Injuries/Harms Resulting from Incorrect Adjustments/Alignments Performed by Yoga Asana Practitioners
Ghazaleh Shamaei Irani
Ph.D. student in Yoga Therapy, Department of Yoga and Naturopathy, Gujarat Ayurved University Jamnagar, India.
Abstract
In the current scenario, yoga has become a tremendous trend around the world, as it offers a lifestyle teaching methodology mixed with physical exercises for all practitioners. According to available data, there are around 30 million practitioners worldwide. Yoga is thought to be an injury-free tool and has several benefits, such as relieving pain and stress, that it affects mind i.e. increases mind potential and leads to peace. Many people are going to be attracted by others due to other motivations. However, because of the improper practice of yoga, they are caught by injuries easily and stop the practice. Proper body alignments play an important role because misalignment can lead to injury. These injuries include bone fracture, muscle strain and sprains, joint dislocation, bone spur, sciatic nerve damage, and strokes. There is a need for a scholarly investigation to find all the injuries related to misalignment during yoga practices. In this article, different parts of the body that have been injured due to misalignment are discussed. Furthermore, different poses have been discussed, especially the ones that are considered risky and tough, as well as the methods in which they can avoid these injuries. The present study discussed the basic solutions to avoid the above injuries with misalignment which includes expert supervision, warming up, exercise to strengthen the weak parts of the body, starting with simple poses, and estimating the body's capacity.
Keywords: yoga-injury, incorrect alignments, yoga practitioners, yoga adjustment.
INTRODUCTION
Yoga is an art and science that includes several sets of postures that affect the practitioner physically, mentally, and spiritually.‘Yuj’ is a Sanskrit word meaning to join/ unite; The word Yoga is derived from ‘Yuj’ which includes breathing control, meditation, and body postures/poses [1]. Practicing yoga leads to perfect collaboration between the practitioner’s body, mind with nature. The main purpose of yoga practice is to stretch each muscle in the body, to stretch the nerves and the glands [2].
Because of different benefits, practicing yoga is useful for people with type 2 diabetes, asthma, bipolar disorder, pain syndromes, pregnancy-related health issues, mental peace, and helpful in cancers advanced stage treatment. Practicing yoga is safe for healthy individuals when it is done under the supervision of an expert instructor, otherwise, the wrong alignment during different poses can lead to various adverse effects such as nerve damage and even stroke [3].
The risk of injuries from practicing yoga is less than the injuries from various exercise-related activities such as running, jumping, cycling, and so on. However, yoga can’t be completely safe. Misalignment of body parts during any yoga pose can cause serious harm to the different muscles and ligaments of the body [4].
In brief, the benefits of yoga can be summarized as follows:
Physically- Weight loss, improving muscle strength [5].
Physiologically- Improves sleep quality, assist in the management of diabetes and blood pressure, and breathing-related problems can be solved [6].
Psychologically- Yoga has the potential to decrease depression, anxiety, and stress [7].
Emotionally–In the management of negativity, difficult conditions is helpful [7].
Spiritually- Yoga assists the practitioner in qualitative feelings, mental peace [7].
MISALIGNMENT IN POSES AND YOGA INJURIES
Alignment is termed as the proper way in which the body should move in every yoga pose to gain full benefit. Any practitioner following different movements other than of the body parts is called misalignment [8]. In the current scenario, people are showing interest in practicing yoga because of the several benefits, but it can be harmful if practiced by any professional without proper guidance. Proper practice of yoga gives extreme benefits to the practitioners, whereas misalignment during exercise can cause a lot of complications [9].
