Sprained, Strained, or Pained

Learn how to identify and heal your students' soft-tissue injuries.

By Julie Gudmestad

Support Healing

The degree of damage determines what level of care is required to support healing. If a muscle, ligament, or tendon is torn completely apart, that body part won't usually function: A person won't be able to raise the arm overhead with a torn rotator cuff muscle, or walk on a knee with a torn ligament. Surgery will be needed to pull the separated ends back together and attach them securely, and a lengthy rehabilitation period usually follows the surgery.

If the damage is mild or moderate, without a major or complete tear, the treatment plan isn't as clear-cut and requires more judgment on the part of professional caregivers, yoga teachers, and the body's owner. Here are a few guidelines for yoga teachers, so students can get all the benefits of coming to class without exacerbating an injury. These suggestions should be followed during the acute phase, when the injury is still painful and inflamed (red, swollen, and hot), which may last a few days with a mild condition or a few weeks or even months with a more serious injury.

• Avoid painful activities and positions. While the body is trying to repair and "stitch up" the torn tissues, pain indicates that the healing process is being disturbed and the new repairs are being torn up. At best, it will take even longer for the injury to heal; at worst, the tissues could be injured more severely.
• Avoid the position and activity that caused the injury. This will minimize disturbance of the healing process. For example, if the lower-back muscles were strained while bending over to pick up the lawn mower, forward bending in yoga could reinjure that area. If an ankle sprain occurred when the foot slipped off the outer edge of a clog, grounding the outer edge of the back foot in a standing pose such as Virabhadrasana II (Warrior Pose II) reproduces the position of injury.
• Know when to encourage immobilization. Mild muscle strains, including stiffness and soreness from overworking in a new activity, shouldn't be immobilized: Don't spend 48 hours lying on the couch with back muscle soreness after the first gardening day in spring. In fact, some gentle movement helps circulate the blood through the injured tissues, facilitating healing. However, with more serious injuries, such as a sprained ankle or knee ligaments that are swollen and painful, immobilizing the area with an Ace bandage or brace allows the body to go about stitching up the tissues without repeated disturbance.
• Gradually rebuild activities. Encourage your students to practice gentle movement and very gentle stretching of the injured area as the pain subsides. Depending on the severity of injury, it takes time to rebuild the strength and flexibility of the injured area. If your student returns to full activities after a week or more of rest-and-repair time, chances are good that the de-conditioned tissues will be re-injured.

What's the bottom line for your yoga students? Encourage them to listen to their bodies and make choices that will lead them toward health and wholeness, not repeated and chronic injuries. Don't urge them to push into or "work through" pain, especially in an injured area. And finally, teachers you need to know that stretching isn't a panacea for every musculoskeletal problem—sometimes stretching can make an injury worse. Sometimes a period of stillness, to allow the body's innate healing process to take over, is just what the doctor ordered.

Julie Gudmestad is a certified Iyengar Yoga teacher and licensed physical therapist who runs a combined yoga studio and physical therapy practice in Portland, Oregon. She enjoys integrating her Western medical knowledge with the healing powers of yoga to help make the wisdom of yoga accessible to all.

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