Interpertation of pain and injury in context of Ashtanga Yoga practice

Foreword from Stu Girling

First of all I want to say that I really love the way Iain writes and that he has the conviction to always say exactly what he is thinking. For this particular post I felt it was necessary to put a little bit from me up front as the views put forward are so opposite to mine. So why am I posting it you may ask. Well the answer is very simple. As a resource site I welcome disparate views because it makes us examine our own position, gives a fuller picture of different opinions about a subject and opens up the potential for discussion and expanding knowledge. I really enjoyed reading the post that follows and the fact that it gave me the chance to revisit and evaluate my own perspective. I will place my own views in the first comment, until then please do read, digest and ruminate over everything Iain has to offer. – Stu Girling

Interpretation of pain

“I’ve been studying low back pain for the last 50 years of my life and if anyone says they know where low back pain comes from, they’re full of shit” – Alf Nachemson, quoted in the video.

I agree with the message of this video completely. After watching it, I felt compelled to write more about my interpretation of pain, injury, pathology and healing, especially in the context of the Ashtanga Yoga practice.

The structurally transformative process which arises from correct, long term application of the Ashtanga Yoga system of practice necessarily involves some experience of discomfort. Many practitioners don’t understand the inevitability of these unpleasant phases of the Ashtanga experience. Rather than accepting and patiently working through the discomfort using the method of practice, some practitioners immediately seek help from outside modalities in an attempt to eliminate the pain or discomfort as quickly as possible. Fortunately, the treatment they seek is usually not as dramatic as surgery, but the surgical tourism industry in countries like India does serve a number of Ashtangis who want a quick and easy diagnosis and treatment solution for their knee pain.

When a student reports pain to me, my general advice almost always falls along the lines of “Continue to practice. Back off somewhat, perhaps we’ll need to temporarily modify your practice, don’t push into the pain, but continue to practice.” Depending on the characteristics of the individual situation, I’ll probably have some more specific advice to go along with that, but in general terms that about covers it. With continued careful practice, if the pain doesn’t get worse, or it moves around to other areas of the body, or it spreads out, or it slowly improves, then I generally feel confident to tell the practitioner that they don’t need to do anything else. They shouldn’t seek other forms of manual therapy, nor do they need to consult a doctor and have medical scans. With continued intelligent and aware practice, it should work itself out and resolve itself.

Reorganizing and recalibrating

The pain which arises out of daily, long term Ashtanga practice often represents a deeper reorganizing and recalibrating of the tension and structural patterns of the bones, tissues and fascia. This reorganization is actually a sign of correct practice and is a desirable result. Those who don’t want significant internal transformation shouldn’t practice this system of yoga.

Tension is an inherent property of a healthy human being, and of any stable structure in the universe. Tension is a necessary condition for life itself. Disorder and chaos are the path of least resistance (and least tension) in the universe. For a complex structure (whether it is a molecule, a human being, a society, or a solar system) to remain stable and not degenerate into chaos and disorder, some organized force – involving tension – is an essential property of the system. Complete elimination of tension is therefore not the goal of our practice. A human being that is free of all tension is a human being that has experienced death and disintegration. The component parts of the dead human being are free to disintegrate into chaos and disorder, until they are absorbed by other stable structural systems. Death is the only true state of freedom from tension.

Bandha

The goal of our practice is to reorganize and recalibrate the tension patterns in our body-mind system so that we can have a more functional and stable relationship with the environment which we live in and are a part of. The state of bandha could be considered as the optimal state of tension for the human being. When opposing forces are balanced in bandha, the tension moves to the deepest “structural” layers of the body, such as the pelvic floor and the key supportive muscles for all of the joints, which are “designed” to hold us steady and stable in relationship to the earth and its field of gravity. In bandha, the tension is largely removed from the sleeve muscles, which are “designed” to be free and ready to respond to the need for movement. Hence the state of bandha is a dynamic balance between the forces of tension and release (or, bondage and freedom). This creates healthy and functional tensegrity patterning within the human structure. For me, this functional repatterning is the goal of asana practice.

