Fibromyalgia and gentle yoga

” Yoga teaches us to cure what need not be endured and endure what cannot be cured”, B.K.S.Iyengar

Many years ago I regularly attended Iyengar Yoga classes with a very talented Halifax  instructor, David Thomas. I believe that it helped me keep up with regular activities and my professional career. For the past two decades I have not done yoga even though I knew that the benefits would sustain me as I grew older. I lacked discipline and the pain and fatigue has increased considerably since then. I have very little flexibility.

In despair because of my increasing  stiffness I enlisted the help of David once again. We decided to do a modified yoga program that would not over tax me nor cause increased pain. This was not to be misconstrued as ‘treatment’, rather a program that I could use on my own eventually as I began to become(hopefully!) more flexible. It would be a gamble about how much I could do and maybe the slowly earned benefits would increase my mobility somewhat. Neither of us knew how much I could do in the course of these private lessons once a week. This blog will be an on-going account of the program David is developing as we go along. His studio is extremely well equipped with bolsters, straps, blankets, mats, blocks both sponge and wooden and so on.  I was eager to be there, remembering how much I enjoyed the peacefulness in that quiet environment all those years ago. The program would be suited to me and my physical issues and not adaptable for everyone.

April 8th,2010

Davis said that this would be a learning experience for him as well as for me. He said this as all the while I was thinking about how long he has been teaching yoga and how I trusted him completely. Still, it wasn’t easy to let go of fear and I have to admit I did not know how I would manage getting up and down on a mat. We began slowly by talking about what I could and could not do.

The difficulty for most of us with fibromyalgia is that we don’t usually feel the pain during movement and it becomes a challenge to know when our bodies have had enough as the pain does not usually show up until a day or two later. So, how was I to know what I could and could not do, I wondered with anxiety?  That first day we only did 2 postures : 1) after David learned that my upper body was like cement and that I suffered from pins and needles in my arms, particularly at night, he correctly realized that the stress was coming from my shoulders. To help with that I was to lie flat on the floor with my shoulders tucked under, (instead of being hunched up!) and my tail bone aimed gently downward. My outer hips were supported with sponge blocks. My arms were to the outside and he encouraged me to understand that the pain in my arms was coming from the shoulders, therefore my hands had to be relaxed and not rigid. This position was quite comfortable, relaxed and meditative. 2) standing, with  wooden blocks against the wall and pressing my calves into the blocks, I was to learn how to ’embody’ the sensations. Knowing that while I was able to intellectually understand what I was doing it was also necessary to allow the bodily sensations to actually ‘change the brain’. These were words I understood and embraced in spite of my lack of success so far at actually changing that stubborn brain of mine with any kind of movement therapy.

David could see that the way in which I stood usually puts stress on my lower back and I told him how I usuallyclasped my hands behind my back in the shower to push my shoulders back. However, this is not a good movement as it places strain on my lower back. It was somewhat difficult to keep the blocks in place in this second position and the posture made me anxious so we did not do that too long. We practiced placing a wooden block between my legs high up on my thighs  and forcing my thighs inward toward the block. That hurt too much immediately so we stopped that activity. It is fear which can overcome me with movement.

The hour ended with David having a better understanding of the challenges I (and he) were facing. He was aware of my upper body, standing posture and lower back issues. I can hardly remember that hour now as I was anxious and not at ease wondering how much pain I would feel the next day.

April 9,2010

Yes, I was in pain with my hips. I had all of the props that I had bought many years ago but could not find the wooden blocks. David e mailed me to ask how I made out and I told him I could not find the wooden blocks so he said to go with the sponges. All I did the rest of the week was to practice lying on the floor with my shoulders tucked under, except for: the easy lying on the floor letting all my limbs go loose. This was a strange thing to do: lying  on the floor, legs bent loosely up in the air and assuming the baby position of arms and legs fluttering about in any direction as an infant does.  An easy process that can be done in bed or on the floor. Aha! That is surely helpful in changing the brain patterns!