Misalignment of the body during practice of any yoga poses can create hindrance in usual body movement. If a practitioner stretches his/her body or improperly quickly shifts the body weight, it can produce injuries. Yoga injuries due to misalignment are a danger to all practitioners. Harms caused by misalignment include fracture, strain and sprain, joint dislocation, bone spurs, sciatic nerve damage, stroke. Many of these practitioners suffer from injuries due to incorrect postures [10]. By the means of proper yoga alignment, you can guarantee all the positive aspects of yoga, so that with the cooperation of all the muscles involved in the best way, physical strength can be created. It leads to strength boosting, with the application of less pressure on the joint or muscle. Body movements are the results of some movements of various body parts. Alignments allow all parts of the body to move mutually, keeping the body safe. Through the proper yoga alignment, practitioners may enjoy yoga with ease and full benefits by avoiding any harm. It is the clear fact that all yoga practitioners have different body features such as flexibility and strength. Therefore, the alignment must be varied for different people [11].
Following are some alignment principles [12, 13]-
Following are some benefits of correct alignment in yoga practice [14, 15]
Some common rules for alignments are as follows [16-18]
BODY PARTS AFFECTED BY MISALIGNMENT
Not every practitioner can be aware of the seriousness of the misalignment during any yoga pose, as long as they are not affected by the injury. Whenever someone practices yoga with the misalignment, the most affected body parts that get injured are the neck, back, knees, and shoulders. The harm appears in a variety of forms, including bone fractures, muscle strains and sprains, dislocations of joints, bone spurs, sciatic nerve damage, and strokes.
Following are some examples of the effects of incorrect alignments on different parts of the body:
1. Wrist Injuries due to misalignment
The wrist is a tiny joint that is constantly being used in various activities. If the hands of any practitioner in any posture are on the surface than the body’s weight will get shifted on wrists, which will lead to the injuries. First practitioners should warm-up their wrists, before exerting force on them to avoid such misalignment injuries. Practitioners should keep their palms flat on the mat; they should not “cup” the floor. Practitioners should not allow the fingers to rotate inward. They have to put their knees on the floor to modify while building strength in their wrists and shoulders [19].
2. Shoulder injuries due to misalignment
The most common misalignment practiced by many practitioners is pulling their shoulders too hard during stretching, which can lead to injury of the shoulder girdle or rotator cuff. Moreover, some practitioners don’t keep their shoulders held back and down, and away from their ears. Shrugging compresses the shoulders in this way, can injuries the muscles. While practicing posture like an upward facing dog, people should broaden their collarbones through their palms, and should not stretch too hard on their shoulders [20].
3. Elbow injuries due to misalignment
In any pose, whenever the elbows are bent by the practitioners out to the sides, it may lead to joint pain in the elbows. Lowering down with the outward-pointing elbows can put pressure on the joint. Twists are useful in reducing tension, but if performed by the improper way can overextend or bruise the intercostal muscles. To avoid this, practitioners should lengthen upwards through the spine before twisting. Practitioners should also squeeze the elbows to avoid movement of pressure through the elbow and wrists [21].
4. Lower Back injuries due to misalignment
Lower back pain is the result of rounding through the spine because the opposite roundness leads to flexing of the spine. This leads to disc problems, achy feelings. Some practitioners perform forced elongation without bending the knees. This leads to irritation of the low back, and hips. Furthermore, this misalignment may lead to injuries in the sacroiliac (SI) joint. Many practitioners aim for reaching the floor, they have to take a deep breath, and keep back straight, to support lower back’s muscles [22].
5. Knee injuries due to misalignment
Due to misalignment during some poses, such as the cross-legged position, locking the knee in many practitioners can lead to pain/discomfort/tension. If the hips of any practitioners are tight in the pose, this will lead to pain/tension at the knees. To prevent this, practitioners should avoid sitting in a cross-legged position for longer. Practitioners should place the block or any blanket under the knee in cross-legged positions to reduce strain. Furthermore, practitioners should never allow the knee to cave inward or just outward for the same reason. When the knees move inward, they apply pressure to the lower back and hips. Outward exerted force on the ACL of the knee and micro-bend of the knee is essential, because it keeps the knees in line with the toes [20].
6. Hamstring injuries due to misalignment
Whenever a practitioner tries to increase the flexibility of this part with overstretching improperly, it leads to injuries. As far as hamstring stretching is concerned, less stretching will be more helpful for the practitioner. Many practitioners push through the hips in lunges, which is responsible for those strains, pulled muscles, and sprains.