We can think of ourselves as having two temporally distinct, but interconnected postural states. One of these states is the transient postural state which we happen to occupy at any given moment in time, throughout our daily lives. This is a relatively superficial and temporary postural state, and largely reflects a relatively temporary and superficial action (or inaction) of the muscles and tissues of our body. It is also reflective of our emotional state at that given moment. The other postural state which we can consider is the long term postural tendency, which reflects the deeper structural habits and patterns that we have adopted over our entire lives. This postural tendency is a cumulative result of the habits we generate through each of our transient postural states throughout our lives, along with the genetic tendencies which we are predisposed to from birth. This long term postural tendency could be thought of as a deeper and more crystallized (though not impossible to change) state of tension patterning within the human system.

Tensegrity

Postural states reflect tensegrity patterns which organize the forces of tension and release within the body-mind structure. The momentary transient and the long term postural states influence and inform each other in a reciprocal relationship. Each momentary transient postural state provides an input into the human system which influences the more crystallized form of the long term postural tendency. If the transient state is similar in nature to the long term tendency, then the input of the transient state will strengthen and support the structure of the long term tendency. If, however, the transient state contains aspects which are different in nature from the long term tendency, then the input of the transient state will tend to induce a shift or change in the tensegrity patterning of the long term tendency. The causal relationship between the two types of postural state also flows the other way. The patterning of the long term tendency will also influence and inform how we hold ourselves in each momentary transient state.

In my view, the role of asana – vinyasa practice is to use conscious awareness in the transient postural states of each asana and vinyasa that we occupy during our daily practice, so that these transient postural states provide tensegrity patterning inputs which are healthier and more functional in nature than the patterning of our long term postural tendency. When this happens, the transient states of each asana and vinyasa of our practice encourage and induce a shift and transformation towards a healthier and more functional posture in the long term structural tendency.

When we do this day after day, using muscular strength, flexibility and awareness to provide the same repetitive tensegrity patterning inputs of the particular Ashtanga series that we are working on, the tensegrity patterns of the deeper structures of the human system, which reflect the longer term postural tendencies, eventually must shift and change in order to support the new transient movement patterns which we are regularly engaging in.

If we practice each posture and vinyasa with some degree of the balanced energetic state of bandha in place, then over time, our long term postural tendency will also tend to reflect the properties of bandha more naturally and readily. In a state of bandha we are in a more harmonious and functional relationship with the field of gravity. For example, when we stand in samasthiti with bandha in place, we tend to stand somewhat taller and more effectively spatially organized than we would if we were simply standing around, unaware of our posture. Practitioners who apply bandha well in each of the transient momentary postures (asanas and vinyasas) of their daily practice will actually grow taller over time. I have experienced this myself. My natural resting posture is now at least several centimeters taller than it was before I started daily yoga practice. I have also observed this happen in some long term students of mine.

This process of shifting and changing the long term structural tensegrity patterns of the body through asana practice is where the transformational pain arises, which many long term practitioners experience from time to time. The long term effects of shifting the deeper tensegrity patterns are healthy and beneficial, but the short term experience of getting from here to there can be uncomfortable. Imagine what has to change deep within the structural organization patterns of your body for you to grow taller. It is unlikely that this would happen without some pain or discomfort along the way.

Continued practice through these periods of discomfort is the best (and often the only) way to resolve this discomfort. By continuing to provide the inputs of the transient postural states of our daily practice, we encourage the patterning of the long term structural tendency to continue to evolve, until it eventually reaches a new stable conformation. There is an “intelligence” and functionality in the pain we are experiencing in this transition period. If we halt the process by stopping practice, or confuse the process by adding other, different inputs (such as resequencing the asanas, bodywork, manual therapy, surgery, etc), then the process gets sabotaged and in some cases this can make the pain worse, or simply transfer it to other parts of the body-mind system. If, however, we continue to provide the familiar inputs of our daily practice, the evolution in our long term postural tendency will continue to move with the intelligence of these familiar inputs of the Ashtanga series. Eventually, the longer term postural tendency will settle into a new, stable conformation. Once this new stable conformation is reached, the transformational pain generally subsides naturally. Sometimes the pain subsides gradually, getting a little bit weaker each day as the body continues to shift and stabilize into its new structural state. Sometime the pain disappears instantaneously, perhaps during some movement in our practice or perhaps while we are at rest later in the day.

