Jill Miller, who is the inventor of a program called Yoga Tune Up, recently revealed on her blog about a month ago that she needs a total hip replacement. At the age of 45. Now, she has been absolutely instrumental in helping many, many people discover a modality that can really help irritated tissue and brought it to the main stream. The story, however is what I want to bring your attention to today.
What was telling about her first blog post, which you can find HERE (and I’ll link to the second part HERE) is that she felt nagging pain not only for most of her life but for the past seven years. Until recently she didn’t bother to have it looked at because she was worried about surgery for personal reasons. That’s fine.
This is one of the most respected and knowledgeable (from an anatomy standpoint) body teachers IN THE WORLD and even she ignored her symptoms. We all do it, from your fellow office worker to high level athletes who want to keep competing.
“I’m okay, I just need to stretch.” “I’ll start using my therapy ball.” “I’ll take a couple of weeks off from running and everything will be fine.” And then we go back to doing the same thing that caused the problem in the first place and are suddenly surprised when the issue comes back – and worse.
Just this week another client of mine’s husband after almost a year of pain finally decided to go to the doctor and get checked because his knee wouldn’t stop failing and buckling. My prediction is either a torn ACL or a severely torn meniscus (or both). The problem is that he’s been walking around on it for the better part of a year without any treatment or attention, and likely it’s gotten a lot worse. This might mean that something that could have been helped with therapy before might need surgery now.
I’ve said it before and I’ll say it again:
Your body isn’t stupid.
Pain, collapse, restricted range is a signal that something is wrong.
The sooner you figure it out and fix it the better off long term you will be.
If you have water coming into your basement, you figure out where it is coming from and plug the leak. You don’t sit there and wait for it to subside, clean it up and then wait for it to happen again. Mold sets in. The leak might get bigger. Other things can come into play that make a simple leak a catastrophe. Your body is no different.
When your body is subjected to stress, it responds to it. This can result in either stronger muscles, or deterioration and loss of integrity. A large part of my job is finding out the perfect balance between just enough and too much load, stress or torque on joints. You need to consider your body as a whole and what loads it is being subjected to daily, weekly and annually to really figure this out.
And in case you’re wondering, sitting is a load. Driving is a load. Weight training is a load. Yoga is a load. I remember when I sat through the Yoga Tune Up course (I did not certify because I have no desire to be a yoga instructor) and a room full of body practitioners looked at me like I had two heads when I suggested that yoga poses – especially extreme ones – are still heavy forces through joints. They are, in case you’re wondering. Jill Miller says that herself in her articles. Years ago I wrote a post about why a downward dog is downright dangerous for most people. It’s HERE.
One big fundamental rule I teach my clients is that they should walk out of a workout feeling better – not worse. This means they are far more likely to have had an appropriate level of stimulus and will have a better long-term response. They won’t get worse, they will get better. Isn’t that the whole idea?
The point of this is that nobody is invulnerable to the rules of the body, even people who have spent their whole life practicing something that is supposedly therapeutic. Don’t assume that if you have a problem that things like stretching and pounding yourself with a yoga ball is the answer. It might just make things worse over time. Seek out someone who knows the rules of the body and can identify a proper strategy to bring your body back into balance and stop overloading tissue.
So the next time you work out, try taking a step back. Are you pushing through pain? Have you had a problem for a while and have been ignoring it? Take a really close stock and tell yourself that you should probably get that taken care of before subjecting your body to even more stress.
Because nobody wants a hip replacement at the age of 45. At least I don’t.
Feel free to message me or find me on social media if you have something you would like to identify or a question. Injuries and providing solutions are what I deal with every day.
This was inspired by a client of mine who wanted to restart yoga after a bad back injury.
What if, as a trainer I told you that we were going to do an exercise that did the following:
I want you to lengthen out your posterior chain as much as you can, throw both of your shoulders into extreme extension, put yourself into spinal flexion (even if you can’t properly tilt your pelvis) and stretch out your hamstrings and calves as far as they can go (thereby also yanking hard on your sciatic nerves) – oh, and do it while loaded with up to 70% of your body weight, and the load increases the further you get into the exercise. So for a 150 pound female that would mean their shoulders and knees are loaded in extension with up to 105 pounds on their spine and other joints.
Does that sound like a good idea for anyone, let alone people recovering from injury?
The funny thing is, people in yoga classes do this almost every day. It’s called a downward dog.
