There have been a couple of overlapping issues to the original article on Sit Bone Pain. It just shows that whatever the issue, problem, or pain is… it can be coming from a number of different places. Figuring it out isn’t always so easy. We also naturally try to come to some conclusion about what is going on and sometimes wrongly assume that all, in this case, sit bone pain is created equally. What I’d like to do is offer a couple of other scenarios that are somewhat common. They would also change the way in which you work with sit bone pain. In the original article, I’m specifically talking about dealing with sit bone pain as a result of a hamstring tear or irritation.

First we have the Trigger Point. There is a trigger point in the gluteus minimus or sometimes the gluteus medius which can create pain around the sit bone. One of the most common complaints that goes along with one of these two being the culprit in sit bone pain is this. The pain tends to increase when I’ve been sitting for a long period of time, in a car or in a seat. Yes, this could be the sign of other things as well, including everyone’s favorite… piriformis.

All I can tell you is this. On at least 4 occasions I’ve met students with sit bone pain who have mentioned that the pain comes on during the day while they’re sitting. I check their gluteus minimus on the side of their hip and… when I press it reproduces their sensation. I realize this may be beyond your skill set so have them check themselves with a tennis ball or something similar… or send them to a Neuromuscular Therapist.

Second, we have the Adductor Magnus as the real culprit. Differentiating between the hamstrings and this adductor is relatively simple. If the sit bone hurts when doing a wide leg forward bend but no while doing a forward bend when the legs are together, it’s more likely to be adductor magnus which has an attachment on the sit bone as well. It’s not because of a trigger point but instead it’s because it probably got injured, usually during a wide leg forward bend! I would suggest that the same posture will be the one to stretch that scar tissue and alleviate the problem.

As always, proceed slowly and be willing to change course based on the feedback of the person you’re working with.

I think we can all agree about one thing with regard to the shoulders in downward facing dog. None of us like to have our own or see our students shoulders stuck up in our or their ears. How do we get our shoulders out of our ears? In addition what is the effect of this on our elbows, wrists, and hands? Or is it the other way around? Do our hands, wrists and elbows have an effect on our shoulders?

All of the “separate” elements that make the arm are actually linked together. The “separate” parts are the scapula, shoulder joint, elbow, wrist, and hand.

The hand/wrist, elbow and shoulder joint all create a kinematic chain of joints. In plain English this means that they have an interrelationship with one another. In other words, when your hands are on the floor, if your elbow bends, then both your wrist and your shoulder joint have to change. If you change the position of your hand, your elbow or shoulder joint may change.

This same concept is also true of the leg, however there is one critical difference. At the proximal (top) end of the leg is the pelvis and at the proximal end of the arm is the scapula. The pelvis doesn’t have the ability to move around in the same way that the scapula can move. The major difference here is that when the scapula moves it also changes the position of the shoulder joint and humerus in space changing its relationship to the other elements of the arm.

The Scapular and Shoulder Movement

I personally like to set the scapula up first in downward dog. It’s the part that seems to attract our attention first anyway.

The action of moving the shoulders away from the ears is usually seen and described as depression (downward movement) of the scapula. I believe this to only be part of the story. The depression that we cue and see is actually mixed together with a combination of protraction (around the front) and an upward rotation of the scapula. Actually, the scapula is already upwardly rotated if the person is in down dog. But when we add in the protraction, the largest part of the shoulder, the deltoid seems to externally rotate.

This is due to the movement of the scapula moving the humerus and shoulder joint in space. It is more externally rotated but as a result of the movement of the scapula not necessarily the shoulder joint. My sense is that the protraction part is often the one that’s missed out or less commonly cued. The reason we want to include some protraction is because it activates one of the most important stabilizers of the scapula, the serratus anterior muscle. I’ve discussed the importance of this muscle in other posts such as so, you want to do a handstand and in the more recent piece about headstanding.

We often forget about how important stabilizing a joint or structure can be. We naturally think of muscles contracting and creating movement. Activating and stabilizing the scapula sets a stable structure for the humerus to move relative to. To be fair, there are a number of other muscles that also help to stabilize the scapula but none better equipped than the serratus. These muscles would be the trapezius, rhomboid, and pectoralis minor.

With the scapula stabilized we also create a stable foundation for the body to be supported above the arms. This allows us to create movements at the other joints more efficiently. Instead of rotating our upper arm at the shoulder joint by itself, the movement and then stabilization of the scapula has already done some of this work for us. This means, less effort is required in creating all of the external rotation we want in the upper arm.

Scapulae retracting, Shoulders rolled in

Scapulae starting to protract around front

Scapulae protracted - notice the change in shoulder and in elbow from just moving the scapulae.

The Elbow, Wrist and Hand

The crease of the elbow is often cued to be facing forward in downward facing dog. I’m personally not a big fan of this positioning. I feel that it encourages too much effort and movement in the shoulder joint itself without the scapula being involved. It’s also the part of the arm that probably shows the most amount of variation in natural shape and positioning. I think it is generally a bad measure of correct action and alignment.

I’m not saying that we shouldn’t use or pay any attention to the elbow either. As I already mentioned a change in any of the elements tends to affect the others. We can use the elbow to release the tension and then create movement in the shoulder joint. By bending and softening the elbow in down dog we can more easily find the right amount of movement or positioning in the shoulder.

