Anatomy of Injuries: Learn Yoga Anatomy

Transcript

[Music] introduction to injuries common ailments and best practices so yoga is a physical practice so we use the body in order to move through our meditation basically um as such it's subject to limitations and the occasional mishaps that physical practice might actually have in short injuries so understanding the pathology of common injuries as seen in a yoga class will empower you to suggest common sense modifications to the practice um and it's also going to help you to recognize your own scope of practice we're not doctors we're not chiros we're not physios and that's not our job but we'll talk about that a little bit more as we go along so doing so just having a general understanding of some of the common things that happen in the body is going to help you be able to support your students in the best way possible and also know when to refer to someone else like when to say because you're lucky okay go over here like that's beyond what i can do so it's empowering for us to recognize what our tools are and then where our limitations are so scope of practice statements are the concise descriptions of brought in broad non-exclusive terms of each regulated profession's activities in areas of professional practice these statements describe in general what each profession does and how it does it so understanding our own scope of practice gives us clarity about what the boundaries of our knowledge and our participation should be so what is understanding your own scope of practice as a yoga teacher help you do know know your limitations yeah and know what you're responsible for and really what you're not as a student have you ever asked a teacher or yoga teacher about your injuries probably because oftentimes we assume our yoga teachers have a lot of information about our bodies do students always tell their yoga to always tell their yoga teachers about their injuries no you could have students working with lots of stuff and they will never say a word so why do what do you think our scope of practice is as a yoga teacher what are we responsible for to keep them safe to do our best to keep them safe while practicing what each profession does and how it does and how do we do that how do we keep students safe we you know we do our best to offer good alignment yeah good queuing clear i think cueing body awareness in your students is key to and can help them be their own self healers to your face i know that sure i can get into the answers but maybe should i fully go to the classical expression just to get my ego out my nose or whatever so i mean this body awareness i think is such a wonderful tool to teachers so that they know their limitations yeah so encouraging bodily awareness and what i hear in you saying dina is to also give your students responsibility for their own practice so we are trained to lead students through shapes called asana we are trained to lead students through breath exercises called pranayama sometimes meditation exercises we are trained to know modifications or variations that may make a pose more accessible and we should teach those to the best of our ability understanding what the risk factors are of certain poses and having a general idea of maybe who shouldn't do them if they have certain conditions are we trained to diagnose are we trained to offer solutions are we trained to do poses or postures that are not yoga postures no not in this context at least you may have other training right so we teach smart yoga that's it that's what we do and what i think that we can do too is offer common sense modifications common sense modifications suggest things like that that will help make the that'll help our students move in a pain-free range of motion so we lead healthy people through safe yoga practice like we're not yoga therapists even right we're not trained in teaching injured people mostly predominantly healthy population offer students common sense modifications and empower students to move in a pain-free range of motion or maintaining pain like some students have chronic pain if they come and they have arthritis we don't want to increase their pain levels we want them to maintain right so that's that's what we do if a student's like this hurts then we offer common sense modifications to take them out of pain or we can proactively do that if someone comes in and says hey i hurt my wrist when we do handstand i'm going to be like i want you to do this with your hands at the wall and do warrior three instead so i'm offering a common sense modification that honors the intention of the pose but as a yoga teacher i know an option that i could give this person that might be better for their body and then we empower them to be responsible for their own health and well-being yes yes and because of that we can refer them to outside practitioners or suggest like if a student ever comes to me and says hey i have an injury what do you think i'm like have you seen a physio have you seen a doctor because that indicates to them that that's beyond my scope of practice if someone comes to me and says hey it hurts when on my wrist when i do this then i can be like okay we have five poses where we're doing this so instead of that i want you to do this you know that's like a common sense thing that i could do oh hey it hurts when i put weight on my knee great here's a chip foam block or hey here's an option where you don't put weight on your knee that's within my scope is to offer them options but it's not in my scope to fix them or to figure out what it is so how do