In Parts 1 through 3, we talked about general principles for treating yoga injuries and got into a few specifics regarding several common problems. In this fourth and final installment, we'll explore the bigger issue of what injuries have to teach us and how—properly viewed—and skillfully addressed—they can be a vehicle into a much deeper practice.
Students with serious injuries may need to forgo classes for a while, particularly if they've been attending fast-paced sessions or ones in which everyone is expected to do the same thing. (Some seasoned teachers can work with injured students in a class setting, but this is more the exception than the rule.) With injuries, students need to learn to tune into sometimes-subtle indications that a particular pose is not good for them right now, and that's harder to do in the din of a busy class. Experienced students are generally better able to care for themselves in class when they are hurt, but it's still probably riskier than a careful home practice.
Skipping class may be difficult for students who are attached to their teachers, their usual practice, and the attendant social environment. But it's simply not appropriate for students to be doing yoga practices that may be exacerbating injuries, or delaying their healing. The Bhagavad Gita defines yoga as "skill in action." But there can also be yogic skill in inaction. Sometimes the best yoga you can do is no yoga—or at least not the yoga you've been doing. One of the great beauties of this discipline, though, is that there are so many tools in the toolbox that there are almost always other yogic practices you can do instead.
"But I Like Doing That Pose . . . "
It's important to remind your students that any injury that limits what they can do presents a perfect opportunity for self-study (the niyama, or spiritual observance, of svadhyaya. What led to the injury? Is there something that the student can change to prevent a recurrence? As mentioned in Part 1, most yoga injuries are caused by bad biomechanics or trying too hard (or both), and <a href="/health/ayurveda">Ayurvedic imbalances can also play a role. Dietary, herbal, bodywork, or other measures to correct imbalances of vata, pitta, and kapha can be useful adjuncts to yogic treatment—so it might be a good idea to refer your students to an experienced Ayurvedic healer, too.
For the injury to heal and to prevent future ones, getting at its root causes is essential. Often dysfunctional postural alignment and patterns of overwork are deep samskaras, or engrained habits. Even if your students can't change these grooves of thought and deed right away, bringing awareness to them is the first step. In cases in which tightness in the fascia is contributing to dysfunction—common in carpal tunnel syndrome, knee injuries, and shoulder pain, for example—bodywork, particularly kinds aimed at deep tissue, can be a useful adjunct to yoga therapy.
A Time for Reflection
A broader question you might raise with a student who resists modifying his or her practice in response to an injury is: Why are you practicing yoga? If it's to improve health or grow spiritually, then you might ask why they are so attached to doing something that's bad for them (even if it is yoga). An injury may thus allow your students to deepen their understanding of themselves and grapple with important questions they may not have thought much about.
Some students, of course, will resist your suggestions to refrain from some classes or poses, but at least you can plant the seed. Try to have compassion, and stop yourself from coming off as overly judgmental. Deeply engrained behavioral patterns are hard to change, and in many other areas of their lives, students may be rewarded for overworking and ignoring feedback from their bodies. Try to get these students, in particular, to use the breath as a gauge of whether they're going too far. When students are out of whack from an Ayurvedic perspective, things that are bad for them can feel right, contributing to an unwillingness to follow sensible advice. Slowly correcting these imbalances can lead to better decisions on their part.
A yoga injury can also be an opportunity to broaden your students' approach to yoga. If they can't do their usual asana practice, you may be able to get them to give Pranayama, chanting, or meditation a more serious try, since many of the same benefits—and some additional ones harder to get from asana—can come from these yogic tools. Remind your students that, in the long run, a regular pranayama or meditation practice will also make them better asana practitioners. An injury can provide an opportunity to encourage students who normally shun restorative poses in favor of pedal-to-the-metal asana to bring more balance to their practices.
Gratitude and Learning
Though it may take your students some time to realize it, an injury can also give them time to cultivate gratitude. That may be the opposite of what they feel like doing, but "cultivating the opposite," Pratipaksha Bhavanam, is precisely the remedy that Patanjali recommends for difficult times. Rather than dwell on what you're missing, think of all you have to be grateful for, including all the parts of your body that are working pretty well. And even though yoga resulted in an injury, it also provides many tools that can very likely help heal it. Consider, too, that by improving balance, flexibility, muscle strength, bodily awareness, and so on, a regular yoga practice is probably preventing many injuries off the mat as well as helping prevent more serious medical problems, from diabetes to heart attacks.
Going further, injuries can inspire practitioners to learn more about anatomy, bringing awareness to areas of the body, postural habits, and physical and emotional patterns (especially patterns of trying too hard) that your students may only be dimly aware of. For students who are themselves teachers or who aspire to teach, an injury can make them much more effective, as they learn about injuries and how to work with and around them. In retrospect, I'm grateful for the yoga injuries I've had because they've taught me so much.
Then there's the niyama of santosha, or contentment—that is, learning to be happy even when you don't have everything you think you want. It's a sure sign that your yoga practice is yielding benefits when your well-being doesn't drop so precipitously during life's inevitable challenging moments. After one of my former teachers underwent a total hip replacement, I spoke with her about the new limitations in her practice. Even though certain poses she loved were now off-limits, she smiled broadly and said, "I can do enough."
Dr. Timothy McCall is a board-certified specialist in internal medicine, Yoga Journal's Medical Editor, and the author of book Yoga as Medicine: The Yogic Prescription for Health and Healing (Bantam). He can be found on the Web at www.DrMcCall.com.