Students come to yoga to heal their bodies and minds. But, like any movement practice, there can be a risk for yoga injury. As a teacher, it is your responsibility to mitigate that risk of injury to the best of your ability especially now with online classes.
While yoga is very safe, misalignments in certain poses can cause repetitive stress injury over time. Pushing the body into “deeper” shapes without properly engaging muscles to support the joints can also cause pain and injuries. Other poses, minor injuries like strains and sprains can occur from falling out of the pose in an unsafe way. Many students also come to yoga with a range of past injuries and other conditions. It’s important to know what injuries your students have so that you can help them to avoid re-injuring themselves.
Below is a list of some of the most common injuries – and how to prevent these yoga injuries.
Neck injuries, while uncommon, are probably the scariest injuries that can occur while practicing yoga. Many students walk into your class with an already tight neck from daily stressors. The two poses known to cause neck injuries are shoulder stand and headstand.
To keep your students from hurting themselves in these poses if you choose to teach them, practice the below:
Salamba Sarvangasana or Shoulder Stand:
- Keep your students from looking around. Always demonstrate to your students how to get into shoulder stand and any poses that you’ll be leading them through from that pose so that new students aren’t tempted to look around. Demo this BEFORE putting them into the pose from a position where they can easily see you without cranking their necks.
- Set up in Iyengar style with a folded blanket or stack of folded blankets under the neck. Shoulder stand with the body in a vertical position puts the weight of the entire body on the neck in extreme flexion which can cause a strain or sprain, or worse – a disc injury, or bone spurs.
- Make sure to properly warm up your students and prepare them for the pose before sequencing it into your class.
- Students with pre-existing neck injuries or conditions should avoid this pose.
Sirsasana or Headstand
- Headstand can be safely practiced if your student has very strong shoulders. Be sure to cue your student to use their shoulders to push into the ground, rather than dumping their weight onto their head.
- Never instruct a student to kick up into a headstand. Have them press up, or tuck one knee at a time into their chest. Kicking up with no control causes too much momentum and falling out of headstand can cause immediate injury.
- Avoid using a wall. When students have a wall behind them, it is more difficult to resist the urge to kick up and teaches them unsafe behaviors. If they don’t have the strength to come up without kicking, they should not practice headstand yet.
- For students that DO have the strength to come up with control, but are afraid of falling, it is okay for them to practice with their back to the wall so long as they do not intend to use the wall to help balance. The wall is only there to help with fear, not with the pose itself.
- Make sure to properly warm up your students and have them practice all of the key actions or component parts of the pose before you get them into a headstand.
- Students with pre-existing neck injuries or conditions should avoid this pose.
Other ways to help your students avoid neck injuries are by teaching them to practice with a relaxed neck. Some styles encourage students to look up in backbends such as Upward Facing Dog, and standing postures such as Extended Triangle pose. Instead, teach your student to find a position for the head that is comfortable like looking forward maintaining the head in line with the spine. Students also attempt to get “deeper” into twists by looking far over their shoulder. Encourage them to align their chin with their sternum instead so that the twist only happens in the thoracic spine or area of the ribcage, which receives the most benefits from twisting.
Shoulder injuries, especially rotator cuff injuries, are very common. These are typically injuries that occur over time from repetitive stress doing the same poses, such as Chaturanga Dandasana, over and over again with improper alignment.
How to avoid:
- Proper alignment in Chaturanga Dandasana is crucial. If your students are dumping their shoulders down lower than their body, it puts weight on the rotator cuff – which is not meant to hold the body up. Instead, get them to lower forward and down in one smooth motion. If they cannot do this, or hold the pose safely for a full breath, have them practice a modified version.
- There are three ways to modify Chaturanga.
- The first is to have your students on knees in a modified Plank pose, lower all the way down to the floor, and do Bhujangasana, Cobra pose. In this version, they need to keep the elbows hugged into the side body until they are more than halfway down. Then, if the elbows naturally flare out to the sides a bit this is okay. Forcing the elbows in the entire time can put unnecessary stress on the bicep tendon.
- The second, is to start on knees in modified plank, and lower only halfway down. Then transition into Upward Facing Dog. In this variation, they should keep their elbows hugged into their side body.
- In the third modification, students can work with a strap looped around their upper arms. This will ensure that their chest does not dip down lower than the height of the elbow. This is very supportive and great for working with privates, though it may not be feasible to do for every Chaturanga in a led class.
Downdog can also cause pain or injury in the shoulders. Pressing the chest back towards the thighs repeatedly can take the students out of integrity in the pose and cause them to dump into their joints. To avoid this, have your students wrap their shoulders by engaging the shoulder blade down towards the hip and distally towards the chest. This engages the serratus anterior muscle and helps to support the shoulder girdle. Many students treat Downdog like a backbend, instead have them draw their frontal ribs in and engage their core.
Other shoulder injuries that can occur in a yoga class are more rare. Students with previously dislocated shoulders are at a higher risk of dislocating them again. Hands on assists that push on the shoulders, such as in Savasana, can cause a dislocation. Always ask your students about past injuries so that you know how to work with their bodies.
