Yoga Injury Prevention: How World-Class Yoga Teachers Get World-Class Yoga Injuries
Part 2 (of 4 Parts)
An Introduction to Some Basic Realities of
Yoga Injuries and Yoga Injury Prevention
In the last article, we were discussing weaknesses with the ideas of strengthening the body too much as well as warming up and striving for perfect postural alignment.
Now we’ll move on to some of the other issues showing up, potentially causing yoga injury and harm.
RECRUITING OR “ENGAGING” MUSCLES
We’re often instructed in various “engagements” (muscular contractions, and therefore shortening) of certain muscles, performing usually subtle movements that will, allegedly, “protect” the body. We’re told this will contribute to yoga injury prevention. Yet, like overtly “strengthening” your muscles, this is another potential source of short-term positives with many possible long-term negatives.
DON’T GET STUCK WITH A PELVIC TUCK … OR A “SCOOP”
One example is “tucking the pelvis” or “scooping the sacrum” to “protect the lower back and spine.” Closely related to that is “engaging the gluteal muscles” which is necessary to do anyway to perform the above mentioned movements. This is a posterior or rearward tucking of the pelvis. (Please See Illustration to right.)
Another variation of this is to pass the lower back against a wall or floor when doing various exercises or stretches. That creates the same problems.
Not too long ago, and for decades prior, that general group of actions was taught and prescribed by yoga teachers, Pilates and Tai Chi instructors, personal trainers, chiropractors, physical therapists, medical doctors, and others. Too many physicians, therapists and exercise coaches still teach this action.
It very often feels good when you do the action, because it stretches over-contracted muscles in the lower back, and engages the “core” muscles. And the feeling of “doing something” with “stuck muscles” often has positive sensory associations with it.
But finally, after many years of prescribing or recommending this action to so many people, more teachers and therapists are now acknowledging how potentially debilitating that multi-muscle & joint “engagement” of tucking / scooping is. One reason is it almost inevitably compresses your lumbar disks, as well as hip and knee joints, and the sacroiliac joint, too!
I started talking about this issue in the mid-1980s, but more than a few people thought I was crazy to criticize such a widely utilized and physician-prescribed technique. Many MDs, DOs and DCs, as well as physical and occupational therapists, prescribed this action as therapeutic. Many books and articles recommended and described this action. It was widely accepted as a good thing.
But what I was finding in the treatment room, one-on-one with actual human beings, was NOT what they were writing and illustrating in the books on bodywork and various therapies. I, along with a few others, was coming to very different conclusions, which today are, thankfully, far more widely known and accepted.
I came to the conclusion that rather than letting the pelvis and sacrum move downward at the back (which shortens the front), it was FAR better to lift UP though the spine and rib cage. This requires a relaxing and lengthening of most of the surface and deep abdominal muscles, rather than contracting and tightening them.
And, in some cases, a gentle engagement of the transversus abdominus muscle assists in creating “lift.”
This can be accomplished by “allowing” (not forcing) the rib cage to move up and away from the pelvis. But the lift must occur at the sides of the waist, not just the front.
(That is, for the most part, the only muscle I suggest people learn to “engage.” But that must be done in such a way that it does not become chronically contracted.)
One motivation for this dangerous practice of tucking or scooping, which flattens the lower back, is because so many people believe most people have too much forward curve in their lower back, or lordosis.
SEEING WHAT’S *NOT* THERE
One problem is too many physicians, therapists, teachers and coaches think they can stand back at a short or long distance and observe the contours of their client or patient’s body and perform an effective “postural evaluation” without actually getting up close and palpating the bones with their hands, through the flesh. I observed so-called “experts” doing this on many occasions.
Yet in many people, the fleshy contours of their body appear to reveal one view of what’s going on. But if you get up close, and actually palpate the bony landmarks with your fingers, you will often discover the exact opposite is what’s really going on.
For instance, you might see someone with an apparently deep, forward “scoop” or curve in their lower back. The assumption, then, is they have an excess lumbar lordosis, or forward curve of the actual spinal vertebrae. This is very often why “flattening of the low back” or “tucking the pelvis” is recommended, to reduce this allegedly excess curve.
Inner Reality Sometimes Opposite of Outer Appearance
Yet some people, though they DO have a big overall forward curve of the lower back REGION, the lumbar bones are doing the exact opposite o what you might think. In some people, if you palpate the bones, you’ll see there is a minimal or NO curve, and a few people even have vertebrae slightly protruding rearward out the back of their lumbar region.
They have the opposite of excess lordosis, although it’s very hard to believe that from a casual, superficial look. I call this a Pseudo-Lordosis:
And I have known excellent and well trained doctors and therapists who completely missed this fact in some of their patients, because they did not properly palpate and evaluate. They just assumed it from the outer appearance at a distance.
