When Your Wrists Hurt

Baxter Bell explains Carpel Tunnel Syndrome, and how to approach your yoga practice when your wrists hurt.
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Baxter Bell explains Carpel Tunnel Syndrome, and how to approach your yoga practice when your wrists hurt.

Baxter Bell demonstrates Wrist Flossing.

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In almost every class at least one student mentions problems with wrist pain. Usually the pain is associated with some repetitive activity, and often they are sitting at a computer for a good portion of their workday. Sometimes there are other factors at play, such as driving a lot, or using tools at the construction site or in the garden. On rarer occasions, some trauma, like an unexpected fall, may have set off pain in the wrists and into the hands.

In many cases, it's related to the carpal tunnel, the small passageway at the palm side of the wrist that contains the median nerve and nine tendons that bend your fingers. When the tendons that form the tunnel get irritated and inflamed, like from overuse or injury, the nerve becomes compressed, and it leads to pain, numbness, tingling, and even loss of strength in the hand. Sometimes the pain travels from the hand up the forearm toward the elbow. This is called Carpal Tunnel Syndrome (CTS).

A study done in 1999 and reported in the Journal of the American Medical Association, looked at yoga as a treatment for CTS and found to be potentially beneficial. The poses taught focused on increased openness in the chest, neck, and shoulders, such as Urdhva Hastasana, or Upward Salute.

Over the years, I have worked with lots of students on creating modified yoga practices that work toward the same goals, as well as teaching students ways to modify the hands when they are called upon in yoga asana to bear weight. The standing poses are particularly helpful in improving range of motion at the shoulder and arms, improving overall posture and strengthening and moving the head and neck around. The Warrior poses are particularly helpful. Poses that require the bottom hand for support, such as Trikonasana, can use fingertips or fists on a block or the floor to keep the wrist in a more neutral alignment. During a period of acute pain, a student with CTS might need to avoid weight-bearing poses for a while, even the ubiquitous Downward Dog. But as symptoms improve, adding back a pose or two at a time that does challenge the wrists to be both strong and in full extension, like Plank Pose, could be a reasonable goal.

On rare occasions, a student will come to me with wrist pain that seems to have developed because of their yoga practice. Usually the student did not take time to progress slowly enough to let the wrists develop the strength and flexibility required of more advanced hand-weight-bearing poses, such as Handstand and Crow (or Crane) Pose. Or, they suddenly increased the frequency of classes that they attended that depended heavily on such poses, like the Ashtanga primary series. Advising these students to dial it back for a while, and addressing the wrists just like the students with CTS above, can help the wrists heal and allow for a smart return to their previous practice.

Last year Leslie Kaminoff developed a no hand-weight-bearing practice for Yoga Journal that is a good resource.  Also, in Yoga as Medicine, Timothy McCall writes about CTS with yours truly pictured doing the poses. That chapter is excerpted here. The wrist-release pictured, developed by Boston yoga teacher and chiropractor Tom Alden, is called wrist flossing. I have found it to helpful to teach it to my students who find themselves in front of that computer all day.

Is it time for you to take a break from your computer and do some yoga for your wrists?