In yoga and in life we ask a lot of our shoulders and wrists.  Common actions like reaching, grabbing, texting, typing, etc would not be possible without them. It’s important to understand the anatomy of these areas, so we can prepare ourselves properly to bear our bodyweight and avoid injuries.

Now you’re probably wondering:  How do shoulders and wrists get injured in yoga?

The answer is quite simple: a lack of proper preparation & repetition, repetition, repetition.

In this article we’re going to discuss a lot of information, here’s the outline:

  • Preparation of our upper extremities: shoulders & wrists
  • Ensuring our core is stable to support our shoulders and wrists
  • Avoiding extra strain in Repetitive Shoulder/Wrist Movements in Yoga
  • Scapular Biomechanics

 

Injuries Off the Mat

Before we discuss yoga, it’s important to note that wrists and shoulders get injured commonly from daily off-the-mat life!  

  • We are constantly rounding our shoulders forward when we sit.
  • We spend a lot of time texting and typing with our wrists extended.

This is the position a lot of modern people find themselves in throughout their day. It’s nicknamed “Troll Posture” or “Human Cashew Position” due to the position of the shoulders haha.

Another important note: it’s not “poor posture” that’s injuring you off your mat. There is no such thing as perfect posture.  Posture is dynamic in nature and variability is key.

  • How long have you been holding [insert position here]? Over 20 minutes? Okay, it’s time to move!
  • How many times do you repeat that position? Okay, it’s time to change it up and introduce some variability through new movement!

This concept is essential in understanding how wrists and shoulders get injured in yoga because it’s likely they were already stressed and overworked. Now throw some arm balances in or something as simple as a High Plank and BOOM you may have placed the straw on the proverbial camel’s back. Hence why it’s important to prepare and ensure proper muscular engagement for stability before you place weight into those joints.

The Importance of Preparation

I little bit of prep can go a very long way.  Given the nature of our daily off-the-mat movement, we need to reestablish neutral position for our body, so our upper extremities can move with ease and safety for the rest of your class.  “Flexion is the new neutral” – Greg Lehman

“Meet people where they are at, so you can take them where you want them to go”

If you’re a teacher, take this quote into mind when you sequence your classes. If you’re a student, don’t assume your teacher is going to prepare YOUR body for everything.

Posturally many of us are coming from that common place of sitting, so ask yourself following questions:

  • What kind of movements can you sequence in to help them reestablish their neutral position?
  • What kind of movements will help take some of the strain out of the shoulders and wrists?

The answer is simple:  Put yourself in that Cashew shape and then do some movements that reverse it.  It’s so simple and guaranteed to feel pretty damn good!

Prep Your Shoulders:

Look again at the sitting skeleton above. A lot of your preparatory exercises will likely be opening up, or stretching, the front line of your body and engaging, actively contracting/shortening, the backline (extension based movement). Example: A few repetitions of Cobra pose is a great easy example of extension based movement that engages your backline and opens your frontline.

Prep Your Wrists:

You can safely assume that people were texting/typing a lot throughout their day. Here’s what that looks like:

Texting and typing in this extended position can place a lot of strain into the wrist joints. To add to it, whenever we place our hands on the ground, we’re also putting our wrist into extension! Wrist extension is an interesting position, because it places a lot of compression force, or creates less space, in the joints between your Carpal bones.

This is an end-range extension. That means your wrist really can’t go much further into extension and there’s more force in your joints from your body weight. That can be a lot for your wrist, especially if it’s already compressed from your daily life. It may not happen right away, but repetitively loading your wrist throughout your class and in your future classes and it’s a timebomb waiting to go off.

Decompressing, or adding space, for the wrist joint should be apart of the warm-up for every yoga class.

Here are some of my favorite ways to prepare wrists for yoga:

Thumb Release – (Creating space by releasing strained muscles)

  • Pin the muscle at the base of your thumb.  (This will be the part that is slightly elevated comparted to the center of your palm, and is close to your wrist)
  • It should feel pretty squishy – that’s muscle
  • This area may be tender from overuse, so press lightly and do some small circles to invite movement
  • Pin that spot down, then reach your thumb to your pinky knuckle.  Repeat this 3-5x
  • Open and close your hands to compare the sides, then switch!