we communicate about injury so what's the best way for us to find out about injuries do you think from students i think you let them know that you care to know about them right i would like to know yeah yeah and i think giving them the opportunity to so that they're not just telling you about their injuries yeah no one wants to hear about my shoulder and what do you do it like hey anybody's got an injury just tell me now raise your hand what's a better way i think for part key forwards are super important as a studio owner and as a yoga instructor i think it's your responsibility to look at any alerts but your teachers never see those forms of seeing those alerts so that your teachers yeah i understand but i'll just be honest as someone in the yoga business like the teachers never see the student files no understood but if you're doing your job and i know that liz is coming into my class i should know what liz's deal is yeah i could ask them as they sign in you could ask them as they sign in like just thinking realistically that's maybe ideal world yeah did you do your teachers look at those well that's good in most yoga studios they do not but ask at the beginning of class like if anybody has any injuries well if you do that how much how likely are they to say yes some will depends on the person but maybe one-on-one when they sign in or you can offer it through a class i think you guys are having trouble that's good yeah so you could offer proactively for common injuries or stuff like that i love the idea of teachers being up on the park hues i just know that realistically in the studios i've worked in it hasn't worked out that way well it's like 40 people in your class you can't look through everything so but asking students one-on-one like at why yoga where i teach we come around and collect tokens at the beginning of class so my patter is hey i'm going to come around and collect your token if there's anything you're working with in your body that you want me to know about that way it covers not just injury but it's anything they could be pregnant they could be i don't know having a bad day whatever they could be menstrual whatever they want to tell me that's i usually will contextualize it that's related to the practice that i should know please let me know and that way and you can maybe even contextualize it to say not just for the sake of telling me but so that i can support your practice and offer you modifications if it's appropriate like you could we could even tell them why we want to know so it's not just like hey i want to hear about your bad day it's like i want to be able to support you in your practice so if there's anything i should know then tell me usually observation is a great idea right up observing students how they enter and move in your space and even how they're entering and moving in their practice it's true so what information should you provide to the student so say a student tells you like hey you know i have so actually let me ask you this first if a student says yes i have a knee injury or yes i have a shoulder injury what might be an appropriate follow-up question we just go like okay great are you aware of your limitations do you know how to modify your practice to support yourself you know how long have you you know that that that's useful because my job again is to provide common sense modifications so if they say to me i can't lift my arm above this then i might say great when we all do down dog why don't you stay on hands and knees or whatever it might be oh hey we're doing handstands so when we do handstand i actually want you to do this instead so you're giving them you know so that you can proactively change the thing this is a place where i would also refer people i'm going through this have you seen a professional right just to give them the idea that i'm not responsible for that injury and that there's resources out there that can support them and they can get more information on it most people are like no like that's a good idea go see someone all right oh here's a good one okay so student comes in here's a little thorny issue for you student comes in they're like i can't you know i can't bend my knee at all do you ever kick it or something do you ever kick a student out of class what do you think yeah so no no would you ever say maybe you shouldn't be here in this prize well the only time i think yeah i agree with you i think it's people come for inclusion so and to feel part of a community to feel supported and connected so my tendency would never be to kick a student out of class unless i saw they were in physical danger to themselves for example hey i just hit my head i may have a concussion i'd be like we need to get you to the medical people you know you might have a concussion and you need to be checked out so in those kind of acute situations then you have to use your own judgment but generally speaking i'm like as long as you're comfortable modifying your practice so that you're moving in a pain-free range of motion or not increasing your pain great hand and hand the responsibility back to them all right so let's talk about acute versus chronic injury i just mentioned it an acute injury is something that's like just happened right they're severe and sudden this could be anything from a broken bone to an asthma attack so acute injury we don't want to see those in class that's where you should probably be getting checked out by somebody smart who can help you like hitting your head we'll talk about this when we talk about hot but it's like somebody falls down they hit their