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!
When we practice yoga postures, we might be doing them for different reasons. We may be trying to reduce the pain in our backs, improve our balance, burn a few calories or experience a deeper spirit within. These are drastically different goals, and we can't use the same techniques to achieve them all. Hundreds of "yoga" postures and practices exist these days, and they don't all attain the same things. As you practice, think carefully about what you are trying to accomplish, and use those postures that will help. Here are the 5 different types of yoga postures:
1. Seated, meditation postures. These are the oldest, most traditional yoga postures. When the Yoga Sutras (or any text that is more than 1,000 years old) refer to asanas, this is what they mean: a seated, upright, stable and relaxed position. These positions are not used for their own benefit or to create health, but to facilitate the more internal practices of breath control and meditation. These are the quintessential "yoga postures," Lotus and Siddhasana.
2. Positions to prepare the body for seated meditation or help the body recover from it. As anyone who has tried to sit still for a long period of time knows, it is difficult for the body. A certain amount of flexibility is required in the hips and knees, and some strength and control is required in the spine. How does one build these? Several positions, usually seated, were propagated in early hathayoga to help the body prepare for sitting or recover from the imbalances that arise during sitting. These postures include Cowface, Butterfly, Cobra, Bow and Locust. These are some of the first non-Lotus postures.
3. Anti-gravity postures. Influenced by tantra, hathayoga had many practices that were designed to prevent the precious bindu from dripping out of the head and into the abdominal fire. This was thought to improve vitality, spiritual potency and life. This is where we get the practices that turn the body upside down or "draw upward" the energy, winds or fluids of the body. Headstand, Shoulderstand, Mula Bandha, Uddiyana Bandha, and the upward-focused intention of many postures are intended for this purpose.
4. For physical health. These postures and exercises are much more recent, often coming from calisthenics, gymnastics and wrestling. They build strength, flexibility and health in the body. There are lots of different positions that affect varied parts of the body, so they are vast and diverse. Kuvalayananda called these "cultural" postures. These have become central to the practice of modern yoga.
5. For demonstration and impressive accomplishment. From ancient times, yogis have been associated with the ability to do remarkable feats. In the last couple hundred years, that has increasingly meant physical demonstrations of balance, endurance, strength and flexibility. Influenced by the developments of gymnastics, acrobatics and contortion, these practices include Splits, Handstand and most arm balances. This tendency toward outwardly impressive beauty has been compounded with the rise of photography, the internet and visual communication media like Instagram. Who doesn't love to see a beautiful, impressive picture of a body?
One type of posture is not better than the others. There is no hierarchy here, though as yogis some danger lies in focusing on the body and in cultivating techniques for display. Worth noting is that postures can have drastically different purposes, goals and intentions. When we practice them, we should know what we are practicing so we can move in the right direction.
Western medicine has known for decades (and yogis have known for thousands of years) that controlling the breath is a powerful tool to access the mind.
Now we know that this connection is largely via the autonomic nervous system. Every time we inhale, the heart rate goes up a little. And every time we exhale, the heart rate goes down a little. This is controlled by the two parts of the autonomic nervous system (sympathetic and parasympathetic, respectively).
In everyday life we tend to get overwhelmed with tasks and stress, which causes an overstimulation of our "active" nervous system. Our heart rate stays a little higher, we have trouble relaxing and we feel this as stress.
In recent years breathing techniques have been making their way into the popular culture, with everything from heart rate variability monitoring devices to smartphone apps that help you control the breath. This includes a great new app called the "Breathing App" developed by yogi Eddie Stern and Deepak Chopra.
The basis of their app is so-called "resonance" breathing, a specific, regular tempo that has benefits like lowering the blood pressure, improving heart rate variability and positive applications for anxiety and depression.
The tempo is not difficult to achieve and is accessible for nearly every person. It ranges from breathing 5-7 times per minute as opposed to our normal rate that is closer to 15 times per minute. (5 times per minute is 12 seconds for a complete inhale & exhale. 7 times per minute is about 9 seconds for a complete inhale & exhale.)
We recommend the "Breathing App." It is free and quite simple to use. It requires nothing more than a couple minutes of your time to breathe, regulating your inhale and exhale to achieve the coherence and resonance between the breath, heart and nervous system. Hopefully it will bring a little bit of peace, relaxation and well-being.
Put your forehead on your knee!
We've all heard this instruction thousands of times. The phrase and its variations have become synonymous with correct practice of "head to knee" postures. The problem is this: the forehead touching the knee should be a result of the correct muscular usage, not the end goal.
This may be a surprise, but there is little to no benefit in touching your head to your knee. Unless you are making the argument that the head benefits from its contact with the knee (which it might, due to a nerve plexus or gland), or the knee benefits from its contact with the head, it becomes obvious that the value of the position lies somewhere else, even if the well-known signifier of the posture is the famous "head on the knee."
