Why do some yoga poses hurt?

Yoga should never hurt.  

Your back is gonna hurt like hell.

Ask any teacher and they’ll give you a strong argument about why one of those answers is correct. With the myriad of bodies and experiences we see on a daily basis, a yoga teacher learns quickly that as we think there is only one right answer, we couldn’t be farther from the truth.

I like to say, yoga should never hurt you. It should never be damaging to your body. That doesn’t mean it doesn’t hurt sometimes.

How do you know when yoga is healing or hurting?

We often confuse pain and stretching

Yoga is all about getting to know you.  Your body. Your mind. Your Self. Much of our daily lives revolve around ignoring the way we feel so we can get through the day and get our work done. We ignore our aching hips on the two hour commute as much as we avoid movements that remind us of what it feels like to live in this body.

When we first start to move every part of our bodies in yoga, the sensations are unfamiliar and we can frequently categorize the uncomfortable sensation of stretching or moving a joint through full range of motion as pain.

Backbending when you haven’t done it in twenty years hurts. Clearing mineral deposits from your elbows hurts. Tensing up when you are trying to stretch hurts. Bringing back full range of motion to a hip that only sits in a chair or a couch hurts.

Ask yourself, is this pain or the sensation of stretching?  As a general rule, pain means stop and discomfort means go.

Sore muscles become stronger muscles

Muscles need stress to become stronger. One of the side effects of that stress is delayed onset muscle soreness. While it is certainly possible to over-exert yourself in yoga, DOMS is a natural part of increasing strength. This form of discomfort initiates within 24-48 hours of exertion and should resolve itself within three days.

Tolerable sore muscles mean progress. Don’t be scared.

Cramps

Our brains are designed to seek avoidance of anything that causes us discomfort. Cramps are no exception to this rule. Inadvertent and strong contraction of muscles in a cramp can be abruptly painful. It causes us to immediately cease the activity and often violently avoid the sensation.

There are three main causes of cramps, excluding medications and preexisting conditions:

  1. Dehydration. This is a serious condition and is accompanied by a host of other symptoms like the inability to uncurl the fingers, vomiting, confusion and difficulty breathing. Individuals who are dehydrated need immediate intervention. This is not the cramp you get during cobra.
  2. Mineral deficiency. These cramps are generally not experienced during exercise. Nighttime leg cramps can often be attributed to a deficiency or imbalance in calcium, magnesium or potassium. Talk to your healthcare provider about an appropriate supplement if you experience nighttime cramping.
  3. Exercise intensity. Dr. Martin Schwellnus proposes that as you increase the intensity with which you are using a muscle, it can take time for the brain and body to synchronize, resulting in over-contraction of the muscle. This occurs particularly when the muscles are fatigued. This period is known as “altered neuromuscular control” and was originally theorized because studies have shown no correllation between hydration and electrolyte levels with muscle cramping in extreme athletes.

The first two causes of cramping rarely apply in a  yoga class. This leaves us with muscle fatigue and exercise intensity. We often seek muscle fatigue to get a muscle to “let go” before stretching it, so the cramp is a sign we are on the right track, just maybe a little to far too fast. Deepening muscle strength through increased length or intensity of contraction can, at times, be accompanied by cramps.

As unpopular as this may make me, I am a fan of cramps in class. It means I’m doing something new. Going somewhere I haven’t before. Finding new depth or strength I didn’t know I had.

Keep your breathing regular and slowly decrease your intensity and watch that cramp melt away. In a nutshell, cramps in class are not dangerous. Don’t panic.

Rusty hinges, adhesion and scar tissue

After we finish development, it is use it or lose it with range of motion and flexibility in the body. In our adult lives, we sit or stand in the same position for hours at a time, sometimes a majority of our day. It is a rare individual that uses their body through full range of potential movement each day. Most people use much less than even half of potential movement.

Joints that aren’t used through full range of motion are the perfect place for calcium oxalate crystals to deposit. This is a painful form of arthritis. As a rolling stone gathers no moss, so a moving joint keeps surfaces clear from crystalline arthritis. Clearing mineral deposits from the joints is not always a pleasant process. Take your time. It will get better.

Muscles that remain tightened in the same position for long periods of time can form hydrogen bonds between the muscle fascia that get more dense with time. Stretching those long-bonded filaments of connective tissue, like moving a crystallized joint, can feel much more intense than simple “stretching”. Again, move slowly, but don’t be afraid.

