Trigger points

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Margot asks:

I’ve had a double hip replacement, the second last January. Everything is fine and I am working daily on flexibility. Would the Yoga Trapeze be for me?

So the Yoga Trapeze, if you don’t know, is an inversion devise where you can hang upside down, you can do a bunch of poses. It’s a really great question, Margot. The answer is, I don’t know. What happens is, when you’re inverted in the Yoga Trapeze, you’re actually hanging from your legs, and in some cases, hanging from your hips, so it might not be the best thing. It might be perfectly fine, it might not be the best thing, but for sure I’d check with your doctor. I don’t really know. So, it could be too much pressure for you, especially depending on where you’re at in the healing process.

Priti asks:

I have really tight calf muscles and recently got diagnosed with plantar fasciitis. Are there any gravity poses that would address calf muscles and quads that I could add to the routine with the rest of the poses?

This is a really, really common foot problem and really a challenging one to deal with. There’s all kinds of different theories about how you can cure it and how you can fix it. I’ve never dealt with it myself, so I don’t have any great suggestions. What you’re looking for, Priti, is something for your calf muscles and your quads. One of the more effective calf muscle stretches that you can do is a one legged Downward Facing Dog, and that is normal Downward Facing Dog and then take one leg way, way up into the air. And this is more effective than almost any other calf stretch you could do. People will hang off the edge of stairs and things like this, but in this position you get leverage, it’s safe and you can put quite a bit of pressure on that calf muscle really safely, so I’d recommend that.

In terms of stretching your quads, I would do a pose called Lightening Bolt in the Gravity Series, which is very, very effective. Hope that’s helpful. Hope you find a quick recovery there.

Ricky asks:

I started yoga 4 months ago I did morning Sun Salutations and few balances and stretches, but I wasn’t breathing properly and I did the squat thrust, not the lunge one, and I pulled a muscle in my lower back. I don’t want to do that again. What do you think, should I go slow, carry on or stop?

Okay, so here’s the thing, Ricky, with yoga, if you do enough of it, just like anything, something is going to hurt one day or another. It’s just like if you played tennis for 20 years or 20 months or 20 minutes, probably something is going to get sore. You’re using new muscles. I doubt you pulled a muscle. I bet you just have a bit of soreness there, especially if you’re doing a lunge. It’s a pretty safe pose.

A little bit of soreness is normal. The key thing to remember is that most serious injuries are not actually injuries, they’re re-injuries. So just really respect your body. If you’re feeling sore, if you’re feeling like you hurt something, take it easy and back off. Definitely keep stretching, definitely slow it down, but don’t stop. Just take it easy and back off and find your way through. Be really careful, especially with your lower back, but again, it’s normal to get a little bit sore. It’s normal, sometimes, to get a lot sore. It’s part of the process.

If you haven’t skied in a couple years and you go skiing, you’ll wakeup with some really, really sore legs, probably some really sore shins and maybe even ankles, and there’s absolutely nothing wrong with that. It’s just perfectly normal. Now, were you to, after you hadn’t skied in two years to go skiing every day for 14 days, well there’s a really good chance you could get an injury.

So, like anything, be reasonable, take it slow, don’t be alarmed, but respect your body.

Jan asks:

I have been thinking of seeing a massage therapist for an area where hamstrings joins the glutes. I have tightness/pain deep in that area. I think it’s called the piriformis. Do you have any recommendations for relief?

Piriformis is a muscle kind of deep in your bum. People call it Piriformis Syndrome, which is where you get sort of this tight ball of knotted muscle in your bum that can give you a lot of pain. It’s one of the things that sometimes massage can be really helpful for.

The key thing that I always say with massage is just make sure you look at it for what it is. It’s massaging muscles. It’s not going to make you more flexible, it’s not going to cure a bruised area. It can certainly help to break up scar tissue if you’ve hurt an area, but you need to be really careful that you don’t inflame that injury. So just make sure that you know what you’re getting into.

I find there’s a lot of misconceptions about massage, and people think that by getting a massage they’re going to get more flexible or that it’s going to heal a bruise or something like this. You have to be really clear about what it is doing. There’s really fantastic benefits to massage, but just make sure you know what you’re getting into. If you do have a trigger point, if you do have Piriformis Syndrome, massage can actually be really helpful if you get somebody who knows what they’re doing.

So, I’d just go give it a try, Jan, and definitely keep stretching, too. In most cases, if you’re doing a great yoga class or you’re working with a good teacher, you can get fantastic results, often better results, from working on yourself through yoga.

Su asks:

I did the gravity stretches for about 2 months and got a lot more flexible, but about 4 months ago a ventilator and an air-condition “killed” me. On my right side from shoulder to the knee and a lot of trigger points have been re-activated. (I think Su was installing something and got some injuries.) Coming from my old injuries and the whole side is stiff and hurting. Do have any experience with trigger points?

That’s a great question, Su. Trigger points are a term people use for these areas of our body that tend to trigger pain. I have one under my right shoulder blade, and I probably get it from working on a mouse on a computer. I’m not really sure what it comes from, but I’ll get this really debilitating sharp, shooting pain right under my shoulder blade, and that’s kind of my trigger point for the rest of my back pain. And it’s happened to me in a yoga practice, where I’m doing a Chaturanga and I literally can’t use my arm and lift myself up off the ground.

And a lot of people have these funny trigger points. It’s often in different parts of their back or their shoulders, where all of the stress or tension of their day gets kind of isolated and it kind of radiates out from there. Trigger point therapy is something that you might look into. My friends at the Healthy Back Institute have this cool trigger point board (See Fenix System Here). I made a video about it about a year ago or so, where you lay on this board with very focused pressure on certain trigger points.

This is another example of places where I found massage therapy is very, very helpful. It is relieving trigger points, so you get that isolated, tense area and you have somebody work on it, self-massage, infrared heat therapy can be really helpful, and of course just good old fashioned stretching.

Doing the gravity stretches felt good, but the next day it hurt so I stopped. Is there something that would do better? Should I keep going or is it better to pause?

Okay, so here’s the deal with stretching and pain. So, if you’re doing anything new physically, like we talked about skiing. If you were to do cycling, whatever it is physically, you’re going to feel something. You might feel sore, you might feel tired, you might feel stiffer, you might feel more flexible, but you’re going to feel something. There’s kind of good sore and there’s bad sore. People say things like ‘hurts so good’.

The way to know if you’ve done too much is if you’ve done your yoga practice, you’re feeling really sore and then you start to practice the next day and about 10 minutes into it you’re still feeling really sore. If that’s the case, like 10 minutes into it still feeling really sore, it’s time to stop, take a break, maybe take a day or two off and then come back to it. Again, you don’t want to push too hard.

If you find yourself really sore but after you get out of bed and you walk around it goes away, it’s a good sign that you’re kind of working right in a safe level. Soreness is part of the process, and you’ll find that your soreness goes away very quickly. So, a pose that will make you really, really sore for a couple weeks will suddenly stop making you sore, even though you’re doing deeper and deeper stretches. So, just something to keep in mind.