This is so elementary but necessary as I break down the fear of pain upon movement and understand just how gently I must proceed. Stay tuned for the next installment.

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April 14, 2010

David had a chair ready for me when I arrived. There were soft blankets in the seat and soft blankets along the back. I was to practice bending over from the back of the chair at the waist, touching the pillows on the seat and slowly begin to understand the movement of my spine and tail bone as I got up to full standing position. Tucking the tail bone down is important as I rise.  This can be done anywhere in the house and knees can be bent. This, like the baby position on the floor are preps only, and can be done anytime during the day and often. While movement in various ways of the arms and body while standing are helpful, they are less beneficial than lying on the floor when the elevated bent legs are also free to move about randomly.

We discussed how I used to love the initial beginnings of the class I took years ago with the feet up on the wall. I told David I would like to begin a ritual of different poses gradually building up to several as a home routine. So, my favorite pose will begin the routine:

Legs up on the wall: Lowering myself to sitting parallel to the wall on a less sore side, so that when I lower myself my butt will be against the wall and feet up on the wall. Butt as close to the wall as possible and feet pointing towards the ceiling, balls of toes upward, shoulders tucked under,arms outstretched and hands loose, not rigid, blanket under my head. I love this pose and have done it often over the years and sorry now I stopped this past year. It will be part once again of my daily routine. It is still difficult to get up and down on the floor to the mat  but I struggle and manage. I can stay as long as I want in this position and until pins and needles begin in the feet  which is an indication that my legs are getting tired. To offset that I can bring my legs down somewhat and let the soles of my feet touch one another.

Soles of feet coming together, knees to fall to the side: Down on the mat which has two blankets lengthwise, one slightly overlapped at the bottom and another cross wise and one under my head (4 soft blankets), I am sitting with knees bent and I draw my heels in to buttocks, then I allow knees to fall to the sides, feet soles come together. I then lie back with sponge blocks to support outer hips and lower legs, arms to the side, cover my eyes with a bean bag and breathe to my lower abdomen. How relaxing! I find that my legs slip so using a belt around the waist and feet helps maintain that position.

So, now I have 2 preps and 2 positions to practice at home.

April 15/10

I have another prep:  Kneel on good knee. Bad knee that hurts above the trapped nerve is bent on the floor and I put a belt around bottom of knee cap to back of knee then x belt at back of knee. Ends of belt over top of knee and buckle up and stand. Good support for this weaker knee. No pain or discomfort, hurrah! Now these are the 3 very aggravating struggles I have to deal with: 1) left buttocks torn muscles of several years ago with subsequent 2) bursitis in the left hip,  3) a trapped nerve below knee of right leg (patellafemoral syndrome). Hmm, wonder what David will do with the other 2  weird issues since I now have a prep for the trapped knee?

April 21/10

I am fearful again today, wondering if I am doing the right thing. I remember writing that yoga had eventually caused too much pain, but I think it was because I was not combining it with meditation. I don’t know how one can happen without the other with fibromyalgia. Going into a yoga session requires feeling somewhat relaxed, and definitely safe. This is a state of mind I rarely achieve without meditation and even then I am never completely at ease. A racing mind is my everyday challenge, imagining things that have to be done, should be done, need to be done, immediately, for myself or others.

There is also the view (right or wrong), that while yoga helps with flexibility it does not strengthen as, for example, what using machines for strengthening could do, such as with a  ‘slow burn’ technique. In yoga because of increased  flexibility there is the danger of actually weakening some muscles and injury. Many exercise experts,  physiotherapists, and chiropractic practitioners deal often with patients/clients who suffer from yoga injuries. I know that hurt does not mean harm so I must be careful not to confuse the two, such a difficult thing for those of us with so much daily pain. Am I hurting because of fibro or are the stretches harming?

