Poses Without Pain

Here’s how to help ensure that your yoga practice brings harmony, not harm.

by Naomi Mannino

September 2011

Rebecca Scritchfield, MA, RD, LD, a Washington, DC sports nutritionist, naively assumed that her active lifestyle and knowledge of health issues would make for a pain-free yoga experience. So Scritchfield, 34, was taken aback when she hurt her knees badly during a yoga class five years ago.

“I thought I was fit enough to jump into any sport or activity and I didn’t realize that yoga moves are different than my usual running or biking workouts. I pushed the stretch on a pigeon pose and tweaked my sore knees even more,” she says.

Rita Trieger, a 51-year-old registered yoga teacher at the Stamford Hospital Health and Fitness Institute in Connecticut, recalls a similar injury scenario a decade ago. “I was really fit. I was trying to outdo everyone else in the class and I pushed a triangle pose until my hamstring popped. After that, I couldn’t do anything at all for six months,” she says.

Trieger learned her lesson and is now mindful of her yoga students and their risk for injury. “Most beginners are not cautious enough of their body’s signals and can easily hurt themselves,” she says. “But really fit students are competitive and often push the poses too far. A yoga injury can put you out of commission for months. Fit or not, you have to take it easy doing yoga.”

A Stretch Too Far

The US Consumer Product Safety Commission recorded more than 5,500 yoga-related injuries that were treated in 2007, the latest year data is available. Nonetheless, the American Academy of Orthopedic Surgeons (AAOS; www.aaos.org) believes that improvements in strength, balance and flexibility gained through regular yoga practice outweigh the injury risk. The caveat is for you to practice poses properly, using your individual flexibility as a guide.

Among the more common yoga injuries are those that result from over-stretching the neck, shoulders, spine, legs and knees. The AAOS warns that weak or sore spots are especially vulnerable to more serious injuries—such as tears to muscles, tendons or ligaments—when yoga is practiced incorrectly.

Lewis Maharam, MD, a New York City sports medicine specialist, agrees that it’s easy to hurt yourself while practicing yoga. “I see plenty of hamstring tears from over-stretching,” he says.

“Because your back has more ligaments and muscles than any part of the body, low back injuries from over-pulling are common.” Be aware of the learning curve with yoga, he urges. “Yoga is a terrific sport to increase flexibility and strength but, just like any sport that needs instruction, you need to learn proper yoga practice with good supervision.”

Many yoga students don’t want to spend time learning or practicing yoga basics such as proper breathing, which can help you avoid injury. “Your breath to a muscle is like water to a sponge,” Trieger explains. “When you fill that sponge with water, you can twist it without tearing it. Your breath nourishes the blood flow with nutrients and oxygen, allowing muscles to move and stretch while removing metabolic waste.”

Peaceful Posing

It’s also important to practice proper alignment during yoga poses, or asanas, and use modifications suggested by your instructor to avoid injuries. “My yoga teacher asked about pre-existing weakness or conditions and offered pose modifications that I ignored. If I had listened, I probably wouldn’t have hurt my knees,” says Scritchfield ruefully.

Look for a class with a low student-to-teacher ratio, especially if you are a beginner, Maharam advises, so the instructor can monitor and modify your alignment and technique while you are learning.

The old fitness axiom “no pain, no gain” doesn’t apply to yoga. “Yoga is supposed to feel good, and pushing through painful poses is how I got hurt,” says Scritchfield, who has since calmed her competitive ways during yoga class. “Practitioners always say that it’s not a competition and to stay centered on your own body signals and breathing.”

Adds Trieger, “Knowing the difference between mild, healthy physical discomfort and real pain is important. The thing most people miss during yoga is listening to your body.”

Path to Healing

If you do feel a pull or a strain or more, Maharam recommends finding a qualified sports medicine doctor who is fellowship trained (training undertaken in addition to a standard medical residency). Such physicians understand proper body movement, exercise injury prevention and injury diagnosis, and will help you return to your activities faster.

To find a sports medicine health professional near you, ask at your local major medical center, look for a “best doctors” issue in a local or regional publication, or check the
www.castleconnelly.com “Best Doctors in America” database. Your local professional sports teams, Maharam adds, can recommend the sports medicine specialist its players use.

Too much inactivity can actually hinder the healing process. Maharam suggests engaging in some movement, rather than total rest, after an injury. “The new acronym for injuries is MICE, which stands for Movement, Ice, Compression and Elevation,” Maharam says. “Early movement is more effective than rest because it brings in blood flow and removes metabolic waste—but only when properly prescribed by a sports medicine doctor.”

Let common sense be your guide. Trieger says, “Yoga can be great for everybody, but you have to look inside yourself in order to stay injury-free and get the most out of your yoga practice.”

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