By: Sarah Penning, DPT
Overuse injuries are the most common yet at times the most difficult injuries to rehab. It takes time, patience, hard work and the most challenging of all, rest from the activity that people often love. Runners, tennis players, swimmers, avid gym members and even those who practice yoga can be at risk for developing on overuse injury.
Recently I had the humbling experience of injuring my own shoulder while practicing yoga. As a physical therapist and strong proponent of yoga I was somewhat baffled by my injury. I thought to myself I have been taking yoga for almost 4 years and have never been injured. I consider myself strong, healthy and well-educated about injury prevention as a health care provider. Then I realized I was just like so many of my patients strong yet prone to injury secondary to imbalance.
Yoga has an over abundance of health benefits and has been around for over 5,000 years. Many have caught the “yoga bug” and swear by the physical and mental benefits of this practice. The Sanskrit word yoga does indeed translate to “union” or “to yoke or harness.”1 For many of us we find ourselves on our mat seeking union, seeking balance in our lives and in our bodies. Yet unbeknownst to us we may be putting our bodies in a vulnerable position if unaware of the muscle imbalances that often develop in yoga.
Muscle imbalances within the shoulder girdle often develop in yoga due to the extensive amount of push type exercises such as chaturanangas that most practices entail, without sufficient counter poses.2 When repeatedly transitioning from a high push-up to a low push-up position into upward facing dog, injuries such as tendonitis (inflammation of the tendon) and bursitis (inflammation of the bursa) can often develop as well as instability of the shoulder.
When in a plank position it requires much strength from the anterior muscles of the shoulder, such as the pectoralis major and minor, anterior deltoid and long head of the bicep tendon. These muscles must work in a static or isometric way to stabilize the anterior aspect of the shoulder girdle. When lowering from a high plank to a low plank position these muscles must then work eccentrically to control the decent of the body as these muscles lengthen. Finally when pushing the chest through to upward facing dog the triceps and muscles that lie between the shoulder blades must concentrically contract or shorten to attain this posture.
In many instances beginners taking a yoga class do not have the strength in the aforementioned muscle groups when quickly transitioning from the above positions. Commonly practitioners find the transition from low plank to upward facing dog the most challenging secondary to weakness in the triceps and inter-scapula muscles. This translates into poor body mechanics of the upper body and trunk. For example, when the shoulders drop lower than the hips in chaturananga this can impinge or inflame the muscles that lie in front of the shoulder through repetition of poor alignment when one struggles through a vinyasa.
After sustaining such a shoulder injury due to yoga people often report pain when lifting the arm overhead, out to the side or across the body. The pain is usually localized to the front or outside of the shoulder and these areas are also tender to touch. Lastly, reports of stiffness and or discomfort may be experienced in the front of the shoulder when efforts to stretch the front of the shoulder girdle are made.
The first thing one should do if they are having shoulder pain is to seek medical attention from a physical therapist and or an orthopedic doctor. Physical therapists specialize in musculoskeletal injuries and can aid in determining a diagnosis so that appropriate treatment can be rendered.
As a physical therapist who is currently recovering from a shoulder injury and providing treatment to many with shoulder pain I believe strongly in the benefits of physical therapy and it’s ability to return athletes to their previous level of activity. When dealing with any person who presents with an overuse injury it is imperative that one determine what weaknesses reside. In many instances there is a commonality in the imbalances found within the shoulder girdle. Frequently patients will present with tightness and muscle bulk in the front of the shoulder which is countered by weakness and atrophy in the muscles in the back of the shoulder and in between the shoulder blades.
In the acute or early stages of a shoulder injury a physical therapist may use an array of various modalities, such as ultrasound, soft tissue massage and ice to decrease the inflammation. Ultrasound functions as a deep heater of the tissue and aids in fueling the healing process while massage helps to break down scar adhesions. Once the signs and symptoms of acuity have decreased a series of stretches and strengthening exercises for the shoulder are prescribed.
When a patient begins to engage in the process of rehabbing the shoulder education is key. As a physical therapist it is imperative to teach patients about their injury and why certain exercises are beneficial or counterproductive. Through sports specific training and education about modifications and safe form, physical therapists can equip people with the appropriate tools to return to the very activity that may have brought them through their doors. In simple terms physical therapy can act as a catalyst for people to achieve equinity and independence in maintaining balance.
The physical therapists at Bounce Back Physical Therapy have been rehabilitating clients with overuse injuries for many years earning a reputation for their individualized sports-specific training and commitment to quality of care. The therapists on staff are happy to conduct a free screening upon appointment for those who may be experiencing pain or are interested in learning about how physical therapy could benefit their body.
