Is pain keeping you from your yoga practice?
“there are four noble truths. They are the noble truths of suffering, the cause of suffering, the cessation of suffering and the path to the cessation of suffering” -Buddha, not that the Buddha spoke English.
We all experience suffering. There are times in our lives when we wish for a different outcome for the story than the one we experienced, or are experiencing. We have all endured a physical, and oftentimes a mental pain. Our bodies have failed us, we have been separated from a loved one, and in those times we feel helpless or hurt.
The buddha describes suffering as both physical suffering such as stubbing a toe, hunger, lack of sleep, or having a chronic debilitating disease like polio, MS, Parkinson’s, etc. and emotional suffering such as when things don’t go our way.
When I moved to California I was an emotional mess. The woman that I had been dating and was planning on moving with me called it quits 2 months before leaving and my heart was crushed. When I got here I was sleeping in a friends spare bedroom, depleted from the lack of hunger, unemployed, and unsure I was doing the right thing. During that time I kept thinking that if I ‘fixed’ my life, I could secure a well paying job, I could get out from under the generosity of my friends room, and the girl would take me back. Or maybe if I moved back to Chicago everything would be different and I could take back what my life was before moving?
But I wasn’t happy in Chicago. I was looking for something different. I loved, and still love the people of Chicago. I loved where I worked and the people I worked for. I loved where I lived, and the freedom of biking everywhere, but I was suffering in the stagnation of feeling like I wasn’t moving forward when I lived there. I knew I had more potential, more to offer. That’s why I moved. That, and I couldn’t take another winter.
But the move was awful. I was suffering from holding onto the past and how great everything in Chicago was and comparing that to Los Angeles and everything I lacked here. Instead of accepting what is, and learning how to deal with the situation that I was in, I was looking for an easy way out. Some friends worried I was suicidal at the time.
Emotional suffering is something that can be read about in books, observed in scientific studies, quantified, and qualified with words like; irritation, frustration, stress, anxiety, misery, and pain. You can choose your own word to describe it, but it is something that is individually unique as a thumbprint and only really understood through personal experience. This is what the Buddha talks about when understanding the causes of suffering, if we look deep enough we see that we are attached and holding onto an idea.
Hal Elrod describes in his book, “The Miracle Equation,” a rule he lives by called the ‘5 minute rule’ where he gives himself 5 minutes to curse, get upset, act in any manor to fully embrace and express the attachment to his perceived outcome. Once the 5 minutes are up, he says out lout, ‘Can’t change it.’ This begins his path towards the cessation of suffering and the beginning of peace and acceptance. It sounds ridiculously simple, and a bit irrational, but when we understand that peace is not happiness, that peace is freedom, perhaps he is on to something?
It sounds a bit like George from Sienfeld screaming, “Serenity now!” and we all know how that ended.
Without actually embracing and accepting the circumstance, we can’t begin the healing. It’s the same with turning to drugs and alcohol to numb the pain or to celebrate a victory. The feelings of great accomplishments and celebration are numbed with drinking and not fully embraced or lived to their fullest expression. Sometimes turning to drugs or drinking to escape the destitute feelings of depression can seem like a valid option, and I wouldn’t argue, but the depth of expression is not fully realized or released.
Conventional medicine acknowledges that, emotional suffering held onto for an extended period of time can cause physical suffering, including but not limited to; headaches, upset stomach, constipation, diarrhea, and low back pain.* It is important to understand the physical connection between the sympathetic and parasympathetic nervous systems and the ‘fight or flight’ response and how the organ systems respond.
Yoga, Qi Gong, or Tai Chi, when taught as a connection between breath, movement and focus, can be a tool that the individual can use with their response to the variability between the sympathetic and parasympathetic nervous systems. Read about that (here)
That doesn’t mean that a yoga practice is itself ‘without pain.’ On the contrary, there are two types of physical injuries that are associated with a yoga practice. Acute injuries occur suddenly, such as a muscle strain. This often happens when learning a new asana or stubbing a toe on the refrigerator at 4am.
Chronic injuries occur over time typically from overuse and/or improper technique. How many catvari positions are in the primary series? Are you feeling elbow/wrist/shoulder pain? It could be a sign of improper form, an over pronunciation and downward rotation of the head of the humorous caused by the scapula not being retracted down the back. This can be commonly seen in new students of ashtanga or students who frequent vinyasa classes without direction of anatomical structure. Over time, the supraspinatus muscle becomes strained tearing the tendon, or because the weakened scapular retractors (rhomboids and trapezius) are compensated using the pectoralis minor to round forward compressing the neurovascular structures of the brachial plexus.
