Sunday, May 23, 2010

Yoga and Wrists

Please understand that, as with anything on this blog, the below is just my personal opinion and what I believe other instructors to have taught me. I am not a doctor; please see a doctor if you have carpal tunnel syndrome or other wrist issues and need assistance or medical advice.

As many of you know, I have carpal tunnel syndrome. After years spent waiting tables and carrying heavy trays, I attended law school at night while working full-time during the day. This meant I was typing for much of the work day and then nonstop for hours each night as I took notes in class. Then I'd type case briefings, notes, and assignments on the weekends, though I did also take a yoga class most every Friday, Saturday, and Sunday--my yoga practice kept me sane during those four years!

By the second year of law school, I was dealing with serious wrist pain and numbness, and I finally went to the doctor. He recommended I wear wrist splints whenever typing and also when sleeping. I'm embarrassed to admit it took me months to succumb to wearing the wrist splints during class--they're not attractive, and I receive endless questions about them when they're on--but they truly are a blessing. I can't complain one bit about carpal tunnel syndrome when I've got such an easy, inexpensive, non-intrusive remedy. If I wear these, I have almost no wrist pain or numbness on an average day. I just have to be careful not to type for too long, and I've accepted that I'll never be the most sought-after jar opener in my family. I also wear them when I lift heavy things, move furniture, etc.


I have a pair of wrist splints (also called "computer gloves") at work, at home, and in my yoga bag for when I'm checking students into class. The computer check-in process gives me an additional opportunity to connect with students; they often ask me why I'm wearing wrist supports, which can result in helpful conversations about their own injuries.

I've been practicing yoga a little over ten years now, and I've had carpal tunnel syndrome for at least the last four of those years. Throughout that time, I've been paying close attention to all of my instructors' hand placement and especially to their cues regarding hand placement and wrist health. For the most part, yoga has helped my wrists, but I do have to modify sometimes and avoid some poses (crow especially).

Over the years, teachers have told me to press into the knuckles of my fingers and thumb; to grip the mat, which results in many of my knuckles coming off the mat; to press into my fingertips; and to press through the "L" of each hand, meaning press through the index finger and thumb. I've tried each of these, and the only thing that's really worked for me is relaxing through my hands and allowing the knuckles of the index fingers to come off the mat. My understanding is that this is technically incorrect, but it's worked pretty well for me for years now.

I'm not saying any of the cues mentioned above are bad cues--it's just that they haven't worked for me. I've had quite a few instructors teach me new techniques to deal with my wrist issues, but I think they were drawing on knowledge and experience related to wrist injuries, not carpal tunnel syndrome.

But things may have changed for the better. Last weekend I attended two workshops with Nicki Doane, and she spent some time talking about hands and wrists. After talking with her, I finally understand the cue to press into the "L" shape of the hands. She described it in much more detail, and she calls it pressing into the "triad" of the hand. Nicki told us to press into the three places I've marked below.


All of these years, I've been misunderstanding this cue and pressing into #1 and #2 but not #3. It never helped my wrists, so I gave up on that cue, but I've been trying to press into this triad over the past week, and so far it seems to be helping. The jury is still out, as, in my experience, one week isn't long enough to really know if something will work for my wrists, but I am cautiously optimistic!

Another very helpful thing Nicki shared is that we teachers need to be specific when we cue to spread the fingers wide. While we do want students to spread their fingers out, we do not want them to spread their thumb wide. The carpal tunnel narrows when the thumb is spread wide like it is in the next photo.



Instead, the thumb should be kept where it naturally lands, as in the below photo.


Nicki explained that, if hand placement is correct, downward-facing dog can actually help people with carpal tunnel syndrome. But, as you can see from the above, if hand placement is incorrect, downward-facing dog can worsen the condition.

I've read that carpal tunnel syndrome is a contraindication for down dog as well as chaturanga and some other poses, but I've always chosen to listen to my body and continue doing those poses. For me, they seemed to actually help my carpal tunnel syndrome, at least so long as I kept my hands placed the way that felt right for me personally. Now I understand better why that hand placement has worked for me all these years. It was only after I did yoga teacher training and started questioning my hand placement that I began to have problems.

There are also lots of great wrist exercises that can help. The June issue of Body+Soul Magazine explains a couple of quick ones (page 44), and Emma over at The Joy of Yoga shared a terrific wrist sequence earlier this month; click here to check it out!

Does anyone else have any recommendations or other thoughts to share regarding yoga and wrists/hand placement? What works best for you?

9 comments:

  1. Great post! Thanks for sharing your experiences. Yoga can be really daunting for people with wrist problems and I know more than one person who has chosen not to go on because of downward facing dog!

    One modification that can help is to place a rolled-up towel or yoga mat (or two) under the hands to cushion the wrists and make it easier to push the weight back onto the heels. Or, avoid poses like down dog and do puppy pose or dolphin pose instead - same spine-lengthening goodness without the stress on the wrists.

    Great to hear your experience.

    ReplyDelete
  2. PS - you have fabulous looking hands!! Don't know how you manage it... my nails are always chewed off!

    ReplyDelete
  3. This is helpful. I have been confused by the "L" as well!

    ReplyDelete
  4. Wow, what a lot of good information. I usually use the "L" cue, but I like the bit about including #3. I don't know if I'm clear about that or not (we'll see tomorrow).

    I think it's so helpful for students to see their teaching struggling with or modifying a pose. It gives them "permission" to do the pose differently--even if the teacher already explained the modification. I'll bet your gloves have helped a number of people!

    Thanks for the explanation.

    ReplyDelete
  5. love this post! I have always misunderstood the "L" cue, thinking it meant the L shape my index-thumb makes....

    great post :) thank you!

    ReplyDelete
  6. Thanks for visiting, everyone, and thanks for your feedback and suggestions!

    I've been using this technique this week again, and so far I think it's working pretty well! I'm very grateful to Nicki Doane for taking the time to go over all of this during her workshop.

    ReplyDelete
  7. WOW. This post is so fantastic and incredibly timely. I love working out, I do all sorts of cardio, weights, etc, but only very rarely do yoga. Even though my dad is a yoga instructor and a regular practitioner.

    My main problem with yoga is my wrists! They always hurt and feel over flexed and no position I can get them in relieves this feeling. But, your suggestions are brilliant, especially the thumb placement. I was always straining to push my thumb apart from the rest of the fingers....gah!

    Thank you SO much for this great post, I'm going to go back to the yoga studio and give it a try!

    ReplyDelete
  8. Great post! I had repetitive muscle syndrome too that was on the verge of carpel tunnel years ago. The triads really saved me. Downdog really strengthened my wrists and arms and I'm happy to say that I can do crow now. Somedays I could feel the symptoms come back, but I know exactly what I need to do to alleviate it and nip it in the but before it gets too bad.

    ReplyDelete
  9. @The Voracious Vegan, thanks so much for visiting! I really, really hope these tips are helpful to you. Please let me know how they work out. I will also post a few more tips soon, as there are a few other things I've learned that might be helpful.

    @liveloveyoga, if ever I actually do the full expression of crow pose, I will post a photo on this here blog. It would be a serious yoga miracle for me :)

    ReplyDelete