Singing Dragon speaks to Noah Karrasch, author of the brand new book, The Self-Care Guide to Surgery – a guide for people who have undergone (or who are about to undergo) surgery and what to do to aid recovery.
In the interview, we speak about preventing surgery and why we should be thinking about posture. Noah shares bodywork techniques to help our daily lives and advice for those facing imminent procedure.
Noah Karrasch is a licensed deep tissue massage therapist and holds a teaching degree from the University of Missouri, Columbia. He teaches CORE bodywork skills around the world. He is also author of: ‘BodyMindCORE Work for the Movement Therapist’, ‘Meet Your Body’, ‘Getting Better at Getting People Better’, and ‘Freeing Emotions and Energy Through Myofascial Release’.
Most of us make those New Year’s resolutions: I’ll lose fifteen pounds, I’ll work out regularly, I’ll settle the old score, I’ll make more money, etc., etc. Too many of us don’t seem to get those resolutions to resolve into something new and better. In my head, one of the reasons for that is we set goals too ambitious, instead of setting smaller and more achievable ones. To that end, I’d like you to think about your expenditure of energy in terms of movement during the day. It seems to me that most of us don’t move nearly enough, and that when we finally do move we effort a bit too much in our desire to fix everything quickly. Neither of these ‘fixes’ will fix anything, and in fact, just may make things worse.
Let’s start with that second idea first: it’s a new year, and we’re going to trim off the fifteen holiday (or before) pounds, then we’re going to get the new wardrobe, then the new job, etc., etc. We set very lofty goals, then stop fairly quickly when we feel defeated by the goals we’ve set, and we begin to feel like a failure. How to change this? It’s simple, really. We merely set smaller and more achievable goals instead of lofty grand ones. Instead of forcing ourselves to lose fifteen pounds, why not focus on eating a bit healthier with more of the good foods – vegetables, fruits, fiber and more water in the diet? Without going kamikaze and feeling the need to monitor everything that goes through the lips, we can simply start being a bit mindful of the things we ingest, and mindfully and gratefully absorbing them and their nutrients. Continue reading →
Marlysa Sullivan is an assistant professor of Yoga Therapy and Integrative Health Sciences at Maryland University of Integrative Health. She is also adjunct faculty at Emory University in the doctor of physical therapy where she teaches an elective on integrating yoga into physical therapy care. Her research interests have focused on developing an explanatory model of yoga therapy based on philosophical and neurophysiological principles. She is the co-editor of the book Yoga and Science in Pain Care: Treating the Person in Pain (Singing Dragon, 2019).
In this video, Marlysa guides viewers through a meditation practice for inner well-being.
Yoga and Science in Pain Care Treating the Person in Pain
Edited by Neil Pearson, Shelly Prosko and Marlysa Sullivan. Foreword by Timothy McCall.
This is an integrated approach to pain rehabilitation that combines pain science, rehabilitation and yoga with evidence-based approaches from respected contributors. The book shows how to integrate the practices of yoga and pain science, and promotes the movement to a patient-valued, partnership-based biopsychosocial-spiritual model of healthcare. Read more
Language is powerful, as is pain. Both can be forceful motivators of behavioural change. Spoken language can be interpreted in many ways. Sometimes we even question whether words mean what we think they mean. Pain can be the same. We wonder whether pain really is intended to “get us to stop or change our behaviour”. We might also wonder “exactly what is it that I am supposed to change? Maybe the change I need to make is to stop responding this way to my pain!”
As a yoga teacher, leading groups in asana requires instructions that will keep your students safe. As such, cognitive contemplations such as the above are not well-suited as part of an asana practice dialogue. We use language that guides our students to be aware of what is happening in the present moment. We guide them to find the right challenge so they can explore preconceived notions, all the while staying present with, and not ignoring what’s happening now. We use language that provides options for change. “What would happen if you changed the way you are breathing right now?” “Or what you are thinking?” “Or if you let go of some of the aversion to the emotions or tension that you are feeling in your body right now?” In other words, we use language that encourages awareness and language that encourages self-regulation – often of body, breath, thoughts and emotions. Note that this language of awareness is not the same as asking a student to be aware “as the first step to change”. This is language that focuses on awareness as important in and of itself. Continue reading →
Dr. Steffany Moonaz is a yoga therapist and researcher in Baltimore, MD and serves as Director of Clinical and Academic Research at the Maryland University of Integrative Health. Her book, Yoga Therapy for Arthritis, was published in December 2018 by Singing Dragon.
In this video, Steffany talks about accessibility in yoga, how the practice can be adapted to suit the individual, and how it improves quality of life.