In a study of running related injuries novice runners have a greater risk for injury than more experienced runners.** Perhaps novice runners are less aware of the amount of pronation in their step, their gait and proper type of shoe to address their specific needs? Perhaps novice runners ignore the subtle initial signs of a stress or strain, and ‘push on through’ because, you know, ‘No pain, no gain’ and those other slogans that we sported on the back of fluorescent NO FEAR shirts in the 90’s.
Physical pain we quantify medically on a chart from 1-10. Depending on the clinical setting and protocols of the clinic, there are analgesics, or OTC meds to block the nerves that can be given to cope with the pain. For an acute problem, NSAID’s, or other meds can be helpful to reduce inflammation and irritation to the area. The problem with nerve blocking agents is that they don’t actually address what is causing the irritation, they address the effects of it.
Using analgesics and OTC NSAID’s for a chronic pain without actually addressing the aggravating factor is like placing a band-aid on an arterial bleed without applying pressure. You can change the dressing all you want but that alone isn’t going to stop the bleeding and your patient will die. Habitual use of OTC medications or illegal drugs to alleviate the pain isn’t actually stopping the cause of the pain, nor is it teaching the patient how to cope with the situation. Unrelieved pain is a common symptom in methadone treatment programs and associated with mental distress and function as well as clinician frustration.***
Conventional Medicine is recognizing that opioids are not the only treatment to deal with chronic pain. Patients are seeking alternative, non-addictive, treatments as they recognize the limited shortcomings of Conventional Medicine. Slowly, with reluctance and caution, Conventional Medicine is looking at alternative medicinal therapies.
In Traditional Chinese Medicine (TCM) pain is categorized into two groups, Qi stagnation and Blood stagnation. Qi is the movement and force behind the movement. In Ayurveda medicine Qi is referred to as Prana. When there is a lack of movement of Qi/Prana the body experiences a feeling of being stuck. This can result in tension, cramping, or dull aching pain. This is the type of pain experienced in a heart attack or angina pectoris which is described as a crushing pain. The Qi, which wants to be moving, isn’t and is getting backed up like the 405 in rush hour.
Aside from a dull aching pain, the other type of pain is a sharp stabbing sensation. TCM refers to this as Blood stagnation. You can think of this like having a bruise under the skin which is blood spilled out of the blood vessels, stagnated in an area and not moving. When you have a bruise and it is pressed, there is often a quick flinching retraction due to the nature of the pain.
Acute or Chronic pain in Conventional Medicine is often a combination of both Qi and Blood stagnation in TCM. The plan of treatment in TCM to address the pain is to get the Qi and Blood to flow again. The goal of treatment is not to remove or dull the pain. The goal is to change the patients relationship to pain. Depending on the severity, duration, location, and mechanism of injury a patient can expect to feel results in a little as the first treatment however it is more common that with chronic injuries 4 to 6 treatments are recommended to make successful steps in recovery.
Recovery is not always a complete restoration to the previous nature of the person before the pain started. TCM is not going to cure; cancer, or headaches, or be more effective than drugs. You should be cautious of anyone claiming that it is or can be.
A broken bone can be reset, but the muscles and vascular structures of the bone have been permanently changed. By treating with TCM and moving the Qi and Blood in the area of injury or pain, the nerves that were restricted and hypersensitive can be released improving vascular flow. As opposed to Conventional Medicine which addresses the problem with nerve blocking agents, but even Conventional Medicine can’t cure pain.
TCM uses a variety of treatment methods just as Ayurveda uses herbal remedies, abyanga (special massage with oils) and yoga (specific movements, breathing, and postural holds in a specific sequence) to treat the patient’s pain. Because of the multi faceted and customized approach to each individual, it is difficult to obtain conclusive definitive research.
There are a few published studies that are beginning to look at fMRI scans of the human brain and biological tests, like heart rate, in control studies of the effectiveness of TCM however test group size is small, often not randomized, and participants usually come in with a preconceived cognitive biased.****
Overall more clinical studies are needed, however there is evidence in randomized clinical trials that TCM is effective if not more effective than standard Conventional Medicinal treatments for stress, anxiety, pain, and depression. There is some supporting evidence that TCM is effective in treating; sleep, PTSD, smoking cessation, and eating disorders however there is a need for more quality studies to be done.
*https://www.webmd.com/mental-health/features/10-signs-ailing-mind#1
***https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2846657/
****https://www.takingcharge.csh.umn.edu/what-state-evidence
