The document discusses common injuries that can occur in yoga practice and how to prevent them. It notes that the most common injuries are caused by repetitive strain, overstretching, or moving too fast without being ready. The neck, spine, wrists, shoulders, knees are particularly vulnerable. It emphasizes starting any new pose from a place of awareness of one's own body and limitations. It also discusses the roles that the teacher plays in preventing injuries by being knowledgeable, observant of students, and teaching with compassion.

1. Obstacles That Wound

2. Wise Words
• YOGA IS MEANT TO HEAL NOT HURT……… If it hurts you’re doing it wrong…
• “It is important to acknowledge the true damage on all levels that yoga can do
when ego surpasses awareness and wisdom, when asana and goals trump
deeply listening to the body, when yoga styles and methods are
uncompromising, and when inexperienced or misguided yoga teachers lead
bodies living modern lifestyles into places they are not prepared to go.” -
Eden G. Fromberg, DO Holistic obstetrician/gynecologist
• According to the U.S. Consumer Product Safety Commission, there were more than
5,500 yoga-related injuries treated in doctors' offices, clinics and emergency rooms in
2007, incurring a total cost of approximately $108 million.
• "People approach yoga in a typical American way, very competitive, very
comparative…. it's almost the opposite of what yoga was designed to be." Dr Betsey
O’Neill medical director of the integrated medicine program at Allegheny General
Hospital, and an avid yoga practitioner
• The most common yoga injuries are caused by repetitive strain or overstretching and
occur at the wrists, shoulders, neck, along the spine, and at the sacroiliac joint (which
links the spinal column and pelvis), hamstrings, and knees. These injuries occur
when students move too fast or beyond their limits and try to force themselves into
postures.

3. What is the responsibility of the
asana teacher?
Seat of the Teacher
• Prepared – know your curriculum, your style, be aware
of other styles, be educated in variations (of seed pose)
and props
• Knowledgeable – study study study study practice
practice practice practice
• Unless you are a licensed doctor or therapist *do not
attempt therapy
• Observant – become a master of awareness and
observation, differentiate between vision and sight
• Compassionate – meet your student where they are

4. What is an injury?
• I am not this body.
Using the body as a path toward moksha
Competition=Ego
• Is there a pre-existing pathology?
Ask at the beginning of the class
• Is there a propensity?
Inflexibility
Weakness

5. There is
No Way
to
Avoid
Injury

6. How Does an Injury Occur?
5 Klesha
Avidya – Ignorance
Asmita – Ego Identification
Raga – Desire
Dvesa – Avoidance
Abhinivesa – Clinging to life

7. If avidya is the obstacle:
Knowledge
Anatomy – especially of the spine, shoulder and
hip girdles
Kinesiology – what are the functional ranges of
motion
Asana – what is the seed pose?
A posture that shares
common principles of
alignment,
architecture and awareness
with subsequent relative variations

8. Types of Joints
• Ball & Socket (moves in all
directions hip & shoulder)
• Hinge (moves in 1 plane: elbow,
ankle, knee)
• Pivot (pointed or rounded process
of one bone fits into a ring
structure. Rotation:
atlas/axis=skullCervical 1,C2)
• Gliding (flat limited movement eg;
Scapula/clavicle
intertarsal/intercarpal)
• Ellipsoid (oval shaped moves in 2
planes radius-carpals wrist)
• Saddle (both surfaces saddle
shaped- moves in 2 planes,
thumb)

9. Connective Tissue
• Ligaments: connect bone
to bone. Can be over-
stretched or torn. Difficult
to heal as ligaments are
connective tissue and
have little vascularity.
• Tendons: connect muscle
to bone. Can be torn.
Take six months to a year
to heal due to low
vascularity.

10. The Neutral Spine
• A neutral spine has
natural curves.
The spine may
Flex
Extend
Laterally Flex
Rotate

11. Vertebrae Anatomy

12. Shoulder Girdle
• Flex
• Extend
• Abduct
• Adduct
• Rotate
*most mobile and
weakest joint

13. Brachial Plexus

14. Pelvic Girdle
• Flex
• Extend
• Abduct
• Adduct
• Rotate

15. Lumbar Plexus

16. Good Place to Start

17. Common Predispositions
• Hyper Flexibility (most common hyper
extension in knee)
• Hypo Flexibility (tight hips/hamstrings)
• Scoliotic Curves
• Leg Length Discrepancy
• Toe “IN” Toe “OUT”
• “Flat Foot”

18. Common Injuries
• Neck: Poses like "plow," "shoulder stand" and
"headstand" can be risky, because if done
improperly they can put undue pressure on the
neck. Beginners should try these poses only
under the close supervision of an experienced
teacher. Alternatives to shoulder stand include
half shoulder stand, legs up the wall, “happy
baby” pose. Alternatives for headstand include:
wide leg forward bend, dolphin pose.

