This is part of a series about Injuries In Yoga.
The single most common injury that we see in the yoga world is a hamstring attachment injury. It happens due to over-stretching the hamstrings. Since so many postures and exercises target this muscle group on the back of the thighs, what often ends up happening is we over-stretch and the tendon that attaches the hamstrings to the sit bones gets damaged. Quite often, we mistake this new, intense sensation for a "deeper" hamstring stretch, so we continue to push (or more often pull). This makes it worse, and many of us don't realize there is an injury until serious damage has been done.
Stretching the hamstrings has become central to many styles of yoga. Like many other physical elements of modern practice, this emphasis comes from gymnastics, contortion and dance. In any given class, we may stretch the hamstrings from numerous positions: standing, seated, legs together, legs split, one leg, both legs, etc.
This injury creates pain at the point where the hamstrings attach to the sit bones (ischial tuberosities), at the base of the pelvis in the back, pictured to the right and circled in red. It can be painful in forward folding positions, and may be sore after class so that it hurts to sit down. It is sometimes called "yoga butt". This injury is so common that almost half of yoga practitioners---men and women---have it currently or have had it in the past.
Common postures that could strain the hamstrings are: Hands to Feet, Standing Separate Legs Stretching (pictured above), Standing Bow, Standing Splits, Stretching, Separate Legs Stretching and Tortoise, etc. Take a moment to notice the similarities in these positions, pictured below. They all tilt the pelvis forward with relationship to the femur (thigh bone). This makes the hamstrings long, which is why we feel the "stretching" in the back of the leg. The deeper these postures are, and the harder we push them, the more likely it will be to damage the attachment of the hamstrings.
HOW TO HELP
First and foremost: rest. I know you don't want to hear this, and resting can be a real challenge for the mind and ego. This injury can take months or years to heal, and the more we aggravate it the longer it will take. Avoid forward folds for several months. Seriously! You can still do lots of other exercises and postures, but avoid forward bending of the hip for awhile. DO NOT STRETCH YOUR HAMSTRINGS!
Second, don't overstretch the hamstrings, even after you're healed. The natural range of motion of the hamstrings only gets the femurs (thigh bones) to about 90 degrees with the pelvis when the knees are straight. This means that the vast majority of contortion-influenced yoga postures that "stretch" the hamstrings take it too far, which is why injury is so common. You might not be able to do Standing Splits with the same picturesque beauty, but you will be able to walk and sit without pain.
Third, strengthen and shorten the hamstrings. We did a whole blog on this, where we explain a handful of postures and exercises that will make the legs strong and help prevent injury. These include Balancing Stick, Squatting, Bridge and Jastiasana.
The most important thing to take away from this is that you can get hurt from yoga practice. If you have pain at the back of your hip, the top of your hamstrings, at or near your sit bones, and this is exacerbated when you do forward folding postures, STOP IMMEDIATELY! It is very likely that you are damaging the upper attachment of the hamstrings. Take the time to let it heal, and then perhaps adjust your approach to the physical postures so that they have less likelihood of injury.
Over the past few months, we have heard increasingly loud calls for talk about injury in yoga. So many students are hurt or have pain, and they don’t know what it is, how it happened or how to fix it. Some are even told by their teachers to push through the sensation to continue deepening the physical postures. After all, these exercises and postures are supposed to be healing, right? When we describe the common yoga injuries, students are both 1) shocked that you can get hurt doing yoga, and 2) surprised to hear us describing the pain and difficulty that they experience.
Yes, yoga can hurt you. It’s true. If you’ve practiced the physical forms of yoga that are popular in the West for more than a few months, chances are you’ve been injured or know someone who has. This is not to say that physical yoga practices are inherently dangerous or should be avoided. The same risk is present in virtually any physical activity: basketball, running, bowling. Anytime we use the body in a repetitive way and push it to go farther and farther, the risk of injury is quite high. We generally don’t know the limits of our capabilities until we go too far!
Yoga is mostly thought of as a healing, healthy and therapeutic form of exercise, not to mention safe. Since most of us approach the practices thinking they will help us, we overlook the possibility for injury until it’s too late. It is especially true in the yoga world, where we want to believe that it only has the ability to make us better, more open, happier, peaceful versions of ourselves. The idea that any of these practices could injure our bodies, nervous systems or minds feels foreign and even contradictory. So all too often we disregard it. Until we get injured. Even then, we may think it was our fault, that we weren’t doing the practice right, because a “healing” practice couldn’t possibly be dangerous.
But injuries are quite common in yoga. And each style has its own tendency toward certain imbalances, as the stress and repetition in each practice are a little different.
We are going to do a whole series of posts about Injuries In Yoga. We will go into some depth about the most common injuries we see, which include hamstring attachment strain, hip impingement and labral tear, meniscus tear in the knee, supraspinatus damage in the shoulder, bicep tendon strain in the shoulder, sacroiliac instability in the low spine, and neck pain in the base of the neck. All of these can be created or exacerbated by physical yoga practices.
For now, we want you to know that yoga can injure you, especially if you think it never will. Always take care and try to understand what you’re doing and why. Some intense sensations are safe and even beneficial, while others are not. Use caution and ask your teacher if you’re not sure. If they tell you that you won’t hurt yourself in yoga, get a new teacher.
If you have an injury or had one in the past that you’d like to tell us about, please comment or message. Let us know your experience!
"Locking the knee" is a concept in yoga that was popular in the 60s and 70s, including the styles of BKS Iyengar and Bikram Choudhury. It originally comes from weightlifting, where full extension of the knee joint and concerted contraction of the quadriceps are paramount. You will still hear weightlifters talk about "locking out" to refer to the full straightening of a joint that is under stress.
For the most part, this concept has dwindled in the yoga world due to the confusion it causes. There are at least 3 different meanings to the phrase "lock the knee," depending on what position you are in and who you're talking to. An anatomist has a different definition than a Bikram Yoga teacher.
These are the three meanings:
1. CONTRACT THE QUADRICEPS
This is the original meaning of the term as it comes from weightlifting and bodybuilding. Used in quadricep-heavy exercises like squats, "lock the knee" meant to straighten the knee as much as possible by squeezing the quadriceps with great force.
In the yoga world, this has also become a way to relax or stretch the hamstrings, since engaging the quads naturally causes the hamstrings to disengage. In addition, it is sometimes believed that engaging the quadriceps, which causes the kneecap to lift up, will protect the knee joint from hyperextension. (It won't.)
2. RESTING THE FEMUR ON THE TIBIAL SHELF
Anatomically speaking, a normal knee has the ability to hyperextend by a few degrees. It can go past the 180 degrees of a straight leg by about 4-6 degrees. When we are standing and our legs are bearing weight, we have the ability to hyperextend the knees and "rest" them on the tibial shelf. They settle back and the muscles of the leg relax, allowing us to stand for long periods of time without using much energy.
When the knees are resting in this manner, they are "locked." To unlock them, there is a specific muscle (the popliteus) that unlocks the knees before they return to normal function.
This definition of a "locked knee," which is essentially slight hyperextension, is often conflated with the first: contracting the quadriceps. Unfortunately, the combination of hyperextension and contracted quadriceps will accentuate the knee's tendency to hyperextend and possible create instability.
3. ENGAGING ALL THE MUSCLES AROUND THE KNEE
Normally, the contraction of the quadriceps is accompanied by a relaxation of the hamstrings, and vice versa. It allows for effortless movement of the knee back and forth. But this relationship can be overridden with conscious effort and control, contracting both sets of opposing muscles simultaneously. In yoga parlance this is called a bandha, a "lock."
When opposing muscle groups around a joint are consciously contracted together, the joint does not move. On the contrary, it becomes immobile and quite stable. This is often done to create stability and pressure gradients that effect the blood and heat flow in the body.
As you can see, the phrase "lock the knee" can mean a handful of different things. And it is important to note that the interpretations can conflict with one another. The first involves engaging the quadriceps while relaxing the hamstrings; the second involves relaxing both the quadriceps and the hamstrings; and the third involves engaging both the quadriceps and the hamstrings.
