focus on opening up my upper back and lengthening the muscles along the front of my thighs. I actually increased the flexibility of my back and my thighs by reverting to an easier version of the pose.

Continuing my yoga practice through my injury also helped me get through cancer. Finding time to practice every day helped me to find balance and maintain a sense of regularity in an otherwise stressful period.

Too often yogis believe that if they cannot do a full expression of a pose because of an injury, they do not want to practice at all. I say that is a mistake. There is always a reason to practice even if you cannot do something because of pain or illness. You can always change your focus to what you can do, and there is always something that you can do.

Do I want to eventually get back to doing a full Ashtanga practice again after my surgery? Yes, but I also want to further explore what I have learned about my body by slowing down my practice and focusing on things other than whether I can get into the full expression of bhujapidasana (arm pressure posture).

One last thing I’d like to add. With all the recent media hoopla regarding the potential for yoga to injure, I’d like to note that my yoga practice is likely not the main culprit for my injury. My orthopedist tells me that it has more to do with my age and construction of my shoulder, and I have spoken with many women who had a similar experience who never practiced yoga. To tell the truth, my biggest pain flare-ups have had more to do with me doing things like moving furniture or gardening than practicing yoga, but the end result has been a dramatic impact on my yoga practice.

Elayne Robertson Demby is a professional journalist who specializes in financial, legal and economics topics, although she has covered topics as diverse as food and gardening. In addition to being a long-term yogi, she is also certified by the Yoga Alliance to teach yoga (RYT 200). Elayne credits her teacher training with helping her continue her practice through her injury, along with all her wonderful teachers at The Yoga Shala in Ridgefield, CT. She lives in Weston, Connecticut with her husband and two children. You could reach her via email.

~

Prepared by Soumyajeet Chattaraj/Edited by Tanya L. Markul

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8 Responses to “Practicing Through Pain. ~ Elayne Robertson Demby”

  1. Tanya Lee Markul Tanya Lee Markul says:

    Posted to Elephant Yoga on Facebook and Twitter.

    Tanya Lee Markul, Yoga Editor
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  2. Thaddeus1 says:

    "Too often yogis believe that if they cannot do a full expression of a pose because of an injury, they do not want to practice at all. I say that is a mistake. There is always a reason to practice even if you cannot do something because of pain or illness. You can always change your focus to what you can do, and there is always something that you can do."

    This is such a wonderful offering and reminder that the practice is not so much what happens on the mat, but what happens between your ears while you are on the mat. I, of course, hope and pray that you will someday have the opportunity to explore your practice without pain, but I also can't help but feel that in some sense you are one of the lucky ones. You've been given the chance to truly explore the depth of the Ashtanga practice, and most importantly, you haven't wasted it. Thank you for the guidance and inspiration.

    Posting to Elephant Ashtanga. Be sure to Like Elephant Ashtanga on Facebook.

  3. Annie Ory says:

    It's wonderful that you've continued your practice. I often tell students that when they can't do the poses, if they just lay on their mat in savasanah, and breathe mindfully, they've practiced. It's rare to see anyone take that advice.

    I know this will sound insane to an Ashtanga yogi, but I've done, and taught, different kinds of yoga, so I'm a bit more open minded than most yogis, and I feel that you would benefit greatly from Bikram yoga. The heat, and lack of ever putting weight on the shoulders, would allow you to begin to really heal this injury. It's great for after breast cancer treatment too, which has the potential of making, as you've experienced, issues in the upper body more intense. I won't try to convince you. I will just say what my beautiful teacher told me all those years ago – she taught hatha yoga and I took her classes but was too injured with my congenital joint displaysia to practice any longer in her class – she simply said "Annie, just try it, for 2 weeks, it can't hurt to try something for 2 weeks, if it doesn't help at all, don't go back any more." Within 2 weeks my joints had stopped dislocating in my sleep and I was walking normally and feeling less fearful of subluxations. I hope you try it, and I hope you experience the same healing. I am getting ready to open a vinyasa studio and if I had a student with a chronic shoulder injury at my studio I would send them up the street for at least half their practices to the Bikram studio. It's a very physically healing yoga practice. I will go there myself on a regular basis even though I own my yoga studio. I wish you wellness and healing.

