Inspirations
Yoga Rahasya
Yoga Rahasya II.26, 4.31
After having examined the origins of the diseases of the body and senses, the teacher must apply kriya yoga. Otherwise there will be no benefits. To destroy the diseases of the body, the body must be used.
Key Points
The application of yoga therapy is an advanced skills that should
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not be used except after several years of training.
When working with injury, work slowly and conservatively so as to
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create a positive evolution towards healing.
the Injured Warrior
It is inevitable that either ourselves or our students will face minor changes in our physical abilities on a daily basis, prompted by the physical stress of our yoga and non-yoga practices. When physical practice is improperly done, either because of overexertion, lack of attention to the quality of movement or breath, or some other factor, we open the door to injury. Physical injury may also arise
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for many other reasons, including accidents, defects at birth, and aging.
Within the textual tradition of yoga, injury is often presented as a karmic outcome of our actions, and therefore an opportunity to learn from them. This sensibility and perspective is unlikely to be the initial landing spot of any but the most equanimous yogins, however. It is far more likely that people injured in physical activ- ity, including yoga, will experience a predictable pattern of behav- ior in relationship to injury.
Psychological Stages of Injury
When a person sustains an injury that substantially reduces his or her ability to perform certain functions, there is a relatively predict- able pattern of behavior that emerges. The value of knowing this pattern is that it will give asana instructors insight into communi- cating with the injured student.
Injury-Relevant Information Processing
1. . In this initial phase,
the injured student is coming to understand the nature of the injury and the extent to which it will limit movement. There many also be questioning as to why the injury happened (both on a practical and emotional level) and the emergence of nega- tive thinking patterns around the injury.
Emotional Upheaval and Reactive Behavior
2. . In the following
phase, the student becomes emotionally active in relationship to the injury. Emotions can include anger, shock, self-pity, de- nial, and disbelief. (Note that from a psychological perspective, the emotional responses are rarely presented as positive mental experiences).
Positive Outlook and Coping
3. . In this phase, the student accepts
the injury and begins to develop positive reaction and coping strategies. At this phase, the student can actually begin to heal the injury on a physical and mental level.
Responding to the Injured Student
Many students, particularly those with a strong attachment to their yoga practice, will want to continue to perform poses that will exacerbate the injury. A common example of this is students with wrist injuries, particularly those created by carpal tunnel syn- drome. For these students, poses such as chaturanga dandasana or downward facing dog may create immense pain and discomfort. However, they may ignore the pain, feeling that they can “power through” these pain points or that doing these poses will, over time, alleviate the pain.
With all students, but especially those with injuries, it is important to share with them the importance of the first yama, ahimsa. Nat- urally, those students in the second phase of psychological aware- ness will not be prepared to hear this kind of lesson. However, until they recognize that their practice must evolve to address the injury, the students will continue to experience pain and physical limitations that will likely resolve far more slowly than it would with proper care and attention.
While the student is healing, you may want to make it a point of checking with the student after each class or session to determine their attitude and relationship with his or her injury. Recalling the various stages of psychological adjustment, try to encourage the student to move through the second stage into the third stage of injury awareness. As discussed below, offering options within a pose that, while still providing the physical benefits, may prevent further strain or reinjury can be important. Above all, recognize, even if only on behalf of the student, that there is a lesson in the injury.
Modifying the Practice
When dealing with injuries, the first concern is not to exacerbate the condition. In the first stages of injury, there is usually a good deal of inflammation and heat in the area, as the body shifts blood
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flow to the area to assist with healing. After this stage, the body begins to lay down new tissue to heal the site of injury. During the acute stage of inflammation and swelling, some specific asanas may be recommended, but a complete vinyasa practice may not be possible or advisable. After the body has begun to heal the injury site, the student should follow a conservative practice plan that will gently restore the area to full mobility and ability. For example, if the student has strained the hamstrings, then poses that stretch or strengthen the hamstrings should be done with complete mindful- ness to the sensations in that pose.
In some cases, modifying the practice may involve the complete re- moval of certain categories of poses. Particularly in group classes this can be awkward for the teacher as well as the student. While the best course of action is to encourage the student to follow the feedback received from his or her body, many students will become discouraged if a good portion of the class is not accessible to them. It is up to you as the instructor to determine how best to proceed. The most practical approach is to continue to teach the class in a manner that is consistent with your intentions for the group, and individually encourage those students with injuries to develop right relationship with the practice.
Students living with different abilities
Another dimension of the injured warrior are those students work- ing with chronic or permanent differences in ability. Some people with permanent disabilities may continue to caught a negative mental cycle regarding themselves and their injury. However, many people with continuous or lifelong differences have learned to cope and adapt. The former group of individuals should be handled as discussed above.
The latter group, however, have likely developed different coping strategies and activity patterns surrounding their injury or disabil- ity. For that reason, these students may known how to modify their
physical yoga practice. As with any new movement system or pat- tern, students will likely need to multiple exposures to best figure out how to best adapt the pose to their bodies. As an instructor, it is your role to encourage them to find the appropriate adaptations, working with them as necessary to insure that the modifications will give them the same benefit as the original proposed structure of the pose.