Thursday, December 15, 2011

The psychology of injury in Ashtanga: Some thoughts


I just watched the above video by Kiki, in which she talks about some useful ways to modify the practice to work with and help to heal wrist injury.  If you are working with injuries or other issues in the wrists, you might find this useful.

Not being a very experienced practitioner, I don't have any specific anatomy or posture tips to offer for practicing with injuries. What I would like to do instead is to say a few things about the psychology of injury in yoga, specifically Ashtanga Vinyasa Yoga. A lot has been written about the common injuries that Ashtangis have sustained in the course of practice, and how to go about treating those injuries and/or modifying one's practice to work with those injuries. All this is valuable and useful information, of course. But I have noticed that very little has been written about what I call the psychology of injury, i.e. the mindsets and attitudes that Ashtangis with injuries tend to adopt. I'm not talking about the mindsets and attitudes that lead to injury: We are more or less familiar with this (ego, pushing too far beyond one's limits, neglecting to listen to certain signs from the body, etc, etc.). What I am interested in talking about are the mindsets and attitudes that Ashtangis tend to have when they have an injury. I have noticed that very little has been written about this area. I'm not sure why this is. But I personally think this is an important area to discuss and think about. After all, according to yogic philosophy, the mind and the body are ultimately one entity. If this is so, then what goes on in the mind inevitably manifests in the body. This being the case, it seems to me that the sort of attitude or mindset one adopts when one is working with an injury will have a direct impact on how effectively one heals from the injury.

Since I hurt my knee more than a month ago, I have had the good fortune of communicating with a few Ashtanga teachers who have worked with injuries at one time or another in their practice careers. They have offered me a lot of helpful advice and specific suggestions. Through my discussions with them, I have noticed that Ashtangis who sustain injuries in the course of their practice tend to adopt one of two attitudes towards their injury:

(A) The Badge of Glory Attitude: As the name suggests, Ashtangis who adopt such an attitude display their injuries almost proudly, as signs that they are super-dedicated or devoted to the practice; so dedicated that they quite literally sacrifice their bodies to the practice. I must admit that while I have heard lots of stories about such Ashtangis, I have never actually personally met such an Ashtangi. Maybe they don't exist anymore. I don't know. But if the stories I hear are reliable, then such Ashtangis have at least existed at one time or another.

(B) Shame/Embarrassment: Quite a few Ashtangis are either reluctant to talk to others about their injury, or keep their injuries secret altogether, because they feel shame and/or are embarrassed about their injury. Why are they ashamed or embarrassed? According to one of the teachers I communicated with, this may be because they are embarrassed about being seen as "not evolved enough" to be able to practice without sustaining injuries. Perhaps they are also embarrassed/ashamed about adding to Ashtanga's bad rep: They are embarrassed/ashamed about becoming another example of why Ashtanga is a dangerous/injury-inducing practice ("What? You busted your knee/shoulders/broke your back doing Ashtanga? See, I told you this is a dangerous style of yoga to practice, but you wouldn't listen, etc., etc."). I can personally attest to the presence of such attitudes of shame/embarrassment among Ashtangis: I struggle with these feelings myself.

As you probably figured, neither (A) nor (B) is a productive or healthy attitude to have towards injuries. (A) causes one to not listen to one's body during practice, and to do things that might well lead to more injury in the future. It may also give people the impression that Ashtangis are supposed to have a gung-ho attitude towards injury ("If you're not breaking your leg, you're not working hard enough!"), and may either lead people new to the practice to do things that are harmful to themselves, or turn people away from Ashtanga altogether.

(B) is not a productive attitude to have either. If one is embarrassed and reluctant to talk about one's injuries, one might end up suffering in silence, making what is already a difficult experience more unnecessarily difficult. It is also harder for such an individual to seek help. Perhaps more importantly, injury can be a valuable learning experience both for the individual and for others who may benefit from hearing about experiences of injury healing. If one does not talk about injury out of shame or embarrassment, one deprives oneself and others of a valuable learning experience.

Please don't get me wrong: I am not saying all this to chastise or single out people who choose not to speak about their injuries. I'm not trying to start any kind of "Let's Talk about Injury Until the Cows Come Home Movement". Nor am I trying to start any kind of witch-hunt, or anything like that. Your body and mind (and mouth) are yours and yours alone, and it is totally up to the individual to decide what is the best course of action to take. I am just observing, based on my own experience, that neither (A) nor (B) are productive attitudes to have, because both of them ultimately do no good to either the practitioner or to others around him or her.