Why do we, as yogis, practice physical postures?
Depending on your goals, there may be a handful of answers to this important question. The exercises may increase your flexibility, increasing your ability to move the body without pain or limitation. They may help you relax, spending a little time each day focused only on your breathing and forgetting about your stress. They may help your balance, strength, blood pressure or sleep.
At the center of all these motives is the spine, perhaps the single most important communication pathway of our body and mind. We can live without our arms and legs, but we cannot live without our spine. It provides structure, protection and support for our heart, lungs, organs and head.
Almost every signal sent from around the body, from the fingers to the toes, makes its way to the central nervous system by way of the spinal cord. And almost every command about balance, movement or breath also travels via the spine.
So every exercise, whether of the feet, arms, hips or abs is also an exercise of the spine. Even breathing exercises and meditation require communication through the spinal cord as we control our ribs, abdomen and posture. Paramhansa Yogananda called the spinal cord a "lightning rod for the divine."
Our practices should contain plenty of attention to the health and function of the spinal column (the structural part) and cord (the nervous system part). We should keep the muscles of the spine strong and mobile, as well as doing what we can to protect the bones and discs strong; plenty of forward bending, backward bending and twisting. And we should also keep our awareness on the communicative aspects of the spine: its nerves.
As one of our teachers said: "The arms and legs assist the posture. Every posture is in the spine."
"Suck your stomach in!" goes a common instruction in yoga class. This cue is present in a lot of different lineages and styles, and goes to the heart of an important conversation in the yoga world: What are we teaching?
Let's explore the meaning of this instruction, beginning with the elements involved. Namely, the "stomach" and "sucking in."
What is the stomach?
It is an organ in our digestive tract. It is high in the abdomen, just below the ribs and diaphragm. It is the first place our food goes after we chew and swallow it.
How do we suck the stomach in?
We don't. We can't. The stomach itself has muscles that help us in digesting and passing food through our system. But they are involuntary muscles that we can't consciously control. This instruction, "Suck the stomach in," refers to the stomach in a much more general and imprecise way, where "stomach" actually means "abdomen."
The muscle that pulls the abdomen in is called the transverse abdominis. It wraps around the belly like a corset, helping us breathe and stabilizing the spine when needed. If you are wondering what if feels like, exhale your breath forcefully and feel the sides of your abdomen. They will be tight and contracted. This is your transverse abdominis.
What are we actually teaching?
That brings us back to the instruction, "Suck your stomach in." If we take the instruction at its word, it is impossible. The stomach's position cannot be changed consciously nor can its muscles be contracted consciously.
The only way that this instruction makes sense is if we interpret "stomach" to mean "abdomen" and proceed to contract an abdominal muscle that "sucks in."
Also, if our students take us at our word (which I hope they do), they are learning that the stomach is something that can be "sucked in," which it is not. This is worrying, essentially teaching an inaccurate and incorrect concept to unknowing students.
The easiest of fixes
This instruction can be modified ever so slightly to become an effective cue. "Pull your abdomen in" or "pull your belly in" are both anatomically sound and they accomplish the desired result: contraction of the transverse abdominis. They remove the danger of propagating false information to our students and encourage them to learn the correct way.
A huge amount of the sensory and motor processing power of our brain is dedicated to the hands. It is necessary for us to function as we do in the world, picking up objects of various shapes and sizes, carrying things, judging their texture and temperature. But it means that at any given time, the brain has more of its attention focused on our hands than it does on, say, our back.
This function of your brain is represented by the picture above, called the Homunculus. It represents the amount of the brain's sensory power that is dedicated to each part of the body, with greater attention displayed by larger features. The results end up being almost obvious, with a lot of the brain's sensory attention focused on the lips and tongue, eyes and ears, genitals, hands and feet. These are the most sensitive parts of the body.
What does this mean for us as yogis?
