Learn More About Your Shoulders

In my last blog I talked about my dilemma and my decision of no longer doing chaturangas, a yoga pose which starts out with the yogi in a high plank and coming down so that you are just hovering above the ground, in my yoga practice.   It is a pose that, when done incorrectly, can cause a number of shoulder pain and discomfort.  I was intrigued by what might be causing me my shoulder pain and what I can do about it without having to seek out medical attention since it has not been causing me any type of grave discomfort.  It has made me take a look at my shoulder further in depth.  It is quite funny, really, that even though I claim myself to be a "yoga geek" I never really spent time looking into my own shoulder musculature to see what was going on.  I just kept saying that, "there is something in there that doesn't feel right."  Talking to some of my other yoga cohorts, one suggested that maybe my pec minor and teres minor muscles may be to blame.  Spending some time in both of those areas have been really transformational for me and have given me a clearer picture of what muscles are truly working when  I move my arm one way or another or when hey just plain hurt.  I think it first helps to have a clear idea of what muscles are part of the the shoulder and how they work.

The rotator cuff muscles consist of the supraspinatus, infraspinatus, subscapularis and the teres minor.  Those muscles are used to help move and stabilize the shoulder joint.  They also help to adjust the position of the humeral head (a bone of the upper arm) and the scapula or shoulder blade during shoulder and arm movement.   As you can see above, there are tendons and ligaments, which are not shown, that also support the structure of the shoulder and it tends to be at those sites where injury occurs.  The pain can either be acute or chronic depending on how the muscles have been injured whether due to a fall or just from repeated use of the arm or even old age.

Pain and spasms can occur that can limit the range of motion of the shoulder,  the muscles may no longer make smooth movements in the shoulder as it is being moved.  This means that you can no longer raise your arm overhead or when you move your arm, you hear some pops or cracks or it just feels gravely.  It may even be the case that there is fluid that has accumulated due to inflammation of the joint capsule.  Arthritis or a build up of calcium deposits may also be the culprit for limited range of motion.

Above is a picture of a rotator cuff tear in the supraspinatus muscles.  Most rotator tear cuffs occur in the supraspinatus and usually affect the tendon and not so much the belly of the muscle. Depending on the severity of the tear, you may have the option of taking care of it through some simple exercises.  It is important to keep in mind that most rotator cuff tears happen due to degeneration of the joint over time and not so much from sports injuries.

Thankfully, I don't not believe that I am suffering from a tendon tear but mostly a strain just from overuse  and tightness of some of my rotator cuff muscles.   Looking at these pictures may seem confusing to have the understanding you need to know what muscles in your shoulder are affected, but spending some time feeling around for each of those muscles will bring you some greater awareness.  What works for me is using my Yoga Tune Up® Massage Therapy Balls and palpating them.  You can use tennis balls at home if you don't have a YTU ball or even a racquet ball will do.  Placing the ball while lying in the ground or up against a wall in some of those shoulder joints may feel uncomfortable at first, but can provide a huge amount of relief if those areas are feeling stiff.  If there is inflammation, then the thing to do is rest the shoulder and ice it.  When you feel that the inflammation has gone down, then it is important to move it again.  When the shoulder is immobilized for a long period of time, then scar tissue and adhesion can build up and make the situation worse, movement is key here.

No More Chaturanagas...At Least for Now

I am such a jet-setter...so, this past weekend I was in Los Angeles studying with my teachers' (Jill Miller) teacher, Glenn Black.  I went to a three day training with a pretty sad right shoulder to begin with and with every intention that I was not going do anything that would just aggravate it even more.  I was doing fine the day before I left, keeping it immobilized, but I think that I may have aggravated it even more by having to hoist my luggage into the overhead bin on my flight :(  I would say that during the three days I was there, a lot of attention was spent on the shoulders, lower back and hips, there was no set agenda, which was nice.  I won't go into all the details, but we worked on movements that were both dynamic and ballistic that allowed for full range of movement through the shoulder joint.  We did this as well as various other movements for the shoulders and by the end of the third day I came away with this new revelation.  I am not sure why I had never thought of it before but I guess it just dawned on me right there and then.  I swore that I would give up doing chaturanga dandasana.  No, not quite the same as having to give up chocolate, this was not a pose that I necessarily craved, but it just felt wrong for me to continue to beat myself up.  So, I vowed to no longer do this pose until I can make sure that I am doing it right.  I also felt an obligation to my students.  How could I put them through a somewhat advanced pose without ensuring that they were getting all of the necessary corrections on alignment?  I also didn't want to be wincing in pain in front of my class while doing it.