  4. mariavlong says:

    This is going to be so helpful to so many. She did not mention that she was cheerful and outgoing with her sense of humor intact throughout the whole thing, but I can!!

  5. shay says:

    Just posted to "Featured Today" on the brand new Elephant Health & Wellness Homepage.

    Shay Dewey
    Please "like" Elephant Health & Wellness on Facebook.

  6. shay says:

    Just posted to "Featured Today" on the brand new Elephant Health & Wellness Homepage.

    Shay Dewey
    Please "like" Elephant Health & Wellness on Facebook

  7. Rob J. says:

    I can relate very well to your pain. Last July I was biking to work on a nice sunny day. When I was going down the hill only blocks away from the restaurant I work at, a car suddenly turned right without warning in front of me. I tried to come to a stop, but didn't have enough time or distance. I ended up clipping the fender of the car as it turned (luckily we were both only going about five miles an hour at that point) and going for a short flight. Although shaken, I didn't appear to be injured at the time (not even bleeding); I thought my right shoulder was just a bit sore from landing on it, but nothing more. When the pain got worse and then didn't fade, I went in for x-rays two days later. It turned out that I had landed just wrong and had split the end of my right clavicle into a Y and chipped a few fragments off of the end of it. When they opened me up for surgery, it turned out that I had also torn the ligaments in my shoulder that hold the clavicle down with the rest of the shoulder. They had to put two permanent screws in my clavicle to put it back together and drill two holes with titanium buttons connected by heavy sutures to pull the clavicle down where it was supposed to be and hold it there while the repaired ligaments had time to reconnect to the bone.

    I was/am a very active guy. I enjoyed biking, yoga, gardening, and all other sorts of physical activity, including a lot of use of both arms in my career as a chef. Losing the use of an arm, especially my dominant one, was very hard. For the first time in my life I experienced brief moments of true depression, not just moments of temporary sadness. They didn't last long, but it was one more unusual aspect added to my life on top of all of the things taken away from it.

    In November, I was ready to try to do yoga again, although my arm was still very weak. I found a local studio and started showing up to classes once a week. I talked to the instructor before I started and ended up modifying a lot of poses to accommodate being unable to support much weight on my right arm, but it felt so good to be able to practice again. Although I felt fine on a day to day basis, just a bit sore after using my arm, I ended up building up a little too much inflammation in my shoulder, and right around Christmas it started to hurt badly enough all at once that I ended up dropping almost all of the physical activity that I had slowly been returning to and making a previously unscheduled return appointment to my orthopedic office to see if something had slipped out of place. It turns out that I had just over worked it trying to rush too quickly back towards my old active lifestyle and by letting it rest for a couple of weeks the pain faded and recovery resumed again. Unfortunately, the yoga studio that I had found and started making connections at went out of business during the period that I was letting my arm rest again.

    Since then, I have not yet looked for another studio, but have been using this time to become more in touch with my home practice. Although I first started taking yoga classes back in 2005, I've been an on-and-off again kind of intermediate level student. There would be periods of time where I was taking a lot of classes and stretching a bit at home and times where I wouldn't be taking classes and would only stretch for a few minutes at a time every couple of days. Over the last few months, I have been spending more time at home reading about/studying yoga and getting into the habit of having a more regular home practice, even if it just means lying on my bolster on the floor and meditating for a while after I get home late at night after a long day in the kitchen. Since I overworked my shoulder around the holidays, I've been steadily recovering, always reminding myself not to push too far too soon again. To be more at peace with my life, even though I still have some limits on what I can do almost nine months after the accident. I can finally hold plank pose long enough to start working my core again. When I finally get a sunny break in the Portland rain on one of my days off, I can go for a short run and try to slowly rebuild my cardiovascular endurance. I can get out in my garden and use both arms to weed, trim, and till so that my vegetable seeds can go in the ground. And even though I really, really, really miss being able to work on arm balances and inversions (losing the ability right when I was starting to get a really solid crow or tripod headstand going for long periods of time), it just means that I get to spend more time on my ever present problem area of tight hamstrings. There are a lot of asanas that I can't do still, but that doesn't mean that I can't do yoga, only that I have more time to spend on other aspects of my life and practice that need tuning.

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