Pain vs. Inflammation: What Every Yoga Teacher Should Know with Andrew McGonigle

Interactive Transcript

spk_0 Hi everyone, it's Arundati and welcome to episode 200 of the Let's Talk Yoga podcast.

spk_0 It's officially October and I hope you are having a wonderful start of this season.

spk_0 I have a conversation with Andrew McGonegal on the show today and Andrew is someone I discovered

spk_0 on Instagram. He's usually known as Dr. Yogi on Instagram. He actually was training to be a doctor

spk_0 and then slowly moved away to teach yoga, become a massage therapist and anatomy teacher.

spk_0 He has been studying anatomy for over 20 years and he combines his skills and experience to teach

spk_0 anatomy and physiology of yoga in courses worldwide and he also runs the Enlightened Yoga Collective

spk_0 which is a education based online community membership program or yoga teachers. He's an author

spk_0 and he's written two books. His first book was supporting yoga students with common injuries

spk_0 and conditions. It's a handbook for yoga teachers and yoga teacher trainees and that I believe

spk_0 came out in March 2021 and then his most recent book is the Physiology of Yoga that was published

spk_0 in June 2022 and Andrew lives in Los Angeles with his husband and I've been following Andrew

spk_0 for many years now and Drew and I are talking about pain and inflammation on this episode.

spk_0 We've done 200 episodes and we haven't touched these topics yet and I haven't really

spk_0 approached these topics because there is so much that can be said and needs to be looked at when we

spk_0 talk about pain and inflammation. So Andrew breaks down for us very clearly what is pain, what is

spk_0 physical pain, what is psychological pain, the role of the nervous system, the role of lifestyle

spk_0 and mindset, research studies. He has such wonderful research studies that he shares throughout

spk_0 this episode. We look at what does this mean for a yoga teacher who walks into a class not

spk_0 necessarily knowing the medical history of a student and if they say they're experiencing pain,

spk_0 how do we encounter this in a wholesome way and what it means to age with a body that experiences

spk_0 pain and and there's so many more layers to pain. We also transition to inflammation and we talk

spk_0 about what is inflammation, the different types of inflammation and how do we use yoga to combat

spk_0 inflammation and there are so many bits in this episode that I hope you will take into your practice

spk_0 and into your life. I really hope you find this conversation useful and that you are walking

spk_0 away with some amount of clarity and certainty about pain and inflammation. As always, if you enjoy

spk_0 the Let's Talk Yoga podcast, feel free to rate and review this podcast. Your support is what helps

spk_0 us continue so we can go from 200 episodes to 500 episodes. Enjoy this conversation with Andrew

spk_0 McConnagal. I'll see you on the other side. Hi everyone, I'm Arun Dati and you've just tuned in

spk_0 to the Let's Talk Yoga podcast, your ultimate online destination for learning about yoga, whether

spk_0 you're a seasoned yoga teacher or a curious yoga student, there's something for you here. Let's

spk_0 this podcast be your virtual yoga school. We offer insights, inspiration and loads of learning

spk_0 exploration of yoga along the way. But first, who am I? I'm an Indian immigrant yoga teacher living

spk_0 in America for the past decade. I have my own yoga school here in Seattle and I'm also a Bollywood

spk_0 choreographer and I've nurtured a thriving yoga community at my studio as well as a global yoga

spk_0 audience through my courses and this podcast. Through this podcast, I intend to create a space for you,

spk_0 the yoga student and your teacher to learn about yoga in that. Think of this as your online yoga

spk_0 school free teacher training coming to you every week. So grab your cup of tea and let's jump in.

spk_0 Hi Andrew, welcome to the Let's Talk Yoga podcast. Oh, thank you so much. It's so great to

spk_0 be here. I'm excited to be number 200. It's amazing. I know, right? And I can't believe we are at

spk_0 episode 200 myself. And while the 200 episodes should be something celebratory, you and I are

spk_0 going to celebrate by talking about pain and inflammation. I mean, I think these are exciting and

spk_0 relevant topics. So to kick things off, how would we define pain and are we only talking about,

spk_0 say, physical pain because these conversations come up in yoga spaces all the time and it is very

spk_0 common for a student to say that hurts. So how would you define pain? Yeah. So it's typically

spk_0 defined as an unpleasant sensation. The most important thing to understand about pain that most

spk_0 people don't realize is pain is an output from the brain. So pain isn't something that your body

spk_0 or nervous system are detecting, but it's actually something that your nervous system is creating.

spk_0 So that's something I think sometimes for people it's a bit of like a light bulb moment.

spk_0 So for example, if you were to put your hand on a hot stove top, you're not feeling pain.

spk_0 What is happening as receptors in your fingertips are feeling the extreme heat. They're sending an

spk_0 impulse to the brain that then creates a pain impulse so that you pull your hand away from

spk_0 the hot stove top. So it's something that's it's important to understand. And so basically

spk_0 pain then is a neurochemical impulse coming from the brain out to the body, really given us

spk_0 information typically about our environment, whether that's internal or external. So yeah,

spk_0 so I think that's something interested. And then there's a difference between what we call a

spk_0 acute pain and the chronic pain. Now, again, the definitions for these vary depending on the source.

spk_0 Typically a acute pain is pain that you're feeling for less than three months.

spk_0 Then chronic pain is typically described as something that you're feeling for greater than three

spk_0 months. Okay, now I don't love the term chronic personally because chronic really means

spk_0 permanent. And as we know, nothing in life is permanent. You know, we're either wanting to

spk_0 make things that feel fleeting more permanent or we're wanting to make the things that feel like

spk_0 they're always here kind of move away. And that's just not how life works. So I prefer to use the

spk_0 word persistent because even if you are feeling pain for longer than three months, you're going to have

spk_0 good days and you're going to have bad days. You know, you're going to have moments in a day where

spk_0 you don't notice it in other moments where it feels more severe. You're going to have things that

spk_0 trigger it and things that relieve it. So it's basically like a wave that are peaks and troughs.

