Pathophysiology, Inflammation, Injury & Recovery

Question 1

How does SIJ injury impact a students’ Yoga Practice

Answer 1

• Can be very painful in Chronic stage
• Often worsened when rising from seated to standing when the joint is unloaded & also hyperextending upward (bow or locust pose
• Asymmetrical postures can be challenging & cause tightness in the hip flexors Psoas.

Question 2

List 3 postures to avoid for SIJ injuries

Answer 2

1. Paschimottonasana/Seated forward bend as it will may cause nutation of the sacroiliac joint particularly if the hamstrings are tight.
2. Astra Candrasana 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 3

What’s the protocol to manage an injury?

Answer 3

Nature of injury
Recency

Level of pain
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

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

Answer 4

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 5

Name 2 postures contra-indicated for Soft tissue injuries

Answer 5

ALL POSTURES in acute phase (1-3 weeks after injury)

follow first aid RICE treatment (Rest, ice, compression, elevation)

Question 6

Name 2 postures contra-indicated for Prolapsed disc

Answer 6

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 7

Name 2 postures contra-indicated for Neck Injuries

Answer 7

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 8

Name 2 postures beneficial for Rotator cuff injuries

Answer 8

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 9

Name 2 postures beneficial for Sciatica Lumbar spine injuries

Answer 9

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 10

Name 2 postures beneficial for Soft tissue injuries

Answer 10

After 3rd week of resting & medical clearance,

gentle stretching can begin to support healing

Question 11

Name 2 postures beneficial for a Prolapsed disc

Answer 11

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 12

Name 2 postures beneficial for neck injuries

Answer 12

Bhujangasana/ Baby Cobra – gentle stretching

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

Question 13

Name 2 postures beneficial for SIJ Injuries

Answer 13

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

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

Why should students with HBP avoid intense spine twists?

Answer 15

Intra-abdominal pressure

Question 16

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

Answer 16

Practice on an empty stomach
Intense spine twists should be avoided by students with HBP due to the intra-abdominal pressure
Open twists during pregnancy
Students must be well hydrated
Students with LBP should ensure they come out of 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

Question 17

What are the common causes of injury in yoga?

Answer 17

Practicing without awareness
Over-stretching
Insufficient limbering to heat the body
Poor verbal and visual instruction
Home practice without supervision
Overworking muscles causing tears and strains
Misalignment placing unnecessary pressure on the joints
Not informing teacher of injury