Male Announcer: You’re listening to From Pain to Possibility with Susi Hately. You will hear Susi’s best ideas on how to reduce or even eradicate your pain and learn how to listen to your body when it whispers so you don’t have to hear it scream. And now here’s your host, Susi Hately.
Welcome and welcome back. I am finishing up this new mini series on helping people to optimize knee and hip rehabilitation post-surgery. This mini-series has been designed for yoga teachers and other health professionals who are integrating yoga into their practices, as well as clients themselves. And this is because I work with both groups of people. I have a one on one client base as well as a IAYT accredited certification program along with a catalog of courses that offer continuing ed and help clientele get well again.
The reason I’ve set it up this way is because my reality is that 95% of the yoga teachers and other health professionals I train also have pain. So they need as much help themselves as do their clients. And as the health professional gets better, they become that much more effective at working with their clients.
So the way that I teach integrates the what to do and why to do it and it’s offered to people who are engaged, who are thoughtful and who want to know how to help themselves. So I welcome both, both the yoga teacher professional and the people who want to just move better and feel better. So with that, onto the episode.
Today I want to focus on the common activity that many of my clients want to be able to get back to post hip or knee surgery, and that would be golf. Now, it might seem odd that I’m including both hip and knee in this episode when I’m speaking about getting back to golf, because wouldn’t we just focus on each joint separately because each joint is different?
Even though the mechanics of each joint is different and the impact on the golf swing will be different and the impact of surgery on the joint will be different, what I am watching for is similar. This is because the dynamics of the golf swing are impacted by how my client sets up through their whole body from feet to pelvis to head and out to arms and hands.
So when I’m helping my clients improve their overall mechanics while keeping their specific joint in mind, my clients get back to the course in a timeframe they are super happy with. So how do I work through this process?
First, I begin with their setup and how they address the ball. I know that it is time to explore this phase when they have graduated from their formalized rehabilitation. It’s clear that their joint is intact and is healed well because they’ve been medically cleared to gain strength and mobility that will support their return to the course.
Now, I say it that way because there is retraining needed to return to the course effectively. So if there has been knee surgery and that knee is the lead leg in their setup, it can experience quite a bit of torsion. And we can make this a much smoother transfer blow with less impact on the knee if we clear up the compensation patterns through the hip, how the ribs rotate and what the shoulders do, nevermind what’s happening with their feet.
And for the hip, the stability through that joint in both phases of the swing, both forward and back, will impact just how smooth and coordinated the swing will be. The hips are also highly impacted by the foot placement and how the ribs rotate. So, many of the components are similar between what I’m working with whether someone is coming out of knee or hip surgery.
The bumper sticker on this is if I can help my client gain more stability and reduce some of the torsion related forces in a step-by-step way that is steady and consistent, their return to the course will be smoother with less flare ups. So in considering the setup, a key piece that I focus on is how they are moving into flexion at their hips and their ankles, and how to build both strength and endurance in this initial stance.
One way that I explore this with my clients is with a mini wall sit, with the emphasis on mini. I choose this position that they could be in for 30 minutes, not because they’ll be there for 30, but rather because they’re so comfortable in the position. I want this retraining process to be one where ease is present, where worry or concern about their joint is minimal or non-existent. And this will support their nervous system to be in a state that is settled and calm, both which are conducive to healing, strengthening and stabilizing.
Now, you might be thinking that with this mini wall sit position it’s not that ideal because it’s not mimicking the actual setup as they address the ball. The angles of their joints are nowhere near what they would be when they are golfing. And you are correct, but that’s not the focus I have for using this wall sit. Rather, the focus is on developing their mobility, their stability and strength in small step by steps.
In this position of a mini wall sit I can guide their attention quite easily to their feet and how their feet are placed on the ground, feeling for the three points: the center of the heel, the ball of the foot and the base of the pinky toe. And then from that position, what are they feeling through their legs? Through the knee? Through the hips into the pelvis? Can they settle easily with their breath?
Here’s where they also get to notice what gripping patterns exist in their ribcage because hands down, coming out of a hip or a knee issue that required surgery, they will likely have a pretty solid bracing pattern and gripping pattern through their ribcage. So if I can help them recognize that here in this position, we can start to make some real headway as we move into subsequent movements.
So one of those might be something that I call weight shifting or deweighting, where we’re quite literally moving the weight from one leg to the other without gripping, bracing or moving through the ribcage or the head.
So we’re just in the mini wall sit, playing around with adding more strength to one leg, pressing what I like to say the blueberries into the floor with that one foot. Let the other leg and foot become light. Notice where the load transfers through their body and then switch it back to the second side. And then they move that way, one side to the other, noticing, honing and refining.
We can also add to the mini wall sit a side bend or an upright twist. And again, with the intent for building some strength and stability while keeping compensation strategies low or giving an opportunity to refine the compensation strategies.
As they build the stamina here, I may include more hip flexion with the torso coming off the wall and leaning forward at the hips as if they were about to address the ball. Now we still aren’t in the actual setups, we’re still playing with the parts, building it up step-by-step.
Here it can be really fun in this position with the back off the wall, moving into hip flexion at the pelvis on the leg bones, we can add a twist, right? The pelvis stays steady on the wall, we can still feel your butt against the wall.
But it’s not in a hard or anchored way. It’s what I like to call soft and still. They feel their fee, they feel their legs and they start to add a twist between their ribcage and their pelvis. So the ribcage is the one moving, the pelvis is staying quiet.