By: Sarah Penning, DPT
Bounce Back Physical Therapy
215 Sugartown Rd.
Wayne, PA 19087
http://www.bouncebackpt.com/
References:
Turlington, C. Living Yoga: Creating a Life Practice. NY, NY: Hyperion; 2002.
Yoga and Shoulder Injuries. 2009: 1-4. Available at http://www.acrocore.com/yoga-and-shoulder-injuries/ . Accessed March 3, 2009
Friday, October 23, 2009
Wednesday, October 7, 2009
No Rush. No Distractions.
My oldest daughter turned 16 years old a few weeks ago and last Saturday morning she eagerly awaited her first driving lesson. Now I’ve been teaching for a long time but I never realized what a huge responsibility it would be to teach someone how to drive.
My husband took the first crack at it and brought her to a parking lot to go over the basics. After an hour or so, she wanted to take me around the block to show off her new skills. So I relinquished all control and allowed my baby girl to drive me around for a few minutes. After arriving safely back in the driveway she and I talked about the importance of being a safe driver and how she needed to take responsibility for her actions behind the wheel. I simply told her that as long as she was not in a rush to get anywhere and as long as she was not distracted, that she would be just fine.
Later that night I thought about what I had said. No rush, no distractions, everything will be just fine. No rush, no distractions. I realized that those simple words sum up what I say just about every day when I teach yoga. My teaching mantra is based on reminding Verge Yoga students to slow down and to pay attention.
In simple terms, mindfulness means paying attention on purpose. It means thinking, moving, speaking and acting in an unrushed and deliberate manner. We can practice mindfulness on our yoga mats, our meditation cushions, in our kitchens and in our cars. I was essentially teaching my daughter about being a mindful driver by using a few simple yet powerful principles. And as we all know, these principles can and should be applied to just about everything we do or don't do in life.
No rush. No distractions. Keep your eyes on the road, stay focused and everything will be just fine.
My husband took the first crack at it and brought her to a parking lot to go over the basics. After an hour or so, she wanted to take me around the block to show off her new skills. So I relinquished all control and allowed my baby girl to drive me around for a few minutes. After arriving safely back in the driveway she and I talked about the importance of being a safe driver and how she needed to take responsibility for her actions behind the wheel. I simply told her that as long as she was not in a rush to get anywhere and as long as she was not distracted, that she would be just fine.
Later that night I thought about what I had said. No rush, no distractions, everything will be just fine. No rush, no distractions. I realized that those simple words sum up what I say just about every day when I teach yoga. My teaching mantra is based on reminding Verge Yoga students to slow down and to pay attention.
In simple terms, mindfulness means paying attention on purpose. It means thinking, moving, speaking and acting in an unrushed and deliberate manner. We can practice mindfulness on our yoga mats, our meditation cushions, in our kitchens and in our cars. I was essentially teaching my daughter about being a mindful driver by using a few simple yet powerful principles. And as we all know, these principles can and should be applied to just about everything we do or don't do in life.
No rush. No distractions. Keep your eyes on the road, stay focused and everything will be just fine.
Thursday, September 3, 2009
A Day in Space
Today I experienced incredible spaciousness. My two daughters went off to high school this morning. They took the bus at 6:30 am and I picked them up after soccer practice at 4:30 pm. I was on my own for ten hours. During that time, I must have checked my on-line calendar at least four times just to be sure that I wasn’t missing an appointment or a phone call. There was a strange slowness about the day and I found myself floating in it.
Don’t be mistaken, I did have to teach and then work today but there was a sense of vastness surrounding the day that I have not experienced in a long time. Gone from my home office were the faint calls of, “Mom….Mom….where are you?” Absent from my agenda was the insane schedule of drop-offs and pick- ups that I scurried through all summer. There simply was just space. I have to tell you that I love space.
Our yoga practice creates space in our bodies. Our meditation practice creates space in our minds. We create such room in our lives anytime we are just present and in the moment. We can discover pockets of space in our lives if we just look for it. Perhaps it is those twenty minutes home from work or the quiet hour before dawn. Time spent in spaciousness can crack us open. It can help us feel more alive.
My day in space was spectacular. I am looking forward to more of it. The great news is that today is the first day of school and next summer is a long way away.
Don’t be mistaken, I did have to teach and then work today but there was a sense of vastness surrounding the day that I have not experienced in a long time. Gone from my home office were the faint calls of, “Mom….Mom….where are you?” Absent from my agenda was the insane schedule of drop-offs and pick- ups that I scurried through all summer. There simply was just space. I have to tell you that I love space.
