Yoga Poses that May Trigger Injury and Pain

Yoga can help eliminate pain by boosting balance, strength, and flexibility, but for some individuals, certain yoga poses may induce undesirable tissue damage, causing more harm than benefit. ¹ Kocyigit BF, Sagtaganov Z, Yessirkepov M. The effectiveness of yoga as a form of exercise in the management of rheumatic diseases. Rheumatol Int. 2023;43(5):795-801. doi:10.1007/s00296-023-05291-9 ^{, 2} Yoga injury prevention - orthoinfo - aaos. Accessed April 7, 2023. https://www.orthoinfo.org/en/staying-healthy/yoga-injury-prevention/

Yoga injuries are usually mild and transient, and include ligament sprains and muscle strains. ³ Cramer, Holger; Ostermann, Thomas; Dobos, Gustav (2017). Injuries and other adverse events associated with yoga practice: A systematic review of epidemiological studies. Journal of Science and Medicine in Sport, (), S1440244017310502–. doi:10.1016/j.jsams.2017.08.026 ^{, 4} Russell K, Gushue S, Richmond S, McFaull S. Epidemiology of yoga-related injuries in Canada from 1991 to 2010: a case series study. International Journal of Injury Control and Safety Promotion. 2016;23(3):284-290. doi:10.1080/17457300.2015.1032981  The knee is the most commonly injured body part in yoga (with over 40% of reported injuries), followed by the foot and thigh (with 26% and 19% of reported injuries, respectively). ⁴ Russell K, Gushue S, Richmond S, McFaull S. Epidemiology of yoga-related injuries in Canada from 1991 to 2010: a case series study. International Journal of Injury Control and Safety Promotion. 2016;23(3):284-290. doi:10.1080/17457300.2015.1032981

Rarely, more serious problems such as nerve injury, bone fractures, joint dislocations, head injuries, or concussions may occur. Repetitive strain to or overstretching of a body part is a frequent contributor to yoga-related injuries. ² Yoga injury prevention - orthoinfo - aaos. Accessed April 7, 2023. https://www.orthoinfo.org/en/staying-healthy/yoga-injury-prevention/ ^{, 4} Russell K, Gushue S, Richmond S, McFaull S. Epidemiology of yoga-related injuries in Canada from 1991 to 2010: a case series study. International Journal of Injury Control and Safety Promotion. 2016;23(3):284-290. doi:10.1080/17457300.2015.1032981  Yoga injuries are typically more common in women and those with pre-existing conditions. ⁴ Russell K, Gushue S, Richmond S, McFaull S. Epidemiology of yoga-related injuries in Canada from 1991 to 2010: a case series study. International Journal of Injury Control and Safety Promotion. 2016;23(3):284-290. doi:10.1080/17457300.2015.1032981 ^{, 5} Liu AM, Chu IH, Lin HT, Liang JM, Hsu HT, Wu WL. Training Benefits and Injury Risks of Standing Yoga Applied in Musculoskeletal Problems: Lower Limb Biomechanical Analysis. Int J Environ Res Public Health. 2021;18(16):8402. Published 2021 Aug 9. doi:10.3390/ijerph18168402

Common yoga poses and their side effects on different body parts are described below.

In a warrior 2 pose, the back limb experiences a higher degree of torque and stress. This increased stress may cause soft tissue damage along the inner side of the knee due to excessive pulling of the patella (kneecap). Injury may also occur beneath the surface of this crucial bone, which can lead to degenerative changes over time. ⁵ Liu AM, Chu IH, Lin HT, Liang JM, Hsu HT, Wu WL. Training Benefits and Injury Risks of Standing Yoga Applied in Musculoskeletal Problems: Lower Limb Biomechanical Analysis. Int J Environ Res Public Health. 2021;18(16):8402. Published 2021 Aug 9. doi:10.3390/ijerph18168402

Beginners who overstretch during a pose or hold a pose for too long, or those with pre-existing knee disorders, may experience knee pain after yoga.

For some people, the deeper stances in the lunge postures of warrior 1 and warrior 2 may subject the hip joint to higher mechanical loading. This load can cause greater fatigue in the muscles that surround the hip joint (periarticular muscles). The increased muscle fatigue reduces the natural protective mechanism of the body to shield the joint from sudden trauma, resulting in pain. ⁵ Liu AM, Chu IH, Lin HT, Liang JM, Hsu HT, Wu WL. Training Benefits and Injury Risks of Standing Yoga Applied in Musculoskeletal Problems: Lower Limb Biomechanical Analysis. Int J Environ Res Public Health. 2021;18(16):8402. Published 2021 Aug 9. doi:10.3390/ijerph18168402 These risks may also occur with the crescent lunge, triangle, and pigeon poses. ⁶ Mears SC, Wilson MR, Mannen EM, Tackett SA, Barnes CL. Position of the hip in yoga. The Journal of Arthroplasty. 2018;33(7):2306-2311. doi:10.1016/j.arth.2018.02.070

Individuals with hip pain, hip impingement, and/or osteoarthritis of the hip should consult a trained yoga instructor and use caution while performing these poses. ⁵ Liu AM, Chu IH, Lin HT, Liang JM, Hsu HT, Wu WL. Training Benefits and Injury Risks of Standing Yoga Applied in Musculoskeletal Problems: Lower Limb Biomechanical Analysis. Int J Environ Res Public Health. 2021;18(16):8402. Published 2021 Aug 9. doi:10.3390/ijerph18168402

Mechanical loading of the ankle joint is high in single-leg yoga poses, such as the tree pose and warrior 3 poses. For this reason, it is recommended that anyone with a prior history of ankle injury or degeneration of cartilage in the ankle joint should be cautious when performing these poses to prevent further injury and pain. ⁵ Liu AM, Chu IH, Lin HT, Liang JM, Hsu HT, Wu WL. Training Benefits and Injury Risks of Standing Yoga Applied in Musculoskeletal Problems: Lower Limb Biomechanical Analysis. Int J Environ Res Public Health. 2021;18(16):8402. Published 2021 Aug 9. doi:10.3390/ijerph18168402

Ankle pain may be experienced by beginners who overstretch the ankle and foot during a pose or hold a pose for too long, or those with pre-existing ankle and foot disorders.

When considering yoga, it is important to select the class level that is appropriate for you. For beginners, it is more important to start slowly and learn the basics, such as rhythmic breathing techniques, rather than stretching beyond a limit tolerable by the body.

Low-to-moderate-intensity yoga, such as Hatha yoga, may be a good start for beginners, elders, or those with pre-existing conditions. Hatha yoga can be modified based on an individual’s needs, and participants typically enter into a yoga pose, hold the pose, and exit from the pose in a slow, steady, and smooth manner, reducing the risk of injury. ⁷ Grabara M. Could hatha yoga be a health-related physical activity? Biomedical Human Kinetics. 2016;8(1):10-16. doi:10.1515/bhk-2016-0002

It is crucial to discuss any underlying illness, injury, or medical condition with the yoga instructor before starting a new class. Qualified yoga instructors have special training in treating musculoskeletal disorders and can help prevent injury and pain by recommending helpful pose modifications.

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