I prefer to look at both the shoulder and then at the angle of the wrist crease. I would suggest that both of these structures are more likely to have or develop trouble over time than the elbow.

In order to change the direction in which the wrist is facing, we actually need to change the position of the hand. Not only do we get stuck in which way the elbows are facing, but also in which finger in the hand is facing straight forward. Which finger is facing forward has an impact on whether the line of the wrist is facing forward, inward, or outward. Which is correct also depends on what the shoulder looks like.

I tend to start with lining the crease of the wrist with the front edge of the mat. This means that as someone moves through the most common positions of chaturanga, up dog and down dog that their wrist is bending in a more or less right angle and forward and back.

But depending on what the shoulder looks like, I may be willing to adjust the hands by rotating them outward slightly. This tends to increase the ability of some people to open their shoulders and find space. I have had some dramatic changes in shoulder pain from simply rotating people’s hands outward slightly and lining up their wrist or beyond and angling the line of the wrist outward slightly.

What this also means is that it’s not their middle finger that is pointing straight forward. This is a generally well-accepted element of alignment and I’m sure some of you will disagree with anything but the middle finger pointed straight ahead. I believe it is a good starting place and then we might have to adapt to the individual if it turns that it doesn’t benefit them.

Middle finger is pointed forward - notice line of wrist - This is how my anatomy works.

Index finger pointed forward - Wrist angle is changed

Conclusion

There is no one perfect “right” way of positioning your hands, wrist, shoulders and scapula. Even though I may be suggesting you do or say something different from what you do now, I’m not suggesting that this is the “right” way. What I am saying is that we may want to look at whether we actually fit into the standard alignment points of the shoulders, elbows, and wrists in downward facing dog. Or at the very least start to think of these elements as being inter-linked and changing one can affect change in one of the others.

I personally like to engage and move the scapula first because the muscles that control it are larger and can help hold the entire shoulder girdle more efficiently than say the muscles that only rotate the humerus. In my experience this is more efficient for holding the posture more comfortably. It also then allows the muscles that rotate the humerus to function more easily in adding any bit of rotation they may need. The idea is that each joint contribute it’s part in an efficient way. Not one joint trying to create the movement of the entire chain.

When I’m teaching, I don’t assume that everyone should have his or her hands, wrist, elbow or even shoulders in the exact same place as everyone else. Their personal anatomy and tensional patterns in their musculature are going to be what decide that ultimately. So it’s not like I go around changing everyone. If I see what looks like stress running through someone’s wrist, I line that up and let the hand express the angle of the wrist. If it’s the shoulder that needs more space, I might also change the hand or bring to the person’s awareness, their ability to move their scapulae if needed. We have to be willing to experiment and stay open, not just to being right, but also to being wrong.

Elbows pressing into floor to feel serratus contract.

Having a Play

If you want to find your own serratus anterior you can feel this muscle activate by doing a couple of really simple exercises. Take a childs pose, arms forward. Let the elbows be bent slightly and resting on the floor. If you have any type of pinching feeling in the shoulder itself while doing this, bend your elbows more by bringing them back toward your body.

Now, press your elbows into the floor and bring your mental awareness to the sides of your body just in front of your armpit. Hopefully you can sense the contraction of a muscle there, which would be your serratus anterior.

Don’t stop there. Move into downward facing dog and put a slight bend in your elbow to help us feel this again. After you bend your elbows slightly, imagine you are sending them down toward the floor as well as toward one another in front of your face. You shouldn’t have to use one hundred percent of your strength to make this happen or to feel the sensation; twenty to thirty percent should suffice. Can you feel it

Trying working with this in your down dog and see where it takes you.

Happy exploring,

David

Some time ago I threatened to write an article about pain showing up in the joint that connects the collarbone to the breastbone. I have had a couple of more recent requests to talk about this potential problem in Supta Kurmasana. As always I try to look at the anatomy, its function, observations about the posture itself and perhaps some ways that information may inform the way we work in the posture or adjust it.

I’m gonna get technical on ya for half a second if for no other reason than to teach you my algebraic (not really) equation for coming up with the technical name of any joint in the body.

The equation is bone + O + bone = Joint Name

The breastbone is technically called the sternum, the collarbone the clavicle. Add them together and make a couple of changes to the endings of each one and you have the stern-o-clavicular joint. And it’s the sternoclavicular joint that can go “pop” while doing a Supta Kurmasana.

The requests as of late have unfortunately come out of injury during adjustments in this posture. But injury to this joint doesn’t only come during an adjustment. We can easily do it to ourselves if we’re not careful and to be fair, even if we are being careful.

Seems strange to talk about being careful when talking about putting our legs behind our head and then binding our arms behind our back while face down. It can occasionally leave one to wonder why on earth we would ever do such a thing to ourselves? I believe that question might be better left for a different article some day in the future.

Joint Structure and Movements

The joint itself is quite unique. OK… I’m gonna get anatomical on ya again. Joints are classified by their shape and/or function. Some joints live outside of the normal classifications that have been created. This is one of them. This joint is usually classified as a saddle joint, imagine two horse saddles, flip one upside down, rotate it ninety degrees and the curves forward and back meet up with one another in such a way that the saddles move along one another in two directions.

The sternoclavicular joint is shaped almost exactly like this except its curves are not quite so deep as a horse saddle. In the case of this joint it moves forward and back in what we call protraction and retraction. It moves up and down in what we call elevation and depression. This fits nicely with the design of a saddle joint.

