Saturday, March 24, 2012

Don't have a cow: Reduce pain in your wrists in yoga poses

Cow pose (not shown here but I couldn't resist these pics of cows doing yoga) is one of the most common beginner's
postures and is also one where yogis might first encounter wrist pain

It has become very clear to me that when new students come to yoga class the portion of my brain dedicated to recall of names drifts off and starts doing complicated inversions.  I had been calling a student named Sanjeewa Sanjay for a long time before someone else kindly pointed out his real name.  I think I was calling Udeni Upeksha for a few months before her friend quietly came up to me after class one day to politely point out my ongoing error.  I was so proud to have remembered Arosha's name that I used to call her name out all the time.  About a year later she told me it was Aroshi.  In any case, if you have been coming to yoga for a long time now and I have failed to call you anything then I think it is safe to say that your name is suspended in neon lights on a billboard out there that I just can't seem to read and I'd be more than happy if you told me, or, if you are too shy, just came up to class wearing a name badge for a little that you display prominently on your mat.  Ditto if I have been branding you with a secret yoga alias.

That said, while I seem to have some semantic blockage (which I am trying to fix with some training in arbitrary mnemonics), the thing I have found most new students have difficulty with when turning up to class is with taking pressure off of their wrists. 

When you start out yoga (at least in my classes) we spend a bit of time on all fours, first in cat/cow variations and later in adho mukha svanasana (downward facing dog). 

Cat-cow pose--many students find this tires their wrists out

The cat/cow variations look like a piece of cake.  How hard can it be to be on your hands and knees for a few minutes?  Don't babies spend months there?  But as most of us soon find out babies seem to be much better at yoga than us and pretty soon the wrists start to ache.  The most common question I have after class is what to do about sore wrists, which makes me very happy. Not the bit about wrist pain but the fact that someone identifies an issue and asks me questions.  Yoga shouldn't be painful so if it is then we need to do something about it!

There are many reasons your wrists can be sore when you practice yoga.  I, for instance, fell off a rock climbing wall many years back and landed on my outstretched wrist.  It has not been the same since.  Some people also have diagnosed wrist conditions that are aggravated by placing weight through the wrist joint (if you fall into the category of people with known conditions then please do let me know--I always need to know about injuries or conditions).  Injuries and medical conditions notwithstanding, I think it is fairly safe to say that one of the most common reasons for wrist pain is that most of us do not know how to use our hands, forearms, and upper body properly to generate a feeling of lift and to distribute weight evenly throughout the hand.

Try the following suggestions the next time you try the cat-cow pose combination). 

Mindful Placement
So much of yoga is about being mindful.  Whenever you place your hands on the ground, do so mindfully.  If you look at the back of your wrists and bend your wrist backwards you will see lots of little lines running from one side to the other.  These creases of your wrist should be parallel to the top of your yoga mat.  Your middle finger will end up pointing roughly straight ahead (not completely).  Spread your fingers apart comfortably and lengthen them into the floor.

With your hands correctly positioned, it is time to generate lift. 

Generating Lift
I can't think of a yoga pose offhand where you are not trying to generate lift.  This does not mean we are trying to fly or levitate as we practice--we are still firmly connected to the ground.  It simply means that we need to use our connection to the ground and align ourselves in such a way that we are not simply sinking downwards. 

To generate lift we need to be mindful (there's that word again) of the natural arches that exist throughout our body.  The arches all of us would be most familiar with are the arches of the feet (even if you are flat-footed you will be aware of the absence of a well defined arch) and, to a lesser extent, the arches in your spine.  What you might not be aware of is the fact that your hand has natural arches too.  

The arches in your hand are important.  Without them you would find it very difficult to do things with your hands.  If you turn your palm up to the sky, hold your hand loosely, and bring your wrist up to eye level you will see there are dips and mounds on the surface of your palm--it is not flat.  As you practice yoga, therefore, you do not want to practice "flat-handed".

To cultivate the arches through your hands as you practice, I like to envisage that I am trying to pick up the floor or a very large ball (say a basketball) with my hand.  The point about this is that to pick up the ball or the floor you would first need to spread the mounds of your knuckles wide.  You would need stretch your fingers long, and press down through your fingertips.  Then, once you have your "grip" you'd then need to lift up. Imagine your hand as a suction cup--stuck to the floor around the edges but sucking up through the centre.  There is no way you would ever be able to pick up the floor or a ball if you only pressed down through your wrists. 

This is not the whole story though.  When you generate lift like this, what you will notice is that the mounds of your fingers (below your knuckles) have a tendency to lift off the ground, as do the fingers themselves.  The next step is to engage through the mounds of your fingers.

The Mounds of the Fingers
When you cultivate the arches of your hand, the mounds of your fingers will undoubtedly lift off as will the fingers and you will find yourself connected only through the fingertips.  This is normal due to the structure of your hand. 

Once you have generated your lift then, you need to try to press the mounds of your fingers down into the floor without collapsing the arch structure entirely.  

Most people find that the base of their index finger is tough to keep down.  Be mindful (there I go again) of not letting it become a habit to let it float in mid-air.  To help keep the index finger mound down bring try to roll your wrist and hand from the outer corner of your wrist in a diagonal towards the mound of the index finger.  This action is coming from your forearm, just above your wrist, and you should see that your forearm rolls in (pronates) when you do this. 

This is good to practice because if you get into the habit of putting too much pressure on the outside edge of the hand and letting the mound of the index finger stay airborne you will find it difficult to do some of the more advanced postures (especially handstand).
Props and Modifications
There are other strategies to minimise pressure on the wrists.  These include:
  • making a fist in certain poses such as cat-cow and plank (I had to do this when I had my wrist injury),
  • being on your forearms instead of your wrists (such as forearm plank or forearm downward dog), 
  • making a little wedge or hill on your yoga mat to elevate the wrists slightly and send more weight down into the base of your knuckles and fingers (you could fold up a hand towel),
  • placing your wrists slightly in front of your shoulders rather than beneath your shoulders (which will change the angle of the joint and make the stretch less extreme)
  • practice 'Namaste' at your chest, pressing your hands together and keeping your wrists in contact as you draw your palms down towards your navel without letting the wrists come apart (to stretch across the palm side of your wrists if this is tight)
I am happy to explore these options with you in class if you are still experiencing wrist issues.  If you are not a one of my students then your own yoga teacher will surely be able to help!

You'll no doubt find using your hands and forearms correctly is hard work.  Spreading your weight evenly through your hands is tough and first when you are used to working that way, but, as with everything, with practice it will come.

A discussion about how you use your hands is not really complete without thinking about what is happening around your shoulder blades (scapulae), shoulders, and elbow joints but I will have to save that for another post.  Suffice it to say that no part of your body works in isolation and you will find that a lot of stress can be removed from your wrists if you are using the rest of your body correctly.

For now, happy and safe practicing!

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