Nobody’s Fool: Lessons from Pain, Rehab, and Beyond…

On this April Fool’s Day, I am nearly six weeks into post-operative (hip replacement) rehab. The more-than-3-year journey that led up to this point has taught me many things. When it comes to fitness and exercise, for example, I have learned that so much of what one considers a workout to preserve or bolster health is the fun, often advanced stuff. What is essential for resilience of body and mind, however, is fairly simple, yet nonetheless challenging, especially when one is compromised.

Special note: Although this piece reflects my experience with osteoarthritis and post-surgical rehab, the routine is an efficient, effective alternative practice for anyone short on time; needing a mental or physical boost; or looking for an “off-” or “sick-day” source of circulation and limbering.

Since my mid-40s (I am now 57), my favorite forms of physical activity have been swimming, walking, and kundalini yoga. I considered these to be “softened” versions of what I had done previously: biking, running, dance, and full-body cardio moves, often with weights. And throughout my 30s and early 40s, I was an avid ashtanga yogi: I taught, practiced, studied, and thrived on the power of the fast-paced, acrobatic, contortionist tradition. I will always revere what the form did for my stamina, mental stability, and fluid strength.

But as with so much of what a younger body loves, there comes a time when a reprieve or retooling is necessary. With that admission, I grin a bit, sigh softly, and slightly roll my eyes as I imagine my late father’s satisfaction: Finally, he would be thinking, she has seen the light.

“Moderation in all things…”

That refrain, stated outright and continually, was my dad’s siren song. As an enthusiastic, curious, stubborn young ‘un (and even when not so young), I heard those words as a dampening, strangling threat to my own determination to try everything, and to do it with gusto.

But dang it if Dad was not on to something…

While I can not possibly regret the joy, emotional catharsis, strong muscles, or mood-balancing that extensive, intense workouts provided, I do question the near-obsessiveness that accompanied them. And when my hips tried to call a truce in 2018, I shrugged and assumed that they would be fine, that my ways would prevail, and that we—my hips and I—would find a way to continue on as always we had.

Cut to 2020, and my first desperate need for cortisone, shot straight into the withered, crying hip joints. Even then, I would not quit: Movement had always been my mental and physical sustenance, and pain seemed no reason to doubt that.

But by December 2020, when even the forgiving water of a compassionate pool could not assuage my pain, I knew that my approach had to change. Although it was too late to save my hips, I vowed to be kinder to my body once the hips were replaced. I had a new mission: Move for the mind, move for function, and move with the gratitude that only the threat of immobility can engender.

So, here I am, having stumbled through the first month of post-surgical recovery; recognizing progress, as I simultaneously contend with the ever-worsening pain and dysfunction of the other hip; and deeply considering how I will move forward, and what those moves will look like.

The following practice consists of the techniques and exercises that I have found to be invaluable to recovery. As such, I have realized their place in any day’s routine, for any body, at any age: For hard-core fitness folks, they may seem simplistic; however, to forget the basics is to forget one’s human-ness. Engage with the moves as if they are as vital to your health as a long run, heavy-weight session, or challenging yoga class: They are.

Start seated, on a chair, on the floor, or in bed. Close the eyes, and breathe: Inhale through the nose as you feel the chest rise, and the ribs expand; visualize the descent of the diaphragm and its gentle pressure onto the organs. As you exhale, be conscious of the belly’s retraction and contraction, and of the diaphragm’s slow, steady rise into its nest beneath the ribs. Take 3-5 of these deep, focused breaths.

With the abdominals, lungs, and attention awakened, shift your seat to ensure that you are perched atop the sit-bones: spine and head upright and aligned, shoulders and neck at ease. With the hands on the knees, begin Sufi Grinds: Circle the entire torso to the right, allowing the pelvis to partake of the motion. Inhale as the body circles through the front half of the circle, tipping the pelvis forward; exhale to circle through the back cross-section, tipping the pelvis back. Make 8-15 circles, then reverse directions, moving counter-clockwise, for 8-15 circles.

From there, bring yourself to stand. Taking a cue from qigong, place the hands next to the hips, palms up: Inhale, and arch the spine, pulling the elbows back. Exhale as you flip the hands, moving the backs of the hands forward as you round the spine deeply. When the hands nearly touch in front of the torso, inhale as you turn the palms up again, pull the elbows back, and arch the spine. Repeat for a total of 10 undulations.

Now, extend the arms straight forward from the shoulders, parallel to each other: left palm down, right palm up. Inhale: As you exhale, shift the weight into the heels as you do a slight squat, only enough to feel the bends at the ankle, knee, and groin; simultaneously, the left arm rises 30 degrees, as the right arm moves down 30 degrees. 

As you inhale, straighten the legs, and bring the arms back to neutral, left palm still down, right one facing up. Immediately exhale into the modified squat: This time, the right arm lifts 30 degrees, as the left lowers 30 degrees. Inhale back to neutral. Repeat the squats with alternating arms for a total of 10-15 times.