However, there is one additional function that lies outside the normal saddle shape. This joint also has the ability to rotate and it is in this function that the injury in Supta Kurmasana most likely occurs.

It’s not that this is the only place that we utilize the rotation at this joint. Most bindings behind our back such as Marichyasana A, B, C, D, and Prasarita Paddotanasana C with hands interlaced behind the back are but a few examples. What happens here in Supta Kurmasana is that we have to mix the rotation of the clavicle with retraction. Retraction is when the lateral or outer end of the clavicle is moving back in space. In this case, it happens by virtue of us reaching our arms behind our back. Mixing the two together increases the amount of pressure in the joint.

In a Supta Kurmasana you happen to be doing this combination of movements while going around your thighs. By virtue of this “obstacle” being in the way it forces us to reach further, and create more general tension through the sternoclavicular joint when we bind.

All of this makes adjustments a bit precarious depending on the student and their individual factors. Do they have short arms? Tight shoulders? Wider thighs? Wider torso? There could be a number of additional factors that could be seen as potential restrictions in the binding component of a pose such as this.

I would suggest that we look at our own ability or at our students’ ability to bind in postures such as Parsvattonasana, Prasarita C (second most common place for injury at this joint with palms facing out behind the back), and the Marichyasanas.

Adjusting the Pose

I don’t want to get too deep into how one should adjust this posture. The teacher should fit the adjustment to the student of course. Not to mention I’m not going to take on how to adjust the legs here. All of it together is a whole other article and perhaps even a book!

It is common to bind the arms first in this posture and then put the legs behind the head. In many instances the binding comes before the rest of the posture happens fully. As we might do in those Marichyasanas I mentioned earlier. We would naturally bind our arms first and then fold forward or twist fully.

This posture might be an exception to that rule. For instance, assuming that some of you out there put yourself into a full Raja Supta Kurmasana where your legs are completely behind your head. Do you do this with your hands bound first? No, you don’t. You sit up, put your legs behind your head and then lower yourself down to the floor using those hands and arms and then after your forehead is on the floor, you bind your arms.

I’m not sure why this same order of operations shouldn’t apply to putting someone else into the pose if you’re helping them. I know for me personally, If I bind my hands first and then someone tries to put my legs behind my head… It ain’t happening easily for them or for me. It also isn’t going to be very comfortable for me either.

Other people are different, thinner legs and longer arms might not have a problem either way they are adjusted. Think about it, does binding the legs to the side of the body allow those legs to move more easily or less easily?

Trying to adjust someone’s legs after binding their arms may even make them tighten up. Why? Because they’re trying to hold onto the binding between their fingers or hands. This is a place where that pop can happen.

The other place where the joint tends to get injured in this posture is when the arms are being adjusted more deeply behind the back. Often the elbows are squeezed together from behind. If it’s you trying to bind your own shoulder, or you trying to adjust an arm deeper, don’t forget to help the shoulder get further forward.

The shoulder should move down toward the floor before the arm tries to reach back and rotate. Moving it down toward the floor first tends to alleviate pressure at the sternoclavicular joint and make more space for the rotation to happen around the leg if it’s already behind the head.

What do to if you have an injury here?

The most likely culprit in an injury here is a torn ligament (there are always other possibilities). Before you freak out over the word tear, let’s define what that means to a ligament. Tear implies that the fibers in the ligament have been stretched past a point where they can return to their original shape/position. It’s like your old slinky. Once you stretched it out, as we all did at some point in its life, it never went back together in the same way. There would be slightly larger gaps between the coils than when it was new.

A better way to describe it is to say it was over-stretched. What do we do about this? Ice it. Reduce inflammation, and swelling if there happens to be any and keep moving the joint around. Remember that scar tissue is going to start forming whenever there is an injury to soft tissues in the body. If you do nothing, it gets tighter and more restricted.

Don’t necessarily move the joint around to the degree that tore it, but keep moving it. Just keep in mind that at a joint like this, you may quickly realize how interrelated things are in your body. Your clavicle moves with each breath you take. Muscles that attach to it also attach to your head and neck. It’s possible that injuring the sternoclavicular joint may cause a number of compensations to go on in and around your neck.

Trapezius and SCM attachment onto clavicle

The sternocleidomastoid attaches very close to the sternoclavicular joint and then just behind the ear on the skull. Your trapezius muscle is attached to the end of your clavicle and scapula (which both move together). It’s other end attaches to the back of your head and neck. And the subclavius muscles that sits under (sub) the clavicle (clavius). All of these muscles exert their forces on the clavicle itself and the joint. If they are in balance, then the clavicle is in balance. If some of them tense up in response to injury, which can happen, then the balance is thrown off. If the balance is off the repercussions can be neck and shoulder pain as a result of the initial injury to the joint. So it can be much more widespread than we might initially think.

Conclusion

With the recent articles coming from many sources, including the NYT article that I had to respond to… we should all take pause and consider how we’re practicing, as well as what and how we’re teaching it. If there is one thing I’ve learned over the years as a teacher observing my teachers, it is that I should be observing my students. It is my responsibility to help the student, sometimes this includes helping them go deeper and sometimes it is about holding them back from the posture and sometimes from themselves.

In a posture as deep as Supta Kurmasana, it is very easy for tension to build in the tissues and joints. Pay attention to the sensations in your own body. If you’re the teacher, try to imagine being that student.

