Bodily Changes and the Teacher Within

May is stroke awareness month. Is this on your radar? If not, it should be.

Adults in the United States over the age of 25 have a 25% lifetime risk of stroke, although some people are more likely than others to experience stroke—more men than women and more Blacks, Hispanics, and Mexican Americans than whites. These patterns are changing.

Every year, 10% to 15% of people who have a stroke in the US are aged between 18 and 45 years.

According to the American Stroke Association, stroke rates have increased by 40% among this age range in the last few decades. And a 2020 study also found that stroke rates are rising faster among young women than young men.

In 2012, Abigail had a stroke in her 30s. She remembers feeling dizzy and experiencing some ringing in her ears when she had a chiropractic adjustment. She took some ibuprofen and went to work, teaching corporate yoga.

Her voice stopped working, her right side started to go numb, and she thought she was really sick. She instructed the students to move down to the floor with her and she continued to teach the class. But her symptoms worsened. She thought she was going to lose consciousness and crawled over a student and to ask him to call 911. The EMT arrived, thought Abigail had vertigo, and told her to lay down and rest.

Listen to Your Body

Because yoga taught Abigail to listen to her body, she knew that what she was experiencing was more than vertigo. She asked the EMT to take her to the hospital, where the emergency room neurologist on duty immediately knew that Abigail was having a stroke. By that time, she had nystagmus—uncontrollable shaking of the eyes—and a CT scan showed a tear in an artery and a cerebellar stroke.

Abigail was transferred to the intensive care unit (ICU) for testing and treatment. For the first couple of days in the ICU, although Abigail was awake and conscious, she didn't really know that she had had a stroke. She knew something was wrong but was unaware of the extent of the physical impact of this cerebrovascular event.

A couple of physical therapists came up to my room and one got on either side of me and, you know, hoisted me up and helped me out of the bed. And they're like, okay, now it's time for you to go for a walk. And this was the first time I had been out of the bed, I didn't realize that I couldn't walk until then. It was just a surreal moment because I was giving the command to walk and my right leg just wasn't doing what it should. I kind of did this zombie shuffle with a therapist on either side of me a few feet down the hall, an exhausting turnaround and came back and rested.

So that was hard. That was the moment when I really felt betrayed by my body. It was a tough emotional time coming to terms with my body not functioning like it was supposed to be.

Abigail spent about a week in ICU relearning some basic movements before returning home. She learned to walk again using a walker, continued with physical and occupational therapy for six months, and had a home nurse to check her blood clotting every few days, because she was prescribed Coumadin, an anticoagulation therapy.

The Long and Winding Road to Recovery

The road to recovery for Abigail has been long and arduous. After physical therapy ended, she launched herself into a self-guided healing and recovery program that involved learning biomechanics with Katy Bowman at Nutritious Movement in Seattle. Bowman provides gait training, which worked for Abigail, who wanted to address knee and hip pain which she thinks was cause by ataxic gait. Abigail was determined to stop using the walker as soon as possible, and did so three months post-stroke—a gargantuan task.

But her ataxic gait caused knee and hip pain and so she took a year-long biomechanics course. Whole Body Biomechanics involved gait related exercises that stabilized lateral hip muscles and, over time, transformed her gait.

At the same time, Abigail was still bothered by nystagmus-related vision issues that were triggered by sudden movements, somebody moving quickly behind her, or if she moved her head or sat down too quickly. To counter this, she deliberately sought out activities with sudden movement to trigger a nystagmus attack and relearn proprioception. Eight years post-stroke, she also completed a six-month neuro-vision therapy program that helped to improve her depth perception and finally made activities like driving more manageable.

Abigail also joined a stroke and traumatic brain injury support group, which she still attends. She says, "Gathering with other people, whether they had a traumatic brain injury or stroke, listening to their story, listening to their struggles, being together in our emotions about all of it was huge," and helped her feel that she wasn't alone in her journey. Abigail's recovery would have been different without access to immediate emotional support and connection with other stroke survivors. Although medical care is critical, building community around stroke survival is important too.

Adapting Yoga to My Body

Understandably, these radical changes impacted Abigail's ability to practice yoga. But she wasn't prepared for just how much.

