(Practical Use of Pranayama in Alleviation of Pain)
by Peter Fabian
In July of 2011, I attended the Summer Congress hosted by The Meditation Center in St. Paul, Minnesota. It was an opportunity to reconnect with friends, meet new people and experience multiple treasures from the Himalayan Tradition. One of the interesting things I learned was from a friend (CW) who had discovered how to use Ujjayi 1 Pranayama in treating his painful chronically swollen glands underneath the jaw. This account completely captivated my attention. It is an amazing account of diligent practice assiduously applied over a nine month period. At the end, autoregulation of his heart rate rhythm was mastered. The accomplishment is quite laudable. The great lesson to be learned is about what was done, not about who did it. The great lesson was doing a practice with an iron determination that bore such amazing fruit. It is a path of practice that is open to many of us. It was such an amazing systematic effort made day after day over many months that impressed me greatly. I think once again, that it is the strengthening of ones will to focus ones effort at arriving at a place that is talked about, but few examples are given in today’s communities. Here is one such example that invites us all to re-focus our efforts in our practice.
I remember Swami Rama of the Himalayas speaking about the science of breath.2 He stated that there were basically two ways to have conscious control over our autonomic nervous system. One way was to control the motion of the lungs. The other was through our will power. The following contains an example that combines both methods.
This gentleman is a long time yoga practitioner who is quite active. Stating that he is active is a slight understatement. There is a daily 30 mile (total) bicycle trip to and from work over a rigorous Mountain range. He hikes and mountain climbs (above 6000 feet) on the weekends. Also he works as a Mountain Rescue Team Leader with high levels of peak stresses. The large manufacturing company where he is a senior manager keeps him away from his family a bit too.
Over a year ago he noticed that his glands underneath his jaw would become swollen and painful. He found no exertional trigger that would set off his symptoms. There were times that certain foods and periods of increased stress would be associated with more swelling. Otherwise it did not seem to be clear what was causing this condition.
CW did consult with his regular local medical doctor. A follow up blood panel revealed elevated cortisol levels. It was recommended that he try a course of oral steroids.
Later he looked into finding an Ayurvedic doctor, as his travels to India made this a knowable option. The following is a description of his Ayurvedic (USA) evaluation and subsequent very interesting and intense training regimen.
His initial Ayurvedic appointment consisted of evaluation and instructions in a specific protocol to deal with these elevated cortisol levels. His doctor started with a pulse diagnosis for two minutes. No other verbal interview was conducted before this reading. His doctor then proceeded to write a two page list of notes that quite accurately described many of his habits and preferences. These included food preference, when he arose in the morning, his sleep habits, etc. He was also able to accurately relate much of his prior medical history with only this pulse diagnosis. This is amazing but they say not atypical for a good Ayurvedic practitioner.
The doctor then listened to his athletic history as described above. This person was using a Polar wrist Heart Rate (HR) monitor often. He often used 2:1 breathing during his training. This pattern is breathing twice as long on the exhalation as on the inhalation.
They then went outside for a simple walking course of about a 1/2 mile. He wore a HR monitor to record his rate and rhythm. During this time, CW was instructed to keep his heart rate as level as possible during a normal pace of walk.
Returning back to the clinic, the HR monitor information was downloaded into a computer program for simple analysis. The graphic analysis showed that his HR was around 180 beats per minute (bpm), without any unnecessary exertion. The doctor mentioned that this is typically seen in overtrained athletes.
Next, time was taken to teach him a particular breathing pattern called Ujjayi. Ujjayi breath here was done very vigorously both on the inhale and exhale phase. If CW had not been accomplished in diaphragmatic breathing, he would have needed several weeks to train it first. Please follow the above hyperlink for more detailed information on this “pranayama” or breath regulation method of the Yoga Tradition.
Then they repeated the same monitored walking course of a 1/2 mile. During this time he was instructed to maintain a steady 1:1 breathing pattern and use the Ujjayi technique. A repeated analysis of the graphic HR rhythm showed his HR was at 130 now.3 Pretty impressive change with this traditional yogic method of breathing!