Om Shanti,

David

Yes, you can get injured doing a headstand… especially if you take the name literally.

We can often gather information from the name of a posture. Sometimes embrace the quality or energy of the name, like Virabadrasana (Warrior). Sometimes the name is exactly what we should be doing. Shoulderstand comes to mind. It’s not neck stand after all is it?

Sometimes the English name is a little misguiding though. Headstand is one of those posture names that we probably don’t want to take to literally. We don’t really want to put all of our weight on our head do we? No, we don’t, if we do, we might end up being a statistic in a New York Times article.

When we think of headstand we should think that what we’re really wanting is to do a forearm balance with our head lightly touching. This is very hard to do as a beginner but we can certainly look at the anatomical components that create a firm foundation and steady posture.

Hand positions

The great debate is often which hand position to use? For me the answer is simple, the one that keeps the student the most steady and weight off of the head and neck. There is the classic interlaced finger where the palms are open and the top of the head is placed in the hands. The area above the forehead is what we place on the floor. This is the way I do my headstands.

In terms of popularity, this technique has been overtaken by the most popular hand position at present, which is to press the hands into a single fist and then place the top of the head on the floor between or on the forearms. There are variations in the arrangement of the pinky fingers, but either way, a closed fist headstand seems the more popular of the two.

I think the main reason for the popularity of the closed fist hand position is for the sake of alignment. If the head is in open hands then the back of the neck must shorten to place the top of the head in the hands. If you place the top of your head between your forearms, the neck stays in a neutral alignment. This would seem to transmit the force in a straight line through the head and neck.

That seems like a good reason to put the head between the forearms. After all we need a straight neck to do a headstand. Don’t we? Well, if you’re going to put your body weight onto the top of your head, then I couldn’t agree more, keep your head and neck straight so the weight passes through it in as straight a line as possible. But what if there’s no weight in your head? Does it matter?

In Practice

When I come across students who are doing headstand, I don’t change anything if they have built a strong and steady foundation. If they can hold headstand and not have very much weight on their head, then I don’t change it for the sake of having them do it the way I want.

The students that attract me to their headstand are the ones that either can’t do it at all, and have been trying for some time, or those that look wobbly. The wobbly ones make me a bit nervous and need some help. At first, I look to see what it is that is making them wobbly. Of course, I usually start at the foundation of their headstand. What hand position have they used?

I look at the base of a headstand from both a geometrical and anatomical point of view. My personal observation of one of the main changes between the hands being open and the hands closing to make a single fist is where the shoulders end up in relationship to the elbows below and the body above it. The further forward the head goes, as in the open handed set-up, the further forward the shoulders go. When the hands close to make a single fist, the head naturally moves back in space and the shoulders go with it.

At the moment, I firmly believe that this is one of the critical changes that accounts for whether or not someone is wobbling as they are up in their headstand as a beginner to the posture. I’m assuming for a moment that someone has developed or has enough strength in their shoulders to successfully do a headstand. I specify beginner because and advanced practitioner can usually do headstand with either hand position and just has a preference for one or the other.

Notice where the shoulders are relative to the elbows

Notice how the ribs have also popped out

There are two elements at play between these two types of hand positions. One is the shoulder position as I just mentioned. The second element is the head and whether it is up or down. As it turns out, they are intimately connected together.

I’ve already asserted that what we’re really after is a forearm balance with the head lightly touching. As a beginner to a forearm balance would you do it with your head up or down? I’m going to guess that your answer is head up. If you tried to hop up into a forearm balance with your head down in a straight line with the rest of your body I can imagine how easily you would go over your hands and onto you back. Can you imagine a similar thing happening in a handstand? The head looking forward and being up becomes a counter balance. I think there is a similar principle at play in our headstand.

Some time ago I wrote a newsletter article titled “So you want to do a handstand”. In this article, I discussed head and shoulder positioning and even connected a part of it (the pelvis) to a headstand. Think about these three postures I’ve mentioned, headstand, forearm balance, and handstand. Can you see a relationship between them that is a progression? If you were going to make a sequence of development, with which pose would it begin? I think it would go headstand, forearm balance, handstand, no?

When you are a beginner to any of these three postures, it’s easier to do the postures by allowing the shoulders to move further forward. As one advances it may be possible to have the shoulders back further. For instance, in handstand an advanced practitioner may be able to align their shoulder with the line of their arms below and body above. I’ll guess that when they started their shoulders were out in front of their wrist a bit. They evolved or progressed to the more advanced alignment. I believe this process to be true of either forearm balance or headstand as well.

As I said, there are two elements, the shoulder and head position. If the shoulders go forward so does the head. If the head lifts and goes forward so do the shoulders. If we place our hands behind a closed fist our shoulders are naturally further back than they would be if our hands were open. With the shoulders further back and the head pointing down it the shoulder is sitting right above the elbows and the body aligned right above that. I think that in this case it is much easier to end up going over your head and crashing down.

There is an anatomical proportion at play here. It’s simple enough and divides the world into those who can more easily do either one of the two types of hand positions in their headstand. Those with proportionally short upper arms relative to their lower arms will usually have a much easier time doing the type of headstand where the hands sit behind the closed fist. Because the upper arms are shorter it still takes the shoulders forward enough to engage the right tissues in the shoulder complex. If they were to open their hands and put the top of their head in them, their shoulders might actually end up too far forward and throw off balance in that direction.