Whether the pain dissipates gradually or instantaneously, it is continued practice (ie. continuing to provide the same transient structural inputs which have induced the shift) which will bring about this resolution. This advice can be counter intuitive to what many practitioners (and the general population) tend to believe. Upon experiencing pain most people tend to feel that they should A) stop practice for a while and B) consult a physician.

A physician will almost always prescribe rest and recommend avoiding yoga practice until things get better. For the reasons I have already mentioned, this will not likely provide effective long term resolution. A modern physician may also order x-rays and scans, which may confirm disc degeneration, herniation, or ligament, tendon or cartilage tears. As the above video states, a significant percentage of the “normal” population also have some or all of these “pathologies”, yet they don’t have any significant pain symptoms. Some degree of structural “pathology” is actually “normal”. Yet, if an Ashtanga practitioner (or anyone, whether they are a practitioner or not) who is in pain receives the news that their scans have confirmed some structural pathology, then the person will necessarily create a network of physical and psychological labels and restrictions around their pain. They will likely limit and restrict their practice and general life movements based on intellectual theories, rather than on phenomenological experience. The movements which they do allow themselves to perform will be done with fear and trepidation, with the anxiety of making their fragile condition worse. This mentality and set of physical restrictions will not promote healing in most cases.
Ashtanga is a systems oriented type of practice. It is therefore important to try to understands its effects from a systems oriented perspective. The systems perspective of nature and the universe has begun to develop and evolve relatively recently. It is slowly gaining traction in the scientific community, and I believe that it is an accurate and realistic way to understand life and and the universe. It trumps the reductionist methodology which has been the pervading feature of both Western and Eastern approaches to understanding reality for most of the past several thousand years.

Reductionism

Reductionism attempts to understand something by breaking it down into its component parts and then examining the properties of those parts. It looks to the properties of the parts as being the root causes for the properties of the whole. This is what Western science has done for hundreds of years, and this is also what Eastern religions and philosophies, such as Buddhism, do. While both Western science and Buddhist philosophy have yielded accurate, valuable and useful perspectives on reality, they have not effectively explained everything that we experience.

Reductionism is also frequently used to analyze and understand asana practice and its effects on the human system. One of the most well known asana reductionists was BKS Iyengar. Mr. Iyengar took the Ashtanga system, which he learned from Krishnamacharya, and analytically broke it down into its component parts. He took the asanas out of their systematic relationships with one another through the vinyasa system, and turned each asana into a system of its own. He then took each individual asana, and broke it down into its component parts of the actions of each individual muscle, bone, etc. He then noted the effects on each individual body part in each individual asana, and how these effects contributed to the overall functioning and health of the human being. Not surprisingly, Mr. Iyengar’s work became of great interest to the modern medical community, which operates on the same reductionist paradigm.

Mr. Iyengar was a great innovator, and his work certainly yielded some valuable results and perspective. However, some important results and perspective were also lost through his abandonment of the systems view of Ashtanga Yoga. My own personal journey, from being trained as an Iyengar practitioner and teacher to becoming an Ashtanga practitioner and teacher, is that the systems perspective and experience of Ashtanga practice is deeper, richer, and more encompassing than the reductionist Iyengar technique. I value my experience with Iyengar Yoga. I am glad that I had it for four years in the beginning of my yoga journey, but there is a reason that I have been a daily Ashtanga practitioner for the subsequent 14 years. People sometimes tell me that they are drawn to me as teacher because I have an “Iyengar background” and they want that focus on alignment. My response to them is that the two systems are actually incompatible, and cannot be practiced together. I don’t use any alignment principles, props, or techniques from my Iyengar training in my Ashtanga practice and teaching. Alignment is certainly a feature of the Ashtanga system, but it is a very different perspective on alignment. In the Ashtanga practice, alignment is integrated into a systems perspective and experience.

