Reader Question: How can I recover from yoga induced wrist pain?

Hello,

Last week I did a full primary series 2hour Ashtanga yoga class(my first one), and next day I woke up with some wrist pain to rotation on the right side. Then i noticed that i also had some forearm , elbow and upper trap tenderness too. i found that when I pressed on the sides of the elbow hard, my wrist didn't hurt any more. I did some research and found out that I was doing chaturanga wrong like you said on your site. Very, very informative! Thank you.

Any suggestions on healing?

A reader from Toronto

Rest, icing (10 minutes on, 10 minutes off, and 10 minutes on), and gently stretching are the keys to recovery from most minor joint injuries in yoga. But it is important to get a diagnosis from a health professional familiar with yoga injuries first before self diagnosing and treating.

It sounds like you have strained your wrist extensor muscles as well as possibly spraining the joints of your wrist. The extensor muscles start at the lateral epicondyle of the elbow (outside of the elbow with palm up) and control the movements of the wrist and hand. With repeated chaturanga push ups, these muslces are working overtime. And if you were allowing your wrist to deeply extend (dropping the elbow below the shoulder) this strains the wrist and the musculature.

Gentle Stretch for the Wrist Extensor Muscles
With your arm extended, palm facing down, use your opposite hand to flex the wrist down towards the earth until you feel a stretch in the top of the arm and into the elbow. Hold for at least 30 seconds.

When you return to your yoga practice, yes do all the things I've mentioned in the past during Plank Pose / Chaturanga (elbows not lowering below shoulder height, stacked over wrists or behind) and if you re-injure then you might want to consider seeking out some soft tissue treatment (I recommend Active Release Technique) as well as some guidance on how your shoulder biomechanics may be affecting your wrist and elbow. Never practice in pain.

Good luck with your healing.

To learn more about Dr. Robin and Yoga Therapy in Vancouver visit stayactive.ca

Reader Question: What poses benefit recovery from a sprained ankle?

Dear Dr Armstrong;

I have an ankle that has been sprained a number of times, most
recently this past summer. It's a long-term weakness I'd like to try
and improve while/as I rehab from the last incident.

Just wondered if you saw any particular poses as being of most benefit.

Sincerely
A myyogaonline subscriber from Kelowna

Thanks for your email. Here are a few suggestions to try out.

When we sprain our ankles (an injury to the ligaments surrounding the joints) there are two major problems that result: a decrease in proprioception (the sense of where our ankle is in space), and a decrease in range of motion due to swelling, scar tissue, and pain limitations.

Balance poses standing on one foot are excellent to aid in proprioception that is probably diminished as you recover. In particular, balance poses where you are transitioning from one movement to the next. For example moving from Tree pose / Vrksasana (one foot on opposite shin or thigh, knee out to side) to Warrior III pose / Virabhadrasana III (hinged at waist, leg extended behind you).

Also poses that increase the range of motion will benefit you:

• Downward dog / Adho Mukha Svanasana to lengthen calves
• Fierce pose a.k.a chair pose / Utkatasana to lengthen calves and increase dorsi flexion
• Standing poses such as Triangle / Trikonasana, warrior I, or II to stengthen and lengthen the sides of the ankle (being sure to root down with the outer foot)
• Hero pose / Virasana (sitting in a kneeling position, most people would need one or more blocks under the seat or a folded blanket to give more height) being mindful that your knees are pain free in this pose.
• Lunges with the back toes turned under will also challenge the range of motion and your blance at the same time.

Good luck in your recovery, I hope this helps.

To learn more about Dr. Robin, and her yoga therapy offerings in Vancouver, visit stayactive.ca

Pose Down: Eka Pada Rajakapotasana a.k.a. Pigeon pose

My latest pose for myyogaonline
Eka Pada Rajakapotasana / Pigeon Pose

Benefits

• Opens hip flexor muscles (psoas, rectus femoris), groins
• Opens hip rotator muscles (gluteus medius & minimus)
• May relieves sciatic nerve tension and ease chronic low back pain
• Advanced version opens chest and shoulders
• Traditionally thought to control sexual desire, increase circulation to urinary, digestive, and reproductive systems

Contraindications

• Knee injury --> Meniscus or ligament injury
• Sacroiliac joint injury --> due to the opposing action of the legs in this pose which may increase strain across the joint
• History of shoulder dislocation ->do not progress to holding the top of the foot behind the back (Advanced b below) and use caution reaching behind you for the foot

Step by Step
Eka Pada Rajakapotasana (aa-KAH pah-DAH rah-JAH-cop-poh-TAHS-anna)
eka = one pada = foot raja = king kapota = pigeon

*A progression from intermediate to advanced versions will be given.

