Injuries & Conditions in Yoga

Lesson Overview

In this lesson, we lay the foundation for promoting safety in yoga classes.

Objective

Become knowledgeable in injury prevention and ways to accommodate students who have injuries and conditions.

Description

Name five common causes of yoga injuries and how to help prevent injuries in classes. Differentiate accommodation from therapeutics and what is required to safely accommodate students with injuries and conditions. Understand the category of students most at risk of yoga-related injury and how to address some of the inherent challenges of teaching an individual practice in a group setting.

Introduction

Following are three ways to consider and approach the topic of Injuries, Conditions & Yoga:

  1. Preventing injuries from yoga practice.
  2. Accommodating injuries and conditions in yoga practice.
  3. Addressing injuries and conditions via the tools of yoga.

To go beyond accommodation of a student’s condition and attempt to actively address it is not within the scope of practice for a yoga teacher with standard training.

See below for information on each consideration.

Injury Prevention

An international survey of 33,000 yoga teachers, therapists, and other clinicians from 35 countries published in 2009 found that respondents most commonly blamed these five reasons for yoga injuries:

  1. Excessive student effort (81%)
  2. Inadequate teacher training (68%)
  3. More people doing yoga overall (65%)
  4. Unknown pre-existing conditions (60%)
  5. Larger classes (47%)

Source: Angela Pirisi, Yoga Journal, How to Avoid Yoga Injuries

Injury prevention is accomplished through promoting student safety in practice.

  1. Knowledge of Anatomy & Physiology – To promote student safety requires knowledge of anatomy.
  2. Teaching that Generally Promotes Safety– Just as important as knowledge of the body are such teaching tasks as fostering a noncompetitive environment, teaching students to take responsibility for themselves, and referring students with particular conditions to an expert..
  3. Teaching Yoga Techniques in a Safe & Sound Way – The next general area of promoting safety is to properly teach pose alignment and accommodations, and appropriate breath practices..

HOW & WHY STUDENTS GET INJURED IN PRACTICE

Although yoga is intended to heal, many students and teachers find out the hard way that it can also potentially harm. Common yoga injuries include repetitive strain to, and overstretching of, the neck, shoulders, spine, legs, and knees, according to the American Academy of Orthopaedic Surgeons (AAOS)… An international survey of 33,000 yoga teachers, therapists, and other clinicians from 35 countries (published in the January 2009 issue of the International Journal of Yoga Therapy) found that respondents typically blamed five things for yoga injuries: excessive student effort (81 percent), inadequate teacher training (68 percent), more people doing yoga overall (65 percent), unknown pre-existing conditions (60 percent), and larger classes (47 percent). – Angela Pirisi

POSES DON’T INJURE; DOING POSES INCORRECTLY INJURES

One of the participants… had sprained his knee a couple of weeks before while overdoing it in Pigeon pose. I examined him and concluded he had a mild sprain… We began working with the muscular stabilizers of the knee, in particular using a progressive series of postures that culminated in Lotus pose—all while paying close attention to engaging the muscles that provide dynamic stability to the knee joint. By the end of the workshop, his knee was completely pain free and felt normal. At which point he made an insightful comment: “injured my knee doing yoga wrong, healed it doing yoga right.” Put another way, “poses don’t injure people; doing poses incorrectly injures people—and doing them correctly heals.” – Ray Long

Accommodating Conditions

Introduction

To safely accommodate students with injuries and conditions in a group class requires dedication, education, skill, awareness and care. Our intention is to support teachers of drop-in classes, who are working hard to safely support all students.

We bring together expert advice and approaches to support you in making decisions on when to refer out, and how to safely accommodate and serve your students. We’re excited to have brought together such a vast and organized library of considerations, approaches and recommendations, all drawn from well-known authorities in their fields.

There is a great need for safe, effective yoga teaching appropriate for students who are experiencing injuries and conditions.

Each teacher is responsible for considering his or her training and experience — and the cautions related to different conditions — in order to make a determination of what can be safely accommodated in a general drop-in class. We offer extensive and specific information on dozens of conditions to help you with this vital task.

Teachers are advised to be aware of conditions and clues that indicate students would be best referred to a qualified care provider for diagnosis or therapy.

A 13-year study of yoga-related injuries in the U.S. (published in January 2017) found that injuries had increased (from 10 to 17 per 100,000 participants), although the risk of a serious injury remained low (less than 0.02%). It found that the majority of injuries occurred in students ages 65 and over.

THE OPPORTUNITY IN TARGETING SPECIAL POPULATIONS

Yoga teachers would be wise to get educated on how to help special populations practice this art form because that is who is really doing yoga. Sure, the young culture – all the media is around that; it is not around the masses of people who are coming to yoga with therapeutic issues and special population problems… that is why the yoga teachers also will get: “there are too many yoga teachers”, “there are too many yoga studios” because you are all fighting over the same young, youthful bendy types when there is this whole population that is so much bigger. – Amy Ippoliti

TEACHING SENIORS

Studies have shown that just as the number of people practicing yoga has rapidly increased, so has the number of people teaching it. Unfortunately, many of those teachers do not have training to teach older students who lack lithe 20-year old bodies. Authors of this study suggest that, “it would seem that there is a potential lack of appropriate education even for certified instructors.” That is to say, most certified yoga teachers do not have the know-how for instructing students with say, osteoporosis, and teaching them like any other student can lead to an increased risk of injury. – Suzannah Schinder

Be Prepared

See Adaptation Principles for excellent preparatory knowledge and a downloadable cheat sheet.

Use this knowledge with a mentor to develop adequate skills in this deep but rewarding area.

Become Aware of Individual Needs

While teaching yoga asana to groups is common in modern yoga, historically and at a foundational level, yoga is meant to meet individual needs, including a student’s unique nature and changing conditions. Individualizing teaching is particularly important in cases of injury or other conditions.

  • In some cases, such as after recent surgery, it’s vital that students have an individual session with a physical therapist, yoga therapist, or other qualified professional prior to engaging in a group class.
  • To address some of the inherent challenges of teaching an individual practice in a group setting, a teacher must learn about the individual students. This can be accomplished using intake forms, email, and questions outside of and during class.
  • But of course, taking forms that no one reads is not only not helpful, it may also be hurtful if filling out the form causes the student to assume the teacher knows about hiscondition and that everything being taught in class is safe for him. Or perhaps his first teacher read the form, but three months later, he is practicing with different teachers, none of whom know he has high blood pressure or a hip replacement.
  • If students aren’t regularly encouraged to share all relevant conditions and information, and to inform their teacher if their situation changes, it’s likely that many students will simply not share, either because they don’t expect it to be helpful, because they don’t want to bother the teacher, or because they are uncomfortable talking about themselves or the condition.

Addressing Conditions

To go beyond accommodation of a student’s condition and attempt to actively address it is not within the scope of practice for a yoga teacher with standard training.

  • To utilize particular yoga practices with the objective of promoting healing or reducing particular symptoms is within the scope of yoga THERAPY practice, not the scope of general yoga teaching.
  • For example, teachers of some styles of drop-in classes can learn to accommodate pregnant students in their class (while teachers of such classes as Hot Power Yoga are advised to refer out pregnant students). But to use yoga practices to promote a comfortable pregnancy and preparation for birth and postpartum recovery requires a specially trained prenatal teacher.