Practicing Bikram Yoga After a Mastectomy

Don’t let surgery limit your practice. Physical therapy is a must to improve range of motion and quality of life going forward. And, what do you know, the handouts and pamphlets with which I was sent home depict exercises straight out of the yoga tradition. Following are notations of how I modified the postures. Please incorporate what benefits your physical situation; don’t feel limited by my experience.

First, you will experience pain so move slowly into the postures. That being said, don’t let your fear of pain limit your achievements. Many times I stopped reaching at the same point I left off during the previous class, or even at a weeks old measure. I went through all sorts of pressure-relieving  modifications during the cobra series savasana because I assumed it would take months and months AND months to bear weight. It didn’t.

Test your limits every class. I’m not saying it’s okay to pop your stitches, but your body and your abilities change every day. It’s a good idea to check them every day so you don’t get stuck in last week’s temporary inability. For convenience, I’ll refer to a ‘well side’ and ‘surgical side’ to avoid all the rights and lefts.

Pranayama: One elbow will not be able to lift as high as the other, or as high as the class before you had surgery. Look in the mirror. Look. In. The. Mirror. Right away, with the first breathing exercise, accept where you are. You will be amazed how much the mirror helps the healing process. Lift surgical-side arm to tolerance and hold it. Focus on the expansion and stretching you feel in your chest on the inhale. With each class, continue to lift that elbow and breathe deeper. Don’t pay attention to the uneven appearance. Worst case scenario: with your arms at your side, shrug or lift your shoulders up and follow the same inhales and exhales. Tensing up or holding my breath amplified the pain. Slow, conscious breathing carried me through everything.

Half Moon: Think of your well-side arm as a stake, and your surgical-side arm as a vine that’s going to climb up that stake. Start by lifting your surgical arm as high as you’re able. Maybe you place your hand on your same side shoulder to form a stubby wing. Gradually creep your fingers towards the well shoulder, then the arm and pull yourself up on it. Your goal is to reach the top and interlock your fingers. I felt more when the surgical-side was on the bottom in the side bend. When it became too much, I lowered that arm and let it fold across my ribs. I used the same modifications with backward bending.

Hands to Feet: Don’t be in a hurry to fold forward with both arms stretched out in front of you. I started out squatting down and grabbed the back of the well-side heel. Surgical side arm was bent like T-Rex. Let it down slowly. Don’t go crazy pulling on the good side. It hurts to squish in the beginning.

Awkward: Think ‘I Dream of Jeannie’. Stretch well side arm out as usual. Fold surgical-side arm across your front and start by reaching up towards the opposite shoulder. Once there, start creeping your hand down well side’s arm. As you feel more comfortable, separate into two outstretched parallel arms.

Eagle: At first you’re not going to be able to swing your arms without popping a stitch. Do your best to entwine your arms in eagle formation. For me, this posture was the least effected. You may be surprised to realize prior to surgery you pulled your arms into your chest rather than down from your shoulders. The pain you feel now due to that compression will reinforce the need to make that correction going forward. Ahhhh, the silver lining.

Standing Head to Knee: As with Half Moon, the well-side knows what to do. I started out with my surgical-side arm pressed at my side and bent at a right angle. As I leaned forward surgical-side arm crept down my leg towards the ball of my foot until I was able to interlock my fingers. This was my screw-you-you’re-not-going-to-get-to-me posture. It was helpful to have a posture I wanted to attack; a posture I didn’t want to defeat me.

Standing Bow: For the surgical side, I grabbed my foot and kept my heel against my butt while stretching forward. Slowly I started to kick my leg back as far as my pectoral muscles and arm pit could tolerate the stretch. You will feel the difference between kicking back and up on your surgical side. Here’s where you realize just how much the kicking and stretching keep you balanced. For the well side, go back to the image of the T-Rex arm. As I healed I let the surgical-side arm hang straight down while the well side kicked. When the pain eased, I started raising the arm first with a bend at the elbow and then outstretched.

Balancing Stick: Refer to the hand/arm positioning in Half Moon. If it becomes too much, either wrap surgical-side arm around your torso and give a hug, or hold it against your side, parallel to the floor. As you feel better, allow surgical-side arm to hang straight down at a right angle to your body. Next step: slowly raise your arm.

Standing Separate Leg Stretching: Do what you can, what feels comfortable, but do something.

Triangle: This was my horror show. There’s just no comfortable place to put your arm. As with Standing Bow, you realize the importance of opposing forces: right arm stretch up, left arm stretch down. I couldn’t figure out what to do with my head and neck when the surgical-side arm was supposed to be stretching up. Don’t get discouraged. Do your best. It was a great opportunity to focus on patience and acceptance.