What, then, might be a more productive attitude to adopt towards injury? Here's a suggestion:

(C) Acceptance of injury as part of the process leading towards wholeness: One of the teachers that I communicated with was able to use the asana practice to heal a knee injury over a couple of years of careful and patient practice. He shared the following with me:

"It was a long process that took a lot of awareness and had many ups and downs.  The challenge for me was that as it started to feel better, I would inevitably begin to push beyond my limits and suffer a setback.  The pain can be a real indicator that wakes up awareness of an area.  So, much of my work was first and foremost in the area of awareness.  I had to learn not only how to be aware of my limits, but to discern the different muscles, tendons, and other tissues that were at play in a certain movement.  For me it was anything involving a half lotus.

In my case, I had to specifically learn how to stretch and lengthen the adductor group and the quadricep group in these poses while engaging the hip flexors.  It was just a gradual process of learning to discern what to engage and what to stretch and doing my best not to confuse the two.  Over the course of a couple of years, it was like going from blind to sighted with regards to that particular part of my body...  It was a real lesson in listening to my body.  What I didn't do was to skip poses.  I would instead allow as long as I needed to get into poses, and modify if necessary or not go as deep as I was used to going...

This, in my opinion was key to my recovery since it allowed me to address the underlying imbalance (short adductors and quadriceps) that I believe caused the injury in the first place.  This approach is not for everyone, and it took a lot of time and patience.  I often times doubted my process and had fear and anxiety around it, but it was faith in guruji's advice that kept me going.  I don't believe there should be any shame in injury or getting surgery.  These pains and injuries that come up are part of a much larger process leading towards wholeness.  I believe that these imbalances live in our body and cause tremendous suffering either consciously or unconsciously by the ways in which they limit our life experience.  It would be nice if we were tuned in enough to move towards harmony and balance without the injuries and pain, but at least in my case, I have had to learn the hard way periodically.  However,  I am always grateful for the chance to grow and learn and I believe that I am better off having addressed these imbalances."

Before I go on, I should issue a little disclaimer here: I included a lot of details that are specific to this particular teacher's injury-healing process, because I feel that these details are needed in order to convey the depth of his process. However, I must emphasize that none of the above is intended to be any kind of medical advice and/or specific advice on how to practice. As the teacher himself stated above, there is no one-size-fits-all solution to practice issues: This is especially true when one is working with injury. Please be advised accordingly.     

Having said this, I think the gist of this teacher's account lies in the insight that injury and pain are necessary parts of the journey of practice for many people (including yours truly). If one happens to be one of the fortunate practitioners who never have to work with pain and injury through the course of the practice journey, that's great (such a person would probably have to be somebody who has practiced yoga for many lifetimes before this one). But if you are, ahem, a mere mortal like me, take heart: Injury is not the end of the world, or the end of your practice. It is, in many ways, a new beginning.

8 comments:

  1. Great post, Nobel! I can definitely relate to Option B and have experienced shame at not being evolved enough to avoid injury. But I do agree that injury is physical manifestation of a large yet subtle process. The ALL in our favourite catch-phrase, "practice and all is coming" is sometimes more all-encompassing than is convenient... Thanks for sharing the email. I hope that you are still enjoying your practice!

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  2. Thanks Erica. Yes, the "ALL" in "All is coming" often encompasses more than we bargained for :-) But the upside is that the practice is powerful enough to transform everything into fuel for our self-development and self-realization.

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  3. Love the post Nobel, especially the last sentence, it is a new beginning. For me in particular, having experienced not being able to practice at all in two months was a revelation when I finally was able to come back, it [disease / injury ] worked as a cathartic leap forward in my work with the mind, and I came back into the practice with refreshed eyes and a renewed sense of purpose.

    I feel you are getting benefit from talking to these teachers and I am grateful you share because you are quite right that there is not a lot of writing (not at least lately that I've seen) on the psychology of unjury indeed...

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  4. Thanks for sharing, Claudia. I can certainly see that you are coming back to the practice from Lyme Disease with a fresh perspective. Although my situation is different from yours, my injury has also made me work with the practice in a new way; so in this way, I also get a fresh perspective ;-)

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  5. Great post as always Nobel! Thanks to my elbow injury I have cultivated a lot of body awareness. Recently, I have noticed some pain in the elbow which has healed when I do a certain pose and so as, not to have a recurrence of the same injury, I have asked my teacher for a variation for the pose. I think it is important to accept the limitations of our body and find new ways to work around it.

    Karin

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  6. I could tell that we’re on the same interest and obsession. Good to know someone I could share my ideas. Looking forward to know and learn some more from you. I'll be glad to share my own thoughts to you soon. Thank you for sharing such valuable articles. More power!

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  7. Hello Karin,
    thanks for sharing. Yes, I really think that a spirit of courageous acceptance is necessary when working with injury. Accept the injury for what it is, and courageously accept what it has to teach us, and work with it.

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  8. You got a really useful blog I have been here reading for about an hour. I am a newbie and your success is very much an inspiration for me.

    Hip Replacement CT & Hand Injury CT

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