The opposite is also true. If you have long upper arms relative to your shorter forearm you will probably have an easier time with an open handed headstand. In this case, if you were to put your head on the floor behind a closed double fist, your shoulders might end up so far back that you begin to teeter on your elbows. In a sense, you become too aligned for the tissues to be able to engage and counteract any tilt forward or backward.

For those of us with more or less equal proportions we can probably do either of the two hand positions. Possibly depending on slight differences in proportion we will have a preference for one or the other.

Shoulder Forward

Why does the shoulder forward have so much importance? It really has to do with how it causes our body to respond and react. In the handstanding newsletter as well as the Chaturanga newsletter I wrote at length about serratus anterior muscle. Revisit them if you need to. As our body moves forward through the shoulders the body has to engage the muscles to prevent us from collapsing forward at the shoulder joint. I might compare it to how the body uses the quadriceps in warrior pose to prevent us from falling forward through our front knee. There is a natural pushing back and engagement that happens at both of these places. This push back creates stability and strength. What it really is, is our response to body weight and gravity!

If however our shoulders aren’t forward, then this pattern isn’t triggered in the same way. You can see this in the beginners to headstand sometimes when the top of their head is on the floor between a double fist and they go up into a headstand. If they are totally wobbling around then their shoulders never really engage in a stability kind of way. Even though the idea is that they will not be placing weight on their head, they are completely putting weigh on it, and it’s obvious because the elbows are coming off of the floor sometimes. This is a definite indication that something has to change.

There are other effects on other tissues that also get missed. For instance I never let beginners go over to a wall and kick up into headstand. They miss out on using their abdominal muscles. Then when they need them they are not there.

Anatomical Components

When we say we need arm strength for headstand, what do we mean? Where does the strength come from? What is the foundation that is established to physically allow us to do a headstand as if we were doing a forearm balance with our head lightly touching?

The shoulder complex is the source of strength at the foundation. Once we put our hands into the headstand position we are upwardly rotating and protracting our scapula. If you followed along in the handstand article then you know that the strongest muscle for these actions is the serratus anterior. This is exactly why we need to orient our perspective to see how similar headstand, forearm balance, and handstand all are to one another.

When we hear or give the instruction of moving the scapulae down the back for a headstand, what we really mean is the anatomical movement of protraction and upward rotation. Because of our positioning, when we do this it lightens the load on our head and at the same time does draw our shoulders down relative to the line of our body. The feeling of drawing the scapulae down the back is what it feels like, but the anatomical reality is just slightly different.

The way I often express this to students to get them to do what I want is to ask them to try and lift their heads off the floor without it coming all the way off. Give it a try and you’ll probably see the scapulae move as you want them to. Sometimes words can get in the way and when you’re upside down it’s harder to understand directions to move parts up or down.

There is always more to say about headstand but I wanted to put this part of it out because we can miss out on seeing the individual for who they are so easily as we teach. Neither hand position is right or wrong, we should stop thinking that things are so black and white, they’re not. In both of the images above I have the same amount of weight in my head, almost none! Steady as we go in headstand; establish the appropriate foundation for beginners of headstands. Complete beginners of yoga have no business doing this pose anyway! They’ll also end up as a New York Times statistic!

It is disheartening to see the New York Times come out with yet another article that seems to completely miss the point of yoga. I think this one is worse than the last, which described a woman going to yoga and eventually realizing that cross training would lead to smaller sized clothing than if she only did yoga. I can only imagine how these NYT articles are put together and why. Picking quotes and statistics that fit the agenda of the author perhaps? What is the point exactly of this article, to warn people to not try or practice yoga? Is it to break up certain myths surrounding yoga?

A couple of students have asked me to weigh in on this, so here we go.

The first thing that I noticed was that yoga was simply reduced to an exercise method. They might as well have been talking about aerobics, spinning, or just a general fitness class. This part by itself is not surprising, and slightly less concerning than the rest of the article. But, if you’re going to reduce it to the context of exercise, then please compare the injuries, their percentages, rates etc… along with those of what you, the author of the article, has reduced it to. I wonder what the stats are for injuries in other sports? I found this list rather quickly on the web.

The following table of injuries is based on 2006 data compiled by the U.S. Consumer Product Safety Commission’s National Electronic Injury Surveillance System (NEISS).

In the article they listed the worst of injuries from a WORLDWIDE study of yoga in 2009 and found a total of 734 (I added them together) serious injuries. I don’t know what that number would rise to compared to the 2006 numbers above, which were limited to the US and included more than just serious injuries.

There is something else that is underlying all of this in my opinion. It is the perceived purpose of asana. Is it exercise? Is it therapy? Is it a spiritual practice? The worldwide winner seems to be that it is therapeutic exercise. The idea being that you can do yoga to heal your injuries. This certainly isn’t completely false. In fact, practicing yoga asana may very well get rid of a number of injuries or physical issues that you have. I wonder why there weren’t any statistics or interviews with people who have actually gotten better from doing yoga? Probably too many people to interview.

However, the exercise therapy side has been exploited and sold to the masses. Creating the idea that if one feels any sensation when practicing asana, it’s “wrong”. If an injury occurs while practicing asana, you’re an “ego-maniac” and you must not understand the first thing about “ahimsa”. Such stories go around. At the end of the day, it is a spiritual path that uses a physical practice (body), and has a side benefit of being therapeutic.