Returning to pain and pathology, an example of a reductionist approach to pain experienced by an asana practitioner might be to obtain medical scans or use other diagnostic methods to find some pathology in one particular muscle, joint, ligament, etc. Upon discovering (or theorizing) some localized pathology, the experience of pain in asana practice would be understood to be directly caused by that pathology. The treatment would then be to remove that pathology – either through surgery, or less dramatically, through some form of deep tissue release or targeted manual therapy. There would also likely be a number of significant changes made to the person’s asana practice, based on the diagnosis of pathology in some body part.
Another reductionist approach in asana could be exemplified by a teacher telling a student “your knee pain is caused by your tight hips”, and to then prescribe a set of supplementary “hip opening” exercises to be done in conjunction with the regular asana practice. I’ve seen numerous practitioners who believe that “opening the hips more” or “opening the shoulders more” will be the cure to all of the issues which they face in their practice. I am frequently asked by students who are struggling with some particular asana “which body part” is stiff or stuck or needs to open more, and is therefore responsible for their inability to perform the asana.

A more Eastern influenced form of reductionism would be to characterize all aspects of bodily pain, tension, or “blockage” as being psychological in origin. In this view, the mind is seen as being the root cause of all bodily experience and any pain in the body is reduced to some dysfunction or blockage in the psychological realm. The poor student is then left to haplessly believe that their bodily torment is due to some mental issue which they have no real way of addressing.
The key theme in all of the above examples, is the reduction of the holistic experience of the state of a person’s body-mind to a single root cause, and then to assume that the holistic state of the person’s body-mind can be “fixed” by simply changing or fixing that one root cause. This is the essence of reductionism.

A human being is an extremely complex system. There are 11 organ systems in the human body (skeletal, muscle, nervous, integumentary, endocrine, circulatory, lymphatic, digestive, respiratory, urinary, reproductive), as well as various layers of “non-physical” experience, such as the cognitive, emotional, energetic, etc. All of these systems and layers of a human being are interconnected and coordinated in an unfathomably complex network of dynamic relationships and feedback loops.

When this human body-mind system places itself into the transient postural states of a particular asana or vinyasa, there will be an effect of all of these physical, and non-physical systems of the human being, as well as in the network of connections and relationships between all of these systems. The overall effect is a shift in the entirety of the state of the human being. This shift in the whole being is known as an “emergent property” and it cannot be explained by looking at the properties of any of the component body-mind parts, or by looking at how the asana affects any of those single component parts. Emergent properties of a dynamic and complex system literally “emerge” out of the complex dynamics of the relationships between all of the component parts. The key point to understand is that the emergent characteristics of the whole are a result of the properties and dynamics of the relationships between the parts. The emergent characteristics of the whole are not features of the parts themselves. These emergent features can only be understood by looking at the system as a dynamic whole.

A single Ashtanga series, from ekam position of surya namaskar A up to utpluthi, should also be thought of as a system. Practicing any of the Ashtanga series in their entirety will give certain effects, features and results, which cannot be found or explained by looking at the characteristics any of the individual asanas in that series. They cannot even be explained by looking at all of the individual asanas in the series. The effects that one experiences by practicing a particular Ashtanga series are emergent properties which emerge out of the relationships between all of the asanas and vinyasas in the series taken together and they can only be understood by perceiving the series as a complex and dynamic system which is a whole in itself.
A system can vary in its relative stability. When the dynamic relationships between the parts of a system are changing or shifting significantly – such as when the long term postural tendency is undergoing significant shifting – the system can be said to be unstable and in a state of transition. Whatever emergent features – such as pain – the system is experiencing at that time should be thought of as properties of the whole system, not properties of any of the parts of the system. The pain is a property which emerges out of the restructuring of the relationships and feedback loops between the parts of the system, as the system transitions from one structural state to another structural state. The pain is not a symptom of any one root cause or “dysfunction” of any component part of the system.