Now, before the yoga community absolutely freaks out and starts thinking I’m bashing the movement, I’m not. All I’m doing is providing a practical analysis of what people are required to perform to get into this position. I’ve had a client recently with severe back issues try to get back into yoga and the one movement she had immense trouble with (not surprisingly) was this one. I’ve also attended yoga courses where thankfully the instructors were aware of the limitations of this movement and realized that not everyone should perform a downward dog – in fact several of my most respected colleagues actively discourage it since they have realized what it does.
On the flipside I’ve also been to yoga classes where the instructors did absolutely NOTHING except for sun salutations over and over again. You can guess which class I didn’t go back to.
“BKS Iyengar, one of the foremost yoga teachers in the world asserts that this asana stretches the shoulders, legs, spine and whole body; builds |strength throughout the body, particularly the arms, legs, and feet; relieves |fatigue and rejuvenates the body; improves the immune system, digestion and blood flow to the sinuses, and calms the mind and lifts the spirits.” (ripped from Wikipedia) – and it does all of these things.
But what people need to realize as a whole is that some movements that you perform in a typical yoga class are very hard forceful strength movements. Simply because it is packaged as something healthy and therapeutic doesn’t mean that it is. Just like any other type of exercise, it needs to be tailored to the person participating in it. A 200 pound deconditioned person has absolutely no business getting into this position and here’s why:
Here’s what people need to be able to do into order to successfully perform this movement:
Put your arms overhead fully or even behind the torso while internally rotated. This requires a healthy rotator cuff complex, the rib cage to be able to move and the shoulder blade to be able to move with proper rhythm. One loaded movement I often have clients do to test this area is a loaded shoulder extension (think a front raise but over the head with a cable) at various angles in order to engage the entire shoulder complex.
Hinge the hips with proper pelvic movement so that the lower spine isn’t flexed forward putting strain on the lower spine with load – while it’s flexed. Think loaded Romanian deadlifts, and even things like good mornings (I have a bias against these because of where the load is placed but whatever). Just because your hands and feet are on the floor doesn’t mean there isn’t a ton of pressure going through the lower spine in this position.
Fully extend the knees and dorsiflex the ankles as much as possible – general limits here are thought to be 30 degrees but most people have much, much less than that. Generally here in a squatting position I look for the ability of the knee to travel forward properly and therefore dorsiflex the ankle. Can you squat low? Or does your person have longer legs relative to their torso? Are they recovering from a knee issue that might be contraindicated to full knee extension (like a meniscus injury?).
There can be many restrictions in this area and it also has the highest risk of issue due to the excessive load people will put on their knees in order to force themselves into a straight legged position. The restriction might also come from hamstrings, calves or somewhere else, not even the ankle.
So here’s my question: Can or should you do all of these things and hold them for time? No? Maybe this movement isn’t for you.
What people need to realize is that even though it is relaxation based and supposedly “stretching”, yoga is still force on joints. Sometimes a lot of it. Another common flaw of the downward dog is that people will generally run away from weakness. This means that if they are weaker in the shoulders and have trouble there they will dump more load into their lower body in this position. If they are weaker in the lower half they may dump more load into their upper body. I have seen this often in classes. And it can cause a serious problem if suddenly the load shifts by 20-30% into the wrong area suddenly due to a weakness somewhere else. However, due to the nature of the position there isn’t any way to get out of it. Except for compromising by say, lifting your heels or bending the knees or even elbows to put load elsewhere.
So what are some good modifications? Well, like in any other loaded position if you can take the load off a bit, then the person can attempt the range of motion without the excessive joint force. For example, a person with good shoulder mobility but poor posterior chain range and pelvic movement might want to perform a simple hip hinge with their shoulders extended and brace their upper body against something. Prenatal classes often recommend this.
Another option might be to intentionally elevate the heels and bend the knees as I expressed earlier. You can also bend only one knee or alternate sides. For less force on the arms and shoulders, lower the body and rest the forearms on the ground. These are all modifications that can easily be suggested in a class but often aren’t. During a busy class most instructors just don’t have the chance to go around and suggest individual modifications to people.
Or here’s a thought – don’t do it. There are ways to work up to this movement, just like any other yoga movements but so many people make the mistake of jumping in and following along, and then wonder why they are sore the next day and never want to go back.
The good news is that with my modifications to her positions and telling her to skip downward dogs my client successfully navigated two yoga classes and has been able to get back in touch with something she previously enjoyed but couldn’t do.
Don’t get me wrong, I’m a fan of yoga. I’m a fan of anything that keeps people moving, enjoying loaded positions to develop strength and will over time develop additional range of motion. I’m also a big fan of the relaxation side of the practice and allowing people to be in a parasympathetic state, even if it is only for five minutes at the end of class in savasana. It’s something most people should do a lot more of. The reason I’m writing this is to make sure that if you are about to jump back into yoga because you think it is a good way to ease into exercise again – it might not be depending on the class.
