Practicing Yoga with an Injury
For the first several years of my yoga practice, I never had an injury. I would occasionally feel some discomfort, perhaps from stretching a little too far or from working my muscles more than they were used to, but overall, I enjoyed all the benefits of having a regular yoga practice without any of the pain.
However, the honeymoon did not last forever. As I kept practicing, I did develop some injuries. Sometimes the injury was not always clearly caused by my yoga practice, but certain poses were subsequently really uncomfortable. Sometimes the injury seemed to stem directly from the practice. One injury occurred while I was assisting a student.
So what should you do if you want to practice yoga but are injured?
I have some suggestions, but I want to be clear that practicing yoga with an injury is a personal decision and I’m not trying to advise anyone one way or the other. It is up to you and maybe a physician who knows you and has examined you and has perhaps obtained x-rays or advanced imaging to guide your care. I am only sharing what I have learned from years of practicing yoga, from years of being a yoga teacher, as well as years practicing medicine as an orthopaedic surgeon. And I must say I am not one of those orthopaedists who tells patients who come in with pain to stop doing the activity that is causing the pain. Rather I am someone who tries to help people work around their injury if that is what they choose to do.
What I am writing here is not medical advice. Rather, I am sharing my personal experience in the many roles I have that are related to the topic.
You may have an injury that requires you to take time off. Something is seriously torn or you have had surgery and you really do need to take time away from the practice. There are related practices you may be able to do, like pranayama or the Four Purifications (can be found online) or meditation. Or maybe you can cross train or do a different type of yoga.
I have found that some movement is always better than no movement if possible. The older you get, the faster you will lose mobility and muscle if you don’t keep moving and keep strengthening.
The orthopaedic literature demonstrates this as well–moving muscles and joints allows quicker and better recovery than total immobilization. That is one reason orthopaedic surgeons prefer plates, rods and screws and limit casting after a broken bone–even if the patient can’t bear weight on the extremity, they can start moving all the joints above and below the fracture.
I remember early on in my Ashtanga journey, I found a video on YouTube of an Italian man practicing full Primary after breaking his femur which was fixed with a plate and screws and doing the whole practice without putting weight on that leg. It was impressive. It inspired me to keep practicing with whatever injuries I had. And while I mourned the poses I couldn’t do due to an injury, I always seemed to recover the ability to return to them.
One of my Ashtanga teachers said when he was in India, he was advised that if he had an injury in the practice, he should return to Primary series for 6 months before moving back into the Second and Third series. And he did this. I have found this to be less helpful for me. I don’t want to lose the strength and flexibility I’ve worked on for years by stopping poses I can do in the other series just to avoid the handful of poses that hurt. And for those people practicing First series only, what does this mean?
I think after an injury, if you choose to practice, it is best to practice the poses you can do comfortably at first. After a week or two, go back to the poses that prove difficult, but go only up to the point where you start to feel some minor discomfort and stay there.
For example, I developed an annoying pull in my hamstring about 4 years into the practice. At first I avoided stretching much at all on that side. And it didn’t seem to get better. So I gave up that strategy and stretched to the point I felt minor strain, but didn’t go any farther. Over time, I was able to move farther and farther and the pain went away. Maybe the rest I took in the beginning was helpful. Maybe it wasn’t. I don’t really know.
There are studies that show that after a hamstring injury, athletes who continue to use the hamstring in a controlled setting recover faster than those who take a complete rest. Of course, complete hamstring avulsion injuries or tears may require surgical intervention, so please don’t keep practicing without seeing a specialist if you have a palpable defect or experience a lot of bruising which could indicate a complete tear.
Sometimes an injury is the opportunity to explore new aspects or features of the practice. This week a student told me she couldn’t jump forward due to her knee buckling when she landed. However, while she was exploring how to practice around her knee injury, she discovered that if she kept her hands pressed firmly into the floor and her arms active, more of her weight stayed in her arms and she could land without hurting her knee. Her jump throughs actually improved.
Sometimes students have habits of practice or movement that can be changed that may allow you to practice without pain. A teacher can help. But talk to your teacher. Tell your teacher if you are having trouble in a pose. And please tell your teacher if you have an injury! Teachers are not psychic. They may notice if you grimace every time you do a certain pose or that you move more slowly and carefully on one side, but the best approach is to verbally communicate with the teacher. And the teacher may be able to guide you to change something you are doing so that pain will go away. Sometimes seeing another teacher can be helpful. I have noticed that sometimes a teacher will watch a student do a pose in a less than ideal manner for years and think that is just the way the student does that pose and not try to change it and then a visiting teacher will come in and make a change and lo and behold–the pose improves. Sometimes a second set of eyes is helpful. But remember, a conversation with your teacher can open new possibilities in a pose.
And then there are the inevitable changes that come with aging. As an orthopaedist who does joint replacements, I see a lot of people day in and day out whose cartilage has worn out over the years. I again think there are ways to practice with arthritis and I know a lot of people who practice after joint replacement.
It’s OK to modify, use props, or leave out some poses if they aren’t working for you. This is one of the benefits of an Ashtanga practice. You can make it your own.
So I do recommend that if you yourself feel inclined to practice while injured, go for it. There are profound mental and spiritual benefits achieved from the physical practice even if you have to leave out some poses or do less than all out in a pose.
But remember–yoga should feel good.
There is no need to try to push yourself too far when you have an injury. But maybe don’t stop everything either. Be wise. Listen to your body. Listen to a teacher you respect who knows you. Be kind to yourself. Just don’t stop moving.