I suggest that in many cases of pain or discomfort experienced through long term Ashtanga practice, adopting this perspective is the most accurate way of understanding and dealing with what is taking place. The system of the Ashtanga series is exerting an effect which is causing a shift or change in the tensegrity dynamics of the relationships between the parts of the system of the whole human being. The pain is something that emerges out of the shifting of this complex and dynamic set of relationships. The pain is not a property of any one part of the system and should not be attempted to be addressed through a perspective of linear causation.

This brings us back to the quote from Alf Nachemson which I put at the beginning of this article. No matter how learned one may be in anatomy and physiology, I don’t think that anyone can conclusively say that they understand exactly where a person’s pain is coming from – especially in this type of situation. This is because the pain is not due to any one root pathology in any one part of the body. The pain is simply a reflection of the shifting relationship dynamics between all the parts of the whole human system. How these patterns are structured, and how they are changing, is far too complex for any human mind to completely understand.
The resolution to the pain necessarily involves retaining a systems perspective. In cases of “transformational pain”, the system of the Ashtanga series should continue to be practiced with as little modification to the dynamics of the system as possible. This way, the inputs that the practice is exerting on the human system remain consistent, and the intelligent reorganization process which the practice is inducing retains some stability. The human body-mind system will eventually imbibe and embody the transient daily inputs of the Ashtanga series in the more stable long term postural state which it is moving towards. Continued intelligent movement will resolve the pain. Restriction and reductionist oriented intervention probably will not.

Modifying the practise

In my 18 years of daily yoga practice (14 of which have been Ashtanga), I’ve gone through many periods of pain, which have lasted anywhere from a few days to the better part of a year. Some of this pain has been severe, and accompanied by serious mobility restrictions. In most cases, these periods of pain were a by-product of a deeper restructuring/recalibration of my body’s relationship to gravity, as I have described in this article. Most of the time, the pain could be localized to a general area of the body, but usually not to a specific structure (ie. a particular muscle, tendon, bone, joint, etc). My approach to dealing with these periods has always been the same: Pull back to a more basic version of my daily practice. Often this would mean a less advanced series, or even a partial series. I would practice as much of the series as felt energetically sustainable, even if it was still accompanied by pain or discomfort. Often, my decision on which series to use “therapeutically” or how much of the series to practice was intuitive. I find that decisions based on systems thinking often feel more intuitive, because they require a different form of cognitive understanding than the more analytical reductionist approach which we are habituated to in most modern societies around the world.

Generally, if I had to modify more than one or two postures or vinyasas in that series which I had chosen to practice, I would stop my practice at that point and go into the finishing sequence. Using this method, day by day and week by week, I would always see a gradual improvement. Improvement is defined as an increase in mobility and a decrease in pain and (equally importantly) an increase in a sense of confidence and mental/energetic stability and vitality. This could also be simplified by saying improvement is defined as a movement towards stabilization in both body and mind. As my condition improved, I would add postures and series back to my practice until I arrived back at my standard normal practice again. Some days, it might be just one inch more of space in one particular posture that could be taken without inducing pain, but if I paid attention, there were always some signs of improvement and usually on a daily basis. The pain would often move around, shifting to different places in my body, spreading out, until eventually it would disappear completely. Other times, it would happen more dramatically. I have had experiences where very serious pain completely vanished from the body instantaneously, after performing a particular posture or movement in the course of my practice that day. Whether the “recovery” was gradual or sudden, the technique was the same: careful, aware and embodied movement, to whatever degree of capacity I had at the time, encouraged and actively led to the eventual resolution of the pain.