Scar tissue forms when the body heals from an injury. Scar tissue cannot be eliminated, but it can be remodeled. Through movement and stretching, one can realign the collagen fibers in the lumpy scar tissue so that it is both stronger and more plastic. Through this process, the scar tissue begins to act more like the original, flexible tissue that was in place before the injury. The older the scar tissue, and the more trauma to the area, the more uncomfortable this remodeling process can be.

On the mat, the yogi should practice with awareness and patience. When we want to achieve yoga “goals” too quickly, we can cause injury. Take your time. Move with awareness, and be patient. Start where you are and build strength and range of motion from there.

Osteoarthritis

Osteoarthritis is the condition in which the protective cartilage in a joint is worn down, eventually to painful bone-on-bone contact within a joint. Osteoarthritis generally forms from uneven tissue-loading or repetitive movement. There is no cure for osteoarthritis, but yoga is a great tool to help strengthen the soft muscle tissue around the joint and reduce the amount of painful bone-on-bone contact.

In the practice of yoga, individuals with this condition should focus on precise alignment of the skeleton in poses and building strength around the joint. Range of motion exercises are helpful because they help palpate the circulation around the joint, maintaining and improving joint health. Individuals with osteoarthritis must practice to tolerance only.

Once the painful bone-on-bone compression is felt, going deeper will only exacerbate the wear and tear on cartilage and bone. This is not a pain to try to tough your way through. Through practice and attention you will find the places where you need to stop before you reach the pain.

Chronic Illness

Fibromyalgia, rheumatoid arthritis, lupus and other autoimmune disorders are often noted for unsourced, chronic pain. Practicing yoga with these conditions hurts. That’s the cold, hard truth.

The good news is that yoga also miraculously relieves the long-term pain. There is no clear explanation of why, but moving the body with awareness, increasing circulation, improving alignment and strength all help to eliminate the seemingly endless pain. Read more about Joseph Encinia’s inspiring recovery from RA.

Other forms of chronic illness are also notorious pain producers. Sometimes it is being unable to move for long periods of time or the way we hold ourselves in response to the illness that causes pain.

Take your time and move slowly, but get started with yoga. The body functions best when it is being used and yoga is one of the safest ways to find the limits of your body in any condition and begin to improve your health.

Chronic Misalignment

Duck-footed. Hunch back. Sway back. Ding-toed. Flat foot. Forward head.

These common misalignments are not in the original design template of the human body. “My father was duck-footed” is not a genetic precursor for you to turn your toes out. The human leg was not designed to be used in that way. We learn postural habits from our surroundings just like we learn syntax and social cues.

Some of these misalignments are caused by accident, injury or habit. You may have developed a habit of jutting the ribcage forward at the beach to appear thinner or have a forward head from working at a computer desk all day.

The most insidious component of chronic misalignment is uneven tissue load. Take this valgus, or abnormal rotation, of the heel below. Misalignment of the heel causes adjustment of the bones of the entire leg, hip and eventually the pelvis and spine. Uneven load in the tissues over time leads to failure of the muscle or tendon fibers. This flat foot might just be causing your migraine headaches.

As you work to change chronic misalignment, you may experience discomfort and pain. This is part of the process of realigning bones, strengthening muscles and healing connective tissue. With this type of pain, it is important to have a strong team of therapists helping you through the process to ensure you stay safe, progress at a rate appropriate for you and practice with a depth and attention to alignment that is not causing you further damage.

A good team includes experienced and educated yoga instructors, massage and physical therapists, maybe even a chiropractor, doctor or sports medicine specialist. Check out Dr. Mike Evan’s video on chronic back pain for more information on diagnosing chronic pain, creating a team and developing an attitude that will help you to heal.

You have bad alignment in class

I know it. You wanted me to say something nice. You expected something more supportive, and all you got was tough love. Get ready for more real talk.

Your alignment sucks.

I hope that is bold enough to get you to make a change. Your teacher said your foot should be pointing straight up over the top of your head in Standing Bow. Yours is pointing over at a boat moored across the river in Kittery and you are surprised your sacroiliac injury isn’t getting better?

You want to go higher in floor bow, so you leg your legs spread three feet wide. Yoga must be bad for knees.

You want to come down lower in half moon, so you turn your chin, twist your spine and collapse your chest. I guess yoga causes neck injuries.