His doctor briefly explained that his adrenals had become overactive. They were producing excessive cortisol. The body can become fixated at these higher levels of cortisol production during an abnormal stress response. If he could train during his physical activity with this Ujjayi technique, he would be able to retrain his system. He would learn how to autoregulate his HR under physical stress. (Even emotional stressors that elevated his HR would be controlled subsequently). WOW! The following will describe an outline of his training regimen from the first month to his final Ayurvedic consult in the ninth month.
First and Second Month:
His normal bicycle route was elevating his HR too quickly with the hills. Therefore a 15 minute warmup period on the flats while doing Ujjayi was initiated. Then continue on his route with slightly less hills. This new route added 60 minutes/day to his previous time of commute. Therefore he had to arise 30 minutes earlier every day (4:30 am, whew!)
He had to try to maintain his HR always at 120 or less during the ride. A Polar HR monitor was used daily. The first week of doing this very strong and forceful Ujjayi made his throat very sore and raw feeling. There were lots of episodes of choking, coughing and breaks in the technique while continuing to pedal to work. Just try it yourself right now for those who have an idea of the technique — remember it is “vigorous”. Ok, once you stop coughing, please continue reading.
Also during this exertional effort of riding and restricted breathing style there were other strong symptoms. One feels as though they are deprived of oxygen. When you just don’t feel you are getting enough oxygen it can be fairly alarming. Oh, I’m suppose to relax also during this physical effort–oh, oh the ole HR is hitting above 120 again. Ok just try to do the Ujjayi, keep pedaling and stay here. Many times the thought of quitting crossed his mind this first week. Egads this sounds like tremendous focus and dedication at these challenging times.
The second week was a little better. He was getting used to the Ujjayi and the sore throat problem was subsiding. Still this tremendous fear of not be able to breathe was right there. Thoughts of quitting were never far from his mind.
By the third week he was able to perform the Ujjayi breath 100% of the time, except not in the hills. He was not in Nirvana to say the least. It was an effort still but doable.
Third and Fourth Month:
He now returned to his original mountain route. A five minute warmup on the flats were his only preparation. The Ujjayi was full and loud. He still had to maintain the HR of 120, but only on the flats. During the hills he was no longer restricted to maintain the 120 bpm. He was just to observe the HR response during the hill work. It was noted that he wasn’t hitting his previous peak of 180 bpm as quickly as before.
It was still a struggle to do 1:1 Ujjayi breathing in the hills. Occasionally he would have to slow the pace. Realize that his work load was so high and his breathing so restrictive that he noted symptoms of exertional intolerance. He referred to these symptoms as spinnies and stars. (equilibrium and visual disturbances). In this third month, the hill work frequently interrupted the Ujjayi breathing simply because of ventilatory insufficiency (lack of oxygen). He therefore had to reduce the speed of his ride. Therefore again he extended his commute time. (Oh boy, gotta love those early mornings).
It might be hard for us mere mortals to imagine this type of effort. Certainly the discipline of this level of training could be unknown to many of us. Remember that he is actually operating at a high level of athletic function. Even several high level athletes that tried this regimen, still ended up stopping before completion. His level of sankalpa (resolution) was demonstrated day after every day. Both his mind and his body were being strengthened.
By the beginning of the fourth month he was able to breathe with Ujjayi 100% of the time in the hills. Realize too that he was hiking and mountain climbing on weekends above 6250 feet, still using the Ujjayi breath. Again it was done with great difficulty and tremendous discipline. He had his ole familiar symptoms of spinnies and stars for company.
Fifth and Sixth Month:
During the fifth and sixth month he now consciously tried to not let his HR peak above 120. His focus now was to relax and do the Ujjayi breathing. During this time, he would internally focus on keeping the HR steady and eliminate the prior peaks.
