Poses for Tendonitis in the Biceps

I've been dealing with recurring tendonitis in my biceps tendon for a year and a half. Are there specific asanas that will help, or asanas I should avoid?

By John Friend

--Maureen Bradley

John Friend's reply:

The good news is that your yoga practice can be very therapeutic for this condition if performed with good alignment. In general, the tendonitis will be aggravated by muscular actions that pull the top of the biceps muscle away from the humerus (the long bone of the upper part of the arm), and by any misalignment of the humerus.

The most common misalignments of the humerus include dropping the head of the humerus (top of the arm bone) down away from the neck so that the shoulders slope downward, excessively internally rotating the humerus (thumbs turning toward the sides of the body when the arms are down by your sides), and drawing the head of the humerus forward. Certainly, weight-bearing poses such as Chaturanga Dandasana (Four-Limbed Staff Pose) will be more difficult to perform with good alignment and therefore are considered riskier. So, it is important to choose poses in which you can consistently maintain good alignment.

Here are some key alignment principles to practice in all poses which will help relieve your biceps tendonitis:

1. Keep your shoulders square across so that they are not sloped downward. Keep the sides of your ribs lifted from waistline to armpits.
2. Move the head of the humerus straight back into the back plane of the body.
3. Externally rotate the humerus. Do this as much as you can without pushing the head of the arm bone forward.
4. Maintaining the alignment of the arm bone as described above, engage the biceps muscle so that it firmly hugs the humerus. In general, to keep the biceps muscle engaged to the bone, the energy of the biceps muscle should flow from the crease of the elbow to the front of the head of the arm bone.

Apply the above alignment principles in the following poses:

• All standing poses, especially Parsvakonasana (Side Angle Pose), Trikonasana (Extended Triangle Pose), and Virabhadrasana II (Warrior II Pose).
• All seated forward bends, especially Janu Sirsasana (Head-to-Knee Forward Bend) and Parsva Upavistha Konasana (forward bending over one leg in Upavistha Konasana).
• It is in the most basic poses like Tadasana (Mountain Pose) or Sukhasana (Easy Pose) where healing can take place.

You can perform poses like Adho Mukha Svanasana (Downward-Facing Dog) and Bhujangasana (Cobra Pose) in which the arms are weight-bearing if you can maintain good alignment. Chaturanga Dandasana is one of the most difficult poses to keep the head of arm bone in alignment. Every time the head of the arm bone goes forward and the biceps pulls forward, away from the bone, you will aggravate the injury. Therefore, it might be prudent to skip this pose until you heal.

This month's expert, John Friend, is the founder of Anusara Yoga, which combines the celebration of the heart, the art of inner body awareness, and the science of universal principles of alignment. For further help in learning these alignment principles, please consult an Anusara Yoga teacher in your area by visiting www.Anusara.com or calling (888) 398-9642.

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