19. Common Injuries
• Spine: Repetitive motion, moving from a “hinge”
between two vertebra, using torque to create
twist can result in back damage.
• Engaging the abdominal muscles helps support
the spinal muscles.
• During forward bends it is advisable to bend
your knees to decrease pressure in lumbar
spine and in seated forward bends to sit with
hips raised to decrease excessive pelvic
posterior tilt .

20. • In back bends avoid relying on a single
hinged area between vertebral bodies.
• . Develop twists with consistency instead of
forcing with torque as pressure and twisting
at the same time creates a sheer force
that can herniate vertebral discs.
• The spinal cord and spinal nerves travel
through and are protected by the vertebral
bodies. Stressing the spinal column affects
the entire nervous system.

21. Common Injuries
• Wrists: Here's a great example of
knowing your own condition BEFORE you
enter the classroom. Do you have carpal
tunnel syndrome? Then DON'T perform
poses that put excess weight on your
wrists. Modify using forearms instead of
wrists.

22. Common Injuries
• Knees: Don't force your knees into Lotus or other
vulnerable positions. Without adequate hip-joint flexibility
you could tear a meniscus (cartilage) or you could
stretch or tear one of the knee ligaments. Micro-bend
and soften knees in forward bends instead of hyper-
extending. To prevent knee injury, it is important not to
force the knees, especially in Padmasana (Lotus Pose)
and instead turning the thighbone outward from the hip
joint. Pulling up on the foot or ankle or pushing down on
the knee in Lotus puts a tremendous crushing force on
the cartilage of the inner knee. Sitting on a block, pillow,
or rolled up yoga mat will keep the hips higher than the
knees reduces joint pressure.

23. If asmita is the obstacle:
Self Realization
• What is yoga?
• What are we uniting?
• What is the ego? What is the self?
• Awareness – observation.

24. Asana
Patanjali’s Sutra
#1 Yama: Ahimsa – non violence, Satya –
truth, Asteya - non stealing,
Brahmacharya – celibacy, Aparigraha –
non greed
#2 Niyama: Saucha –purity, Santosha –
contentment, Tapas – austerity,
Svadhyaya – study, Ishvarapranidhana -
surrender
#3 Asana – stable, comfortable seat

25. If raja is the obstacle:
Detachment
• Which postures do you LOVE to do?
• Which teacher’s practice would you LOVE to
emulate?
• Which postures would you LOVE to be able to
do?
• What do you LOVE about yoga?
• Hyper flexibility
• Addiction
• How to detach? Aware Reveal Forgive

26. Vertebral Extension (backbend)
• Cervical spine - most extension
• Thoracic spine - some extension
• Lumbar spine - less extension, closing of
foramen
• Returns disc to body of vertebrae from
posterior herniation
• Distraction – creating space between
articulations of a joint

28. Vertebral Rotation - Twist
• Sacrum NO TWIST
• Lumbar - Lower back rotation
is limited to less than 2
degrees per segment, since
excessive rotation could lead
to spinal cord or nerve
damage.
• Thoracic – Some Twist – (30
degrees)
• Cervical – Most Twist (60
degrees)
• http://www.spine-
health.com/video/spine-
anatomy-interactive-video

29. Hyper Flexibility
• Addiction
• Spondylolisthesis
• Disc – bulge, herniation, prolapse
• Heat

30. Back in Business
• Up to 80%
of disc
issues
have no
symptoms
• 20% of
back
surgeries
relieve
symptoms

31. If dvesa is the obstacle:
Forgiveness
• What poses do you HATE?
• Do you HATE that there are poses that you
cannot do?
• Which teachers or students do you HATE being
jealous of their practice or their bodies?
• Lifting the veil
• Embracing darkness
• What is, and how do we forgive? In time, we
give what we get. We get what we give.

32. Hip Openers
Padmasana
• Neutral spine, hip flexion,
abduction, external
rotation, knee flexion,
ankle neutral
• With a neutral spine: the
functional range of motion
for hips flexion is 0 to 90
degrees
• Functional range of
motion for hip abduction
is 45 degrees.
• Functional hip external
rotation is 0-45 from
center of body
Functional knee flexion is
120 degrees, neutral
ankle is 0 degrees of
dorsiflexion

33. Inversions
Inversion poses like shoulder stand and head stand put the head
lower than the heart and raise blood pressure.
• CONTRAINDICATIONS:
Refrain from these poses if you have
heart related problems
hypertension = high blood pressure
diabetes or glaucoma- eye issues (seen floaters in eye)
neck problems
epilepsy
previous stroke
sinus problems
hernias
• Be aware of students falling out of inversions and crashing
into other students in a crowded class, always walk around
the room and offer assistance to students who need help.
• Reassure students that less radical poses have benefits and
that practicing safely may reduce symptoms and allow them
to access a more intense posture after some time.
Appropriate variations: waterfall pose - viparita karani
Preparation to more safely access inversions : rocking, down
dog, dolphin, cat/ cow

34. Down Dog is an Inversion
• How do we reconcile contraindications?
• Seat of the Teacher – Educate yourself,
educate your students
• Refer the “at risk” student to an
appropriate class
• The student ultimately makes their own
choice, what do you want to see?

