Yoga and Pain Management:

Of the countless trauma that affects and shapes our lives, some are but minor irritants while others challenge our very existence. Large or small, significant and insignificant, all stressful events have an accumulating affect upon our body, mind, and spirit.

The accumulated stress of daily life, and how we respond to it, may be represented in following graphic which I call, "The Pain-Threshold Model." The dotted line represents a person's “pain-threshold level,” which is normally higher in healthy people and considerably lower in chronically ill, injured, or aging people.

The Pain-Threshold Model

Accumulated stress and stimulation typically fires below a person's normally high threshold-level, as depicted with the normally healthy "person" on the left; and the person is able to tolerate a considerable amount of stress and stimulation before feeling "overloaded." Everyday physical and mental tasks are easily performed.

On the other hand, when illness, injury, or even normal aging causes the pain-threshold level to lower, as with the "person" on the right, the exact same amount of stress and stimulation as before, will be now be perceived as overwhelming and causes the person to struggle with life's daily tasks.

Said another way: Normally, accumulated stress and stimulation “fires” well below the pain-threshold-level and you can easily cope, even in the face of adversity. Although there are many factors that affect the amount of stress in your life; chronic illness, injury, and normal aging lowers the pain-threshold level causing you to become increasingly sensitive to the numerous normal and abnormal stress and stimulation that life throws at you.

The following list offers some typical examples of conditions, factors, and events that affect stress. Some are within your ability to control while others are not:

• Accumulated illnesses
• Old and current injuries
• Your age and genetics
• Your diet & nutritional intake
• The effects of seasonal changes
• Your emotional and spiritual health
• Your work and its impact on your life
• Your relationship with family and friends
• Your health care and the medications you take
• Environmental pollution, noise, and overcrowding
• Your personal finances and your relationship to money
• Appropriate or inappropriate exercise, including yoga
  

If accumulated stress and other adverse events accumulate to the point where, if over time, accumulated stress or stimulation continually “fires” at or above your pain-threshold-level (as depicted on the right side of the above graphic), it will be perceived as an assault by your nervous system.

In order to protect itself from further attack, your body's fascia will then begin to contract. When your body's fascia contracts, it is usually felt first in and around areas of old injuries and surgeries. In acupuncture terminology, this particular response to fascia contraction is known as a "facilitated pathway." Continued stimulation into a facilitated pathway causes the reemergence of pain from old injuries you thought had long ago healed ... and because of the increased pain, additional soft tissue begins contracting that begins a vicious cycle of contraction, increased pain, and additional fascia contraction. Additionally, overall fascia contraction is further exacerbated by stress.

And herein is the crux of the problem: When you can't appropriately manage your stress, and when pain and stress continues to build, the effect is that your pain-threshold level will decrease and/or your stimulation will continue to increase ... which causes your body's overall fascia to continue contracting ... and with the increasing cycle of elevated pain and fascia contraction, there comes a point by which your ability to normally function ceases.

In the terminology of both neuromuscular therapy and Recovery Yoga, such people are referred to as being "generalized."


Generalization: A result of fibromyalgia or other conditions that cause a major contraction of the body's fascia:

Medically speaking, generalization is a result of, or is similar to having "fibromyalgia" or any number of conditions that adversely affects a person's overall fascia; and as a result, adversely affects their quality of life. For an excellent educational website on fibromyalgia and myofascial pain, refer to the following website (you can return to this page by selecting the "back" button on your browser):

http://www.sover.net/~devstar/index.htm

Having fibromyalgia or being generalized are difficult conditions for the medical community to diagnose; and oftentimes, the patient is left with inadequate treatment feeling frustrated, emotionally unsupported, and alone. Worse yet, and unfortunately way too common is when their complaints are dismissed by doctors (and family) as being psychosomatic in nature.

Unless you have been there yourself, generalization is very difficult to comprehend. If you are a normally healthy yoga teacher or body therapist and you work with chronically ill or severely injured students, your intention is obviously to alleviate their immediate distress while facilitating their long-term recovery. However, without an experiential or even a conceptual understanding what it means to be generalized, a condition that often eludes medical professionals, the yoga teacher or body therapist's best intentions are unfortunately and commonly ... not enough.

Most yoga programs and body-work interventions will usually provide some degree of short-term pain reduction, which is without a doubt, rewarding to both client and teacher. Unfortunately the client's pain almost always returns without satisfying the core issue of long-term pain reduction.


What it feels like to be generalized:

When stimulation “fires” well above a person's pain-threshold-level, most everything that person does, even the things that were once easy and joyful ... becomes painful and overbearing: The normal stresses and stimulations of life that were once easily managed, now becomes unbearable. You are said to be "generalized" when:

• Your previous ability to multi-task is compromised as is the quality of your work; and it becomes increasingly difficult to complete even common tasks.

• You go through your day wishing it to be over and when you go to bed exhausted, you go down with the hope and expectation that tomorrow will be a better day. But when you awake in the morning already tired, deep down, you know the day will only get worse.

• As the day grinds on, virtually any stimulation be it bright lights, loud noises, being too cool or warm, etcetera becomes uncomfortable. But when it all gets worse, even normal conversations or a loving touch can be annoying, irritating, or even excruciating. Your entire body literally tightens up to each and every new stimulation and you soon feel so physically, emotionally, and spiritually “up-tight,” that you come to the point where you feel as if you can't take it any more ... but you have responsibilities and obligations, and you have to press on.

• Just as the day before, you can't wait to get to bed; but even so, you fear the inevitable that you will awaken the next morning feeling just as tired and exhausted as you did this morning.

And the worst thing of all is that those around you, including your family and co-workers, can't understand or appreciate how bad you feel or how hard it is for you to get through your day.


Conclusion to Part 1:

I've created the above Pain-Threshold Model with the intention of describing what it means to be generalized. Remember this: As soon as a generalized yoga student "tries" to do an exercise, or when a body-therapist goes too deeply too quickly, the increased stimulation only causes additional soft-tissue contraction ... and with it increased pain.

In the next section, I present a protocol I've developed that has never failed to help people in chronic pain to feel better. Even so, the foundations for Recovery and ExTension Yoga are not a cure for illness, chronic injury, or the discomfort that accompanies aging. They are instead, logical and sensible guidelines for helping a person to move toward balance and union; and along with that movement comes a reduction of the stimulation that is responsible for chronic pain and distress.

End of Part 2

Click here for Part 3
The Natural Progression of Recovery Yoga

I profoundly acknowledge and appreciate BKS Iyengar for introducing me to the use of props for supporting the body of chronically ill and injured students.

Also thanks to Paul St. John and Judith Walker for teaching the elements of neuromuscular therapy.

Their combined teaching led me to the understanding, logic, and techniques that allows Recovery Yoga to be such an effective tool in managing the effects of generalization and chronic pain.

End of Part 2

Click here for Part 3
The Natural Progression of Recovery Yoga