Yoga Therapy for Arthritis A Whole-Person Approach to Movement and Lifestyle
Dr Steffany Moonaz and Erin Byron. Foreword by Dr. Clifton O Bingham III, MD
Arthritis limits physical mobility while also impacting energy and mental health. Focusing on mental practice and physical postures for a whole-person approach, this guide will support yoga teachers, therapists and health professionals in working with individuals to live differently with arthritis, as well as those individuals themselves. Read more
Shelly discusses the nuances and different orientations of compassion in pain care and how having compassion for self, and for the other, is critical for better pain care outcomes. She discusses some of the topics of her book chapter about what the current research is saying about compassion, why we don’t always act in compassionate ways, compassion in healthcare, and the value of integrating compassion training along with the wisdom traditions and practices of yoga into modern day pain care without getting practitioner burnout. She explains that yoga is inherently a compassionate practice and can also offer a space for further compassion to emerge. Shelly also shares with us the difference between the terms “Persistent Pain” and “Chronic Pain” and when/why to use them.
Neil is one of the global leaders in pain education, including education on pain biology. He summarizes what the research says about how pain is not an accurate indicator of tissue health. No one diagnostic test or alarm from our body tells the whole story about how we will experience pain, how our nervous system is wired to receive and give danger signals and what other factors contribute to the lived experience of chronic pain. He discusses if we should use pain as a guide for how far to push ourselves in exercise and movement practices. He goes on to explain how education about pain management is an intervention tool.
Marlysa discusses her passion for eudaimonia (finding meaning and purpose in life) when living with chronic pain. She explains when we have meaning, connection and purpose, that numerous (and very fascinating) physiological changes take place in our bodies. These changes have been thoroughly researched in scientific studies, and have been shown to contribute to positive health changes, particularly helpful for people living with persistent/chronic pain. A Yoga Therapist has the potential to help a person in pain find connection, meaning and purpose in life. This will impact the client’s physiology, their perception and ultimately their experience of pain.
The 3 also discuss the White Paper they have co-authored along with Matthew Taylor about how and why yoga therapy can be part of the national Integrative Pain Policy Congress’ strategy towards Comprehensive Integrative Pain Management (CIPM) to address the current public health pain crisis. The paper includes a review of the available evidence we have to support yoga therapy as an important team member of CIPM and outlines recommendations and CTAs to make impactful progress towards better pain care. The paper is currently under peer-review and hopefully published in 2020.
Chapter contributors to “Yoga and Science in Pain Care” include Joletta Belton, Steffany Moonaz, Matthew Taylor, Matt Erb, Lori Rubenstein Fazzio, Tracey Meyers Sondik, Michael Lee, Antonio Sausys Marun-Avisap, with foreword by Timothy McCall, MD.
Yoga and Science in Pain Care Treating the Person in Pain
Edited by Neil Pearson, Shelly Prosko and Marlysa Sullivan. Foreword by Timothy McCall.
This is an integrated approach to pain rehabilitation that combines pain science, rehabilitation and yoga with evidence-based approaches from respected contributors. The book shows how to integrate the practices of yoga and pain science, and promotes the movement to a patient-valued, partnership-based biopsychosocial-spiritual model of healthcare. Read more
Shelly is a physiotherapist, yoga therapist, educator and pioneer of PhysioYoga with over 20 years of experience integrating yoga into rehabilitation with a focus on helping people suffering from chronic or persistent pain, pelvic health conditions and professional burnout. She guest lectures at yoga and physiotherapy programs, presents at yoga therapy and medical conferences globally, provides mentorship to health providers, offers onsite and online continuing education courses for yoga and health professionals and is a Pain Care U Yoga Trainer.
She maintains a clinical practice in Sylvan Lake, Canada and believes that cultivating meaningful connections, compassion and joy can be powerful contributors to recovery and well-being. Shelly is co-editor of the bookYoga and Science in Pain Care: Treating the Person in Pain (Singing Dragon, 2019).
In this webinar, Shelly discusses chronic pain and the possibilities that lie in yoga therapy to improve health and manage pain.
Yoga and Science in Pain Care Treating the Person in Pain
Edited by Neil Pearson, Shelly Prosko and Marlysa Sullivan. Foreword by Timothy McCall.
This is an integrated approach to pain rehabilitation that combines pain science, rehabilitation and yoga with evidence-based approaches from respected contributors. The book shows how to integrate the practices of yoga and pain science, and promotes the movement to a patient-valued, partnership-based biopsychosocial-spiritual model of healthcare. Read more
Karen Rodham is a health psychologist who has spent seven years working exclusively with people who are living with Complex Regional Pain Syndrome (sometimes known as Reflex Sympathetic Dystrophy or RSD).
Imagine your loved one has developed a pain condition. Medicine does not reduce the pain, they can’t tolerate being touched in the area affected by the pain; they find it difficult to leave the house because they are afraid that someone might accidentally bump into them; they are less tolerant than they used to be and they can no longer do the things they used to do. You are desperate to help them, but nothing seems to work. You can’t even give them a hug because this makes their pain worse. How might you feel?
