Brandon Hartsell Sunstone Yoga®

Take Pain out of Your Yoga Practice Do you experience pain in your yoga practice? Based on informal research and practical experience, about 60% of readers are reluctantly nodding their heads. If you’ve had a regular yoga practice for 5 or 6 years, the odds of pain are even higher, and you may not even want to risk nodding your head. Following years of dedicated practice, too many yogis are experiencing pain that stretching does not fix. And yet we know that yoga heals pain. People walk into their first class with chronic, even debilitating, pain, and walk out feeling better then they have in years. New practitioners learn to breathe deeply, to relax more completely, to balance and strengthen their bodies, and to push to the edges of their flexibility to find release and bliss. It can work for a long while; but too often, yogis are pushing through pain to get deeper, without resolving why the pain is there, or creating new injuries by stretching into ranges they can’t control. Elizabeth Rondeau got relief from the chronic neck pain she suffered after only two yoga classes, and was instantly hooked. Five years later, the yoga instructor and studio owner started to develop pain in her low back. “It was weakness and degeneration,” says Rondeau, and kept practicing through it. The pain kept up and suddenly there were postures in her regular practice that had to be avoided. Standing Forehead to Knee was the first to go, then Balancing Stick. Triangle pose followed a short time later, and suddenly, sit-ups were starting to hurt. Her chiropractor was no longer able to help her out of pain. “I was discouraged,” Rondeau says, “and more than a little concerned, wondering what I was going to do about it.” Pain does not have to be part of your yoga practice. The current model of yoga practice in this country offer practitioners like Elizabeth a few choices: push through the pain, adapt your posture to compensate around the pain, or avoid certain postures or yoga styles altogether. Tricia Keller pushed through pain with the encouragement of her yoga master. Pain was simply a part of her yoga practice. But pain is an indicator that something is wrong, and often, the cause of the pain is not muscle tightness or inhibition, but muscle weakness. You are not listening to your body if you are attempting to work through pain with yoga; there is a better way to get there. Here at Sunstone Yoga, students and instructors like Elizabeth and Tricia are finding relief by addressing weakness in the body with isometric and active stretching techniques. Pioneering a methodology we call Pain Free Yoga™, Derrek Taber and Brandon Hartsell developed a series of muscle tests, correction poses and core strengthening yoga classes to turn on weak or dormant muscles by focusing on active symmetry and increasing strength in the extreme ranges of motion. All styles of yoga can do a great job of strengthening, but the focus is generally on maximizing flexibility, which we believe has its limits. The body simply wasn’t designed for unlimited passive stretching without proportional strength in the passive range, and pain is often a sign of weakness. If you hurt going into Downward Facing Dog, the problem may not be lack of flexibility in the spine and hamstrings, but lack of stabilization in the hips and abdominals. When a muscle is in a range it can’t control, reciprocating muscles move in to compensate, potentially leading to pain and tightness from overuse or incorrect use. The reciprocal muscles tighten to protect the stability of the weak muscle, and all the stretching in the world will not loosen a muscle that is being told by the body to tighten. The muscle is tight because it needs to be tight, so the problem is not the lack of flexibility in the stretching muscle but weakness in the muscles that support the stretch. The answer is to address the strength in the weak area to alleviate the pain, and allow the flexibility in the opposing muscles to follow. What happens when we stretch The muscles contain mechanoreceptors, called Golgi tendon organs & muscle spindles, which inform the central nervous system of activity in the muscle and cause the muscles to contract or relax. When you stretch a muscle, the central nervous system signals the muscle spindles to resist the stretch, and the muscle reflexively contracts. That’s