spk_0 So it's not just like permanent thing that's always necessarily going to be there. It's just I like

spk_0 that idea of like persistence rather than chronic because the term chronic makes people think I'm

spk_0 always going to have this. Yeah. And you know, so I think that this is where language is so so

spk_0 important. For yoga teachers who sometimes walk into yoga space and they don't know the history

spk_0 of a yoga student and what they're experiencing. Is there any specific general questions you would

spk_0 encourage yoga teachers to inquire about, especially if they don't know the students in front of them?

spk_0 Yeah. So if you are asking about someone's general health and someone mentioned something like

spk_0 osteoarthritis or they mentioned something like they have a pro-lapt disk, I think, rather than

spk_0 fixating on that actual terminology and that diagnosis, it's more about finding out

spk_0 what that person's experience is today because someone could be diagnosed with a pro-lapt disk

spk_0 but they currently have absolutely no back pain and there doesn't seem to be anything that triggers it.

spk_0 So I think in the seminar with osteoarthritis you can have days that's very bad and days that

spk_0 are quite good. So really it's about finding the questions that help you understand like how someone

spk_0 is doing in this moment and then asking that person, you know, how can I support you today?

spk_0 Because sometimes it's interesting. I've noticed that when I've gone to class and sometimes

spk_0 overheard a teacher's reaction to someone sharing something about their health and sometimes

spk_0 we can kind of feed into the narrative that someone has about their body. Like if someone comes

spk_0 to say, oh, I have two pro-lapt disks, I've heard it, you go, oh my goodness, it sounds awful.

spk_0 Like it's amazing that you've shown up today and actually instead of that, it's you know saying

spk_0 something like, I really appreciate you sharing this with me. You know, how are you doing today?

spk_0 How can I support you best in this moment? I think it's a really important thing because we talked

spk_0 about the kind of, we've talked about the physiology of pain in terms of what actually happens,

spk_0 say that when we put our hand on the stuftop, but what we haven't talked about is the kind of

spk_0 psychology of it because there's a huge psychological component to pain and really our mindset and

spk_0 our language, the language we use maybe to describe our body or to describe the experience we're

spk_0 having has a huge impact on the way we might experience pain. Okay, so if you're someone that

spk_0 tends to have a more positive mindset, research tells us that we're going to experience

spk_0 less pain potentially. Yeah, if you have a negative mindset, you're more likely to experience more

spk_0 severity of pain or pain for longer. You know, it's really interesting. If you're the type of person

spk_0 that catastrophizes, so essentially making a monk genoid of a mole hell, then that's going to

spk_0 affect your experience of pain. You know, the words we used to describe our body, so if you

spk_0 have issues with your knee and you have knee pain or you've been diagnosed with something like

spk_0 arthritis, if you're saying things like, oh, you know, my knees screwed or you know, then if you're

spk_0 using that kind of negative language to describe your body, then you're probably more likely to have

spk_0 pain, you know, for a longer period of time. It's really fascinating. And there's some research that

spk_0 looks at the language that medical professionals use. And if you were to say you were experiencing

spk_0 pain or dysfunction in your body and you were to go for a scan, if you're told that you have

spk_0 degeneration or abnormalities, which is very common language that is changing. If you're told

spk_0 that, you're actually more, it's going to take you longer to feel better compared to someone

spk_0 that has told, oh, these are normal age-related changes. So the language is so, so important.

spk_0 Literally change someone's entire experience. And thankfully the medical world are shifting now

spk_0 and getting rid of language such as degeneration and things like that. And they're using this

spk_0 term like normal age-related changes. I also think as yoga teachers in these rooms, it is the

spk_0 responsibility to create that safe space for that, you know, very safe sharing of, hey, this has

spk_0 happened with my body and you remain very neutral to compassionate in how you respond. Because, of course,

spk_0 we have liability forms and we ask people to share if anything has that we need to know about before

spk_0 teaching, but not many people do. So many times people will just think it's not significant enough

spk_0 to tell you that they're back spasms every now and then or something else. And I think it's also the

spk_0 the responsibility of the teacher to create that very safe environment where they can privately share

spk_0 with you and you don't make a big deal like, oh my god, you're still walking into class here. Yeah,

spk_0 you know, that would just you dig a hole and bury yourself in it at that time. So speaking of pain,

spk_0 is pain always a direct indicator of tissue damage or some other bodily injury?

spk_0 It's such a brilliant question. In the past, the science world and the medical profession used to

spk_0 really believe that there was a very, very strong relationship between tissue damage and pain.

spk_0 So for example, if you were experiencing pain in your shoulder, the belief was there's something

spk_0 wrong with the tissues of your shoulder. And we need to do something about this. And very

spk_0 typically people went down the rid of having surgery. There were then some really amazing kind of

spk_0 landmark studies done that really changed our whole perception of this. And on various parts of

spk_0 the body, let's talk about the lower back, lower back pain is like super, super calm. It's probably

spk_0 the most common of all the pains in the body. So there were these landmark studies that basically

spk_0 gathered together groups of people that were not experiencing back pain. And they put them into

spk_0 categories, depending on their age. So let's say 20s, 30s, 40s, up to 80s, 90s. And they were all

spk_0 had, they were all the detailed scans. And a large percentage of people with no back pain were

spk_0 found to have pro-lapse discs. And the incident increased with age. So what they realized is it's

spk_0 very possible to have what in the past would have been deemed a source of someone's back pain.

