Becci Curtis Yoga

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My broken collarbone: week 1

Left clavicle, anterior surface. Plate 201 in Henry Gray (1918), Anatomy of the Human Body. 

What I thought last week v. what I know this week

A mere 5 days after snapping my clavicle in two (well three technically), I made the bold claim that I could 'see the shape of Week 1 already'. On the assumption that I would have a week's worth of adapted yoga postures to share with you, I even thought I could make a video. 12 days in, I now have the insight to admit that I was getting a bit ahead of myself. 

There is no video because having underestimated how exhausted I would feel and how much I would be unable to do, there has been very little in terms of a physical yoga practice. As I presumed you would not be interested in watching me variously sleep, eat comfort food and over-indulge in Scandi drama on iPlayer (Follow the Money - you need to watch it!), I'll be saving my entry into the vlogosphere for another time [cue sighs of relief].

All about the 'C' words [17]

For anyone who has never broken their collarbone before, it is an odd thing to break. I don't know about you, but I've certainly never given my clavicle a second thought. To be honest, I'm not even sure I realised I had one, let alone two. If I had to stab a guess at it, I think I've said, heard and written the words 'clavicle' and 'collarbone' more than one billion times over the last 10 days. [In case you're wondering, the number in the square brackets above is the clavicle/collarbone word count for this blog post alone.]

As if that wasn't enough, an odder thing about breaking your collarbone is that it can't be immobilised completely. You just have to rest, limit any movement (by wearing a sling or, a brace) and to try not to displace the bone as it begins to heal. In the early days, however, this means that you can hear the bone ends rubbing as you move (a gross and superfluous detail I know, but perhaps of some comfort to readers coming to this with a fresh break themselves: "Thank goodness! This is normal!"). It's an off-putting clicking sound that, at best, makes you regret being able to hear. 

Anyone who has suffered a similar injury to mine [I'm avoiding saying either of those words now] will also have acquired an implicit anatomical understanding and newfound respect for their shoulder.  When your clavicle [well, it was never going to last] fractures, your hand and the rest of your arm is totally functional (unless you've had the bad luck to injure that too) and it comes as a surprise to discover that your shoulder has been doing (or should I say 'shouldering' - sorry, I couldn't resist) the business you thought your arm had been taking care of for all of those years. Your arm is giving the presentation. Your shoulder is making the stupid PowerPoint. Without your shoulder, you can hold a cup of tea in your hand but you sure as hell can't drink it, and if you're on the side of the door that says 'Pull', you are staying where you are.*

Despite thinking the doctor's advice to remove my sling within a week rather optimistic, I have been able to do this and resume some normal (albeit small-scale) daily activities, like being able to shower/eat with both hands/dress myself etc.  Each day has brought progress and I have a pretty good, pain-free range of movement, compared to the worst I had expected - all because a Humanities degree and a licence to Google makes me eminently more qualified than an Orthopaedic specialist. This is why I have refrained from including a picture of my broken collarbone here - the internet doesn't need any more of that shit (you're welcome). 

Although I have missed the convenience and freedom of cycling, I have enjoyed re-discovering this thing they call 'walking' and having a grade A, watertight reason to do nothing without feeling guilty. However, as I'm starting to be increasingly able, I can feel this beginning to wear off.

Let's get back to yoga

Doing a limited amount of exercise makes me feel unsettled and irritable, so knowing that getting back on the bike is still a way off,  I have been keen to do as much yoga as I can under the circumstances. Following all that week 0 time spent resting, I was actually looking forward to the challenge of working around my current limitations. I already knew that I would need to avoid anything that could potentially put my clavicle out of alignment. This means that any down-dogs, chaturangas, standing forward folds, sun salutations, postures requiring me to lie on my front, or on my side, are all out of bounds (for the time-being at least). 

As any upper body work is off the cards for a while, I wanted to spend this week focussing on maintaining the strength in my legs, lower back and abdominal muscles to stabilise the foundation of my newly wonky body. As other parts of the body are called on to compensate, any injury you sustain will have a knock-on effect elsewhere - e.g. pain in your back, hips, knees etc. Therefore maintaining, or developing a strong core, is invaluable in helping to prevent problems further down the line. 

NB: Below I describe some of the things I have tried this week; if you are coming to this with your own collarbone injury and you want to try some of these postures, make sure to listen to your body. Take it slowly and if you feel any sharp pain, or unusual discomfort, stop. Remember, I am not a doctor (see above). These exercises are also suitable for those of you with perfectly adequate collarbones - you may find them helpful if you are new to yoga, have a different shoulder injury, or limited mobility. They are also suitable for new mums who are ready to begin some gentle exercise after giving birth. Whoever you are, take the same heed as above: know yourself, practice intelligently and be patient. Little and often, is better than doing too much in one go. 

