Can Yoga Cause Injury?

I recently received this link from a friend with the title, “Bad Karma: How Yoga Can Lead to Serious Injury – Sloppy teaching and overly competitive students are giving yoga lovers serious and scary injuries”. As you can see, the title says it all. So, the answer to the question, “can yoga practice cause injury?” is apparently “yes”.

But this begs the question – how can a practice which is considered to be a healing art and science cause physical injury? To understand the answer to this question, we have to recognize that like any other physical exercise, yoga also involves physically stretching the body in different ways. Injury occurs when we don’t pay attention to the basic safety guidelines which have been prescribed for every form of exercise.

Definition of Asana

When practicing yoga, we need to constantly remind ourselves of the basic definition of an asana (posture) according to Patanjali – “sthira-sukham- asanam” (Yoga Sutra 2.46) which means “a posture must be ‘sthira’ – steady/firm AND ‘sukham’ – comfortable”. Even though Patanjali intended this definition to be applied to meditative sitting postures only, the definition is now commonly extended to the postures that are practiced as part of a Hatha Yoga practice. For example, if you are doing a seated forward bend, you should be able to hold the final position steady while feeling comfortable in the pose. I always tell my students that you are comfortable in the pose if while maintaining the pose you can maintain a genuine smile on your face. If you have a convoluted expression in your face while trying to get into the pose or while in the final pose, you definitely are not in a ‘sukham’ position. While practicing our asanas, we need to develop the ability to distinguish between minor discomfort and pain. We must remember that we need to challenge ourselves in our practice so we can develop leaner and more flexible muscles. As we know, one of the five Niyamas is ‘tapas’ which is usually translated as ‘austerity’. In our yoga practice we can take it to mean that we take ourselves to the edge in the practice but not beyond. When we take ourselves to that edge, we will feel some level of discomfort for a short time. However, if that feeling becomes ‘painful’ then we have extended ourselves beyond our capability. So it is critically important that we are fully aware of every move that we are making and where the edge happens to be for that move. If we go beyond the edge, injury WILL most likely occur. But if we learn to step back a little when we get to the edge, we will keep our practice very safe.

Students pushing themselves – spirit of competition

So, why do we allow ourselves to be stretched beyond our limits? It is our ego which is pushing us to try harder so we can ‘show off’ that ‘perfect’ pose to ourselves, our teacher or the rest of the class. Our ego is driven by our desires, our insecurities and our fears. We live in a culture which rewards the number one and looks down upon all the “also rans”. We tend to be competitive with others as well as ourselves. It is as if we are there to prove something or to achieve something. Yoga is a deeply personal experience and should really never be guided by any extraneous circumstances. We need to constantly remind ourselves that yoga is not a competitive sport. At our deepest core, we are perfect the way we are.

In an article in the Yoga Journal, Carol Krucoff  writes, “I lifted one foot, grabbed my big toe, and extended my leg into Utthita Padangusthasana (Extended Hand-to-Big-Toe Pose)—and felt a sickening pop in my hamstring… It took me six months to be able to run again and more than a year to fully extend my leg in Hand-to-Big-Toe Pose. I learned the hard way that there is no place for showing off in yoga.”

Teachers pushing the students

Another major reason for yoga-related injuries is that many teachers tend to push the students to achieve ‘perfection’ in a pose. Sometimes in the interest of helping the students, they end up making vey harsh adjustments which can easily result in injury. Part of the reason for this might be the lack of proper teacher training for some of the teachers. With the increasing popularity of yoga, there is a great demand for teachers. To meet the demand many programs which last only a weekend have come up to train yoga teachers. These teachers usually come from a fitness background and are ill-equipped with the subtleties of the philosophy, psychology and the practice of yoga. As a result, not only do they practice and teach yoga purely from a physical perspective, they are not able to communicate to the students the value of awareness and mindfulness which is critical in preventing injury. In some instances, even the highly experienced teachers have a tendency to push their students.

Pace your progress

Because of the popularity of yoga, many new students are drawn to the practice. Since most people lead a pretty sedentary lifestyle, their muscles and joints are usually very tight. However, when they get to a yoga class, they see around them some of the well-sculpted bodies of students who have been practicing for a while. In an effort to emulate their bodies and their movements in the poses, they tend to over-extend themselves which results in injury. It is very important to pace the progress in your yoga journey, taking it easy in the early stages. Only when you feel that you have gained some experience and are able to assess your own edges, you may try to deepen your stretches.

Find an experienced yoga teacher

These days there is a spate of yoga-related books, DVDs and online videos and podcasts available which make it attractive for people to use these as guides and practice on their own at home. There is no doubt that practicing at home is highly desirable to deepen the practice and the experience of yoga. However, in the beginning, it is very important to learn the proper technique and movements for all the yoga poses from an experienced and qualified instructor. The instructor can guide you properly based on your own background and experience as well as keeping in mind any physical injuries or other limitations that you might have. If you forgo this important step of learning from an instructor, you may end up doing a pose the wrong way for a long time, eventually ending in serious, sometimes irreparable injury. In case of a doubt regarding the mechanics or alignment in a pose, do not hesitate to consult with your teacher.