Practitioners should use blocks or blanket during training against standing wrinkles, as this will bring the floor closer, and should avoid any uncomfortable movements during their practice [11].
7. Neck injuries due to misalignment
Many practitioners put incorrect extra pressure on the cervical vertebrae, in the repeated manner in some poses. These results lead to neck injuries and the possibility of losing the neck flexion. Some practitioners perform full inversion of the neck that may be risky in the absence of any experts. Head jerking in standing position may be risky; it may lead to falling on the floor and thus, injuries can occur. Backbend should be avoided by the practitioners having a neck injury, this may be more complicated [10].
8. Hip injuries due to misalignment
Wear, tear, and sedentary lifestyles are responsible for tightness in the hips. Many practitioners follow the maximum range of motion of the hips to reduce the stiffness of the extreme level, leading to painful inflammation, hip joint disorders, and finally the transformation of it into arthritis. To avoid injuries, the hips related poses should be done slowly under the supervision of an expert [17].
Misalignment during some Yoga poses and injuries
Many yoga poses are not suitable for practitioners who are new to yoga and also not suitable for the elderly or who do not have certain diseases or injuries. Practitioners need to listen to their bodies instead of their mind; they should not put themselves to the point of strain. However, there is no need to give up any pose entirely, care should be given to the particular pose, and it should be done under the supervision of some experts.
1. Shoulder Stand (Salamba Sarvangasana)
This posture is performed by moving legs in an upward direction in the air with the support of the shoulders [22]. Shoulder Stand (Figure 1) is useful for better thyroid and metabolism regulation, reducing heart rate.
Figure 1: Shoulder Stand
Misalignment responsible for injuries:
Long-term practice with weight displacement can lead to wrist pain and joint damage. Additionally, it is common that only the index fingers are pressed against the back. Using a blanket would be favorable for practitioners.
2. Bridge Yoga Pose (Setu Bandha Sarvangasana)
Figure 2: Bridge Yoga Pose
Practitioners use this pose to stretch the thighs, neck, spine, and chest opening. During this pose, a “locked bridge” is created between the arms and the legs. This pose (Figure 2) can be used as a preparation for deeper backbends. It is useful in insomnia because it calms the mind and headache, backache, and fatigue. It is not suitable for people with neck and shoulder injuries [23].
Misalignment responsible for injuries:
3. Cobra Yoga Pose (Bhujangasana)
Figure 3: Cobra Yoga Pose
This pose (Figure 3) is done by the practitioner to stretch the chest and shoulders. It is done by placing the palms under the shoulders and pushed down until the hips lift slightly. The legs are outstretched and the feet’s back remains on the ground. This yoga is useful in improving lung capacity and reducing stress [24].
Misalignment responsible for injuries:
The Legs too wide.
4. Standing Forward Bend (Uttanasana)
Figure 4: Standing Forward Bend
In this pose (Figure 4), the practitioner after standing position, bends forward at the hips, until the palms can be placed on the floor, just behind the heels. This yoga is useful for hamstrings, calves, and hips [25].
Misalignment responsible for injuries:
5. Bound Triangle Pose (Baddha Trikonasana)
Figure 5: Bound Triangle Pose
Trikonasana (Figure 5) is a side bend that involves stretching the extended leg hamstrings, and contraction the abdominal muscles. Practitioners do this in two sequences, facing left, and then right. This yoga is useful for people with headaches, low blood pressure, or diarrhea [26].
In the case of the heart, the condition practitioner should practice against the wall while placing the top arm on the hip. If a practitioner suffers from high blood pressure, he/she should look downwards instead of looking upwards.
Misalignment responsible for injuries:
6. Camel Pose (Ustrasana)
Figure 6: Camel Pose
Ustrasana (Figure 6) consists of a back-bending yoga posture. This is performed by yoga practitioners for flexibility and body strength, which is useful in improving digestion. The hands in back bending move to touch the heels, and heels face towards ceiling [27].