You keep losing the grip, so you use a towel to augment your hand strength. Ah! It’s yoga, not tennis that causes rotator cuff injuries. Phew!

Or are your ready to take responsibility for your actions and use yoga to change your body and your life? There are very specific reasons for the way your yoga teachers cue the postures. The sequence of the cues is critical. The words we use intentionally to create specific actions in your body to keep you safe, and to help you maximize the therapeutic benefit of your practice.

Here are the steps to achieve a healing practice.

  1. Frequency: You have to show up. Regularly. Not once a week you show up and work so hard you pass out, puke twice and have to go home and take a nap. Regular, consistent, dedicated practice. You are worth it.
  2. Accuracy. Alignment is the first priority in any pose. Even if you can only move one inch into the pose. With no alignment, there is no therapy.
  3. Intensity. Only when you are showing up regularly, and executing the postures with accuracy and precision in your alignment, do you add the intensity and depth. Intensity is the privilege of the mindful practitioner.

Intensity is the privilege of the mindful practitioner.

Injury

Injuries happen in life. We slip on the ice, aggravate a shoulder playing tennis or get too aggressive in a pick up basketball game. With few exceptions, a modified practice can be continued with an injury, but pain will be an important guide.

Last year, we had a student practicing with a broken leg. She did her practice in a chair for the standing poses and elevated the leg on the floor. After two weeks, her doctors told her the leg was ready for weight-bearing. After four weeks, the fracture was invisible on an x-ray. Her doctors were blown away by the speed of recovery for a woman in her fifties.

One of the main reasons yoga helps you to recover from an injury is blood flow. Increased circulation helps support and speed repair and rehabilitation. The tricky part is not letting a misguided ego tell you to go for it in floor bow even though your shoulder bursitis is bothering you.

The most important action to take when you have an injury is speaking. Talk with your doctor or physical therapists when they analyze or diagnose you. Ask questions like, what types of movement should I avoid? And, what movement should I do to rehabilitate from this injury? Many students bring in a printout of the poses they have questions about. Get specific and don’t leave without an answer. You may be the first patient they have had who really wanted to know.

Talk to your teachers. Any well-educated teacher has yoga therapy and yoga for the infirm in their training profile. They can’t help you with your whiplash if they don’t know your neck is bothering you. You are not a yoga expert, so you may not realize that forward folds are aggravating your herniated discs.  You might be great at aerodynamics or flag football. Let your teachers share their expertise and experience with you.

I can’t tell you how many students have complained that an injury was not healing and when I asked them to take it slowly or avoid a particular movement temporarily have replied with, “Well, I like to push,” with a cheeky smile. Apparently, you also like to stretch a twelve-week recovery out to eighteen months.

Bones take four weeks to heal. Muscles take around six weeks. Connective tissues can take up to sixteen weeks. The average woman recovers from a common yoga injury to the hamstrings tendon in eighteen months. Talk to your providers and listen to your body so you don’t end up in unnecessary pain for years.

Over-Aggressive Practice

This could be a sub-section of the injuries category. Like all physical activities, you can create injury in yoga. Yoga has tremendous therapeutic potential. It can also cause harm.

We see it and want to achieve it. We know if we work hard, we can pull ourselves up by our  bootstraps yoga mats and live the American yoga dream.

I hope you listen to what I am going to say next.

Too good is no good.

More is not always better for the human body. You might not be strong enough yet for headstand. Your body may not be genetically designed for full wheel. You can cause wrist injury by misalignment in handstand. Shoulderstand is not for people who have osteoporosis.

This kind of pain is the devil in the world of yoga. This kind of pain is not the walk-through-the-fire-and-emerge-clean kind of pain. This isn’t the suffering that leads to redemption. This is the antithesis of yoga: disunion of mind and body.

When you are in the posture, with healthy alignment, to the best of your ability today, that is the ultimate destination of yoga. It is meditation in it’s purest form: the mind in the body, one second at a time.

Take your time. Ask questions. Be patient. When we approach pain with awareness, we realize that in the words of the great Emmy Cleaves, “Pain is a gift.”

sara headshotSara Curry is a Bikram Yoga studio owner in Portsmouth, NH. A lifetime of back pain lead her to yoga at the turn of the millennia. The freedom and recovery she gained from yoga drives her daily practice and her determination to bring yoga’s healing potential to as many people as possible.