Now the reason this can be effective is that pre hip and knee surgery the ability to rotate through their torso often becomes quite limited, and we need to free it up and that requires retraining. The beauty of refining this movement is not only will it help their swing, it will also help their walking and their balance.
All that I’ve mentioned so far are examples of how I might begin with someone moving toward the setup and addressing the ball phase of their golf game, and then moving it into rotation work which is now starting to move them toward their swing.
As they feel more comfortable we can start to take these principles to the driving range with their short irons, their wedges, their putters. They can practice the concepts of feeling the three points of the feet, feeling their weight transfer, the stability of their pelvis as they train their rotation and their swing in a shortened range.
Most of the time when my clients are at this stage of recovery, being at the range is a really great place to simply drop balls, explore their standing movement patterns. There’s no need to actually get all the way to the ground, and then pick up the ball. Now, most of my clients at this stage can get down to the ground and back up again relatively smoothly or quite smoothly.
Sometimes I’ll be working with someone who is new to me and they are relearning this dropping down to the floor and back up again. They haven’t really regained that, that’s one reason they’re seeing me. So being at the range can be a great place to simply, as I mentioned, just drop the balls and explore their standing movement in the short swings, the putting, the chips without the need to get to the ground. We can continue to build out that patterning when they’re with me in their one to one sessions.
And having said that, what’s so interesting is that when they build up the movement patterns associated with the shorter swings, not only does it feel empowering and inspiring and getting back to an activity that they used to do, but it actually helps improve the global mechanics that are needed to get down and back up off the floor.
Because so often that getting down and back up off the floor, we just tend to think about the lower body. But actually it’s the upper body as well. And when we integrate those two, then that process of moving towards the floor and back up again becomes better. And that will be a topic for a future episode.
So now it’s time to explore the course, like actually out on the course. They’re feeling better through their legs. They feel more stable on their feet. There’s more agility, generally, and nimbleness. They’ve got better balance, and their walking pattern is good. They just feel better and they feel more mobile, their breath is easy. They just can tune more into themselves interoceptively and proprioceptively. It feels good.
So when it’s time to explore the course, the decision is very, very clear and easy about playing a shorter round. I don’t tend to have to convince my clients, and I’m not a huge fan of convincing anyway. But I don’t have to even go down that path or close to that path of suggesting that they play a shorter round. They just know in their body that that is what’s required, and using a cart and sticking with the short irons and the wedges.
In some cases, clients won’t do the drive at all, like nowhere even near, not even with the short iron. They might even just play best ball. Each person will be very, very different in how they initially modify their return to course, and honor the phase of recovery that they’re at.
Now, some people listening to this might be surprised that my clients are willing to do that. I realize that we have a medical model that we all kind of swim in, which is are our clients being compliant? And how do we make our clients compliant?
And yet, I don’t have that as an issue. And I think a big reason for that is everything that I’ve mentioned before this point is that this really is a collaborative process. I am helping them retrain. I am helping them grow that inner confidence in themselves. So they just get that that’s part of the process.
When you search online for ways to get back to the course and ways to improve, I mean, granted, it’s a blog post, it’s not very much information, it makes sense. But there’s not very many step-by-step ways of getting back. And then when I speak to the clients who do work with me, their medical team hasn’t been all that supportive or effective in being able to help them with that step-by-step.
In many cases it’s because the medical team are not golfers or are not familiar with the golfing. But it’s also because they don’t spend a lot of time pondering the mechanics of getting back to the golf game. They’re more interested in helping fix the knee and helping them get past that first phase, that first three months of recovery.
So it makes sense that they haven’t been given the step-by-step because that hasn’t been the focus. And that is one of my focus points, which is why what I do integrates so well with the recovery process.
Oftentimes, what I’ll also add is a short program that a person can do between the holes or between swings, particularly if they’re in a game with four people and other people are doing their thing. And they can use a bench or a tree or the cart to do some really easy exercises or therapeutic movements to free up any tension that might be building through the game.
It’s also a great opportunity to kind of come back to their breath, to play with some yoga Nidra principles and other types of principles that can help settle the nervous system, quiet things down, refocus their mind and simply tune back into their body.
Overall, the key for me sharing this episode, for professionals and their clients, was I wanted to share with you how I work with my clientele. To give a few samples and a few ideas of what I do with my clients to help them reduce their pain, improve their function, and really help them honor the principles of recovery so they can get back to the course in a smoother and sometimes quicker way than people might initially imagine.
So many people believe that pain is just a part of the process. And yeah, they’re not wrong. And you can retrain your body, your system, improve your state of being and your breath, how your nervous system functions so that you can get back, your clients can get back to a golf game that you love.
Now, if this resonates with you and you want to dig in deeper to these concepts, I am running my integrative mind body approach to hip and knee recovery this November. I would love, love, love for you to join me. And you can read more about it at learn.functionalsynergy.com/hipknee. Now, this program is designed for the yoga teacher, yoga professional and other health professionals who like integrating yoga into their practices.
And I have many people enrolled who are not yoga professionals but do like yoga and are interested in getting back to their game. And maybe they are six months or a year, or here in Canada when I’m recording this it is not golf season, but they might be planning for a trip later in the fall or into the spring or winter and they want to be ready. So you are welcome as well.
It will be a thoughtful process. It will be an awareness process and you will probably get more information than you may have even imagined. All right, so I would love for you to join me. Again, that’s learn.functionalsynergy.com/hipknee. I look forward to seeing you online. Take care. We’ll see you next time.