Our yoga practice creates space in our bodies. Our meditation practice creates space in our minds. We create such room in our lives anytime we are just present and in the moment. We can discover pockets of space in our lives if we just look for it. Perhaps it is those twenty minutes home from work or the quiet hour before dawn. Time spent in spaciousness can crack us open. It can help us feel more alive.
My day in space was spectacular. I am looking forward to more of it. The great news is that today is the first day of school and next summer is a long way away.
Wednesday, August 19, 2009
Seek Silence
When enough of us learn how to become deeply and profoundly quiet, then the hysteria of the world will begin to subside. - Marianne Williamson
Every single day, we are bombarded with noise pollution. We have become so accustomed to noise, we’ve grown desensitized. If it’s not the T.V. or music, people chattering on their cell phones, horns honking and trucks backing up, it’s our alarm clocks; it’s our hairdryer; it’s the microwave alerting you that your dinner is ready. Excessive noise, like excesses of any kind, wreaks havoc on our nervous systems and on our psyches. By 5 or 6 o'clock, our ears are ringing, our heads throbbing, and we feel so weary, we collapse from mental exhaustion and auditory overload.
This week, find ways to experience silence. If you’re alone in the car, turn off the radio. If you are cooking, turn the T.V. off. Stop yourself first thing in the morning, when normally you might absent-mindedly switch on the news. Let the bird singing outside be the only sound to accompany your breakfast. And don't be afraid to be absolutely alone. Learning to live with periods - even pockets - of silence, will help to soothe frayed nerves and lighten your heart. You may find you experience moments of bliss, even as you cut the carrots or fold the laundry. It is during these small moments of breathtaking silence that we “hear” our soul force.
Erich Schiffman, author of Moving into Stillness, writes, "When you experience yourself in stillness, that is, when your mind is at its most focused, energetic, present, alive, relaxed and whole hearted state, you will "hear" the voice of God whispering in the depths of your being. You will recognize his voice as the voice of your soul. That voice speaks your deepest and most genuine desires."
Don’t believe it? Just try it. Find silence this week. Find it today. Find it in this very moment. Listen in stillness, and you may sense a profound serenity you’ve never imagined.
Every single day, we are bombarded with noise pollution. We have become so accustomed to noise, we’ve grown desensitized. If it’s not the T.V. or music, people chattering on their cell phones, horns honking and trucks backing up, it’s our alarm clocks; it’s our hairdryer; it’s the microwave alerting you that your dinner is ready. Excessive noise, like excesses of any kind, wreaks havoc on our nervous systems and on our psyches. By 5 or 6 o'clock, our ears are ringing, our heads throbbing, and we feel so weary, we collapse from mental exhaustion and auditory overload.
This week, find ways to experience silence. If you’re alone in the car, turn off the radio. If you are cooking, turn the T.V. off. Stop yourself first thing in the morning, when normally you might absent-mindedly switch on the news. Let the bird singing outside be the only sound to accompany your breakfast. And don't be afraid to be absolutely alone. Learning to live with periods - even pockets - of silence, will help to soothe frayed nerves and lighten your heart. You may find you experience moments of bliss, even as you cut the carrots or fold the laundry. It is during these small moments of breathtaking silence that we “hear” our soul force.
Erich Schiffman, author of Moving into Stillness, writes, "When you experience yourself in stillness, that is, when your mind is at its most focused, energetic, present, alive, relaxed and whole hearted state, you will "hear" the voice of God whispering in the depths of your being. You will recognize his voice as the voice of your soul. That voice speaks your deepest and most genuine desires."
Don’t believe it? Just try it. Find silence this week. Find it today. Find it in this very moment. Listen in stillness, and you may sense a profound serenity you’ve never imagined.
Thursday, July 2, 2009
Speed Limit 35
I am not sure exactly when this happened or why it did now upon my turning 45 years old but I recently realized that most drivers are not paying attention on the road. I included myself in that group until this past June. We drive too fast. We are unpredictable in our movements. We multitask. We are not present.
If you are already a safe driver then please ignore my group statement. I thank you for your safety on the road while I have been half asleep at the wheel.
What I have finally come to realize is that accidents happen when someone is not paying attention. In the blink of an eye a life or lives can be ruined. All it takes is one unpredictable move or accelerating through a yellow light. One time. That’s it.
There will always be drivers that are not paying attention and I don’t want to be that person. I’ve worked too hard in my practice of becoming more mindful to throw it away on a stupid cell phone call or song change.
This realization has overwhelmed me this past month. I have awoken, so to speak. I have slowed down. I am driving the speed limit and stopping at the Stop Sign not 5 feet in front of it. I am not taking cell phone calls in my car. I am trying to pay attention.
I often say in class at Verge that our yoga practice creates steadiness in the mind so that we can make conscious decisions. There is more mental space after a yoga practice. It is in that space that we find the time to move and speak more mindfully.