spk_0 It's possible to have that and have no back pain. And because they clearly saw that the

spk_0 incidence increased with age, they realized that this is just a normal part of the human age in

spk_0 process. So it doesn't mean that it's not possible to have a pro-lapse disc in your spine and to

spk_0 have back pain. But it's also very, very possible to have that and be non-noiser to go through your

spk_0 whole life and not know. And then there was all the research that also tells us that these

spk_0 these things can spontaneously resolve. So up to 50% of cases, people's herniadesx

spk_0 spontaneously resolve with conservative treatments without surgery. And the fascinating thing is they

spk_0 find that the greater the herniation, the greater the chance of spontaneous resolution.

spk_0 So if you are scanned and told that you have a herniated disc, you want to hope that you have a

spk_0 really big one because it means that you've got a greater chance of it spontaneously resolving.

spk_0 So in the past, if you were scanned and you were told, oh, you have a herniated disc, it's like

spk_0 it was it was presented to you as if, okay, this is the the this is the the root of the problem.

spk_0 And we're not really, isn't it's way, way more complicated than that? It's similar with

spk_0 knees. There's been these amazing studies that gathered people together that had no knee pain.

spk_0 In different age categories, and then they x-rayed them. And a reasonable percentage of them

spk_0 were fined to have changes in the knee structure that would typically contribute towards someone

spk_0 being diagnosed with osteoarthritis of the knee. But these people had no knee pain or dysfunction.

spk_0 So again, we're recognizing that these changes in the body are part of this normal aging process

spk_0 that we all have to go through as humans. If anyone comes up with a way to not age, please let me

spk_0 I'll sign up to that. It's called yoga. So this is the thing. So basically,

spk_0 what this knowledge did was it basically helped us to help the science world, the medical world,

spk_0 to create a new model for looking at pain. And it's called the bio-psychosocial model. So yes,

spk_0 there's biological elements to it. There could be testidamins. It could be a genetic thing,

spk_0 a family history of something. But there's psychological issues. So it could be mental health,

spk_0 could be playing a role, stress. It could be your social economic status. It could be

spk_0 financial worries. Lifestyle could be diet. And what's beautiful about this is instead of just

spk_0 focusing on tissue damage, tissue damage, it's looking at a holistic view. It's stepping on

spk_0 looking at that entire person. And then when you take that more holistic view, you're more likely

spk_0 to actually find the issues that then can be addressed. So one of the ways that I personally like

spk_0 to think about pain is that if you think of all the stressors in your life at the moment,

spk_0 okay, you might have physical stressors, you might have these psychological stressors,

spk_0 we talk about the social stressors. If basically, if you're perceived ability to deal with those,

spk_0 is low, then you're going to likely end up experiencing pain as a result.

spk_0 That's one way to do them. So basically, the beautiful thing about the biosecose social model is

spk_0 it helps us to tackle pain in a better way. Because a lot of people were having surgery

spk_0 for these specific issues. And they just weren't improving at the rates that people hoped. So

spk_0 and now that we're able to take this more holistic view, we're able to help people get out of pain

spk_0 more readily, which is which is pretty exciting. So as this biosecose social model has been

spk_0 is a game changer in the science world, in the medical world. It's the first time I'm hearing that.

spk_0 So thank you for sharing it in such details. It reminds me of two things. One is a couple of years

spk_0 ago, I tore my ACL and had ACL reconstruction. And I remember very clearly that, you know, in America,

spk_0 they just give you very heavy pain meds, narcotics to be precise. And I remember my surgeon had

spk_0 prescribed some intense level of, I forget what it was, but some narcotic. And at the point where

spk_0 the pharmacist also was like, every two hours you want to take four pills, that's a lot.

spk_0 Something like that. It was crazy. Even they flagged it and we had to call the hospital and all of that.

spk_0 I barely had any pain for surgery. So I refused to take it. And the surgeon could not believe it

spk_0 that I went off of it a day after surgery because I was like, you know, this is very low grade pain.

spk_0 And like is immobilized. And I can manage it. It was surprising to me too because I've not broken

spk_0 anything before. So this was my first surgery. And I was expecting to be in some amount of pain.

spk_0 And just that the fact that the level of pain that I thought I would experience physically

spk_0 and what I actually ended up having was very different. And I do think mindset had something to do

spk_0 with it. Just I now when I when I hear you speak, I look back and almost had a painless recovery.

spk_0 There was some pain, but it's totally manageable. And another thing when you spoke about the needs

spk_0 is I was born and raised in India. I spent a good 26, 27 years there. And something I would notice.

spk_0 And I even noticed the summer when I went back was everyone there has knee pain, especially women.

spk_0 And it's something and you'll see women, especially perimenopausal, menopausal women,

spk_0 you will see they will walk with a slight limp. And it's it's amazing to see how, especially in the

spk_0 most women have that. And it's almost like you expect to get it. There are also lifestyle factors.

spk_0 You don't climb stairs as much. And even the stairs you climb by very like small stairs. And you're

spk_0 walking on a flat path. So you're not really doing in climb decline. You're not squatting as much.

spk_0 You have a lot of help at home. So you're not really doing any very hard manual labor unless that's

spk_0 your job in many ways. So it's just everybody has knee pain and it's largely lifestyle.

spk_0 And sometimes you may not even have any structural issues. You just think you have knee pain because

spk_0 every other woman around you has knee pain. And it's something we talk about like friends of mine.

spk_0 We talk about it, like especially yoga friends. We're like, how do we fix this? Everybody in the

spk_0 more and observation. Exactly. And how like mindset is just so important and also your expectations.