head they're disoriented that's actually something that needs to get checked out right but somebody who comes in and sprained their ankle a month ago that's more chronic someone who comes in with chronic arthritis that's an ongoing condition that doesn't require immediate care just requires moderation perhaps so a chronic condition could include arthritis recovery from some sort of injury ongoing spinal issues whiplash scar tissue you know someone who's dealing with disease or cancer something like that that's ongoing we're mostly going to see chronic issues in our class because if someone has an acute injury most likely they're at the hospital or seeing a doctor so common chronic issues that you might see spinal issues ligaments and joints muscles inflammation fluid issues and repetitive stress injuries now the purpose of this next section of this isn't to make us able to diagnose or fix any of this it's simply to provide us a framework for being able to communicate with students more effectively about what may be going on in their body so that we can support them in their practice i'll be really honest you don't need to know any of this this is actually sort of beyond the scope of your own practice in a way the only thing that i need to know from a student is what hurts when you do this when what are you doing when it hurts let me tell you how to not do that thing that hurts do you know what i mean so i actually don't need to know anything about shoulder injuries or spinal injuries if they say it really hurts when i backbend i'll be like okay let's not do that i don't actually need to understand why or what the diagnosis is or anything like that but i think it's a nice help does that make sense to you guys do you understand what i mean like you're not responsible for that but what you are responsible for is helping them to move in a range of motion that feels appropriate to their body and to giving them options for doing that in a way that makes them feel part of the class if possible right so we're not just like go lay down in shavasana but i can give you something to do that actually will be part of the yoga practice where you feel included but all of it i think it's nice for us to have this so that we have a language with our students but just know that you're not responsible for understanding all of these things in depth yes so far so good make sense is it a relief at all because one of the things that we're most afraid of is injuring our students right at least that's what i think a common fear that was one of my things that i was really scared about so first we're going to look at so first we're going to look at common issues with the spine so we looked at the spine recently so the spine has four curves as you probably remember and spinal issues are usually the result of disc issues so they're intervertebral discs the disc deteriorates that's causing pain bony issues like if things aren't aligning properly or the discs aren't stacking properly that could also be an issue most commonly it's disc issues so we have the bulging disc and the herniated disc right where that inner does anyone remember what that inside is called the inside yeah the nucleus pulposus when it squirts out or squeezes out beyond the analyst fibrosis that's called like a herniated disc so most of the time and we talked about this when we did anatomy of the spine most students are here so if you guys sit up tall onto your sitting bones for a moment and you can feel what happens if you let the sitting bones tuck under as opposed to tilting forward so tucking under versus tilting forward and what position are are people most in yeah exactly most of the time we're here right so this would mean that my discs are squirting out the back usually that means that forward folding this is going to exacerbate that problem whereas back bending finding more of the natural curve can actually be therapeutic for the problem as a general as a general gist oftentimes students won't actually know what's going on in their back they'll just say my back hurts or i have back pain again in this situation it becomes like what movements or what positions exacerbate that pain make it worse and then let's not do that let's do the opposite or for some students if there's a bony issue where hyper extension is actually worse for them then it's like okay let's not do that so when we're doing this position you do this position that makes sense or if people are having a hard time because they're rounded under and this hurts it's like great when you forward fold make sure you're not rounding to forward fold make sure you really work from your hips and maybe you stay up a little bit higher right so we can see all i'm doing is saying what hurts how do we not do that where are some places i can offer you some common sense modifications where i so that that doesn't come up spondyliothesis this is an interesting condition so this is someone whose lumbar discs has slid forward see here's their sacrum and this is slid forward you guys see so unlike your chronic people who are like this for this person being in a backbend will actually cause more of that slide and usually that hurts so i had a student i did a private with the student who had this information he couldn't do anything that was a backbend everything had to be rounded for him so like all of the modifications that we did for him were about keeping stability in the lumbar spine not going into any back bends and really any back bends he did i would say i just want you to take your shoulders back working your shoulder blades so