Practicing Bikram Yoga After a Mastectomy

Don’t let surgery limit your practice. Physical therapy is a must to improve range of motion and quality of life going forward. And, what do you know, the handouts and pamphlets with which I was sent home depict exercises straight out of the yoga tradition. Following are notations of how I modified the postures. Please incorporate what benefits your physical situation; don’t feel limited by my experience.

First, you will experience pain so move slowly into the postures. That being said, don’t let your fear of pain limit your achievements. Many times I stopped reaching at the same point I left off during the previous class, or even at a weeks old measure. I went through all sorts of pressure-relieving  modifications during the cobra series savasana because I assumed it would take months and months AND months to bear weight. It didn’t.

Test your limits every class. I’m not saying it’s okay to pop your stitches, but your body and your abilities change every day. It’s a good idea to check them every day so you don’t get stuck in last week’s temporary inability. For convenience, I’ll refer to a ‘well side’ and ‘surgical side’ to avoid all the rights and lefts.

Pranayama: One elbow will not be able to lift as high as the other, or as high as the class before you had surgery. Look in the mirror. Look. In. The. Mirror. Right away, with the first breathing exercise, accept where you are. You will be amazed how much the mirror helps the healing process. Lift surgical-side arm to tolerance and hold it. Focus on the expansion and stretching you feel in your chest on the inhale. With each class, continue to lift that elbow and breathe deeper. Don’t pay attention to the uneven appearance. Worst case scenario: with your arms at your side, shrug or lift your shoulders up and follow the same inhales and exhales. Tensing up or holding my breath amplified the pain. Slow, conscious breathing carried me through everything.

Half Moon: Think of your well-side arm as a stake, and your surgical-side arm as a vine that’s going to climb up that stake. Start by lifting your surgical arm as high as you’re able. Maybe you place your hand on your same side shoulder to form a stubby wing. Gradually creep your fingers towards the well shoulder, then the arm and pull yourself up on it. Your goal is to reach the top and interlock your fingers. I felt more when the surgical-side was on the bottom in the side bend. When it became too much, I lowered that arm and let it fold across my ribs. I used the same modifications with backward bending.

Hands to Feet: Don’t be in a hurry to fold forward with both arms stretched out in front of you. I started out squatting down and grabbed the back of the well-side heel. Surgical side arm was bent like T-Rex. Let it down slowly. Don’t go crazy pulling on the good side. It hurts to squish in the beginning.

Awkward: Think ‘I Dream of Jeannie’. Stretch well side arm out as usual. Fold surgical-side arm across your front and start by reaching up towards the opposite shoulder. Once there, start creeping your hand down well side’s arm. As you feel more comfortable, separate into two outstretched parallel arms.

Eagle: At first you’re not going to be able to swing your arms without popping a stitch. Do your best to entwine your arms in eagle formation. For me, this posture was the least effected. You may be surprised to realize prior to surgery you pulled your arms into your chest rather than down from your shoulders. The pain you feel now due to that compression will reinforce the need to make that correction going forward. Ahhhh, the silver lining.

Standing Head to Knee: As with Half Moon, the well-side knows what to do. I started out with my surgical-side arm pressed at my side and bent at a right angle. As I leaned forward surgical-side arm crept down my leg towards the ball of my foot until I was able to interlock my fingers. This was my screw-you-you’re-not-going-to-get-to-me posture. It was helpful to have a posture I wanted to attack; a posture I didn’t want to defeat me.

Standing Bow: For the surgical side, I grabbed my foot and kept my heel against my butt while stretching forward. Slowly I started to kick my leg back as far as my pectoral muscles and arm pit could tolerate the stretch. You will feel the difference between kicking back and up on your surgical side. Here’s where you realize just how much the kicking and stretching keep you balanced. For the well side, go back to the image of the T-Rex arm. As I healed I let the surgical-side arm hang straight down while the well side kicked. When the pain eased, I started raising the arm first with a bend at the elbow and then outstretched.

Balancing Stick: Refer to the hand/arm positioning in Half Moon. If it becomes too much, either wrap surgical-side arm around your torso and give a hug, or hold it against your side, parallel to the floor. As you feel better, allow surgical-side arm to hang straight down at a right angle to your body. Next step: slowly raise your arm.

Standing Separate Leg Stretching: Do what you can, what feels comfortable, but do something.