Many of us are already walking around with some type of shoulder dysfunction.  It may not be very noticeable now, but it is similar to what happens when you have back pain and you do something as simple as bend down to pick something up, and then feel the shooting pain.  I feel that this is similar to the shoulder as well as what happened to me.  My almost ten years of practicing yoga and at least six years of doing Ashtanga Vinyasa, I was always doing chaturanga dandasana, it was part of the vinyasa flow and primary series that I practiced.  For those unfamiliar with what I am talking about, below is a picture:

As you can see in the picture, there is a lot of weight being loaded in the front of the body.  The shoulders are and lower back are lifted and the elbows are pointing straight back and hugging in close to the body. When I started out doing Ashtanga, I was going into chaturanga from uttanasana or forward bend and jumping into the position as you see above.  If you could imagine, I was literally putting a ton of weight onto my unsupported and unaligned shoulders and I was doing this over and over and over again.  I never noticed any pain in the beginning and I was in my 20s during this time, so I felt great after every practice.  Then last year during an AcroYoga class, I was working on an inversion with my partner where I was the flyer and she had to have her knee somewhere along my right shoulder and something got knocked around in there or maybe the pain sensors just awakened and since then, I have been having a dull aching pain in my shoulder.  I don't blame it on AcroYoga and I also don't partially blame it on Ashtanga, but mostly to my habit of hunching my shoulders.  I still have to remind myself several times during the day to drop my shoulders.  My upper trapezius muscles are also rock hard from all of the tension that I carry as well as from hunching my shoulders forward.  So, with overly contracted muscles and incorrect alignment of my joints for who knows how long, I added insult to injury due to my yoga practice and not receiving correct alignment on my shoulders.  I am currently at a state where I need to be delicate with my shoulder as I am almost in fear that I will tear something in there.

I have two pretty good ideas of which muscles are affected and have been spending some time recently to massage and do some self myofascial release in those areas.  My next step is to work on strengthening the muscles around that area.  I even noticed this morning as I was reaching for a cup in the cupboard how I had to readjust my arm and shoulder to do the task of reaching, I am using other muscles to compensate for the ones that are too weak to do the job and therefore putting me in this current state.

So, because of this I will no longer do chaturangas, at least for now, until my shoulder is fully healed and can be assured that when I do them again, I am in correct alignment and out of pain.  Lastly, the other awakening that I had was that I need to do more self care.  My shoulder has been asking for some attention for some time now, about a year and a half and I didn't really listen and assumed it would just go away.  But, if I had started doing some type of self care for my shoulder, I would probably not be writing about this right now.  It gave me the great idea to offer a class or workshop starting n the new year about self care for the body.  Most of us rely on a yoga class or our massage therapists, bodyworker, etc. to relieve us from the pain that we endure.  How about putting some of that power as well as knowledge into your own hands?  Think about it, how often do you touch yourself?  I don't mean it in that way, but in a loving and healing way, a way that can help release tension and pain.  It can be something that you can do every day, whenever and wherever you want without having to pay a dime.  Be on the look out for that in 2011!

The Time and Place for Overindulging

So, last weekend I was in Chicago for a wedding. I was only there for a total of three days and I was so surprised at just how much I ate and drank. If you have ever been to a wedding, it is definitely a time and place for overindulgence. There is the rehearsal dinner, breakfasts, lunches or dinners with friends and relatives, then the reception afterwards. It is a time for celebration and joy and one of the ways that we truly invoke that is through food and drink. It was my second day in Chicago and during the reception, which was being held at an Italian restaurant, they served traditional Italian food with at least a 6-8 course meal. There was even certain points during the dinner, that we had to tell the waiter before he even put the food down that we did not want it. Now who would turn down free food? Someone who has clearly overindulged :)

It truly brought up the question for me about overindulgence and do we really know when to say enough is enough. Looking up this word, overindulgence, it is defined as excessive indulgence . The word satiety comes up for me as well when I think of excessive indulgence which means to satisfy fully. When we are fully satisfied with a meal, then there is very little chance that we would want to overindulge. But there may have been times when you are in a party mood, such as at a wedding or if you go to a really great restaurant and may feel overwhelmed by the food that you continue to indulge beyond the point of satiety.

How do you listen to your body? How do you pay attention to your body's many signals that you have clearly had to much to eat or drink and that you should probably slow it down or just stop? How many of you out there actually listen? It took a lot for me, I would have to say, to realize that I couldn't eat any more and to truly slow down and listen to my body. Especially given that I was at a party and having a good time and enjoying the wonderful food. I would have preferred to miss out and feel fine later on that evening or the next day then stuff my face and feel like crap later on completely regretting eating just one more entree.

I will leave you with a quote by Marucs Fabius Quintillian,

"Satiety is a neighbor to continued pleasures."

So, I ask you, whether it be alcohol, food, sex or whatever is your true enticement, do you take the time to evaluate how you are feeling while in the moment of indulging? Do you know when to say enough is enough or do you harbor guilt instead? A question for you to ponder...