Your right quad hasn't been the same since that run. The injury to your rotator cuff has frozen your painful shoulder. Carpal tunnel syndrome is a thing... and it's got you by the wrists. Maybe yoga can help to restore you to flexibility and function.
What Is Yoga Therapy?
Yoga therapy adapts the ancient practice of yoga to help with a great deal of physical ailments, including:
- Muskoskeletal or joint injury
- Chronic health conditions
- Side effects of allopathic treatments like chemotherapy
- Recurring injuries based on misalignment or a lack or strength or flexibility
Yoga therapy can de-stress, calm, and focus a patient who has suffered a physical trauma or who is anxious about her health and mobility. Yoga can ease pain, increase vitality, improve attitude, restore balance and normal activity, expand flexibility and range of movement, and generally contribute to health and wellbeing. The therapy is a gentle practice tailored to each client and specific injury.
Yoga Plus Traditional Medicine
In the case of injury, yoga therapy is a complement to traditional medical care that works in tandem with allopathic treatment. Yoga helps restore flexibility and range of movement recovery after surgery and can prevent adhesions. It strengthens and realigns older bodies to improve balance, lower the chance of falls, and encourages independence in daily activities. It reveals postural and positioning anomalies that can cause repetitive motion injury in workers, such as carpal tunnel syndrome, or in runners who develop piriformis syndrome.
If you become injured, seek appropriate medical attention for the acute injury and ask your medical practitioner about adding yoga therapy to your recovery plan. If you notice a persistent or chronic muscle discomfort or a tendency to repeat a muscle or joint injury, a yoga therapist can identify a weakness, movement pattern, or behavior that contributes to the problem. The therapist will then work with you on specific asanas or a customized sequence to correct the problem that causes the chronic injury.
How Does Yoga Therapy Work?
Dr. Steven Weiss, a licensed chiropractor, nutritionist, and yoga therapist, and author of The Injury-Free Yoga Practice, who offers yoga therapy in his practice in Sarasota, Florida, stresses that yoga therapy always begins with a question of alignment.
"All yoga is alignment," he says. "Alignment is the key to all therapy. There's nothing magical about asanas. The magic is in the overall form of the pose: For a rotator cuff injury, how does this shoulder joint move to bring my arm up? If I have a quadriceps injury, how do I strengthen the supporting muscles along the sides of my knee?"
Dr. Weiss begins by assessing postural alignment in poses like mountain and warrior. He then develops a therapeutic sequence to correct misalignment that contributes to or results from an injury. The pose "prescription" includes holistic stretching and strengthening of the muscle systems related to the injured area.
How Does a Single Pose Work?
Chair, or utkatasana, is a standing, active pose -- unlike chair yoga, which is a seated series of asanas that allows mobility-challenged people to begin rehabilitation or improve range of movement and flexibility. Chair pose is a semi-squat -- you'll feel the burn in your thighs as you hold the pose. That's one way you know the asana is working to stretch and strengthen injured quads. It also builds strength in the entire thigh, the calves and ankles, and can relieve lower back pain.
Dr. Weiss adjusts patients in the pose to improve the alignment of the spine and strengthen the whole back. Scooping the tailbone forward corrects overarching in the lumbar spine. Drawing the navel in and jutting the ribs forward lengthens the spine and opens the chest and back.
Modify the pose by raising your hands high over your head, palms facing each other, to stretch your chest and shoulders. Test your alignment, or find extra support in this pose if you are weak or taking it slow, by standing with your back to a wall, tailbone barely touching the wall. Start small, with three to five breaths, and stay in the pose longer as you gain strength.
Frequency and Repetition
A therapist will adjust the timing of the poses and the frequency of practice to each patient and each injury. Few therapists are willing to make a blanket statement about ideal practice goals and limits. But, for injuries like those that cause lower back pain, a study published in the International Journal of Yoga Therapy points out that passive, supine poses like savasana -- corpse pose -- should be held for up to five minutes to retrain muscles or to reduce inflammation at the point of injury.
Active poses designed to increase mobility may be held briefly for up to 20 seconds and repeated up to eight times. Once healing progresses, the patient may hold a pose for up to two minutes, with fewer repetitions, to improve strength and flexibility and restore proper anatomical alignment. Daily work on assigned poses yields gradual improvement and consistent results.
Poses That Help Heal
Laura Staton is a Brooklyn-based Integrative Yoga Therapist with a Master of Science in occupational therapy. She works at Staten Island University Hospital, teaches therapeutic studio classes, and sees patients privately. She stresses that every client is different, but her go-to poses include a half-dozen or more that typically find their way into a sequence designed to promote healing.
"The pose really depends on the goal," says Staton. "Chronic muscle tightness is a common issue, and one approach to releasing and rehabilitating a muscle or joint injury is to work with the supporting surrounding muscles."
Staton suggests you might find the following poses in a yoga therapy session designed for your particular injury.
Mountain pose, or tadasana, will strengthen thighs, knees, and ankles, ease sciatica, and correct posture. Poor posture causes or contributes to many injuries, especially for weekend athletes who desk-jockey all week. In mountain, stand tall, feet barely touching and parallel, body stacked so the head is centered over the widespread shoulders, the lifted ribs, the pelvis, all the way to the floor between the ankles. Breathe for one minute in perfect balance, muscles lightly contracted, thinking tall. To increase the balance challenge, close your eyes, or raise both arms straight up and clasp them overhead.