One particularly interesting experience came during my first few months of my Ashtanga practice in 2004. I had a lot of energy and enthusiasm at that time in my life, and I was practicing with an older style teacher who generally didn’t stop practitioners at the asanas they couldn’t yet perform fully. Due to my Iyengar background, I could already do many of the postures, so within a few months of beginning Ashtanga practice, I was doing all of primary and all of intermediate series as a 3.5 hour daily practice. Needless to say, I was in a significant amount of pain and experiencing dramatic structural changes. I watched the coming and going of different pains and the resulting structural shifts in my body with great interest and curiosity.

Backbending

When I had begun practicing Iyengar yoga some four or five years prior to that, I learned how to practice dropping back from a standing position into a backbend on a beach in Northern Goa. I wasn’t ready for that movement, but after watching a flexible girl in our class do it, I wanted to try. My teacher obliged and encouraged me to try. Through sheer will power, I managed to arch back and land successfully in a backbend. It was exhilarating and empowering. Two days later, when our class was “working on” backbends again, I wanted to try dropping back again. I managed to succeed, and this time my teacher came over and pulled me back up to a standing position. We went on to practice standing postures, and I felt a pain in between two vertebrae of my lumbar spine. The pain grew stronger over the course of that day and ended up staying with me for the rest of my four month stay in Goa that year. It also brought up a lot of negative emotions. Eventually it resolved itself completely.

During the first few months of my Ashtanga experience in 2004, my nemesis became kapotasana. It was very difficult for me to catch my heels, and every day when I was about to arch back into kapotasana, my teacher would appear in front of me and pull my hands directly to my heels from the air. It was always terrifying, but once it was done it felt exhilarating. It happened every day. My teacher could be on the other side of the room as I was preparing, but as soon as I started to arch back, he would magically appear in front of me and pull my hands to my heels. The transformative effects of the practice on my entire being during that time were profound, and that one particular daily experience of kapotasana seemed to be at the heart of everything that was going on. Sometimes, I would sit in meditation later in the day, and spend an hour with my eyes closed, meditating on my experience of kapotasana. Over and over again, I would replay in my mind, in my nerves, and in my body what it felt like to have one hand, then the other hand on my heels, my elbows down and then…boom…that rush. Like a tape looped on repeat, over and over again. It was all part of the deeper integration of the experience into every layer of my being and the transformative process that was taking place.

Eventually, I started to feel some minor back pain between the same vertebrae that I had hurt years before in my Iyengar beach drop-back experience. Day by day, the back pain grew worse. I began to reexperience the same emotions which I had felt when I hurt my back in Goa, and I grew increasingly fearful and anxious when I prepared for kapotasana each day. Still, the energetic rush that ensued after being pulled into kapotasana made it all okay. One morning, I woke up and my back was very sore. It felt exactly like it had after the injury in Goa, and I also felt very depressed. “Great”, I thought. “I’ve arrived back here. At least four months of back pain….” I forced myself to go to class and practice, but I made a strong and solemn determination that I wouldn’t perform kapotasana for some days. “When he comes over, I’ll tell him I can’t….”

I kept an eye on my teacher as I practiced the postures leading up to kapotasana. Sure enough, when the time came he appeared in front of me. “No, no, not today”, I said firmly. “Just go. Breathe”, he replied. “No, my back, it really hurts…”, I said. “Go!”, he commanded impatiently. I sighed and started to arch. I felt the familiar pain between my vertebrae and he went to grab my first hand to pull it to my heel. I panicked and managed to yell out, “No!” I resisted his pull and tried to come back up. “Shut up and breathe, don’t cry”, he hissed from above me. He kept pulling and I panicked even more and started flailing around until I had wormed my way out of the posture and out of his grasp and collapsed in a heap on the ground. It was such a scene that everyone in the room had stopped practicing to look over and see what was going on. My teacher stood over me shaking his head disappointingly. Another teacher who was practicing close to me called over, “He needs to squeeze his legs more so that he doesn’t get back pain.” My teacher looked up and responded loudly so that everyone could hear, “Huh! There’s nothing wrong with his legs or his back, he’s just got a WEAK MIND today, that’s all.”

