Yoga is often recommended as an injury prevention and rehab tool since it can increase flexibility and balance while boosting a mindful approach to movement. But just because it’s low impact and some classes are labeled as “gentle” doesn’t mean it’s an injury-free zone.
“There’s a perception that whatever you do on your mat is automatically safe,” says Dennis Cardone, associate professor of orthopedic surgery at NYU Langone Medical Center. “But that’s simply not true. Also, it may lead to a false sense of security and overconfidence; a dangerous mix that can result in a chronic issue in the long run.”
For example, yoga offers a good way to warm up for other activities — which can lower your risk of injuries as a result — however, Cardone says it’s helpful to be aware that improper form can cause problems. Here are the five most common issues, along with tips on how to prevent them:
HAMSTRING ATTACHMENT STRAIN
Yoga students seem to be especially prone to hamstring attachment issues, compared to those doing other types of activities, says yoga teacher Simon Park of Liquid Flow Yoga, which leads workshops around the world.
Located at the top of the hamstring, where the tendon attaches to the sit bone, this tiny area deep inside the bottom of the glutes can tear slightly with repeated overstretching. So, poses like forward folds can cause a strain if done too aggressively. When that happens, the tears can cause scar tissue to build up, and that can make the tendon even tighter.
“That leads to a student thinking they have to stretch even more,” says Park. “That, of course, just makes it worse.”
To minimize the chances of this happening, bend the knees and consciously engage or tighten the hamstrings. Often, hamstring attachment problems start because the hamstring releases and is slack as we hinge forward. That can cause a sharp tug on the attachment’s tendon, resulting in a tear.
When it comes to medical visits that originate with yoga, wrist pain may be the top complaint, Cardone notes. This tends to happen most with fast-moving yoga practices where students are jumping back into plank pose and then jumping forward.
In some styles of yoga, a common instruction while in plank is to tilt forward, so the forearms go past the wrists. Over time, moves like these could strain the wrists.
“Our wrists were not meant to bear our entire weight, that’s just not in our physical design,” says Cardone. “If it’s done briefly, there’s usually not much of a problem. But when the wrists are loaded with weight, over and over, then chronic pain can result.”
To reduce your risk, distribute your weight throughout your body, rather than pushing forward in less-intensive poses like downward dog or plank — this keeps more of the stress off your hands and wrists. Also, do significant warmup poses before attempting handstand, so your alignment is better.
Thanks to hunching over smartphones, a condition called “text neck” is now a thing. Tilting the head forward all the time can increase the load that has to be supported by the neck and spine.
That can lead to weakened neck muscles that are more prone to injury in certain yoga poses, especially if you’re twisting your head one way and your body the other or trying to constantly look up in a pose like upward facing dog.
Particularly tough are poses like camel where students let their heads fall back, in a gesture that seems like it’s releasing the neck muscles but may actually be putting more pressure on them.
Whether you’re prone to text neck or not, create a better environment for your neck in yoga class by increasing your shoulder strength, which can help support your neck better.
Also, avoid completely letting your head and neck release so the full weight of your head is tipped backward. This can strain the front of your neck but also cause compression in the back of the neck.
ROTATOR CUFF INJURIES
Many yoga poses involve bringing the arms over the head, Cardone says, and if done improperly, the rotator cuff could be at risk for problems, especially over time.
The rotator cuff is comprised of four muscles that stabilize the shoulder. They wrap around the joint from the back, front and top, connecting the ball of the joint into the shoulder socket.
Sometimes, the muscles are underworked, making them weaker, and that can make a vigorous yoga practice into a bigger risk. Poses using weights or sequences that rely on shoulder strength can overtax the rotator cuff and cause compression and inflammation, says Cardone.
Protect your cuff by strengthening your arms gradually. For example, in pushup variations try having your knees on the ground or lowering by only a few inches before pushing back up. Keep your elbows in close to your body rather than winging out, which can also strain weak rotator cuff muscles.
LOWER BACK PAIN
Yoga is beneficial for back muscles, especially since it puts an emphasis on releasing tightness in the hips — sometimes a major component in lower back strains. But yoga can also be a contributor to pain in that area, Cardone says.
“This happens most with people who feel competitive about yoga,” he notes. “They try to touch their hands to the floor even though they haven’t been able to do that before, or they lock their knees when bending forward, thinking that’s the ‘right’ way to do it.”
Protect yourself by remembering yoga isn’t a competition — there’s no yoga in the Olympics, after all — and it’s much better to focus on alignment than “progress” in a pose. Also, if you already have lower back issues, limit the amount of twists you do or at least do them gently and with minimal twisting to avoid exacerbating the issue. It’s also a good idea to talk to the teacher before class so he or she can suggest modifications.
INJURY PREVENTION STRATEGIES
As well as implementing strategies specifically for these areas, there are some good general principles to keep in mind, according to Park.
The most common missteps he sees are students practicing too aggressively — meaning they make every transition into a power pose — and progressing into a more complex pose without doing enough to warm up first.
“Often, students believe that if they do more, if they go deeper into a stretch or arch their backs more, that’s a good thing because it’s more challenging,” Park says. “But that can feel like just pushing your body around. You’re not working with it, not paying attention to what constitutes your true edge.”
Challenging yourself can feel satisfying, but it’s very helpful to understand the difference between going a few steps outside your comfort zone and leaving it completely. Listen to your body, adjust according to your needs and increase the level of difficulty gradually. That way, you’ll get all of the benefits with fewer injury risks.