Should we practise yoga when we are injured? The answer of course is "it depends" (i.e. the nature and severity of the injury) but invariably the answer is usually a yes!
If you lead a physically active lifestyle that includes yoga, you will undoubtedly at some point find yourself either straining a muscle, or worse injuring yourself. Shit happens, but it doesn't mean you should stop moving. Yoga can always be modified to account for injuries such as a sore shoulder, pulled hamstring, a knee injury, neck strain, or a pulled muscle anywhere else in the body. The yoga student or practitioner needs to take ownership of their body and yoga practice, whether in a class situation or whilst practising alone. An injury usually happens in one area of the body, which leaves the rest of the body perfectly able to move and function normally. Waiting for an injured body part to heal might take several weeks or even months. To stop your regular yoga practise for several weeks or months will have consequences, mostly negative ones, in the sense that you will experience a loss of strength, a loss of mobility and a decrease in your flexibility. Personally I have practised in a knee brace, following knee surgery, and simply adapted my practise. That was my choice and I am not saying everyone should do this or similar, but getting on your yoga mat with an injury can help develop a deeper interoceptive awareness, offer an opportunity to practise a deeper level of self-care, and enable you to listen even more deeply to your body's signals, and your unique body language.
A good rule of thumb when carrying an injury or strain, is to move gently to the very edge of pain or discomfort but never push past that. Move in a pain-free range of motion. With back pain for example, the advise is generally to keep moving, echoing the adage that "movement is medicine". This keeps the blood flowing and may encourage healing. Working with an injury is also very positive to cultivate stronger mental fitness and a sense of feeling in control of one's body. It is rare that we don't feel good for moving, and in most cases, we feel uplifted. Do not use an injury as an excuse not to go to class, or get on your mat. Use it as an opportunity to be creative, adaptive and gentle with yourself. Injuries are there to teach us something. Dig deep and find out what message your body is trying to present to you.
The language of sensation... here are some questions to ask yourself during movement.
Is it pleasant or unpleasant?
Is it threatening or nurturing?
Is it safe or dangerous?
What does the research say?
While there's limited scientific research specifically on yoga and injuries, existing studies suggest that a modified yoga practice can be beneficial for individuals with injuries. Here are some key findings:
* Pain reduction: Yoga has been shown to reduce pain associated with various conditions, including back pain and arthritis.
* Improved flexibility and mobility: Gentle yoga poses can help maintain or improve flexibility and mobility in injured areas.
* Stress reduction: Yoga's stress-reducing benefits can aid in the healing process.
* Enhanced body awareness: Practicing yoga with an injury can increase interoceptive awareness, helping individuals listen to their bodies and avoid overexertion.
Adapting Yoga for Common Injuries
Here are some examples of how to modify yoga poses for common injuries, strains or sprains:
Wrist injury or wrist strain
Wrist pain or strain is common in yoga, caused more often than not by poor technique in weight bearing poses such as downward dog. or, coming to yoga with something like carpal tunnel syndrome, where yoga seems to make things worse! Spreading the palms wide in poses such as table top, plank and down dog is very important and spreading the weight or effort through the palms and fingers, and out of the wrists is key. In addition, begin with some regular mobilising and strengthening of the wrists to avoid strain in the first place. Make a fist and circle the wrists/hands 10 x one way and 10 the other way. To strengthen the muscles of the forearms that support the wrists, hold your arms and hands out in front of you. Spread your fingers and then curl your fingers into the palms. Speed this up and begin "flicking" the fingers (like you are flicking water off your hands), and continue until you feel fatigue in the forearms. Now stretch by interlacing your fingers, and flip your palms inside out. Press the palms forward and arms to straight, and press the knuckles forward. This is a great wrist stretch and strengthening exercise!
A person with mild wrist pain might be able to work on fists, which holds the wrists in a more stable position, or holding a block by wrapping the fingers around a block - or switching between different positions. Often a change of hand position is enough: using the finger pads, inner edges of the palms and more muscular engagement, rather than dumping into the wrists. If weight bearing is too much (remember to work in a pain-free range of motion), avoid weight-bearing poses on the wrists. For example, instead of downward-facing dog, try table top on forearms, or try down dog on forearms (dolphin pose). You could of course take a child's pose or stay in table top. When in plank, bring your knees down to take weight out of the wrists, or take forearm plank or plank on fists.
If a teacher offers a more challenging pose such as handstand, try Warrior 3 instead or move to a wall, and adopt the shape of a handstand, but upright, and learn to use the core to avoid a "banana back". You can practise plank at the wall too, and chaturanga.
Hip Injury
Avoid any pose that might aggravate the hip, but in particular, be cautious of deep hip openers such as single leg pigeon pose, and Warrior 1 or 2 if they cause pain. Try Crescent Lunge instead of Warrior 1. Use a block or blanket under the hip or knee in hip-opening seated poses, and be mindful of working within the limits of pain. Recline onto your back and try reclining pigeon pose or a simple knees to chest.
Knee Injury
In any pose that requires the knee to fully extend or a standing pose that bears the body's weight through the knee joint (e.g. pyramid pose, Warrior 3, Tree Pose) soften the knee joint and spread the force into the muscles and out of the joint. Never push past pain, and avoid any pose that causes a sharp or burning pain, or discomfort in our around the knee joint. Use a blanket under the knees in poses such as table top, and low lunge, and a cushion under the hips in child's pose to reduce knee flexion. To gently stretch the quads, lie on your belly and bend one knee. Reach your hand back to catch the foot and gently draw the heel to the buttock. Use a strap in necessary. This quad stretch can also be done standing. If a deep squat is out of the question, squat down to a degree that you comfortably can and use a chair in front of you if need be.
Low Back Pain
Avoid poses that exacerbate back pain or cause a sharp, hot pain. Avoid poses like deep backbends, deep forward folds (bend the knees as necessary), and be very cautious of seated twists if they cause pain. Focus on gentle poses such as Apanasana (knees to chest), rocking side to side, child's pose, gentle cat-cow movements, and bridge pose, resting the sacrum (low back) on a block if need be.
Remember, these are just general guidelines. It's essential to listen to your body and consult with a physio if an injury is not getting any better. If a pose causes you discomfort, ask your yoga teacher or other qualified, experienced yoga teacher for advice and for a modification or alternative pose.
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