1. From your hands and knees, bring your right knee forward to the floor just behind the right hand. Outwardly rotate the right thigh so that the right foot is in front of the left knee, shin on a 45 degree angle on the floor. Strongly flex the right foot to align the ankle and shin bone. (Note: The further away the foot is from the knee, the greater the outward rotation in the hip, the greater the challenge)

2. Curl the left toes under and begin to press the floor away, walking the knee further away behind you until the leg is fully extended with shin, knee and thigh in contact with the floor. The right knee may come slightly outside of the line of the pelvis.

3. Draw your inner thighs towards each other, slightly lifting the pelvis higher. Find the middle point where equal weight is between the left and right sides, and your pelvis is squared to the front of your mat. If your right hip is off the ground, slide your left leg further back first, keeping the hips square. If the right hip continues to be off the ground use a folded blanket, foam block, or bolster under your right hip for support, keeping the hips square and level.

4. Uncurl your left toes, looking back to see that your ankle is in line with your shin, and your leg is running in a straight line behind you.

5. On an inhale, send your tailbone down towards the earth and the crown of your head up towards the sky. Exhale and slowly walk your hands forward in front of you, placing elbows on the floor or arms extended in front of you with torso on the floor.

6. Breathe slowly for at least 5 deep breaths.

7. Slowly walk your hands back up towards your body, placing the hands slightly wider than shoulder width. Send the head of the arm bones back, allowing the upper chest to lift slightly so that the collar bones are broad. Inhale sending the tail down and the crown up, walking the hands closer and closer to the body on an exhale so that the torso is moving towards an upright posture. Breathe here for 5 breaths or continue with the advanced pose below.

8. Advanced a): If you are able to painlessly and evenly stay in this posture while removing your right hand from the earth, you may reach your right arm behind you with the palm up. Draw your lower belly in to stabilize the spine, inner thighs moving towards each other. Bend your right knee and grasp the flexed foot with your hand. You may stay here and breathe or progress to the next stage.

9. Advanced b): Point the foot and slowly shift your hand to the toes of the foot by outwardly rotating the arm deeper, slowly lifting the elbow forward, upwards, and eventually backwards so that the palm is facing down. Press the left support hand into the floor to lengthen the waistline, keeping even weight in the left and right sides of the body. Breathe here or progress to the next stage.

10. Advanced c): If you are able to maintain your balance and stability draw the lower belly in, move the inner thighs towards each other, lift the left arm up and back, grasping the foot with both hands. Send the head of the arm bone back into the socket, keep the action of the lower belly and legs, and breathe.

11. Slowly, release the foot, place both palms on the floor and step back to Adho Mukha Svanasana / Downward Facing Dog. Return to your hands and knees and repeat on the other side.

Modifications / Cautions

• Low back pain in the pose – if at any point you feel low back pain in the pose, back off, draw the low belly in and lengthen through the spine to avoid compression. A folded blanket, foam block, or bolster under the bent leg thigh will add support and may relieve the pain. Do not continue in pain.
• Knee position – the knee is a hinge joint (open-close) and therefore should not be challenged from side to side. In pigeon pose the weight of the body and the pressure of the floor challenge the knee joint on either side. It is important to keep the ankle in dorsi flexion (toes up) to align the shin bone. If you are feeling any tension or pain around the front knee, back off, place the foot closer to the opposite groin, and consider a supportive blanket, block, or bolster under the thigh. Do not continue in pain.
• Progressing to advanced versions – a belt may be used around the foot rather than holding with the hand. Before entering the pose, make a small loop in a strap and place it around the back foot at the ball of the foot. Set up the length of the strap on the floor beside you. Enter the first phase of the pose, during the second phase, bend the knee and grasp the strap a) arm behind you palm up, b) turn the palm down, externally rotating the shoulder sending the elbow forward, up, and back, or c) with both hands behind you. In each stage slowly walk the hand(s) back so that the tension increases on the strap.

To learn more about Dr. Robin visit stayactive.ca