Yogis, it’s time to get honest with yourselves and start respecting your body's limitations. We’ve all heard success stories of people who have healed their body, mind, and emotions through yoga. But lately, I’ve been hearing about more and more students and teachers (including myself) who’ve been hurt by their asana practice.
Why is everyone talking about yoga injuries all of a sudden? For one thing, there are more people practicing yoga now and so likely more injuries. But getting injured by yoga, which most of us start doing for its healing benefits, can also be confusing, embarrassing, and counterintuitive. All of that can make it hard to talk about.
My Yoga Injury Story
I started practicing yoga during a time when I was dealing with chronic health problems and a lot of stress. I was originally attracted to it, because it reminded me of the moving meditative quality I used to find in dance. But unlike dance, where I was taught to push past pain and difficulty with a smile on my face, yoga, ironically, encouraged me to respect my body and its limits.
While I thought I was working within my limitations, years into my yoga practice, I made the decision to stop lifting leg weights in order to increase my flexibility to get into Visvamitrasana, which would eventually be photographed for this Master Class article in Yoga Journal. I was happy when my consistent practice “paid off” and I was able to work into “advanced” poses that required a lot of flexibility and arm strength. What I didn’t know was that 14 years of dance, followed by 16 years of yoga, plus 7 years of not counteracting all the stretching with strength training, had led to overuse of my hip joints and strain on my tendons and muscle fibers.
A couple of years ago, my body started telling me it was exhausted and didn’t want to do long practices or extreme poses. Did I listen? No. I had big plans, work to do, classes to film, and bills to pay. One day, while demonstrating Compass Pose, I pulled my left knee into my armpit and immediately felt a deep pain in my left groin. My initial reaction was frustration with my body for not keeping up with me. I pushed past the pain and continued doing everything I’d been doing. A week later, while teaching I demonstrated Side Plank with my top (injured) leg in Tree Pose and heard a “pop.” That was the straw that broke the camel’s back. I was in so much pain that I could barely sleep or walk for 5 months. During that time, to teach I either sat in a chair or hobbled around in pain.
Today, 19 months later, after three x-rays, two MRIs, six doctors, six physical therapists, two acupuncturists, and multiple injections, I’m still walking on eggshells. It’s painful to stretch, strengthen, and externally rotate my left leg or pull my left thigh toward my chest. I've slowly progressed from 14 to 43 simple yoga poses, but basics like Happy Baby, Child’s Pose, Crescent Lunge, Warrior II, Triangle, or a simple cross-legged position are difficult for me. After a year of being misdiagnosed, I found out I had labrum tears, a strained psoas, multiple hamstring and gluteal tears, tendonitis, and tendonosis. According to my orthopedic doctor, the labrum tears were caused by repetitive deep hip flexion—the head of the femur bone hitting the hip socket. (Think poses like Visvamitrasana, Tittibhasana, deep forward bends, and even Child's Pose.) Unfortunately, my labrum and gluteal tears might have to be fixed surgically, which will also come with a bonus package of 5–12 months of rehab.
I haven’t talked much about my injury, not so much out of embarrassment or secrecy, but because I made a decision a couple of months into the healing process to focus on the positive and what I could do, rather than what I couldn't. I find talking about the injury, and focusing on the physical and emotional pain it's caused, is a depressing road that leads nowhere.
Unfortunately, I’m not the only yogi dealing with serious injury.
It didn't take long to reach out to a handful of other highly skilled teachers in San Francisco (where I live), Los Angeles, and beyond, who have been injured by yoga. Like myself, Jill Miller and Melanie Salvatore August have suffered from major hip injuries due, in our opinion, to overuse. Jill recently had a hip replacement. Erika Trice healed a back injury using yoga, but ironically feels too much asana created repetitive stress injuries in her shoulders and lower vertebrae. Sarah Ezrin recently had shoulder surgery for an injury that she also believes too many Chaturangas and binds contributed to. Similarly, Kathryn Budig assumes years of repetitive movement, vinyasas, and emotional stress led to the shoulder labrum tear she just recovered from. Jason Bowman had surgery for a knee injury that he attributes partially to the regular practice of poses requiring external rotation paired with deep knee flexion like Lotus Pose. Meagan McCrary thinks it was 10 years of hyperextension and nerve entrapment around her joints in practice that short-circuited her nervous system and caused her severe chronic pain. I also know many teachers who have had to reduce the intensity of their practice or focus more on strength training due to non-yoga-related injuries.
In the classroom, I see shoulder injuries most often. They tend to happen to ambitious newer students who skip learning the basics and push hard the first 6–18 months trying to “advance” their practice. Normally I find students experience shoulder pain when they practice too often, do too many Chaturangas (incorrectly), or try to get into arm balances when their alignment is off. Luckily, most students are grateful for any tips and corrections when it comes to injury prevention while other students don’t think the adjustments or warnings are for them until it’s too late.
What do you do after a yoga injury?
On a brighter note, if you are injured, your life is not over by any means. I have actually “accomplished” more since I’ve been injured by thinking outside the box and stepping beyond the lines of the path I had created. I discovered that I love writing articles and blogs, mentoring teachers, experimenting with yoga props, swimming, and having a simple, yet satisfying yoga practice. I still take yoga photos (some of which have been published in Yoga Journal Italy and Singapore). And I’m currently creating a co-led teacher training with Jason Crandell. My injury has given me an opportunity to step back and create a different life for myself.