In fact, when I looked back on the training I received on postural evaluation, the instructor was making many of the same errors. While his formula for evaluating posture was VERY correct and immensely helpful (it is a central part of my system of therapy), even he sometimes missed the boat on application of his own principles. That was in part from when he was evaluating people from a distance and not palpating.
Ironically, in that training program, my back went into severe, extremely painful spasm for three and a half years. I believe it was because, due to an improper evaluation, he was releasing the wrong muscles of my spine, throwing me further toward imbalance, rather than back toward normal. Obviously, this motivated me to figure out what had gone wrong.
Of course, a number of people suggested I had “weak abdominals,” the exact opposite of my problem. They were FAR too “tight& short,” not weak.
Attempting to “reduce lumbar lordosis,” in such cases, means you will actually be putting even MORE rearward force onto their vertebral bodies and disks. If their disks are compromised, you will actually be making them WORSE and more prone to disk herniation or rupture. After a while, the facet joints on the back of the spine (what chiropractors and osteopaths “adjust”) get fixated and dysfunctional as a reaction to what’s going on here.
So this is Not A Good Idea. … And “tucking that pelvis” or “scooping that sacrum” or “flattening the lumbar curve” all do that exact dangerous thing, flattening the lumbar spine. (See again the 1st illustration on this page.)
Another very common error is if you view someone standing from behind, their fleshy contours might look as if one hip is VERY much higher than their opposite hip. Yet amazingly, if you palpate the bones, the opposite will be true.
And those special metal frames with the movable wires you stand in front of that help with postural evaluation? They can be misleading too if you don’t do the actual, direct palpation of the bones.
So, VERY OFTEN, the Outer Appearance of the Flesh is the Exact Opposite of the Inner Reality of the Bones.
And by-the-way, most people, when they allow their pelvis to go where it actually belongs and UN-tuck? They feel like they are “sticking their butt out.” But that is only temporary while all the other muscles normalize. That normalization, and a whole lot of other related ideas and techniques, is well covered by the solutions in my e-book, Simple Steps to Let-Go Yoga. [That Opens in a New Window so you do not lose this page.]
SO-CALLED “PROTECTIVE ACTIONS”
Another “protective action” is drawing the shoulders down and back and away from the ears to keep the area “alive,” “engaged,” or whatever. Or “snapping” the latissimus dorsi muscles (the large “wing” muscles of the back and shoulders, are illustration below) to hold the torso erect, or “lifting the pelvic floor” such as in Kegel exercises. (I’m just getting started on the many possibilities here, but you get the idea. And some yoga teachers are very prolific in their ability to create flowery language that distracts them from the actual, anatomical reality.)
Most of those actions feel good … for a while, sometimes a long while. That’s why so many people like to do them.
But notice in the illustration of latissimus dorsi, above. It’s main function is to control the shoulder. If you go around “snapping” or “engaging” that muscle too often for too long in order to “hold the torso vertical,” the muscle gets chronically contracted. Then, it starts to put increasing amount of pressure on the arm and shoulder joint. You start losing range of motion in the shoulder, then worse problems develop. …
And so it goes. … And not very well.
In the pelvic tuck action, stretching the lower back muscles feels good, EVEN IF they are already in an over-lengthened state, which is very common. This is more visually obvious if the person has a significant “flat back” or loss of lumbar curve. But this is not always obvious. Learning to do precise postural evaluations, or knowing a therapist who understands these principles, is important to knowing where you actually are.
Evaluating yourself is not as easy as some teachers or therapists make it out to be. In my case, after three and half years of pain back in the early 1980s, and no one who was able to properly evaluate my own structure, I finally saw a full body X-ray of me. I instantly knew what I had been doing wrong, and was able to correct it in a few months time. But if I had not known that approach to plural evaluation, I do NOT know for sure I would have been able to figure it out. …
So I owe Daniel Blake, founder of Structural Bodywork, a debt of gratitude for coming up with that evaluation system. (He is no longer in practice nor teaching.)
Over-Lengthened Muscles Can Be “Tight” Too
And paradoxically, an over-lengthened muscle can be VERY contacted and tight, even more so that over-shortened muscles, further complicating proper postural evaluation and structural analysis.
Yes, tucking the pelvis or a “cat stretch” can reduce tension in those specific muscles. But if they are already over-lengthened, and not enough attention has been paid to the opposing, over-shortened muscles, such as abdominals, hamstrings and/or gluteals, then the short-term relief might have dire long-term consequences.