what it is designed to do, to prevent you from moving into a dangerous, unstable position. If the stretch continues beyond 6 seconds, however, the Golgi tendon organ responds, causing a relaxation, or shutting down, of the muscle. This is a protective reflex mechanism that allows the muscle to relax before reaching the end of its elastic range, which can damage the muscle fibers. Under normal conditions, the muscle shuts down only temporarily; within a few moments, it turns back on. But over time, repeated passive stretching with no attention to proportional active stretching trains the muscles to stay shut down. “Like a car battery that needs a jump start,” explains Derrek, “isometric contractions charge up the dormant muscles, and by adding strength in the extreme ranges through repeated practice, the muscle maintains its charge and gradually increases its power.” In addition, reciprocal inhibition means that as a muscle contracts, its opposing muscle automatically releases and stretches. So the stronger and more stable we can make the hips in Downward Facing Dog, the more likely the spine and hamstring flexibility will increase without pain. Recent research, although small in scale, challenges the common perception in yoga that all stretching is good. An Australian study of 1538 Army recruits found no statistical difference in injury reductions between groups of recruits who added stretching exercises to their regular jogging and side-stepping exercises.1 A study of marathon runners in Hawaii found that people who stretched after their run had a lower chance of injury than people who stretched before running, and the stretching group in fact had a 33% higher chance of injury over those who did no stretching at all.2 One study of athletes with groin injuries found that 23 of 34 injured athletes who only strengthened and did not stretch returned to pre-injury levels within 3 months, compared to only 4 of 34 athletes in the stretching group. Even more interesting, the study concluded that the athletes who had not stretched nonetheless had the same increase in range of motion as the stretching group.3 Add active stretching techniques to balance passive stretching When you lift your knee up toward your chest for Wind Relieving pose, the muscles of the lower abs are working. The height you can lift it up is your active range of motion. As soon as you grab the knee with your hands and pull it closer to your chest, you’ve moved into the passive range, the area you don’t control. The difference between the active and passive range is therefore unstable. Injury is more likely to occur in this uncontrolled range. By increasing the active range of motion through exercises that strengthen the body into its extreme ranges, the gap decreases. The goal of Pain Free Yoga is to increase the active range of motion to within a close percentage of the passive range, and then move each of them forward together. The concept isn’t really new. The exceptional fitness yogis we have known who have really excelled have always used active stretching. Early in the development of their yoga practice, their bodies allowed them to go into the extremes of a position, and the next logical step was to contract their muscles. In Separate Leg Stretching, for example, an exceptional yogi will instinctively activate the muscles by lifting the heel off the ground, or releasing the foot in Standing Head to Knee. Passive versus Active Standing Head to Knee Set up Passive versus Active Standing Head to Knee Kick Out "These are active postures that were never taught as active stretching," Hartsell concludes, “but they are present in people with exceptional practices.” Pain Free Yoga emphasizes and encourages a more exceptional yogic practice by addressing weakness directly before moving into depth. Waiting until you are passively flexible enough to “do” a posture before considering your active flexibility will only work if you are predisposed to get to that point before the muscle is conditioned to shut down. Advance Symmetrically Correct progress is symmetrical progress. Pain Free Yoga techniques are meant to be used with traditional yogic techniques to fortify and complement other styles, allowing you to achieve the increased range of motion you want from a position of strength, stability and balance. The first step to identifying where weakness