Yoga - Practical Bodywork

Satirical Aerobics

For years I have had a dream.

It strikes me that most exercise videos are excessively earnest. Perky! Sincere! Cheerleader-esque!

There seemed to be few, if any, home workout routines for people with a healthy sense of irony, and a taste for the absurd. My people.

For too long I lacked the time, the equipment, and the chutzpah to make an ass of myself, without losing 30 lbs and an ankle brace or two.

But now–thanks to the unremitting skill and attention of Terry McHugh of NovaCare Physical Therapy, and Dawn of MotherHeart Studio–my chronic knee and ankle injuries are so well-healed that I can skip, sauté and bourreé to the satisfaction of all my kitchen appliances, and the total expense of dignity.

Because nothing hurts.

EXCEPT MY BROKEN, BROKEN HEART.

The Five Stages of Healing (Bodyworker Edition)

Like a lot of other practitioners, I tend to suffer from bodyworker machismo. I spend my days treating other people’s pain, and ignoring my own. Which is exactly what I advise my clients not to do.

Recently, I hurt my foot. The technical description of what I did was tearing the plantar fascia on my right heel, after changing my running gait from heel-strike to ball-strike, and then doing yoga with a calf muscle in spasm. But that wasn’t my experience. My experience was that I got out of bed one day and my foot hurt.

So, for your edification and amusement, here are the five stages of Macho Bodyworker Healing.

1) Denial.

All I need to do is warm up, give my foot a rubdown, and it will go away. Like, in ten minutes. In a day or two. In a couple of weeks. Don’t mind me, I’m walking very slowly today. I’ll just stop running until this gets better. Dammit.

2) Bargaining.

I can’t afford to get this treated. I know all about plantar fasciitis, from that two-year bout with it I had, a decade ago. It’s not THAT bad. I’ll stay off of it for a weekend, roll my feet, wear my arch supports. Do some self-treatment on my gastrocs and soleus every morning, and evening, and several times during the day. See? All better!

3) Desperation.

It’s not getting better. I can’t afford to be crippled for two years, again. I can’t afford NOT to get this treated. I’ll call that Rolfer, what was his name? Brian Stern! He’s expensive, but so what? I’m crippled! My body is my livelihood! I have to keep up with two kids in the Franklin Institute! Help!

(Brian Stern is excellent at what he does. He restored considerable articulation to a pair of malformed ankle joints which were rusted stiff. Also, he is warm, approachable and sympathetic. Don’t you hate it when you go to a doctor, in desperate pain, and you get the sense that you are a boring nuisance to said doctor, and to most of his staff? That’s one nice thing about bodyworkers–most of them genuinely like people.)

4) Resignation.

Okay, that was great. My foot still hurts, though. I’d better do the foam roller every day, twice a day, and some gentle yoga. In fact, I should not skip the yoga even when I stop hurting. Because that’s what started this problem in the first place.

5) Exhibitionism.

All better! Mostly. I can walk right-left, right-left again, instead of thump-drag, thump-drag. I’ll do the foam roller for another week before I resume running. Meanwhile, I’ll describe this process in excruciating detail on my blog, so that others may learn from my foolish suffering.

Physician Heal Thyself

Piriformis_muscle

Image via Wikipedia

–guest post by Sujatha Ramakrishna, M.D.

Having a family full of doctors can be such a mixed blessing. Most physicians are aware of the pitfalls of being related to someone who knows way too much about every little ache or cough.

When I was a fourth-year medical student interviewing for residency positions in psychiatry, I met up with the department chair at UT Southwestern in Dallas, whose wife was also a physician. I guess he must have gotten bored with the usual interview questions, or perhaps he took one look at my transcript and decided there was no way was he accepting me into his program, because the discussion took a personal turn.

He asked me what it was like having two physicians for parents, and hinted that certain issues had arisen over the years with his own children. My response was simply, “Well, when I was a kid, and I got sick, they either didn’t care at all … or they totally freaked out.” He just about died laughing at that one. It must have sounded incredibly familiar to him. Perhaps that answer meant that I would have gotten accepted into his program after all.

Now I am a grown-up shrink, and I still have a family full of doctors who provide ample advice, both solicited and unsolicited, for every ailment imaginable.

A few months ago, I got up quickly after sitting in an awkward position on the edge of my couch, and I thought that my right leg was asleep. Well, walking it off, of course, was the solution. Only … whoops! I had foot drop. For those of you who don’t know, this means that when you try to walk your toes drag the ground. Flashback to those med school classes, trying to remember what that meant. Was I having a stroke? A compressed nerve? Hysterical paralysis?