Flipped Hand Table Top Stretch — (Creating space via stretching your overworked wrist extensors)

  • In Table top, flip one of your hands, so that your palm is up and the backside of your hand is on the ground. (Image 1)
  • This will stretch your wrist extensors (the back line of your hand)
  • You can lean back a little bit to increase the stretch. (Image 2)
  • Hold for 10 secs, then switch.

Another simple exercise (not shown) is grabbing your hand on the pinky side of your palm and pulling it away from your elbow.  You can often feel the carpal bones move around with this simple Decompression Stretch.

If your wrists hurt too much to put weight into them, adding a lift to the base of your palm can be a game changer.  Create a small incline with by folding up your mat, using a towel or blanket creates space in the wrist joint.  Keep your knuckles and fingers lower than the base of your palm and your wrist is going to feel amazing!

Summary: Proper prep is important in mitigating shoulder/wrist injuries in your yoga classes.  It can take out the strain of daily life and really open people up to some good healthy movement.   Bringing yogis back into a neutral position is a great way to start any kind of movement, especially yoga asana!

Avoiding Upper Extremity Injury – Core Stability

Core Stability is the second component to staving off injury to our upper extremities.  Our bodies can move in a large variety of ways, but often a lot of those ways are unnecessary or can cause injury.  Your core is designed to resist and help transmit movement from your lower body to your upper body when you move.

Understanding this principle in biomechanics is HUGE because when your core lacks stability, the force of your movement can get transmitted to other joints and areas (rather than where it should occur).  This form of compensation will cause extra strain on those parts of your body and with enough strain can often lead to pain.  We can often see this form of compensation in the shoulders!

The stability of your shoulder is like a diving board. To ensure it’s strong when you reach and grab things, the support should come from below it.

For a lot of us, this isn’t the case. Try it for yourself:

  1. Grab something with a little weight to it (like a water bottle)
  2. Hold your arm out in front of you with your elbow straight
  3. Close your eyes, and see where you feel your muscles engaged around your shoulder.

A majority of people will say they feel it from the top (via their neck muscles). You should feel it under your armpit.

So what do you do? Bring the stability back underneath your shoulder by activating your core!

Pelvic Rock – (Synchronizing Core Stability with Shoulder Movement)

  • Start in Table Top, widen your knees and bring your toes towards each other
  • Pull your hands towards your knees,  You’ll feel your abdominal muscles brace and activate
  • Keep the Pull Inhale: rock forward
    • Shoulders go over your fingertips
    • By maintaining that pull towards your knees you should feel like you’re about to lunge forward off your mat
  • Keep the Pull Exhale: rock backward
    • Bring your hips towards your heels
  • Do 4x maintaining the pull of your hands to your knees the entire time

Another great way to get your shoulders synced into your core and also strengthen your stabilizer muscles is to do what your shoulders were designed to do: Reach!

“The reason why we humans have arms is to reach and pull food to your face.”

We first learned how to use our arms when we were infants laying on the ground and reaching to grab things.  One of the best ways to ensure core and shoulder stability is adding a reach to a Sphinx pose!

Sphinx Reach (Shoulder Stabilizer & Core Stability Exercise)

  • Lay on your stomach in Sphinx Pose, where you lift your torso up with your elbows comfortably on the ground
  • You can widen your elbows and bring your hands closer together to lessen the lift of your upper spine
  • Look to the right (about 45 degrees away), then inhale as you slide your right hand slowly to the right
  • Return to center with an exhale
  • Look to the left, then inhale slide your left hand slowly to that spot
  • Return to center, repeat 4x each side
  • Important Alignment Notes:
  • The only thing moving is your reaching arm, your torso and supporting arm should remain stationary and engaged the whole time
  • Always look first, then slide to properly use your neck in this exercise
  • As you get better you can lift your hand when you reach, just make sure your torso remains solid!

