Oh, and it’s not officially called “yoga wrists” even though wrist pain can get triggered in yoga. It can also occur in things like CrossFit or just by using bad ergonomics at work, says Robert Gillanders, a physical therapist in the Washington area. “Good alignment applies to everything you do — from riding your bike to how you set up your keyboard,” he says.
The bottom line is that when the wrist is hiked upward — extended — it puts stress on all the soft tissue, especially tendons, in the wrist. When it comes to keyboard typing with hiked wrists (your wrists should be completely neutral), the stress is low but frequent; when it comes to things like yoga or CrossFit, the stress is high but infrequent, he says.
When the stress is high, it can trigger pain and eventually injury, says Angelo Dacus, an associate professor of orthopedic surgery at the University of Virginia, who specializes in hand and other upper extremity disorders.
“People walk on their feet, not on their hands,” says Dacus. “So when we load the wrists, it’s important that we allow for a certain adjustment period.”
In other words, if we are using our hands as feet such as in arm balances, planks and downward dog, we need to give them a chance to get stronger gradually — not go from couch to 100 chaturanga (a triceps-focused yoga plank) push-ups in one practice.
Not only are the forearms and wrists likely to be too weak and unconditioned to hold a plank or do repeated push-ups, but if the core, too, lacks strength, the problem gets compounded as the yogi is likely bring the weight forward toward the shoulders (away from the weak core), creating even more extension in the wrists, Gillanders says.
“Now you’re asking your wrists to work in a very strained position,” he says.
Another reason for wrist pain is the position of the fingers — or rather the weight distribution in the fingers. If you roll the weight out toward the pinkie you are more likely to feel wrist pain than if you place more weight into the “L” shape of the hand — the thumb and index finger, Shade says.
“I’ll say during class, ‘place your hands shoulder-width apart — unless someone has very muscular shoulders, then they might need to be a little wider — and then spread your fingers out wide,’ ” she says.
But the issue can also be lack of flexibility. For example, if you’re doing a downward dog and your hamstrings are very tight, you are likely to lean forward into your shoulders and wrists and cause a similar type of strained position of the wrists.
Know yourself and adapt
Along with alignment, it’s important to progress and modify according to ability and fitness level, agree all three experts.
“Don’t compare yourself to other people in the class. Know your limitations,” Dacus says. “Build your own pose and talk to the instructor for guidance.” For example, if someone complains about low-level wrist discomfort, Shade might suggest the following modifications:
●Instead of downward dog, do dolphin (dolphin is a downward dog done on the forearms.)
●Instead of doing a wheel pose on the floor, you can place blocks at an angle against a wall and place your hands on those blocks.
●Instead of cobra or upward dog, the modification can be a baby cobra or sphinx (a cobra on the forearms).
●Instead of plank on your hands, do a plank on your forearms and come down to the knees if the core is too weak to hold up the hips.
Dacus suggests that if the pain is mild but persistent, you might try wrist wraps during yoga. They provide relief and are also a reminder to be extra careful with your wrists. “They provide compression and support but they also advise you that you have something to be extra mindful of,” he says.
So, what exactly are we being mindful of — is it carpal tunnel syndrome, tendon inflammation, joint impingement? It is more likely to be inflammation or an impingement in the wrist joint, Dacus says. (Carpal tunnel syndrome is less likely if the pain is felt on the back of the wrist, he says, as the condition usually expresses itself with pain in the palm side of the hand and wrist).
For light to moderate discomfort, Dacus suggests keeping an eye on the pain and modifying as discussed above. But if the pain lingers and worsens, it’s time to have it addressed by a doctor.
Gillanders often asks his patients what their level of pain is on a scale from 1 to 10 and suggests the following:
1-3: pain is tolerable; modification can be used but might not be necessary
4-6: pain is moderate; modifications are suggested
7-10: rest and treatment
“And if you have any stiffness or swelling, then it’s time to get it checked out,” Gillanders says.
Shade suggests yogis alert their teachers about discomfort and injuries so that the teacher can either give them modification, suggest a different level or class, or even just rest.
“Mindfulness has to be part of any practice,” Shade says. “Keep observing your body and don’t let anything go unnoticed. That’s when injuries happen.”
Boston is a fitness trainer and freelance writer. She can be found at gabriellaboston.com.
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