Yoga Therapy For Plantar Fasciitis

When working with yoga therapy clients, knowing what NOT to do is just as important as taking the right treatment approach. In this segment, Brandt shares advice about working with plantar fasciitis, and stresses how to avoid aggravating this common and painful issue.

There’s a couple things you want to look at with plantar fasciitis. One would be, you know the condition itself is like a shortened fascial state like on the foot but usually it includes the calf and up the hamstrings. So at some point you’re gonna have to stretch that. So it’s not difficult to figure out how to do that if you’re a yoga teacher, but what’s not as obvious maybe is if you look behind someone if they’re supinating or pronating that would need to be corrected too. So you’d have to look at, or my advice would be to look at them standing from behind and see if you can get those Achilles tendons to line up straight, if they’re not, you lift their toes and have them form arches and possibly you figure out how to get their feet back into neutral so that would be one thing. And then when they’re not symptomatic or really warmed up, you’d want to very gently lengthen the fascia on their feet, and their calves, and possibly their hamstrings.

But here’s the thing. What I see a lot of people do it, and I’ve even seen PTs do this, you can’t just take somebody who has plantar fasciitis, which is basically the tearing of the fascia away from the heel. And then start stretching the heck out of it because we’re just gonna make it worse because I think it’s gonna tear more. So the trick to it is, along with the sort of structural piece is to teach the person how to get very warm before they do any stretching. And then do some fairly long holds. And at first, I would target the calf area and see if you can get the calf to lengthen without feeling it in the bottom of the foot and then see if you get the hamstrings to lengthen without feeling it at the bottom of the foot. And then the final thing I do would be to do a more sort of extreme stretch where you would lift the foot off the ground, balls of the feet off the ground at some point, but that’s after they’re better. So the mistake I see people making is kind of going for these big stretches, you know, and you see this a lot in athletes so they’re very game to do things usually. So, you know, you get someone in to your practice then athlete and they’re like, yeah, I’ll just stretch it out, tell me how to stretch. But you’re likely gonna do a lot more damage, so, what I’ve seen is people have plantar fasciitis and get it made much worse by the stretches.

So the key is where the person feels it. So you really want to be targeting, usually it’s not the fascia on the foot that shortens actually, could be but usually the real problem is up the posterior chain fascially, so really going to be sort of long, gentle stretches in the calf and the hamstring. I’ve worked with that condition hundreds of times, it’s very common and that usually works. And as you give the person what to do, you know, make sure they’re warm. So actually the first thing in the morning probably isn’t your moment, so make sure they’re already warmed up and then you can go further by actually having them heat the area. And I know a lot of times if you have inflammation people think ice because it cools it, but really what you want is all the tissues to be warm and open before you do any kind of manual stuff with them.

Yoga Therapy For A Rotator Cuff Tear

Listen in as Brandt shares strategies and discusses best practices for working with rotator cuff tears.

One was a question about rotator cuff tears. What’s the deal with them? Can you tear it more and how careful do I need to be? That’s really the basics of this question. So, the answer to that is, it depends. Without giving an hour lecture on rotator cuff tears, I’ll say this – that basically tears have different sort of grades to them. So, it depends how severe the tear is, so you need some information from their doctor about tears. There’s no way for you to know how torn something is. But that said, unless it’s really intense, so they usually grade them, so if it’s a low-grade tear which is kinda the most common thing especially if it’s not a trauma, if it’s just like over time. I see a lot of people have tears and, you know, usually when a yoga therapist gets, and they’ve been to PT, and so this has been my experience. This is just one possibility, but a lot of times they’ve gone to PT and they’ve done rehab exercises that have either worked partially or not worked. When they haven’t worked, it’s usually has something to do with – well, there’s lots of reasons they could not work. But often what you see as a yoga therapist coming in after all that is, or what I’ve seen is that the PT has given them exercises that were too strong. They didn’t work on them gradually and I think that was a problem.

The other thing I see kind of commonly is with older people, say above 60, sometimes they write them off like, “Yeah. You have rotator cuff tears and here’s a couple of exercises.” And, you know, obviously, no PT or Physio should do this, but it just kind of happens a lot. I don’t know if it’s just because of ageism or…because I just see so many and it’s kind of a mill and it’s hard to keep track of everyone. But they say, “Well, you’re good enough.” I get a lot of those. So, one thing you need to remember is that non-painful movement is really important. So the non-weight bearing, no-pain movement to warm up the area, and also to sort of treat whatever arthritis may not be in there coexisting with the tear, so that would be good. Do a lot of that, a lot of moving and breathing. And then when you start to strengthen, one of the key things is to do it in a way that’s suitable to their shoulder. And you can’t always tell while you’re doing it. So a lot of times it’ll feel fine in the session but what you want to do is follow up and make sure that you’re doing things that don’t really inflame it too much, say, the next day afterwards. I always follow up with my clients. So, those are the two things I would think about.