Start with a warm-up

It is important to do some gentle warm-up stretches in the beginning of each class. In my classes, I use the cat-cow stretch as a warm-up. Many times I also add some ankle, knee and leg stretches from a seated position. These stretches allow the spine and other joints to loosen up gently and prepares you for deeper stretches. Even in a sequence like the Surya Namaskara (Sun Salutation), you should try to do the first round at a gentle pace. When you feel that your body has sufficiently warmed up, then you can start experimenting with deepening the stretches.

Practice with full awareness

Yogis tell us that we can look at ourselves as consisting of five koshas (sheaths) – Annamaya Kosha (the physical sheath), Pranamaya Kosha (the vital sheath), Manomaya Kosha ( the mind sheath), Vijnanamaya Kosha (the intellect sheath) and the Anandamaya Kosha (Bliss sheath). Of these, the first three – physical, vital and mental – are more readily accessible to us. In our yoga practice, we need to be fully aware of these levels at all time during the practice. Listening to messages received from the body, observing any changes in the breathing pattern, and watching the mind by observing feelings and emotions arising in the mind will help develop a sense of harmony among these three layers. This will alert us any time we try to go beyond our limits so we can immediately take a step back and prevent any potential injury. Please read my post on mindfulness here for some more discussion on this important topic.

An extension to this concept of awareness is to learn when not to hyperextend the knees, elbows or other joints. In a standing forward bend, for example, there might be a tendency to hyperextend the knees. If your practice requires long hold times for poses and you do this repeatedly, then there is a possibility of injury if the knee is hyper extended. Similarly we must avoid hyper-extending the wrist in the upward-facing-dog position.

My personal example

In my own practice, I have suffered a few injuries which took a long time to heel. After I finished my yoga teacher training in 1996, I started teaching a few classes on a part-time basis. In my classes I noticed that many of my students were more flexible than I was, especially when it came to simple forward bending poses. In the Paschimottonasana (seated forward bending pose), for example, some of my students were comfortable bringing their forehead to the knees. In my own case, I could reach the toes with my hands but I was unable to lower my forehead to my knees. Watching these flexible students, my ego as a teacher took a jolt and I started trying harder to build more flexibility. And, of course, as expected, I ended up hurting my back.I could not sit on the floor anymore and had to teach my classes sitting in a chair for the next couple of weeks. A few years later I injured my knee while trying to sit in Padmasana (Lotus Pose) for long periods of time. Over time, I have learned my lessons well and hopefully will be able to overcome pressures from the ego and stay injury-free!

Apply Yoga Philosophy

Patanjali’s philosophy as explained in the Yoga Sutras can be directly applied to our daily practice. The five ‘yamas’ (social discipline) and five ‘niyama’ (self-discipline) contain the most practical guidelines for making progress in our yoga endeavors. For example, ‘ahimsa’ (non-violence) can be directly applied to our asana practice. If we stretch ourselves beyond our capacity we are violating the principle of ahimsa by hurting ourselves. Similarly, one of the niyamas is ‘santosha’ (contentment) which tells us that we need to be happy and contented with our current state of the body, accepting it as it is without judgment. I think the most important of these guidelines is ‘ishvara pranidhana’ (surrender to a higher principle). As per this value, we completely let go of the ego, practicing yoga purely as an offering to this higher principle and accepting with grace whatever outcome we get out of the practice.

So, in summary – yes, it is possible to get injured practicing yoga; but it is up to us to follow certain fundamental guidelines, as stated above, and keep our practice free of injury. Here is a summary of the guidelines that will help us avoid injury:

• Remember the definition of Asana: “sthira-sukham-asanam” – steady and comfortable – holding the final pose with a genuine smile.
• Start with gentle warmup: simple cat/cow stretch, gentle ankle and knee stretches etc.
• Find a Qualified/experienced teacher: find a teacher who can work with you at your level and guide you with a safe practice, not pushing you.
• Awareness/mindfulness: Complete awareness at the body, breath and mind levels. Listen to the body – backing off when approaching the edge.
• Yoga is not competitive : Yoga is a personal experience; there is no room for competition either with others or with yourself.
• Pace your progress: Nothing happens overnight. Allow your muscles and joints to get used to various stretches before attempting to go deeper.
• Seek guidance: When in doubt, ask your teacher or refer to an authoritative book.
• Apply yoga philosophy: Yoga Sutras of Patanjali represent the guiding philosophy not just for your yoga practice but for life in general. Apply the concepts of ahimsa (non-violence), santosha (contentment), tapas (austerity), and Ishvara pranidhana (surrender to a higher principle) to your yoga practice.
• Avoid hyperextension: Avoid tendency to hyperextend the knees in poses like forward bends or the elbows in up-dog etc.

I would love to hear your stories of any injury that you might have sustained while practicing yoga or how you have been able to stay injury-free over time. Please post your comments.