Online Health Chat with Judi Bar, E-RYT 500
September 28, 2016
If you are plagued by chronic pain, introducing some basic yoga practices, including meditation, breath work and gentle and/or restorative poses, can help increase range of motion for better functionality. These practices can also help reduce stress levels, relax the body, mind and nervous system and, as a result, may help to lessen inflammation,alleviate the intensity of chronic pain and create a higher quality of life.
Restorative yoga has been shown to affect chronic pain by focusing on the mind-body experience through yoga poses, breathing techniques and meditation practices. By focusing on conscious breathing and having healing thoughts while letting go of tension and stress, the body and mind are able to rest. Relaxation has been shown to be healing for chronic pain by altering the body’s response to stress. Consistent practice encourages the mind and body to react differently to pain.
About the Speakers
Judi Bar, E-RYT 500 and therapeutic yoga specialist, is an author, international speaker and yoga program manager in the Cleveland Clinic Wellness Institute where she designs programs for patients, families and employees. In addition to specializing in therapeutic yoga to treat chronic pain and illness for patients, she has developed unique yoga programs that are accessible to everyone, even those not comfortable in a traditional yoga class. She created the Come As You Are Yoga DVD series.
Judi’s inclusive style of yoga has brought the ease, benefits and simplicity of yoga to patients, families and caregivers. She also has established one of the first Yoga Alliance-accredited yoga teacher training schools at a major medical institution. Follow her on Cleveland Clinic Health Essentials blog as a featured expert. Enjoy videos and articles at Judi Bar: Health Essentials.
Judi_Bar: I am honored to be able to answer your questions. Here are some tips and golden threads for anyone who has chronic pain.
- Chronic pain is defined as pain for longer than six months.
- There are many reasons and layers why we have the pain.
- Always make sure you have gone to your physician for a checkup when you have had pain longer then a short period of time. And continue checking in with them if your pain continues.
- Pain is our body’s way of letting us know to pay attention.
- Listen to your body, and don’t ever force anything when you feel the pain.
- Hydrate. Drink plenty of water, which helps pain.
- If you aren’t already, eat a non-inflammatory diet, which helps pain from the inside out.
- Find a relaxation practice (meditation, breath work, etc.) that you can do each day. Stress only makes pain worse and helps the pain from the inside out.
- Do gentle movements each day, if possible, to keep your body moving. Do less on the days that you feel more pain.
- When you feel the pain, notice it, take a deep breath and let it go with a sigh.
- Don’t anticipate that you will feel the pain when you wake up. Perhaps today you will feel better.
- We will attach a PDF with some very basic poses for you to choose from.
- I have two DVD’s available. One is a beginner and the other advances a bit. We will give you those links if you wish to get them.
Let’s Chat About Yoga & Chronic Pain
For Back and Neck Pain
Tbart1970: I would like to be advised of poses that help strengthen the back and alleviate lower back pain.
Judi_Bar: That's a big question. The link below will show you some basic yoga moves.The idea is to gently move the spine in all directions to keep yourself fluid. When you do the strengthening motions, remember to pull your navel center in to build up your core, which will drop your tailbone for better alignment to support your lower back. Remember to breathe and listen to your body. Here is a visual aid of 16 different positions that would be helpful. Yoga on the GO! 16 yoga poses you can do at work or in a chair:Blessings! Judi
n.pers: What movements do you suggest for herniated discs in the back and neck?
Judi_Bar: It depends on how new your herniated discs are? If they are new injuries, then follow what you are told to do by your physician. If you have had them for a while (years), then allow your body to tell you how far you can go in a movement. Lack of movement can cause problems in and of itself. It’s best to find an experienced yoga teacher or yoga specialist to support you and show you correct alignment, then you would be able to do more at home.
NME22: I've been dealing with chronic upper back and neck pain for one and a half years. I've tried chiropractic, massage, acupuncture and muscle relaxers. I've seen spine doctors, rheumatologists, integrative medicine, functional medicine, musculoskeletal, vascular and neurosurgeons, and the pain is still there. I eat clean (currently cutting out carbs and dairy to try to heal Candida), and I work out at home with a mix of yoga, Pilates, HIIT training, free weights, bands and cardio about five days a week. I have a desk job and try to stand and walk as much as I can. I'm trying to reduce my stress, but again, nothing is helping this pain go away. I don't know what else to do. I love yoga and have done traditional and Buti yoga. Do you have any other suggestions? Thanks for your time.