35. If abhinvesa is the obstacle:
Surrender
• What is fear?
• What do I truly fear?
• What can be feared?

36. Yoga Therapy
• The following is a list of tentative definitions of Yoga Therapy by the
International Association of Yoga Therapy:
Yoga therapy, derived from the Yoga tradition of Patanjali and the Ayurvedic
system of health care refers to the adaptation and application of Yoga
techniques and practices to help individuals facing health challenges at any
level manage their condition, reduce symptoms, restore balance, increase
vitality, and improve attitude.-American Viniyoga Institute Gary Kraftsow
• Yoga therapy is that facet of the ancient science of Yoga that focuses on
health and wellness at all levels of the person: physical, psychological, and
spiritual. Yoga therapy focuses on the path of Yoga as a healing journey
that brings balance to the body and mind through an experiential
understanding of the primary intention of Yoga: awakening of Spirit, our
essential nature.-Integrative Yoga Therapy (U.S.A.)Joseph LePage, M.A.
• Yoga therapy adapts the practice of Yoga to the needs of people with
specific or persistent health problems not usually addressed in a group
class. Samata Yoga Center (U.S.A.)Larry Payne, Ph.D.

37. Yoga Therapy
• (Yoga therapy is) the use of the techniques of Yoga to create, stimulate, and maintain an
optimum state of physical, emotional, mental, and spiritual health.
Judith Hanson Lasater, Ph.D.
• Yoga therapy consists of the application of yogic principles, methods, and techniques to specific
human ailments. In its ideal application, Yoga therapy is preventive in nature, as is Yoga itself,
but it is also restorative in many instances, palliative in others, and curative in many others. -Art
Brownstein, M.D.
• Yoga therapy is of modern coinage and represents a first effort to integrate traditional yogic
concepts and techniques with Western medical and psychological knowledge. Whereas
traditional Yoga is primarily concerned with personal transcendence on the part of a "normal" or
healthy individual, Yoga therapy aims at the holistic treatment of various kinds of psychological or
somatic dysfunctions ranging from back problems to emotional distress. Both approaches,
however, share an understanding of the human being as an integrated body-mind system,
which can function optimally only when there is a state of dynamic balance.--
Georg Feuerstein, Ph.D.
• International Association of Yoga Therapist: IAYT supports research and education in Yoga
and serves as a professional organization for Yoga teachers and Yoga therapists worldwide. Our
mission is to establish Yoga as a recognized and respected therapy. IAYT membership is open to
Yoga practitioners, Yoga teachers, Yoga therapists, Yoga researchers and healthcare
practitioners who utilize Yoga in their practice. Current membership (c. 2009) is approximately,
2,600. Membership has tripled since the IAYT renewal in 2004. IAYT also serves members, the
media, and the general public as a comprehensive source of information about contemporary
Yoga education, research, and statistics. www.iayt.org

38. Yoga Therapy
• Phoenix Rising Yoga Therapy is an holistic healing art. It invites presence and awareness,
rather than prescribe treatments. Using age-old yogic approaches to deeper presence and
awareness we are able to know ourselves more fully. Out of this knowing, we are more easily
moved to embrace the opportunity for change, growth and enhanced well being in body, feelings,
thought, and spirit."— Michael Lee, Founder, Phoenix Rising Yoga Therapy Author of "Turn
Stress Into Bliss" www.pryt.com
• Thai Yoga Therapy- Thai yoga massage, an ancient healing art that is said to date back to the
time of the Buddha. Thai massage can feel like a nurturing, effortless yoga practice in which your
partner moves your body in and out of postures, enticing your muscles into gentle stretches and
your mind into deep relaxation.
• Iyengar Yoga, created by B. K. S. Iyengar, is a form of yoga known for its use of props, such as
belts and blocks, as aids in performing asanas (postures). Iyengar Yoga is characterized by great
attention to detail and precise focus on body alignment. Iyengar pioneered the use of "props"
such as cushions, benches, blocks, straps, and even sand bags, which function as aids allowing
beginners to experience asanas more easily and fully than might otherwise be possible without
several years of practice. Props also allow tired or ill students to enjoy the benefits of many
asanas via fully "supported" methods requiring less muscular effort. www.bksiyengar.com
www.yogarosa.com local Iyengar studio in Hallandale Beach.
• Doug Keller- Yoga Therapy teacher, author of Yoga As Therapy & Refining the Breath: The
Yogic Practice of Pranayama. www.doyoga.com
•