It relieves fatigue and anxiety and is useful for respiratory ailments. The practitioner should avoid deep backbend, the start should be slow, and some other poses should be practiced to warm-up the spine.
Misalignment responsible for injuries:
7. Headstand (Sirsasana)
Figure 7: Headstand
This pose (Figure 7) is also called the king of yoga postures, in which the body is completely inverted on the floor and stays upright by the means of forearms and head. It has several benefits including brain calmness, stress relieves, strengthens legs, arms, and spine. It also improves digestion and removes depression [28].
Misalignment responsible for injuries:
8. Handstand (Adho Mukha Vrksasana)
Figure 8: Handstand
In this pose (Figure 8), the practitioner balances on the hands and lifts the feet. It calms the mind, relieves stress and anxiety, improves emotional balance and stability, and relieves fear.
Misalignment responsible for injuries:
9. Down Facing Dog (Adho Mukha Shvanasana)—
Figure 9: Down Facing Dog
The practitioner performs this by bending their bodies and touching the ground with the palms, and the hips remain at the top (Figure 9). This yoga is performed by a practitioner for deep stretching of the hands, back, shoulders, chest, hamstrings, and spine [29].
Misalignment responsible for injuries:
10. Warrior 3 (Virabhadrasana III)
Figure 10: Warrior 3
In this yoga, practitioners keep their body weight on one leg, while another leg and hands stretched in the air in a parallel line (Figure 10). This pose has several benefits including strengthening the shoulders, ankles, and legs [30].
Misalignment responsible for injuries:
11. Thunderbolt Pose (Vajrasana)
In this pose, the practitioner sits on the heels by placing calves under the thighs (Figure 11). Hold the practitioner, the four-finger gap between the kneecaps, and the toes of both feet touching each other.
Figure 11: Thunderbolt Pose
This pose is useful for strengthening blood circulation in the lower abdomen and helps to improve digestion and strengthen the thigh and legs nerves [31].
Misalignment responsible for injuries:
12. Four-limbed staff posture (Chaturanga Dandasana)
Figure 12: Four-limbed staff posture
This is also termed as Low Plank, in which practitioners straighten their body parallel to the ground, and are supported by the palms, and toes, along with elbows placed at 900 angles (Figure 12). This pose helps to strengthen and provide flexibility for the arms, wrists, forearm muscles, abdomen, and tones [32].
Misalignment responsible for injuries:
13. Frog Pose (Mandukasana)
Figure 13: Frog Pose
This pose includes the movements of the hands, shoulders, hips, and legs in such a way that the final look is like sitting way of a frog (Figure 13). It is useful for the sacral iliac joint and inner thigh muscles, it is a hip, and the lower back and groin opener pose with deep breathing and lungs expansions. It is also useful for relieving headaches and mild depression symptoms.
The frog pose in yoga is a hip, groin, and lower back opener that targets muscles in your adductors, hips, and lowers back. Before attempting this pose, practitioners should make sure that their knees are warm and can bend completely [33].
Misalignment responsible for injuries:
14. Crow Pose (Kakasana)-
Figure 14: Crow Pose
This pose is a compact arm balance in which practitioners move their full weight to their hands by folding their legs, and the final shape looks similar to the sitting crow (Figure 14). It is useful for strengthening of upper arms as well as the forearms and wrists [34].
Misalignment responsible for injuries:
15. Half Pigeon (Ardha Kapotasana) —
Figure 15: Half Pigeon
In this pose, the practitioners stretch their chest in an upward direction, by placing their hands on the floor and by bending one knee by placing in front and placing the back foot firmly on the floor in the backward direction in such a way that it looks like pigeon’s chest-puffing (Figure 15). This is a pose for stretching the hip and back, which is useful for lengthening the hip flexors [35].
