Benefits and Concerns

–          Feet

o   Benefits: Proper alignment begins with the feet. An accurate connection of the foot to the ground results in an increased likelihood of correct knee and hip alignment which affects the spine and ultimately the rest of the body. In yoga, the accurate connection of the foot includes the application of padha-bandha or the foot lock. Padha-bandha supports the longitudinal arch (i.e. the lengthwise-arch of the foot) and the transverse arch (the lateral-arch of the foot, in the direction of big to little toe). When these arches are supported they prevent eversion of the foot which puts more pressure on the medial (or inner) side of the foot.

o   Concerns: Some students have arches that have always been collapsed; being born with fallen arches is known as structural pes planus. Although asana can relieve pain, this will likely never go away and orthopedics must be used. Most students experience functional pes planus, which develops due to weakness in specific muscles. The plantar fascia or connective tissue on the soles may be weak.

• Focusing on the feet especially in all standing asana will help, as well as pointing/flexing feet in joint movements.

–          Ankle

o   Benefits: All standing balancing asana will help develop strength and stability in the ankle. Proprioception is the awareness of where a joint is in space relative to itself and the surrounding environment. When balancing asana is practiced, the body is forced to utilize this mechanism to stabilize the ankle joint and maintain that position. This prevents the ankle from becoming de-stabilized

o   Concerns: Eversion and inversion can result from ankle instability. Inversion is more common due to the structure of the ankle joint which results from the lack of stability; whether that’s the articulation of the bones, or the strength and laxity of the ligaments on the lateral side. If a student is lifting the ball of the foot in any asana, they are likely causing inversion of the ankle.

• Be aware of poses that may cause excess pressure on the ankles for those with ankle injuries (ex. Vjrasana) or causes excess inversion/eversion.

–          Knee

o   Benefits: Proper knee alignment in all poses can strengthen and balance the muscles that support the knee’s ligaments and the patella. It can also lubricate the menisci and articular cartilage which prevents osteoarthritis.

o   Concerns: Many students experience issues with knees for a variety of different reasons. Imbalances in the musculature of the legs can cause internal rotation of the femur which places excess pressure on the ligaments and/or patella. Collapsing of the arches in the feet can also cause the knees to fall towards each other. Weakness or fatigue of the vastus lateralis/medialis can cause lateral/medial tracking of the patella on the respective side. Make sure the knee is in proper alignment so that the joint is stacked over the ankle for most asana. For example, if the knee is further than the ankle in Warrior ll it places added pressure on the anterior cruciate ligament (ACL) which can cause or aggravate an injury.

• Without proper hip rotation, students practicing full/half lotus may experience knee pain. Hero pose is usually an issue for students with knee problems, attempt to use bolster under the sit bones but otherwise skip. Tightness in the iliotibial band can cause knee pain in pigeon. Place blankets underneath knees for any asana on knees ex: camel.

–          Hip

o   Benefits: Many poses help open the pelvis and relieve tension in the hips. This can prevent or alleviate issues with sciatica, and keep your pelvis in alignment. Flexibility and alignment in the hip can also prevent issues in the knees and/or ankles. Movement at the hip causes the joint to secrete synovial fluid which provides lubrication, reduces friction and improves shock absorption.

o   Concerns: Some poses may be hard on the knee joint due to the ilitibial band (originating from the tensor fascia late or TFL) on the outer hip. Pigeon for example may need to be modified or a prop placed under the raised hip for support. Tight hips can also cause anterior pelvic tilt which makes it difficult for many asana and puts excessive pressure on the low back. Be mindful of students that have trouble sitting (place blanket underneath sit bones) and use caution when practicing poses that stress the low back.

–          Back

o   Benefits: People with issues in their back (ex: scoliosis, lordosis, kyphosis) can benefit from the length created in the back with asana. Many poses strengthen, and lengthen the muscles of the back. Many poses create space between the vertebrae in the intervertebral joints which often become compressed due to gravity over time. Yoga also helps to lubricate these joints, especially with twists.

o   Concerns: Some people develop these issues due to imbalances in the musculature, however some people are born (i.e. congenital) with these conditions. Students may experience back pain in specific poses

• Support the low back in forward bending; instead practice ardha-utanasana (half-way lift) get students to place palms on above/below knee. Give students the option to practice gentler backbends instead of more intense ones (ex. Do cobra instead of updog, or bridge instead of full-wheel)

–          Wrist

o   Benefits: Increased weight bearing on the wrists in most poses (i.e. downdog, plank etc.) signals the brain to build stronger bones at the point of pressure. Bones in the forearm (i.e. radius and ulna) increase in bone density, along with the bones in the palm.

o   Concerns: Many people experience pain in the wrists due to the amount of weight bearing and stress it can cause to the joint. Make sure students develop a good hasta-bandha (hand-lock) which will relieve pressure on the wrists. Ensure the joint is stacked properly (i.e. directly underneath shoulder for poses like plank) and give the option to come down to the elbows.

–          Elbow

o   Benefits: Many poses strengthen the muscles and tendons that support the elbow joint.

o   Concerns: Those with specific injuries such as tennis elbow may not be able to straighten or bend the elbow. Many poses can be down with arms on the hips or at the sides instead. Each person’s injury can be a different experience so modifying or using props under elbows when necessary

–          Shoulder

o   Benefits: Strengthens and improves stability in the shoulders and more specifically rotator cuff muscles, improves blood flow to the head which prevents headaches and muscle tension

o   Concerns: Issues with range of motion due to inflexibility or injury can result in difficulty/pain with many poses (ex. down dog, side angle or basically anything where the arms are raised overhead). Give options to rest arms down to the sides, or come down to the knees when necessary to take pressure off the shoulders.

• Avoid poses that put excess pressure/strain on shoulders such as shoulder stand, plow, headstand or handstand

–          Neck

o   Benefits: Many poses either relax tension in the neck, or strengthen the muscles that support the cervical vertebrae. This can help maintain proper alignment in the spine, and relieve tension headaches

o   Concerns: Some poses can but excess pressure on the neck, and may not be good for someone who already is experiencing neck tension or has whiplash.

• Avoid bringing the head back in poses such as camel, avoid headstand, shoulder stand, plow, and fish

–          Head

o   Benefits: Inversions ensure proper blood supply to the brain along with the pituitary and pineal gland; reinforcing our growth, health and vitality. Weight bearing on the head will signal the brain to produce stronger bones in the skull.

o   Concerns: Many people experience pain when practicing poses such as headstand; try using a blanket or light pillow underneath for support but avoid if pain persists. Another suggestion is to try practicing headstand supported (tripod).

Other considerations

–          Inversions

o   Benefits: Improves circulation throughout the body; more specifically venous blood and helping it return to the heart. The improvement in circulation prevents issues such as varicose veins. Improves lymphatic drainage and therefore immune response. Sends blood to the brain; helps to revitalize the mind and think more clearly.

o   Concerns: Avoid inversions completely if student is pregnant, menstruating, eye/ear/sinus infection, high blood pressure, heart disease, any internal issues (i.e. recent internal surgery, kidney issues etc.), hernia

–          Meditation

o   Benefits: Calms the busy mind, allows for parasympathetic response (rather than sympathetic, our fight/flight), clarity of thought

o   Concerns: If someone is mentally unstable meditation may not have calming effect. Certain meditations also aren’t appropriate for those with anxiety. Try exercises such as counting each breath.