I was diagnosed with Left Hemifacial Spasm in fall of 2002. Since the spring of the same year I’ve been working in my Yoga practice with a view to stopping the spasms. Although these are early days I believe Yoga may be able to provide some insight into this particular dysfunction.
Before I go further however I should say that this is the way I see things in my body. There is no substitute for a good Yoga teacher and in beginning this work my teacher could see in my body what I could not feel. There are many good teachers out there and many disciplines but I can only recommend what I have come to know. I have been taught in the "Iyengar method of Hatha Yoga" and I find it to be precise, scientific and sincere. Lastly, although I am focusing on specific problems that I have this is only in the context of a complete regular Yoga practice; I work on all the āsanas I am taught.
In brief, I am a 43-year-old male 6’1" and 220 lbs. I am healthy though at least a little stiff. In my life I have had only two major illnesses, I was born with Torticollis (Wryneck) and at approximately 20 years of age I suffered from Spontaneous Pneumo Thorax (Collapsed Lung). The first condition corrected with Physio during my first six weeks and the latter by surgical intervention (entry in my left armpit).
After a year of gradually worsening conditions and a confirmed HFS diagnosis. In the spring of this year (2003) my teacher started looking at my back in poses specifically she looked at my shoulder and muscles on either side of my spine. I followed her instructions trying to cultivate some little understanding in my own body.
To be concise I will attempt to describe some of the instructions I have found most relevant in one pose Adho Muka Svanāsana. I have included annotated pictures illustrating these points. These photographs are not intended as instruction, Yoga is experiential; words and pictures cannot convey the direct education the poses can deliver. And pictures of my poses can convey even less! Props (wooden blocks, belts etc.) are used here in this method to give access and insight into the poses even if one cannot do the full pose. I will move from here to these same points in a few other poses.
While in Adho Muka Svanāsana my teacher looked at my back in detail. She said things like “ this shoulder blade moves in easily, this one sticks out”. This shoulder blade moves away from the spine this one crowds in”.
The simplified objective here is that the shoulder blades should move down the back away from the crest of the shoulders and spread across the back away from the midline. The shoulder blades should also move into the back (towards the anterior) to lift the back ribs and thereby lift the chest, lift the heart. In this way a backbend is found in the thoracic spine. This has been explained to me by a number of instructions, a few of which are seen below in the photographs.
Adho Muka Svanāsana
Adho Muka Svanāsana (front view)
I have found this work on my left shoulder difficult, what my right shoulder knows instinctively my left shoulder has somehow forgotten. The equal application of these instructions to both sides will often cause my left shoulder to shake. I am learning to stay in these poses despite the discomfort, shaking and lack of resolve. Though I found great resistance to the actions she described I am also starting to see some results.
In early June of 2003 the spasms were getting pretty bad. I decided that if things did not get better I would give Botox (an HFS therapy) a try in order to control the spasms. A few days later I was doing Urdva Danurāsana (see photo) at home when I noticed tightness on the left side of my thoracic spine. The only words that convey the sensation are” blue” and “smoky”. As absurd as it seems using a visual description of something I could not see none the less the left side of my thoracic spine appeared to me “blue”. I asked my wife to look at my back in Adho Muka Svanāsana (above). I asked her to look along my spine for the area that did not go” in”. Meaning the area where there was no groove above my spine. She pointed to the exact place that I had felt in Urdva Danurāsana.
I told my teacher about all of this and she looked at this in class and began to work on these specific issues. Later that month we did a series of classes and worked towards a difficult pose for me Pīncha Mayūrāsana the actions in the shoulders are much the same as Adho Muka Śvānāsana. When we got to the pose after several classes of preparation and considerable assistance. I was able to actually work in the pose for the first time. That afternoon I had about three hours with no spasms or twitches!
With this encouragement I have worked towards this pose and in all poses have added emphasis on my shoulder blades. In early July I found a good Urdva Hastāsana would stop the spasms most times. Although this is no longer the case there is always some physical or mental adjustment that I can make to stop the twitching
In early September I began to feel some tingling at the base of my neck at the bottom of my cervical spine. This sensation comes and goes and will on occasion move from the spine outwards towards my left shoulder and down my back an into the space between my spine and shoulder blade. Since the time that the tingling started the frequency and intensity of the spasms has diminished further. The spasm and tingling seem unrelated, very rarely will the two occur simultaneously. I mention it here as a significant marker for me in the progress of HFS and because I have noted similar feelings in other parts of my body that I am sure are due to the effects of Yoga.
When I first experienced HFS it was in Yoga class during Savāsana, a restorative supine pose done at the end of class. While relaxing in this pose the twitching started, oh so slightly at first. HFS has at times dominated my classes making it difficult to continue.
I have been forced to learn how to calm the spasms with my breath, concentration and relaxation in order to stay in the poses. These methods have moved out of the classroom and aid me in the rest of my life. Yoga class is currently one of the times I experience the smallest number of twitches. The attention to detail and necessary concentration seem to keep things at bay. Still the spasms may be bad immediately after a class or some hours later.
Some of the poses, which currently have more potential to start spasms, are Parivrtta Trikoāsana to the left, Parivrtta Pārśvakonāsana to the left, Vīrabhadrāsana I, Prasārita Pādottānāsana (1st stage). In short poses that compress, or that I allow to compress, the left side of my neck and upper thoracic spine. However there is no clear indication that this compression is immediately responsible for the onset of spasms. As typical the spasms are more likely to start when I am tired at the end of the day.
I have tried to give some impression of my practice here but there are so many details in one pose and absolute attention to detail is one of the hallmarks of Mr. Iyengar’s method of Yoga. I fear that I may give the wrong idea of this work, so please if you wish to know more find a good teacher and try some Yoga. I have tried to report only my experiences and not to speculate about the causes or make any promises.
In brief my Yoga practice and HFS has become: Look for the problems, listen to what my body is saying, work with sincerity and be grateful for what comes.
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Iyengar Yoga Home page
Canadian Iyengar Yoga Teachers Association