that was our solution that we came up with together for helping him to support his own condition in the context of a yoga practice so let's take a little pause here before we move on to this sciatica well actually sciatica we'll talk about this real quick because we already talked about this is the last little slide on the back so true sciatica remember happens from the impingement of the nerves on the way out has anyone had sciatica in here yeah and what makes it worse sitting too long yeah so sitting too long makes it worse holly sleeping anything in the yoga practice make it worse great great so we would say like okay well let's not do that right when everybody else does that is that when you're standing forward folding is when you're sitting and forward folding standing great so okay so maybe we would say like instead of you doing the forward fold when you come down you do this part this part bend your knees and you go ahead and step right back into plank so we avoid that whole pose altogether great so i'd say great i want you to bend your knees don't worry about forward folding when we're doing uttanasana instead like what pose would feel better to you rather than doing this big forward fold maybe you do chair pose instead i'm sorry but like maybe that's it so she can do something in the flow of the practice that's accessible in that moment and then we've problem solved it together so she feels like oh the teacher's not going to think i'm a jerk for not doing what she's saying right that's half the reason students tell you about their injury is just to say i'm not ignoring you i'm just in pain so i need to do something different oh cool so that's how we might troubleshoot something like that okay let's pause here and we'll practice and we'll meet back after practice okay so what we're looking at are just some common injuries to give ourselves a framework for how to discuss things with our students so what is basically our what is our scope of practice just to refresh ourselves on injuries and injury management as yoga teachers what are we actually responsible for what they are just modify give them options exactly to hear what they are to modify them to give them options for asana to move in a pain-free range of motion or to not increase their pain levels i think that's really kind of all we can do but we are going through some of these things just so that we have a vocabulary to understand clearly what students might be telling us so let's look at connective tissue issues common ailments and best practices so we've touched on some of this before so sprains are an injury to ligaments like lehman's connective tissue so ligaments what do they connect bless you what a ligaments connect their connective tissue that connects what together what do tendons connect muscles to bone ligaments connect bone bone do they take a long or a short time to heal long once they stretched out do they revert back to their earlier shape easily no they are prone to re-injury exactly so what can we do to support areas of the body that have suffered a ligamentous injury like and now the connective tissue is a little bit loosey-goosey around there what props well props are good like what are you thinking of like using blocks like if you have a certain injury in a like say your water a half string that might be a muscle oh but like a hamstring tendinous injury right which i totally get like i feel that particularly when we overstretch our hamstrings so what as a what as a general rule if we don't have stability through the ligaments how else can we get it the muscles so like for example props can be super helpful in helping us to do that like if you put my hands on blocks when i'm doing my hamstrings it's easier for me to not hang in them right so that would be an example of using props to support that as teachers we can also say like really take your tailbone to the top of your thigh so you're hugging the top of the hamstring together or if i'm doing like if my ankle has been sprained and i'm super wobbly i could say hug your outer shin in so i'm using the muscles to stabilize that joint all right so again common sense stuff if there's a place of laxity and connective tissue where passive support isn't available we can help our students remember that they have active support options like if someone has a tweaky si joint it's unstable i might tell them hey lift your pelvic floor hug your outer hips in whatever you can do to engage the muscles around that area to create more stability that can be helpful all right the knee the acl i just wanted to mention this because so many of my students come to class if they've had a knee injury a lot of times they're like i busted my acl so what is the acl does anyone remember inside chris crossy inside what joint what's that joint well inside what's the joint the knee joint yeah it's the crossy ligament inside the knee joint that's exactly right and it helps to stabilize the shin going forward and backwards and this is one that off like when one of the ligaments of the knee goes this is the one that i hear about the most so i imagine that it's prone to popping um so before surgery sometimes students don't have surgery like they don't necessarily get surgery right away like they might be walking around with a compromised acl for a while so before surgery before it's fixed they may lack stability in which case again just like we did with the ankle sprain what might we ask them to do if they don't have connective tissue stability how can they get stability your muscles so how many muscles cross the knee a