His technique worked. From my collapsed and disempowered state of body and mind on the ground, I suddenly felt a rush of anger and energy surge through me. How dare he call me weak minded! I’ll show him! I quickly got back up and muttered “All right, I’ll do it!” He smiled amusingly and stepped back to watch me. I took the preparatory position and unhesitatingly started to arch back into kapotasana. Instead of fear and trepidation, I felt a strong sense of pride and confidence. There was no back pain and I reached back and caught my heel with my first hand without help for the first time ever. My teacher then stepped in and gave me a tiny bit of help on the second hand. I put my elbows down. “See?” He said from above, “Now what was all that crying and fussing for?” The pain between my vertebrae had completely vanished and it never returned.

The above example is dramatic, and I certainly don’t recommend or apply these kinds of methods in general. Nonetheless, it shows how quickly and suddenly the tensegrity state of a system can shift and change, and how many different factors there are which contribute to the internal relationship patterns in a particular state of body-mind. In this particular case, the shifting of a mental and energetic perspective contributed strongly to the crystallizing of a new and healthier physical structural pattern in my body.

Movement heals

Movement heals. Fear and limitation do not. I’ve also experienced this outside of the yoga practice. When I was in my early 20s, before I had started practicing yoga, I injured my left groin while on a multi-day backpacking trip. A friend and I were attempting to cover what seemed like a never-ending amount of distance over a particularly challenging section of terrain on the West Coast of Canada. We had already taken several hours longer than we had anticipated to cover the distance required to arrive at our next destination. The only way I could will my body to keep going was to imagine that my legs were like powerful pistons, pumping up and down into the earth. Somehow, the image allowed me to ignore the muscular fatigue that had set in long before. We finally arrived near dusk at the beach where we were to camp for the night and we both threw off our heavy packs and collapsed in a heap on the ground. We lay still for a long time, enjoying the flood of endorphins rushing through our systems. When I finally got up some time later, there was a deep ache in my left groin. The pain got worse as the evening went on, and it was still there the following morning. I had no choice but to strap on my pack and walk again the following day, as our feet were the only way to get back to civilization.

The injury stayed with me for some time, and I began to grow concerned. I had plans to soon embark on my first trip outside of Canada, and I had a flight to Indonesia booked for a few weeks later. I’d never experienced such a persistent pain at that point in my young life. Eventually, I went to see a doctor. The doctor didn’t order any scans or tests, and after a brief examination told me that I would be fine in 6 – 8 weeks. I expressed my concern about my upcoming trip to Asia, as I planned to be very physically active. I wondered out loud whether I should “limit myself and rest more”. The doctor grinned broadly at me and replied “Iain – Never limit yourself, you’ll be fine.” Those words had a powerful healing effect, and filled me with confidence. I went home in a good mood and happily continued to plan for my trip. Though the pain was still there, I no longer focused on it or thought about limiting myself because of it. A few week later, I had landed in Bali and the pain in my groin was completely gone.

Over the next months, I traveled through several of the Indonesian islands and eventually flew to India and began to travel around the subcontinent. I kept up my usual habit of vigorous physical activity, and the groin injury seemed to be a thing of the past. I never thought about it. I eventually wound up in Hampi. One day, I was lying on one of the giant boulders in the late afternoon, enjoying the sensation of the heat that still radiated out of the sun-warmed rock and into my body, even though the sun had faded into the horizon some time earlier. I was completely relaxed and at ease and peace. Suddenly, I felt a “sproing” in my groin and the pain returned, just like that. I was stunned. I hadn’t been very active at all that day, and in the moment that the pain returned, I was lying down, completely relaxed, enjoying a nice heat radiation massage from the rock. I walked back to my guest house worried, and my concern grew as the pain persisted over the next few days.

