Approximately 19% of the population of Canada lives with some form of chronic pain (Statistics Canada, 2018). That’s more than six million people by today’s numbers. That’s a lot! It’s no wonder so many people are drawn to yoga classes in search of a holistic healing modality to help navigate the challenges of living with persistent pain.
I’m one of those people. While I dabbled in yoga as a teenager, it wasn’t until my mid-twenties that I came to the practice in earnest as a way to support my physical and mental wellbeing while struggling with several chronic health issues and a very stressful & physically demanding job. Not too long after that, I developed a spine injury. Yoga was one of the main things that my doctors, physiotherapists, and other practitioners encouraged me to keep up with, so that’s what I did. The only problem was that a lot of yoga hurt me. At the time, I didn’t know much about modifying my practice for spinal disc injury and chronic pain (aside from avoiding spinal flexion, as recommended by my doctors), so I continued as usual - even becoming a certified yoga teacher in the early days of the injury. Over the next several years my injury progressed, despite all of the careful stretching and strengthening, physio, doctors, specialists, and so on. I eventually found that if I wanted to continue practicing physical yoga, I was going to have to learn some ways to adapt what I was doing to suit my body more specifically.
In a lot of ways, I think of myself as a bit of a guinea pig. Over the years of developing chronic spine pain and a long search for a formal diagnosis (severe disc herniation, degeneration, and nerve compression), I learned through trial and error how better to support my body and nervous system. I started to take trauma-informed trainings, learn more about pain science and the nervous system from expert teachers and medical professionals, and I was introduced to the wonderful world of adaptive yoga from both personal experience/need and wonderful teachers such as Jivana Heyman, Carol Krucoff, Kimberly Carson, and more.
My physical practice now looks incredibly different than it did in the days of my initial training to become a teacher. I can truly say that while there are many movements that I am no longer able to do, I’m so much more in tune with my body and mind than I ever was in the days of favouring big fancy postures such as Urdhva Dhanurasana (Wheel Pose) and Bakasana (Crow Pose). After all, true yoga has nothing to do with what shapes we make with our bodies, but how we connect to our internal-selves and how we show up in the world.
There are several key components to adapting your physical yoga practice to make it more accessible while living with chronic pain. Here are some of my main tips for you:
Less is More
When it comes to persistent pain, we often need to scale things back. Sometimes that might mean a shorter practice, shorter holds, or less repetitions. There may be certain movements or body positions that are not suitable or accessible to your current state - remember, that is ok! There can also be a lot of value in making your physical movements smaller. For example, instead of lifting your arms all the way overhead, you may opt to lift them to shoulder height. Instead of bringing your hips close to your heels in balasana (child’s pose), you could lower half way. Skip anything that doesn’t feel right. Finding a skilled teacher to show you different posture variations and how to adapt your practice can be very helpful.
Let Breath Be Your Guide
Consider placing more focus on your breath in your yoga practice (and daily life). This will encourage you to slow things down and pay closer attention to your thoughts and emotions. When we connect to our breath, we’re connecting more closely to our internal state of being, which can actually give us a lot of information about how we’re feeling physically. If you find your breath becoming short, laboured, or strained, it may be an indication of over-effort or stress.
Your breath is also a key component to regulation of your nervous system. Practicing slow, conscious breathing and specific pranayama techniques, such as Nadi Shodhana or Dirgha Pranayama, have been proven to help to physiologically reduce your body’s stress response, which as we know, is typically heightened in folks with chronic pain.
Props, Props, Props
Yoga props are incredibly important for physical practice with chronic pain. They can add support, enhance comfort, create physical space in your body, and bring more ease to movements that may be challenging. Whether you’re practicing mat-based or chair-based yoga, having some supportive items can provide you with more opportunity for posture variations and exploration of what feels good in your body. Even some cushions and a blanket or two can make a huge difference in whether a yoga pose feels comfortable or not.
Pace Yourself
Pacing is a major part of self-management while living with chronic pain and the fatigue that can often accompany it. The theory of pacing is that you perform regular activities in small bite-sized chunks, with scheduled rest in between. Even on days when it feels like you could do more, it’s recommended to stick to your pacing schedule so that you can retrain your nervous system and not be tempted to overdo it.
Pacing in your yoga practice could look something like taking purposeful resting postures in between or after more active movement so that you give your body a break. For some, it might also mean that you practice for 5-10-20 minutes per session, instead of longer 60-75 minute classes. Over time, you may find that you have the capacity to gradually increase the length of time you’re able to tolerate certain activities.Restorative Yoga
Restorative is quite often an ideal style of practice for folks with pain or chronic illness. Because it is slow and quiet in nature, you’ll be much less likely to push yourself beyond your capacity. In restorative yoga we work to support the physical body in long-held, propped-up, relaxation-based postures (without any deep stretching). This helps to encourage the natural healing mechanisms of the body to come online by consciously elevating the parasympathetic nervous system response (the “rest & digest” aspect of the NS).
The Other Parts of Yoga
If you’re newer to yoga, you may not know that the physical postures (asana) are only one of eight parts of the practice. These are called the Eight Limbs and are attributed to a traditional text called The Yoga Sutras of Patanjali, which is a guide to spiritual practice in the yogic traditions. This is wonderful news because it makes yoga truly accessible to all people, creating different entry points to develop a personal practice. The eight limbs are as follows:
1. Yama (ethical guidelines for engaging with the world)
2. Niyama (ethical guidelines for engaging with oneself)
3. Asana (physical postures; translates to “seat”, originally referring to sitting for meditation)
4. Pranayama (different breath techniques to extend or enhance prana, “vital life force energy”)
5. Pratyahara (withdrawl of the senses, focusing less on external stimuli)
6. Dharana (intentional concentration on a single point of focus)
7. Dhyana (the state of meditation)
8. Samadhi (through dedicated practice, one may find their individual consciousness merge with the Universe/Divine, experiencing a true transcendence of the individual-self and feeling a deep interconnectedness with all things)
As you can see, there’s much to say about the topic of yoga and chronic pain! I hope this gives you a little bit of insight and direction in your personal practice. I welcome you to check out the online studio to see if any classes might be suitable for you. If you have any questions, don’t hesitate to reach out!
- Katie