And of course, too many people think the cause of the “over-long muscle” problem is that they are “too weak.” So, they recommend strengthening exercises, which causes even more trouble in the long run. Ao NO, they only “show up as weak” (pseudo-weakness) because they are “passively insufficient.” (Sorry, that’s too much to go into here on that one. I’m already WAY over length for an “article.”)
So these are long-term consequences too few people are thinking about, or have any idea about at all. That includes MANY yoga teachers and yoga therapists, massage and bodywork therapists, physical and occupational therapists, personal trainers, and many physicians of all types.
Whenever you spend much time “engaging” or recruiting muscles, you need to analyze, WHAT is the longer term, secondary, hidden, unintended consequence of that action? If you do not know what it is, I suggest you NOT do it. … REMEMBER, very little children have great posture and fluid movement — and NO pain — and have never been to a Yoga or Pilates class, nor a Personal Training session.
ALL of the above mentioned “engagements” of muscles involve increasing tension in certain muscle groups, and it is, in great part, that increasing muscle tension, masquerading as “strengthening,” “stabilizing,” or whatever, and without sufficient counter-balancing, causing so many long term problems and injuries.
This is a first step toward yoga injury prevention, being able to analyze and understand the hidden consequences of those various actions.
SYMMETRICAL versus A-SYMMETRICAL YOGA POSTURES
But, you might say, “I always balance my postures by doing the opposite side.” Surely THAT solves that problem, right?
Well, think about it. IF your muscles are out of balance, and you do your stretches symmetrically, meaning equally on both sides, they are STILL going to be out of balance. You might be more relaxed in your “un-balancing” act, but are more likely to tighten right back up again because of the unequal forces, like gravity, pulling a-symmetrically on your body.
In fact, many people need to do A-symmetrical yoga in order to actually go back into proper “balance” between muscle groups. …
In fact, the over-lengthened muscles can be even MORE contracted than the over-shortened muscles, because they are working harder to fight the opposing muscles PLUS the downward force of GRAVITY.
In further fact, much of the time, I’ll have certain Clients do NO stretching on the lengthened side of a body segment at all, until their body is definitely moving back toward balance. And for some people, that does not happen in a few minutes of stretching, even if it’s “yogic” stretching. [Opens in New Window so you can come right back here, if you want.]
And no, I do NOT suggest people “strengthen” the over-lengthened, allegedly “weak” muscles until they are moving substantially back toward balance AND have developed better control over specific muscles. It is too easy to unintentionally “recruit” other muscles that should not be tightened up. Any weakness is probably pseudo-weakness, not true, fundamental weakness.
ENGAGING OR “LIFTING” THE PELVIC FLOOR
Another good example of potential problems is pelvic floor lifts. I do not disagree these muscles might need some help with so-called toning (such as with Kegel exercises), and I’m sure that’s been of great help, up to a point. HOWEVER, some neuromuscular and myofascial problems emanate from nerve irritation caused by over-contracted pelvic floor muscles.
Some people feel resulting pains all the way up their torso into their chest, or down their legs, from such chronic contractions of the pelvic floor.
Yet, because the bones they attach to do not move much in relation to each other, it is very difficult to get a good stretch into these muscles, making therapeutic interventions even more difficult. Excess tension can be released, but in extreme cases, that requires manual therapy to put direct pressure into the muscle bellies, meaning, in some cases, working internally. That can be a bit intrusive, and not many therapists do that kind of work, in great part due to legal issues, or modesty issues.
NOT COMMUNICATING WITH THE INSTRUCTOR,
OR NOT KNOWING THERE’S ANTHING TO COMMUNICATE
Then there’s this: As a yoga & bodywork therapist, I’ve worked with quite a few people who went to one or two yoga classes, got hurt, and never went back. They wrote yoga off very early in the game.
And they never informed the instructor, either, allowing said instructor to blissfully continue on without the necessary negative feedback, thinking they were doing a great job. But in reality, however unintentionally, they were quite possibly further endangering other and future students.
This was often from some well-meaning yoga teacher instructing new students with no experience to do a so-called “basic” or “beginning” pose like the Plough (upside down on floor, weight on upper back, neck & head, with legs and hips over head, trying to touch their toes to floor behind their head).
For many people with chronic tension and stress in their neck and upper back region, this is a recipe for disaster.
Downward Facing Dog is now well known for exacerbating problems with wrists, shoulder and/or elbows, or upper back and neck issues, and even the seemingly simple Cobra can lock up the back and/or hip region.
Cobra, for example, is often taught as a back strengthening exercise. Yet when it comes to beginners, Cobra is probably more appropriately thought of as for relaxing & lengthening the surface and deep abdominal muscles on the front, rather than strengthening the back.