lot hamstrings quads gracilis sartorius i.t band goes across there so by using your muscular stability you could help to manage an unstable part of the body now after surgery they might be stiff because they've just been prone for a while usually that tendon is actually kind of tight i think when they put the connective tissue up there they literally remake a new ligament and it's a little stiffer so they might lack stability so they might need some support like they might not be able to bend their knee all the way or things like that so you just want to kind of give them options to support them if they can't flex their knee entirely and ask them like say what does your doctor recommend that's always a good question they don't wait there for three months they don't wait there wow either way when they come to class and you say say what does your doctor tell you they'll probably have an answer for you of what they're allowed to do and what they're not so you can base your common sense suggestions on that and then you give the baton to them and you say it is your responsibility to move in a range of motion that does not increase your pain will you take that on and they look at you and they go okay and you go okay i'm cool with you doing that right so give them the responsibility for their own pain levels and managing themselves yeah do you sort of keep an eye on that student that may have a severe injury do you eventually disorder they're on your own or some balance i think of the two i'm not their nanny they're coming to a public yoga class it's not a yoga private i'm not a therapist but if i notice like oh hey i remember that paul over here can't bend his knee all the way and i've just planned for virasana i might go over and say hey paul why don't you do a low lunge instead because the purpose of that and i'll remember what is the purpose of the pose i'm teaching oh if we're doing saddle pose i'm stretching the quads oh well let me give him a pose low lunge where he's getting into the hip flexors a bit but it's not going to make him flex his knee all the way so that's that's our job and yeah i think so yeah other so moral of the story is encourage students to always follow the advice of their doctoral surgeon you guys i have had students come in who say i'm like what does your doctor say and they're like well my doctor says that i should do this but i don't want to do that what do you think and i'm like i think what your doctor says is true like we should never contradict them i mean i know it goes without saying but you're like no man you gotta listen to your doctor i can't contradict i can't empower you to could be a bad bad you know heal like patient all right runner's knee is irritation and pain of the patella moving on the femur that's something itbs is when the it band um that runs from here to here causes the knee to hurt that's what i had when my knee blew up so those are other things you might run into again you're just gonna coach people to move in a pain-free range of motion don't do anything that exacerbates the pain treat the knee like a pure hinge joint kind of all those usual things meniscus wear and tear you're just like god speed don't do anything that hurts you know maybe you know basically in a nutshell so what might be just as a group discussion you guys somebody comes to you and they're like actually i'm gonna give you that as an exercise at the end i'm gonna have you play play yoga teacher and student all right whiplash this is an interesting one so whiplash is a soft tissue damage in the neck usually from impact and what happens is that the head comes forward and then the body goes quite intelligently i really don't want my head to dislocate from my spine that seems like a good survival thing so when these tissues get super long they contract to keep the head on top of your spine this is generally a good thing however it causes whiplash which is bad so your head good news your head stayed on your spine bad news it really hurts so um if someone comes into the class again with whiplash what might you ask them or encourage them to do what might be your message to them i i come in how are you doing great but i have whiplash what would you say yoga teacher well maybe take it easy if you're doing forward folds where you know the head is hanging because that might really um tweak the muscle that's interesting yeah what else might you say that's nice keep your keep your head aligned like should maybe you know if twisting your head to look at your hand and triangle hurts maybe don't do it if letting your head hang down hurts maybe we don't do that no anything else easy exactly like say what hurts don't do that moment of pain free range of motion we could say that for all of these things makes it easy right makes it so easy a hernia is when one part of the body an organ or fatty tissue pops through a rupture in the containing wall basically pops out where it shouldn't be i know sexy sometimes it's caused by over exertion or pressure like if you bear down er and it goes pops out okay sometimes more serious hernias are repaired through surgery sometimes you just put anyone have a hernia sometimes you just pop them back in you're like oh my little when my son was two and a half or three i noticed that he had this tiny little and it didn't seem to bother him but when he went like that it would protrude when he stood up but then if he tilted himself it would go back in [Laughter] here that's so cool yeah a little baby hernia baby hernia so you know if student have has hernia they probably have a sense of what happens