spk_0 So if that's the way that you see people around you age, that's the way that you're going to age,

spk_0 unless you change the way you think about it. Because then you just think it's going to happen to you

spk_0 too. And this is just, I mean, I don't think in the in your 40s, you should be limping or anytime.

spk_0 But and you think that till 85, it's okay to live like that. And so yeah, no, I think that's a very

spk_0 good. Yeah. In Ireland, we say, you know, don't let the old person in. And I don't mean don't let

spk_0 them into the house. They're not okay. But it's persistent. The idea of, you know,

spk_0 there's also a psychological component to age. And yes, of course, we all age. But you can change

spk_0 the way that you view aging. And it has an impact. There's also the studies on this. That's

spk_0 absolutely fascinating. The studies were basically, they took a group of people, let's say in their

spk_0 eighties. And they basically reconstructed what their life looked like two decades before. Let's

spk_0 say in the early 60s. And they were, they were encouraged to live life just like they had been. And

spk_0 a lot of them with all their health parameters improved over a period of time. They basically

spk_0 like aged backwards because there was this mental reset. And maybe also because the light, they

spk_0 had to change their lifestyle as a result. So I think, yes, we all age, but we also get to decide

spk_0 like how we age. And I'm grateful that we're of a generation that now have access to all this

spk_0 amazing information. Because I think for older generations, there's an idea of, oh, I get to slow

spk_0 down. Now, you know, I've worked my life. And yes, yes, of course, you get to relax and

spk_0 distress and have a different lifestyle, but we need to stay as active as possible.

spk_0 And actually, for all types of pain, physical activity is one of the best medicines. And this is

spk_0 proven by science very, very thoroughly. Physical activity is the best way to manage pain. So

spk_0 lifestyle is so, so, so important. Yes, that's a really, really interesting observation you had.

spk_0 Now, I think what you say right lifestyle is so important. And especially today, right, like my

spk_0 grandmother didn't have access to this. My mother probably didn't have access to all of this.

spk_0 But we have access to so much. So it should sometimes be easier for us. But in a yoga class,

spk_0 if how do yoga teachers recognize the difference or help students recognize the difference

spk_0 between say, good discomfort, because putting your bodies in certain positions and putting some

spk_0 strain on them is extremely beneficial. And how do we get a student to recognize potentially this

spk_0 is more bad thing? Yeah, I think, yeah, it's a complicated topic. I think because, well, you know,

spk_0 to start off with everyone is different, pain thresholds, sometimes, you know, and for some people

spk_0 just a slight twinge or even a stretch can feel kind of uncomfortable. Yeah, I think in a yoga

spk_0 setting, I would encourage students against feeling very strong sensation. So if something feels

spk_0 really strong, I think it's advisable. And that's setting to back off a little bit. Okay. But

spk_0 here's the nuance of this. If you're working with a physical therapist, this research that tells

spk_0 us that if you experience pain during the sessions, you're more likely to rehabilitate more quickly.

spk_0 Okay. So pain in itself is not a bad thing. And particularly if you have students who are

spk_0 experiencing persistent or chronic pain, just because they have pain during a yoga class, it does

spk_0 not mean that more tissue damage is happening. Yeah. So pain is not this black or white thing that's

spk_0 kind of good or bad. But in a yoga setting, I don't think it's the place to be pushing people

spk_0 beyond their comfort zone. I think getting people to explore that boundary is can be helpful.

spk_0 So I wouldn't even necessarily talk about pain specifically, but I would say if you feel any

spk_0 strong sensation, you permission at any point to back off to lower the intensity or to slow down,

spk_0 to take a different option, to rest, whatever it is. So yeah, it's an interesting one. And then also

spk_0 reminding people that it's very normal after a yoga class, maybe that evening or the next day to

spk_0 also feel discomfort in your body, particularly if you haven't practiced in a while or you're

spk_0 practicing at a greater intensity than your normal history or you're practicing new poses or new

spk_0 variations of poses, it's very normal for our body to feel some sort of pain or discomfort. And

spk_0 it doesn't mean that anything bad has happened. It's a challenging one. Obviously, we know that

spk_0 yoga is way more than a physical form of exercise. We know that. But looking at it just as a physical

spk_0 form of exercise, there is a risk of injury that comes with that with every form of physical

spk_0 activity. Now the good news is yoga is very low risk, particularly compared to other forms of

spk_0 physical activity. There's a lot of research that backs this up because really in order to

spk_0 injure or tissues, we really need a combination of velocity and load. So speed, there needs to be

spk_0 some sort of speed and then there needs to be a load. A part of a body needs to be stressed in a

spk_0 way that it's greater than it's been trained to deal with. So this is why a sport like skiing or

spk_0 playing football or soccer or netball or something like something that's dynamic that is a lot of

spk_0 speed to it that involves a lot of like load on the body in different directions. That's why

spk_0 things like that have a way greater risk of injury. Yoga, even if it's a fairly fast form of

spk_0 yasa. The chance of injuring yourself is low. It doesn't mean it can't happen. Now I have injured

spk_0 myself in a yoga class before. It was actually from a physical adjustment. It was someone applying

spk_0 force to my body. Someone actually, it never met me before, adjusted me in lotus pose and I

spk_0 sprained my ankle. So it doesn't mean that things can't happen. Someone could maybe topple and fall

spk_0 over it. Like it's life. We can't wrap everyone in cotton wool. So I think it's just, I think we have

spk_0 to take all of this into account. And yes, we don't want people in class feeling strong

spk_0 sensation, feeling pain. But it's not always within our control. And in some cases, even if it does

spk_0 happen, it doesn't mean that tissue damages occurring. If that helps, I think it just helps

spk_0 yoga teachers get out of that fear place because I think it's understandable. Yeah,

spk_0 yeah, don't teach from fear. And I think it's difficult because I think we have a hymnsah.