Still standing, open the side body with focused lateral bends. Again, this variation stems from a qigong move for the Liver and Gall Bladder meridians: These energy channels are associated with the clearing, cleansing energy of Spring. Stand with the right hand a few inches above the left: right palm down, left palm up—imagine holding a ball between the hands in front of you. 

Inhale as you turn from the waist to the right. As you do, the left palm turns up as the left arm straightens up toward the sky; simultaneously, the right palm turns down as the right arm pushes down alongside the hip and thigh. The fingers of the raised, upturned left hand face the right; the fingers of the lowered, palm-down right hand face extend forward. Exhale here.

Inhale long and deep to return the hands to “hold the ball” mode as you turn slowly through center; this time, the left hand is on top (palm down) with the right hand below, palm facing up. Exhale to push the hands into their opposing stretch on the left side: right hand and arm up, fingers pointing to the right; left hand and arm pushing down, fingers pointing forward. Move fluidly back and forth with the breath and movement: Complete 5 stretches on each side.

Next, still standing, bend forward at the waist, so that the torso is perpendicular to the legs: Feel free to bend the knees. Inhale as the left arm swings forward alongside the ear, and the right swings back to the level of the hips; exhale as the right comes forward, and the left swings back. Continue vigorously with powerful breath for 1 minute.

Then, help yourself back to a seated position. If you choose to sit on a chair, sit sideways, so that you can lean back 30 degrees. With the torso at a 30-degree lean back, raise both legs 60 degrees. You may choose to support the legs with the hands; have the hands by the hips; or, for a more intense version, extend the arms straight forward or up alongside the ears. In your selected position, begin Breath of Fire: rapid, equal inhales and exhales through the nose, with enough vigor to pump the belly. Continue for 1 minute. 

Special note: If you can not raise both legs, do one at a time, Or, lift both legs, but let them bend at the knees. Either option will modify and ease the posture.

Now, gently resettle into seated mode, legs long and straight in front of you. If necessary, place a pillow or bolster underneath your bottom and/or knees. Interlace the hands behind your back, lengthen through the elbows to straighten the arms, and raise the arms up and away from the back. With the arms behind, fingers interlaced, and arms raised, ease into a forward bend: Keep the spine long; think of bringing the chest toward the feet, rather than the head toward the knees. Find your personal place of stretch, close the eyes, and breathe in and out through the nose: Complete 8 full breaths.

Finally, resume your favorite seated posture. Begin alternate nostril breathing: With the right thumb closing the right nostril, breathe in through the left nostril; block the left with whichever finger of the right hand feels natural, and exhale through the right. Then, inhale through right, close the right, and exhale through the left. Continue in this manner for 11 full rounds, finishing with an exhale through the left nostril.

Close your session in whatever way your energy dictates. Perhaps you feel inspired to move more: Do your thing! 

Or, if you feel pleasantly still and seek to deepen the state, sit quietly, hands on knees, palms up, eyes closed: Focus on the sound and sensation of your breath. Finally, if you prefer to enter Svasana, lie on your back, arms a few inches from your sides, palms up, and rest. Whether seated or supine, enjoy the peace for as long as you like.

Silent Sundays: Correction–In More Ways Than One (Or: How to Hang On–Day 26)

Back on Day 20 of the “How to Hang On” series, I made an error in counting–or so I thought. Consequently, there are two entries for Day 20, which means that every day after that is behind by one. Thus, today is Day 26 (although previous posts would suggest that it is Day 25). With that correction comes the topic of this Silent Sunday’s practice. When physical abilities become limited, one has to modify, i.e., correct for circumstance.

Yesterday, a friend was asking about cautionary protocols after surgery and during rehab. She ventured: “… And you won’t be able to do yoga.”

This is a common misconception: Many Western yogis view active vinyasa, “hot yoga,” or advanced Iyengar postures as the crux of yoga. As a former teacher and student of ashtanga (aka the original “power yoga”), I , too, was of that mind for several years. Because I was an active, athletic person overall, the quick pace and heat of ashtanga appealed to my energetic tendencies.

During this time, however, I also began studying Kundalini yoga. The mental and spiritual insight that I gleaned from the tradition was enlightening: Ever since, no matter my physical ability or mental state, kundalini has been a part of my practice. About 5 years ago, it became the core; when hip arthritis struck, it became my savior.

So, in answer to my friend, I was able to say that I never stopped practicing “yoga”: I, did, however “correct for” my increasing physical limitations. And, in so doing, I have realized that kundalini will continue to anchor my post-surgical rehab. Spinal exercises, pranayama, and upper body kriyas provide an energizing, clearing, and stabilizing foundation for my body, mind, and overall attitude. When pain subsides enough to allow, I add in movements to strengthen and soothe the lower body, i.e, the Lower Triangle of chakras.

With all of that in mind, today’s Silent Sunday offering is a sample of what I do and have done every day for the past couple of years: Even as my hips deteriorated to bone-on-bone status, I was–and continue to be–able to feed the following energetic nutrition to my body and spirit. This is the most recent iteration of the practice, which means that most people with upper-body mobility and the ability to sit and/or kneel can partake of the routine.

