Dr. Joe Tatta: Shelly Prosko, welcome to the Healing Pain Summit 2.0, it’s great to have you here this year.
Shelly Prosko: It’s great to be here. Thank you.
Dr. Joe Tatta: So I’m, I’m excited to talk to you. You are an internationally known physiotherapist or a physical therapist as well as you’ve incorporated yoga into your practice. And I know you teach something called Physio yoga, which is your own creation and your own kind of brainchild, which is so important in the pain space. So tell me about physio yoga.
Shelly Prosko: Well, it’s physio yoga is something that, um, that I came up with so probably just over a decade ago. And it’s really just combining my skills and training as a physical therapist, um, with my training as a medical yoga therapist. So basically, um, what I do for those, you know, viewers that maybe don’t know what physical therapy is. I think most people do, but maybe some don’t. Um, physiotherapy or physical therapy is basically a, it’s a pretty well respected, uh, rehab rehabilitation health profession that uses evidence-based methods to help, um, help our patients regain and restore movement and function and improve quality of life. We also help reduce pain, increase, um, uh, patient education, uh, and, and even with injury prevention and things like health promotion. So that’s sort of the physio rule. And then I integrate that and I combine that with yoga and that’s, you know, what is yoga is sort of a big, big topic. Um, but basically I use different, um, methods and teachings, philosophies of yoga, Mmm. Which is to help people to promote yoga. The word yoga actually means to unite or to yoke oneness of your body, your mind, your breath, your spirit. And it really helps to promote, um, overall health and wellness, physically, mentally, emotionally, energetically, socially. So that’s kind of a long answer, but basically the physio yoga is this combination of physical therapy and medical therapeutic yoga.
Dr. Joe Tatta: Great. It’s a wonderful introduction and thanks for mentioning physical therapy and physiotherapy because we have an international base here. We’re talking. So in the United States, physical therapists are obviously called physical therapists, but Shelly lives in Canada where they’re actually called physio therapists. A lot of places around the world call them physiotherapists, but it’s, it’s one profession and one base of knowledge. Um, so tell us how your approach is different than let’s say, traditional yoga or traditional physical therapy.
Shelly Prosko: Um, well, it’s different than physical therapy obviously because we’re using, um, yoga as this framework, um, to our approach to treating. And it, it really takes, um, a bio, psycho social, spiritual approach. And I mean, I’m really good physio. I mean, we’re supposed to do that anyways, but this, this approach just really gives you more tools, right? So we can use the meditation and the different breath practices and, and different yoga philosophy and, um, yoga poses and, and really integrate them into the physical therapy practice. So it’s, it’s different than what I would do when I was a regular physio. Um, it’s also different than regular physio because it really focuses on empowering the patient. So it’s really more of a, of a process versus a prescription. It’s not really a, a fix it approach. So what, what I used to do in the patient would come see me as a physio was I would, you know, definitely look at just at what can I do to them?
Shelly Prosko: No. Whereas now it’s more, there’s still some of that that’s the blend, but it’s, it’s much more what can they do to help themselves and, and their and use their, their own body. Um, and I’m the more the facilitator and the guide to help their own processes in the body self heal. Um, so that, that’s how it’s quite different from, from regular physical therapy, but it differs from yoga as well. Um, like I said, yoga is really oneness of body, mind, breath and spirit. But when you’re bringing in this evidence-based physical therapy approach, you’re bringing in the science and even the pain science education, which we know particularly with the pain population was really important. And research has shown that pain science education can help people, um, uh, reduce their pain and manage their pain better too. So the, this physio yoga approach, um, differs from yoga and that it really brings in the science part.
Shelly Prosko: Um, and then to, uh, you know, there, there is something called yoga therapy, which, um, the international association of yoga therapists defines it as. And I’ll just read it here. Um, the process of empowering individuals to progress toward, um, toward improved health and wellbeing through the application and teachings and practices of yoga. So physio yoga is a little bit different than this and that we’re really applying the methods to specific populations and diseases and dysfunction. So we’re, we’re, we’re taking our training as a licensed physical therapist and we’re able to diagnose and treat. Um, so it’s, it’s a little bit different. Um, and then yoga, yoga therapy in that sense.