In general, it means that it's easy for us to think about our hands. We may be doing an exercise that is focused on the spine, but we will wonder, "What do I do with my hands?" Or while we are balancing or breathing, "How should I hold my hands?" It is easy for our brains to answer this call, since it likes to put its attention on the hands.
But this makes it harder to focus on things---parts of the body or mind---that are not the hands. It is difficult to take the attention away from the hands and put it on the spine or abdomen, or knees.
Next time you do (or teach) a posture, check how much of your focus you put on the hands, their grip and their position. Then ask yourself if they are the central focus of the exercise. See if you can move your attention and effort away from the hands to the part that is most important for each practice. It can be challenging at first, but tremendously beneficial.
Let's start with something obvious: we can breathe through either the nose or the mouth. The air that goes into our lungs is the same both ways, but there are vastly different effects on our nervous system and---according to new science---our brain. A new study published in the Journal of Neuroscience showed that "memory significantly increased during nasal respiration compared to mouth respiration."
But they also stated that "core cognitive functions are modulated by the respiratory cycle." Which means that our brain is hugely impacted by how we breathe.
Anyone who has practiced pranayama, which involves a lot of nasal breathing, has probably experienced its effects on the memory. It is almost ubiquitous that breathing practices bring up old memories and stimulate dreams of the past.
Keep your eyes, ears and nose open for more news about this exciting branch of neuroscience! There are sure to be more developments as we understand the brain better.
Most of us don't know where our psoas (pronounced so-az) muscle is. It is deep in the body, underneath our abs and guts, but it has a huge effect on the spine and hips. The psoas hugs the lower spine, the inside of the pelvis and crosses the hip. Its main function is to move the leg by flexing the hip, but the fact that it connects to the spine makes things a little more complicated. It is commonly ignored or misunderstood since it is not readily visible or easy to feel, but it is a vital muscle for our posture, our spinal and abdominal function, and our hip function.
In the picture above, the psoas and the rectus abdominis (6-pack) muscles are shown. The psoas is deep and close to the spine; and the rectus is on the surface of the abdomen. Ideally the psoas has enough length to allow the pelvis a neutral tilt (as pictured on the left). When the psoas gets overly tight or tense, as it often does when we sit for many hours a day, it pulls the pelvis into a forward tilt (as pictured on the right).
OTHER ISSUES ARISE
When the psoas is short, a handful of other problems arise. The first two problems come from the forward-tilted pelvis. These are 1) weak and long abdominal muscles (as seen in the picture), and 2) weak and long glutes and hamstrings on the back of the hips. These lead to poor posture and poor digestion, which in turn exacerbate the muscular issues of the abdomen and hips.
The other problem that arises with a tight psoas, as you can see in the picture above on the right, is that the low spine gets pulled down and forward toward the pelvis. This creates compression, tenderness and pain in the low back. It also cascades up the spine, creating poor posture in the mid and upper spine, which leads to upper back pain, neck pain and chest pain.
WHAT TO DO
It is worth saying that sitting less will help the psoas stay long. Things like standing desks are useful to this end. Every hour that we spend sitting encourages the psoas to shorten.
It helps to strengthen the abdominal muscles, especially the rectus abdominis. Then the pelvis will have an easier time staying neutral and upright, encouraging a relaxed psoas. Abdominal strengthening, like situps, is invaluable to this end.
It also helps to strengthen the glutes and hamstrings with squatting motions. These muscles of the hip will keep the pelvis neutral and encourage the psoas to be long and relaxed. Even if you can't do something like squats or lunges, it helps to do what is called the "Glute Drill", which basically involves squeezing your butt muscles for a few seconds. Do ten squeezes a few times a day and that will go a long way to balancing the psoas.
Palmstand is an unsung hero for the body, directly helping two of the most common physical ailments: a tight neck and a weak abdomen. These two problems lead to all kinds of issues in the body, nervous system and mind, making us uncomfortable, unhappy and perhaps even injured.
Palmstand is accomplished by sitting, placing the hands by the sides of the hips, and then lifting the butt and legs off the floor. It can seem impossible at first, but you can begin by lifting only the butt up and leaving the feet down. It can also help to put blocks under the hands, giving a little extra height.