exists is to look for symmetry in a few basic postures. Do both legs extend or flex to the same degree? Do you twist as deeply on both sides of the body? Can you lift both arms to an equal height? “The PFY method addresses what you can’t do, not what you can do, because it is what you can’t do that ultimately causes you problems,” Taber says. “If you only stick with the postures that don’t cause you pain, then you haven’t taken care of the pain; you’ve accommodated for it. It’s what you can’t do that is going to get you in the end.” Pain Free Yoga’s philosophy is to address the weak postures first. Lack of symmetry or imbalance in postures indicates weakness or inhibition. Addressing the weakness by strengthening into those postures in the extreme ranges - regardless of existing limitations – brings both sides into a symmetrical state, and then both sides can move forward together. Unbalanced flexibility, like abnormally large ranges of motion in some movements and less in other movements in the same joint may contribute to injuries. In classical ballet, for example, where dancers have extraordinary range of external rotation and abduction of the hip combined with less than normal range of internal rotation and adduction, 30% of dancers complain of lateral knee pain, and 33% suffer from anterior hip pain.4 Stability, Mobility, Strength Endurance, and Balance Stability, mobility, strength endurance and balance are the key components of our technique, and balance is the culmination of all components. Balance involves the integration of muscular forces with biochemical information and neurological sensory information from the joint and muscle. This integration positions the body’s center of gravity within the base of support. Even when a person appears to be motionless, the body is undergoing constant postural sway, caused by reflexive muscle contractions that correct and maintain the posture. When balance is disrupted, the response to correct is primarily reflexive and automatic. This is why cueing does not always work. If there is muscle inhibition, cueing the person may only cause further compensatory patterns, by over-strengthening the strong muscles while the inhibited muscles remain unresponsive. Understanding Yoga in a New Light So what about the other styles of yoga? According to Hartsell and Taber, some yoga techniques are reactions to long-term neglect of the active range of motion. “It’s easy to understand how some of these styles evolved,” says Hartsell. “The instructor develops pain and assumes that he or she was doing something wrong: his or her alignment was off, or they should not have performed a certain posture that now hurts.” From there, they develop a means to compensate for the new pain with the false assumption that a lack of pain in their new technique means it is the correct technique, and will also work to help their students avoid injury. Hartsell and Taber believe it isn’t what they were doing that caused them pain – but what they weren’t doing. “Lack of strength is the issue, not the activity,” Hartsell says. Often ‘yin’ is championed as the solution to ‘yang’ injury. But athletic ‘yang’ yoga is no more risky than gentle ‘yin’ forms of yoga. A gentle approach may help you compensate around an injury, but it is not a solution if the injury or pain is caused by a lack of stability and strength. The prescription for Elizabeth and Tricia: some muscle testing and stimulation, and a regular regimen of core strengthening classes that focus on active and isometric stretching. For Elizabeth, Tricia, and hundreds of other Dallas yoga students, Pain Free Yoga is the next big thing to get hooked on: “Yesterday I had the best, strongest practice that I’ve had in the last 7 months and after only 2 visits!” Elizabeth says. “Except for Standing Head to Knee I didn’t have any pain in anything. I am so excited, I already KNOW how awesome Pain Free Yoga is going to be for my students.” That’s what Pain Free Yoga is about. Avoidance and compensation don’t resolve the problem, symmetry and active range of motion do. “You can have your yoga practice back,” concludes Hartsell. Pain Free Yoga is about balance and a strong foundation, core principles of all yoga disciplines. “As long as you are not in pain,” Hartsell says, “keep doing what you’re doing. Just don’t assume that pain has to be part of it.”

