Wrist pain in Cat, Down & Up Dogs, etc...

[MBelleK]

Hi everyone,

I'm usually more of a lurker, but right now I'm so frustrated with my body. I've been practicing yoga daily (with a missed day here and there) for about 2 months.

About 1 month ago, I started having extreme pain in my right wrist during poses like Cat, Up Dog, etc...

Some quick facts about me, but please, let me know if I need to explain more.

- 27 years old, female.
- I'd say I'm in good health, but I'm not necessarily in good shape
- probably ... oh... 40lbs overweight
- yoga is my only form of exercise currently
- I do not experience the numbness associated w/ carpal tunnel.
- the pain is, at times, felt all the way up the 'middle finger' bones in the back of my hand, and as far as half-way up my forearm -- that is, I can DETECT something different, though the pain might not be as active or acute there...
- I have never sprained or injured this wrist in any way that could be aggravated by yoga
- I'd say I have small "dainty" wrists - I can wrap my thumb & index finger around them, with the thumb & fingertip overlapping (if I grab tightly)
- I've taken as much as 4 days off from yoga, with similar pain recurring immediately after resuming asana practice.
- a natural 'leftie' who was switched in catholic school.

About being a natural leftie... I mention this because I still do a great many things with my left hand.... Eating, putting on makeup, brushing teeth, etc. In nearly everything except writing & using a computer mouse, I use my left. I don't know if that's important or not, but I would think that my hands are probably closer to equal strength than the average person you know.

I read an article which suggested bending your fingers @ the 2nd knuckle and pressing the pads of your fingers into the mat, and this actually hurt more than laying my hand flat.

(Oh and I understand that this is not meant to replace visiting the doctor, blah blah. The facts are that I'm one of the millions of Americans who can't afford health insurance--my current employer doesn't even offer it-- so I don't know that I'll be seeing a doc any time soon... I'm just being realistic)

Any help or advice would be appreciated -- any advice other than "don't do those poses"... A lot of this stuff is the core of my practice and I feel like I'd be very unhappy without yoga in my life.

[Nichole]

Hello and welcome to the darkside former lurker
I have a few more question:
1. From whom (a qualified teacher, therapist, friend, etc.) or what (books, DVDs, etc.) are you learning your practice from? If a person, are they offering insight into your wrist issues?

2. When you take days off of practice, how long does it take for your wrist pain to lessen? how long to disappear completely?

3. Have you tried modifying Adho Mukha Svanasana (DD) into a wall dog? You retain most of the same benefits for the body when done properly with appropriate breath, etc. and it often relieves people from their DD wrist pains. In a quick search I found this to give you an idea. I haven't looked closely to see if the instruction is good and the picture doesn't offer the best alignment, but just to give you an idea, take a peek: Modified Downward Dog

4. Have you tried a cork or foam wedge under your hands during DD with any results?

5. Do you know if you are moving in and out of your postures with the appropriate breath? This is important because--here is a overly simplified version of the facts--our breath shapes the internal body, and, therefore, breath shapes our internal support all the way from the soft palate of our mouths to the pelvic floor. This internal support is the foundation for the all asana (postures) and you can have a solid foundation or a weak foundation depending. Proper breath also allows for all asanas to become six-directional: up, down, left, right, front and back rather than just up and down. Having DD become six-directional, rather than just down through the hands and feet, changes everything...you definitely know it when you feel it because it feels light and glorious.

I am looking forward to hearing from you again.
Kind regards,

[InnerAthlete]

Dear MBelleK, (I wish you had included your name in your profile)

Could you outline your asana practice please?
I'd like to know if you are doing a fast-paced vinyasa practice, a Bikram practice in high heat, or a gentle viniyoga practice. Additionally can you describe your sequence of poses please?

Please also examine the following poses:
Urdhva Mukha Svanasana
Bhujangasana
Chaturanga Dandasana
Phalankasana (plank)
Bakasana
Purvottasana
Vasisthasana

And tell me if you are doing these poses and if so, are you having wrist pain when doing them?

Nichole's advice above would approximately mirror my own.
Alignment, action, wedge, GripItz, chair, wall is the protocol I'd tend to follow with you. This outlines a continuum from most effective to least effective until a point is reached where the pain is no longer present.

[MBelleK]

How exciting/comforting to get "real" replies on this!

My name is Melanie, by the way.

I wanted to get a reply posted, but I only have a few minutes, so if I miss anything, I apologize.

Though I've taken classes in the past, I currently live in an area where classes are not common, so I've been using DVDs & books. Sometimes I'll have my husband (who's not qualified, but its better than no one) come and watch a pose, compare with the picture/voice instruction on the DVD & tell me whether what I"m doing looks the same. He is a kung fu student, so he has SOME knowledge about form etc (not that the two are related, rather that he knows how to perceive if two people are truly doing the same thing)

The DVDs I use most are Yogi Marlon's DVDs. I consult the book "Hatha Yoga Illustrated" as well.

Usually the pain is gone a day later, but pretty much any time I put my hand in a 90-degree angle w/ my hand straight out (like in cat pose) w/ any kind of weight on it, this hurts.

