yoga healing

Connective Tissue Injuries and Recovery

There’s a virtual epidemic in our community. I can’t tell you how many yoga practitioners from students to teachers tell me they “just live with it” when they ask about connective tissue injuries. Here is an email I received a while back asking for help about an injury.

Dear Susan,

I am a professional dancer and yogi who has been struggling with a hamstring/adductor attachment injury for nearly a year. The injury has healed, but my range of motion without pain/discomfort is limited due to scar tissue and the fact that I healed in a tighter position. I came across your archived interview with Sarah Powers, and you noted that yin had helped you in recovery from what is (perhaps) a similar injury. I have just started incorporating yin into my practice, and wondered if you could provide any specifics regarding the poses you found most beneficial.

I realize, of course, that every injury and body is different, but in addition to massage and physical therapy, I’m hoping to find ways to continue (although significantly change what had been a rather rigorous practice) healing through yoga. Perhaps you can give me some things to experiment with, as well as a little encouragement!

Many thanks and namaste,

Kristin M

Even if you rest a connective tissue injury until it’s no longer painful, chance movements – like stumbling, or an unthoughtful transition to standing or sitting – are frequent causes of re-injury.

Kristin is right: every body is different. What follows is my personal opinion, not professional advice. I don’t have a degree in medicine or physical therapy.

Wake-up Call

Connective tissue injuries heal slowly, and for many people, these injuries seem never to heal well because of chronic re-injury.

This is partly because there’s so little anticipatory sensation in the areas we injure.

A senior yoga instructor I know spent nearly twenty years rehabilitating an injury to a hamstring attachment because she simply could not feel sensation there before it registered as pain.

Neural Signals & Pain Transmission

With connective tissue injury, the key skill is to slow down.

This is more subtle than moving slower. It means working with the awareness that something in the area of your injury is communicating more slowly or more quietly than the rest of the tissue.

The more often neurological pathways between the brain, nervous system, and muscles are used, the stronger the connections get. If the pathway is not used very often, the connections for communicating are slower and less precise, less clear.

The stronger, more frequently used pathways are hard to interrupt. It takes practice and awareness.

No News is Bad News

It’s better to know what’s going on – to feel subtle sensations that precede pain and injury and adjust sooner rather than later. We have to learn to pay attention in a different, more skilled way.

Less well-connected tissue communicates more slowly. We have to build in extra time to “hear” from it. When we don’t, we literally get injured before we know it.

To heal from an injury and prevent re-injury, it isn’t just a matter of doing things more slowly, but beginning to pause, beginning to wait well before the point of stress, to receive communication that it’s time to rest or change up how we are doing something.

We have to learn to anticipate rather than to respond.

Rather than going on until you hear “stop!” wait until you hear a definite “yes” before you go ahead.

Kristin wrote of her new practice

With an injury, it seems that a whole other level of body awareness is necessary. Feeling nothing and feeling pain aren’t the only options–there is a whole range of sensation that we usually ignore.

Increasing the signal to noise ratio

Less developed connections need more time to signal you to back off.

These signals are going to arrive later than the warnings and signals you’re used to paying attention to from strong connections.

Yin postures are held with the muscles relaxed.
– Paul Grilley

In yin style yoga, we don’t do any stretching; we don’t do any pushing toward anything; we don’t force any alignment.

When I first began to work with my hamstrings in Paul Grilley’s half saddle, I would lean forward, and my range of motion would stop at about half an inch. Even though I couldn’t feel any sensation in my hamstrings, I couldn’t move further forward without pushing, which is counter to the instruction. So I just waited. Low and behold, after waiting for three minutes, I had softened a bit.

Over time, patience paid off with

– increasing the range of motion in the connective tissue
– more clarity and responsiveness in muscular tissue
– increased sensation in areas where I’d “felt nothing” before, therefore alerting sooner and more accurately to inflammatory movement.

I actually stopped getting injured. My posture engagement deepened and strengthened.

Healing

You may have to spend time “rehabilitating” your relationship, getting the feedback you need from injured tissue. The less-developed connections need additional time and attention to signal you to back off.

Recently I heard from Kristin again

The good news is that in a few short days since your email, I’ve begun to notice sensations in my injured hamstring that precede a sensation of pain–an “almost stretching” feeling in half butterfly, for example, that is difficult to put into words–a place in a posture that I would normally plow through without pause. Part of the challenge is really being an observer of the body’s signals, and not waiting or hoping for what you want or expect something to feel like. I’ve learned throughout the duration of my injury,that once you begin to feel the pain, it’s too late!

My personal yin practice

Yin literally saved my teaching career. I added yin to my daily practice, and to this day, I rarely skip it. When I don’t have time for a full sequence, I try to do at least three postures. Doing fewer seems to lead to imbalances, where the relationship among various tissues, tightness and stress is addressed directly in some places and not at all in others. I don’t know if that gives everybody problems, but it has bothered me.

The yin posture sequence, using Paul Grilley’s posture names, I am currently regularly teaching is:

– dragon
– half-butterfly
– resting swan
– swan
– half saddle
– dragonfly
– half frog
– square

Jai Kristin! Thanks for writing and sincere wishes for a healthy recovery.

Leave a Comment

Your email address will not be published. Required fields are marked *

%d bloggers like this: