WAWADIA Update #5 /// “First Do No Harm”: an M.D. on Asana-Related Injuries
June 9, 2014WAWADIA update #7 /// Pain, Performance, and Politics in Yoga: a Conversation with Mike Hoolboom
June 20, 2014My colleague Diane Bruni opened the first What Are We Actually Doing in Asana? event on 5/29 with a personal story of injury, confusion, recovery, and innovation.
Diane taught the very first ashtanga class in Toronto over twenty years ago, and has been a fixture of the yoga scene here ever since. I first walked into her now-famous now-ex-studio in 2005. I saw her name outside, on a rain-soaked poster, next to a class called “Ashtanga Level 2”. I unrolled a borrowed mat in a packed and steamy room.
I was struck not only by her creative intensity, but by the way in which the entire two-and-a-half hours was an immersive ritual of pulsing breath. Nothing was static, no movement was overly-defined. Nobody seemed to know what was coming next, and yet it all seemed to make primal sense. I don’t think I ever heard her use the words “pose” or “posture.” Every instruction pointed towards values like “grace, fluidity, circularity and resilience,” as she recently told Priya Thomas.
Quivering in a pool of blissful/shocked sweat in the dressing room afterwards, I said to a guy covered in mantra tattoos, “So is this ashtanga yoga? I thought that there was a fixed way of doing things.” The guy snapped out his wet towel, folded it neatly, and smiled. “That’s Diane. She knows the ashtanga sequences like no one else. She’s studied with the masters. But now she’s doing her own thing. She knows that yoga means change.”
Nearly five years later, Diane’s creativity — and her love for the ashtanga method — would be severely challenged by a catastrophic injury. Sports medicine doctors eventually told her that ripping four muscles clear off her hip bone while doing a simple wide-angled forward fold had resulted from tissue distention patterns, overuse, and dysfunctional glutes. These were all direct results of the practice to which she had committed fifteen years of her life, and in which she’d become a renowned expert.
In the clip below she tells story of how her hip injury was also primed by the advice she’d received from her colleagues about how to take care of the severe knee pain that had been waking her up at night. Advanced practitioners had told her that the pain was “normal”, not to be worried about, “part of the change that was taking place.” She was told “You have to break your knees” in order to get into the more advanced postures. Still, she was told, she could mitigate her knee pain with hip openers. That’s what we do.
We can’t say that Diane’s story is a common one. The number of asana practitioners who sustain her former level of intensity (2-3 hours per day, six days per week of advanced postural practice for over a decade) is probably a statistical minority. We shouldn’t worry about masses of people rushing out to imitate her. But two things stand out to me.
First: Diane wasn’t just practicing “addictively”, as she says, in order to self-regulate. Her professional attainments and authority as a teacher depended upon that commitment, and upon her students seeing it in action. So regardless of whether her students practiced as hard as her (and many, including her daughter Kathryn, did), the rigour of Diane’s practice was a community ideal. She was in the paradoxical position of performing an intensity that inspired others, including me, while it damaged her tissues. Not only did nobody see the pain that she herself was ignoring, the movements that were causing that pain were actually interpreted by others as beautiful or pleasurable, or both.
I remember seeing her practice in a corner of the crowded room, radiating concentration. I thought “She must feel so integrated, so fluid. She’s become a master of her breath, her movement, and her space. She doesn’t seem to have any of this mental anguish that is my constant companion. This must be the bliss that comes from intense embodied discipline.” I’m sure she did feel integrated in moments, maybe even for days at a stretch. But parts of her were also falling apart, and no one who was watching could tell the difference. The entire allure of the studio depended upon the invisibility of her pain.
(There’s another essay in here about the hidden damage — environmental and sociopolitical — that supports other fantasies, like the necessity for a perfect tomato in February, or the belief that fish stocks are plentiful enough to fill our buffets, or that $120 yoga pants are made by people who have enough to eat. I’ll leave that for the book.)
Secondly: when we hear that Diane was told by her colleagues that her knees must be broken to accommodate the presumably healing qualities of advanced postures, we are certainly hearing something absurd on one level. But this advice is really only one logical outcome of any process that rationalizes pain in favour of a spiritual ideal — and this is not at all uncommon in yoga culture. As I detailed just a little in my own presentation from 5/29, practitioners will often psychologize tissue pain, blame it on their own impurities or karmic failings, or, in Brad Ramsay’s case, frame it in terms of a necessary divine sacrifice.
I don’t think it’s overly wacky to note that the knee has psychic significance in subtler realms of yoga discourse. In the medical maps of Vedic astrology, the knee is governed by the tenth house: the 30° section of sky through which the sun passes at solar noon. This position is called the “house of karma”, and is also said to confer data regarding a person’s visible career: how they present themselves to the economy of the world. The knee, therefore, is seen as a joint of mundane pursuits.
Universally, kneeling communicates surrender, while in subtle yoga, “breaking the knee” would be a sign of becoming useless to the world. The injury is humiliating to the ambitious person, but if a yogi inflicts a knee injury on herself, it could be seen as a conscious act of renunciation. It’s unlikely that the American teachers who tried to help Diane appreciate her knee pain are aware of this obscure connection. But I’m pretty sure their Indian teachers would have been. It makes me wonder how many other vestigial bits of esoteric strangeness echo through our frameworks for pain, and not just or even primarily Indian bits.
There’s one more thing. You’ll hear Diane describe how every asana teacher she’d had, beginning with her first Iyengar teacher, had insisted that she “soften the glutes” in every single pose that would naturally seem to require gluteal support. This, she and many others now feel, leads directly to compromised lumbar and hip safety.
Diane freely admits: “I don’t know where this instruction came from.” I’m clueless too, but I must have heard it a thousand times from many different teachers (I was closest to several disaffected Iyengar-types). It’s possible that it’s just an incomplete instructional meme that made its way out of Pune or Mysore in the early 1980s and then spread like a virus amongst teachers like me who wanted to have a bunch of things counterintuitive (i.e., pseudo-smart) to say. Perhaps it was only the first half of an instruction that was meant to allow for femoral grounding through slight internal rotation in spinal extension. If that’s a desirable movement, then judicious engagement of the gluteals should follow to add support. But I never heard that part of the instruction, and had to figure it out on my own, after a lot of lower back pain.
But I think there’s something more to it than just a repeated distortion rattling through a ragtag network of globalizing teachings. I remember one teacher saying that the larger muscle groups of the legs were “stupid” in their “grossness” and that proper asana practice was meant to find and utilize subtler mechanisms. I remember another teacher strutting around the class, mocking a “tight-butted gym monkey”, whose gluteal tone was broadcast through his pinched facial expression. This was why, he explained, Mula Bandha Was Actually A Very Refined Practice. One had to locate impossibly deep pelvic musculature in an Energetic — NOT a muscular! — Action, which would Sublimate the Downward Outpouring of Life-Force, but without gripping the buttocks! (Or the perineal floor. One teacher repeated ad nauseam that mula bandha was Not. Like. Kegels! He seemed to sneer when he said the word “Kaaaay-guls”, as though degrading its obviously carnal purpose.) It was all very complex, and it had a moral tinge about it that I bought into, even though I’d been attracted to asana for its seeming absence of moralizing.
Similarly, I remember categorical statements being made about the belly: that it should always be soft, that abdominal gripping was a primary cause of wasted prana, that our goal was to return to baby-breathing, and that people who did more than navasana to tone the abdomen were “flexing their egos”. I was told to look for a “strength that was not based on striving”. In this way, not only bodily movements were psychologized, but particular muscle groups, which makes me wonder if this is a natural tendency we have, which lies at the root of all ancient physiognomy.
The message seemed to be: you don’t want a strong ass, and you don’t want a strong belly. It’s interesting that these are also considered to be sites of sexuality and selfhood, respectively. So what kind of body were we being asked to craft? What is this desexualized and “egoless” strength we were being asked to develop? How does it intersect with other overtones of renunciation? What does it mean to disengage from the most powerful heart of our musculature? I’m sure a bunch of folks have insights on this, and I hope you comment below.
Here’s the clip of Diane, followed by a summary for your convenience.
Summary:
- Diane describes her practice as religious and addictive: she had to practice 2-3 hours per day, six days per week.
- “I had to keep practicing because I thought I’d fall apart without it.”
- Neglecting all other exercise, she began to experience something common for practitioners at her level: knee pain. She ignored it.
- “Ashtanga teachers around me said ‘You have to break your knees’ in order to get into those postures.”
- After a year of increasing pain, she decides to get an ultrasound, which reveals a cyst in her knee joint. The orthopaedic surgeon suggests that the cyst has emerged in response to friction, and advises that she stops practicing.
- “My livelihood depended on it. My studio was based on it.”
- She asked her mentors in the lineage what she should do to recover from the knee pain. She was told that she should work on hip openers. She took the advice, and concentrated for over a year on pigeon pose and the like, applying long holds. Her knee pain subsided and she became very flexible in the hips.
- One Sunday morning, she prepared to teach by meditating in several seated, cross-legged poses for about an hour. She even noted the openness and comfort of sitting that way, compared to the pain she’d previously felt in sitting.
- She stood up to begin teaching the class and folded forward in an innocuous wide-angled stance, and felt and heard four sharp pops from her right ilium and ischium as four separate muscle attachments tore away from her bones. She slid to the floor and taught the class verbally, without demonstrating.
- “Nobody knew.”
- She took a cab home and made a medical appointment. She thought the doctor couldn’t understand what had happened, because he was asking what she had done to provoke the injury. She assumed that he was thinking she’d been doing extreme movements, but then realized that the hour of passive stretching in cross-legged seated postures was what he was looking for.
- “The analogy he gave me was that if you take a piece of meat and hang it from a hook, after ten minutes, it’s going to be elongated by a certain percentage of its total length. After twenty minutes, even moreso, and so on. Until eventually, all it takes is a small amount of added strain, and it will break and fall. It rips right off, because it’s gradually becoming weaker under the force of gravity.”
- Rehabilitation was very painful, because she had to question everything. Among other things, she recognized that she’d trained her gluteal muscles to be completely dysfunctional, according to the instruction of every asana instructor she had ever had.
- “What happens when your glutes become dysfunctional is that your hip flexors become overworked. That’s happening for a lot of people right now.”
- It took Diane several years to gain enough security and confidence to speak openly about this flaw in the instruction and her teaching. Part of this confidence was gained through talking with numerous movement experts, physiotherapists, chiropractors, sports medicine people, and practitioners recovering from injury, who all confirmed that gluteal dysfunction is a pervasive and harmful pattern in asana practice.
- In the first few years, colleagues thought that her new insights were crazy.
- “My immediate community was not interested in the revelation I’d had.”
- From here, Diane’s path of continued innovation accelerated, as she realized that she had to overhaul her methods and teaching, and break through layers of confusion and silence.