spk_0 We talk about hymnsah, which is no harm. I think sometimes it's taken very, very literally.

spk_0 I think yoga teachers can think I need to protect my students. I need to wrap them in cotton wool.

spk_0 Now we can actually inadvertently cause harm because of the language we use.

spk_0 Okay, so there's something that's called the placebo effect. I'm sure many people listening are

spk_0 familiar. If you had high blood pressure and I give you an M&M, but I told you this is the latest

spk_0 most effective high blood pressure medication. It's just sugar. I give it to every day and I

spk_0 measured your blood pressure after a week. Your blood pressure will lower because you had a

spk_0 positive expectation. So it comes back to the psychological element that we talked about. No,

spk_0 the opposite is also true. It's called the no-cebo effect. So if I was to give you an M&M and I told

spk_0 you this is cyanide, but you have to take it. But at the end of the week, you would have symptoms

spk_0 of being poisoned. Oh wow. Okay. So it's basically a negative expectation of an otherwise

spk_0 harmless event can lead to a negative outcome. This is proven by science, you know, millions of times.

spk_0 So as teachers, if we're in this fear-based place where we're worried about our students

spk_0 and yourself, we could be teaching a warrior pose and we could say, keep your front knee above your

spk_0 ankle to protect your knee joint. Okay. Now, a student could be in warrior. They could be

spk_0 completely happy thinking about what they're going to watch on Netflix that evening. And they

spk_0 looked down to their knee and their knee has moved beyond their ankle. They could actually experience

spk_0 knee pain in that moment. Not because there's tissue damage happening. Being able to move your knee

spk_0 beyond your ankle, it's a normal movement. You wouldn't have been able to get out of bed today or

spk_0 climb a flight of stairs or get in and out of your car without taking your knee beyond your ankle.

spk_0 Okay. So no tissue damage has happened, but the expectation, the nervous system hears the word

spk_0 protect and is like a red alarm going off. And we can actually experience knee pain as a result of

spk_0 that language. But the other thing that can do is it can instill this narrative in our students

spk_0 that their bodies are fragile and their bodies are anti fragile. Yes. Yes. Her bodies respond

spk_0 positively to stress as long as that stress is kind of given in a progressive way that we're

spk_0 able to kind of adapt to. So yeah. Yeah. It reminds me of, I think because in yoga classes,

spk_0 we have so much of language, right? We queue, we communicate. It is more verbal than many other

spk_0 formats. And it's like if I went to a swim class and the instructor constantly said,

spk_0 do this or you'll drown, do this or you'll drown, don't do this or you'll drown, it would just

spk_0 who would go back to that? So it's, you know, when we sometimes take ourselves out of the yoga

spk_0 context and explore this in a different setting, it just it it lands differently. And something

spk_0 is always good intention. It is. No one's there wanting to cause harm to people, but it's like,

spk_0 we just need to find that place on the spectrum where it's not, I don't want people to care less,

spk_0 not care at all and just let the students do whatever they want. It's like find that midpoint somewhere.

spk_0 It's like how you said, how you said sometime back that let the student explore and find their own

spk_0 boundary and let them explore what that feels like. I think that's such an important thing because

spk_0 otherwise you're putting all these barricades before they even get to that. Something I've used

spk_0 in the past in classes is especially the student is new and if they say it hurts or that's painful.

spk_0 I'm like, my first question is, is it uncomfortable or is it discomfort or is it that sharp

spk_0 pinching, throbbing pain? And is it mild or moderate? Do you think that because it's unfamiliar,

spk_0 it's a new sensation and I encourage them. I'm like, try it again if you feel like you can or

spk_0 want to and and then see if it's just a different experience. And I always tell them, if it lasts

spk_0 after this class, the next class, if it's still there, then we address it. But is it just new? And

spk_0 99% of the time, it's just new and because they've not held held up length. And so that effort

spk_0 is labeled as pain, that discomfort is labeled as pain. So yeah, and also that's beautiful because

spk_0 that you're then taking people on a journey where they start to understand the things they're feeling.

spk_0 Also say things like, here's how you take the load of the plank. What you need is down,

spk_0 get to tabletop instead. Here are other ways we can work. So there are always many different

spk_0 exit points, but they get to decide what that exit point is. Yeah, I love that. It's beautiful.

spk_0 It's beautiful because I think often when people are new to yoga or maybe new to do any kind of

spk_0 mindfulness, kind of practice or a practice where you really want to be in the present moment,

spk_0 I think first of all, they don't know what they're feeling. And then they might get to point where

spk_0 they they realize they're feeling something but they don't know what it is. And then eventually

spk_0 they get to label it. And it's like this beautiful building of awareness over time. And we have

spk_0 to start people somewhere. But if we are always telling people what to do and how to feel,

spk_0 then they're not really going to go on that journey. And I think that's why asking questions and

spk_0 putting the owners back on students is so important, so helpful. And then they're going to have more

spk_0 kind of confidence to also practice on their own. And we want people to be practicing more and more

spk_0 yoga. So if they're constantly relying off at every moment, you know, to guide them, then I don't

spk_0 really know how much that is actually helping them in the long run. So yeah, it's an attraction.

spk_0 I'm with you on that to not teach from that fear base, but also to teach more from clarity

spk_0 and instilling confidence and building them up and recognizing what do they not understand

spk_0 about this specific thing? And how can you deconstruct it to build those layers of understanding?