Complex Regional Pain Syndrome (CRPS) is a pain condition. Most people who experience it improve in the first year, but for a significant minority (up to 20%); CRPS becomes a chronic long term condition. The key symptom is burning pain, but this is a kind of pain that medication barely affects and because of this chronic CRPS is a very difficult condition to live with. Other symptoms include: swelling, colour and temperature changes, hypersensitivity, as well as increased sweat and hair growth in the affected area(s). Although the symptoms are usually experienced in a single limb, it is possible for CRPS to occur in more than one limb, and indeed in other body regions. In addition to all of this, it can take a long time for CRPS to be diagnosed because the symptoms could also be a sign that other serious conditions are developing. These other serious conditions need to be ruled out first which can be a frustrating process, not just for the person who is in pain, but for their loved ones and for the health professional who is trying to work out what is going on. For the person who is diagnosed with CRPS, coping and learning to live with CRPS is not easy, but in the same way that the person with CRPS is learning to live with and cope with the condition, so too are friends, family and loved ones. So what can you do if a loved one is living with CRPS?
Things to do together:
Communication: First, find a way to talk openly and honestly about how CRPS is impacting on both your lives. It is very likely that your loved one is not only trying to come to terms with their CRPS, they are probably also afraid that they are becoming a burden. If this is how they are thinking, the chances are they will be working very hard to keep their feelings to themselves. You will also be likely to be skirting around the issue because you don’t know how to help them. This is a recipe for upset and misunderstanding for everyone concerned. Without open and honest communication you won’t be able to work out what the problems and issues are, and without identifying the problems, you won’t be able to think about how to solve them.
Seek external help: Many people find that those first few conversations can be easier if they use a couple counsellor. Couple counsellors can help you to find a new and non-threatening way of telling each other how you really feel in a safe and constructive way.
Things the person living with CRPS can do:
Stock Story: Many people with CRPS say that when someone asks what is wrong with them, they feel they should explain CRPS in detail. It is fine to do this, especially when you are talking with close friends and family, but it can be exhausting going over and over what CRPS is and how it affects you. One solution is to develop a stock story that gives enough information to give them the gist, without going into minute detail. Something along the lines of “I have a rare form of arthritis” works well, because people have heard of arthritis, know that it is painful and that it is a long term condition, but you can make your own stock story and find something that works for you.
Crisis Card: Sometimes things can get very difficult and it can be hard to know which way to turn. Rather than wait for the next crisis, it is a good idea to make a note of the coping strategies that work for you (e.g. go for a walk, phone my sister, take a bath). You could put them on a credit card sized piece of self-laminating card and carry it in your purse or wallet – that way the next time you feel thoroughly fed up, all you need to remember is to read your crisis card and be reminded of what works for you.
Pacing: A key aim of pacing is to make our daily activities and rest patterns more consistent. It can be tempting when you have CRPS to overdo things on your good days, but this can impact on how you feel on the following days. Doing things at a steadier pace actually helps you to achieve more in a more balanced way.
Building a support network: It is important to have the right kind of people around you. Some of this is to do with you being able to communicate your needs so that other people know and understand how to support you, but it is also about you growing your network and finding positive and like-minded people.
Change your focus: Allow yourself time to effectively grieve for what you can no longer do and then turn your attention to things you can do, or new things you can try. It is normal to feel sad and frustrated about the things you can no longer do when you are diagnosed with a chronic condition. Allow yourself time to process this and to come to terms with the idea that this is how things are for now. No-one knows the future, so you cannot predict whether you will improve or get worse. What you can do is to proactively focus on the positive. Don’t be fooled by how simple this sounds, it is not an easy thing to do, but it is a positive way of dealing with the changes enforced on you.
Relaxation: Stress makes pain worse. Finding different ways to cope when you feel stressed, and learning to head off stress before it takes hold can help reduce the tension you feel in your body, which in turn could reduce the likelihood of stress-related pain flares.
Things the family can do:
Keep your own hobbies going: If you can keep your interests and hobbies going, you will be able to maintain a level of normality. This will ensure that you have an external focus and will go some way to reducing the fear often voiced to me by people living with CRPS that their condition has had such an impact on their loved one’s lives that they are now a burden to them.
Learn about CRPS: This last point is one for the family and the person living with CRPS. Ask the health professionals who work with you for their recommendations about where to get good and accurate information about CRPS. The better informed you are, the better understanding you will have as a family about how to work together.
With all of these points in mind, I wrote the book Learning to Cope with CRPS / RSD: Putting life first and pain second. I share coping strategies that people who live with CRPS find work well. I have also included a chapter focusing attention on loved ones (friends and family of people living with CRPS) who often feel bewildered, frustrated and neglected by the health profession and worry that no-one realises that CRPS impacts on them too. It is important to remember that everyone’s CRPS journey is unique – we are all human beings with different backgrounds and experiences, but it can be helpful to know that there are a range of different strategies you can try that might make coping with CRPS a little easier. Whether you are a person living with CRPS or a person who cares about someone living with CRPS, this book should highlight how you too can move towards putting life first and CRPS second.
powerful, as is pain. Both can be forceful motivators of behavioural change. Spoken language can be interpreted in many ways. Sometimes we even question whether words mean what we think they mean. Pain can be the same. We wonder whether pain really is intended to “get us to stop or change our behaviour”. We might also wonder “exactly what is it that I am supposed to change? Maybe the change I need to make is to stop responding this way to my pain!”
