Spasticity and the Breath
HEMIPLEGIC LEFT SIDE
Contracted arm able to lift over my head, walk on beach no AFO on foot using YOGA!
As a stroke survivor and registered yoga teacher I have found there is a lot the medical community does not take the time to help brain injury survivors learn after a brain trauma, because of some pretty huge gaps in research studies. The things they tell you are you will never get better, they leave out huge gaps in symptoms and recovery , not to mention they tend to push harsh drugs on you just to maintain a mediocre quality of life .
Knowledge about things like Fascia, cerebral spinal fluid, nerve health, nitric oxide, breathing patterns, the relation of breath to spasticity, and inflammation. Simple things like nasal breathing, eye movements, cranial sacral therapy, alignment based manipulations, Iyengar yoga, the importance of sleep, brain foods, meditation and even self care practices are withheld from most models of stroke rehabilitation today. Stroke survivors are pushed to get better, rushed to get back to their lives and often encouraged to just be happy.
Many stroke survivors experience dehabilitating tighnesss, spacticity or tone in the arm- shoulder to hand and leg- hip to foot. Because of this, it can be very hard to resume life and find happiness in life.
2010: My arm wasn’t always like this after my stroke. My left arm was completely flaccid, limp and hanging at my side for about 1 year before it started to inch up on my year by year, minute by minute my spasticity increased and no one could tell me why. I had moments of feeling relaxation in the arm hang sporadically.
But, I had zero control and zero understanding of what my body was doing.
I knew I must seek further.
I tell stroke survivors all the time, having a body part that you can see, feel and touch in many cases, but cannot move anymore is the biggest TRIP you could ever take. It cracks you open with this seeking , this yearning for something different. It’s almost as if the limitations remind you of this UNlimited nature of the universe somehow. A stroke really is a portal to the spiritual realm, it is a doorway, an opportunity “to the self through the self”, As the Bhagavad Gita reminds us.
This was me 2015. My stroke was June 12, 2009.
This year I began my yoga practice unsatisfied by what western medicine offered me: notice my swollen arm from numerous botox injections and daily baclofen doses, anti anxiety meds and anti depression meds.
I was an ideal candidate for a baclofen pump inserted in my spine I was told, as my arm would never relax without these drugs my doctors affirmed. I was swollen as I don’t know what.
The CDC reports:
Every 40 second someone has a stroke. That’s crazy right?
795,000 Americans experience a stroke every year and every 3 minutes and 14 seconds someone dies from a stroke.
From 1990-2019 the rate of stroke increased by 70%, yet the average age of stroke reduced by 17%, according to statistics put out by the AHA 2023.
You’re telling me in 30 years the rate of stroke nearly doubled and yet the average age of stroke lowered significantly?
What is this trend showing us?
A high stress, high intensity society is hurting people at an alarming rate.
Maybe just maybe our nervous system’s are not designed for all this overload- Wifi, cell towers, cell phones, constant stimulation factors.
Not to mention the quality of food decreasing, the frequency of prescription medicine reliance on the rise. Where does our body decompress?
How do our bodies decompress?
Stroke or no stroke, we need time for our nervous systems to rest, our body need time to heal, return to balance, free from any outside influence.
Stroke is the leading rate of long term disability in the U.S and the 3rd leading cause of disability in the world according to WHO.
They (the CDC) also say only 10% will recover fully.
What is a major cause for this permanent state of disability after a stroke?
Balance, speech, vision, muscular tightness, pain are all things that challenge a stroke survivor.
43% of stroke survivors experience spasticity after their stroke.
Spasticity is defined by The National Institute of Health as
“a condition in which there is an abnormal increase in muscle tone or stiffness of muscle, which might interfere with movement, speech, or be associated with discomfort or pain. Spasticity is usually caused by damage to nerve pathways within the brain or spinal cord that control muscle movement.”
Tone is more or less the natural tension, or contraction, in a muscle that resists stretching. Tone is necessary in motor function to a certain degree.
What we know about muscles relaxing is muscles like oxygen right? Oxygen is used in your body to break down glucose and produce fuel to build muscles called ATP. ATP is a molecule that is the source of energy for use and storage oil our cells.
OKAY…. But how do we relax our muscles?
The National Institute of Health recommends these 6 ways to increase muscular relaxation:
5 of which are YOGA, as noted:
1. Progressive Relaxation: Also called progressive muscle relaxation, this technique involves tensing different muscles in your body and then releasing the tension.
