Yoga Therapeutics in Physiotherapy:
Shelly guest lectures at the College of Medicine, School of Physiotherapy, on yoga therapeutics in the physiotherapy profession.
Dustienne Miller. At risk of sounding a bit creepy, I will admit that I have a huge “girl-crush” on this phenomenal woman. I remember about 5 years ago I came across her brilliant work as I was starting to travel around to teach PhysioYoga workshops for optimizing pelvic health.
Dustienne is a board certified women’s health physical therapist, Kripalu-certified yoga teacher, AND a professional dancer. She integrates her love of movement with physical therapy and yoga to help men and women who suffer from pelvic floor pain and dysfunctions.
Dustienne is the creator of a video series that uses yoga postures and breathing techniques to navigate pelvic pain and incontinence: Your Pace Yoga: Relieving Pelvic Pain and Your Pace Yoga: Optimizing Bladder Control. I have been tremendously inspired by these videos and I recommend them to my patients and students regularly.
Dustienne and I had the opportunity to dig deep into the inspiration behind her videos, their impact and if she’d do anything different:
Me: Let’s start with your inspiration. What prompted you to create these videos?
Dustienne: The videos were really born out of a true need for my patients. In 2011 I was working in NYC at Beyond Basics Physical Therapy, and I found myself giving my clients yoga home programs in stick figure form. I realized there was a massive void in video programming available and recognized the need for something to work with at home. Carryover between sessions and after discharge from physical therapy is sometimes a missing link in rehab. Yoga can be an important aspect of the patient’s home program and used for maintenance. I created a program my patients could use at their own pace, in their own space. Read more
Yoga for Ankylosing Spondylitis
Shelly Prosko, PT, PYT, CPI
I recently had a physical therapist colleague ask me for advice about some ‘yoga poses’ that may help her client who has ankylosing spondylitis (AS). I explained that there are certainly some poses I would share with her that could potentially address some of the ‘general’ commonalities of the symptoms of AS and how people with AS may present in similar ways, but I also explained I thought it was important for her and her client to understand that:
1) therapeutic yoga is so much more than prescribing ‘poses’ for a particular dysfunction or special population
2) the statement, “yoga for ankylosing spondylitis” (or any diagnosis) tends to suggest (in my opinion) that we are using a reductionist approach and falling into the trap of treating/addressing a diagnosis instead of a person who is a living, breathing, moving, thinking, feeling and reacting being that is connected to and affected by the surrounding environment. A being that consists of complex systems and layers: each one influencing the other; including the nervous systems, digestive system, musculoskeletal system, hormonal system, immune system, integumentary system, emotional, social and spiritual layers, just to name a few.
That being said, there are certainly some common physiotherapy exercises + yoga methods that can be used for people looking to optimize spinal and rib mobility and alignment, maximize breath pattern, improve pain management, and/or calm the nervous system. But I suppose that would be a really long title for this article. Read more
Overcome Pain with Gentle Yoga Videos Available!
Resources created by Neil Pearson & Shelly Prosko, Physical Therapists & Yoga Therapists
It is known that pain is a complex biopsychosocial phenomenon that consists of many factors that influence the ability to move with ease, including capability of the physical body, breath pattern, psychological and emotional factors, and spiritual or social interactions. In the treatment of chronic or persistent pain, we know that the best long-term improvements occur when people can recover movement and participate in more activities of their daily lives.
Research supports that yoga can be used to address both physical & psychological aspects of persistent pain (Wren et al, 2011). “There is evidence that yoga may be useful for several pain-associated disorders” (Bussing et al, 2012) and growing evidence that specifically suggests different aspects of yoga can help not only reduce and manage pain, but also help people move & function better, and improve health-related quality of life (Ware et al 2013, Holtzman et al 2013, Moonaz et al 2015).
In Yoga for Healthy Aging’s blogpost, “Yoga for Pain Management”, Dr. Baxter Bell explains how different yoga techniques can help calm breathing, decrease muscle tension and improve body awareness, which are essential foundations and skills to learn if people want to move with more ease. He recommends two valuable books on yoga for pain and shares another useful post, “Techniques for Pain Management” outlining why certain yoga practises can be effective management for chronic or persistent pain.
Although we have evidence to support the benefits of yoga for management of persistent pain and many yoga practitioners are using yoga to help their students/clients in pain, there are actually very few resources available for people in pain to practice yoga in a way that safely and appropriately addresses the complex issues of persisting pain and helps people progressively increase movement with ease.
Neil Pearson, physical therapist, yoga therapist, UBC professor, and myself, wanted to create an accessible and safe resource that included more specific guidance to help people in pain. We developed “Overcome Pain with Gentle Yoga”, a series of 7 video sessions consisting of a variety of different practises, each with a different theme that addresses unique challenges that people with chronic pain face.
We chose 7 different themes based on qualities that we knew people with persistent pain often times have difficulty with and can influence pain experience.
The following 7 themes that we have chosen to address in the videos are:
As a Physical Therapist and Professional Yoga Therapist for over 16 years, I am aware of the benefits and use of medical therapeutic yoga and some of the limitations of our current healthcare system. However, after sustaining a traumatic orthopedic injury myself, I had the opportunity to be a patient and experience first hand what it was like to go through our health care system.
Even though I was discharged from the ER and told that rehabilitation wouldn’t start for another 2 months, I knew that there were many aspects of my recovery that could still be addressed to optimize healing. I knew I could, and would, immediately start my own form of rehab and use yoga as my therapy….naturally including and using the knowledge, skills and experience I had as a physical therapist as well.
The first few weeks of ANY injury is so important for healing. All of our physiological systems must be given the opportunity and the right environment to function optimally in order to heal to our highest potential. In orthopedic rehab we focus on the physical layer (kosha). However, the other 4 layers (koshas) of our existence are equally important in the acute stages of an ortho injury (mental, emotional, energetic, spiritual). This biopsychosocial-spiritual approach to all divisions of therapy is essential if we want to treat the whole person instead of the diagnosis.
I felt a responsibility to share this message while recovering from my own injury, as this is part of my life mission: to integrate yoga therapy into our western healthcare system by inspiring, empowering and educating people through wisdom, love, truth and joy.
I had the honour of giving a TEDx talk about “Pushing the Boundaries in Physical Therapy” where I share my story and outline how and why I successfully used medical therapeutic yoga as part of my rehabilitation. There is a 5 min guided body scan meditation that I shared with the audience at the end; so you can enjoy that as well HERE
I started a YouTube Channel that follows my progress using yoga as therapy (in combination with Physical Therapy in the later stages) in the rehabilitation of my Achilles Tendon Rupture on Dec.22, 2013.
I also wrote a short blogpost in “Yoga for Healthy Aging” BlogSpot about the injury and how I used yoga in the acute stages of recovery: “Sudden Acute Traumatic Injury”
Here is a summary of videos from day 7 to 8 months post rupture. My intention is to shed light on what ‘rehabilitation’ can optimally look like, to increase awareness to health care professionals & patients, and to help those recovering from any injury to feel inspired & empowered. Please share with anyone you think may benefit:
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