Standing Separate Leg Head to Knee: Treat it like Balancing Stick.

Tree: I kept my surgical side arm at my side and bent at the elbow.

Toe Stand: Scary at first because there’s a good chance you’re either going down face first, or you’re going to stretch surgical-side arm out to make a landing and be in pain. I tried to turn this posture into a positive challenge. Slow down the bent knee descent and try it with one good arm. It’s great preparation for the advanced entry in to the posture.

Savasana: It really helped me to regroup, slow down my breath and let go of what was upsetting me.

Wind Removing: Hold surgical-side arm folded in on itself; keep it close to your body. As you heal, open up the angle.

Sit up: Keep surgical side arm down, fold at elbow across your torso like a belt at your waist. You’ll be surprised how much more you use your abs! At first it’s really challenging to keep your spine straight, but that’s the goal. I chose attempting the sit up rather than rolling over. Rolling over leads to being belly down and the necessity of pushing up and I just didn’t want to deal with that.

Cobra: You know that saying ‘when a door closes, a window opens’? That was my Cobra. It was too much pressure to start cobra from a belly-down position. I was forced to squeeze my elbows into my side at a right angle and find the back muscles needed to stay lifted! Add in the arm strength and you got yourself a damned good Cobra.

Cobra Series Savasana: Oh good lord, really?! Just lie on your side fetal-style.

Locust: Ok, so I just panini-ed my tits in Savasana to *relax* and now I’m supposed to do it intentionally?! Do your best. As with Cobra….you’ll find those back muscles.

Full Locust: Rather than take off from a belly down position, I approached the posture with landing gear up. Surgical-side wing was tucked in at first.

Bow: Well-side hand grabbed a couple inches below the toes. Surgical-side arm was pressed to my side like I was going into a nose dive. My Bow was intentionally lopsided to keep pressure off the surgical side. It was more of a weeble roll at first, but gradually improved to where I could set up the posture and with healing, add the kick.

Fixed Firm: I lowered down into the posture with surgical-side arm folded over at my waist. With time and stretching I was able to reach for the opposite elbow.

Half-tortoise: Another T-Rex arm posture. You may feel like the entire ninety minutes is an exercise in futility because one side is laid up and you will be sorely wrong. Just as those with limited or no ability to see or hear often sharpen their other senses, you will locate those underutilized muscles and master a posture. Half-tortoise is one of those postures.

Camel: As if Camel isn’t emotionally or physically challenging enough to begin with! While Standing Head to Knee was my posture to rally the troops in the standing series, Camel was my touchstone in the floor series. It has all the elements: back bending, stretching, being upside down and completely exposing your chest. Attack it. The release feels so good.

Rabbit: Keep surgical-side arm close to your side for support. Add in the pull as you’re able.

Head to Knee: I used the same modifications for Standing Head to Knee

Final Stretching: I started to feel the feeling of accomplishment. I’m almost there! Don’t focus on the lack of range of mobility in your surgical side, turn your attention to how far you’ve come and how good it feels to flex your feet and stretch your calves, how good it feels to squeeze your quads and release your hamstrings and how good it feels to fold your torso over your legs. I started with BOTH arms in a pike position with my elbows by my hips. This was my release.

Half Spine Twist: My biggest challenge was for surgical-side arm to grab the knee. I hugged the top of my opposite side knee instead and stretched up like crazy. Add the twist.

Kapalbhati: Woo-hoooooooo! Give yourself a pat on the back, you did great!

So, that’s my practice, with a few peeks into my stream of consciousness during class. What I’ve noticed with my practice is that the past events have not limited my depth or expressions of the postures. As I mentioned earlier, I am extremely fortunate to be able to return to the place where I left off prior to surgery. Sure I feel a slight tug or tightness at times but no physical limitations. I have the mental ones! That is the crutch I grab for every so often. The one that says it’s ok to take it easy, the one that reaches for the modification not because I need it, but because I don’t feel like squeezing or kicking or sucking it in….the one that is still enjoying hiding in the back row. There it is, I said it.

bridget headshot 2Bridget Dubravsky is a Certified and Practicing Bikram Yoga Instructor from Maine. She is also the author of Bikram Yoga and Breast Cancer.

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3 Replies to “Practicing Bikram Yoga After a Mastectomy”

  1. Recently diagnosed and wondering how my practice will be impacted. What amazing sharing! I too love your last paragraph. I will re-read several times for sure.

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