As always, if you have comments feel free to comment here or email me at firstname.lastname@example.org. Good luck with your future practices!
For the past week here in Ottawa I was a participant in a great course called Yoga Tune Up teacher training, where I got to spend seven full days with a bunch of very dedicated professionals getting tuned in to the yoga world a bit more. While I’m still processing everything that happened during the week, I wanted to share my initial observations with my readers and clients because there were a few things that jumped out at me right away I wanted to share.
The people who attended this course with me were from several different corners of the fitness industry. There were yoga instructors, CrossFit trainers, powerlifters, dance instructors, and even just regular people who wanted to learn more about yoga or had taken the class and wanted to learn how to present it themselves. Why did I take it? It is very rare that courses come to Ottawa, and I have known one of the main instructors for a couple of years and have a lot of respect for his knowledge and what he brings to the fitness world with his intention. To be fair, the course was not entirely what I expected and I would not have taken it if I knew what the days were going to entail, as I have no intention of being a yoga instructor – but here’s some things that I took away that are valuable to me. Even if a course isn’t exactly what I’m looking for, my belief is that even if you just get one thing out of it, then it still has value.
The Concept of Sankalpa
On the first day we had to come up with a Sankalpa, or a basic statement that sets your intention around your yoga practice, or simply your life at that point. It is something you are supposed to repeat to yourself in order to guide your thoughts and what you intend to do. In business this could be called a mission statement (although they are usually a lot longer). In some meditation circles it could be a mantra. The great thing is, the simpler it is the better – one sentence can be enough. Sometimes it can be oriented around something you intend to improve personally or within your practice. It is well established that once you repeat something to yourself enough, your brain and body start to believe it. Coming up with a simple statement allows you to touch base with who you really want to be, even if you have to fake it until you make it for a bit.
I would suggest that everyone come up with something like this. Repeating it to yourself under times of stress or when you need to focus on your real intention can be really eye opening in the moment. I know it certainly was for me once I figured out what it is. If you want to know, just ask me.
People Need to Follow Their Inner Voice
When I was getting to know the other participants, a common theme came up constantly through the week very similar to my own. The people had a regular job that they hated, took a class and loved it and realized that they were doing the wrong thing and decided to do something that they liked instead of something that they hated. What a novel concept. I did the same thing almost 15 years ago when I left my high paced stress filled retail management job.
I’m a firm believer that if the universe is telling you something, then you need to go and do it if or when you can. If you can’t manage it right now because of other circumstances, then start planning to get there. I have a client right now who is already planning for her retirement and what she wants to do with her life, but she isn’t retiring for another five years. Even if it takes a few years, for the rest of your life at least you will be working on your authentic purpose rather than wasting away day by day doing something that you hate. Like Jim Carrey said in a recent clip that has been making the rounds of the internet: “you can fail at what you don’t want, so why not take a chance at doing something you love?”
Mobility and Strength aren’t Mutually Exclusive
With the group that we had in the room, it was a great mixture of both “flexy-bendies” and pure strength people, but the greater thing was that everyone was open minded and listened to all points of view without judgement. The thing that emerged (at least from my perspective) was that the really mobile people didn’t have a ton of strength, and the really strong people didn’t have a lot of mobility. It is almost like a large parabolic curve with the x axis being strength and the y axis being mobility and you should aspire to be somewhere in the middle – but it is really hard to get there. There is also a well known correlation between having too much range of motion and not being able to control your joints at end ranges, which can easily lead to injury (something I address constantly with my clients).
The point there is to have a balance – but the one thing that they reinforced during the course (and quite well) was that you can’t achieve a good position of strength if your position is faulty. This means when you are trying to achieve a strong movement or even just to walk properly it is important to begin with proper spinal alignment. So many of us walk around with massive forward head posture and bound up thoracic spines and externally rotated hips, and then we go to a place where we sit all day staring at computer screens lower than our eyes should be, get into cars where we cram ourselves into seats that push everything forward, and sleep with three pillows.
I came out of this course feeling much more mobile than I have been probably in years, and with a renewed sense of who I am and my purpose in the world. It reinforced my path to me and made me aware of things that I had let slip over the past while. Moving forward through life can only be done properly if you have a sense of where you want to be, so sometimes just getting a bit of a wake up call is really valuable, and that’s worth the cost of ten courses to me. I also had a great time and met some incredible caring knowledgeable people who I’m really happy to now be networked with as possible resources for my clients and colleagues.
If you want to know about Yoga Tune Up, visit www.yogatuneup.com and check out a class in the area, it might just be worth it for you.