I have to approach this process with caution, an open mind, not too optimistic nor too pessimistic, some degree of hope while recognizing that my age and lifelong challenges will not bring about immediate release of cemented muscles and may indeed cause more pain. It is about changing my brain pathways… not an easy task for someone of my age. However, I trust David to move slowly and cautiously, knowing I will take one step forward and sometimes two backward. I have little choice now. It is imperative that I develop a movement program and of all the movement therapies I think this will be the safest if I proceed slowly and trust David as the expert.

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The first thing that David asked me today was about the adrenals. I referred him to my March 25/09 blog “The Pain is in the Brain”. Adrenal fatigue is probably very common among those of us with a hyperactive nervous system always ready for ‘fleeing or fighting’ in situations which may or may not be warranted. He likened it to body posture as well, since the lower back becomes fatigued and sore (located near the adrenals…the kidneys) when we are ready for flight and assume that position with our bodies. I’m not sure what I think about this explanation but I know my lower back is generally tired and sore when I feel rushed or stressed, whether or not it is because it is near the adrenals is not something that can be shown to be true or false.

A new prep position: Sitting in a chair with lower legs perpendicular to the floor stand up without allowing the knees to go forward or back.I have to push back with my hands for this to happen. Here is David doing this:

Upper leg over lower leg :lying on mat with both knees bent, walk left foot out about 3 inches to the side. Place right foot over left knee. Then press right foot into resisted left knee and move left knee over to the right. This is the resistance stretch. For the strengthening stretch, direct left buttock downwards to floor to bring left knee with a resistant right foot. This is intended to help the trapped nerve.

Legs up on wall: With mat between legs attach 2 straps pulling  one way and one pulling the other way.

Lying on a bolster :Sitting on mat then lay back on bolster and lift back ribs up and then lay over the bolster without compressing lower back. Place head back on a wooden block and eventually lower block if possible. Sponge block under buttocks option. This is the 3rd position I am to do daily.

I left tired and with brain fog, not sure I understood all the instructions.

April 22/10

Tired and yoga sore but not fibro sore except for usual lower back pain.

April 23/10

David responded to me with this: “In my opinion yoga is about support—in all different parts of our life. If you do the poses without the active muscle then you don’t have support. As for your practice we really haven’t started yet. Once we go through a complete practice then that meditative quality will start to appear”. I agree with him and that is why I chose to work with him and in his studio which is incredibly built for support that avoids harm. So far I am doing well with his instructions. Today even the yoga pain is gone from the hour we spent together 2 days ago! I would advise anyone who needs a movement therapy practice and has the challenges that we with fibromyalgia suffer from to find a high caliber teacher with insights and experience to develop a practice that is individualized for you personally! IT MUST BE A SUPPORTIVE PRACTICE WITH PROPS! I am very fortunate.

April 28/10

THE POSES

Pose # 1

On a sticky mat. Place the bolster xways. Use 3 sponge blocks with a flat mat on top of them. Lie down. Shoulders and head on the sticky mat over the bolster. Knees are bent. Strap above the knees the width of my fist pressing against the belt.

Pose # 2

Place a hard block (about the size of a meditation sitting block) against the wall on a sticky mat. Have padding available for feet. Sit on the block . Belt: around back of pelvis (low) around to front to the feet (which have soles touching). Knees are apart . Shoulders are against the wall.

Pose #3

On a sticky mat, chair against the wall. Bolster upright against the seat of chair.  Sit on sticky mat. Arms behind on legs of chair trying to slightly pull chair up. Belt thighs above knees about a fist apart. This is a sitting pose.

Post # 4

Hands against the wall, the height and width of shoulders. Straighten arms by activating arms, not shoulders. Step back, hands in line with spine pressing tops of legs and pelvis back.

Pose # 5

On a sticky mat, one bolster x ways, one bolster length wise. Back of chair available to put arms on legs of chair. Bum on floor.Neck back but supported with towel. Belt around arms. Take arms back to legs of chair. (Belt should be the length from hand to elbows for width).Press arms out and press feet into floor, lifting pelvis.