Judi_Bar: Hi. Thanks for your questions. It is a lot to try to answer in just a few sentences. The first thought I get is that perhaps you are trying too hard to “fix it” and causing yourself perhaps more stress. That can overlay to your lifestyle of doing a lot instead of seeing what it feels like to “be.” That being-ness promotes more relaxation and thus can help with pain. I understand and admire that you are doing so much to support yourself, but be aware of what makes your pain worse or better (when and how), and do more of what makes it better. Listen to what your doctor suggests, also. If you have a diagnosis and have been given PT, I would suggest doing it with yogic breathing and mindfulness. Listen to your body and what it needs. All that we need and the answers will come about when you can find that place of being in the pain. I would suggest perhaps more meditation and a bit less strenuous activity, without compromising strengthening.
I would be glad to speak more with you about it if you wish. Trust that all will be in order and that you will find the answers. Namaste! Judi
buttric: What would be a good exercise for neck pain that I have every morning?
Judi_Bar: Make sure you have checked with your physician about the pain. Watch how you sleep; make sure your spine and neck are in line and not bent at crazy angles that many times we sleep in. Make sure you are hydrated. Watch how you hold your tension during the course of the day. Is your posture good while sitting and standing? Are you remembering to breathe during the day, and are you letting go of held challenges that occur during the course of the day? Those tips can help to prevent the pain.Do some basic neck and shoulder stretches before you go to bed and again in the morning. Listen to your body. That was a great question that applies to many of us. Good luck and blessings!
Laura: Do you recommend any particular poses for people with chronic low back pain? Also, is downward dog OK to do?
Judi_Bar: Hi. A variety of poses will help lower back pain. It will depend on what shape you are in if down dog is OK. It would be best to ask your instructor about it. It is a harder pose, and if your body is not ready for it, it can make it worse. Make sure your stretch and strengthen your back. When you get to the point that you can do the pose, remember to lift your ribcage and lengthen your tailbone. Yoga can support you with chronic low back pain. It just needs to be the right teacher and style for you. Keep up the great work! Blessings. Judi
n.pers: Could you discuss movements and other techniques for neck and shoulder pain, lower back pain and knee pain, preferably movements that can be done standing or in a chair? Thank you in advance.
Judi_Bar: Hi. Thank you for asking. We will post some of our Come As you Are poses that you can access. These are gentle, yet extremely effective motions to help stretch and strengthen. We hold so much stress in those areas. Remind yourself to breathe easily when you do any movement, and try to do at least a few movements daily. You should see relief because you are relaxing the muscles and balancing the energy more. Remember to find a relaxation technique that suites you to help with pain, and do that daily, if possible. Stay hydrated and eat foods that are natural and not inflammatory.
Blessings! Judi Yoga on the GO!16 yoga poses you can do at work or in a chair.
kshor: How can yoga help with arthritic pain in my big toe and ankle?
Judi_Bar: Make sure to stretch your toes and ankles by sitting in a chair with no weight bearing and moving your toes and ankles gently every day. Yoga helps to stretch and strengthen the muscles attaching to tendons in the joints and will support and help your joints. Keep up the good work! Blessings!
jfitz: Can a 68-year-old with bad knees, a bad back and bad shoulders do yoga?
Judi_Bar: Yes, absolutely. Anyone at any age with any challenges can do yoga. The key is finding the right class for you. Gentle chair yoga taught by an experienced teacher would be the best class to find. Many times, community senior centers offer classes along with the Silver Sneakers programs. Observe a class first; this is important for you to see that your needs and goals can be met and especially that the yoga is adapted. Even though yoga is so good for you, you can hurt yourself in a class if it is the wrong style, instructor and most importantly if you don't listen to your body. I am sure that you will be able to find one with some asking around. You will be happy you did. I did yoga for my Mom till she was 89, and it helped her so much. Blessings!
Kaleo: Hi Judi. I have never participated in anything like this before, so bear with me. I have ankylosing spondylitis, an autoimmune condition in the arthritis family. The basis is inflammation of the tendons and ligaments throughout the body, particularly where the connective tissue meets. It causes many bone spurs, and, if not treated properly, fusion of the bones. I take Remicade (biologic IV infusion) every six weeks, and until June, was taking an NSAID. The NSAID gave me ulcers, so now I can no longer take them and my AS has gone from 0 to 100 in no time, especially the lower back and hip flexors. There is terrible inflammation. I also have bone spurs in my toe, right hand and left shoulder, along with a tear there. There are so many areas affected at once. My neck is fused C-4 - C-6, which was unrelated. I love to swim and do chair yoga (I can't get down on my knees and elbows). I just need to reach out to someone who can help me develop an exercise regime that is right for me. Do you have any suggestions?
