Practicing yoga asanas with an injury and how to modify

We’re taught in the YTT200 how to ensure correct alignment in postures to avoid injury, which is such a fundamental part of a safe and sustainable practice, but what about if you come to yoga with a pre-existing injury?

I tore my piriformis around 18 months ago – I was not fully warmed up, I was practicing in a cold room on a cold tile floor and I dropped down into hanumanasana on my right side, extended over my right leg into a forward fold and that’s when I heard it… RIP! The piriformis is a small muscle located deep in the buttock, underneath the Gluteus Maximus – it originates at the sacrum and inserts at the top of the femur. My glute was incredibly sore for several weeks and didn’t seem to be improving, I continued regular practice, determined not to let the injury stop me from progressing, despite the pain. Eventually, the isolated pain began to radiate down my leg towards the back of my knee and so I sought the advice of a physiotherapist.  The sciatic nerve passes directly behind, or in some people, through the piriforis and any trauma to the piriformis can cause pressure on the sciatic nerve, resulting in radiating pain or spasms. My original muscle injury had now led to compression of my sciatic nerve, making most standing asanas incredibly painful, in fact, it even hurt to sit down for any length of time.

With regular rehabilitation of the muscle and dry needling therapy, I steadily saw improvements, but my own ‘drive’ or perhaps in some sense, ego wouldn’t let me ease off my right leg. I’d push through the pain and fully extend in uttanasana and paschimottanasana, determined not to let my flexibility diminish. Inevitability the injury recurred and I now have a lot of scar tissue build up, which is still slightly compressing my sciatic nerve. Scar tissue is tough, inflexible and fibrous; it binds itself to the damaged soft tissue fibers in an attempt to pull the damaged muscle fibers back together. Subsequently, a bulky mass of fibrous scar tissue surrounds the injury site, which is never as strong as the tissue it replaces. Scar tissue also has a tendency to contract and ‘deform’ the surrounding tissues, so not only is the strength of the tissue diminished, but flexibility of the tissue is also compromised.

I have to accept that my right glute & hamstring will always be a weak spot for me. I could easily further damage this tissue; so I’ve had to learn my own limits in asanas that, on my left side, I have no issues with. It’s been a tough lesson, I get frustrated that I can’t get into the full expression of most folding or extending & abducting asanas. This for me is a personal journey about not only understanding and listening to my body, but also not allowing myself to get consumed by ego.

On my path to maintain a daily practice, despite injury, I have learnt how to modify where I need.  I feel that it’s important to not view modifications as a ‘lesser’ expression of the posture. This is something I still have to remind myself and it’s certainly a work-in-progress, but with embarking on this journey to become an instructor, I must practice what I preach!  The positive is that I have become hyper-aware of my body – I feel incredibly in tune with it, I can tell if I can go deeper, or need to ease off; I can sense when my alignment isn’t quite right and am able to ‘self-adjust’; I’m also ready to reach for a block or bolster when I need.

Some days, I find it really hard to straighten my right leg fully in uttanasana, so I keep it slightly bent.  Same goes for parsvottanasana. In paschimottanasana, I’ll take a block under my right knee, or days when it’s feeling particularly painful, I’ll take janu sirsasana paschimottanasana instead. Experiencing these modifications has also increased my awareness that there seems to be an unspoken assumption that if we bend our knees, we aren’t ‘doing it right’.  The objective of forward folds is to experience a lengthening of the spine, not to stretch the hamstrings (although this is an affect of these poses) and I think it’s a shame that so many ‘force’ themselves into a pose with discomfort – maybe we should all try to bend those knees once in a while…?

Here’s my list of some things that are vital, if you come to yoga class with a pre-existing injury:

  • ALWAYS tell the instructor if you have an injury. It’s important that they know not to adjust you in certain asanas or how to assist with modifications
  • Listen to your body, if it hurts, ease off. The goal is not to feel pain, an asana should feel comfortable
  • Don’t be afraid to use props – they’re there for a reason and they don’t make your practice lesser
  • Not vital, but advisable – try loosening up the injury before practice with a foam roller or massage ball and again later in the day, it will help to stimulate the blood flow and warm up the tissue, which can help with flexibility and also promote healing

So, in summary, based on my own experience, you can still enjoy a rounded asana practice with an injury and you shouldn’t be afraid or put off to try a class because you may need to adapt or modify – a good teacher will be able to guide you, but it’s also important to remember to listen to your own body, forget the ego and maintain a safe practice. You only get one body, take care of it.

 

 

 

 

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