spk_0 Like how if there was a child in the room, you would break something down and simplify it.

spk_0 I think sometimes we as yoga teachers need to also work more on keeping things more simplistic

spk_0 in our approach. The answer is not, don't do it. The answer is probably three other questions

spk_0 and a slightly different approach. So continuing to speak about pain, what role does the nervous

spk_0 system play in either amplifying this or sometimes even suppressing and quietening those pain

spk_0 signals? Because we have people who when I'm doing aircodes push through the pain when they're not

spk_0 supposed to. Yeah, it's a huge part. The nervous system plays such a huge role in our experience of

spk_0 pain. And I think, you know, if someone is experiencing persistent pain, they can probably recognize that

spk_0 when they're feeling stressed or when they haven't slept well or when they've had an argument with

spk_0 their partner or when a bill comes in that they forgot about and suddenly feel overwhelmed financially,

spk_0 these are the things that can end up amping up their pain. And then when we're able to do all these

spk_0 amazing practices, Pranayama meditation, yoga, being a nature, you know, all the wonderful things

spk_0 that make us feel more centered, more connected, more calm, this can often don't regularly pain. So I

spk_0 think this is really, it's so so special. I see I see this as a toolbox, you know, I see all these

spk_0 practices that I've been cultivating over the years as a toolbox that I can dip into every day

spk_0 to help me feel somewhat balanced. And sometimes experiencing pain can be information,

spk_0 it can be information that maybe maybe you need to slow down a little bit, you know, maybe you need

spk_0 to take an evening off and instead of watching Netflix run a bath, do a meditation, maybe you need to

spk_0 have more meaningful social interaction. So call a friend or book in a coffee with someone and

spk_0 have that connection, you know, so it's I think, again, I don't want people to think of pain as a

spk_0 negative thing because often it's just, it's it's it's it's giving us useful information, it gets us

spk_0 to stop and go, okay, what is happening right now? So for example, the other week, I was sat on the

spk_0 sofa and all of a sudden, I felt really sharp lower back pain. Okay. Now rewind 10, 15 years,

spk_0 when I didn't know was much about pain science, I might have bought into that and I might have

spk_0 thought, oh my god, what what's happened? I put my back out or I've slipped a desk, I've done

spk_0 something. I probably would have fed into that and there's a good chance that I would have

spk_0 experienced back pain for some time. I probably would have got only and I can't go to the gym tomorrow

spk_0 or I need to slow down my yoga practice or I need to go back to bed or something. But but what I do

spk_0 now with all the information I have is I go, okay, I need to check in with myself, like what is

spk_0 going on for me today? And and then thanks, Kapi, go, you know, what I am stressed, I didn't realize

spk_0 it, but I'm feeling really, really overwhelmed because I've got the scary podcast interview tomorrow,

spk_0 you know, I'm going to be asked on these questions about about pain and then like more often than

spk_0 not, then I'm able to shift out of that. You know, yes, I'm maybe I'm maybe feeling sensation

spk_0 back for the next hour or something, but then before you know what I've forgotten about it and

spk_0 the pain has gone. So I'm again, I'm not trying to say that it's always in our head because I don't

spk_0 want to invalidate any of those experience, but again, it's this psychological element to it.

spk_0 It's so important. So if you can help to regulate your nervous system, more possible using these

spk_0 tools that we have at our disposal, then it is definitely going to help you with the kind of

spk_0 experience you're going to have for sure. No, I think that is it is so important to just sit with

spk_0 that pain and explore it and address it in whole some ways. And I think back in the day also,

spk_0 I remember when I was very young and if my grandparents had any pain, the doctor would actually

spk_0 say back in the day, go rest, stop doing this. Sometimes even PT is the first thing the physiotherapist

spk_0 will tell you is stop doing everything. But I'm glad that we're at a point in time where we can

spk_0 explore this a little more fully. And so that brings us to inflammation. And correct me if I'm wrong,

spk_0 pain and inflammation often show up hand in hand. And but are they the same thing? Like sometimes

spk_0 that phrase, right? It's two sides of the same coin. So what is inflammation? And is there a

spk_0 difference in in the short term versus long term impact of inflammation? Yeah, sure. So great

spk_0 questions. So pain and inflammation are often linked. They are technically different things.

spk_0 So inflammation is produced by your immune system. So acute inflammation happened in the short

spk_0 term. It's vital actually for survival. So again, it's not don't think of it as a black or white

spk_0 like good or bad thing. It's part of your innate immune response. So it's this very

spk_0 non-specific but rapid response that we have that helps to keep us healthy. It helps to keep us

spk_0 protected from pathogens. So it's like a wound that swells up. Exactly. Yeah. You get your redness,

spk_0 you get your swelling, you get your pain often associated with it. So even think of your nose

spk_0 running. Say your outside in some pollen or something, your nose runs, that's all part of your

spk_0 innate immune response. Tears, saliva, your hair, bodily hair, gastric acid, bile, your skin,

spk_0 all this all this is all part of your innate immune response. So you've I'm sure most of us

spk_0 have had some sort of allergy or hay fever symptoms at some point in our life or maybe like a mild

spk_0 cold. That's your innate immune response trying to clear the pathogen from your body. So this is

spk_0 where I have a problem with people making kind of generic statements such as oh yoga boosts your

spk_0 immune system. Because if that was the case, yoga would also be boosting your innate immune

spk_0 response and you would feel permanently unwell. You would feel like you had allergy symptoms all the

spk_0 time and you would end up feeling pretty depressed. So this is an interesting one. So we'll come back

spk_0 to this because this is a cute inflammation. Then unfortunately what can happen similar to pain

spk_0 is inflammation can end up staying around in the body way longer than we need it to and it becomes

spk_0 chronic again. I don't love the word chronic. I would rather say persistent system. And this could be

spk_0 because your nervous system isn't fully regulated. It could be to do with lifestyle again. It could

spk_0 be because you have a sedentary lifestyle. You're not active enough. There's a lot of elms could be

spk_0 to do with dietary things. It could be to do with infections you have that basically this inflammation

spk_0 stays longer. And if you've had inflammation in your body, you're going to feel pretty rubbish.