Judi_Bar: It’s great that you are already doing chair yoga and swimming. You want to keep as much motion in your body as you can without too much stress on your joints. Have you seen an integrative medicine specialist who can help to evaluate you from the inside out? Are you eating a non-inflammatory diet that can take some layers of the inflammation off? Also, seeing a physical therapist can help. A yoga specialist can be found in the International Association of Yoga Therapist by showing your location. Add a meditation/breath practice to your daily routine, which will help calm your pain response. Remember to breath easily and mindfully during the course of your day. You are so wise to be getting the extra support you need to keep your well-being and functionality at its optimum level. God bless. Don't give up and keep up the great work! Judi
lacey: I am dealing with chronic pain in my hip as a result of a pregnancy and my hip bone being pushed forward from the weight of the baby (per the physical therapist's assessment).I have done physical therapy and that did seem to help. I continue to use the exercises from PT and am starting a yoga class tomorrow evening. Are there specific poses that would be more helpful or harmful to my hip?
Judi_Bar: I am glad you are working with a physical therapist. Their work is brilliant and so specific for you as a patient. I would need to have more information to help you, but suggest that you speak with you instructor about it for his or her suggestions. It’s best to take it easy, get used to your body in yoga and continue to do the exercises the PT gave you to support you. Most importantly, listen to your body, letting it guide you during class. Blessings and good luck!
Choosing to Practice Yoga
mmg31991: Can people who have chronic pain and who are overweight do yoga?
Judi_Bar: That's a great question; and yes, absolutely you can! Finding the right teacher and style is most important here. Look for an experienced instructor who has a few years of experience. There are many styles, and one-size-fits-all does not apply. Look for chair, therapeutic, gentle, wellness, gentle beginners. Observe a class before you choose. See the link to suggested poses. I am glad that you are considering a class. You will find that you can feel better on so many levels once you find the correct class for you. Don't give up. There are classes out there. Blessings! Judi again, here is the link: Yoga on the GO!16 yoga poses you can do at work or in a chair.
lacey: What would be helpful to know in starting a yoga class for the first time? Is there any kind of preparation you would suggest?
Judi_Bar: Find an instructor who is Yoga Alliance-accredited and who is experienced. Observe him or her teaching and decide if his or her style and demeanor supports you in your goals. There should no forcing you into poses or breaths. The yoga should be adapted for you and your body. You should feel a bit challenged, but also some accomplishment at each class. Observe that the instructor teaches from his or her heart. I am so glad that you are thinking of taking classes. You will find it to be so supportive and can even be life changing. Blessings!
Here is a link (which will be repeated many times today) for information about the DVDs and a printable copy of the poses: Integrative Medicine: Yoga
Kailee: We live in Naples, Fl. I tried a yoga class, but it was way beyond me. I have L4-5 bulging discs, spinal stenosis and a gluteus minimus tear. I have tried PT, epidurals (which don't last) and chiropractic. I have to say Advil and chiropractic exercises help the most. Sleeping is difficult because of the pain. How do we find a good instructor for this type of problem?I am nine years out from breast cancer and am still on Arimidex, which causes lots of joint pain. Thanks.
Judi_Bar: I know that diagnosis can present you with a lot of pain. You are right; you need to find an instructor to help you. Walking into an average class (which is not usually a one-size-fits-all) can actually hurt you. Locate the International Association of Yoga Therapists and put in your location to find more of a specialist to help you. Please remember when you find them that the yoga should be adapted to you and done mindfully specific to your injuries, including plenty of breath work, meditation, relaxation and daily movements to help support you. There should be no pain while you are practicing. I would suggest that you bring your PT info with you and that the therapist connect with either the PT or your doctor. Don't give up hope. You can keep moving and can feel better with the right tools. Practice as much relaxation technique as you can. Blessings to you! Keep up the great work.:)
Kailee: Do your videos offer these different types of yoga? I just looked at the site for instructors and there is only one listed here but no website for her so it is hard to say how she would be. There is lots of yoga here, but the one at our gym was way too much for someone in pain starting out.