The third thing is a technique. Actually, Karina in this course was teaching that to us on the last retreat. But where I’ve used forearm stand against the wall, sometimes on the floor, depending on the shoulder to sort of reset the shoulder. I’ve used other techniques like that where you use the muscles and then the working theory is other muscles take over usually for the supraspinatus which is torn. Her group has a technique where you do forearm standing against the wall and you relax your upper traps, and then right afterwards, you kinda swing your arms up and down, and that sort of resets it for the day, or forever, or for a few hours depending on the person. So that’s another technique that I could show you sometime. The main thing is that you have to kind of stay on them and make sure that the strengthening exercises you’re doing are not inflaming it too much because, you know, it’s a sign of a couple of things. But one is that you’re really getting at the sort of attachment where it’s torn and that could be really dangerous.

Where I’ve seen people make mistakes in the past is that they don’t follow up properly. And so the person seems fine, and then it swells up, or it hurts a lot the next day, and then the person thinks, “Well, this is probably just part of me having a hurt shoulder. I’ll just keep doing what I’m doing.” And that’s kind of the danger zone. So I would be careful there. Make sure you follow up. You want to talk to them on the phone the next day. You can do it by email. I try to actually talk to them so I can ask them some questions. Questions like, “Well, does your whole shoulder hurt today more than it did yesterday? Is it more sore today than it was yesterday?” Some people are pain sensitive and they’ll always tell you something hurts. Other people go the other way and they’ll be like, “Oh, it’s fine.” I have a guy like this right now, actually, I’m working with who says, “Oh yeah, it’s fine.” But what he really means is that he can handle the pain. So you have to ask more specific questions like, “Look, is the pain today worse than it was when we were working yesterday?” That’s a very specific question as opposed to “Does it hurt?” So just keep all that in mind.

Yoga Therapy For Trauma

When someone seeks out a Yoga Therapist because they are suffering from trauma,  the role of the Yoga Therapist to facilitate this transformation with the self takes skill and knowledge. In this segment, Brandt explains the difference between and best practices for working with trauma in a group class versus a private session.

You know, working with people that have suffered trauma, it’s a very different experience to work one-on-one than in a class. So there are certain things that are the same, like how you might use invitational language, how you give people lots of options and don’t require them to do things necessarily. And then there’s a similarity in the physicality where you create a safe space, where you as the teacher are not coming at them, standing over them, etc.

But the difference I think, and where sometimes people are confused is in private sessions, this is similar but different in that, where in both cases try to encourage people that was certain kinds of experiences. And the primary one is interceptive or sensory experiences, where you’re feeling things in your body and you’ve heard probably a lot of times trauma lives in the body or in the tissues. And that’s true in that, in order to allow trauma to move and be resolved, the body has to be felt. If the body’s cut off, not always, but it can be more difficult. So, often it’s a good idea to whatever level a person can feel their body and that could be as sort of big a body experience like big asanas, and as small as feeling the breath move in and out. But being in the body can be extremely useful.

But when you’re working with somebody who really is interested in a curative solution in terms of working through their trauma and, hopefully they’re supported by a psychotherapist of some sort, or social worker, or psychotherapist, or a psychiatrist. But, you know, some sort of mental health professional as well. But in private session, there’s more of a place to allow them to explore how they feel about their trauma, or the reactions to it, or things that trigger them for themselves in a safe environment. So usually that’s not going to happen with 20 people around you. But if you can create a container where that’s possible and you can resist the urge to sort of process with them. And use yoga practices to allow them to have experiences and then maybe talk it out for themselves. So in our retreats we do a lot of active listening techniques so that we can get used to this experience of listening without judging, of not implying anything with our physical bodies, or the things that we say.

So in that way it’s different and I think the other way it’s different is that you’re working through the koshas, and in private sessions you may have a better take on where that trauma lives. I mean it’s quite likely envisioned of maya kosha because that’s where our unconscious patterning is stored but it could certainly be in other places as well. And to really help people specifically with practices for that so you’re not just generalizing like a trauma-sensitive practice that doesn’t trigger them. You’re more looking in a private session at a practice that allows them to work with their bigger stuff in a way that is actually safe for them or that they can do. And that’s all about relationship, so the questions around that we’re sort of like, well what do I do? Do I simply just teach them yoga and not trigger them? Do I talk to them about their stuff? Do I work with things? And then so the answer is, you slowly work into that those kosha techniques that we learn in the course with their consent and permission.

Once you’ve established a relationship with them that’s solid, and once you have their consent and, you know, consent in this case can be tricky, I think, because sometimes it’s hard to consent to what you don’t know is going to happen, right? So consent is when someone can say, I understand that this technique might bring up this stuff. But to be honest with you, I’m really interested in doing this work because I feel like that’s going to be beneficial to me. And then so you give them techniques that might help them let’s say, deepen their access to their vision of maya kosha which could allow some stuff to move and you would do that while explaining to them that you are a support system but they also might need other supports.

Yoga Therapy vs. Physical Therapy: What’s The Difference?

Listen in as Brandt discusses how a Yoga Therapist might work with a client who has already been to physical therapy, as well as some of the different approaches between the two therapies.

Using Ritual to Balance Anandamaya Kosha [Bliss Body]

“You absolutely can offer ritual to a non-yoga person—someone off the street. People have all sorts of rituals in their life. Watch baseball if you want to see people with rituals.”

Listen in as Brandt gives examples of ritual that can help access bliss and balance the anandamaya kosha [bliss body].