A cork or foam wedge? Not a block?

I purchased a wrist brace from the pharmacy yesterday, and wore it during my practice, it seemed to help. It has splints & is meant to stabilize a carpal tunnel wrist. This is a similar brace to the one I bought.



A typical practice is :

- Some moving cat posture (15-20 reps, I don't really count)
- A moving down-dog (going from cat, to dog, stretching out the hamstrings, about 5x)
- A down dog held for about 1 minute, then a rest in child's pose
- 2 sun salutations
- triangle, each side
- warrior 2 to revolved side angle, each side
- ubhaya padangushtasana, boat pose, & some floor stretching
- some twists, bridge pose, legs-up-the-wall
- meditation/mantra chanting

(about 30 to 50 minutes in length, average)

I do put a lot of effort into matching the breath with the instruction... If I can't breathe quite as slowly or as long as the instructor, I'll move through slightly faster than she goes. My average breath is about 4 beats in, 4 beats out... I use Ujjayi breathing with each breath.

I hope I've hit on all the important stuff. I'm wondering if it could just be my excess body weight putting strain on my wrists, which are still developing strength??

Also, can I have some feedback on wearing the brace?

[InnerAthlete]

A block my dear will not reduce the wrist flexion in those ouchy weight-bearing poses. So "no" not a block. A wedge will reduce that angle by about 10º and for some that's enough.

It absolutely can be the student's excess weight which makes weight-bearing tough on the wrists...and the rotator cuff muscles, when the student is doing Chaturanga Dandasana over and over (with excess body weight).

The brace is okay if it makes YOU feel better. It will not provide a healing element to the wrist but rather will allow you to practice without mobilizing the joint. I would prefer my students adopt a mindfulness approach and not do those things that are hurting or not do them so intensely.

You might also consider asking this question of Yogi Marlon through her web site here.

[MBelleK]

Originally Posted by InnerAthlete

You might also consider asking this question of Yogi Marlon through her web site here.

That was my next move, actually. She is very communicative via email, and I've written her before.

InnerAthlete, I'm curious about the brace, since I think, for now, I'll continue to use it. I'm hoping that it will allow me to practice without pain (and also without doing further damage to the wrist) which will, in turn, give me the space to build strength which will offset the pressure I'm putting on it?? Is that right?

Also, can you recommend any exercises (yoga or otherwise) which will strengthen the surrounding muscles and help the problem? I've heard that, in yoga, wrist pain develops most commonly from an under-development in the muscle UNDER the forearm (the part that is usually less hairy). Is there any truth to that, that you know of?

InnerAthlete, I also want to thank you for your help and advice. I always know I'll stick to reading a thread if I see you contributing to it, because you give such thorough advice! (I mean that!)

[InnerAthlete]

You are of course welcome for the advice and I thank you for the compliment. I'm very blessed to have a teacher of teachers as my guru. I owe my clarity to he and his wife and the teaching staff at Yoga Centers in Bellevue, WA.

I have moved through a wrist issue or two and done so without the use of a brace. So in my body what you suggest would not work for me. It may work for you and I'd be anxious to hear your personal results. It is one of the only ways to know. Become a petri dish and be your own experiment.

Immobilizing does work in some cases. And I've had students with such braces and left them completely alone with it. It is fine with me. But to me it seems a bit like medication which reduces feeling and thus closes the dialogue between mind and body. The larger question is "what is my body trying to tell me?". Will you still discover that with the brace? Perhaps. So try it.

There is a wrist series we use in Purna Yoga but it is not something I am comfortable with teaching in this medium. Outside the yoga construct you could work with a tennis ball, squeezing it for 20 reps three sets morning and night and you could do wrist rolls with a small dumbbell or can of food. I'd do these sitting in a chair, knees at 90º, forearms resting on thighs, curling the weight down into the fingertips then back up toward the inner elbows. Then flip the arms and do the reverse.

BUT this all presumes building surrounding muscles is the answer. How would it be to put so much into that an then have it not work? But what else have you got out there in the boondocks?

[Pandara]

Hi Melanie,

You have received good advice here and I don't want to subtract from it. It is my strong belief that by the time a physical disease or illness or discomfort manifest we have ignored the underlying emotional aspect for a very long time. I therefore belief that these diseases, illnesses or discomforts we suffer are our body's way to tell us that something deeper has been ignored for too long.

I belief every body part tell us something about the issues we have ignored and the wrist represents those aspects of ease with life and how we move through life so far. Perhaps you can do some little introspection, go back to the time it started and ask yourself what made you feel un-easy when this pain in the wrist started? Did you feel restricted and do you still continue to feel restricted by someone or something or a situation?

Perhaps working with the advice given and this might help you to get to an answer and solution that will satisfy and help you to feel "easy" again in your life.