you know like if i'm am i going to have someone who has an abdominal hernia i have some like take a big breath exhale twist and then take a big breath in to create intra-abdominal pressure like probably not that's probably a bad idea so you might tell them to take it easy to watch their breathing you know they don't have to like create a lot of pressure inside and they will probably know what movements make their hernia pop out if it pops up so you can avoid those movements that's fine all right so muscles can also be injured through overworker trauma so a strain a sprain is connective tissue a strain is muscular tissue muscle so the muscles get ripped and i know they're connected but so muscles can heal pretty quickly that's a big bruise so what happened is that the muscles tore and they're very blood-filled they're vascular and so you got a big bruise right connective tissue when it tears you might get some bruising and swelling and stuff like that but connective tissue it's not so vascular so it wouldn't look like probably won't look like that so if someone has a sprain what might be again what would you say is a take it teacher what else would you say if it hurts don't do it if it hurts don't do it exactly move in a pain-free what makes it worse don't touch it don't do that yeah exactly it hurts when i do this then stop doing that this is the thing is that the body is actually pretty good at healing itself given the right stimulation and right environment for healing so if we're constantly doing something that re-injures ourselves obviously it's not going to heal but if we give ourselves good stimulation or good you know prompts for healing whether that's space or rest or whatever it might be then the body is actually like amazing medicine is kind of about creating conditions for the body to do its magical things it's amazing so inflammation anything with an itis is inflammation so when you hear bursitis arthritis tendinitis appendicitis it means that something is inflamed so inflammation marks an immune response in the body so the body swells up the body sends blood and white blood cells it sends out its emergency troops to heal it up so inflammation can be like redness soreness pain swelling um now the rice protocol has basically gone out the window i think real we're over the rice protocol the rest ice compression elevation thing that's old school now what do we do now we don't do rice did my physios or doctors know well i think that i think that there's still a face for her yeah yeah you shouldn't be resting to the point where you're doing nothing you should be gentle range of motion pain-free range of yeah yeah that makes sense and ice and heat is controversial yeah right because they yeah ice and heat is controversial this is for the folks at home gentle range of movement yeah so icing is controversial compression if they're swelling if they're swelling yeah okay and then elevation just like you said yesterday heat up will help so yeah so elevation still applies so hot and cold is controversial and now we're starting to recognize that immobilizing and just resting without any movement is actually not very great for healing right so that's like what you were saying earlier people trying to get up earlier from surgeries and things like that because actually the resting is causing more problems than the injury or the movement all right so this is an inflammatory response in the feet little swollen immune response here one thing that's common is like a tendonitis tendon tendinitis which is tennis elbow or um golfer's elbow i think is what it's called it's when if you guys take your hands to your upper arms for a moment and then turn your draw your wrist in and then extend it out and hold on like right to the sides of the bony part of your upper arm right beneath it can you feel how your tendons engage on one side than the other so the tendons for your wrist are located through your forearms right so people get tennis elbow i think it's the backhand i think it's this that does it this thing and then golfing is this way basically it's overuse in this of this action or stabilizing in this action and these guys get inflamed and sore and then people who play tennis never want to take a break so they're like you're like rested and they're like now i'm gonna keep doing it i understand i had tendonitis for a long time honestly it just took time it took like five six months and it finally just went away but it was like i had tendonitis in my out it was like sore and achy and stuff like that i mean i tried to do things that didn't hurt you know but it was just sort of like low low kind of uh i'm like low threshold pain kind of consistently and then over and then i stopped noticing as much and then one day i was like oh it's it's gone i know and my dad had it a while and he used to do this protocol with weights where he would actually work it i think he thought to increase blood flow was the idea i think behind that of actually getting more circulation in there to get things moving yeah sometimes it just takes time which is super irritating so but it's sometimes that's what it takes um okay so again in these situations these are chronic it's chronic stuff so don't increase pain levels you know um if there's something that exacerbates the condition tell them not like okay don't do it um you know so that might mean changing hand positions in yoga or changing how you weight bear here's another example of inflammation of arthritis right where the joints get inflamed and arthritis can either be wear and tear over time so the