Summary: Powering up your core muscles can take a lot of unnecessary strain out of your shoulders and even your wrists.  It puts the support and stability where it should be: under your shoulder via your torso and abdomen.  Once you feel those muscles your arm balances and other hands-supporting-your-weight poses are going to be so much easier and cause much less strain!

Common Biomechanics of Repetitive Shoulder Movement in Yoga Asana

Proper prep and Core Stability are great ways to stave off injury.  The third aspect of common upper extremity injuries requires us to consider the positions we repeat throughout our classes.

I, along with a few others, jokingly call some of this movement “Shoulder Shredding.”  This is because there are a few common transitions/poses that can place some repetitive strain into the shoulder/wrist joint.  There’s only so much your joints can handle before they start to “shred,” or deteriorate, due to inflammation from the excessive strain.

It boils down to two pretty common movements:

  • Chaturangas (or sub-optimal poses that encourage excessive end range loading of your shoulder & wrist joints)
  • Overhead movement

Chaturanga

In my professional opinion, the common vinyasa transition of Chaturanga to Upward Dog can mangle your shoulder joints.

Why?

  • Regardless of form, lot of yogis do them way too fast
  • Repetition! There’s often at least 10 and up to 30  in your average vinyasa class
  • Form (even the best form is sub-optimal to repetitively do for your shoulder joint):
    • The position of your elbows closer into your torso requires more core strength than your elbows wide.  A lot of people don’t have the amount of core strength to sustain the pose, let alone do it over 10x
    • People dipping too low by lowering their chest lower than their elbows
    • Hinging forward puts excessive end-range stress into your wrist joint!
  • Upward Dog compresses the shoulder joint and the Axilla (armpit).  Repetitive compression of these spaces isn’t great for the soft tissue structures like your nerves, blood vessels, lymph nodes, and tendons

I’d like to take a moment to note that I’m biased against Chaturangas. My shoulders used to hurt so much after taking a vinyasa yoga class and it wasn’t until I started skipping Chata’s did they begin to feel better and more importantly stay healthy.  In my opinion, Chaturangas are shitty junk-food movement.

Sure, you can do them and that’s awesome that you did the 30 throughout class today, but what was the intention behind that transition?  Where’s the substance in all that repetitive movement?

Take a moment to think about it: there’s really not much substance to a Chata. Given the position of your arms, you likely didn’t increase the strength of your muscles a whole lot and instead just repetitively loaded your wrist and shoulder joints. Yoga asana is meant to alleviate tension, not create it!  So good for you for doing them all, you’re now a little bit closer to a painful shoulder/wrist.

I don’t teach Chata’s anymore (for all the bulleted reasons above). A lot of other anatomy based teachers I know also agree that they shred shoulders more than strengthen them.  There are much safer and way more challenging ways to transition yourself back to Downward Facing Dog.

I know I speak pretty ill of Chaturangas, but on a final note:  You can keep doing them and still be fine, the last thing I ever want to do is instill a fear of movement in your practice.  All I ask is that you please take the time to prep for it, don’t do it all the time, and be aware of how many times you’re doing it in a yoga class.  Practice moderation, Brahmacharya, with Chata’s.

Reaching Overhead:

While not a bad movement, repetitively reaching over your head can also compress anatomic structures in your shoulders.  Especially if you haven’t taken the time the open up your frontline with your preparation!

There are two common ways to reach overhead, and the classic example is Mountain Pose Tadasana:

  1. Outward version: Arms reach up and around (shoulder abduction).
  2. Forward version: Arms reach forward to go up (shoulder flexion)

Knowing this is really important because these are two very different positions for your shoulder joint.

Note the Head of the Humerus (the top of the upper arm bone, that looks circular).

When you Abduct your arms (bring them out to the sides and overhead):  Your shoulders naturally elevate to compensate and allow for space for the Humeral Head.

When you lift your arms in Shoulder Flexion (Arms forward to go up, like a thumbs up): Your shoulders stay in place because of how the humeral head is rotating.