Isn’t the real purpose of asana to prepare the body and mind for meditation? We could take this one aspect much deeper. If you start off with the mindset that its purpose is therapeutic than it is ridiculous if someone says that have injured themselves doing therapy. In this article, they don’t even give yoga credit as something therapeutic but it seems to be underlying the mindset of the teacher if not the author. There is this sense of “how dare yoga injure anyone!” “How appalling that injury could or should occur when doing something as therapeutic as yoga.”

Well… um… it’s kind of an intensely physical activity, so the likelihood of physical injury tends to go up if you’re doing intensely physical things. Whether it’s yoga or not.

Can you get injured while doing yoga? Yes of course you can, why does everyone pretend that you can’t. Do we try to injure ourselves in practice? Of course not! Does it happen, sure. Hopefully it doesn’t happen regularly and if it does, check yourself or find a new teacher!

I really enjoyed the teacher’s remedy for people getting injured… make the class ridiculously hard! Really? I guess I understand his intention, to get people to take responsibility for their own actions in their practice. This was another observation I made. All of the injuries were a result of the person doing the asana. Yet the person is never blamed, only the asana. in this case, yoga in general is blamed as the culprit. Not the individual’s physical history, their age, weight, general health. None of that is ever mentioned to put the individual and their injury in perspective relative to the asana that is blamed for their injury.

The truth is that the asana, the method, the system, is completely neutral. It is us who colors all of these things with our understandings, misunderstandings, physical limitations, attitude etc… The asana doesn’t exist until WE do it. WE are ultimately responsible for what we choose to do with our body.

I think students often do WANT too much too quickly. This is an important part of why people are getting injured practicing yoga. Not to mention that there are just simply more people doing yoga! The other is that it is also the responsibility of the teacher to teach students according to their individuality and lifestyle and stop people from doing things that they and their body are not ready to do safely.

Ah, I said it, the safe word. Safety, safely, safe. It’s an illusion. No one can predict what’s going to happen to someone, either in a good way or a bad way. The same pose that can heal you can also harm you! The difference is YOU! Sometimes injuries happen unexpectedly, accidently, and all we can do is make up stories about how it happened and why.

If you want to know how to do asana and yoga in general as safely as possible than maybe this list will help.

First, as the scriptures say… find the most qualified teacher in your area. This is not necessarily the one who can do the most tricks, sound the most spiritual, and be the most popular one on youtube. Although they might be good teachers also.

Second, study and practice with them as deeply as possible.

Third, Also go to their teacher

Fourth, stay as present as you can with what you’re doing.

Fifth, see that it’s you that creates everything, including the asana.

Sixth, practice consistently, and don’t make yoga an exercise regime that you do once or twice a week.

Seventh, BREATHE!

I could go on about the state of yoga in the US. Read Eddie Stern’s response to the article as he talks about the Mcdonification of Yoga.

This article simply went too far. So far it’s actually ridiculous. Don’t let it shake your faith and dedication to your practice. There is nothing here except for exceptions to the norm, and the norm is that yoga when practiced consistently leads to personal evolution. If you’re stuck worrying about the physical, then there you are, stuck worrying about the physical. So says the anatomy guy! HA!

I wasn’t going to make this a “post” but I’ve never gotten so many email replies to a newsletter.

Here are a few additional Links that aren’t in the official newsletter as it went out.

Oz’s Facebook

Where she taught in London

Her Bubble of Happiness website

 I guess I should say… Happy New Year!

I’m in a rather reflective mood and a little bit down. I know that many of you are on this list because you want some yoga anatomy information. You’ll have to accept my apologies this time around because I don’t have an anatomy article for you. Actually, I have one, but it remains in a word file. You’ll have one next month, I promise.

A friend of mine from London, Ozge Karabiyik, “Oz” passed away on New Years day. A few days earlier while in India, she fainted, hit her head, slipped into a coma and then within a few days slipped away completely.

With this event surrounding my New Year, the thought of sending out a newsletter that spoke of the gross anatomy felt small, simplistic, and perhaps even a bit fake. What about the bigger yoga?

After all, we’re all aspiring yogis and yoginis aren’t we? This tragedy makes me think about a theme that has come up in my life over and over again and how it relates to our yoga practice. The theme is the balance between being a spiritual being and being a human being. In this case the spiritual side of me, knows that Oz has simply changed states or form, not destroyed, not gone just perhaps expressing itself as a different aspect of consciousness, who can really say for sure.

This perspective is certainly comforting. But then there is the human side. I would not call myself a particularly emotional person but I definitely feel the sadness that has come along with Oz’s passing, the thought of my own mortality perhaps and the questions that then arise about my life. How will the spiritual and the human parts of me live out the rest of my life?

I think that Oz’s last gift to me personally was this reflective mood. She has unknowingly reminded me that my spirituality and humanness are of course intertwined. I know that if I come too much from the spiritual side, I lose some of my human quality. I can seem aloof and uncaring; I know this because it’s been reflected back to me more than once. The fact that I feel this sadness might be a good indication that I’m more balanced at the moment.

I feel like our yoga practice reflects this interaction between spirituality and humanness. There is the obvious physical work and rigor, reminding us just how human we are. At the same time this physical work opens up and stimulates thoughts of the spiritual component of who we are as well. Reflecting back the balance of the two in our lives.

Whenever anyone that we know passes away it can make us reflect and take stock in what we have, what we want, what we don’t want, what is important to us, etc. Oz was young and vivacious and although her life was rather short, from my point of view she lived a full one.