Bharadvajasana

Some gentle supine yoga postures seemed the obvious place for me to start; being supported by the floor would decrease the chance of inadvertently overdoing it and stop me worrying about accidentally forcing my collarbone out of line. My lower back has particularly suffered from a lack movement this week, so I wanted to begin with a simple twist (Supta Jaṭhara Parivartānāsana). However, I soon found out that lying down made the benign positional vertigo (BPPV) I've been experiencing since my head injury, much worse. (As the old adage goes, it's not advisable to practice yoga if you have to catch the floor on the way around!) So, if lying down presents some difficulties for you, use a chair for Bharadvajasana instead, which is exactly what I've been doing. (If you are an office worker, you can try this at your desk - it's good for relieving your poor back from hours spent sitting.)

Bharadvajasana (using a chair). Illustration from Asana for the Ages by Marla Apt, republished by Feathered Pipe Foundation.

Starting with your right-side; sit sideways on a chair [make sure it has a sturdy back and is at a height where you have both feet firmly on the ground]. Keeping your legs and feet rooted, turn towards the back of the chair, taking hold of each side with your hands. Inhale and breathe up towards your chin, lifting your chest (not your shoulders!). As you exhale, slowly start to turn by pushing with your left hand and pulling with your right, whilst drawing your abdomen in. [ If you have a right-side shoulder injury, you will need to be careful not to pull too hard with the right hand as this will force your shoulder back. The same goes for the opposite side.] Turn to look over your right shoulder, hold for 5 breaths. Repeat on the opposite side. 

Pelvic tilts

As Marjaryasana (cat/cow) or any kind of sit-up movement is currently off limits, pelvic tilts are fantastic for mobilising the lower spine and strengthening the abdominal muscles. If you are particularly weak in this area, pelvic tilts will allow you to build strength safely, protecting your lower back more effectively than any gym-style crunch - often when the abdominals are weak, we aren't able to engage them properly, so in order to perform a sit-up, we pull ourselves up by loading our bones rather than using our muscles (hint: you will know you are doing this if you are coming into a sit-up, chin first, feet lifting). This might mean that you are able to impress your friends by doing 100 sit-up-looking movements, but unfortunately, you won't be making your abdominals any stronger. 

You can choose to practice pelvic tilts with your legs straight or knees bent, either lying down or standing against the wall (this week I chose the wall). If you can lie down but find it painful to take your head to the floor, you can rest your head on a pillow, or on the back of your forearms (see picture). Additionally, if you find the floor too hard, you can practice pelvic tilts lying on your mattress - I sometimes do this to release tension in my lower back before going to sleep. 

Pelvic tilt. Fig. 2 in Andrew J. Cole (2007), Lumbar Spine Stabilization Exercises.

With your back in neutral [you should be able to slide a hand underneath your lower back; leave your hand there if you want to check you are doing the pelvic tilt correctly to begin with], inhale and start to curve your lower spine, taking your navel (and pelvis) upwards [your back will move further away from your hand underneath]. As you exhale, start to press your spine (and pelvis) downwards and draw your navel in [your back will now press against your hand]. Repeat, alternating inhale (curve up) and exhale (press down), as many times as you like. When this becomes easy for you, start to extend the length of your exhale, pushing out all of your breath as you squeeze your back down to the floor (or wall) and hold for a second, before starting to inhale and beginning the exercise all over again. This method will require your abdominal muscles to work a lot harder. 

Baddha Konasana 

Aside from applying a deep stretch to the inner thighs, I find practising Baddha Konasana (bound angle pose) good for easing stress and tension. It's a posture I normally go to in times where I feel a bit weary and in need of lift (quite literally - if you place your focus on extending your body from the crown of the head, you lengthen your spine and feel taller). Normally, I would practice Baddha Konasana unsupported however, this week, I chose to sit against a wall for reasons of comfort more than anything. There is a tendency to collapse the lower back in this posture - sitting against a wall will help you solve this.

The great Mr. Iyengar in Baddha Konasana. Plate 101 in B.K.S. Iyengar (1966), Light on Yoga.

Begin by drawing your hips as far back into the wall as possible, bend your knees and bring the soles of the feet together. You would usually clasp your hands around the feet here (see picture) but in order to stop any temptation to pull my shoulders down and put pressure on my collarbone, I have been resting both hands on top of my ankles. Choosing the appropriate hand position for you, inhale and press your thoracic spine (the back of your chest) towards the wall behind. As you exhale, keeping some tone in your abdomen and your lower back strong, draw both of your knees down towards the floor. [Don't be discouraged if your knees don't go as far as Mr. Iyengar!] Hold for 5 breaths (or, as a long as you find comfortable) and repeat if you want to. For a passive stretch, you can do this posture lying down ( Supta Baddha Konasana) - gravity will do most of the work for you.

Weeks 2-3

Three postures were the extent of my yoga practice this week. Although I hope that weeks 2-3 of my broken collarbone will see me undertaking more physically, I intend to relax my expectations of what I will and won't be able to do. Taking on the lessons of week 1, instead of focussing on a particular set of activities designed for a set reason (like maintaining abdominal strength), I will just be trying to practice what I can, when I can, and seeing where that takes me. 

*I do have the use of a perfectly good, if comparatively untrained left hand, so this is a slight exaggeration designed to elicit shock and/or sympathy.