This week marks the 16thweek since my surgery. I’m back to all activities including crack climbing. I hiked up the Mt of the Holy Cross (one of the 14ers in CO) with a bunch of good friends yesterday and that was quite reassuring that my ankle/leg did not even twinge going up and down. I’m ready for a long hard day of being in the mountains again!
I wanted to write how I have been incorporating yoga practice into my ankle rehab because it has helped me regain the flexibility and stability A LOT. Yoga is not the only thing that I did (and do) to rehab but it’s a huge part of me getting more mobility back. It was no brainer for me to use yoga practice after the surgery because I have 19 years of consistent yoga practice under my belt and I knew well how beneficial it could be. I have practiced yoga to heal my many previous injuries and I have also witnessed and helped many students heal their injuries with yoga.
Yoga came into my life during my college years in Boston. I’m not the most flexible yoga practitioner and teacher (I used to be more flexible, but being an athlete in Colorado does not help being very flexible somehow…). What else have I practiced physically and continuously nearly 20 years? None other than yoga. Being consistent (yes, there was definitely up and down and slow period for yoga in my life…) is something I’m very good at since I was young and yoga became a part of my life naturally maybe because I found yoga to be sustainable and non competitive.
The obvious benefit of yoga is physical (asana practice). Another big benefit of yoga for me is the awareness and capacity to be able to breathe when I really need it. Breathing is tightly connected to your parasympathetic nervous system and with slow and conscious breath, you can calm and relax your body and mind. Being able to use my breaths to control my nerves and emotions has been helpful and without the practice and knowledge of yoga practice, I would not have found the benefit of it. The most recent use of my conscious breath was this week at my dentist while he was drilling my tooth deep down for a long time. The slightly less obvious benefits of yoga are sprinkled in my day-to-day life. I have incorporated some yoga philosophies into my life for years. In recent years, mainstream “yoga” mostly means pose/asana practice in a class set-up. However, many do not know that yoga expands its meaning and practice way into other areas of our lives and makes our lives so much more vibrant and peaceful. Yoga Sutra is an important yoga study text written by Patanjali at least 1700 years ago and a lot of modern yogis and yoginis get into the study of Yoga Sutra once the physical practice has started and learned. It was the same for me, started physical and my teachers taught me useful teachings of Patanjali that can be incorporated along with my asana practice. Some of them are quite practical and I understood easily but some of them are not digestible or comprehensible for me yet. I wish I had kept up with the study of Sutra… however, I do have a renewed commitment to refresh my memory of Yoga Sutra and study further.
With that said, several teachings of yoga came to shine the light on my journey after my ankle surgery. I’m humbled by all these teachings because they are difficult to DO even if I remember. That’s why yoga is a life-long practice for me because I am not going to get them all at once, perfectly. Here are some I tried…
Remembering of the True Self (Vairagya)– I had to remind myself that what I “do” does not define “who I am”. Just because I was not able to climb, run, give a massage, take the trash out etc, it was not that I lost the sense of myself. My identity does not have to be defined only as a “teacher” or “athlete” but can be identified as a “great partner to my loved one”, “dedicated person to learn” and more. I had to let go of my usual labels and learn to sit with my true and raw self. It was my suffering that taught me to be more compassionate and it was other people’s kindness that reminded me to be more empathetic.
Contentment (Santosha)– I accepted the new reality quickly. I had to be happy with what I had and what I did not have and happy with what I could do and what I could not do. It was easy for me to focus on the negative things every moment I was sitting at home pondering when my leg was going to get back to normal. Yoga teaches me to be content with the present moment and be at peace with whatever situation I am in. Whether I am on the top of the mountain or on the bed being sick, I can always try to find the positive side of the situation. Of course, that does not always happen, but I learned to remind myself that what I have is enough and I am lucky to be surrounded by people who truly care about me.
Witness (Sakshi)– I did let myself be sad, angry, grumpy, and upset once in a while after the surgery. As you know, when you get into that negative vibe once, it’s hard to pull yourself out. What I tried and enjoyed doing was to observe my emotions as it came and went as a third person from outside. Then, I was able to pull myself out of the negative thoughts and emotions quicker instead of soaking in the sadness of my own world. Often time, I found some humor in my anger and grumpiness that I made fun of myself and laughed at myself. The sooner I could talk myself into switching the mode, the quicker I could get out of the situation. And as a witness, I was able to calm myself and moved onto finding a solution or making a peace with the situation. It does take a skill of being totally present at the moment.
