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Diagnosing Hammy Injury
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sherimiami
Posted 2008-03-01 6:08 PM (#104204)
Subject: Diagnosing Hammy Injury


I have suffered an injury to my left hamstring - right where my left leg joins my left hip/butt - and haven't been able to do uttanasana or a host of other asanas for a month. In fact, I haven't been back to class in a month and I'm going out of my mind. I had a pain in that area (right in the middle of my butt) for several months, but then a few Saturdays ago I was late to class (anusara) and I just jumped in without stretching (I know, I know...). During an assist, the pain became so bad that I couldn't really finish class. The pain has been with me ever since. It hurts when I bend over, sit down for more than 10 minutes, etc. My gut tells me that something is definitely pulled. I'm paralyzed with fear at the thought of not being able to continue my current practice.

Where do I even begin to get this properly diagnosed? An orthopod? Sports medicine doctor? I know cerebrally that this could be a good growth opportunity for me and will change the way I practice (probably for the better), but I'm just having a hard time getting on the right road to recovery.

Any thoughts you or anyone else could provide would be deeply appreciated.

Namaste,
Sheri A.
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OrangeMat
Posted 2008-03-03 7:48 AM (#104296 - in reply to #104204)
Subject: RE: Diagnosing Hammy Injury


Sounds like you should be listening to your gut and your butt.

Did you talk to the teacher after the class? Since you said it was Anusara, the teacher should be able to observe and correct your alignment in your forward bends, if it's just a strain to the muscle. If you suspect it's a tear, then go see a medical practitioner. In my experience (and not just with hamstring injuries, which I've had several times myself in the past), your body tends to be smarter than your mind. Go get yourself checked out.

Heh, I should take my advice as well, considering I haven't been able to sit comfortably myself for a month now (right hamstring microtears at the origin, because you know those old injuries never really go away). While my uttanasana is feeling somewhat better lately, my foot (arch mainly) doesn't feel exactly right (going to see the podiatrist this evening to find out if my orthodics that I wear while running are the culprit). Parsvottanasana, however, is still inaccessible to me; that's a more intense stretch of the muscle (hence the name, hah), so I'm trying to have patience and not "push" that pose.

Anyway, good luck to you (and to us both!).



Edited by OrangeMat 2008-03-03 7:49 AM
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Nick
Posted 2008-03-04 2:31 PM (#104404 - in reply to #104204)
Subject: RE: Diagnosing Hammy Injury



20005001002525
Location: London, England
Hello,
What posture was it that you were being assisted with, and what form did the assistance take?
There's a few muscles on the back of the thigh, but having said that, it's almost certainly some kind of hamstring or hamstring tendon issue-seeing as it's uttanasana that hurts. In which case you might want to consider strengthening your hamstrings rather than stretching them, to some extent.

Nick
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Posted 2008-03-05 2:23 AM (#104420 - in reply to #104204)
Subject: RE: Diagnosing Hammy Injury


Hello Sheri.

I have a few thoughts.

The first is that students bringing injury to class should do so in relationship with their teacher. It is not that every student who has an injury avoids adjustment nor is it that every style of practice offers a tailored practice for those who do come to class with injury. However both may so so in some instances.

My concern then is two-fold: 1 that a student was adjusted when she should have been modified, and 2 that a student may have come to class out of integrity with the safety practices of the chosen style of yoga and chosen teacher.

I do realize that there are some practices that require the student fit the practice rather than the practice fitting the student. As I've only taken one Anusara class I cannot say where John Friend and company stand on such things. If it is the former then you simply do what everyone else does no matter what your current state of mind/body/spirit might be.

More specifically the location you cite for your injury or the feeling of it is awfully close to where the hamstrings originate (sitting bones or ishcial tuberosities). So it may be a muscular issue (a pull of the muscle) or it may be in the tendon. It may also be bursi involved. If the pain were limited to the belly of the muscle that may be different.

You ask about diagnosis. Most sports medicine clinics would be able to diagnose you. Or your Gp in conjunction with a P/T may also be able to tell you. It's usually muscle testing and palpation.

I would highly advise dealing first with what you define as paralyzing fear. It will be very difficult to do "efficient healing" in a fear state.

If you were my student I would advise a modified asana practice, a shift in diet, and specific work to manage inflammation.
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sherimiami
Posted 2008-03-05 4:07 AM (#104421 - in reply to #104204)
Subject: RE: Diagnosing Hammy Injury


Thank you all so much for your thoughtful responses.

I am actually going to my first yoga class tonight (after a month's hiatus) and will be very mindful to practice within my boundaries. My yoga instructor is aware of my injury and will modify my practice as necessary. Though I'm not sure how much I'll really be able to do, words can't describe how excited I am to hit the mat. It's amazing how important yoga has become to me since I began last year.

I am also going to see a sports medicine doc to accurately diagnose my injury. I've also been working on strengthening my hammy (rather than stretching it). I still feel significant discomfort, but I'm hopeful that this too shall pass.

Thanks again for your responses. I'll let you know how I progress!!

Namaste,
Sheri A.

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OrangeMat
Posted 2008-03-05 6:35 AM (#104424 - in reply to #104420)
Subject: RE: Diagnosing Hammy Injury


purnayoga - 2008-03-05 2:23 AM I do realize that there are some practices that require the student fit the practice rather than the practice fitting the student. As I've only taken one Anusara class I cannot say where John Friend and company stand on such things.

In my experience with Anusara style, it is the latter. The alignment principles may be universal, but the ensuing external shape of the body is totally dependent on the individual student.

