Monday, September 16, 2019

Yoga Asanas and Injuries

by Ram Rao

Yoga philosophy has its origin in the Vedic texts and the underlying principle is that an individual's well-being at the level of body and mind helps re-connect to his/her true nature through direct and personal experience. A clear mind is not affected by stress and a clear mind produces a healthy body thus creating a greater connection with one's own pure, essential nature. Thus, Yoga prepares the body and mind of the individual for the eventual liberation and enlightenment. 

Yoga philosophy describes achieving mind-body oneness through four different methods and one of them called Raja yoga, the Royal Path of Yoga, or the Yoga of Practice, utilizes an 8-fold path, Ashtanga Yoga, (Ashta=eight; Anga=limb) to achieve the union of the body and mind. Each step in the 8-fold path is additive as it prepares the individual for the next higher step. The third of the eight steps is “asana” which means seat, settle, and in the yoga context "posture."

In today’s world, Yoga is thought of as “asanas only,” something like a stretching tool to keep the body limber and agile. People are drawn to yoga as a way to keep fit even though the idea behind the physical practice of yoga is to help the mind to become clear or pure and develop deeper mind-body awareness. Adults who are mostly sedentary and unfamiliar with yoga look to asanas for improving flexibility, agility, and strength. Although asanas do contribute to these beneficial changes in a proper setting that includes an experienced, sensible, and competent teacher, a tight, inactive, or aging body mixed with a forceful practice and an inexperienced teacher is only a recipe for injuries and disaster.

With asana practice now turning more into some sort of a competitive sport, it has resulted in yoga-related injuries and a bad rep for yoga. Just as uncoordinated or improper movements can put any individual at risk and subsequent injury in any sport or training program, the same is true for Yoga asanas which require coordinated movements of several areas/parts of the body. A research study in 2016 concluded that yoga-related injuries nearly doubled from 2001 to 2014. Some of the most common yoga injuries include the following.

Lower Back: Lower back pain is a common asana-associated injury due to rounding through the spine in poses like forward bends and downward dog. Tight hamstring, lower back muscular problems, over-stretching the major muscle groups in the lower back, or forcing the muscles into elongation can result in disc injury and lower back pain.

Knees: Knee injury is very common among yoga practitioners according to a research study owing to meniscus tears primarily due to tight hips or preexisting injuries.

Wrist: One of the smallest joints in the body, the wrist is already overused thanks to repetitive movements, many hours spent typing and texting on computers or hand-held devices. Many yoga poses such as downward facing dog, plank, side plank, chaturanga, handstand, crow, and others require for the practitioner to be on their wrists. If done incorrectly, these same poses can cause or aggravate wrist pain.

Shoulders: Shoulders and elbow pain primarily arise due to repeated and forceful exertion resulting in injuries to the musculoskeletal system. Doing a pose incorrectly and repeatedly, holding the pose for a long time, several repetitions of a certain pose or a sequence of poses, practicing several rounds of sun salutation and doing it incorrectly all may result in strain and overload in the shoulder joint (the meeting place of the arm's humerus bone and the clavicle). Often, practitioners become so fatigued from the repetitions of the same pose that they miss align themselves and incur injure.

Neck: Neck injuries come from putting undue pressure on the neck in poses like wheel, shoulder stand or headstand. If not properly done, these poses add tremendous body weight on the neck resulting in compression of the cervical vertebrae and subsequent injury. In addition, other common injuries involve the sacro-iliac joint, sciatic nerve, and hamstrings.

Given that there are so many benefits of yoga but also the potential risks, what does a practitioner do? The best solution is to avoid yoga injuries and this is how.

1) Recognize the fact that each individual’s body and yoga journey is different. Learn the foundations of yoga poses from an experienced teacher to safely build your practice.
2) Be patient and gradually ease into the pose, listening to the cues from the body, and not pushing past the zone of comfort.
3) Move into a pose at our own pace, even if everyone else is moving fast.
4) Provide sufficient time to open up the parts of the body that are more prone to injury.
5) Be honest and brave to find out from the teacher about the various options to be in a pose partially and find the benefits from this option of a pose.
6) Stretches and warm up exercises before any vigorous yoga practice helps to loosen areas of the body that might be prone to injuries.
7) If a teacher pushes on you, pulls, or applies pressure to get you further from your comfort zone, request the teacher to back off. If you have existing injuries, tell your teacher, modify your poses, and back off on the intensity to avoid making the injury worse.
8) Practice gentler styles of yoga if you are more prone to the effects of heat and dehydration, dizziness, or muscle cramps.
9) Never feel shy to use props and do not hesitate to ask the teacher for recommendations using props if you have any limitations.

In the early stages of our asana practice when we hold a pose, we are simply mastering the skills to sustain the correct posture. As our practice deepens, we blend our asana technique with energy, passion, and wisdom to find ourselves fully “in” the pose. Each pose offers an individual the opportunity to explore and control physical and mental aspects including breath, attitudes, emotions, concentration, and intent. 

The goal of asana practice is not to assume a physically perfect posture but to fully come into the pose, to feel open, grounded, and calm even if it is a challenging pose. The focus is more on achieving stability, mobility, and encouraging integration—gently coaxing all the tight muscles to move and work together, paying close attention to connections—between one part of the body and another, between thought and action, and between breath and movement. 

So whatever it is that you do as part of your yoga practice, make sure you are in your comfort zone, be aware of every move, and recognize the fact that yoga is not a workout but more of a mind-body experience that has the power to transform from the inside out. You’ll then be surprised at how rewarding it is!

Rammohan (Ram) Rao comes from a family of Ayurvedic practitioners and Vedic teachers in India tracing back to the illustrious Vedic-acharya Rishi Kaundinya (although Ram admits he cannot do the Eka pada or Dwi pada Kaundinyasana). With a doctorate in Neuroscience, Ram was a Research Associate Professor at the Buck Institute for Research on Aging. He focused on various aspects of age-associated neurodegenerative diseases with emphasis on Alzheimer’s disease. In addition, Ram completed the academic training at the California College of Ayurveda (CCA) and received his certification as Clinical Ayurvedic Specialist. He has been a faculty member of the California College of Ayurveda and teaches in their Nevada City location. Ram is also a dedicated Hatha yoga practitioner and is a Registered Yoga Teacher from Yoga Alliance USA. In his spare time he offers consultations in YAMP techniques (Yoga, Ayurveda, Meditation & Pranayama). Ram has published several articles in major Yoga/Ayurveda magazines and has been a featured speaker in several national and international meetings and symposia. He is a member of the National Ayurvedic Medical Association (NAMA) and is on the Research Board of the Association of Ayurvedic Professionals of North America (AAPNA).

This post was edited by Patrice Priya Wagner, co-editor of Accessible Yoga blog and member of the Board of Directors.

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1 comment:

  1. Love this blog entry. I teach yoga and I see so many students and teachers almost punishing themselves it seems, during their practice. I teach yoga from a nurturing, self love view. I figure if we can't first treat ourselves with respect and love, how can we treat others with the same? Thank you for writing a beautiful piece.