Perhaps I have slowed down enough in my yoga practice to recognize how I am moving out there on the roads. Perhaps turning 45 years old has helped me recognize the fragility of my life. Who knows? All I know is that I feel better more peaceful in the car. It is a new practice for me. I call it Mindfulness Driving.
Hopefully this blog will encourage you to observe your driving style. Perhaps you have always been safe. Maybe you need a little nudge. Like I said, I am not sure why this awakening happened now, I am just grateful that it did.
Peace.
Cara
If you are already a safe driver then please ignore my group statement. I thank you for your safety on the road while I have been half asleep at the wheel.
What I have finally come to realize is that accidents happen when someone is not paying attention. In the blink of an eye a life or lives can be ruined. All it takes is one unpredictable move or accelerating through a yellow light. One time. That’s it.
There will always be drivers that are not paying attention and I don’t want to be that person. I’ve worked too hard in my practice of becoming more mindful to throw it away on a stupid cell phone call or song change.
This realization has overwhelmed me this past month. I have awoken, so to speak. I have slowed down. I am driving the speed limit and stopping at the Stop Sign not 5 feet in front of it. I am not taking cell phone calls in my car. I am trying to pay attention.
I often say in class at Verge that our yoga practice creates steadiness in the mind so that we can make conscious decisions. There is more mental space after a yoga practice. It is in that space that we find the time to move and speak more mindfully.
Perhaps I have slowed down enough in my yoga practice to recognize how I am moving out there on the roads. Perhaps turning 45 years old has helped me recognize the fragility of my life. Who knows? All I know is that I feel better more peaceful in the car. It is a new practice for me. I call it Mindfulness Driving.
Hopefully this blog will encourage you to observe your driving style. Perhaps you have always been safe. Maybe you need a little nudge. Like I said, I am not sure why this awakening happened now, I am just grateful that it did.
Peace.
Cara
Tuesday, June 23, 2009
The Power of Now
Our minds are like muscles. At any given moment, we are either mentally weak and limp or mentally strong and focused. Like physical muscles, our minds can be trained to become stronger and more useful to us.
There is huge power in Mental Strength Training. When our minds are strong, stable and clear, we are “present” in what we are doing. When present, we are more peaceful and easier to be around. We learn to speak with clarity and conviction. When present, we connect deeply with others. We are able to influence and lead others from a deep and authentic state. From this powerful state of being, we have access to the tools needed to rally our team of co-workers around our message and vision.
When you feel stressed, recognize that you in a weakened state of mind. Stress is the result of too many thoughts barraging our minds at one time. Too much planning, worrying, and replaying stimulates the stress mechanism sending our nerves and emotions into a frenzy. Bottom line, when we are stressed, we have no power or influence.
The good news is that we can train our minds, our mental muscles, to become “stress-free”. With some practice, we learn to slow down our minds and clear away useless and repetitive thoughts. The result is that we rise above the level of stress and instead of just trying to manage it.
There are a few simple exercises in our Mental Strength Training Model:
1. Focus on the Breath
2. Observe Thought
3. Sit in Silence
4. Accept this Moment
When our minds are strong and focused we have access to great power and intuition. We just seem to know what to say and what to do. Mental Strength Training helps us become more fully engaged in the now. I am confident in saying that understanding the potential and power of being here now can change your lives just as it has mine.
Peace.
Cara
There is huge power in Mental Strength Training. When our minds are strong, stable and clear, we are “present” in what we are doing. When present, we are more peaceful and easier to be around. We learn to speak with clarity and conviction. When present, we connect deeply with others. We are able to influence and lead others from a deep and authentic state. From this powerful state of being, we have access to the tools needed to rally our team of co-workers around our message and vision.
When you feel stressed, recognize that you in a weakened state of mind. Stress is the result of too many thoughts barraging our minds at one time. Too much planning, worrying, and replaying stimulates the stress mechanism sending our nerves and emotions into a frenzy. Bottom line, when we are stressed, we have no power or influence.
The good news is that we can train our minds, our mental muscles, to become “stress-free”. With some practice, we learn to slow down our minds and clear away useless and repetitive thoughts. The result is that we rise above the level of stress and instead of just trying to manage it.
There are a few simple exercises in our Mental Strength Training Model:
1. Focus on the Breath
2. Observe Thought
3. Sit in Silence
4. Accept this Moment
When our minds are strong and focused we have access to great power and intuition. We just seem to know what to say and what to do. Mental Strength Training helps us become more fully engaged in the now. I am confident in saying that understanding the potential and power of being here now can change your lives just as it has mine.
Peace.
Cara
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