Joined: 23 Sep 2006
|Posted: Wed Oct 12, 2016 2:49 am Post subject: Yin yoga for an achilles tendon tear
|Recently I received the following question:
Hi Bernie. I have a question for you: Recently a piece of sheet metal cut 2/3 of my achilles tendon. Through resting the foot and now extensive physio, I am able to walk with a limp, and it is healing every day. I do VERY modified yoga and I have been doing yin for about a month now. My physio therapist is so great, but is being a little wishy-washy when it comes to surgery. He initially said I didn't need it, but today said that it might be a good option for the future. From what he said today, I gathered that my tendon is healing and will continue to do so, but that the newer tissue won't be as strong (he said in 5 years if I suddenly need to run, it could rupture?) My feeling and hope are that meditation and yin can heal my tendon. If it was an absolute must then obviously I would get surgery, but it's kind of a "you choose" scenario and I am not sure what to do! I am reaching out to you because you seem to have an equal appreciation for modern medicine/science and yoga, and I would love to hear your thoughts on yin yoga healing the tendon completely? Or yin supporting the healing after surgery? I realize this is a BIG question, and do not worry, I won't do exactly as you say just because you say it. I am doing a lot of research and checking in with how I feel about it, but I just so believe in the healing of yoga AND I don't want to jeopardize my tendon because I didn't get surgery... what a pickle. Thank you of taking the time for this question! Loving your classes on Gaia.
Injuries are always tricky because ever individual heals in their own unique way. I am not sure what to suggest you do in your case. I do know that tendons do take a long time to heal because of their structure. They are made up of long chains of collagen, but in order for a tendon to really heal, the fiber has to reach all the way across the injury. It doesnt build up in layers, but has to have all that length right away. That is challenging and takes a long time. This is one reason that surgeons insert already long segments of tendon across the injured gap that they harvest from somewhere else. The body can then work with that bridge to thicken the tendon and make it stronger, but if there is a gap where there is no tendon, it is hard for the tendon to regrow across the gap.
Since you are keen to investigate this yourself, let me refer you to a study called The role of stretching in tendon injuries by E Witvrouw et al. (It would be also be valuable to check out several of the papers they cite.) Their final conclusion was that both ballistic and static stretching should be incorporated in the prevention and treatment programmes for tendon injuries. But, should that be the case for you? I cant say. In the Yin Yoga philosophy, a long held, static stress is supposed to stimulate fibroblast activity through mechanotransduction, which may make the tendon thicker, stronger, and in time longer. This study did not evaluate yin-type of stretches but the more standard yang-static stretching and ballistic stretching. This yang kind of static stretching did not affect the stiffness of the tendon, while the ballistic stretching did reduce its compliance (which means it got weaker and more elastic.)
All I can suggest is that you do some experiments, some trial runs, and see what happens. You are in therapy, so this may hurt, but you have to judge whether it is good pain or bad pain. Working with your therapist you may be able to come up with a protocol that is worthwhile, perhaps shorter yin-like stresses along with strengthening exercises?
Good luck, and let us know how it goes.