I had to really come to terms with the relationship that I have with my body. And I had to learn to love myself again, in this post-stroke body. My yoga practice will probably never be the same as it was before. And that was really hard for me because I had been practicing yoga for a long time.

Abigail's response was to adapt. She started using furniture, chairs, walls and being more flexible about her idea of yoga. And as soon as she felt she was able to experience a yoga practice in a different way using these props, it helped her emotionally, adding a meditative element to a gentler approach to yoga.

It helped my recovery a lot, just helped my brain regenerate. Those neural pathways helped with that neuroplasticity. So even though my yoga practice didn't look the same as before, I was still getting just as much, if not more benefit from the practice. I had to be so in-tune with my body. It's like when you're learning to walk again as a little kid, or when you're learning to walk as a little kid, like you're falling and getting up, and it's a constant experiential learning time. And that's what it was like for me. Everything was new again.

Svādhyāya and Adaptive Yoga

Svādhyāya is a Sanskrit term that means self-study. For Abigail, Svādhyāya has been vital to healing and recovery. Although her stroke support group was helpful, and she received excellent care from her healthcare providers, she noticed a gap in information about nutritional, herbal, and supplemental support for the brain. Beyond emphasizing the importance eating greens to support vitamin K production, healthcare providers offered little in the way of limited nutritional support. 

There are studies now that show blueberries reduce cognitive decline as we age. Anybody working with a stroke survivor or a TBI person should be feeding them blueberries. There isn't really like a good nutrition protocol for people who are super concerned about healing their brain. For instance, lion's mane mushroom is really good for improving brain-derived neurotrophic factor. There are a lot of things you can do to support the brain.

As a result of this gap in nutritional information for stroke survivors, Abigail attended herbalist school and researched a range of alternative modalities to support healing, such as meditation, red light therapy, and other biohacking practices.

Yoga has also been a vital part of Abigail's recovery. A year or so after her stroke, she studied with Matthew Sanford, became certified as an adaptive yoga teacher, and began teaching mobility-focused classes to older adults in her neighborhood. She also offers a 10-hour immersion to launch yoga teachers on the path to teaching adaptive yoga.

Abigail views adaptive yoga as for anyone who doesn't feel like they fit the typical fit, young and active type that is represented as a yoga practitioner by social media. Many of her students are older adults who want to stay mobile and functional as long as they can, people who have had injuries and crave some movement, or people with different abilities as a result of TBI or stroke. Many people feel disconnected from their body or want to improve the relationship they have with their body.

You can't say adaptive yoga is this one thing. It's really a journey. It's an exploration of making yoga accessible for the body that you're in today, helping you experience the energy of the pose, whether that's directional energy, subtle energy, grounding energy, that's accessible to everybody, no matter what condition their body is in. You're literally adapting yoga to fit your body's needs, whatever they may be.

Bodily Changes and the Teacher Within

One of the lessons of recovery for Abigail has been that the body changes, whether as a result of trauma, disease, or aging. As she puts it, we all have to face bodily changes and many people have ongoing body issues. We don't have to suffer big trauma to feel betrayed by our bodies in some way.

When I first felt betrayed by my body, yoga helped me learn to love my body again, to live in my body. It was to be okay with the journey that my body was on. I didn't appreciate my body before I had the stroke. Now I appreciate all that. It's such a beautiful gift to have this body. I feel like yoga was such a big part of recovering my mind, body relationship and I knew I had to teach it. In our culture, yoga can be such a fantastic tool to help, to help to heal that relationship. Not necessarily your functionality, but that relationship is one of the most sacred relationships you have in this life.

Abigail emphasizes the importance of developing self-knowledge and bodily awareness and of cultivating the teacher within.

In our culture we outsource so much of our self care to authority, doctors, experts; and that’s great because there is so much knowledge to learn there. But ultimately, we need to learn the teacher presence within us and listen to the message our body is telling us. That part of the story always makes me emotional because had I listened to him and not my body I could have worsened the physical effects of the stroke, perhaps long term, or I could have died. That yoga lesson truly helped to save my life. So for anyone teaching yoga, taking yoga, know that it really teaches you to listen to your body again and rebuild self trust.

According to the Centers for Disease Control and Prevention, someone in the United States has a stroke every 40 seconds. Early action is important. Yet only 38% of us are aware of the major signs and symptoms of stroke.

Build your stroke recognition knowledge bank.