Misalignment responsible for injuries:
16. Double Leg Forward Stretch Yoga Pose (Paschimottanasana)
Figure 16: Double Leg Forward Stretch Yoga Pose
In this pose, practitioners stretch their legs and spine sitting on the floor (Figure 16). The end of some poses is done so that the body stays warm and ready in this pose. It is useful for stretching the pelvis, hamstrings, calves, groins, and spine [36].
Misalignment responsible for injuries:
Practitioners force themselves to bend forward, especially when sitting on the floor, which may result in pain in the back.
17. Half Moon Yoga Pose
Figure 17: Half Moon Yoga Pose
In these poses, practitioners stretch their rear leg, and front hand, and only fingerprints stay on the ground [37]. It strengthens the spine, ankles, abdomen, and thighs (Figure 17).
Misalignment responsible for injuries:
Lifting up and out of the bottom hip, it causes the pelvic joint to collapse and puts all the weight on their standing legs.
BASIC FACTS TO AVOID INJURIES DUE TO MISALIGNMENT
Proper alignment during poses is the key to achieving the maximum possible benefits of any pose. Following are some points that should be followed by all practitioners, especially beginners:
1. Supervision of an expert
Injuries by misalignment are due to a lack of knowledge. Initially, practitioners should start the practice of any pose under the supervision of experienced and trained experts. In the absence of any experts, there are more risks of injuries. Some practitioners start practicing yoga by reading some books, but that's not enough. Practical knowledge is mandatory to prevent injury, because a very simple pose if performed by misalignment, may lead to injury. If each practitioner is practicing a specific pose for a few minutes, he/she should not try to finish the pose in a hurry, it should be done slowly.
2. Warm-up
Like another physical activity, the warm-up is very essential before yoga. Stretching should be done slowly and carefully in tight areas without any hurry. This helps to relax the muscles and reduce the risk of injury. Furthermore, there should be no over-stretching as it may be harmful to exist injuries.
3. Strength by functional exercise
Practitioners should try to build strength in their weak areas such as the knee and hamstrings by the means of some exercise. Aerobic exercise is very helpful for it. The practitioner must be ready for the practice of yoga mentally as well as physically.
4. Start with basic yoga
Yoga should not be done hastily; especially beginners should start with basic pose. They should not try some hard poses immediately after starting the practice of poses. If a particular type causes side effects such as dehydration, pain, dizziness, or muscle cramps, it means a particular pose is not suitable for that practitioner. The practitioner should select the poses according to their body, for example, if someone is suffering from a neck injury, they should not practice a pose that includes neck rotation or inversion. Patients suffering glaucoma should not perform poses including body inversion.
5. Using Props
A practitioner who is going to start practicing yoga should use props like yoga blocks, walls, and blankets. Older practitioners should be more cautious and use these yoga blocks. For example, practicing some inversion position with the support of the wall is a more safe game for beginners.
DISCUSSION
In the current environmental condition and sedentary lifestyles, people are moving for good health. They are finding their destination in the form of yoga. Many yoga classes are being held around the world. This indicates the craze of the public for yoga and health. Many people are attracted to practitioners who practice yoga and are in good shape and posture.
However, in some aspects, yoga has the potential to attract people. this list has endless benefits. this is not only physically beneficial for the practitioner but also beneficial for the mental aspect of the practitioner. It calms the mind and improves the practitioner's lifestyle.
In this article, the various positive aspects of yoga are briefly discussed. However, all of these aspects can be achieved by a practitioner who follows the proper alignment during yoga practice. If there is any yoga demonstration during practice, there is more risk of injuries. This negative turn of yoga can’t be underestimated. Beginners should not blindly follow other experienced practitioners to perform some hard poses. As definitely there will be misalignment during the practice of that pose. The body will give the acknowledgment for it in the form of fractures, strains, sprains, dislocations of joints, bone spurs, sciatic nerve damage, and stroke.
The basic solution to avoid all these injuries by misalignment includes expert supervision, warming up, adding exercise to schedule to strengthen weak body parts, starting with simple poses, estimating an individual’s body capacity.
REFERENCES
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