How to Avoid the Most Common Yoga Injuries

Tue, 11 Oct. 2011 - 2:45 a.m. MT
Credit: ARA Staff - American Running Association

Though the essence of the 5,000-year-old yoga tradition lies in tranquility, mindfulness, and transcendence, yoga’s increased popularity in recent years has led to a multitude of variations of the practice. These include more aggressive forms of yoga like Bikram, Iyengar, Vinyasa, and fusion yoga, which sometimes combines yoga and Pilates, or may work a specific area of the body such as in the Yoga Booty Burnout classes available in many health clubs. In part due to its transformation into a fitness activity, and in part due to the sheer number of new students, yoga injuries are more common than ever.


Shoulder girdle/rotator cuff injury. Many yoga injuries are caused by overstretching. The biomechanical stresses associated with getting a good workout are a far cry from the original purpose of traditional hatha yoga: to prepare the mind for meditation. Among the more common acute injuries these days are shoulder girdle/rotator cuff injuries. These can occur during plank and crocodile poses, during which knees are off the floor such that the lower half of your body is without support. If you feel shoulder strain during these positions, drop your knees to the floor and bring your hands together. 


Lower back strains. Forward bends and twists can cause back problems, particularly if you are not experienced in maintaining correct form. It’s best to bend the knees for all forward flexion, which will also reduce strain on the hamstrings. 


Damaged knee joints. Never force your knees into a lotus or other vulnerable positions. Hip flexibility must be obtained first; without adequate training you may tear a meniscus or one of the knee ligaments. To protect knees, do gentle hip-opening poses like the pigeon pose or baddha konasana. This poses is the familiar one in which you sit with the soles of your feet together and knees out to the sides. 


Wrist injury. Many yoga injuries are chronic, resulting from microscopic trauma occurring over time through repetitive stress to the same joints, often in tandem with poor technique. Tendonitis in the wrists can be common in inexperienced practitioners of Vinyasa yoga. If you are experimenting with this type of yoga during your workouts, take care to perform salutation movements correctly, such as the down and up dog poses. 


Pelvis and gluteal inflammation. Soft-tissue inflammation can occur in the buttocks when the pelvic joints become destabilized by too much seated practice. 


Neck injury. Poses that do not support your head can be dangerous. Among these are the plow, shoulder stand, and headstand. Note that a yoga instructor may show you how to perform these poses correctly, but if you try it with tight neck or shoulder muscles, you may injure yourself. For this reason it is best to practice yoga in small classes where a teacher can become familiar with your experience level, flexibility level, and even pre-existing medical conditions. People with hypertension, for example, are not advised to perform these inversion poses. 


To find and vet a particular instructor or studio, visit Yoga Alliance is a voluntary registry of teachers and schools. To be registered in the database, instructors must demonstrate that they have met Yoga Alliance standards for 200 to 500 hours of training. 


ACE Fitness Matters, 2007, Vol. 13, No. 6, pp. 12-13


Start Now with Simple Steps to Stave off Running Pain


Many aches and pains runners endure are due to strength and flexibility imbalances or weaknesses, and these are the first areas of careful examination by any physical therapist wishing to identify an underlying problem. At the same time, preemptive steps to correct such hotbeds for injury can be taken by anyone with the time and inclination to stay out of the doctor’s office and on the road, track, or trail. The following exercises will help you target common culprit muscles and build your overall strength and flexibility, as these areas are too often overlooked.


Thigh muscle stretches. Thigh muscle stretches are best performed after your muscles have warmed up. Consider five minutes on a stationary bike, a brisk walk, or performing half-squats. The adductor (inner thigh) muscles can be stretched in several different ways, so find the one that causes you to feel the greatest stretch. 


1.) While standing or kneeling, straighten one knee and raise your leg directly to the side. The straightened leg should rest on the floor if kneeling, and on a chair or table if standing. Next, bend your trunk toward that leg, holding the position for a count of 20. Relax and repeat several times, varying the side-bend with a directly forward bending of the trunk as well; this may produce an even greater stretch. Repeat for the other leg.


2.) While sitting on the floor with legs spread apart as far as possible, bend forward and attempt to bring your chest as close to the floor as you can. Hold for a count of 20, relax, and repeat several times.


3.) Sitting on the floor, bend your knees pointing out to either side, grasp your feet and bring the soles together, and pull your heels as close to your groin region as possible. (This is a position similar to the pigeon pose in yoga—see Yoga Injuries in this issue.) Use your elbows to push down on your knees, ideally to make them touch the floor. Hold for 20, relax, and repeat. 


Hamstring stretching. It’s best to have your muscles warm for this stretch as well. Lie on your back with one knee bent. Bring your other leg up as high as possible while keeping the knee straight. You may grab that thigh with both hands and pull, or use a belt or towel around your foot to pull it up. Be sure to keep your back flat against the floor throughout, holding for a slow count of at least 20. Lower your leg and repeat several times and then perform the same stretch on the other leg.


For abdominal muscle weakness. Traditional crunches, or partial sit-ups, are very helpful for ab muscle weakness, which is a common problem that can lead to groin pain, lower back pain, and other core-related problems. Runners too often skip the abs, but by spending a little time here you will notice a difference in your running form, turnover, and general run-readiness. It’s best to perform these “trunk curls” in a diagonal fashion. Most of us know the drill: Lie on your back with both knees bent and feet flat on the floor—but with your hands behind, as opposed to touching, the back of your head. The temptation to help your core do the work by pulling with your arms will be diminished. Lift one shoulder blade off the floor as high as possible without allowing your lower back to leave the floor; slowly lower your shoulder blade to the floor, and repeat 10 times. Perform a set of 10 on the other side, then go back to the previous side, continuing on until these become quite difficult.


Sometimes simple changes in running routine can alleviate pain and stave off injury. If you are experiencing groin pain, knee pain, heel pain, or any other of the more common runner’s aches, consider whether new running shoes may be in order. Additionally, be wary of repeating the same workouts on canted surfaces. Running in the same direction day after day on a paved street with a slanted surface, as most streets indeed have, serves as a functional leg length discrepancy. Vary your workouts, and remember to look for more opportunities to run on dirt or grass.


The exercises in this article were contributed by Brian L. Bowyer, MD, of the Ohio State University Sports Medicine Center.  



(RUNNING & FITNEWS® May / June 2008 • Volume 26, Number 3)


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