spk_0 You're going to probably have brain fog, lethargy, generalize pain, discomfort.

spk_0 This is basically what it is. So a cute inflammation vital. We wouldn't be able to survive without it.

spk_0 Chronic inflammation we don't want it. There are so many conditions that have a chronic

spk_0 inflammatory component to them. So think of inflammatory bowel disease.

spk_0 Think of rheumatoid arthritis. Even osteoarthritis. We've talked with this a little bit. So in the past,

spk_0 osteoarthritis was viewed as a wear and tear condition. The belief was that from physical

spk_0 activity over the years, let's say your knee joint, for example, begins to wear down. And then

spk_0 eventually you have bone on bone and you get pain and dysfunction. Now we mentioned some of this

spk_0 research because it's actually possible to have those changes on an x-ray that would typically

spk_0 help you be diagnosed with osteoarthritis. It's possible to have those x-ray changes but to have

spk_0 no pain and dysfunction. So what the research over the last decade has told us as the main component

spk_0 of even osteoarthritis is inflammation. It's low grade systemic inflammation, something

spk_0 inflammation here at the body that happens to be shown up in certain joints for certain people.

spk_0 It's a little bit of a mystery as to why that is the case. But the exciting thing is that then

spk_0 that gives us a way to tackle this. So rather than thinking, okay, it's a wear and tear condition.

spk_0 It's only going to get worse or it's not permanent. Inflammation can shift in the body. So if we're

spk_0 able to tackle inflammation, then we can help our knee osteoarthritis feel better. So that's the

spk_0 exciting thing. And one of the main ways we can do that, similar with pain is through physical

spk_0 activity. Okay. Your nervous system is amazing at conserving energy. So if you're physically active

spk_0 on a regular basis, this is recognized by your nervous system. And it begins to conserve energy

spk_0 to give you the energy each day to be physically active. And the easiest way that it can do that

spk_0 is by reducing inflammation in your body. It reduces inflammation. And then you end up feeling

spk_0 better as a result. So if you can progressively increase your physical activity over time,

spk_0 it's going to be the best thing to reduce inflammation in your body. Yoga plays a role here.

spk_0 Yeah. Yoga is wonderful at reducing systemic inflammation in the body. There's some really

spk_0 robust science that is emerging that is telling us this. Okay. The good news is that, you know,

spk_0 most people here are listening because of yoga. But if you've someone in your life that has

spk_0 inflammation, and maybe yoga isn't their thing, maybe they struggle with yoga for whatever reason,

spk_0 that's okay. They just need to find the physical activity that works best for them.

spk_0 Yeah. So yoga yoga is wonderful, but actually yoga is not necessarily better than any other activity.

spk_0 Okay. So as long as they're moving, as long as they're physically active. So that's the

spk_0 really exciting thing about inflammation is yes, it plays havoc on your body. I've had

spk_0 chronic inflammation before. It's very, very, very challenging. And often it's like a hidden

spk_0 disease. You know, I could look healthy on the outside, but feeling terrible, brain fog,

spk_0 complete lethargy, low mood, or the things. So, but the exciting thing is that we're now

spk_0 realizing how we can go about tackling it, which is, which I think is very, very exciting.

spk_0 There's, I think what happens is we don't know how to catch it. Right? So identifying things like

spk_0 brain fog, low mood, just that inertia of not wanting to do anything. What in Ayurveda,

spk_0 sometimes they would call tamas is, is, it's reminding me of that. Are there any myths or things

spk_0 that we say in the wellness and yoga world about inflammation that need clearing up? Because

spk_0 every day I think I say 10 different new videos on eat this for inflammation. Do this for

spk_0 inflammation. And even like, even if I don't have inflammation, I'm getting it by just watching that.

spk_0 Anything that you see that really, you're like, you roll your eyes and you're like, oh my god,

spk_0 I wish they would stop. Yeah, I think, I think just again, that idea that it's bad,

spk_0 that's like inflammation is a bad thing. Remember, it's an important part of our immune response.

spk_0 And this is why also, let's say we, I was just spraying my ankle today when I'm hiking.

spk_0 The latest research tells us not to put ice on it. I'm not to take an anti-inflammatory,

spk_0 like ibuprofen because you want the inflammation to take place to heal.

spk_0 No, yes, if the pain is persisting a week or two weeks later, yes, I said and take the ibuprofen.

spk_0 But in the short term, we actually want the inflammation to be happening to help us to heal.

spk_0 So I think it's that kind of idea of it being kind of black or white. I think there are probably more

spk_0 meth-study with pain and obviously it's all wrapped up here with inflammation.

spk_0 I think the biggest myth in the wellness world that I see about pain is that there are,

spk_0 let's say for back pain, that there are specific exercises that are more effective than others

spk_0 at helping your back pain. And this is where core stability comes into play.