Pose # 6

Place 2 bolsters end to end lengthwise with a flat mat at end of bolster. Place 4 sponge blocks on the flat mat (top of head). Shoulders will come down on bolster, head back on the flat mat. Fold arms by clasping elbows, putting elbows out into hands. Arms rest on blocks over head. Do twice then rest with arms beside body.

Pose #7

Two bolsters lengthwise. Belt above thighs. Shoulders and head on floor. Knees bent on bolster if lower back is irritated.

Pose # 8

My final pose: Lying flat on a sticky mat, bolster x wise, blamket under head, arms out to side. I LOVE THIS FINAL POSE AS I COVER MY EYES AND MEDITATE, BREATHING FROM MY ABDOMEN. VERY RELAXING.

So there you have it. I try to do these poses at home as I luckily have all the equipement, but it isn’t easy. Getting up and down on the floor is difficult. I am usually fatigued after doing them and have to rest. I am to do them 3 times a week but cannot manage that yet. If it is to be helpful (and that I cannot determine yet), it will be a slow process. This is a program modified just for me but it isn’t a difficult one if people are more flexible than I am. It is also supportive and should not harm anyone.

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Good luck. Check this particular blog again in a month to see how I am doing!

May 16/10

Hmmm! A new twist on things. I haven’t been doing well with the lying down inversions and just had an e mail from David who said he had attended a workshop this week-end with an  expert Iyengar instructor  and asked about how he should work best with me. She told him that I needed movement, not lying down poses! This ties in to the neuroplasticity philosophy and also that which I learned from my ‘slow burn’ sessions with physiotherapist Nick Matheson. So maybe it will all tie together. It has been a hunt and seek experience. The expert suggested back bends while standing and other standing poses, eventually doing an upside down inversion hanging from ropes, gasp!  Yes, it is true that movement is KEY! But some of the more relaxing poses at the end of the regime I began are good too. More as we change our direction!

May 19,2010

Whatta day! I was my usual fearful self wondering what was coming next. Yikes that didn’t feel too good in my groins!

Next came the 2nd pose. Grumble, grumble…I whined some more.

Now the last one for the day

The challenge will be to find wall space at home where I can have my back against the wall and a place to locate my feet as he has shown me. The next challenge is to discipline myself to do this and finish with one or two of the meditative, relaxing, lying down positions.

May 20,2010

Even though it was somewhat painful at first, David suggested I just be with the pain. In other words “don’t whine so much and get on with it!”. He is a very gentle man so did not say this in so many words though:-)! I can’t believe I am not overly sore or hurting today! I am to do these 3 stretches 3 times a week. More will be added next week, I’m sure! So, please stay tuned.

May 22,2010

Tried these poses at home and immediately went into a  flare-up. Too strenuous. Having a bad week.

May26,2010

Aha! David showed me a good trick for my tingling arms that fall asleep at night. Place a rolled up Ace bandage or small face cloth snug  under the arm pits and press into it. Ouch, that certainly hits the spots that are tender. Maybe tonight I will have better luck with sleep. Tried less agressive, more passive poses today and as David says: “We are still experimenting”.

Sitting in a chair twisting from side to side; lying on blankets imitating back bends and other more tame poses. Here we go for another week.

May 30/10

Flare-ups have not ended since I began this process. Like using the strengthening machines I have now lost hope that I can manage yoga. Difficult not to get into self blame and feeling like a failure. Intense pain in hips and buttocks. I waited too many years to begin this journey. Younger people with fibromyalgia should begin gentle yoga immediately! I will continue the meditative aspects I have learned but not the other strengthening movements or standing poses. It isn’t David’s fault I have not done well. It was all an experiment, but oh! the self admonishment.

I listen to the words of a friend: Those who give up stay down. I can’t give up movement but must be even more gentle with myself. Thank you, David.

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