Tuesday, December 21, 2010

Let’s talk yoga, a Greenland paddle and healing a wrecked shoulder

Wrecking yourself is pretty easy. It can be sudden or come upon you over time from chronic overuse or stupid abuse. I’ve done all of the above with yoga and paddling . . . all things that are supposed to be good for you, right?

All of the wrecking part was my own fault though. None of it was an accident.

I’ve wrecked my back with yoga and I’ve rebuilt myself with yoga.

I’ve wrecked my shoulder paddling and later found a path to rehab and prevention that included a Greenland paddle and yoga. A good combo!

Don’t you just love sports!

According to all the physios I’ve frequented, it’s those of us who do sports that they see most often. And it seems that shoulders and knees could win an award for being the parts of our bodies that we mess up the most often.

I’ve learned a lot from my mistakes. The path to learning is sometimes long and painful. Some may say, “always!” But, it’s amazing what you can discover when you really need to.

Misery does not love company – you will hang out there alone.

My perception - how I viewed my injury and how I learned to deal with it had to change for me to get well and stay well. It is really easy to reflect back on a hard-to-heal injury and talk about it in a positive way when you’re well. It’s a lot harder being there – injured – for a long time and wondering if what you wrecked will ever heal. It always seems like forever. And one year seemed like a very long time for me to heal a wrecked shoulder, but it’s amazing how many people will help you along the way.

I’ve been reading a few chat posts from paddlers near and far talking about injuries, especially shoulder injuries, as they wonder about recovery times and treatments, and what they’ll do with themselves in the down time while all their buddies are out there having all the fun.

When it happens to you, you need support. Not just medical support. It can be a long road to recovery, and people without the same injury can get tired of hearing about yours!

Keeping a positive attitude can be tough when you don’t feel like you’re making much healing progress, suffer a few set backs, and start to wonder if the injury and the pain it’s causing you may become part of your everyday life. It is difficult to be patient, but I learned that finding ways to keep a positive attitude and not giving up was one of the most important parts of healing for me.

Everyone is different in their path to recovery or not recovering, but sometimes it just makes you feel better to hear someone else’s story. Here’s mine.

How I wrecked myself with yoga

You know the drill, “Hey, I’m athletic and in good shape. I used to do those full back bends all the time a few years ago. I’ll buy a power yoga video and go for it.”

Rip, tear. “Uh, oh, this can’t be good!”

No, it wasn’t. It was the sound of my back muscles ripping out. I was pretty wrecked for three months, could barely move or get out of bed without pain, and had to take a lot of heavy duty anti-inflammatories and pain killers.

I learned (kind of but not totally) that over-estimating myself and trying to learn yoga from a TV screen and a video wasn’t a very good idea. Sounds obvious.

I didn’t know much about yoga and figured it just wasn’t for me. There were lots of other sports and activities I could do. So, when I healed, I left yoga alone for a few years.

The next time I really wrecked myself was paddling and it was my right shoulder

I brilliantly combined trying to learn how to roll (incorrectly by pulling my head up first instead of my shoulder, a common beginner mistake), with being seduced into paddling distance in wind with big powerful Werner Cyprus spoons. And if you paddle with guys, it is harder to keep up. So you work harder. But I like that anyway. Girl paddlers can relate! I likely used more shoulder power than torso rotation for stroke. So many of us paddle this way, even when we know better. It can become a habit you don’t even notice until you start to get sore.

I could feel things were straining in my neck and shoulder on both counts – from the rolling practice mistakes and paddling distance with the big spoons, so I gave up trying to learn how to roll that summer, took a little time off, then kept right on going . . . paddling distance with big spoons.

By the end of the paddle season that year, I couldn’t use or raise my right arm. The muscles and tendons of the rotator cuff of my right shoulder were extremely strained and inflamed.

The rotator cuff is made up of four muscles and tendons that help move and stabilize the shoulder joint. Unless you’ve had this injury, or a good case of tendonitis, you can’t believe how painful it is and how difficult it is to treat and heal. The shoulder is a complicated joint!

Somehow, when all the practitioners who helped me heal told me that shoulder injuries are very common for paddlers, I felt better. It’s amazing how stupid you can feel in hindsight.