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Posted 2008-03-05 11:38 AM (#104427 - in reply to #104204)
Subject: RE: Diagnosing Hammy Injury


Could you expound on this, my Orange friend?
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OrangeMat
Posted 2008-03-05 7:46 PM (#104444 - in reply to #104427)
Subject: RE: Diagnosing Hammy Injury


purnayoga - 2008-03-05 11:38 AM Could you expound on this, my Orange friend?

Gladly.

In Anusara yoga, there is something called the Optimal Blueprint, which in the simplest terms means that for any particular person's body, there is an optimal way that body should be aligned in order to be "happy", even though external shapes of different bodies might end up being looking very different. I believe this is similar to Iyengar style, where the pose is made to fit the individual body. John Friend originally started as an Iyengar teacher, which I'm sure you already know, which accounts for his strict use of physical alignments in Anusara.

The rules governing these alignments are universal, however. For example, there is an alignment rule that says that the top of the femur bones should always move toward the back of the body, into the hamstring muscles of that leg, and that is to be done no matter what pose, nor the individual's physical ability or flexibility level. So whether your anjaneyasana is completely open in the pelvis, or limited by tight muscles and joints there, the top of the BACK leg thigh bone will always press UP into its hamstring, and the top of the FRONT leg thigh bone will always press DOWN into its respective hamstring.

More detail than you needed, or not the sort of detail you were looking for? Heh, forgot the third option, that I answered your question completely!

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Posted 2008-03-05 11:16 PM (#104455 - in reply to #104204)
Subject: RE: Diagnosing Hammy Injury


Submitted for your approval...

When the class is "doing" Virabhadrasana I (for example) and there is a student in the class with an injury to the lumbar or sacral spine, that student may be best served by being moved to the wall or working in a significantly modified way.

Furthermore, a practice that does not operate in the above fashion may qualify as one that requires the student to fit the practice rather than the other way 'round.

The question is, how do yoga teachers alter the class curriculum to protect and nurture the injured student? In some classes that answer is "not at all" and in other classes that answer is "completely".

Edited by purnayoga 2008-03-05 11:20 PM
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OrangeMat
Posted 2008-03-06 7:31 AM (#104464 - in reply to #104455)
Subject: RE: Diagnosing Hammy Injury


I can only answer you within scope of my own knowledge of the curriculum (avid beginner who is studying quite seriously) and personal injury experience (quite a bit, considering the pose you used as an example ). I would say that regardless of injury, the alignment actions should be worked in the pose, even if the physical pose shape is to be modified quite a bit.

We're talking actions vs. movements here, I think, so it's apples vs. ahem, oranges. In the style that you teach, would you say that the ACTIONS are modified to fit the student as well as the physical pose itself?

Using your example of Vira I, then, if I lift the back heel to protect the integrity of the lumbar, or shorten my stance so that the front thigh is no longer parallel to the floor, I would consider that a major pose modification. That's the essence of Structural Yoga, a therapeutic style, yes? The pose is made to fit the body. I tend in that direction as well, but Anusara takes it a bit deeper.

Rather than just altering the body positions, since the pose is built from the inside out, the alignment principles are practiced (which everyone can do -- that's my point, I think) and the body will reflect physical ability layered on top of those principles.

We emphasize taking the top of the thighs back, inner spiral of the back leg, stronger pelvic loop on the front leg than the back (outer spiral there), and of course, maintaining kidney loop throughout. When the alignment points are worked on, the tendency toward injury is reduced. Or in other words (as it's been my experience with my S/I instability), practicing the alignment principles is the proper therapy to heal.

I'm still not sure if we're talking about the same thing, so let me know.

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OrangeMat
Posted 2008-03-06 7:42 AM (#104465 - in reply to #104455)
Subject: RE: Diagnosing Hammy Injury


One more thing, and hopefully this will help to explain better: I practice the Anusara alignment principles ALL THE TIME, not just when I'm on my mat. When I stand, when I sit, when I walk, even when I run. Especially when I run. It's basically very detailed instructions to having proper posture (again, a very simplified explanation, but still). The rules for proper posture don't change from one person to another, based on injury or whatever, do they? That's really all I've been trying to say here.

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Posted 2008-03-06 1:00 PM (#104493 - in reply to #104204)
Subject: RE: Diagnosing Hammy Injury


Om to you Om.
Both posts very well articulated. Thank you.

Re:

The rules for proper posture don't change from one person to another, based on injury or whatever, do they?


The "rules" really? I would contend that they may.

I would contend that they are not rules at all but guidelines or parameters (which are supple and flexible where rules are not).

Alignment is important. When I teach asana I teach in an alignment-based method. So by my very actions and choices as a teacher I'm advocating alignment. Howeverrrrrrr....

Can a student with a significant scoliosis adhere to the rules you have in mind? Can a student with a hip replacement adhere to the rules for Vrksasana? Should a person with a herniated L4-L5 follow the rules for uttanasana, bhujangasana, setu bandha, urdhva dhanurasana?

I'm suggesting that in some therapeutic constructs (which is not every construct) the actions may be more relevant to the student feeling and experiencing than the alignment. AND that may be a safer approach for that student at that time for those teachers who place safety at the top of their list.


Edited by purnayoga 2008-03-06 1:04 PM
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OrangeMat
Posted 2008-03-06 1:17 PM (#104498 - in reply to #104493)
Subject: RE: Diagnosing Hammy Injury


Therapeutic contructs, yes, ok. Not my area of expertise or even experience in a yoga setting, other than having been injured myself. So I don't know. I do know that John Friend has workshops on Yoga Therapeutics, and that my teacher has attended. If and when I ever get that far in my studies, I'll let you know what I learn.
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