His cycling pace had to be slowed down the first couple weeks of this training period. Again his focus was not to be thinking about the mechanics of pushing and pulling on the pedals, etc. His focus was breathing and internally making the HR steady without any accelerations of this internal rhythm. He kept relaxing and doing the Ujjayi breath. This feedback of his internal state was the regulator of his training work load. He became very connected internally to the sensations of what it felt like when his heart rate would elevate. He built up both conscious and subconscious feedback for the auto regulation of his pulse during high levels of exertion.
By the end of the 6th month he was able to maintain his HR below 120. There was much less effort needed to do the Ujjayi and maintain his HR at his prescribed target. Still there were times during the strenuous ride when his heart rate would peak above 140 bpm. At these times he was able to easily restore it to the proper training levels.
He was noting in general that over these past six months of training, he was feeling progressively less fatigued. Realize that during this time he was still quite busy in the organizational and administrative duties of his job and avocational pursuits. Remember he continued to pursue vigorous hill and mountain work/rescue activities while still practicing the above regimen.
Seventh and Eighth Month:
Now he was gradually reducing his use of the Ujjayi breathing. This means it was less vigorous and less loud. Within the 7th month, he introduced only doing the Ujjayi on exhalation, not on the inhalation phase. He still practiced on consciously maintaining his HR at or below his 120 bpm target during exertion. He stated that he was now finding it much easier to do this autoregulation of the HR without needing to use the Ujjayi breath.
At the end of his 8th month, he was able to completely stop the use of Ujjayi and still consciously and proficiently autoregulate his HR response. He was now using his original bicycle commuter route of 30 miles round trip.
He was now scheduled to have his final check in with his Ayurvedic doctor. During these previous months he had phone consults with this doctor. They were just progress checks. No real changes in his program were made at these times.
Now he and his doctor noticed several improvements. There were no longer any tender swollen glands. There had been a gradual reduction of these signs over the first 6 months. He could not say that he had any real increase in energy, as he was always energetic. The bicycle commute though was made with less exertion and effort now. He now had to reduce his caloric intake because he was much more calorically efficient. Fats and starchy carbohydrates were reduced at this time.
Also at this time he started using a single speed bicycle (geared at 42/18). Starting this single speed bike on the hills and mountain passes was tremendously difficult even now. He had not turned into Superman yet. You have no idea how difficult it is to pedal a single geared bike over mountain passes. Tears fill your eyes, not because of emotions but because of shear severe maximal efforts required here. He just felt that his prior rigorous training made it doable.
Now listen closely to this next sentence. He was able to still keep his HR at 120 even when initially adapting in the first couple of months to this new endeavor. This response is just a demonstration of an amazing adaptive capacity that is trainable.
He found that he could mentally regulate his heart rate under many conditions of physical and emotional stressors. Listening to his inner sense of his cardiac function became second nature. He was able to accurately sense and autoregulate it’s rate under biking, hiking, climbing, kayaking and skiing. As mentioned before, even under emotionally stressful situations, he could sense an elevation in his HR and again begin to autoregulate it, thereby modulating his emotional response in these situations.
It has been a year now after the intense training period. He still finds the effects of sensing and autoregulation to be an intimate part of the way he lives. Everything that he did has been done by others. Of course some who have attempted it have dropped out. As you can see it is a rigorous training regimen.
Realize what you want. Design a proper program. Engage in it and shape your mind with your determination. The body will follow. Realize that there are no short cuts. It is a lot of work if you wish to achieve something other than the ordinary. You can be extraordinary through such as is encouraged here. Now go and train.
1 See http://www.chopra.com/ujjayi. Ujjayi breathing is mentioned in Science of Breath. For more on Ujjayi breathing, read Path of Fire and Light, Vol. 1, by Swami Rama.
2 Science of Breath by Swami Rama, Dr. Rudolph Ballentine, Dr. Alan Hymes. Available at the online bookstore at The Meditation Center (http://www.themeditationcenter.org/jnana/index.php?) and at http://www.yogaineurope.eu/store/books/catalog/4/. It is also available through firstname.lastname@example.org .