You fluctuate between the dull and annoying deep ache to the more painful muscle spasms, and the hard knots that don't seem to go away, especially in the muscles that run from your neck to your shoulder. The rotator cuff muscles and what they connect to do not seem to want to heal, despite time off, rest, drugs, and a lot of expensive physiotherapy. And set backs or relapses to recovery seemed to come along often enough for me. The pain was always worse at night. So you miss out on sleep too. That’s always fun when you are feeling pretty miserable - it gives you even more awake time to feel your discomfort!

The problem with an injury to one part of your body like a shoulder is, that the rest of you is well and ready to go. You are not sick. You need to figure out what to do with yourself, especially when everyone else you know is out there enjoying all the things you normally love to do.

The next thing I did wrong – immobilize myself

When my right shoulder was completely unusable, I stopped activities and didn’t raise or use my right arm. I just left it alone and took some pain killers. “I’ll just wait until it heals,” I thought.

Then, a few weeks later as I was dropping someone off at the physio for knee rehab from a basketball injury, the physio said hi to me and reached out to shake my hand.

“I can’t do that,” I replied.

“Why not?” She asked.

“I can’t move my arm.” I said.

She asked me a few questions, then gave me an order.

“You go see the receptionist right now and make an appointment with me tomorrow. If that shoulder freezes up you’ll be in real trouble, and I’ll have a heck of a time trying to fix you!”

“Ummmm, yes maman.” I replied.
You could not say no to this woman. She was absolutely sure of herself, and that’s just what I needed at the time.

I’m very lucky I ran into her. Luck is on your side sometimes, and timing is everything!

So I was off to a long race with all types of treatments to reduce inflammation and pain, heal what I wrecked, rebuild strength and flexibility, and then wise up and plan to not make the same mistake twice!

Types of therapies I used to get to the recovery stage

I decided to go for everything that might help

Regular trips to the doctor

Proper diagnosis is important and getting the right types of medications if you need them. I had to take a lot of meds for awhile. If homeopathy works for you, great!

I worked with qualified physiotherapists

I had to work with therapists and listen to what they told me. Sometimes I don’t. Sometimes we forget or don't realize how important simple things like icing or doing an easy exercise for 5 minutes is. A good therapist is good at scolding and reminding you to do your homework! Ever wonder why, at each visit, that they always ask you if you're doing what they told you?

They’ll discuss the options for treatment of the trauma and exercises to incorporate along the way as you recover. They give you lots of moral support too! You’ll be treated in a place with lots of other people at different stages of recovery from injuries. It made me feel better and less alone with my injury, as there were lots of people going through the same thing I was.

Listed below are the treatments my licensed physio administered to me and that I found helpful
  • Ultrasound
  • Transcutaneous electrical nerve stimulation (TENS)
  • Manual manipulation
  • Acupuncture
I had to request the acupuncture. Although, in North America, acupuncture is becoming more and more mainstream, I was actually surprised that my “traditional” physiotherapist had also studied acupuncture. I thought I would have to go elsewhere for that. But like any practitioner, some are better than others, and the results you get usually speak for themselves.

Diet and fluids
 
Eating healthy foods is pretty much a year-round practice for me (I’m not perfect, I dive into cookies often enough), but when I am injured and trying to heal, I start to think about foods and fluids that can help me rebuild a little faster. I made sure that protein was not forgotten in my diet, along with all kinds of fresh vegetables and carbohydrates. But I added some natural fresh fruit like pineapple, which contains the enzyme Bromelain, that is said to have potent anti-inflammatory properties.

I also had to remember to drink lots of water to help flush out the extra toxins I was ingesting as I had to take a lot of medication for awhile to get me through the “pain I couldn’t stand stage”. This can be a tricky stage for your stomach and digestion to handle. I’m a big fan of herbal teas too. Lucky for me, as I had to give up coffee for a bit. I’m not here to recommend anything to anyone, I’m just recounting my own experience. Everyone is different and has to listen to their own body.

Ice!
 
Icing my shoulder helped reduce the pain and inflammation. It just felt good. I used a bag of frozen peas or corn, which fit nicely over my shoulder and stayed put pretty well. Then I re-froze and reused the bag 2 or 3 times a day for 20 minutes of icing. I marked the bag, “DO NOT EAT” to make sure no one used it for food, as you can’t eat foods that you have thawed and refrozen.