Always, every day, first thing in the morning–sometimes before donning clothes–I awaken my spine. Depending on what my body tells me, I begin on my back or kneeling: On the back, knees are bent, feet hip with apart; I then rock my pelvis forward and back, slowly and gently. Simultaneously, I consciously engage with the breath: inhale to tip the pelvis forward, exhale to retract it back toward me. Allow 1-2 minutes of this focused, warming move.

(If on all fours, similarly flex and extend the lower spine only, attempting to isolate the pelvis: inhale to lightly extend the lumbar spine; exhale to softly round.)

Then, I engage the full spine. On my back, I inhale to tip the pelvis forward; then, I exhale to begin rolling it up and away from the floor, incrementally continuing up the entire spine until I am in a modified Bridge. Then, inhale to lift the arms up and overhead to the floor; exhale to bring them back down, followed by the articulated roll-down through the spine–all on the same exhale. Repeat about 10 times.

(If on all fours, this would become a full Cat/Cow, flexing and extending through the entire spine. After about a minute, this would be followed by “Bird Dog”: extend the left arm straight ahead from the shoulder, while extending and lifting the right leg straight back from the hip. Take a full inhale and exhale, lower, and switch sides: Repeat 3-5 times on each side.)

At this point, I come to a seated posture. Typically these days (as crossed-leg pose is no longer comfortably accessible to me), I begin with legs extended straight out in front: When I need to, which is at about the 3-5 minute mark, I come into Rock Pose (or Hero Pose); I bolster by sitting on a block, feet pulled back to rest outside of my hips, tops of the feet on the ground.

Here begins another round of spinal flexes. At this point, having warmed up, the spine can begin to move more quickly and fluidly. Use this opportunity to ramp up the flow of blood and cerebrospinal fluid, both of which foster mental clarity. Inhale to open the front body with a deep arch through the entire spine; exhale to round and open the back body. Continue for 3-5 minutes.

Next, Sufi Grinds: Roll the entire torso to the right, making sure that the movement includes the pelvis. Inhale to press the spine and pelvis forward, then circle to the right; exhale as you round, tipping the pelvis back, and continuing the clockwise circle into the left side of the circle. Continue in this direction for 1-3 minutes, breathing deeply, and moving seamlessly; then, switch to roll counter-clockwise for another 1-3 minutes.

Now, I begin to engage the arms: Often, I have done so during spinal flexes; for the purpose of today’s practice, however, focus on each piece individually. Begin by clearing the magnetic field around you: Inhale to shoot the right arm straight up, fingers pressed together, palm up, facing left; exhale to quickly withdraw the elbow down to the side. Repeat quickly with the left arm: inhale up, exhale down. Continue rapidly, with powerful nose breath, for 1 minute.

Without a break, alternate the arms up and out to the sides at a 60-degree angle; both palms face inward, toward each other. Same speed, same breath: Continue for 1 minute.

Again, continue immediately: alternate arms up and out in front of you at 60 degrees. This time, the palms face downward. Move vigorously for 1 more minute.

From here, slowly slide out of your seated posture, and come onto the belly. With legs straight or bent at the knees, prop up onto the forearms. Breathe here in Spinx Pose, in through the nose, out through the mouth for 1 minute. Eyes may be closed, focused on the Third Eye.

Then, place the hands under the shoulders, but not onto the floor: Your upper body strength supports the lift. Inhale through the nose, then exhale to rock to the right, rolling the left shoulder and chest further away from the floor. Inhale back through center, hands and upper body remaining off the floor; exhale to tip to the left, rolling the right should and chest open and away from the floor. Continue back and forth for 1 minute.

Now, help yourself onto your back. Extend both legs straight up and together: Inhale through the nose to lower them both a few inches; quickly exhale through the nose to retract them back to 90 degrees. The approximate count is 3 to lower, 1 quick beat to lift. Repeat 10-20 times.

Next, life the upper body and support yourself on the forearms; elbows are under or slightly ahead of the shoulders. Stay lifted and open through the chest, shoulders rolled back: Extend the legs out at 60 degrees, and begin Breath of Fire. Continue for 1 minute; bend the knees slightly to modify; alternatively, do one leg at a time, each for about 30-45 seconds.

You may remain supported by your forearms, or, if feeling strong, extend the arms out along the floor while keeping the upper-body lift. In this position, “bicycle” the legs out at an angle of 30-45 degrees. Continue the full-leg, alternating peddling action for 1 minute: Then, reverse (as if cycling backward) for another minute.

Finally, lower onto the back. If your hips and low back allow, bring the knees in toward you. Inhale, then exhale to bring the legs down to the left; inhale up to center, exhale to the right. Alternate for 5-10 rounds, then lengthen the legs out (perhaps with a bolster under the knees), and settle into Svasana for 5-10 minutes.

Happy Sunday…