Triangle: This was my horror show. There’s just no comfortable place to put your arm. As with Standing Bow, you realize the importance of opposing forces: right arm stretch up, left arm stretch down. I couldn’t figure out what to do with my head and neck when the surgical-side arm was supposed to be stretching up. Don’t get discouraged. Do your best. It was a great opportunity to focus on patience and acceptance.

Standing Separate Leg Head to Knee: Treat it like Balancing Stick.

Tree: I kept my surgical side arm at my side and bent at the elbow.

Toe Stand: Scary at first because there’s a good chance you’re either going down face first, or you’re going to stretch surgical-side arm out to make a landing and be in pain. I tried to turn this posture into a positive challenge. Slow down the bent knee descent and try it with one good arm. It’s great preparation for the advanced entry in to the posture.

Savasana: It really helped me to regroup, slow down my breath and let go of what was upsetting me.

Wind Removing: Hold surgical-side arm folded in on itself; keep it close to your body. As you heal, open up the angle.

Sit up: Keep surgical side arm down, fold at elbow across your torso like a belt at your waist. You’ll be surprised how much more you use your abs! At first it’s really challenging to keep your spine straight, but that’s the goal. I chose attempting the sit up rather than rolling over. Rolling over leads to being belly down and the necessity of pushing up and I just didn’t want to deal with that.

Cobra: You know that saying ‘when a door closes, a window opens’? That was my Cobra. It was too much pressure to start cobra from a belly-down position. I was forced to squeeze my elbows into my side at a right angle and find the back muscles needed to stay lifted! Add in the arm strength and you got yourself a damned good Cobra.

Cobra Series Savasana: Oh good lord, really?! Just lie on your side fetal-style.

Locust: Ok, so I just panini-ed my tits in Savasana to *relax* and now I’m supposed to do it intentionally?! Do your best. As with Cobra….you’ll find those back muscles.

Full Locust: Rather than take off from a belly down position, I approached the posture with landing gear up. Surgical-side wing was tucked in at first.

Bow: Well-side hand grabbed a couple inches below the toes. Surgical-side arm was pressed to my side like I was going into a nose dive. My Bow was intentionally lopsided to keep pressure off the surgical side. It was more of a weeble roll at first, but gradually improved to where I could set up the posture and with healing, add the kick.

Fixed Firm: I lowered down into the posture with surgical-side arm folded over at my waist. With time and stretching I was able to reach for the opposite elbow.

Half-tortoise: Another T-Rex arm posture. You may feel like the entire ninety minutes is an exercise in futility because one side is laid up and you will be sorely wrong. Just as those with limited or no ability to see or hear often sharpen their other senses, you will locate those underutilized muscles and master a posture. Half-tortoise is one of those postures.

Camel: As if Camel isn’t emotionally or physically challenging enough to begin with! While Standing Head to Knee was my posture to rally the troops in the standing series, Camel was my touchstone in the floor series. It has all the elements: back bending, stretching, being upside down and completely exposing your chest. Attack it. The release feels so good.

Rabbit: Keep surgical-side arm close to your side for support. Add in the pull as you’re able.

Head to Knee: I used the same modifications for Standing Head to Knee

Final Stretching: I started to feel the feeling of accomplishment. I’m almost there! Don’t focus on the lack of range of mobility in your surgical side, turn your attention to how far you’ve come and how good it feels to flex your feet and stretch your calves, how good it feels to squeeze your quads and release your hamstrings and how good it feels to fold your torso over your legs. I started with BOTH arms in a pike position with my elbows by my hips. This was my release.

Half Spine Twist: My biggest challenge was for surgical-side arm to grab the knee. I hugged the top of my opposite side knee instead and stretched up like crazy. Add the twist.

Kapalbhati: Woo-hoooooooo! Give yourself a pat on the back, you did great!

So, that’s my practice, with a few peeks into my stream of consciousness during class. What I’ve noticed with my practice is that the past events have not limited my depth or expressions of the postures. As I mentioned earlier, I am extremely fortunate to be able to return to the place where I left off prior to surgery. Sure I feel a slight tug or tightness at times but no physical limitations. I have the mental ones! That is the crutch I grab for every so often. The one that says it’s ok to take it easy, the one that reaches for the modification not because I need it, but because I don’t feel like squeezing or kicking or sucking it in….the one that is still enjoying hiding in the back row. There it is, I said it.

bridget headshot 2Bridget Dubravsky is a Certified and Practicing Bikram Yoga Instructor from Maine. She is also the author of Bikram Yoga and Breast Cancer.