When the ABs are properly balanced with the back muscles, the back muscles do not have to work hard to hold the torso upright. It is held up mostly by water pressure within the belly and gentle contractions of the transverses abdominus muscle.
DEMONSTRATING HOW TO HURT YOURSELF
Then there are the very flexible yoga teachers who love to demonstrate the ideal, “completed pose.” All with (probably) good intentions, they model the completed posture and encourage students to see if they can achieve the “ideal pose” too. But all too often, the completed pose is way out of the range of the student’s capacity to perform, so the teacher is endangering his or her students by leading them to do things WAY too prematurely, if at all.
Most people do NOT need “Pretzel Yoga” to achieve their health objectives.
But that makes me wonder if the teacher is just naive as to what potential damage they’re “inspiring” demonstrations are possibly motivating in their student? Were THEY ever really “tight” and do they realize the significant limitations so many people have? Or are they just showing off, even if subconsciously, for their own ego gratification? Or are they just not aware of the possible consequences, if not danger?
Trusting students to know when they’re going “over the edge” and how far is too far is just not wise, especially for beginners. Many yoga teachers either have forgotten where they started, or were always flexible enough that getting into a completed pose was never a problem for them.
Instructions to “listen to your body” or “don’t over do it” or “be gentle with yourself” and the such instructions do not mean much to people who don’t know what they’re doing. And discovering and working with one’s “edges” is a far more complex and challenging issue than most people realize.
Edges literally become the focal point of the Mediative Mind in yoga.
And some people, maybe many people, are so neurologically de-sensitized they cannot consciously feel where their limits actually are. And a society conditioned into No Pain, No Gain, often just does not register the “easy does it” instructions. It’s beyond their capacity for at least some period of time, when they are most likely to hurt themselves.
FORCE & COERCION
Then there are people who were or are physically forced or verbally coerced deeper into a posture, often by their instructor, sometimes by their own initiative. Maybe they saw a picture in a book somewhere and, believing it was a Good Idea, decided to get themselves into that position, no matter what.
This approach can, in some people, sooner or later, cause a pain, strain, sprain, tears or other dysfunction lasting days, weeks or months. … In some cases, years.
This is further encouraged by, for example, one extremely well known American yoga teacher who says “Don’t listen to your body, listen to ME!” Yet there are so many people in his classes, can he REALLY know what’s REALLY going on in each and every one of them ALL of the time? … Not likely.
Another world-class yoga guru was well known for physically forcing people deeper into postures. He was known to literally push, kick and slap people into “proper form.” This they often called “bringing awareness to your body.” (Awareness of WHAT?) … He even jumped on a few people. …
And of course, there were MANY reports of VERY negative results, including severe injuries.
Such naive or in some cases pathologically ego-driven attitudes and actions, even if in the name of “spiritual enlightenment,” or belief it’s “good” for the student, fuels authoritarian submission in a world desperately in need of far more people learning to think & feel for themselves and act accordingly. But that’s a different conversation for another time.
Anyway, some of these significantly yoga-injured human beings are world-class yoga teachers. But paradoxically, can we suggest they are probably among THE most committed & knowledgeable people in the world about warming up, proper alignment, listening to their body and other such supposedly protective actions? Yet in some cases, world-class yoga teachers, whom are supposed to know, are actually causing some of the injuries.
Yet with such skill and high motivation, and a love of yoga, if THEY are not able to be safe in their own yoga, or are causing injuries, what chance do we mere mortals have of avoiding injury? …
I’d say not much, if that’s the criteria.
IT’S NOT ALL BAD NEWS!
Yet on the other hand, OVERALL, the percentage of practitioners getting injured in yoga is very low, even lower than golf injuries! And it would be difficult to discount the vast number of human beings who’ve gotten many and important, sometimes profound, benefits from practicing yoga. Yet a small percentage of 15 to 20 million people is still a lot of people.
I’ve only covered some of the issues here, but NOW What? What’s going on? What can we learn? Where do we go, what do we do, from here? … And how do we get better at Yoga Injury Prevention?
And now, so that I can afford to keep providing you with all the information on this website, a short commercial break…
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I read David Scott Lynn’s e-book which I highly recommend for every Massage Therapist [and Yoga Teacher] and I was amazed at how intricately he delves into and emphasizes, over and over from various angles, how our work mostly works to affect the Nervous System in a variety of ways. … He explains nervous system and myofascial relationships brilliantly!
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[Part 3 – CONTINUED IN THE NEXT POST IN THE NEXT FEW DAYS … PLEASE WATCH FOR IT!]
Thanks for Reading,
David Scott Lynn (DSL*)
* DSL: Your Hi-Touch Up-Link to the Inner-Net
Inner-Net: Your Psycho-Neuro-Musculo-Fascial System