Dr. Joe Tatta: So you’ve mentioned that you’ve, you bring in aspects of the pain science into physio yoga. What for, I mean, I had David Butler on earlier on the summit, so people will be listening to Dr. David Butler and great message and explain pain. But what does pain science mean for both clinicians and patients? We really should talk to both
Shelly Prosko: well, and you’re talking about the pain science education part, is that what you’re asking? Yeah. So you know, if the research is showing that the, when, when you understand and really know what it is and how it changes, um, how persistent pain changes your nervous systems and all layers of your, of your being. When you understand that, um, you can actually manage your pain better and reduce your pain better. And a lot of that, um, we believe comes from the decreased threat to the nervous system. So if you understand your pain more, then there’s a, there’s a higher chance that you will be less fearful of movement, um, and then, and then therefore there’s less threat to into that number system when you are moving. And so then the output of the brain, um, can definitely be, um, one where like I said, you can, you can move with more ease and then progress therefore function and quality of life. So yeah, pain science education is… Is definitely key part of a recovering your movement when you’re dealing with persistent pain.
Dr. Joe Tatta: Yeah. Very good. Just to learn a little bit about how your body works or actually I should say how your brain works and kind of relates to persistent pain is really, really important. And it should be a part of really every pain clinicians practice as well as everyone recovering from pain. But let’s get back to physio yoga. So why do you think this type of yoga, this type of physio yoga
Shelly Prosko: works so well for people in pain? That’s a really good question. Um, I don’t know exactly. Um, but what I do know is that it’s a combination of things. Um, so basically you’ve got, we’ve just talked about the pain science education. So that’s one component. So it brings that in, but that alone may not be enough. Um, we know that awareness practices can help reduce pain so that the research is telling us that. So breath, body awareness practices, awareness of your thoughts, your emotions. Um, we know that regulation, self-regulation practices, um, so awareness and regulation is a little different. So awareness practices alone can help reduce pain regulation, practices of your thoughts. Breath body can also reduce pain. Movement, we know can reduce pain. So movement in and of itself can be therapeutic and analgesic, right? Can different and chemical changes can happen in the body.
Shelly Prosko: So with, with yoga, with this, with this physio yoga combination, we’ve got all of these. So if one, if we know that one helps to reduce pain and if you can bring them all together, look at how powerful that can be. So I think it’s this, it’s this combination of a little bit of everything. And like I had said earlier that sometimes in the yoga world they’re missing that pain science education, education part. And then in, in our science and, and physiotherapy or healthcare world, sometimes we, we silo these things. So we have the cognitive behavioral therapy or we have all these different aspects, but not necessarily really come together and integrate them when the person is moving, you know, are they really using those cognitive, cognitive, behavioral, Mmm, um, aspects of their treatment that they’ve learned. So I think that’s, um, definitely one of the reasons.
Shelly Prosko: And I think another reason is just that it really helps to sell, uh, to empower the patient. And it gives the patient hope that they can do something right. They can, you know, they can actually take, they can participate in an active participant in their pain care management. So, you know, I think, I think that really is another reason why it’s so effective. And um, if I can I, there is a third one that I, a third reason why or why I thought that physio yoga made me so effective. And I think it’s because.
New Speaker: as a physio yoga therapist, I myself, I have to practice yoga. Yoga is a system of health, right? You’ll get is a life science. It’s not something that I give someone to do. It’s a way of being. So as a practitioner I have to also practice that. That’s part of it. And, and I think that helps me be a better therapist, helps to prevent practitioner burnout, compassion fatigue, and therefore I can strengthen that therapeutic relationship or that therapeutic Alliance. And again, science does tell us that that relationship is really important in the therapeutic outcome as well. So that’s, that’s another reason I think it’s important to mention.
Dr. Joe Tatta: So would you assess it for, is really interesting to me. And I’m sure there’s someone out there listening, they’re saying, well that may work if you have a little bit of back pain, but I have a big hernia disc in my neck, or you know, I have complex regional pain syndrome. I’ve had fibromyalgia, does this work for all types of pain or really only for certain people?
Shelly Prosko: Potentially this can work with everyone, anyone, um, as long as you can breathe and have the ability to be aware, um, you can these practices. Now with that said, there’s of course there’s many, many factors that that influence whether or not a specific treatment intervention works or a certain approach even worse. So, you know, you, you definitely have to be willing to be open to an approach, um, where you believe in, in, so the, the power of, of self-healing where you believe that you can do something about this. So it depends on the person’s expectations. Um, depends on your beliefs, your readiness to change. There’s different levels. We all have different levels of readiness to change. Um, and of course it depends on the type of guidance from your therapist and your relationship with them. Like I said. Um, and how dedicated you will be to the practice and your mind, body connection or awareness.