connective the articular cartilage breaks down and the joints get inflamed or it could be like rheumatoid arthritis which is an immune response so you kind of get the same result but it's coming from an immune condition rather than just the wear and tear so if somebody is like you have a student who's coming in and they have arthritis in their hands but they want to do plank what might you say to them forearms would be a suggestion yeah something that doesn't increase their pain levels now with this kind of stuff we've also seen that the rest thing sometimes some mobility is good but maybe not you know compressive stuff or maybe not too much weight so we kind of want to encourage um avoid increasing the pain levels while encouraging sort of gentle mobility so that they get circulation and movement through the joints which can be good for them so if you're like hey if that if plank on your hands is like bugging you then let's bring you on to your forearms but maybe you can do mobility thing other places right so that your joints are moving we have carpal tunnel syndrome which we chatted about which is when the inflammation of the tendon sheathes inside the carpal tunnel compresses the median nerve and makes the hands hurt what do you guys think so someone comes in they say i have carpal tunnel what might you encourage them to do as a teacher dina what you thinking yeah any thoughts teacher how you might encourage them um you could or may you know it depends how severe it is so it could be like if weight-bearing on your hands exacerbates that let's not do that i often find that carpal tunnel can be exacerbated in yoga because of incorrect alignment in the hands and that students you know how when students do down dog or whatever they always lift the inner edges of their hands up like this you know they're doing it they're doing down dog but their weights all in the base of their wrist right here well if you get students to do this and get the weight off the base of the wrist then you're reducing the um the pressure right there so that could be something that helps them you know using the finger pads and more muscular engagement could help them if that's not great coming down onto the elbows or even doing things on the fingertips may help them depending on how that feels through their wrist you can ask them um yes what was i going to say there was one more porn drink yeah i had students who used to work on their fists yeah because it keeps the wrist in alignment like there's no also no flexion using gloss too sometimes using a block like to hold on to yeah and just so you like your media nervous stretching ah oh that's a great idea that's a great idea because the nerve runs all the way through so if you bend your fingers then you're take putting some slack into it cool i haven't heard that one that's great another thing that you um may do is that there's little wrist buddies they're these circular gel like things and people can put their wrists on them and so that their arm is more in this kind of thing rather than so flexed so their wrist is more lengthened not flexed and then they have something squishy underneath their wrist too and that can be helpful in terms of and it could be something that if they if this is a chronic condition they could invest in a pair of those and take them to all their classes i have one of my students who does that okay so some issues are related to fluid stuff so we've talked about blood pressure high blood pressure if it's unregulated and you don't know what's going on then usually it's treated with medication but if it's not treated then well honestly practitioners should be checking with their doctors because almost everything we do in yoga involves forward folding right so however low blood pressure you know someone stands up and they get faint what are some solutions to that what's that they could lie down yeah like if they're really faint they could bring their head below their heart or they could lay down move slowly through transition from where you've been down for a while yeah right so making those transitions telling your students who have low blood pressure hey transition more slowly don't just stand up because if you just stand up suddenly your body's gonna be like get back down right so standing up slowly moving slowly we talked a little bit about engaging the legs like engaging the muscles of the body to keep blood flow going so blood is moving back to the heart where it can be pumped back up to the brain the body is over 60 water and so edema remember fluid where it shouldn't be things like you know movement usually helps it because you're getting the muscles engaged so someone comes in with swollen ankles using their legs you know moving muscles around can help to move that fluid back into the lymphatic system also legs up the wall license just because ankles are so common all right we've chatted about some of these fluid issues before glaucoma the eye any any place if they have like a sensitivity to fluid pressure you may be like maybe let's not put that below your heart it's kind of common sense so yoga injuries here's the thing in the yoga practice we do yes angeline edema is excess fluid where there shouldn't be can you speak up what would you do yeah so i would muscular engagement helps to move fluid in the body if it were someone for example because usually fluid will pool in the lowest extremities so feet ankles so oftentimes like i'm assuming that this isn't a crazy condition but this is something sort of normal um having them be able to do a shavasana maybe with the