Med school was 20 years ago, as was my last neurology rotation, so of course I had no idea. But I knew that Google would save me … hmm … “damage to the peroneal nerve.” Ok, that sounded reasonable.

But wait, it wasn’t so simple. I also started having twinges under my right seat bone, with radiating pain down the back of my thigh and around to the front of my lower leg. Not good. I had to cancel a trip to Texas, because I had been planning to drive but couldn’t sit for that long.

That’s when all hell broke loose.

My mom the family practitioner called me up, and suggested all sorts of narcotics and muscle relaxants that I could take. She said that if I came down to Texas my sister the radiologist would get me a free MRI. My cousin the orthopedic surgeon asked me if I had back pain, and wanted to know the positional nature of the symptoms.

My aunt the pathologist told me that the real problem was that I needed to acquire more padding on my ass, and suggested having a mojito to get that process started ASAP. As a side note here, one of the really wonderful things about belonging to an Indian family is that you get updates on how much weight you have gained or lost every time you see them, even if the scale says that you haven’t gone up or down 2-3 pounds in the last five years.

My uncle the vascular surgeon, after having a few scotches at that same gathering, started off with a recommendation for a nerve removal, assuring me that yes he had done neurosurgery rotations back in the 1970s (!) and finished with the brilliant idea that a total leg amputation would be a more permanent solution and also earn him more money.

My father the emergency room physician had the most practical advice of all, which was simply, “Don’t drive to Texas.” Words to live by.

Fortunately, another cousin of mine and her husband are physical therapists. I showed them where it hurt, and they immediately said, “Aha! Piriformis!” I said, “What???” We either hadn’t learned about that one in anatomy class, or I had forgotten. More likely than not the latter.

Basically, the problem was a tight muscle which was compressing the nerve. They showed me a stretch that would relieve the tightness — sitting on the floor with my knees bent, crossing the right leg over the left, and using my left hand to pull my right knee towards my left shoulder.

Soon the party at my cousin’s house turned into a mini-yoga class for everyone, which was hilarious but also more therapeutic than any advice that I had received from any of the physicians. I did the stretches that they showed me every morning, and I haven’t had a problem with that nerve since then.

Obviously I am lucky to have such a caring family, and their intentions were nothing but the best. But this story is a great example of how maybe we doctors are too quick to turn to pills, diagnostic equipment, and the knife in every situation. When those things are not indicated, we have few other resources to fall back on.

Back in the old days, doctors didn’t have all the fancy tests that we have now, so they had to spend a lot more time listening to and observing the patient in order to make their diagnosis. You might even say that the close personal relationships which they had with their patients were their best diagnostic and therapeutic tools. We could all use a lot more of that these days.

Weight Loss, Revisited

Certain Foods Can Aid Weight Loss – NYTimes.com.

Pureed vegetables in your casseroles? Seems devious and mildly depressing, but if you must.

However, Pretty Lady’s advice for joyous weight loss is still relevant, so here it is, virtually unedited.

1. Do yoga.

Yoga, by and large, will not directly help a person lose weight. It does, however, gently balance and nourish the body as a whole, thus relieving pain, toning the system, helping to release toxins, and getting you in shape to tackle a more-rigorous workout.

If you are having trouble standing up out of chairs, if your back hurts constantly, and you cannot touch your toes, it is best to start with Basic Hatha. This will involve moving slowly into mildly contorted poses, and learning how to breathe. Select a teacher who explains things clearly, is anatomically knowledgeable, and does not shame you.

If you are already able to touch your toes, or if you do not suffer from chronic pain and are in relatively competant cardiovascular shape (i.e. you do not start puffing heavily while climbing two flights of stairs), you may start with Bikram. Bikram is the fabled Hot Yoga sequence, popularized by Madonna and Gwyneth. It is a series of twenty-four poses, performed in a sauna-temperature studio, which are designed to flush the entire body of toxins, stimulate each body system in turn, and take years off your age.

Pretty Lady can attest that it works. After her first class, she experienced quite a dramatic toxic–well, this does not bear description. After her first two weeks of classes, she looked five years younger. After her first six months of classes, she was bored silly. Pretty Lady is a dancer by temperament, and repeating the same damn series of poses every day drives her bananas.

So she moved on to Vinyasa. Vinyasa Yoga is basically Hatha, but a bit more challenging, rigorous, and movement-oriented. A good Vinyasa teacher will have you puffing and doing acrobatic stunts in no time.