I immediately defaulted to the dogma of limiting my activities again, figuring that resting my body would be the wisest thing to do. I decided to make a beach my next destination, where I could really relax. I had plans to go to the Himalayas a short time later, where I hoped to do a lot of hiking in the mountains. I also had plans to return to Canada following that, where I would work as a treeplanter for several months, saving up enough money to travel again the following year. Treeplanting had been my main source of income for the preceding 3 or 4 years. Treeplanting in Canada is a particularly intense and grueling job, both physically and mentally. It involves living in a tent in the Northern Canadian wilderness for months at a time, spending 10 – 12 hours each day planting saplings in areas that had previously been logged. A good planter could plant up to 3000 trees every day, and earn a decent amount of money doing so. Of course, to do this required a healthy and strong body. An injured leg would be a big obstacle to my plan.

I took my plans to relax on the beach seriously, and for one month I did extremely little aside from lying around, and occasionally swimming. The condition of my leg changed very little during this time. I was growing more and more worried, and pictured myself returning home with very little money and an inability to work at my job of choice, which was necessary to continue with the lifestyle I wanted to live. It was not a happy vision. My anxiety around my physical condition grew.

Eventually, I decided to travel up to the Himalayas even though I didn’t feel much better. The hot season was setting in, and I wanted to move to a more comfortable climate. I stopped in New Delhi on my way up and visited a doctor. The doctor gave me the standard advice of resting completely and taking painkillers. He was quite adamant about his advice and I left his office feeling even worse. I ignored his advice and carried on up to Dharamsala and made my way up to Dharamkot village, where I would ultimately spend the better part of the subsequent two years.

Dharamkot village is perched on the side of a steep mountain, and at that time was accessible by foot path only. Moving anywhere, for any reason, meant walking up and down the steep slope. I was pleasantly surprised to find that my leg felt no worse for this dramatic increase in activity. The mountain environment was fresh and intoxicating to me and I was filled with vitality and energy and a desire to hike and explore deep into the mountains. I began to gather information about some of the nearby trekking routes, while also bitterly reminding myself that I was in no shape to tackle them.

After some time, I heard about a famous practitioner of Tibetan Medicine in Dharamsala named Yeshi Dhonden. Curious and hopeful, I went to his clinic one morning, took a number, and sat in the crowded waiting room. When my turn came, I went in to see the doctor. I described my groin injury to him via his translator, and he took my pulse and then placed his fingers on my groin. “The doctor has found a lump”, reported his translator. “A lump?” I asked. “Yes, an energy lump, something is blocked”, The translator replied.

He wrote a prescription for a collection of Tibetan herbs, dried and rolled into little pill shaped balls, gave me instructions on how to take them and to return for a check-up in two weeks time. He also adamantly explained “And – You must remain VERY ACTIVE while you are taking this medicine!” “Active?” I asked, “Like, walking?” “Yes!” he replied, “You must walk a lot. This will keep energy flowing into the wound, and the medicine will work much better.” I couldn’t believe this wonderful news. “Can I go trekking up the mountain?” I asked. “Oh yes”, he said, “That would be very good.”

Just as when the doctor in Canada had told me not to ever limit myself, I left the clinic of Yeshi Dhonden in a wonderful mood. I felt empowered and confident. I had my bag of Tibetan pills and immediately made plans to go trekking up the mountain. I spent the next six weeks in Dharamsala, hiking, trekking, and also practicing yoga for the first time in my life. I visited Yeshi Dhonden for a check-up every two weeks and would receive a new bag of herbal pills and the news that the doctor was very happy with my progress and that I would soon be completely cured. By the time I flew back to Canada, with enough herbal pills to last me for another month, the pain had vanished. When I started the difficult work of treeplanting a short time later, the pain reemerged briefly and jumped from my left groin over to my right hip for a days, but then it disappeared and never returned, and I continued on my journey as planned.

I don’t want you to have to read another whole article here so I will stop there and allow you to add your own reflections.