NECK & SHOULDERS
In our culture we spend lots of time in front of computers, with our shoulders hunched up and forward. Over time this leads to a tight neck and tightness on the tops of the shoulders. This is exacerbated by the infrequency with which we push (or pull) things down with our shoulders. What ends up happening is the top of our shoulders and neck become overly engaged while the bottom of our shoulders, which act to counterbalance the top, are weak and underdeveloped.
The way to remedy this problem is to develop strength underneath the shoulders by pushing them down strongly. This is where Palmstand comes in. The action of the posture requires a powerful downward push. When you do it, you may notice that your neck becomes long, as do the tops of your shoulders. If you do the posture regularly, you will develop strength under the shoulders, balancing the joint and releasing the neck and shoulder tops!
It is well-known that most of us have weak abdominal muscles, and that this weakness can lead to all sorts of problems like poor digestion and back pain. This is why "core strength" has become so popular and exercise regimes like Pilates are making a comeback.
In Palmstand the legs are held aloft by the abdominal muscles (along with the hip flexors), making them quite strong. If you find yourself struggling to lift the legs, know that your effort is strengthening your abs and that in time you will get them up.
The posture ends up being quite engaged, with your muscles so tight that breathing is difficult. This is okay. Hold the posture strongly for a few seconds before relaxing and breathing. Then do it again. With practice, Palmstand balances the body and remedies two of the most common physical issues in our culture.
In the yoga world, forward folding is practically an obsession. We stand with our legs together and bend forward, we separate our feet and bend forward, we stand on one leg and bend forward, we sit and bend forward...you get the idea.
But most of us know that we need to strengthen our abdomen to support the spine and release the low back. The same can be said for the hamstrings: strengthening them will stabilize the pelvis and support the spine.
The muscles in the front of the hips, called the hip flexors, are another well-known area of tightness in the body. Their tightness is exacerbated by the amount of sitting we do. This tightness creates length in the hamstrings, because the two muscle groups are reciprocally related, i.e. the condition of one group is generally the opposite of the other.
It is well-known that we need to lengthen the hip flexors to relieve hip and spinal issues. Because the hip flexors are reciprocal to the hamstrings, length (stretching) in the hamstrings will lead to more shortness/tightness in the hip flexors, which is undesirable. Another reason why the hamstrings should be strong, not long.
STRENGTHEN THE HAMSTRINGS
Hopefully you can see that strong hamstrings will help to alleviate many common problems in the pelvis and spine, and that over-stretched hamstrings will exacerbate frequent pains and imbalances. So, how do we strengthen the hamstrings?
Squatting exercises and postures like Chair Posture go a long way to strengthening the hamstrings and glutes. They also integrate the hips with the abdomen, which is great. See the link on the right (Understanding Chair Posture) if you have questions about how to do Chair Posture.
Another great way to strengthen the hamstrings is by tipping the body forward halfway, as in Balancing Stick, pictured at the top of this article. Balancing stick is done on one leg, but you can also do the exercise on both legs by standing on two feet and bending forward halfway. Don't go past halfway, since we're not trying to stretch the hamstrings.
Two great strengthening postures can be done lying on the back: Bridge Posture and Jastiasana, both pictured above. Lie on your back and lift your hips in the air. You will need strength in the back of your hips, and this strength will help to release your hip flexors.
Scott & Ida are Yoga Acharyas (Masters of Yoga). They are the head teachers of Ghosh Yoga. This blog is about their experience with yoga practice, study and teaching.
- Make the Hamstrings Strong, Not Long
- Understanding Chair Posture
- Lock the Knee History
- It Doesn't Matter If Your Head Is On Your Knee
- Bow Pose (Dhanurasana)
- 5 Reasons To Backbend
- Origins of Standing Bow
- The Traditional Yoga In Bikram's Class
- What About the Women?!
- What About the Hips?
- Why Teaching Is Not a Personal Practice
- The Central Psoas
- The 113 Postures of Ghosh Yoga