Working with Students Who Have Yoga Injuries, Part 3
In Part 2, we discussed some ideas for treating injured knees and backs, two common yoga injuries. We'll continue in this installment, first by examining wrist pain. We'll also discuss hamstring tears and shoulder injuries, two injuries that can lead to chronic problems.
Wrist problems tend to come on slowly, unlike many knee, back, and other yoga injuries. Your students may complain of a vague ache, and eventually sharper pain, as well as numbness and tingling in their hands, wrists, and/or forearms. The poses most likely to bring on symptoms include Adho Mukha Vrksasana (Handstand), Chaturanga Dandasana (Four-Limbed Staff Pose), and Urdhva Dhanurasana (Upward Bow Pose), all of which involve weight-bearing with the wrist cocked back. In this position, many students flatten the carpal tunnel, the bony canal in the wrist through which several tendons and the median nerve pass. Compression of the median nerve is the principal cause of carpal tunnel syndrome (CTS). Students with small wrists, women (who tend to have smaller wrists than men), and those who are overweight or have diabetes or thyroid disease are at greater risk for CTS.
If you watch a student with wrist pain do Adho Mukha Svanasana (Downward-Facing Dog Pose), you may notice that most of the weight in the hands is falling on the base of the palm near the wrists—in other words, right on the carpal tunnel. You want to teach them to place more weight on the knuckles and less on the base of the palm. This action is facilitated by engaging the muscles on the undersides of the forearms to lift the proximal wrist bones up toward the elbows. Students can practice this action on all fours, then see if they can maintain it when they push up to Down Dog.
For students who have a hard time learning this action, try placing a rolled-up mat or a slant board (thin edge toward the fingers) under the wrist as they do the pose. Once they've got the feel, see if they can reproduce it in the full pose. If, even with this correction, your students still have discomfort in Dog Pose, try having them work to bring the upper inner thighs up and back, which takes weight off the wrist. Bending the knees also lightens the burden on the wrist. If even that proves too much, try Half Dog Pose with the hands at the wall or on a counter top. Learning to place more weight on the knuckles and lift out of the wrist will help make all the other bent-wrist poses, such as Handstand, easier—though if the tendons in the wrist have gotten inflamed, it may be a while till your student is ready to tackle that pose again.