[suryadaya]

Namaste Melanie -
I work 60-70 hrs a week at a computer desk and my practice for the last five-six months has been severely inhibited by the wrist pain that I feel. I'm glad that you came here to get such great advice from people. A week or so ago I came to the realization that I couldn't fight my wrist pain off using frustration or trying to ignore it anymore and I chose to do something about it (which is how I found this post). My asana practices before were usually heavy on the wrist-bearing and so I completely overhauled it. For the last few days I've returned to the practice of severely basic asana that I started out with a few years ago from a beginners book. I concentrate completely on the movements and breath. I spend 20 minutes warming up every joint in my body as slowly as I can manage - usually 5-10 rotations/stretches per movement (and SLOW). I put a lot of emphasis on my shoulders, upper back, arms, wrists - and I massage my forearms and knees and ankles as well. Then I do a cow/cat vinyasa and concentrate on stretching as much as possible while using my legs, my core and my upper arms to support most of my weight - keeping my wrists only as bent as is completely necessary. My asana practice then is forward bends, a lot of balancing poses, and just a few standing/seated postures. The only time other than the cow/cat mix that I am on my wrists is 2 surya namaskars, and they are done with complete attention. I modify my hands, shoulders, back - anything I can to feel that pressure removed from my wrists. A set of two could take me five-ten minutes because I am trying to do it as perfectly and easily as I can. Afterwards during meditation I keep my hands in a prayer position, pressing equally and firmly against one another with a little wider than a 90 degree angle. If I feel pressure, I raise my hands up. I've heard from many people that keeping your hands in the prayer position has a great benefit to this. I also bought a beanie-wrist guard for work and wear it constantly, and I rotate my wrists and shake out my fingers about 3-5 times a day.

So far my wrists feel slightly better, and this return to the birthplace of my yoga practice and slow attention and awareness has made the rest of me feel so incredibly at peace. I have Known for a long time that this slow yoga practice was what really awakened me - but that egotistical stuck-in-the-world part of me said 'the only value is a practice which is challenging!'. Well guess what - it was the biggest challenge for me was to slow down and start doing really really basic 'hold your arm out, rotate your shoulder, hold warrior one for 4 breaths' type of practice - and it seriously has had the best value for me and I feel physically better than I have in a long time.

So to summarize : slow down, act with awareness, and modify your practice so you stay off your wrists. If you're worried about losing muscle tone, the down-dog on the wall thing, as well as trying it or plank on your elbows might help.

I'm thinking of it like... Sthira Sukham Asanum (sp?). The steady and comfortable pose. If I had to stay in the pose for the rest of my life, could I do it? Certainly not if my wrists hurt! So modify it until it doesn't hurt anymore, or do another pose. Work *with* your body to find a compromise, meet your body where it is, and go together from them.

If you keep using your wrists lightly, maintaining attention, treating them like your best friend - they will be able to heal and guide them to the strength they are capable of. Then, in the future you can use them with the awareness you have gained through this attentive study of your body to do the asana practice you wish and still protect them from damage!

[MBelleK]

Suryadaya, thank you so much for your post. It's hard for me to change my routine, because #1 it seems like so much hatha yoga is focused heavily on returning to downward dog... And actually, I don't have any pressure or pain in my wrist when I'm in the full of extension of down-dog since my wrists are not at a 90-degree angle. That's really all that hurts.

I've also found (for some reason) that, if in cat pose, rotating my arms so that my elbow actually points toward the top of my thighs (thus the 'crook' of my elbow points in the same direction as my face) that I experience less pain. However, as this would not be proper alignment, I'm not sure that its an acceptable modification... Also, in cat pose, I sometimes shift my weight more onto my legs, but this means that my knees are just ahead of my hips, rather than aligned as they should be. So again, while it helps, I don't know if its an acceptable modification. InnerAthlete, Can you offer any comments on that?

I've found that the brace helps tremendously. With it, I have been able to resume daily practice, I am able to more through the practice without any serious pain, and I don't experience pain throughout the rest of my day. I still have to be cautious not to extend my wrist to 90-degrees without the brace though.

I do notice that I feel more of a "stretch" on the underside of my forearm on the right side (the painful side) than I do on the left.... Perhaps I need to pursue stretching that muscle more? It just seems odd that this situation SUDDENLY came up... I didn't have trouble like this before. (And Parandara, I can't think of a non-physical reason for it, though possibly I'm not in tune with that sort of thing as much as I could be.)

[InnerAthlete]

Originally Posted by MBelleK

I've also found (for some reason) that, if in cat pose, rotating my arms so that my elbow actually points toward the top of my thighs (thus the 'crook' of my elbow points in the same direction as my face) that I experience less pain. However, as this would not be proper alignment, I'm not sure that its an acceptable modification... Also, in cat pose, I sometimes shift my weight more onto my legs, but this means that my knees are just ahead of my hips, rather than aligned as they should be. So again, while it helps, I don't know if its an acceptable modification. InnerAthlete, Can you offer any comments on that?

Comment? Well sure. I 'm rarely at a loss for words.

If you are just externally rotating your arms and your hands remain fixed you are obviously changing the orientation between the bones of the forearm and the hand. Since my anatomy knowledge is merely functional and not medical I cannot determine much more than that without paging through some anatomical references.

Since your weight is largely on your lower extremities in Marjarasana (cat pose) it is not a major safety issue to do the pose with that external rotation of the arms in your situation. I would not teach it that way but I would not be concerned too deeply about that being improper alignment for that particular pose.

Acceptable modification.