I recall a number of conferences with Sri K. Pattabhi Jois where he would say something to the effect of: “You taking life, taking man’s body, DON’T WASTE!”

Oz didn’t. Her passing has forced me to ask myself how I can be more. More loving toward my wife, more compassionate toward those in need, more giving with my gifts, more fruitful in my endeavors, and generally being a productive spiritual and human being.
Oz always struck me as someone who gave, who shared and offered herself to those around her without really wanting anything in return.

I’ll just remind you (and myself) to use our asana practice as a vehicle and a tool. Don’t be limited by it, get stuck in it, or feel like it is the ultimate practice. It isn’t, life is! Live it to your fullest, whatever that is for you! Oz did. She will be missed by many.

Om Shanti,
David Keil

This month’s newsletter article comes out of a recent trip to the Midwest. I was at a new studio with new students and hosts. This piece is actually a request from one of the hosts, Evan at Tapas Yoga Shala. As always on the first day of practice, I mostly watch and get a sense for what I want to work on with any of the students over the course of the 5 days of mysore classes.

From my point of view there is nothing more interesting than the work of observing the person, their practice, its quality, clarity, focus or complete lack thereof. I watch through the lens of my own experience and understanding of both the practice and my anatomical education and understanding. By nature I’m a problem solver, just ask any of the hosts that have had me fix their computer, network connection, or printer trouble on top of my normal presentations of anatomy or Ashtanga Yoga. It’s a similar approach that I took when doing bodywork and therapy with clients in chronic pain. I would try to understand the problem, and treat it, not just the symptom.

In terms of the practice however, I don’t see things as broken and must be fixed. Things are not so black and white. In the practice and development of asana practice there are stages, levels, understandings, realizations, and deeper awareness on many levels. Instead of black and white issues, I see patterns. Patterns that are either assisting someone in their personal evolution through their practice or getting in the way. This point of view allows space for the individual’s own progression through an individual asana or an entire practice.

It’s when patterns are getting in the way at any level that I decide I want to do something about it. These are patterns that for one reason or another I want to shift, nudge, or completely change based on a number of factors. They can also be on any level, physical, mental, emotional, or energetic. Enter the over squeezed buttocks!

Now, I’m guessing that Evan won’t mind me using his name in print, and hopefully I’m right. The truth is, he’s an advanced practitioner and any changes to his practice were simply detailed nudges that I wanted to make, not major changes at all. The nudge and the work required, subtle and simple changes. As we all know, subtle work in yoga practice can be the most difficult.

The only pattern that I really noticed was “squeezing of the buttocks”. It is a common enough pattern to observe in our own practice or in our student’s practice. Some teachers say to squeeze your bottom tightly in your up dog, others to totally relax it in your up dog. My question is why do either? What are the reasons for advocating either and more importantly, how does it relate to the rest of the practitioners practice?

On that first day watching Evan go through his practice, I realized that I would probably just adjust him in some of his more advanced asana and support what he was already doing. I did notice that he contracted his buttocks kind of strongly in his up dog, but was happy enough to wait and see how things evolved. After all, squeezing to that degree may actually be exactly how Evan needed to do his up dog.

It wasn’t until I saw him doing his backbends and then his drop-backs from standing into a backbend at the end of his practice that I realized that I would intervene and nudge this pattern a bit and see what happened.

What I noticed in his backbend at this point were common patterns that we see in many backbends. Evan was not doing any of this to an extreme; in fact it was minor but obvious enough to me. The first pattern in the backbend itself was where the knees were in space relative to the feet and ankles. They were in front of them by a few inches. This tells me that there is still work to do on the hip flexors such as the quadriceps, adductors, and psoas as well as the shoulders potentially. In addition, the knees tended to be a bit wide relative to the feet. This is another sign to me that the hip flexors need to be more open.

Why are both of these indications of tight hip flexors? The body unconsciously resists the knees moving toward the shoulder end of the pose when the hip flexors are tight. It does this because the more you straighten your leg with tight hip flexors the more likely you will get compression in your lower back because the tension tends to pull the pelvis down and forward adding to a stronger lumbar curve.

When the knees are falling out a bit it’s a way for the body to unconsciously avoid the tension that remains in the hip flexors. As they fall out, the line of pull that the hip flexors have on the pelvis gets put at an angle, reducing the effect of these tissues pulling the front of the pelvis down and forward. If the knees come into line the tension usually increases and places more pressure on the front of the pelvis, which leads to more pressure in the lower back.

What was interesting is that the same pattern of knees falling out tends to be used as a tool for dropping back from a standing to backbend position. People spread their feet wide (he wasn’t), and let the knees fall out to avoid the pressure in the lower back and the tight hip flexors and even use the outer edge of the foot as a fulcrum for dropping back and coming back up (he wasn’t doing this). His feet did turn out slightly but not near the point of teetering on them.

This type of drop-back is a neuromuscular pattern. It makes the legs go wide and externally rotate. Enter the gluteals and deep external rotators. The most obvious is the gluteus maximus, which is designed for powerful hip extension and external rotation. The deeper gluteals are abductors as well as external rotators when their most posterior portion contracts.

I hate to use the words every time, however, almost every time you find someone with their knees wide in a backbend or a drop back you are going to find a buttocks that is also extremely tight. When the buttocks is overly engaged it will abduct the femur and external rotate it. It is difficult to balance the gluteals ability to help extend the joint and at the same time not adding too much external rotation.