Weaning myself from spot therapies and going more holistic - treating the whole body and self

As I started to progress in my healing, which seemed really slow and included several painful set backs, I also felt I was stalling in the same cycle with my neck and shoulder muscles tightening up and getting painful.

What the physio called a set back, was a big and sudden flare up. It felt like I was right back to the beginning and all the healing progress I had made over months of time was lost. But when the physio calmly said, “It’s only a set back,” it made me feel better and changed my perspective from “this is hopeless”, to “ok, it’s just temporary”.

And my physio was right. I recovered more quickly from the set backs, and kept on healing. There are lots of reminders from your body that you are trying to do too much too fast, even when you are being careful and seemingly not doing much at all.

Physiotherapy treatments can be time consuming and they do get expensive over time. After five months I began to wonder if just treating the traumatized area was the best approach. I knew there would be a break point, where I would have to stop physiotherapy and find a way to continue healing, avoid relapses, and practice prevention.

When I felt I was in the recovery stage these are the therapies and activities I moved into carefully

Active Release Therapy (A.R.T)

A friend who worked for a chiropractor who practiced ART recommended I give this therapy a try. It seemed to help me continue healing. ART is related to deep tissue massage and myofascial release, which is the release of the network of soft connective tissue in the body. It is a technique that treats tightness and problems with muscles, tendons, ligaments, fascia and nerves. ART is based on the fact that muscles do not work in isolation. Muscles only work properly if the surrounding connective tissue is healthy and functional, and vice versa.

My shoulder injury from overuse and misuse caused me extreme tightness in particular muscle groups, which in the long term could also mean scar tissue in the problem area. And when you are very tense and sore in one particular area, this affects other parts of your body, both mental and physical.

Other Sports and Activities

Elliptical Trainer

My shoulder was still not up to par for much use but the legs still worked. So I used my elliptical trainer to work the legs and lungs, ignoring the upper body handles of my machine. Doing some form of cardiovascular workout really helped me feel better physically and mentally, and I figured improving my circulation and taking in more oxygen would also be good for healing my shoulder. This also got me in shape for the winter season and cross-country skiing.

You can usually find elliptical trainers at most gyms. They are super popular. But if you buy one, it is really important to research and test them out before deciding.The good ones can be pretty expensive, but can be a worthwhile investment in time and money. I learned this by experience.

Cross-country skiing

Over the winter I took up cross-country skiing on hilly green trails using only my legs. I was the armless skier that season. I worked my legs, glutes, and improved my cardiovascular health. It made me feel great and has became part of my normal winter routine. Although, when my shoulder was still healing, I did worry about the risk of falling on it and causing another painful set back. I was careful and very lucky that no harm came of it, and it was the risk I decided to take.

Yoga

After the winter season, and spring was on it's way, I took up beginner Hatha. Actually, at first, I jumped right into a rigorous Ashtanga class before I was ready and it was too much for me. Old habits and bad habits die hard. I started to reinjure my shoulder. Ouch! I still couldn't raise my right arm over my head. I could only move it half way up. All those downward dogs hurt my shoulders and wrists which hadn't done much all winter and seemed to be atrophying at a surprising rate in just a few months. I loved the Ashtanga teacher and the class, but had to leave it behind and start with beginner Hatha.

It was April at this point and I wanted to be back on the water by June. I didn’t like beginner Hatha at all for at least two months. I wondered how these simple poses and all this breathing could possibly be doing anything for me, but it surprised me. I saw results in the tone, strength and flexibility of my body. I gained better lung capacity and my posture improved. Little by little, with some wincing along the way, I could start to raise my right arm over my head. And today, I can do it with no pain, and have regained strength and flexibility in both shoulders.

The mental aspect of yoga is very holistic. And it is said that a person’s search for more holistic healing approaches and a way of life often comes from the experience of physical discomfort. How true for me!

From this point on, yoga became part of the rest of my life. And I love it! All yoga classes in a studio are an hour and a half though. It takes some time-management to work it in sometimes, but once you learn the basics, it is really easy to make your home practice or away from home practice flexible to your own needs.

Knowing how to practice is one thing, knowing when and where to practice is another matter!

My ongoing rehab and prevention strategies

It seems that once you wreck something, it becomes your Achilles’ heel. It is more prone to reinjury. It may be a part of your body that you don’t use properly due to bad habits or how you are naturally built. My right shoulder is my Achilles’ heel.

