Post-Surgery Yoga

Today marks exactly 2 weeks since my knee surgery—a revision ACL reconstruction (the original was done in May of this year) with additional capsular stabilization. I now have 3 new incisions, some bruising, swelling, and a limp. But I also have another opportunity to learn some things about healing, and how it feels to practice yoga after a surgery. Apparently there was something I didn’t learn the first time!

The first couple of days after surgery, I breathed. I didn’t practice fancy breathing techniques, or specify mudras (although mudras couldn’t hurt, I’m sure) or a particular posture, but I simply used ujjayi breath (aka diaphragmatic breathing). Ujjayi breath is beneficial all the time, but there are some specific reasons why it is particularly helpful post-operatively. Breath that is focused on diaphragmatic movement stimulates abdominal lymph nodes, which can theoretically help with swelling and healing. Improving lymph flow increases the rate of removal of waste products from an inflamed area. In addition, breath stimulates the abdominal organs and improves digestion, which is absolutely integral for a person immobilized and on pain medications to help prevent or ameliorate constipation.  Furthermore, ujjayi breath has been shown to calm the nervous system, and the way I see it, that can only be beneficial after your body undergoes trauma of any kind.

Once I was able to tolerate standing up for a few minutes at a time, I did down dogs with my hands on the back of the couch. I even tried a couch cobra or two. I practiced half sun salutations with breath, and even though I could not fully straighten my knee or equally bear weight through both legs, I was able to work toward both of those things in a functional way. The act of moving my spine in different directions also helped to stave off the inevitable low back pain associated with post-surgical immobilization and stressful posturing (constantly keeping one leg out and up just does nothing for my back). I also found that I could lay on my stomach (which hurt, but you get over it) and work toward sphinx and cobra poses, which ameliorated the back pain and even stretch some into my knee. I performed straight-leg hip stretches in sitting or on my back to the best of my ability – so many muscles that connect through the knee also cross the hip, so it’s important to remember that with any injury, you can work above or below the involved area and see great benefit. This is something I learned in my physical therapy education, but if you want to save yourself all that time and money, just find yourself a great physical therapist.

I have a GREAT physical therapist (Jimmy Armentrout at Baylor Institute for Rehabilitation Outpatient Services in McKinney, TX). I’m picky, as I am a PT, but I think that everyone should be picky. As a patient, you have the right to choose your own physical therapist – take advantage of this! Do your research, and make sure you are seeing someone with whom you are comfortable and reasonably certain knows their craft. I had my first PT session exactly 1 week post-surgery (and I would have gone in sooner if there had been availability). I felt immensely better after my initial visit, and that allowed me to work so much harder on getting stronger and more mobile.

Aside from the biomechanics and the breath, I have to commend my mother, my first yoga teacher, for her huge contribution to healing. My husband and I stayed at my parents’ house for the first week after my surgery, and she cooked me healthy foods, brought me medications, and took me outside each day.

We had long discussions about the various aspects of healing, and how it is so easy to focus in on the “broken” part and ignore the rest of the being. Recovery can be augmented by attuning and attending to the whole body, inclusive of the mind and the spirit. Our bodies are magnificent healers, but they do that job best when a majority of systems are in balance and fully functional. I think this point is ignored far too often in Western medicine, but at the same time, it is up to each of us to take ownership of our own health, and to seek out the resources necessary make the best recovery.

These resources could be numerous – find the best doctor for YOU, ask questions of your physicians and your nurses. Make sure you get physical therapy early on after an injury or a surgery. Try something different in addition to conventional medicine, like Ayurveda, massage, acupuncture, meditation, Reiki, yoga, and see what works for you. Enlist the help of family and friends. In addition to my mother’s care, my father and my husband were pillars of support, from waking up several times in the middle of the night to refresh my ice, to making me laugh in the evenings when my pain was the worst. I enjoyed visits from friends, family, and coworkers, and as write this now I could not be more grateful for or more humbled by the sheer volume of love and support that I have received during this experience. Sometimes it was hard for me to accept the help of these wonderful people – I am generally independent, and loathe to inconvenience others. But I also know that optimal healing cannot take place in the midst of overexertion and worry, so I forced myself to let go and allow others to do things for me. Was I the perfect patient? Definitely not – my husband will testify to that. However, I am being much kinder to me this time around as compared to following my previous surgery in May.

Ahimsa is a Sanskrit word that translates to “nonviolence” or “nonharming,” but I read somewhere that this meaning could be turned around and described as “love in action” rather than an “absence of violence.” Anyway, Ahimsa is something that we generally talk of practicing toward others, but that I have always believed we should first practice toward ourselves. It is in this spirit that I try and quash my desire to do too much, and instead of being physically in action, I am performing the action of showing myself a little love.

A surgery like mine is big in this moment, but small in the grand scheme of things. Either way, it, like any other injury or struggle, is an opportunity for growth. I am grateful for an eye-opening perspective on the importance of holistic health, community and familial support, and for yet another chance to improve upon my practices of Ahimsa and letting go (I’ll keep working on that last one).

As a side note, I did my first modified sun salutation today. It was awesome.