That being said, I would do anything to go back in time, to have listened to my body, and to not have pushed so hard in my practice. I wish I would have avoided ending up in my current limited state, having to constantly monitor and be cautious with my body. I wish I didn't experience pain in my left hip, lower back, and hamstrings on a daily basis. It would also be amazing not to worry about how I’m going to get well or my healing timeline. I’ve accepted the fact that I will no longer do crazy yoga poses, but I would love to one day do simple poses such as Triangle on my left side or move through a vinyasa without pain or fear of reinjuring my body.
These stories are not to scare you, but to encourage you to be careful, listen to your body, and not to push past your God-given limitations! You can have a healthy practice that is extremely beneficial to your body if you can get real with yourself about it. The following questions are a good place to start.
10 Questions to Ask Yourself About Your Yoga Practice
1. Does your practice balance the rest of your life?
If you are already performing high-intensity activities such as running, swimming, cycling, etc., I recommend choosing an asana practice that is less intense in nature, such as Iyengar or restorative practice. That way you can reap the benefits of yoga and avoid overusing your joints, tendons, and muscles. On the flipside, if you lead a sedentary life, then a vinyasa practice might bring your body into balance.
2. Do you practice too much?
As practitioners get serious about asana, some feel the need to do an intense 90-plus-minute practice, 5–7 days a week. Many yogis try to keep up with this “expectation” because they believe it's what a “true yogi” would do. Unfortunately, for many of us, too intense of a practice too often can also lead to overuse of joints and unnecessary repetitive stress on tendons and muscle fibers. I personally don’t recommend doing long, high-intensity yoga practices more than 3–4 days a week.
3. What motivates you to practice?
Your teacher? Your ego? Social media? Your body? Some of us want to “master” complex asana to win favor and praise from our teachers, fellow practitioners, or social media followers.
This need for approval and recognition can be exacerbated when teachers encourage students to push deeper into poses, or praise students who have the ability to get into difficult asana, rather than applauding students with mastery of alignment and stability. If you always want to go deeper or make a pose “more advanced,” where is that coming from and why?
4. Does what you’re doing hurt?
If it hurts, don’t do it. Period. Regardless of whether your teacher is pushing you to go further, or you see other people going deeper.
We come from culture of “no pain, no gain” and pushing past our limits. Hard work, sacrifice, and going the extra mile get us good grades, promotions, and wins in sports. While this mindset can lead to advancement, it can also lead to imbalance. Your internal drive may be high, but your anatomical structure can only take so much. Too much pushing can lead to impingement, strain, and tears in the joints, tendons, and muscles. Honor your body’s limitations.
If you have existing injuries, tell your teacher. Your teacher should be able to show you how to modify poses, which poses to avoid, and maybe even guide you toward poses to heal what ails you. You might also need to back off your intensity with the practice to avoid making the injury worse.
5. Are you protecting your shoulders?
In Chaturanga, do your shoulders dip below the level of your elbows? Do you jump back every time you vinyasa? Do you land in Chaturanga or Plank? I recommend limiting jumpbacks and landing in Chaturanga when you do. For most of your vinyasas, I recommend lowering your knees to your mat or skipping Chaturanga all together to prevent repetitive stress injuries, such as labrum tears and rotator cuff issues. If you have a pre-existing shoulder issue, avoid Chaturanga and arm balances.
6. Are you protecting your hips?
Are you listening to your body? In poses where you externally rotate your legs and/or go into deep hip flexion (like Compass Pose, Tittibhasana, Visvamitrasana, Krounchasana), observe how far your body naturally wants to go without pushing further. Also consider balancing out hip flexibility with abduction, adduction, and gluteal strength training.
7. Are you protecting your knees?
A few pointers: In standing poses, don't let your bent knee go past your ankle. In standing poses that require external rotation like Warrior II, rotate the front leg from the hip socket rather than the front foot. Be sure your body is well warmed up for poses that require deep external rotation with knee flexion like Full Lotus Pose before attempting them. If you already have issues with your knees, avoid Pigeon Pose and practice Thread the Needle on your back instead.
8. Are you protecting your lower back?
Do you warm up before going into deep twists? Recently, many senior teachers and physical therapists alike have begun recommending not squaring your hips in twists, especially if you’re hypermobile, to protect the lower back and SI joints. If you already have lower back issues or have tight hip and hamstrings, be careful with forward bends, particularly seated forward bends. In seated forward bends elevate yourself on a block or folded blanket to avoid rounding your lower back.
9. Are you working on mastering alignment and increasing stability?
I view an advanced student as one who knows how to align their body and use appropriate props when needed. Better alignment will also help you avoid injuries.
10. Can you be happy with where you are?
Be in the present moment; focus on what you can do now, not what you used to do, or what you think you should be doing a month from now. Your practice will change over the years. Don’t get too attached to the current season. This doesn’t mean you can’t have goals, but be realistic and see where your goals are coming from, and if it honors your body.
Shift your goals from intensity, strength, flexibility, and complex asana to digging below the physical. Our yoga culture has drifted away from the purpose of asana. The practice was originally intended to prepare the mind and body for meditation, not a career as a contortionist.