Whether practicing yoga for a few weeks or for many years, any yogi can tell you as with every sport that yoga comes with the potential for injury. Understanding this premise, taking some common sense steps and listening to your body can help practitioners avoid injury while practicing yoga poses. It is the reason why so many yoga practitioners include physical therapists in their health & wellness toolset.
Common Yoga Poses that Lead to Injury
A recent study linked individual yoga poses with particular injuries.[1]
Neck injuries, for example, are often attributed to headstands and shoulder stands. Loren M. Fishman, MD, B.Phil., (oxon.), Spine Universe, Columbia Medical School, is the lead author on the study. He explains yogis sustain neck injuries often because “people do headstand wrong. They come too far forward on their forehead or they go too far back on the crown of their head and they can really hurt themselves that way.”
Prevent shoulder Injuries from weight bearing on the shoulder blade and wrist, which are linked to variation of plank pose, such as chaturanga, four limbed staff pose, and side plank pose, as well as downward facing dog. “People put too much strain on their shoulders,” Dr. Fishman explains. “They put their arms anywhere but perpendicular to the ground, which can cause a rotator cuff tear.”
Practice carefully to avoid shoulder pain or prevent shoulder injury and inprove your range of motion. The mountain pose is a great strengthener for the shoulders but don't hold the pose too long. Avoid it if you have migraines or too high/low blood pressure, it can causes dizziness or imbalance. Additionally, exercises to build strength and improve range of motion in the rotator cuff muscle, try shoulder external rotation and internal rotation exercises, 3 set of 12 for the impacted arm.
Lower back injuries are commonly associated with twists, backbends, and forward bends. According to Dr. Fishman, forward bends are the greatest area of injury. People “try too hard. Their hamstrings are too tight, and they round their back too much. They give themselves a herniated disk, or torn hamstring, or they strain their back.”
Knee injuries are most often linked to lotus pose, warrior pose I and II, hero’s pose, and one-legged king pigeon pose. For example, forcing the knee into lotus pose, rather than turning the thigh bone outward from the hip joint, can lead to torn cartilage in the knee.[2]
Avoiding Injury in Yoga Poses
There are different ways yogis can proactively work to avoid injury. The data suggests most yoga injuries stem from people pushing themselves too far. Thus, avoiding injury requires a yogi to be present and self-aware of their own limitations. Listening to your body as you engage in yoga poses is essential.
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Listening to Your Body:
Don’t Over Use It!
In reviewing Mayo Clinic medical records of patients with injuries primarily caused by yoga over a 12 year period, one study revealed an astonishing 74 % of injuries were attributed to mechanical myofascial pain “due to over use.”[3]
Listening to your body is critical to a safe yoga practice. After a review of emergency room visits associated with yoga related injuries, researchers concluded yoga is generally a safe form of exercise that provides many positive benefits. “[H]owever, those wishing to practice yoga should be cautious and recognize personal limitations.”[4] This is particularly true for practitioners age 65 and older.
Yoga Poses and Pain
“You never go to pain. You can go toward it but not to it,” explains Geo Takoma Moskios, author of The Idiot’s Guide to Power Yoga, and The Warrior Series, Yoga for Men. Moskios has been teaching yoga for 45 years. “If you only go where your body goes, you won’t experience pain. Find your own edge, and work on your edge.” As you continue your practice, he expands, “you’re always finding edges. People go too far, too deep. Back off and work towards where your body should go. Slowly. Carefully. Easily. Without pain. If you feel any pain,” he cautions, “you’ve gone too far.
Building a Well Rounded Practice
It may be tempting to focus solely on one aspect of yoga, such as flexibility. However, Moskios warns this approach is short sighted. “You need everything,” he explains. “You need strength, endurance, balance, focus, more awareness.” This is what a well-rounded yoga practice brings, not the simple achievement of a given pose. Everyone has limitations. “The nature of bones is they are different in every person. It’s just an edge,” Moskios says. “It doesn’t matter how deep you go. That’s not the goal. The goal is to do the series and bring energy, prana, the force of life, to all the different parts of the body.”
Recovering from Injury Through Yoga Poses
Dr. Fishman’s study details the various ways one can sustain a yoga injury. However, he also points out, “even though yoga can give you these injuries, yoga can also cure these injuries.” Extension postures, for example, “produce a partial vacuum in the vertebral bodies and actually suck the disk forward, away from where it’s pressing against the nerve. Simple yoga poses, such as the bridge or the camel can do this.” The same principles apply for herniated disks in the neck. Poses such as camel and upward bow are “excellent ways to draw the disk out of harm’s way.”
Rotator cuff injuries, on the other hand, can be addressed by “standing on your head the Iyengar way, where you lift your shoulders off the floor.” This, Dr. Fishman explains, “encourages another muscle to stay active.” However, he notes, “We don’t understand how the shoulder works that well.” Dr. Fishman recently received a grant for the National Institute of Health (NIH) to study rotator cuff injuries and this yoga pose further.
Maintaining a Satisfying Yoga Practice
Respecting one’s own limitations is one of the keys to maintaining a healthy body for yoga. Moskios reminds us all, “Every single body is different. The perfect pose is where your body goes here and now. Here and now.” Words to live by.
[1] Loren Fishman, Ellen Saltonstall, and Susan Genis (2009) Understanding and Preventing Yoga Injuries. International Journal of Yoga Therapy: 2009, Vol. 19, No. 1, pp. 47-53.
[2] Carol Krocoff, Insight from Injury, Yoga Journal, 2003.
[3] Melody Lee MD, Elizabeth A. Huntoon MD, MS, Mehrsheed Sinaki MD, MS (2019) Soft Tissue and Bony Injuries Attributed to the Practice of Yoga: A Biomechanical Analysis and Implications for Management, Vol. 94, No. 3 424 – 431.
[4] Swain, T. A., & McGwin, G. (2016). Yoga-Related Injuries in the United States From 2001 to 2014. Orthopaedic Journal of Sports Medicine.