2. Work out.

If a person is serious about shedding spiritual poundage, however, more than yoga is required. Once you have done enough yoga so that you can stand on one foot and pull the opposite ankle up to your behind without thinking much about it, you may move on to a more cardiovascular workout.

By far the cheapest and easiest of these is running. Running merely requires a good pair of shoes and a world to run in. If you are not enlightened yet, the world is in front of you; do not skimp on the shoes. Good arch supports are a must. Buy another pair of shoes every six months, whether you think you need them or not. Pretty Lady can attest to the horrors attendant upon working out in bad shoes.

Unfortunately, running is also the sport which causes the greatest amount of wear and tear on the limbs, as Pretty Lady can also attest. If you are over thirty, have flat feet, dicey knees, chronic back pain, or wish to avoid these things, take up biking instead. It doesn’t give you either such a dependable endorphin high or quick physiological transformation, but in the long term it allows you to keep your ability to walk.

Speaking of walking: do it. Every day, at every decent opportunity. Take the stairs. Pop round to the corner store. Stroll up to the lake, or round the park. Visit the neighbors. Fie on this driveway-office-driveway-supermarket-driveway culture. Fie, I say.

It is important to discover a workout which gives you joy. If you love swimming, swim. If you love dancing, dance. If you love hiking, biking, fencing, kickboxing, tennis–well, there you go. If you love beating the shit out of people, there are innumerable martial arts studios springing up everywhere.

3. Watch what you eat.

Pretty Lady is not fond of the Denial attitude toward diet. Proscriptions are depressing and ultimately unsustainable. Surrounding your mental landscape with a forest of ‘no’s’ is not, in her opinion, the best way to cultivate a sense of spiritual freedom, joy and possibility.

Instead, concentrate on adding healthy, wonderful, fresh, nutrious, organic foods to your diet. Focus on fresh organic vegetables, salads, fruits, nuts, whole grains, and fish. Go out of your way to use organic extra-virgin olive oil. Variety is key; get a Thai, Indian, or Chinese cookbook and start experimenting. Make French salads.

Pretty Lady must pause here and give her general guidelines for a French salad.

Take one each of: a green, a steamed or cooked or grated vegetable, a cheese, a fruit, and a nut.

Dress with a dressing made up of: extra-virgin olive oil, lemon or lime juice, balsamic, apple cider, or red-wine vinegar,herbes du provence, salt and pepper.

Suggested greens:
arugula
Boston lettuce
red or green leaf lettuce
endive
escarole
kale (use plenty of lemon in the dressing for this.)

Suggested vegetables:
steamed sugar snap peas
haricots verts (or green beans are fine, sort of)
steamed asparagus
beets, boiled or grated raw
grated carrot
tomatoes
steamed or canned yellow corn
artichoke hearts
mushrooms

Suggested fruits:
apples
pears
figs
kumquats
dried cranberries
mandarin oranges

Suggested cheeses:
bleu
goat
manchego

Suggested nuts:
pignola
toasted walnuts
pecans
sunflower seeds

Feel free to mix, match, add, and experiment to your heart’s content. If you cannot find herbes du provence, get organo, basil, marjoram, thyme, and rosemary, and mix them together.

Also, substitute solid white albacore tuna for the cheese, or add anchovies to the dressing.

Once you have got in the habit of including at least one fruit, vegetable, whole grain, and lean protein in each meal, buttressed by modest amounts of olive oil, you will find that such things as chips, doughnuts, cake, cookies, white bread, deep-fried food, greasy meat, sodas, ice cream, and generally bad-for-you things do not disappear, but lose their central importance. You cannot ingest an entire bag of chocolate chip cookies when your system is already knawing on an exquisite French salad, perhaps with a bit of homemade bread, and an espresso for dessert. You may find the room for two or three cookies. But then your system will simply say, “no, thank you. I do not require more cookies. I am Content.”

4. Love people, love what you do, love your life, love yourself.

Overeating and failing to exercise are symptoms of despair and self-hatred, in Pretty Lady’s opinion. They are an attempt to fill a deep internal void with sweet greasy fluff. This is why the sight of an obese person makes Pretty Lady want to cry, rather than sneer. She has been there herself; most of us have. If you find yourself compulsively overeating, look critically at your life, and ask yourself, ‘what do I need that I haven’t got?’ Be honest. Acknowledge the frustration, the rage, the loneliness, the misery, the humiliation. Forgive yourself for feeling these universal human emotions. Acknowledge that you are a child of the universe, and you have a right to be here.

Then get to work rectifying the real problem, and leave the doughnuts behind.