Shelly Prosko: Um, and even just your current lifestyle situation and the kind of support that you have around you might affect how well this, this approach works. Um, but all in all I would say the main thing is if you can, if you can breathe and if you’re willing to be open to a new approach and if you’re willing to understand that, um, that you do have the power to, to change your pain, your nervous system can change itself, which can change the pain. And I will just add one last thing is that if you, if you don’t believe that just from, from this, which I wouldn’t expect you to, um, two things. One is that’s where that pain science education comes in. So finding a practitioner who knows about pain science, pain, neuroscience education, because that’s a, that’s a process too. And so that can help you.
Shelly Prosko: Um, and then the second thing is if you don’t really believe that you can change your pain cause of yours is just so complex and, and you know, people have told you that there’s nothing they can do. Um, I just want to say that that’s, that would be a normal expectation, especially in our culture when, okay. Everything that we sort of do to help people in pain sends the message that you can’t do anything about it. Well, for example, you know, you, you may get some medication that message says you can’t do anything about it, but here this can or we can a manual therapy, even a, an adjustment or acupuncture, fill in the blank gives us the mess. It gives you the message suffering. If you’re suffering from persistent pain, it gives you that message that you, you can’t do anything about it. So, Mmm. I think you have to be open to the message that you can. And to be clear all of those other things I mentioned medications and other modalities are absolutely part of the plan as well. So self care and self management management is just a part of your overall plan,
Dr. Joe Tatta: right? So there are pieces of it you may need, let’s say some a drug for a very short period of time in the beginning, but ultimately kind of those, you know, active coping strategies, really a what you’re talking about, not the passive ones, the passive ones, they have their place and people don’t use them as much as therapists. However, there should be a time where you
Shelly Prosko: passive treatments and sort of more of the active. Yeah. And the passive treatments can be great if, if they help you move with more ease, right. That’s that purpose. So if, if that’s, if that’s helping you move with more ease and progressed that movement, um, cause that’s what typically you want more function, more quality of life, then they absolutely have their place. Yeah.
Dr. Joe Tatta: So you mentioned movement. So movement obviously is essential because we want to engage with our life and requires us to be mobile and active. Is there anything someone can do right now if they’re having a hard time or they’re just sitting here and watching this that might help to alleviate their stress, quite their nervous system help their pain.
Shelly Prosko: yeah, there’s, there’s something that we can do for sure is a awareness practices. So awareness of your body and your breath is the first step to change. Um, I can take you through a quick one if we have time. I don’t know if we have time or do you want me to just, okay. So let’s, um, everybody at home watching, if you like, you can close your eyes. You don’t have to, but I’m not going to be doing anything so you can close your eyes if you like. And I’m, I’m going to take you through, uh, a breath awareness practice.
Shelly Prosko: And so all you have to do is just become aware of your breath and notice it without trying to change it. Just noticed the rate, the pace of it. And notice if you’re breathing more through one side of the nostril or the other, notice the sound of the breath. If you can notice that the length of your inhale is different than the length of your exhale. Notice the temperature so as it enters the nostrils, is it a little cooler and dryer versus when it exits? Is it a little more warm and moist? That’s okay. If the mind wanders, just come back to the breath and then notice how the breath is moving in your body. Maybe you feel it in the neck or shoulders. Maybe you feel it more in the belly or the ribs. I’m just paying attention to these subtle movements of the body that the breath is making and then bring your awareness back to the nostrils and then try something for me for this last minute. Just pretend you’re inhaling through the right nostril
Shelly Prosko: and then exhaling through the left nostril.
Shelly Prosko: and then inhale back through that same left side
Shelly Prosko: and then exhale through the right nostril. You’re going back and forth. Alternate. Inhale, right nostril. Exhale, left nostril. Inhale, left nostril. Exhale, right? Try that for maybe three or four more rounds
Shelly Prosko: and then release that breath can bring your breath back to normal and open your eyes. So that’s an example of a breath awareness practice. And then I went into a little bit of a of a breath control practice, which is the calming of the nervous system. And to be clear that’s not this obviously magical thing to just take your pain away. But this is where it starts, is that awareness. And then we can, we have to be, we have to be a master at this and once we’re really good at this skill of being aware and maybe even calming the breath, then we can start applying that to when we need to. So when we’re trying to move. And so it’s just one of many different awareness practices. Um, how did you feel Joe?
