Negotiating Injury with Yoga
When yoga could cause harm and what to do.
Yoga Therapy: This is the first in an ongoing series on the therapeutic applications of yoga to appear in LA YOGA Ayurveda and Health magazine.
Adapting yoga practice to meet an individual’s needs is at the core of yoga therapy. In any situation, your yoga practice should ideally keep you physically healthy and strong, while supporting you emotionally. There are times when yoga can be an essential support, yet when we are under stress, we can be more vulnerable to becoming injured from the very practice meant to support us.
This can be particularly important if you are currently feeling fine, yet dealing with stress of difficult events in your life such as someone close to you who may be ill or dying. Support from a regular yoga practice can also be necessary even during positive events, which have their own sets of stresses, such as if you or someone close to you is having a baby.
When I do yoga therapy I draw from the principles of Viniyoga and from my medical background as a registered nurse. Viniyoga is not a style of yoga, rather it is an approach that utilizes yoga “tools” to address the needs of an individual. These tools include asana (posture), pranayama (breath techniques), sound, visualization and meditation.
When treating yourself through your own practice or working therapeutically with a student, there are a few concepts I find useful. These include observing yourself, your lifestyle and any changes that you are going through. Watch the world around you and see how you are affected by outside events. Keep your past history (even genetics) in mind as well as what may be coming up in the future. Your yoga practice can support you through your life changes if you stay aware and allow your practice to unfold. The more you practice awareness and the more you adapt your practice, the less chance you’ll have of being injured as a result of yoga.
At the end of each practice, it’s best to feel calm and centered instead of exhausted. Remember, any big change, even a positive one, is stressful so if you’re in a physically or emotionally stressful period of life, use your yoga practice to provide the strength and clarity necessary to attend to each challenge as it comes up. It may even be better to do two short 15-minute practices during this time rather than one long one. Your needs can help guide you to choose which asana (posture) are best to practice. It’s a matter of staying present enough to listen. Some days you may want to go deeply into a posture, other days moving to the halfway point in a pose with elbows and knees bent may feel best.
As children, we begin sitting on chairs for long hours in school, then we go home to sit and do homework or curl up on the couch and watch television. As adults, if we are engaged in a sedentary job, no matter how much yoga or other exercise we get each day, it can be difficult to offset the long hours of supported sitting (or slumping) that we become accustomed to each day. Through disuse, muscles, tendons and ligaments become “deprogrammed.” Without stimulation, some of the muscles that are intended to support us cease to do so. Other muscles which are not intended to work constantly can end up subject to overuse. This can cause muscle spasms in over-worked muscles and further weakness in dormant ones.
My view of yoga is that the practice should focus on strengthening and maintaining spine (and “core”) flexibility, with less emphasis on working the arms and legs. This type of practice will stimulate the deprogrammed muscles allowing others to relax and work only when needed to perform their intended action. When the skeletal muscles are working properly, the stress on joints, limbs and the spine is lessened. The lines of energy (nadis or meridians) that run throughout the body won’t be compressed and the organs (which are innervated by nerves that pass through skeletal muscle) will function more efficiently.
Proper use of the tools of yoga decreases the chances of becoming injured. T.K.V. Desikachar said, “The breath should be your teacher.” Stay connected to your body through your breath.
Breath is the guide to your own body; it can also be adapted to support you physically and emotionally. Each of the four parts of the breath (the inhalation, the hold after inhalation, the exhalation, the pause or hold after the exhalation) can be lengthened depending upon what you are hoping to achieve during the asana practice. For instance, gradually increasing the length of the exhalation will help calm and relax most people. Observe the precise effect in your own body. In all cases, the breath should be smooth and should not create tension in the body.
Meditation will assist the healing process by relaxing your mind and shifting awareness away from the problem area. When tissue is injured, the painful area becomes inflamed, weak and constricted. Deep relaxation will increase circulation to the painful area, which in turn increases the flow of nutrients and removes toxins.
How can you know when your yoga practice alone is not enough to “cure” your injury? If it has lasted more than a month or two, depending upon the severity of the pain, it is time to see a physician or qualified medical professional. Also, consult a physician or other qualified primary healthcare provider if you feel numbness or tingling, pain radiating from your neck or lower back down an arm or leg, or you feel that a limb is becoming weaker. An appropriate medical diagnosis can be an important piece of information to decide on your next course of action – including evaluating your practice.
When you have received permission to return to a yoga practice after an injury, the next phase of your healing begins. I have found it incredibly helpful to look at the injured area in an anatomy book. You will see where the involved muscles connect; that knowledge can help you protect the area in the future. When treating an injury, it can often be best not to perform asana that involve that area. Instead, focus on stretching and strengthening the parts of the body that surround it.
Breath is the guide to your own body; it can also be adapted to support you physically and emotionally.
Avoid joint pain; if something causes pain in your joints, change the position or modify your practice. If you have chronic pain, avoid making it worse during your asana practice. If you feel like coming out of a pose early or like skipping it altogether, do. If you feel great after a class but experience pain later on or the next day, you’ve done too much.
Once the injury has completely healed, especially if it has taken you away from your yoga practice for a long time, be careful when returning to classes. Students frequently return too soon to their favorite teacher or style of yoga. It is usually better to temper your practice for the first few weeks. If you are used to taking a level 2-3 class six days a week and have been away from it for awhile, try taking a level 1 class for a few weeks, then add a level 2 once or twice a week and continue this progression carefully and with awareness. You will be able to feel how your body has responded to the practice. When you move in too many different directions within the same practice too soon you can aggravate the injury. If this occurs it will be difficult to tell which of the variety of poses has actually caused the pain to flare up again.
Hatha yoga teaches us to breathe, to feel, to be aware of our body in different postures. As we become more intuitive, we feel that we know ourselves better – and to some extent we probably do. If we’re open to it and lucky we will begin to become more aware of how we feel even when we are not doing yoga. This awareness may lead us to evaluate our entire lives and we may decide to do something like eat differently, change our job or even shift the arrangement of our chair at our desk.
This awareness can help us to heal from injury, and ideally, to become more conscious of how we breathe and use our body to help us prevent injury in the first place. Through awareness, breath, meditation and practice, we learn one of the most important lessons of yoga – everything is interconnected and everything in our inner and outer world has an effect on us and can throw us out or bring us back into balance.
Leslie Bogart focuses on the therapeutic potential of yoga specializing in working with beginners and people recovering from illness and injury. She is trained as a registered nurse, has extensive experience in physical therapy and currently teaches at Santa Monica Yoga: santamonicayoga.com; leslieyog@earthlink.net
By Leslie Bogart