Shoulder Abduction & Shoulder Flexion (Visualizing Shoulder/Scapular Movement)

  • When I bring my arms out to the side and up (Abduction) notice how my shoulders elevate with that movement naturally
  • When I lift forward and up (flexion) notice how my shoulders stay down, away from my ears, naturally

We so often cue people to “draw their shoulders away from their ears” but this cue can be sub-optimal based on how you got your arms over your head.  If you abduct and bring your arms out to the sides to lift them then you naturally elevate your shoulders, telling people to pull their “shoulders down or away from their ears” then closes off and creates compression at the top of the shoulder.

The fix is simple: Don’t worry about pulling shoulders away from ears. You can lift safely either way. Let the body do what comes naturally!

On a side note, I usually cue and prefer people to “thumbs up” their way to overhead poses like Mountain. Mainly because this sets the shoulders up with more space and tends to feel better. The only sad thing is that it doesn’t look as graceful as arms wide up.

Summary: In some yoga classes there is a lot of repetitive movement.  Take the time to properly prepare your body for these movements in your practice.  Other things to consider: vary your movement, less is more, and be mindful of how often/how long you’ve been doing something.

Scapular Stability & Biomechanics

You can’t talk about shoulder injuries without mentioning the scapula.  Your Scapula’s ability to move and remain stable is essential for healthy shoulders & wrists!

Scapular Winging is a common phenomenon, and you’ll likely see it quite commonly in your yoga classes.

Scapular Winging is a tell-tale sign of Scapular instability.  Your scapula should be glued onto the back of your rib cage.  If the stabilizer muscles (specifically the Serratus Anterior) are inhibited then your scapula is going to lose its ability to stabilize your shoulder because it’s no longer firmly against your back.

The Sphinx Reach & Pelvic Rock are great exercises for engaging this muscle!  Another one of my favorites is the Push Up Plus (Youtube it, it’s a great exercise for yogis!)

Other important stabilizers are your Mid and Lower Trapezius.

It’s also important to note that simply drawing your shoulders back does not set your scapula up properly. Your Rib Cage is a 3D structure.  You need to elevate your shoulders your ears, then pull them down towards your back pockets. This “Set-the-scap” movement moves your scapula from that forward position to a position where it is set along your back.  This glues and engages your scapula properly on your back and creates a stable base for your arm to move.

 

Here are my favorite Scapular Stabilizing Prep Poses.

Supine T & Supine Y Pose

  • Lie on your back, bring your knees over your hips, & your ankles in line with your knees
    • This position is called 90-90-90 where you have a 90 deg angle at your hips, knees, & ankles
    • You should feel your core muscles activate and you back should be relatively flat
  • Bring your arms out to a “T-shape” with your palms open to the sky
  • Press your hands down into the ground to a slow count of 4, then hold pressing for 4, then slowly relax your arms to the count of 4
    • You should feel the entire backline of your arms and shoulders engage
    • The gradual 4 count press and relax is good for cultivating awareness
  • Repeat this up to 4x
  • Then move your arms into a “Y-shape,” repeat the same 4 count press, hold, and relax
    • This should be comfortable, if it’s not bring your arms into a wider Y
    • You should still feel the back line of your arms and shoulders engage
    • This is great for opening the front of the chest, & prep for overhead activities
  • Make sure your legs stay in the 90-90-90 position the whole time!  We want our core activated throughout so that we synchronize the muscular activation of the shoulders with our core activation.

A lot of people will start to drop their feet or move their knees closer in once they start focusing on their arms.

Summary:  Scapular movement is essential for a healthy shoulder joint. A lot of people don’t have awareness or lack the proper stability. Awareness of your Scapula can really make a difference in improving how people use their arms on and off their mat.

Conclusion:

A little bit of prep can go a very long way in decompressing the shoulder and wrist joints. Core & Scapular Stability are essential to ensure your arms can reach and grab whatever you wish to pull in or support your body weight when your hands are on the ground. Finally, be mindful of the positions you’re putting your shoulders and wrists in during your yoga classes. We already place a lot of strain off the mat, there’s no need to add more when you’re practicing asana.

Namaste!

Dr. YG

Illustrations by Ksenia Sapunkova.