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How Yoga Helps Children With Chronic Pain

Butterflies in the stomach before a test, the pounding of the heart before asking someone on a date or the worry due to a sick pet.

These are common problems in the lives of a child.

But thanks to cyberbullying, the pressure to make it into college and a desperate need to fit in, anxiety has reached near epidemic proportions.

More than 40 million Americans suffer from Anxiety. According to the annual national survey by the American College Health Association, one in six college students has been treated for or diagnosed with anxiety in the past year.

For many of the kids at Cook Children’s, chronic pain only adds to that sense of stress and anxiety.

“Chronic pain affects every relationship in a child’s life. There’s a lot of bullying that can take place. They lose a lot. They lose their ability to play soccer or stay on the football team or they find themselves not being able to go to school regularly and some of our kids can’t go to school at all due to pain,” said Barbara Deleon, Pain Management Services coordinator at Cook Children’s. “So then they lose some of their friends. They lose those relationships that are important to children.”

To help the children who suffer from chronic pain, Pain Management Services uses many different types of therapies to help their patients including acupuncture, acupressure, aroma therapy, massage therapy and different types of physical therapies.

But yoga has always been at the top of the list to add to their pain management tools.

Two years ago, the Pain Management team wrote a proposal to bring a yoga program to Cook Children’s and they received the funding this year. Then the search was on for the right person to lead and teach yoga to the variety of patients dealing with pain and anxiety at Cook Children’s.

Tatiana Miller was that person. Miller brings with her a ton of expertise with hundreds of hours of yoga instruction, as well as a cognitive behavioral therapy practitioner, a stress management life coach and a health counselor.

She is also a wife and mother of two who lives in Fort Worth. Immediately, she knew this job at Cook Children’s was the one for her.

“When they called me in to meet with the Pain Management department I thought, ‘Oh my gosh this is divine. This is more than meant to be. All the knowledge I’ve gained, all the experience I have was for this moment. It was for this department. We’re taking these children and giving them these tools that they had not been given before. These kids are missing school because of their pain. They aren’t able to catch up on reading or math, but they also can’t catch up with just wanting to have a good life. To get their life back. If you don’t have the tools to cope with this pain, you can’t catch up to feeling depressed or angry or frustrated. Anxiety is paralyzing and these kids that once had normal lives aren’t able to do life anymore because of their pain and the anxiety that comes with it.”

The yoga instruction at Cook Children’s provides tools to make it easier for patients to cope with the challenges they may face, including:

  • Anxiety
  • Post-traumatic stress disorder
  • Chronic headaches
  • Sleep disorders
  • Pain
  • Grief
  • Depression

The yoga is designed to accommodate all ages and fitness levels, based on 5 principles:

  • Stillness – learn to quiet the mind and body, become self-aware and develop sensitivity, self-control and self-regulation.
  • Listening – tune in to what your heart, mind and body have to say.
  • Grounding – discover how to be physically present in your body and develop a sense of competence, physical safety and security.
  • Strength – develop physical, mental and emotional strength.
  • Community – enjoy a fun-loving environment where you can explore yoga through the use of movement, breathing and games.

Miller takes the principles with her to help her patients, but these are kids and no two sessions are the same.

“Part of the yoga therapy approach is meeting patients where they are at,” she said. “So I can’t show up with a plan because I might have a teenager and a toddler in a class or all teenagers for all toddlers. The kids may be very active or very tired. So my approach is to show up and to read them. That’s where I start off. I talk to them to make them feel safe. I try to connect to each participant in a way they can relate.”

For all of her training and expertise, Miller said any progress begins with one simple truth: “They have to like me. Because if they don’t, they aren’t going to participate and they aren’t going to listen to what I have to say.”

Miller walks into a room and scans for body language, where the kids are located in the room and their social cues such as are they looking her in the eye.

From there, she begins to reach into her bag of tricks to hook their attention. She may bring out a focus ball to help the kids with their breathing. She teaches them what breathing should feel like and how to slow down their breath.

“If I can get them to slow down their breathing, their nervous system says things are good. We can calm down,” Miller said. “The first goal is to get them in a happy place in their nervous system.”

From there, depending on age and the physical makeup of the class, students may do as many as 15 yoga poses.


Yoga Is For Everyone



But Miller works on more than just the physical during yoga. She works on their self-esteem. She talks to them about feeling empowered and feeling like a leader.

“The true understanding of yoga is the ability to be still and listen. That’s it. Yoga is not body postures. Yoga is not meditation. Yoga is not breathing. Yoga is the ability to be still and listen and not let external circumstances affect your internal state,” Miller said. “A crisis is any time your internal tools can’t keep up with the external demand. That’s why most teenagers live in crisis, which is anxiety, because they don’t have the internal tools to meet the external demands.

“If you teach them to be in the world but have the capacity to come back into themselves and say, ‘Is this real or is it in my head? My thoughts? My emotions? Can I do this? Is this right for me? That relationship within themselves … That’s the stillness and the listening.”

Miller is just beginning the program, but it is catching on throughout the medical center. She has taught children in Pain Management, Rehabilitation, Psychiatry and more is planned, including going to individual rooms for yoga therapy.

Yoga is a way to help the patients at Cook Children’s feel better about themselves. It’s one way to help kids who have lost control either physically or emotional to gain some control back.

“Pain is very physical and yoga can be physical,” Deleon said. “With pain, there is a mind, body connection and in yoga there is a mind, body connection. So the relationship between yoga and helping with their pain is very beneficial to our patients.”

New Yoga Therapy Program at Cook Children's Center for Pain Management

Thanks to the innovative, multidisciplinary approach to pain treatment found at Cook Children’s Center for Pain Management, patients and their families can enjoy the benefits of yoga therapy. Yoga is the process of empowering individuals in the effective use of stress-reduction techniques to minimize pain and anxiety. Patients and parents become informed on how to effectively use yoga approaches, mindfulness and biofeedback techniques, as well as social/emotional cognitive behavioral strategies that promote the development of healthy, lifelong physical, mental and emotional habits. Click to learn more.


Comments 1 - 1 (1)
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Bill Irwin
thanks for your Grand Rounds presentation as well.
Our son has benefitted from yoga and we will see if we can engage the Sat class