Tuesday, June 26, 2018

Interview with Shelly Prosko on Integrating Physical Therapy Practices and Yoga

Accessible Yoga Blog: Where do you teach? Who is the population?

Shelly: Currently, I spend the majority of my time teaching courses to 1) healthcare providers and yoga therapists on ways to integrate yoga into their sessions to enhance or complement rehabilitation and to also address professional burnout and to 2) yoga teachers to help make their yoga classes more suitable, safe and accessible for people living with a variety of conditions and abilities. I also provide one-on-one sessions that integrate physical therapy and yoga (PhysioYoga) for individuals with a variety of conditions with a focus on persistent pain (chronic pain) and pain related musculo-skeletal conditions, acute orthopedic injuries, pelvic floor dysfunctions and breathing pattern disorders.

I also enjoy teaching yoga classes (outdoors when possible) to the general population; especially sharing practices with those who have never tried yoga before because they have felt intimidated, fearful or uncertain about whether or not they could practice yoga.

Accessible Yoga Blog: Can you share a teaching experience that stands out?

Shelly: Peter* was a client I was working with that suffered from persistent (chronic) back pain after multiple spinal surgeries over the past 15 years. He held his muscles very rigid and tense, especially around his ‘core’ or trunk area. He was often told that he needed to keep his spine stable and protected. His breath pattern was rapid and shallow and he held his breath with excessive muscle tension when he transitioned from one position to another, especially during sit to stand, getting up and down off the floor, rolling to and from supine lying and getting in and out of his vehicle.

We had been working on breath and body awareness practices, so that eventually he could regulate the breath to be calmer, and the body to have less muscle tension, so that he could move with more ease and potentially less pain. He was always very afraid to go into any position that required spinal flexion. At one point, when he felt ready and safe, I offered him the option of getting into an adapted child’s pose, with tremendous (and luxurious) support from several props for his entire trunk to rest on, as well as support for his arms so that he was not having to support anything with internal effort. I then offered him a simple mantra to repeat silently to himself on inhale and exhale. Inhaling he repeated: “I am Safe”; exhaling he repeated “It’s Ok to Let Go”.

After a short period of time (approximately 2-3 minutes maybe) Peter was able to fully relax into the posture. For the first time in 15 years, he said that he felt a release both emotionally and physically. His musculature that had been so tense and guarding for so many years had finally let go for the first time; he felt safe and calm (and he was in a slightly flexed position, which he had not allowed himself to be in for almost 2 decades). I noticed his breath pattern had changed also: the rate was slower and it was a relaxed pattern (less effort was used by his upper body, and I could see the rhythmical movement in his lower ribs, spine, lower abdomen and side waist that had never been there before). He was mentally, emotionally and physically calmer and was able to move with much more ease and less pain when he came out of the position and stood up. His gait pattern had changed: less trunk and abdominal bracing and more natural and nuanced movement patterns were noted.

The effects of his experience were even noticeable on his face. His jaw softened. His eyes softened. He looked calm and peaceful and was even able to smile in a way I had never seen before. A sense of peaceful energy was felt by us both. We both expressed and shared some tears of joy and it was a memorable moment for him (and me). He still has his ups and downs with managing pain and moving/breathing in guarded ways; but he is more aware of when he does add tension when it is not needed, and he can change his experience, if he is mindful about it. His experience in a safe and supported child’s pose, with the added mantra, seemed to shift something in Peter that allowed him to explore trusting and letting go in a safe way. This appeared to carry over and help him move with less pain and more peace and ease in other aspects of his life.

*Peter’s name has been changed in order to maintain confidentiality.

Accessible Yoga Blog: Why do you teach this group or this population?

Shelly: I have witnessed yoga practices and philosophy to be tremendously valuable and beneficial for people who live with a variety of conditions perhaps because of yoga’s well-rounded biopsychosocial-spiritual approach of helping the individual in the context of the surrounding environment, instead of ‘treating’ the isolated diagnosis. Many people are interested in yoga for overall health and wellness and more and more people are turning to yoga to help them during times of injury, pain, suffering and recovery. As a physical therapist (PT), I found myself well positioned to contribute to the integration of yoga into healthcare to enhance the rehabilitation experience for people. For the past 20 years, I have felt a growing responsibility as a PT/yogi to make yoga more accessible, safe and effective for people living in pain, with injuries or other health concerns. Mainstream or traditional yoga practices are not always suitable for people with injuries or who suffer from persistent (chronic) pain; often these practices can exacerbate their pain or injury, if not adapted appropriately.

Accessible Yoga Blog: What are you excited to do next with your students?

Shelly: I am co-authoring a new book, Yoga and Science in Pain Care. One of the chapters is on the science surrounding self-compassion and the incredible value that self-compassion has on our overall physical, psychological and social health and wellness, as well as how self-compassion practices can help reduce the pain experience for people living with pain, and may also help reduce the risk of professional burnout for the health provider. I look forward to sharing the research and also my own transformative experiences with self-compassion practices. I’m excited to integrate more of these practices into my courses, classes and sessions so that everyone can experience the potential benefits.

Shelly Prosko, PT, PYT, CPI, C-IAYT is a Canadian physical therapist and yoga therapist dedicated to empowering and educating individuals to create and sustain optimal health by teaching, promoting and advocating for the integration of yoga therapy into modern healthcare. She is a respected pioneer of PhysioYoga, a combination of physical therapy and yoga. Shelly guest lectures at medical colleges, teaches in numerous yoga therapy programs, speaks internationally at yoga therapy and medical conferences, offers onsite and online continuing education courses for healthcare professionals, yoga therapists and yoga teachers, and offers workshops and individual sessions for those suffering from a wide variety of conditions, including pelvic floor dysfunctions and persistent (chronic) pain. Shelly has extensive training and over 20 years of experience of integrating yoga into healthcare and considers herself a lifelong student, truth seeker and change maker. Please visit www.physioyoga.ca for more info.

This post was conducted and edited by Kathleen Kraft.

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