April 3, 2012

Practicing Through Pain. ~ Elayne Robertson Demby

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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