Here are some of many poses I have been practicing for my ankle rehab. There are definitely more poses that are beneficial. Also, in general, yoga asana practice is great for ankle mobility and stability so if you are not sure what to do, just try a public yoga class and you will find it helpful.
I divided poses into two categories. Poses to work on the range of motion for plantar flexion and dorsiflexion of ankles. Plantar flexion is when the toes are pointed forward and down. Dorsiflexion is when the toes are pulled up towards your shin. In my case, both flexions got very difficult after the surgery due to the lack of movements as well as the trauma of the injury and surgery. Atrophy of the muscles in my lower leg was visible and swelling around the ankle/foot still exists. Even my knee (with an ACL surgery) was starting to get achy and weak after a while. These poses below have been done combined with physical therapy exercises, strength training and other mobility exercises in the gym.
(These photos were taken after 11 mile run up in the mountains, so my ankle looks a bit swollen!)
For ankle plantar flexion:
1, Virasana (hero pose) on a block/blocks
This pose is a truth-teller of healthy ankles and knees. After a surgery, I was not able to even get into this pose even with blocks. I used two stacked blocks to start sitting in this pose and reduced to one block. As you can see, it’s strong plantar flexion in the ankle with some weight on it. You want the ankle joint right next to the outer hip and toes pointed straight back. If the ankle is sickling, you want to add more blocks. Knees and thighs closer together.
2, Virasana no block
Eventually, you will sit without a block. This version is still a bit difficult for me. I need a warm-up to go all the way down. Most of the time in my yoga classes, I encourage students to sit on a block or two anyways so that they can sit comfortably for at least five minutes at a time.
3, Virasana variation
This is a Virasana variation. Big toes touch together and open the heels as wide as they go and you sit on the big bowl shape you created with your feet and arches. Your knees can be slightly apart. If it’s too hard, you can place a blanket or a block on your feet to sit on them. In this variation, not only are the ankle/feet stretching but I usually feel in my tibialis anterior muscle (front shin). It’s a great pose for runners!
4, Stretch of top foot, front ankle and shin
This has been the hardest to get back into for me. My left knee can lift high but my right knee has a hard time lifting because my ankle is so painful to do this pose. It’s getting better each week though! You can sit on your heels (heels do not have to be so wide like pose 3.)
5, Malasana (squat)
This is an all-time classic pose for me. It has so many benefits other than ankles. It’s great for opening hips, adductors and knees. It’s great to release low back and strengthen mid to upper back in general. The photo shows the basic squat positions but I have many other variations I like to practice that are even harder and for ankles. You just have to come to my yoga classes to experience!
For ankle dorsiflexion:
6, Dorsiflexion with my own weight
Keep the heel of the front foot down to floor and power the weight on that leg with your upper body. You can do the same pose putting your front foot on the bench/stool as well. I have also placed a heavy kettlebell on my front thigh to keep the weight on for a while.
7, duck walk (extra challenging!)
This is a tricky one! Even with healthy ankles, I think a lot of people struggle with this fun exercise. Imagine that you are on a slackline or a tight rope with your feet only in squat position and are walking on it. Instead of walking fast, I like to hold the each position with both heels down for a while to work on the flexibility and stability of my back foot/ankle. When I’m ready to take a step, I lift the back heel up and step one forward. I call it a duck walk because you definitely look like a wobbly duck even when you do this gracefully.
8, Prasarita Padottanasana variation for outer ankle/foot
Internally rotate the leg from the hip joint as much as you can and go into the wide leg forward bend position called prasarita padottanasana, hinging from the hips. Hands on the floor. In the photo, I have one arm on my back so that you can see my leg position better, but you can keep both hands down. Also, my other other leg is in neutral (toes and knee cap pointed straight forward) but you can have this leg also internally rotated at the same time as well.
And bend the internally rotated leg’s knee slowly and keep the other leg straight. Bend the knee as much as you can and it usually stops because of the ankle range of motion. I like to push my outer ankle out and down towards the floor and keep my outer foot especially outer heel pressed out and down to floor. It can be a very strong opening in ankle joint as well as shin.
I was on set with Yoga Journal a couple weeks ago for a photoshoot. I was really pleased that I was able to do this pose called paryankasana with virasana leg position with no block. If the photoshoot were a month earlier, I would not have done this pose well enough for a photoshoot…Yay for a good timing and thanks for Natasha Rizopoulos (Amazing yoga teacher in Boston area) for a great spotting!!