By Lisa Muehlenbein, Yoga Medicine® Teacher.
Robert W. Service said, “It isn’t the mountain ahead that wears you out; it’s the grain of sand in your shoe.” For me, as a yoga teacher, it wasn’t necessarily a grain of sand, but rather a bone spur in my acromio-clavicular joint that felt like the thorn embedding itself deeper and deeper into my biceps tendon and supraspinatus muscle with every Chaturanga. This impingement in the shoulder joint added to the recipe of my discomfort. After discussing my options with my orthopedic surgeon, I decided that this bone spur no longer had a home in my shoulder. I needed to be able to move freely and be fully functional—after all, that is what I help my clients do each and every day. Why would I treat myself any differently? Why wouldn’t I use what I know to help me heal? So, that is exactly what I did.
After having surgery to remove the barb-like spur, I followed doctor’s orders for the first week as I could only manage to stay in a sling for that long without losing my mind! This body needed to move and get back to normal. I had been in living with this nagging pain for about a year and a half by this point, so I really couldn’t even remember what “normal” was. I started off at two weeks post-op with the usual exercises that most patients are given after rotator cuff surgery to strengthen the muscles surrounding the joint. Since the ball and socket joint of the shoulder are more like a golf ball sitting on a tee rather than the deeply set hip joint, these exercises were my first step, but I was only going through weightless motions because the resistance from Therabands was not added until the one month mark. I noticed that I was subconsciously guarding my shoulder, which created an unproductive level of tension from my sub-occipitals all the way down into the healing joint. The levator and trapezius decided to join the party as well as the teres minor/major and subscapularis, leaving me with aches and pains not only in the joint, but also across the entire upper-right quadrant of my body.
I was now in so much additional pain, something had to be done. I dipped into my Yoga Medicine toolbox and pulled out my green Rad Rollers. I started by addressing the tension and tightness in my suboccipitals that was creating headaches. I placed the balls on top of my cork block (on the lowest level) and found that spot that was holding tension right below the edge of my skull and finally achieved some relief. After the balls, I shifted the block to its mid-level height and enjoyed more pinpoint relief from the corners of the block as they massaged away the woes.
Since I wasn’t that far out of surgery, I wanted to be mindful of the joint itself, so my next area needing a little TLC was my levator and trapezius. To begin gently, I approached these areas in a standing position with one ball placed between my body and the wall, rolling and gliding to find those spots that “hurt so good.”
At each visit to the doctor, I would share what I was doing. He supported me exploring myofascial release (MFR) as part of my healing process. As my journey progressed, I began adding scapular push-ups at the wall to strengthen the serratus in conjunction with the newly added Therabands, MFR and massage. To execute the scapular push-ups, I began facing the wall, placing my palms flat against the wall creating the push-up position in a vertical, standing plane. Gently, and slowly retracting the shoulder blades toward each other and then pushing the wall away. Once I was able to move through my ROM here without pain, I transitioned to performing the scapular push-ups on the floor in quadruped. I was excited to be an active participant in my own recovery!
At the 3-month mark, I was still feeling pain at the end-range of motion. My doctor was happy with my progress, but I wasn’t. If I was going through surgery, I wanted to be pain free. I needed to step it up a notch (or three) while still staying within the boundaries of what my shoulder would tolerate. I added kneeling forearm planks and kneeling side planks to focus on stabilizing the shoulder.
I continued my MFR regimen with some additional attention to the subscapularis, teres minor and serratus; cue the green Rad Rollers and the block! I found that approaching the teres minor/major by lying on my side with my head on the block and the ball underneath me and just behind me was the most effective (albeit intense!) way to address this area. Placing the block on it’s side with the ball on top and just inside the armpit was helpful invaluable at getting into the subscapularis and releasing the resistance I was experiencing in this area. Making my way to release the serratus anterior, only a block on its side was needed as I placed it underneath the armpit and cradled my head in my bottom hand as I explored rocking forward and back with productive results and improved range of motion (ROM).
At 4 months out, I was seeing results with what I was doing, but decided to add the additional modalities of chiropractic, cupping and the deeper MFR approach of the Graston technique in the hopes of getting closer to the goal of pain free ROM. The use of the Graston technique was the most intense (yet manageable) form of MFR that was added to my recovery. Using a metal tool that resembled a metal tongue depressor, my chiropractor would press the blunt edges along my scapular border explaining that she was releasing adhesions. I could feel the resistance of the adhesions as they fought back against the tool. Following the treatment, I could feel a sense of warmth in the area and mild soreness, but more importantly, I could feel increased ROM.
Each day, each pose, each technique brings me a step closer to turning that intention into a reality thanks to my experience and knowledge gained through my Yoga Medicine trainings. I feel gratified to have been an active participant in my own healing journey as I worked side-by-side with my health care providers. While I am not off the mountain just yet, the grain of sand—or rather, the thorny spur—is gone and the view ahead looks clearer each day.
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About the Author
Lisa is the owner of Zen Studios and a busy mom of 4 and grandmother of two. In addition to her degree in Early Childhood Education from Youngstown State University, Lisa has been involved in the health and fitness industry since the early 90's.
With many different certifications in Group Fitness, Personal Training, Pilates, AntiGravity Aerial Fitness, barre and more, yoga has been where her heart and passion is. Lisa has been practicing yoga since the mid-1990's. When Lisa began teaching yoga her pursuit of becoming an RYT began. She couldn’t wait to learn more with each workshop she attended. After becoming an RYT-200 in 2005, Lisa completed the 1000hrs of teaching required to become an E-RYT 200. Since then, Lisa has traveled internationally sharing her love of yoga with others, following her passion and attaining her first RYT 500 through Leeann Carey. She supports the Leeann Carey teaching method of “teaching the student, not just teaching the pose.” Lisa feels strongly that the best teachers are lifelong students. She enjoys learning just as much as she enjoys teaching.
Lisa is currently pursuing an additional 500hr Yoga Medicine training with Tiffany Cruikshank.
”To me, yoga is a place where you can be. I don’t necessarily mean “be” like a physical location like home or work. I mean “be.” Truly “be.” Where else can you give yourself permission to accept yourself and those around you for what they really are? It’s a raw, sometimes scary place, but one that provides a clear view inside the looking glass. There is no judgment about what one can or cannot do, or whether my butt looks big in these yoga pants. It’s a place where I can feel at one with the body I am living in. Breathing and moving at my own pace and with my own breath. Yoga is a place where I can be at peace with the person that I am and not having to pretend to be something that I am not. Does this just happen on the mat during asana? Absolutely not! Living yoga off the mat is just as important as the asana practice. How we treat ourselves and others, what we think and what we say. That’s yoga. How we breathe and how we react to the person that just cut us off while driving down the highway. That’s yoga. Having compassion for ourselves and those around us. That’s yoga. Being good, doing good. Now THAT, is yoga.” ~Lisa