—Bridgette Sparks, Maryland
Baxter Bell's reply
Bridgette, your dilemma is more and more common, both in the physical location of your pain and in your desire to promote healing while not sacrificing your hatha yoga practice. It's important to know that although yoga can be a means to heal physical injuries, it might also be the source of your pain, depending on the skill of the instruction you’ve received and your own attitude and approach to the poses.
In order to continue doing hatha yoga to promote healing rather than making things worse, I encourage you to consider a recent comment I heard while attending a workshop with teacher Shiva Rea. She stated that it's not what you practice, but how you practice. If you set an intention to practice ahimsa or nonharming (the first yama in Patanjali's eightfold path) during your asana practice, you will set the proper tone for your ensuing exploration.
One of the biggest struggles I observe in my yoga students who are dealing with injury limitations is the internal conflict that arises when I give them modifications of what the rest of the class is doing. I often notice a reluctance to do something different, especially what may seem like "less" than a full pose. But if we invoke samtosha (contentment), which is one of the five niyamas (observances), we can accept the way things are right now, in this present moment, instead of struggling with how we'd like our body to be feeling or functioning. This acceptance may help you find the most appropriate external form of the pose, which will enable you to heal your injury and continue to practice regularly.
More specifically, issues of wrist pain can be due to a variety of causes, from tightness of the muscles and tendons of the wrist, especially the flexor muscles of the forearm, to specific syndromes, such as carpal tunnel syndrome (please see my related column on CTS), to the presence of anatomical changes at the wrist, resulting from significant trauma or growth of ganglion cysts in the joint. I recommend going to a good sports medicine doctor to see if there's something serious going on that might require more than asana.
Finding an instructor who is well versed in the use of props to safely modify poses for you is very important at this stage of your practice. Foam wedges can help reduce the severe angle of extension of the wrist in poses such as Upward-Facing Dog, Handstand, and many of the arm balances. You can find them anywhere props are sold (and often in yoga studios). I'm very pleased by how many of my students report the disappearance of their pain with regular use of this prop.
There are also several variations of common poses that involve the wrists. For example, you can do Downward-Facing Dog with the forearms on the floor (often called Dolphin Pose). You can also try Ardha Adho Mukha Svanasana (Half Downward-Facing Dog or Right Angle Pose) at the wall, with the arms and torso parallel to the floor. This helps lessen the pressure of full body weight on the wrist joints. Upward-Facing Dog done on fists instead of open palms eliminates the extension of the wrist, which can often lead to wrist pain.
With some thoughtful investigation and exploration, you can not only continue your yoga practice but also promote healing. It would be great to hear back from you about what you discover.
Baxter Bell, M.D., teaches public, corporate, and specialty back-care yoga classes in Northern California, and lectures to health care professionals around the country. A graduate of Piedmont Yoga Studio's Advanced Studies Program, he integrates the therapeutic applications of yoga with Western medicine.