Tree pose, or vrksasana, stretches your groin and inner thighs and expands your shoulders and chest. The one-legged pose strengthens the spine, calves, thigh, and chest, opening the rib cage for better breathing. To regain balance or stable footing after an injury, tree pose is your challenge. You'll be working your core and your mental focus to avoid wobbling and stay strong yet relaxed for the 30 seconds or more that you breathe evenly through the pose.
Boat pose, or navasana, is magic for tight hip flexors and groin and strengthens your core muscles at the same time. Strong core and flexible hips equals healthier back. Pulled groin muscles are painful and immobilizing. After the initial trauma treatment, when the inflammation subsides, boat pose will release tightness, restore range of motion, and strengthen injured muscles. Seated on the mat with legs extended and spine tall and straight, press your hands to the mat just behind your hips, bend your knees, and raise your legs together, then straighten your knees so your toes are at eyebrow level, about 45 degrees. Extend your arms parallel to the sides of your thighs or knees. Hold the pose for 10 to 20 seconds at first. If you can't straighten your knees, keep them bent, shins parallel to the floor.
This one -- downward-facing dog, or ahdo mukha svanasana -- is the big dog. It does everything, and you'll find it in most therapeutic sessions, such as in dynamic stretch sun salutations or by itself. Downward dog stretches wrists and hands, the arch of the foot, calves, hamstrings, the back, and shoulders. It strengthens arms and legs, builds bone, lowers stress and blood pressure, and can help with arm, shoulder, and hamstring injuries. If the full dog is too much at first, place your palms on a chair or against a wall. Hold the stretch for one to two minutes, if you can, before releasing the pose.
Extended Triangle Pose
Triangle, or utthita trikonasana, is an all-purpose, feel-good stretch that strengthens. It lowers stress and relieves an aching back, and it lengthens or opens the shoulders, chest, spine, groin, hips, hamstrings, thighs, calves, knees, and ankles. Bonus: it also strengthens the thighs, knees, and ankles. Triangle can help with an injury to the intercostal muscles by opening the rib cage and restoring flexibility and free breathing. Try for 10 deep, even breaths on each side.
Cobra pose, bhujangasana, is a slow, adaptable back-bending stretch that is easily modified to rehabilitate upper and lower back injuries. The full pose -- hip bones and thighs on the mat, legs fully extended behind you, palms on the floor under the shoulders, and elbows straightened to push your body up and back into a strong curve -- can be difficult or impossible to perform for someone with a back, wrist, or shoulder injury. So Staton recommends placing a folded blanket under the pelvis and starting with the body weight supported on the forearms, resting them as wide as the edges of the mat. This keeps the arch small and soft and relieves pressure on the arms, shoulders, hands, and pelvic bones. Go for three to five slow, steady breaths at the height of your arch. You get the benefit of a back bend without having to execute the full classic pose, allowing you to build strength and flexibility as you work safely toward full arm extension and a deeper arch.
Don't Overdo It
Some poses, while extremely beneficial for a healthy yogi or yogini, are too challenging or too risky for a patient in recovery. These are asanas to avoid or to approach slowly.
Inversions are more advanced asanas, rarely assigned in the initial stage of a healing program. Headstand and shoulder stand are the marquee inversions, known as the King and Queen of poses. But headstand requires strong core muscles and places your full body weight on your shoulders, arms and wrists. Shoulder stand challenges the back, shoulders and neck and should only be attempted with props, a comfortable, supportive cushion, or folded towel beneath your shoulders to maintain a safe angle for the neck.
Milder inversions are frequently part of therapy, though. Downward dog lifts your butt higher than your head and provides so much strengthening for the upper body and stretching for the hamstrings and calves that you'll find it in many therapy sequences. Another way to introduce the benefits of inversions without the risk is a pose like legs up the wall, in which you lie on the mat with your glutes close to the wall and your legs extended up and resting against the wall. In every case, pain is not part of the pose. Work with your therapist to find the poses and modifications you can handle and never "push through the pain."
How to Find a Yoga Therapist
Growing numbers of medical doctors prescribe yoga therapy as part of treatment in recovery from an injury or surgery. But they're not sending you to yoga class. A yoga therapist is a certified yoga teacher, nurse, or licensed physical therapist with hundreds -- sometimes thousands -- of additional hours of training in techniques that include asanas, alignment, breath work, meditation, ayurvedic nutrition, and traditional yoga philosophy.
More than 3,400 of them are certified members of the International Association of Yoga Therapists (IAYT), and that can be a good place to search for a credentialed professional in your area. Hospitals and clinic programs may feature affiliated yoga therapists, and some offer regular therapeutic yoga classes for rehabilitation and prevention.
For specific injuries, yoga therapy is most often customized and personal, so you may need one or more private consultations or sessions to address your problem.
Injury-Free Healthy Habits
An injury can represent a weak point that you either baby or strengthen going forward. Obviously, the best option is to prevent future injury, so therapeutic yoga then becomes a regular practice. Whether you use yoga therapy to recover from acute trauma or to address the physical challenges of a sport or occupational activity, attention to the asanas results in better body awareness and a lower risk for injury.