spk_0 The, what's fascinating is, core stability is everywhere. Okay, it's this multi-billion dollar

spk_0 industry. It only came about as a concept in the late 90s. You know, it's not something that has

spk_0 been around forever. It's this kind of modern concept and it's not really evidence-based. Okay,

spk_0 so you can have the strongest core in the world and experience back pain. You can have the weakest

spk_0 core in the world and have no back pain. No, no. And interestingly, you can, you can have back pain,

spk_0 you can do core exercise and your back pain can get better, but it's not because of the core

spk_0 exercise. It's the fact that you're being physically active. So again, I think the myth is that,

spk_0 oh, if you've got this or this, like do this specific thing, it's just about being as active as you

spk_0 possibly can be. I think that's one of the main things. And then the other thing, the other

spk_0 bug bear that I have about pain and the wellness entry is actually around posture. It's really

spk_0 interesting. The idea of good posture, it's a social construct. Like it is not evidence-based.

spk_0 Again, it is a multi-billion dollar industry, ergonomics, setting people up with these

spk_0 desk, you know, and just concept. Yeah, a lot of people make a lot of money from it. It's not

spk_0 evidence-based. There was this really interesting study that looked at a particular industry and it

spk_0 looked at the incidence of back pain. And then they went in and did all these interventions. So they

spk_0 did all the ergonomic chairs and desks and the screens at the right height. They gave people all

spk_0 the advice on picking up heavy objects, you know, do it with a street spine hinge at the hips. All

spk_0 this advice was given how to sit and stand. And then after this, let's say six months after all

spk_0 this intervention, they looked at the incidence of back pain and it had not improved. Okay.

spk_0 What is more likely to impact whether or not you're experiencing pain at work is job-satisfaction

spk_0 and not actually what you're doing at work. It's really, really interesting. So there's no way to

spk_0 sit or stand that is going to prevent you from getting back pain. I'm not saying that posture

spk_0 isn't important. I can sit, slouched and feel pretty flat. I can sit upright and after a few

spk_0 minutes, feel, bones that uplifted the way you sit inside a fixture breath, and all these things

spk_0 and get it. There is the literally there. But I would say instead of worrying or putting too much

spk_0 focus on how you sit on set or stand on a regular basis, just try to move more. So if you have a

spk_0 desk job, it's not like the perfect way that you're aligning yourself while you're typing. But

spk_0 take a break every 30 minutes and walk around the office, do some chair yoga, do a breathing practice

spk_0 and then get back. So it's breaking up like sedentary lifestyle with movement. We have evolved to move.

spk_0 We have not evolved to sit, stand in any one static position. So I think that's one of the biggest

spk_0 myths that it's a repository that is causing back pain. It's just not evidence-based. It's really,

spk_0 really interesting. As fascinating to me that there's no, it's not evidence-based because you see so

spk_0 much, right? The hazard of sitting and things like that that keep flashing. So to close things out,

spk_0 is there any final thoughts that you want to leave yoga teachers with when it comes to pain and

spk_0 or inflammation and help them to recognize it and maybe even work with it in yoga spaces or in

spk_0 their own lives? Yeah, I think, you know, we talked about a little bit about the kind of general

spk_0 symptoms that someone can have if they are experiencing chronic inflammation. So I think it's just

spk_0 recognizing how important it is to be providing people with these tools that we're providing them with.

spk_0 Simple meditations, simple breathwork practices, simple sequences that they can do at home that they

spk_0 could do in bed or in a chair or it's the simple things. We don't have to reinvent the wheel. I think

spk_0 we just have to give people tools that they feel confident to do at home on a regular basis.

spk_0 And I think it's also plain with the idea of slowing things down because sometimes when someone

spk_0 has brain fog or feeling lethargic slowing things down a restorative practice can be helpful,

spk_0 but sometimes the thing they need most is to actually move a little bit more vigorously.

spk_0 So not to always think what's the slow styles that are going to be helpful for these people,

spk_0 but it's like whatever it is, there's going to get that person to move, you know, it's going to be

spk_0 key. And for any listener right there that is dealing with inflammation or pain, just try to show

spk_0 up for yourself every day. And even when you're not quite feeling like it, you know, take a brisk walk

spk_0 around the block, you know, move your body in the way that you can. You know, think of all the things

spk_0 that lift you up, spending quality time with people, cooking your favorite meal, you know,

spk_0 taking that bath and like in the candles, whatever it is. And just, you know, just try to show up

spk_0 for yourself every day and the way that you can. And you know, the chances are you're going to start

spk_0 to feel a little bit better over time. So yeah, I hope it's been, I hope this has been useful

spk_0 for people who just changed his people's mindset a little bit, you know, I think it's it's

spk_0 extremely useful. And I was thinking of this quote as you were sharing that and it's from this book,

spk_0 I'm not able to remember the title of the book. It can come to me right after we stop recording.

spk_0 This is when you're losing your mind, find your body. And I think it is, it's the simple advice

spk_0 Andrew, that is so important. And like I said, we don't need to reinvent the wheel. It is really

spk_0 these small, simple day to day things that we should be doing. The question is, are we doing it?

spk_0 So this is very helpful. And I know there's a lot more out there about pain and about inflammation,

spk_0 but this is a wonderful jumping off point into these conversations. Thank you so much for being here

spk_0 and doing this. I hope you come back to get nerdy about some of these some other topics in future too.

spk_0 Love to. But yeah, and thank you for all your wonderful questions. And yeah, it's been really,

spk_0 really great talking about all this with you. Thank you. Thank you.

spk_0 Thank you so much for listening to the Let's Talk Yoga podcast. Make sure you are in the know how

spk_0 by being on our monthly newsletter. The link to that is in the show notes. I've also linked all

spk_0 of Andrew's socials, his courses as well as his website in the show notes at Let's Talk Yoga

spk_0 forward slash. Listen until next time take care. Bye bye.

Pain vs. Inflammation: What Every Yoga Teacher Should Know with Andrew McGonigle

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