· I.E. BALLING UP THE FISTS AND RELEASING, SCRUNCHING UP THE FACE AND RELEASING, HOLDING THE BREATH AND RELEASING.
2. Autogenic Training: Through a series of mental exercises involving relaxation and ideas you suggest to yourself (autosuggestion), your mind focuses on your body’s experience of relaxation.
· I.E. YOGA DHARANA AND DHYANA (concentration, meditation, body awareness, sensation YOGA NIDRA.)
3. Guided Imagery or “Visualization”: In guided imagery, you picture objects, scenes, or events that are associated with relaxation or calmness and attempt to produce a similar feeling in your body.
· I.E. MORE MEDITATION AND YOGA NIDRA
4. Biofeedback-Assisted Relaxation: Through feedback that is usually provided by an electronic device, you learn how to recognize and manage how your body responds. The electronic device lets you see how your heart rate, blood pressure, or muscle tension changes in response to feeling stressed or relaxed.
5. Self-Hypnosis: In self-hypnosis programs, people learn to produce the relaxation response when prompted by a phrase or nonverbal cue (called a “suggestion”) of their own.
· I.E. YOGA DHARANA (concentration, focus)
6. Breathing Exercises: For breathing exercises, you might focus on taking slow, deep breaths—also called diaphragmatic breathing.
· I.E. YOGA PRANAYAMA (breath control)
We move into understanding Stroke and its relation to breath.
The National library of Medicine has studied the link between breath and stroke recovery finding:
“As dysfunctional breathing has been reported as one of the factors affecting the quality of life post stroke, a number of studies have focused on the need for improving the breathing function in these patients.”
Does this research seem to indirectly suggest the importance of teaching patients post stroke ways to improve breathing function as this study suggests?
“Most people unconsciously hold their breath in between the inhalation and exhalation. This is an extremely bad habit as it tenses the body, disrupts the normal breathing rhythm, creates an imbalance in the nervous system, and by throwing off the healthy respiratory system can be damaging to the heart.”
Swami Rama discusses this serious human disturbance as a reason for breath based meditation practices in his manual for meditation called Meditation and its Practice.
A condition called CPB or CENTRAL PERIODIC BREATHING defined as breath with 3 or more cyclical pauses in breath- lasting at least 4 seconds, separated by no more than 30 seconds of normal breathing was found present in 53% of Acute stroke patients.
According to the National institute of Health
All studies and quoted materials are linked on resource page.
But you can read the affects of this inconsistent breathing and the relation to stroke here!
Okay so let’s pause for a moment and address this key factor Simple human anatomy has given us access to.
When we breath in and out through our nose or hum our paranasal sinuses excrete vasodilastorgas nitric oxide.
This nitric oxide increases blood flow, eliminating the need for many harsh blood thinners and also has a role of lowering and maintaining blood pressure.
Am I the only one connecting the dots?
According to the American Heart Association the leading cause of stroke is high blood pressure.
There is a remedy for this that lies within?
Okay so we understand the need for improved breathing function in stroke survivors in terms of quality of long term life.
We understand more than half of stroke survivors presented with this abnormal paused breathing cycle.
Yet no one speaks about the breath in acute or outpatient therapy services.
WHY?
Can we assume giving stroke survivors access either individually or in group class settings access to guided breathing techniques might benefit long term quality of life in all stroke survivors regardless of age or race?
I TEND TO THINK YES!!
Read the research and make your own conclusion.
Our breath is there only function in our body that can happen with thinking about it or without thinking about it.
And if you have a human body, you have a respiratory system that functions just like mine.
Although every stroke is different we are all humans and are all bound by this human body.
When we breathe without thinking about it it comes from our brain stem (our PONS) our autonomic nervous system that controls our involuntary physiologic processes, things like our heart beating, blood pressure, digestion, sexual arousal, instinctual human things from our brain stem or our reptilian brain, our “under evolved” survival instinct brain.
“The behavioral, or voluntary control of breathing is located in the cortex of the brain and describes that aspect of breathing with conscious control, such as a self-initiated change in breathing before a vigorous exertion or effort.”
When we consciously take a breath, thinking about the breath as you're taking, it comes from another part of our brain.
Our cerebral cortex consisting of gray matter being our outer most layer of nerve cell tissue. Meditating for one minute helps increase grey matter in the cerebral cortex according to Harvard research teams.
Read more on Meditation and the mind about these benefits meditation has on the brain and its role in healing.