Pain in Ashtanga yoga, and being friends with the body.

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I’m writing this in the context of my present Ashtanga vinyasa yoga practice, but after more than twenty years of sustaining various traumas to the musculoskeletal system stemming from a number of activities, I’d like to look at how we relate to pain and minor injury, and at the belief systems we have around solutions and healing.

I’m wondering, first of all, when the tipping point occurred – that moment we realized many of us now trust modern medicine more than we do the natural healing and regenerative power our bodies. Let’s call it the ‘run to the doctor’ reflex that we get as soon as an unexpected pain hangs around for more than a couple of days. I’m also wondering when we started craving a medical diagnosis every time, one that would give us a rational explanation for our pain and provide a rapid solution. Quite often, (see below), medical science can offer no such thing, and relying upon it for a satisfactory answer caters more to the mind’s (at times somewhat obsessive) compulsive desire to understand and feel reassured, than it actually provides genuinely useful input. Finally, I’m wondering when it is so many of us decided we’re the ones who need to tell the body what is wrong, and not the other way around! We get an MRI, or a doctor’s diagnosis with lots of fancy words, and we reason as follows: “My MRI shows “X”. As a consequence, the doctor says I have “Y”. So now I know “Z” is what I need to do about it!” All three of these points are, I think, related to a deep, perhaps not entirely conscious, fear, which would have us believe, ‘If I don’t take matters into my own hands, the body is not going to sort things on its own!’

Medical imagery – invaluable information or extra worry for nothing?

“The Biology of Belief” is the title of a ground-breaking book by Dr Bruce Lipton, and I borrow the expression here to introduce the following anecdote. About three years ago, I was suffering from recurrent soreness in my right elbow. I noticed it most in Adho mukha svanasana, (downward facing dog) though to all intents and purposes I was not approaching the asana in the wrong way. So I had a couple of X-rays done and took them to a reputable therapist. He detected nothing wrong from a hands-on examination, but from a cursory look at the images, he concluded there was slight wear and tear in the joint. I was taken aback, since recent images of both a wrist and a knee showed no such signs, even though these joints are said to be more prone to arthritis symptoms or early degeneration than elbows are. But I took the information to heart, and integrated it as a given. I was now convinced I’d have to “work with” the elbow, and that certain aspirations related to yoga practice and other physical activities would have to be shelved. I acted in accordance with this belief, and my experience appeared to confirm its validity. And yet, on some level I remained skeptical. And so, when I saw a renowned and experienced osteopath for a different issue months later, I tentatively showed him the elbow X-ray, and asked him about the wear and tear. He frowned in concentration and took a long, hard look at my frontal and side-view X-rays. After what seemed like a disconcertingly long time, he looked up and said, “Nope, all looks like perfectly healthy to me!” I went home with a new belief, and sure enough, within a short space of time the elbow’s functionality improved immeasurably.

Be careful what you believe

The point here is not to establish which of the therapists was, in fact, right, nor to illustrate a possible placebo effect (I also began relating to the elbow with more trust, and therefore using it differently, which must also have been beneficial). Rather, the question is, when did I (and possibly many of us) arbitrarily choose to believe that just because the body is no longer in brand new, showroom condition, this means it is bound to start malfunctioning or causing problems, discomfort or pain? Many things that we use in our daily lives – motor cars, bicycles, electrical appliances – get considerably worn, and yet continue to work perfectly for a long time. In fact, in some cases, some wear and tear seems to be almost desirable, hence we say that a machine may need to be “run in” or a pair of hiking boots “broken in” before they provide satisfactory or optimal service. And these are all inanimate objects that possess none of the infinite intelligence of the body, nor an equivalent in-built repair and maintenance system! So when did I start to know better? Or to put it another way, when did mind wisdom become superior body wisdom?

A picture is worth a thousand words.

Or is it? What if the wrong conclusions are drawn from it? Let’s go back to the limits I mentioned above of medical science’s ability to provide explanations. I wrote the present article after stumbling upon an in-depth look at pain resolution in Ashtanga by Iain Grysak. He introduced his article with an enlightening video on back pain. The message in the video is that most doctors look for damage or abnormalities to explain pain. They do this making ample use of medical imagery, as well as other tests pertaining to the symptoms the person describes. But what if the pictures don’t tell the whole story? Or, worse, lead a patient down the wrong path? In actual fact, a great many people whose bodies give them no pain whatsoever also display signs of damage – sometimes to the extent that, from a rational medical perspective, they should be suffering intensely.

“The map is not the territory”.

I love this quote a Tibetan Buddhist friend shared. What it points to is that the image we have of reality in our minds is not reality itself. I feel this applies equally to our present topic – the mental construct we have of our pain or injury in our minds is not the same as the experience we have of it in our physical body, the sensations in the tissues displaying the symptoms. The risk, I feel, of “knowing” too much about our condition, is that it may adversely interfere with how we relate to it. If our mental conviction of what is wrong and what must be done overrides our capacity to listen to our body, it hinders our ability to cooperate with the body by being open to suggestion.

In his article, Iain Grysak speaks in more detail and much more eloquently about pain in Ashtanga than I can, not to mention from a place of far greater authority, by virtue of his very considerable experience as a practitioner and teacher. If I may, I would nevertheless like to share a couple of thoughts, born of my own experience doing various physical activities and also yoga.

“If you rest, you rust!”

The first is that unless it is absolutely essential (such as in the case of broken bones), giving a body part complete rest may be the worst possible thing we can do. To my knowledge, even after a hip or knee replacement operation, patients are encouraged to be cautiously up and about again after only a couple of days. Even gentle movement, I am told, helps stimulate damage repair, draw the body’s attention to an area that needs it, and encourage the arrival of the “repair crew” on the premises. The inspirational David Swenson mentions a friend of his who was still surfing daily at the age of a hundred. His reasoning behind this was that, “If you rest, you rust!”

The second idea, specific to Ashtanga yoga practice, is that discomfort, and perhaps a fair amount of it for a substantial length of time, is inevitable. This sounds obvious, but let’s remember that the whole musculoskeletal system goes through a process of transformation and re-balancing – the body, nice and comfortable in its postural habits (including the bad ones), may take a great deal of coaxing and kneading before it agrees to a new, more harmonious state. Internationally renowned Ashtanga teacher John Scott recalls how, when practicing under Pathabi Jois, he would sometimes be almost in tears from the pain in his ankles, which he realized, “needed to open more.” Now I’m not advocating we tolerate such extreme discomfort, but Scott’s words illustrate my point. Furthermore, my feeling, at this stage in my practice is that once one commits seriously, there is no turning back. The transformation of the body has to be complete enough to at least have reached a new state of equilibrium. A job half done may be as good as botched. And this is why we need the courage to work, wisely of course, and while listening to the body, through the aches and pains that arise, as a result of our commitment. Anyway, for more details and very worthwhile read, I leave you in the capable hands of Iain Grysak.

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