Why Squeeze?

Well there are good arguments to be made on this end. The most obvious is that by engaging your gluteals and buttocks muscles in general, you encourage more hip extension, which is needed for a deep backbend. This is true. The gluteals help create hip extension which in turn leads to a deeper backbend.

I have also heard from a few students, not many, but a few, that squeezing their buttocks actually releases their back. It’s hard to argue with someone’s personal experience, especially when they have an established practice. People do have different anatomy and this may be the simple answer to why people have different experiences of doing the same thing in their practice.

We could also argue for squeezing in another way. We could encourage engaging the adductors of the thigh to undo the overly tight buttocks. The adductors are known for being both adductors as well as internal rotators of the hip joint. The exact opposite of what we find from the gluteals. Perhaps working them together balances the leg in the middle of the two extremes. The idea would be that we take advantage of the gluteals ability to help extend the hip joint, but not let it use it’s function as an external rotator. Subtle, but possible.

Why Not Squeeze?

The answers that come up for me surrounding this question is first, how the squeezing fits into the rest of the persons practice and their own experience of it. In other words, does it lead to other “negative” patterns? Negative is on a continuum here, not a static negative or bad thing.

I might ask other questions or observe other parts surrounding the squeezing of the buttocks. In up dog, does it make it seem like the person is only bending in their lower back? Personally I like to see an integrated movement through the spine, which includes as much upper back as possible.

Does the buttocks contract at the beginning or at the end of the up dog movement? If it’s at the beginning than I see this as the buttocks leading the movement and not accentuating the depth of the up dog as it might if it were happening at the end of the movement.

More importantly, does the squeezing in a place like up dog then train these muscles to contract in places where they either don’t need to? Such as a drop back, or the entire time you’re in a backbend. In these moments does that pattern then lead to a further avoidance of the hip flexors that actually need to be lengthened more anyway?

Tying it Together

So it’s what I see in the bigger picture that directs me to make changes on a pose-by-pose basis. There are two main patterns in the bigger picture that tend to make me work with people and relaxing their buttocks more. The first is the bigger back bending picture and the signs are what we’ve already discussed.

The second is for those students (usually beginners and often runners or athletes) who have really tight hips. As I’ve already shown in the lotus prep video, the gluteals and deep rotators are highly involved in lotus type postures. Every time these students contract their buttocks in an upward facing dog or a backbend, they are encouraging tension into the very muscles that need more softness and length to do the lotus type postures.

For Evan, who is already aware of and has already done loads of work on this pattern, the question becomes can we un-train that pattern of buttocks contraction to the next level. The start of the undoing can happen in upward facing dog. Is it necessary to squeeze your buttocks there? No. I don’t think it is. Does this mean you shouldn’t? No. It doesn’t, it’s about how and when you do it that is creating a pattern and whether or not that pattern is manifesting itself negatively in other places. If it were a brief squeeze at the end of an up dog, I wouldn’t change a thing unless the person had some complaint or injury that might be related to it.

Could Evan shut off his gluteals when he was in his backbend and/or dropping back? Yes he could. Did it reduce the amount of outward rotation and abduction in his legs as he dropped back? It did. Was it harder to do this way? Yes, especially when it’s different than the way you’ve been doing it for years. Could he maintain that without my hands helping to hold his thighs in and internally rotated, not sure but at least he has something to work on!

With this method the group of students each practice at their own pace without being guided through each pose by the teacher throughout the class. It’s not a led or guided class where everyone is doing the same pose at the very same moment. Everyone still does the same poses, just at his or her own pace. This allows for a deeper connection to develop between teacher, student, and the practice. With only four students in the room there is plenty of individual attention that is given to each student. It’s almost like having a private lesson in a group setting. Over five days of daily practice the student begins to go through a process and grows within their practice, this comes from the amount of attention, the discipline and the dedication of practicing daily, the effects will encourage and inspire you. Knowing the practice of Ashtanga Vinyasa Yoga is not a requirement, only being open minded and receptive to learning is required.

Pay for one week of Mysore with the button below:

Interviews About Mysore – What it is etc…

These elements are vinyasa/breath, bandha, dristhi, and asana. It’s one thing to know what these words mean, and another to have an experience of them. We will be doing small pieces of practice to illustrate the concepts and practices that lead to an actual experience of these elements. We will also take a look at why this method is so often misunderstood. Bring your skepticism and judgements if you wish.

The intention in this workshop is to create a perspective and understanding of the practice that allows us to appreciate it. The practice is mostly misunderstood by people who have not practiced it. When I use the term practice, I don’t mean going to a led primary series class and thinking that one has practiced it. What I mean is a minimum of 5 days of practice in a row, with a teacher who can transmit the essential points of the practice that leads one to an EXPERIENCE of the practice.

Ashtanga is much more than doing the postures in a particular sequence.

This is a lecture based workshop and aimed at those who have an open mind and a desire to understand the system in a way that enhances whatever method of practice they choose to participate in.

In this segment of the workshop we will first take a broad perspective of what the purpose of yoga asana is and how bandhas fit into it. In order to do this we will look at the physical aspects of the bandhas as well as access points in the practice, and how breathing relates to creating the energetic fuel for the bandhas. All of this will be employed through practical exercises to have an experience with.