Now I use yoga more wisely and a Greenland paddle for ongoing rehab and prevention.

I find combining different forms of yoga give me better mental and physical balance, flexibility, and health. And a little variety always rocks! Finding the yoga forms you like, and the yoga studios and instructors who can teach and motivate you may take a bit of time and patience. It took me awhile, but I found it very worthwhile.

And it’s the same thing with Greenland paddles! Not all Greenland paddles are made the same! They are made from different designs and materials. And if you are trying one that is custom designed for someone else, (or one of their mistakes that they are trying to get rid of!) you may not like it at all. You may need to build or try several before you find one you really like, then learn the techniques to get the most out of it. Well, that’s what I did. I’m still learning and I like it!

Hatha yoga

This is the base and heart of yoga. It’s good to start here at a beginner level and properly learn the poses, breathing techniques, and philosophy of yoga. From a good and safe beginning you can tailor your practice to your needs and wishes. Hatha is my base.

Ashtanga yoga
 
Ashtanga is a very athletic flowing form of yoga. If you don’t have a good base and knowledge of the yoga poses and breathing techniques already, and some core strength and balance, it can be very tough, if not impossible to keep up with an Ashtanga class! And Ashtanga practitioners chant at the beginning of the class and at the end of class. The opening chant is only 8 lines of Sanskrit. When I was new to Ashtanga, it made me uncomfortable, but now I’m trying to learn it. And the way the chant sounds in each class is so different, I find that interesting. The chanting has its own purpose and benefits as well. You can feel it. If you're not already an avid chanter, you may want to research the benefits of chanting and give it a try. Some family members may think you are odd, though.

I always warn newbies to yoga if they want to tag along in a class with me. I say, "I think you'd be better off starting with beginner Hatha, but ok, come along. They're going to chant. Are you ok with that? Will that freak you out? Also, please make sure to tell the teacher this is your first yoga class so he or she can look out for you."

Ashtanga pushes me a bit but I like the challenge.

Yin yoga

Yin yoga uses longer more deeply held poses (usually 3-5 minutes) that helps to stretch and release the deeper connective tissues of the body, the fascia, among other benefits. Breathing techniques are part of every form of yoga. Yin yoga is harder than it looks and may surprise you. I sometimes gravitate to certain yin poses that I like to relax and gently and carefully stretch out some body parts that can feel stiff or sore after doing some other sports like paddling, cycling, hiking, or cross-country skiing.

Yin yoga seems to focus a lot on opening up and stretching the hips and shoulders, and these can be good spots, especially for paddlers, to work on.

Greenland paddle

Now I paddle mostly with a skinny stick that puts less strain on my shoulders as the resistance from the water is spread out over a longer thinner area than my big Werner Cyprus blades, which grab a lot of water all at once and sometimes wind! I still love the power of the big spoons. I just use them a lot less now.

It took me time, patience, dedication, and a number of conversations with myself to figure out how to get yoga right for me, but the less straining Greenland paddle had a nice conversation with my shoulder and the water every time I used it.

You can also visit Adanac Paddles, Dover, Ontario, Canada. They are GP paddle makers and provide a lot of information about GPs. They also talk about how a GP might be of help to you if bladed paddles are causing you some pain. 

Impromptu yoga

Yoga training can be very disciplined and systematic. But that doesn’t mean it can’t be flexible and fun. Yoga is always there for you, wherever you are, whenever you need it. It's in a class of its own.

Paddlers who do yoga have a lot of advantages, both physical and mental. Plus, we can get out of the studio to some of the neatest places on the planet to strike a pose in the great outdoors!
I'll be looking for some yoga/paddle trips next season. Some outfitters incorporate this combo into trips.

One of my favorite things is what I call Impromptu Yoga.

Find a moment.

Find a place.

And strike a pose!

It doesn’t have to be perfect. There won’t be anyone there to adjust you, unless you’ve brought your yoga instructor along!

And if you’re stuck in the city, you can still grab some mall graffiti and have a yoga moment.

Best wishes for your rehab if you’re on that path, and learning how to prevent injuries that you don’t deserve.

Whew! This is a monster post and popular in my Web stats. So hopefully, it is helping some of you out there. And, it will serve as a reminder to me to be more careful about wrecking stuff!
 
The BaffinPaddler

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