Wrist pain or injury may be the most common of all yoga injuries. Like most injuries to a joint, wrist injuries can be avoided with proper muscular engagement, ie: not “dumping” weight into joints, but rather lifting weight out of the joints.
Proper alignment when weight bearing in the hands is also important. Teach your students to:
- Use Hasta Bandha or the “hand lock”. Spread the bones of the hands and fingers into the mat, and press through the grip points in the palm, and fingers.
- Keep palms flat on the mat. If you see your student lifting the index finger knuckle, encourage them to press down and spread their fingers.
- Avoid internally rotating when weight bearing. Instead, keep the wrists neutral.
- In poses like Chaturanga, Plank, and Vasisthasana or Side Plank, modify by practicing on knees while building up the strength to do the pose.
Many of your students have jobs where they already place repetitive stress on their wrists from typing or using a mouse. These students may need to practice with a wrist brace or wraps. They also would benefit from practicing on wedge blocks that decrease the angle of the wrist while weight bearing. They may also modify Downdog for Dolphin Pose, and Handstand for Forearm Stand.
Always warm up your students wrists early on in the practice, especially if you plan to incorporate challenging arm balances, handstands, or side planks.
Low Back Injuries
Lower back injuries are very common, not just in yoga but in everyday activities. The lumbar spine is not supported by other bone structures, like the way the rib cage supports the thoracic spine. It is fully reliant on the core muscles and legs for support.
Low back strains, sprains and disc injuries happen often. Another common injury is to the SI joints (sacroiliac joints) in the lower back. SI joint pain is so common in yogis that it is nicknamed “yoga butt”.
Some places to help your students avoid low back pain or injury are:
- When forward folding with a rounded spine, most of the pressure is placed in the discs of the lumbar spine. Because it is not supported, these discs are most susceptible to injury. Teach your students to anteriorly tilt the pelvis before forward folding to avoid rounding the back. If you see your student with a rounded spine, encourage them to bend their knees in poses like Downdog to straighten out the spine – or work higher, perhaps on blocks, in folds like Parsvottanasana (Pyramid pose), or Uttanasana.
- The same goes for poses like Utthita Trikonasana (Triangle Pose) and Utthita Parsvakonasana (Extended Side Angle). If you see your student dumping their ribcage down, encourage them to work higher by placing their hand on a block, or higher up the leg in Triangle. Look for length on both sides of the ribs.
- Twists can be very beneficial for back pain and health. However, when practiced incorrectly they can cause instability or pain in the SI joints.
- Practice all twists, including supine twists, with a level pelvis. When the hips are out of alignment, and your student twists their spine, it can pull the SI joints in different directions. These joints are not meant to have flexibility or move much at all.
- In a twisting lunge with the knee down, instruct your student to align their hips over the back knee, level their pelvis, and maintain a level pelvis while twisting. Watch for students that want to get “deeper” into the pose by twisting their hips.
- In supine twists, instruct your students to stack their hips so that the sacrum is perpendicular to the floor. Their knees and ankles should also stack if they are twisting with both knees. **if the students shoulder blade lifts off the mat with hips stacked, teach them to support their shoulder with a prop or reach their arm over head with palm facing towards the floor and a wrapped shoulder as written above under Shoulder Injuries. Letting the arm hang in the shoulder joint can cause damage to the joint.**
- Backbends are also very beneficial for a healthy back and spine – when practiced with integrity.
- Focus on length rather than depth.
- The lumbar spine already curves into a backbend shape, making it very easy to dump into for a “deeper” backbend.
- Encourage your students to the lengthen the tailbone down, and lift the rib cage up and back. Cue them to keep their belly drawn in so the core supports the low back.
- Watch for knees splaying out to the sides in backbends, and encourage students to squeeze the inner leg lines. You can teach them how by having them squeeze a block between their thighs while backbending. Using the inner leg lines is safer and supportive for the SI Joints and lower back.
Hamstring sprains, strains and tears are all common yoga injuries. Hamstring tears are the most common and they typically occur at the attachment, where the tendon attaches to the sit bone. This injury happens often from repeatedly overstretching. These small tears cause scar tissue build up, which often gets the student to overstretch more to “help loosen it up” but actually makes the injury even worse.
To avoid this, encourage your students to:
- Stay active in poses. Often when students are “stretching”, they stop engaging muscles, dump weight into joints, and lose integrity in the pose. This often happens in practices like Yin where the joints are unsupported and poses may be held for a long time with no muscular engagement.
- In poses like Ardha Hanumansana or Half Split, and Hanumanasana or Splits Pose, teach your students to engage the hamstrings by pressing the heel down and energetically dragging it backwards. Do this same action in other hamstring stretches like Pasvottanasana or Pyramid Pose.
- Bend their knees. Never force a student to straighten their legs in any forward folds. Instead encourage them to allow a slight bend in the knee. This is kinder both on the hamstrings, and the low back.
- Work higher. Give your students blocks in forward fold poses like Uttanasana and Prasarita Padottanasana if they cannot easily reach the floor. This takes weight out of the hamstrings and places it into the hands instead.
- Engage the quadriceps, which are the antagonist muscles. Cue your students to engage their quads by lifting the kneecaps while stretching their hamstrings to avoid injury.