The distinct benefit comes from using the abdominal muscles (rectus abdominis) to bend the spine forward, compressing the organs, glands and intestines; and from forward- bending the neck, compressing the throat. These two foundational elements are then accentuated by what the rest of the body is doing, whether balancing on one leg as in Standing Head to Knee, maintaining external rotation of the opposite hip as in Seated Forehead to Knee, or kneeling as in Rabbit.
Sometimes the cue---to put the head on the knee---and the posture work together. Great! The muscles in the neck and abdomen engage, the spine bends forward, the throat and abdominal contents get compressed, and the head touches the knee.
But often the instruction and the posture don't work together. Our head may be able to touch the knee without the valuable engagement, bending and compression. We get the end result of the cue, so we think we are benefitting from the posture. But the important parts of the posture are left undone.
Those that struggle with "head to knee" poses will get great benefit in finding their abs and contracting them as best they can. Will their head get close enough to touch their knee? Maybe, but maybe not.
Those that are stronger should try to get their head closer to their hip than their knee. This will continue to develop their abdominal strength and compression past the point of their head on their knee.
"Touch your forehead on your knee" can be a great visual cue. However, as practitioners and teachers, we need to remember cues are attempting to make an action happen in the body. They are not the goal in and of themselves.
In a yoga class there are many complex and interesting postures to put the body in. They challenge our strength, flexibility, balance, concentration and coordination. It is easy to get lost in fascination with this complexity and lose track of the simplest, most fundamental things our body should be able to do: squatting; sitting up and its opposite; pushing up with the arms; and pulling up.
The opposite of a sit-up is also important. You may call it a back sit-up, back extension or Cobra Posture as it is often named in yoga (pictured at the top of this article). Either way, it involves lying on your abdomen and using your back muscles to bend your spine backward. The combination of these two motions---sit-up and back sit-up (cobra)---will strengthen and stabilize the spine.
These are 5 simple and important movements that every healthy body should be able to do to some degree. If we lose our ability to do these basic movements but still cultivate more complex ones, we are increasingly likely to develop imbalance and injury. Since the physical practices of yoga are about balancing the body more than anything else, it is always worth visiting and revisiting these movements. Without a balanced body, a balanced mind is almost impossible.
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.
Here are three of the simplest and most useful postures you can do. Do them in the morning right after you get out of bed, do them in the middle of the day for a boost of energy or to reduce your stress. You can do them late in the day, too, but then you should do the Wind Removing Posture twice instead of once. It will prevent your nervous system from getting too energized before bed.
PLANK (pictured above left)
This posture will strengthen your arms, shoulders, chest and abs. It can help improve your posture and reduce back pain.
Hold the body as straight as possible, including the spine, hips and legs. It will be difficult to breathe, but that is because you are using your muscles. Take small breaths, keep your neck and face relaxed, and hold the posture for a minute if you can. Then rest and breathe normally for a minute.
COBRA (pictured above center)
This posture will strengthen your back and release tension in your chest and throat. It compresses the kidneys and adrenal glands in your mid-back, helping to reduce stress by reducing cortisol. It will help to stabilize your spine, reduce back and neck pain.
Lie on your belly with your hands under your shoulders. Lift your head and shoulders using the muscles of your back. You may need your arm strength a little bit, but use it as little as possible. You will feel the muscles on your back near your spine light up. Breathe up high in your chest, near your collarbones. Hold it for a minute if you can. Then relax and breathe normally for a minute.
WIND REMOVING, SEATED (pictured above right)
This posture calms your central nervous system and stimulates your digestion and immune system. It is so simple to do, yet incredibly effective.
Sit and pull your knees close to your chest. Wrap your arms around your legs. Now breathe deep into your belly. This is important. As you inhale, you will feel your abdomen expand and press into your legs. This type of breathing affects your nervous system, digestion and immune system. Do this for a minute and then lie down on your back and relax for at least one minute.
In our normal bodily positions like standing or sitting, the head is above the heart. Pumping the blood from the heart up to the head requires fighting the effects of gravity, so blood pressure in the head is higher than other parts of the body.
When we adjust the position of the body, as we often do in yoga practice, the head sometimes goes below the heart. When this happens, gravity pulls blood into the head, raising the blood pressure. Our body adjusts by decreasing the blood pressure in the head to protect the brain and face. This effect can be both positive and negative depending on our health and our bodies' ability to adjust the pressure.
If we are healthy, the shifting of the blood pressure up and down can be beneficial, teaching our systems how to respond to changing conditions. This is why healthy people should put the head below the heart.
If we have high blood pressure we must be very careful. Whenever the head goes below the heart, it is possible that the blood pressure will get dangerously high before the body responds. Or the body may not respond effectively and let the blood pressure stay too high for too long. So those of us with high blood pressure should take care when putting the head below the heart.
We can do gentle "inversions" by bringing the head even with the heart or only slightly below. This can be done in forward folding positions and kneeling positions like Half Tortoise or Child's Pose.
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