Judi_Bar: My videos are the Cleveland Clinic style of yoga. I use the chair and standing poses in one, and the nature video uses the chair and mat. The Come As You Are Yoga DVD was created so that anyone can do it, as long as you honor your body and self while you are practicing with it. The best way to find an instructor is to go visit and observe a class. I would not suggest gym yoga for someone in pain. Look online at International Association of Yoga Therapists for suggestions in your area. Good luck and thank you for your questions! Judi
Just for Joints
debra: I am finding that I have more joint pain/injuries as I age. Is there any part of yoga that can help strengthen joints, especially knees, wrists, ankles and elbows? Thank you.
Judi_Bar: Stay hydrated. Get as much range of motion as possible, perhaps weight bearing with proper alignment to build the strength in your joints. We do have to adjust to our maturing, but noticing it is half of it. Supplement your yoga with a well-rounded cardio and resistance practice. Find a yoga class that you feel comfortable with and that will get you what you feel you need. Keep up the good work!
BeeDub: What poses would be good to help with arthritis in the hips? I do a regular Yin weekly class, which I hope is the right type of yoga to be doing for this as well.
Judi_Bar: I am a firm believer in variety for our bodies. Yin has great stretching, but how about strengthening? I would suggest adding another class that will support your hips, legs and back muscles for a more well-rounded routine. Also, range of motion is important for lubrication of the joints, and doing a variety of poses that you would get in a traditional class (like chair, tree, firebird, etc.) will help to strengthen. Keep up the great work! Namaste.
EDIED: When doing poses such as downward facing dog, the hands are flat. Is that safe when having arthritis in the hands?
Judi_Bar: Your wrists will tell you if it is too much. If you have not built up your strength and stretch, to do down dog effectively you will be putting too much pressure on your wrists. Evaluate that for yourself, and if you feel you are strong in down dog and your wrists hurt, adapt it by using your fists or use a prop to lessen the angle. Remember, safety is first, and always listen to your body. Build up to harder poses slowly. Blessings!
debra: I would like to know if yoga can help improve your memory. Thank you.
Judi_Bar: Yes, there are many studies now that show that physical activity and meditation can help memory. The focus on details and remembering both for mind and body creates neuro and muscle memory. The eventual relaxation response that one gets from yoga also helps us with our memory. Mindfulness, that is present moment awareness, keeps us in the present so that we are more clear. I think you will find that you will like it and feel better, too. Good luck and blessings!
ValerieJune: Please explain how practicing yoga affects our lymphatic system both physically and mentally. Thank you so much.
Judi_Bar: Our lymphatic system needs motion, breath and gravity to move the lymph through our bodies so that the nodes can filter the toxins. Also, yoga stimulates the areas that contain more lymph nodes around the shoulders and groin area. I think the by-product of practicing helps us relax and be mindful, which will support us mentally. Since the lymph contains nutrients, waste products and hormones, it’s helpful to keep things flowing for mind and body. Blessings! Judi
EDIED: What poses would improve my rounded shoulders? My back posture is not pretty.
Judi_Bar: Stand against a wall with your back facing it, and work toward getting your shoulder blades down and back for five breaths or how many you feel you can start with. Do the Fan Pose from the PDF, which opens your chest. Do shoulder rolls and neck stretches. Support your head with your hands if you are doing a gentle extension (backward bending) or any time you raise your arms above your head. Watch so you don't drop your head back, crunching your next. Watch your seated and standing posture, and with practice you will be able to stand up straighter. (This includes while you are eating, watching TV, driving, walking.) It’s really important to get back to good posture for so many health reasons. Thank you! Keep up the great self observance! Blessings Judi
That is all the time we have for questions today. Thank you, Judi, for taking time to discuss yoga & pain with us today. Don’t forget to follow her on Cleveland Clinic Health Essentials blog as a featured expert, and enjoy videos and articles at Judi Bar: Health Essentials.
On behalf of Cleveland Clinic, we want to thank you for attending our online health chat. We hope you found it to be helpful and informative. If you would like to learn more about the benefits of choosing Cleveland Clinic for your health concerns, please visit us online at MyClevelandClinic.
Judi_Bar: You were so awesome! Thank you for your questions and support. So, be aware of your body and your needs. Remember to practice being in the moment, listening to your body and doing your yoga every day. It will help you on so many levels! Blessings and Namaste! Judi)
For resources on learning yoga, class information or details on the Cleveland Clinic School of Yoga at Cleveland Clinic’s Wellness Institute, please call 216.448.HEAL (4325) Option 4, or visit us at Integrative Medicine: Yoga for more information.
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