Dr. Joe Tatta: I feel great cause you know, to be honest with you, it’s it, it’s a lot of work and it’s very intense to do interviews with, you know, 30 speakers who are experts in this space. So have to really be on my toes about their topic and know their topic as well as you know, all my topics. But, um, you know, it really brings, you know, back the message to me that taking a couple of minutes, and that probably was only three minutes lie and time it, but taking a couple of minutes just to, you know, get in touch with your breath and from your breath, everything begins to change. Your nervous system quiets, your respiration changes, your blood pressure changes, your focus and your intention changes. So all of those things are so important. So if you’re someone out there watching and you know your fear, you know you have a fear of movement, so many people do, you can just start this twice a day for two minutes, twice a day for five minutes, work your way up to 10 minutes. And then once you get some confidence, you check out, you know, Shelly’s work or maybe you go down to your local yoga place and, you know, take a beginner class or something like that. But, you know, it brings me to the point of classes in yoga. Why, what should someone look for if they’re going to go out into world of yoga and there’s many different, um, practices and studios, what should they really look for? What should they maybe stay away from?
Shelly Prosko: Um, well I would say if you’re some, if you’re, if you’re someone with chronic persistent pain, um, I would say just don’t, don’t necessarily just walk into a yoga studio and take a gentle yoga class, kind of do a little bit of research mix, look, see what the, the background of the teacher is. It’d be great if they had some, um, some pain care, yoga education. Um, so that, that would be the first thing is just see if, if there’s any education of the team that the teacher has surrounding surrounding pain. Um, but another thing you could do, what I would highly recommend is find a, and I, I’m biased to physical therapy, um, but find a physical therapist in your area and, and they can help you seek out a yoga teacher or therapist and then they can work together. So whether or not the yoga teacher therapist has training in the pain science, at least your physical therapist does. And then they can, they can work with, with that yoga teacher or therapist. Um, and so that, that’s what I would say is just, just start with looking, looking at the background. Mmm. The teacher and, and it gets your therapist to help you.
Dr. Joe Tatta: Perfect. Great, great advice. And obviously you’re an expert in this. You’ve developed your own, you know, system for, you know, this perfect mix of physical therapy, pain science and yoga, which I think is just brilliant because it just flows and integrate so well together. But if people want to learn more about you and how they can find you, where can they find you?
Shelly Prosko: The best place to find me is that my website. So it’s www.physio yoga.ca. That’s P H Y S I O yoga.ca. Um, and on there, the best thing is if you just go to my blog, you can see where you can sign up for my newsletter and I give lots of articles and videos, lots of free stuff. Um, and then also on my website, I have videos that you can purchase and there overcome pain with gentle yoga that I did with Neil Pearson. Um, he’s also a physical therapist and yoga therapist. Um, so my website is, is where for sure I would say go and then, Mmm. And then you’ll find on there all my little icons for the social media links. So I’m on Facebook, Instagram, Twitter. So whatever your thing is, you can, you can find me on there through my website.
Dr. Joe Tatta: Great. So please check out cellie Prasco she’s got some really great tools. Um, she does some great work with Miele who was on my summit last year, who did a great talk and I think Shelly’s, um, talk this year, really supports that, but probably takes it to another level, which is really incredible. So check her out. You also have an opportunity to help Shelly spread her message. So make sure you click the button below to share it out on Facebook or on Twitter so we can spread the message of hope and healing for not only this summit, but also for Shelley and her message. Make sure to stay connected to the next interview on the healing pain summit and we’ll see.
Shelly Prosko: Excellent. Joe, can I mention one more thing? I just wanted to mention Neil’s site because there’s some great resources on there for clinicians that are needing more information to help people in pain and also for people suffering from persistent pain. So that website is, life is now.ca so you can go onto there, there’s memberships and great stuff on there.
Dr. Joe Tatta: Excellent. So just for everyone’s knowledge, their life is now CA and physio yoga CA will be on the website, on the healing paints, on the website underneath Shelly’s bio. So click there and you’ll go right to them for instant and easy access.