(Ashtanga Vinyasa) Yoga with Wrist Injuries; a guest post by La Gitane

10:45 | Labels: injuries, injury healing, La Gitane, modifications, practice, wrists

So much of our regular Ashtanga yoga practice relies on being able to bear weight with our hands: Chaturanga, vinyasas, jump-backs and jump-throughs, you name it. Because of this, injury to the wrists can often be a very debilitating and demoralizing blow to our practices. It's easy to become discouraged when a particular body part that has served us so well and whose reliability in carrying us from point A to point B on the mat we have virtually taken for granted suddenly breaks down and becomes the source of great pain rather than pride.

But if you are suffering from wrist pain or injury, fear no longer! In response to my recent call for guest posts about healing from injuries in the practice (I'm still accepting guest posts, by the way, just so you know...), La Gitane from Yoga Gypsy has written a very illuminating post in which she describes in great detail her journey of healing from a recent wrist injury. She includes some very useful suggestions on how to modify your practice to work with this great bane to Ashtanga practice; now we will have no excuse not to practice if and when, God forbid, we injure our wrists. Sigh...

Before I shut up and let you read her article, I feel that I should also say a couple more things about La Gitane. In my mind, she is most famous in the Ashtanga blogosphere for writing that infamous open letter to Ashtanga back in June, in which she admits that she's, ahem, seeing other yoga. Ha! Talk about Brahmacharya violations... (Bad Lady!) I don't know if she's now back with Ashtanga, or if she's still persisting with her Ashtanga infidelity; in either case, what other people do (or don't do) behind Ashtanga's back is none of my business, so I'll leave it at that :-)

In "real" life, La Gitane works in international development as a communications professional, and is based in East Timor. She also teaches yoga.

Alright... now that I have gotten my daily ramble out of my system, I shall leave you in peace to enjoy La Gitane's post. More later.

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(Ashtanga Vinyasa) Yoga with wrist injuries

by La Gitane

When I saw Nobel was asking for guest posts about practicing with and healing injuries, it felt pretty serendipitous, because about 6 weeks ago I injured my right wrist. I think it happened while I was practicing an arm balance: I lost my balance and started to tip forward, but caught myself. I didn’t notice it at the time, but I must have over-strained my wrist in that moment.

Anyway, one day my wrist just hurt like crazy. The pain was most pronounced in the wrist joint itself, but radiated all the way up to the elbow. I couldn't put ANY weight on it. However, I was able to modify my practice and now it is healing quite happily. Since I know that the audience of this blog is an Ashtanga audience, I’ll write from the perspective of having a wrist injury but wanting to still do an Ashtanga or vinyasa-based practice. I shouldn’t have to say it, but of course, if you are practicing with an injury you are always best to seek a doctor’s opinion – especially if you have pain that lasts for more than a week without any improvement.

For me, there are two key components to dealing with an injury in yoga. The first is quite obvious: protect the injured area and allow it sufficient time and space to heal. The second is to identify the root cause of the injury and work to prevent it from happening again.

It's important to remember that in yoga therapy, the mantra is "function over form". You have to let go of attachments to a particular pose, and find others that move or stretch your body in the same way. From a physical perspective, for every pose that you aren’t able to do, look at the pose and identify what the main muscles are that are stretched and strengthened, and then find other ways of achieving that. From a mental perspective, think about these modifications as an opportunity to deepen your sadhana, your study of the practice, and as an investment into an injury-free future: not as a sacrifice.

Dealing with a wrist injury in vinyasa yoga involves some pretty obvious modifications, but in fact, it didn’t affect my overall practice too much. I was still able to practice a dynamic flow with a combination of standing and seated poses. I also wore a wrist brace to support the wrist and reduce movement, and massaged the affected area daily with anti-inflammatory gel. I wore the brace to teach as well, and used the opportunity to talk about wrist safety and alignment!

Part I: Dealing with the Injury – practice modifications

Week 1

Practiced (wearing the brace) without putting any weight on the wrists
Instead of sun salutations A, I warmed up my back and hamstrings by simply moving through tadasana - urdvha hastasana with a backbend - utanasana - looking forward - utanasana - urdvha hastasana with a backbend – tadasana.
I practiced the standing poses as normal, except without placing any weight on my injured wrist in poses like trikonasana, parvritta trikonasana, parsvakonasana etc., and I avoided any odd angles for the wrist like bringing the hands into reverse prayer in parsvottanasana, or grasping the foot in ardha baddha padmottanasana.
For all poses that required putting weight on the wrists, I substituted others that targeted similar areas of the body. So for example, I substituted cobra or shalabasana for upward dog, dolphin pose for downward dog, dolphin plank for plank pose, fish for purvottanasana, bridge for urdvha dhanurasana, and so on.
Instead of taking the traditional vinyasa between seated poses, I practiced the following standing vinyasa that was taught to me by one of my Ashtanga teachers. It doesn’t place any strain on the wrists but still emphasizes core strength and stretches out the back between poses. (You might want to add halasana between navasana and standing up to help get some momentum!)

Week 3

Once my wrist was generally pain-free and stable, I began to gradually and mindfully re-introduce weight bearing poses, while continuing to wear the brace.
Before practice, I warmed up my wrists with some gentle wrist stretches. (See this old blog post for details: http://yogagypsy.blogspot.com/2012/04/simple-excercises-for-wrist-pain.html)
In addition, I used extra padding under my wrists at all times I was putting weight on them. An extra yoga mat is perfect for this. Place it under the palm of the hand with the fingertips hanging off the support. This reduces the angle between the wrists and the floor and helps line up the arm bones. For a vinyasa practice, two extra mats is ideal, because you can place one either side of your feet and it won’t interrupt your flow.

Practice modifications:

No jump backs / forward / throughs
Plank and chaturanga with knees on the ground
Fewer breaths in downward-facing dog, or dolphin pose instead
Replace upward facing dog with cobra / shalabasana
No arm balances
For all vinyasas between seated poses, I continued with the standing vinyasas shown previously

Week 6

Practice modifications:

Continuing to warm up the wrists before practice and stopping periodically to stretch them out
Continuing to use padding, but practicing without the brace
Jumping back to plank before lowering to chaturanga - this places considerably less strain on the wrists than jumping straight to chaturanga.
Alternating between standing vinyasa and jump-backs, slowly building back the number of vinyasas
Re-introducing arm balances with sufficient padding under the hands
Closely observing how my wrist feels for the rest of the day, to know when I have gone too far.

Part II: Identifying the root causes

This, of course, is much trickier. For wrist injuries, there are a few possible causes that come to mind. Maybe you readers can add more:

1. Practicing with poor alignment of the wrists

2. Practicing with hyperextension of the arms, locking the elbow joint and putting too much weight/strain on the wrist

3. Long holds in downward dog when the hamstrings & shoulders are very tight, leading to too much weight on the arms and wrists

4. Practicing plank/chaturanga/jump-throughs/backs/arm balances without having enough ‘lightness’ from the core and from the back body, thereby putting too much strain on the wrists

5. One-off injury caused by putting too much weight/strain on the wrist, probably while attempting a new arm balance

I think in my case, 4. are issues I need to work on in my regular practice, although the injury itself was caused by 5. So I am working on building core and back body strength, and making sure that I do my jump-throughs and -backs slowly and mindfully, with control.

Thanks for reading! Have you ever practiced with a wrist injury? What did you do?