Pathophysiology, Inflammation, Injury & Recovery

Question 1

What other precautions or risk factors would you consider when facilitating a yoga class?

Answer 1

Practice on empty stomach
well hydrated
Intense spine twists should be avoided by students with HBP due to the intra-abdominal pressure
Open twists during pregnancy

lung conditions shouldn’t practice in a heated rooms this irritates the lining and alveoli in the lungs
Students with LBP should exit standing forward bends slowly as to not cause light headedness or nausea
Students with sinusitis and/or conjunctivitis need to avoid long inversions due to increased inflammatory processes
Strong twists for acute inflammatory bowel diseases (IBD) are contra-indicated
Students with glaucoma or eye injuries avoid inversions and any asana that increase cardiac or pulmonary hypertension

Question 2

How does SIJ injury impact a students’ Yoga Practice

Answer 2

Very painful in acute/chronic stages
The Gluteus Medias/Maximus, & Piriformis muscles often tight so Biceps Femoris (Hamstrings) Erector Spinae overcompensate.
Often worsened when rising from seated to standing as the joint is unloaded & also hyperextending upward (bow or locust pose)
Asymmetrical postures can be challenging & cause tightness in the hip flexors Psoas. Stretching of the glutes helps

Question 3

What’s the protocol to manage an injury?

Answer 3

Nature of injury
Recency
Level of pain (1-10)
Medical clearance check

If there are postures that they are contra-indicated for that I will tap them on the shoulder, have them pause in a rest or safe pose, instruct the class and then return to instruct their modification for them.

Question 4

List 3 postures to avoid for SIJ & Piriformis injuries

Answer 4

1. Paschimottonasana/Seated forward bend as it will may cause nutation of the sacroiliac joint if the hamstrings are tight.
2. Virabhadrasana II/Warrior II as any asymmetrical poses will accentuate the asymmetry of the pelvis
3. Seated Twists as there are shear forces that can be placed on the SI joint during twists, particularly if they are executed to the end of the range for the student.

Question 5

What is the difference between chronic and acute pain?

Answer 5

Acute pain is the result of a clearly defined issue and lasts for less than 3 months
Chronic pain is persistent and can remain undiagnosed

Question 6

How long does acute pain last?

Answer 6

Acute pain lasts for less than 3 months

Question 7

How long does chronic pain last?

Answer 7

Chronic pain lasts for more than 3 months

Question 8

What are the common causes of injury in yoga?

Answer 8

Home practice without supervision
Misalignment = Joint pressure
Practicing without awareness
Exiting postures unsafely
insufficient limbering
Over-stretching/working muscles causing strains/sprains
Inconsistent practice not building strength and stamina
expecting same body response each time
Practicing with acute injuries & not informing teacher
Poor verbal/visual instruction
Strong adjustments given without care or training

Question 9

What should students medically diagnosed with sinusitis and/or conjunctivitis avoid?

Answer 9

Long holds for inversions due to increased inflammatory processes

Question 10

Why should students with HBP avoid intense spine twists?

Answer 10

Intra-abdominal pressure

Question 11

Why shouldn’t those with lung conditions practice in a heated room?

Answer 11

This irritates the lining and alveoli in the lungs

Question 12

Why should we practice on an empty stomach?

Answer 12

To avoid nausea and stomach cramps

Question 13

Why should students with LBP ensure they come out of standing forward bends slowly?

Answer 13

To avoid light headedness and nausea

Question 14

Name 2 postures contraindicated for Rotator Cuff Injuries

Answer 14

Vasisthasana/Side Plank - too much weight bearing
Virabhadrasana I-III/Warrior 1-3 - Overhead movements of the arms can aggravate rotator cuff.

Question 15

Name 2 postures contra-indicated for Sciatica/Lumbar spine injuries

Answer 15

Seated forward fold/Paschimottanasana If pelvis stops tilting anteriorly, due to tight hamstrings and glutes, students may bend from the lower back potentially overstretching the lumbar muscles, causing the discs to bulge backward placing more pressure on the sciatic nerve in the spinal canal.

Parivrtta Uttanasana Variation Knee Bent/ Revolved Standing Forward Fold Pose Variation Knee Bent
No poses with combination of forward folding and twisting.

Question 16

Name 2 postures contra-indicated for Soft tissue injuries

Answer 16

ALL POSTURES in acute phase (1-3 weeks after injury)
follow first aid RICE treatment (Rest, ice, compression, elevation)

Question 17

Name 2 postures contra-indicated for Prolapsed disc

Answer 17

No poses that round the back, involve a forward bend or cause pain, numbness, or tingling.

Janu Sirsasana/ Head to knee pose – combination of forward fold and twisting makes intervertebral discs vulnerable
Prasarita Padottanasana/Intense Leg stretch pose – rounding of the spine opens up the space between the intervertebral discs potentially causing the discs to prolapse further.

Question 18

Name 2 postures contra-indicated for Neck Injuries

Answer 18

Halasana/Plough - Neck vulnerable to overstretching especially if no blanket/support is used under the shoulders
Salamba Sarvangasana / shoulder stand - Too much weight & pressure on the neck & cervical spine

Question 19

Name 2 postures beneficial for Rotator cuff injuries

Answer 19

Bharmanasana/Tabletop
Increases shoulder stability through mild weight-bearing

Gomukhasana/Cow face arms
Stretches and strengthen the whole group simultaneously by creating external rotation in the upper arm, internal rotation in the lower arm, and abduction in both

Question 20

Name 2 postures beneficial for Sciatica Lumbar spine injuries

Answer 20

Supta Kapotasana/Reverse Pigeon - If cause is piriformis syndrome. Stretches hamstrings, quadriceps, glutes, deep external rotators & lateral rotator muscles below the glutes + opens hips

Anjaneyasana/ Crescent low lunge
Re-aligns lumbar arch reducing pressure on intervertebral discs. Stetches groins, hip flexors & quadriceps.

Question 21

Name 2 postures beneficial for Soft tissue injuries

Answer 21

After 3rd week of resting & medical clearance,
gentle stretching can begin to support healing.

Question 22

Name 2 postures beneficial for a Prolapsed disc

Answer 22

Salamba Bhujangasana/Sphinx – Approached slowly can encourage the prolapsed disc to move away from the spinal cord.

Uttana Shishosana/ Puppy - Creates spaciousness between the vertebrae and discs, restoring its natural curves. increases blood flow & stretches spinal muscles.

Question 23

Name 2 postures beneficial for neck injuries

Answer 23

Bhujangasana/ Baby Cobra – gentle stretching
Phalakasana/ plank (elbow variation) – strengthens neck muscles. Therapeutic for cervical spondylitis under the guidance of a yoga therapist.

Question 24

Name 2 postures beneficial for SIJ Injuries

Answer 24

Phalakasana/Plank bilaterally symmetrical pose will not strain the SI joint.

Salabhasana/Locust strengthens hip extensors and external rotators. engage the gluteus maximus, medius, piriformis, superior and inferior gemellus, obturator internus and externus, and quadratus femoris which all contribute to pelvic stability.