The basic rules of Pain Free Yoga™

• Pain is a sign of weakness. Never stretch into a painful posture; first fix the weakness, then stretch.
• Any stretch, even a passive one, can be activated. Always strengthen into poses. Think strengthen, not stretch.
• Achieve active symmetry through all ranges of motion. Work to your limited side, allow it to catch up. Remember it is what you can’t do that will hurt you in the end.
• The key components of Pain Free Yoga in all postures are stability, mobility, strength endurance, and balance. All of these need to be combined to have the best possible yoga practice.

Components of Pain Free Yoga™

• Stability – the ability to control all movement in the body under all conditions.
• Mobility – the joint’s ROM, regardless of muscular control
• Strength Endurance – the ability to maintain a set amount of force productions in a muscle over a period of time.
• Balance – the culmination of all components. Balance involves the integration of muscular forces with neurological sensory information from the joint and muscle, and biochemical information. This integration positions the body’s center of gravity within the base of support.

Pain Free Yoga™ for back pain

Try these postures at home for a few minutes every day, or do a few sets of each right before or after your regular yoga practice.

Strong Floor Spine Twist


Lying on your back, bend your right knee and place the foot on the outside of your left knee. Keep both shoulders on the ground, and without lifting or shifting the hips, simply roll over onto your left hip as far as you comfortably can. Placing a brick, or your fist, underneath the right knee to create a small amount of resistance, and then gently push your knee into your hand. Hold each time for 6 – 8 seconds, and with a 2 – 3 second release in between, repeat activating the muscle in this very light way – 20% effort is enough – for 6 to 8 repetitions.

Tip
Look for symmetry. Do you twist deeper on one side? Practice Strong Floor Spine Twist on your limited side for a few days, and then test both sides again. When both sides are in balance, then practice on both sides.

Muscles Working
One side TVA, opposite side external oblique; also internal oblique, pectinius, adductor brevis



Strong Dog


Begin on your hands and knees in 4 point position, with knees directly under the hips and hands directly under the shoulders. Press up onto your toes in an easy Downward Facing Dog, and then apply 20% effort to pull your feet and hands toward each other. Imagine you are closing your body up like a jackknife, but your hands and feet would have to arc under the floor to get you there. Don’t push too hard here. You should feel only a light activation in the lower abdominals. Hold each time for 6 – 8 seconds, and with a 2 – 3 second release in between, repeat the posture 6 – 8 times.

Tip
Try these adaptations to Strong Dog: Bring the heels of the feet together. Continue to pull the feet forward and the hands back. Walk the feet in 6 inches, pull the feet and hands together. Keep walking the feet closer until your hands and feet are almost together, if you can.



Remember to back away from pain. Improve gradually. Lift the right leg up in the air, pull the left foot and hand together. Repeat on the opposite side.

Muscles Working
rectus femoris, iliacus, psoas major & minor, external oblique, pyramidalis, internal oblique, rectus abdominis



Strong Half Moon Angel



Lying on your back, walk your legs over to the right side of your mat, as far as they comfortably go. Pull your upper body gently to the right also, if there is no pain, so that you have a half moon shape along the left side of the body. Keep both feet and your face pointing up toward the ceiling. Place the back of your right hand on the outside thigh, or place a block between the hand and thigh, and gently try to fold your upper and lower body together. Both legs and the upper body pull to the right, into the resistance of the hand and arm. Hold the pressure at 20% for 6 – 8 seconds and back off for 2 seconds, then repeat 6 – 8 times.


Tip
Turn the outside foot outward to externally rotate the right leg, and repeat the posture. Turn the outside foot inward to internally rotate the left leg, and repeat the posture.


Muscles Working
erector spinae – Longissimus, iliocostalis, spinalis, Semispinalis, multifidus, external and internal oblique, TVA, latissimus dorsi, quadratus lumborum



Strong Pigeon


Begin on your hands and knees in 4 point position, with knees directly under the hips and hands directly under the shoulders. Pull the right knee forward and bring your right foot to the outside of the left knee. Drop the knee down close to the left wrist. Apply gentle 20% pressure to push the knee closer to the wrist. The left knee and shin are pressing gently down and back, and you can lightly activate the glutes to tuck the tailbone under. Hold each time for 6 – 8 seconds, and with a 2 – 3 second release in between, repeat the posture 6 – 8 times on each side.

Tip
To increase the active stretching in this posture, try to lift the right leg up toward the left armpit, pulling up from the foot to work deeper into the external rotation at the hip.

Muscles Working
Psoas minor, lower abdominals

1. "Injuries in Australian Army Recruits, Part III: The Accuracy of a Pretraining Orthopedic Screen in Predicting Ultimate Injury Outcome," Military Medicine, Vol. 162, pp. 481-483, 1997
2. "Rates and Risks for Running and Exercise Injuries: Studies in Three Populations," Research Quarterly for Exercise and Sport, Vol. 58, pp. 221-228, 1987
3. “Muscle strain injuries: clinical and basic aspects” Med Sci Sports Exercise 1990;22:436–43.
4. “Stretching Scientifically, A Guide to Flexibility Training,” Thomas Kurz, 2003; pp.10