legs up the wall rather than flat that might be a nice way to encourage some of that fluid to move back down to the core of the body the edema itself is i i don't see it there's no limitations to what you're doing really like unless you're super swollen that you can't you know move it yeah it's not so much a pain issue like a risk factor or anything it's just yeah just is related to heart failure or something like that yeah chest pain yeah usually the only people who have had um edema that i've encountered would be oh hey my ankles are kind of swollen today something it's usually something like that which is nicely addressed through hey let's put our hips on a block and put our legs up you know so so yoga does a lot of the same movements over time so that means that just like any other physical sport that you might do yoga can be prone to repetitive stress injuries so we've talked about the knee right when we try to get the hip to do lots of things and then the knee is like it's twisted because the hip actually doesn't go for the full range of motion so like that's something that we want to keep an eye on so just for now we're just going to take a look at some of the common pitfalls honestly of the yoga practice what's like what as teachers what do we want to keep our eye on that these postures might inadvertently encourage some inadvertent consequences of practicing yoga yoga but yoga but yoga has a lot of forward folds and if people do a lot of forward folds or they're end gaining their forward folds rather than stretching in the belly of the muscle they might stretch the attachment i totally have had yoga butt where the tendon gets injured from overuse pain may also develop at the bursa at the hamstring so how do we help prevent yoga butt as teachers engage what i don't know if the core is going to help you much there bend your knees i don't know for me if i have a flat back if my knees are straight i can still feel it way up here right like rounding my spine i actually like to round my spine okay this is me i'm the girl who would have yoga butt because i've overstretched my hamstrings for me rounding my spine is great because my back is what gets tight these suckers are super long and this is compensated by tightening up so for me i'm super happy to round my lower back and stretch it out my hamstrings don't need to be stretched more but bend the knees or if you have make sure like maybe you can cue people too hey if you're feeling this sensation all the way by your sitting bone that's not where we want to feel it in the in the belly of the muscle so if you're feeling it up there like remember if something is ligamentous if it's not stable then use muscles to stabilize that's why that second dual action of the sitting bones down can be useful for people who are hypermobile in that place creating some stability through the muscle yes so you said rounding your spine and stopping through well i don't think i would cue rounding through the spine as a general guideline but drawing students attention and awareness to where they should be feeling the stretch for it to be functional could be helpful i cannot get it to go somewhere else right now it is all on my echo are your calves tight i need to like i don't think so not over but i don't know so i'm trying to figure i bend my knees and straighten my back and it won't go those those things though i know that was evil things i've been doing those they're good so that's interesting so it could be bursitis this is where i would say go see physio yeah that's exactly yeah good good good the other big injury i want to talk about here is shoulder stuff chaturanga so a lot of times when we come down especially because it's hot in flow classes and not really instructed because we do it quickly is this in the shoulders which can create pressure across the top of the shoulder and that can be very hard on the shoulders over time so like you don't want her you don't want your shoulders this is an anime character you know she's not real you don't want your shoulders to come below your elbows you want them to rest there and draw the shoulders onto the back so you're not kind of slinging forward and down so how would you help your students to get that right yeah you could cue them draw your shoulder blades together and don't go past 90 through your shoulders you may have to slow down and teach the sun salutation the first couple times that you go through it in a class to make sure students are setting themselves up you may want to use stabilizing actions proactively when you're teaching the sun salutations keep your collarbones broad and your shoulders on your back as you lower down right so the way you teach it can help to reinforce good habits and you might have to educate them like about once a year i'll do a class which is all about the sun salutation i'll turn one of my classes into a workshop and i'll make students go through this kind of stuff and go through chaturanga because if they haven't come to a workshop or a teacher training they may not actually know because when we teach the sun salutations people teach them fast we don't have time to explain why certain habits are better i'm surprised more people are injured because even people have been coming regularly for years that i see and i just well i know that's right but looking at their alignment oh my gosh yeah yeah you know i think we're getting to a place now where we're becoming more aware like i think in the early days of yoga like the knee injuries and the shoulder injuries and all that was much more prevalent because we didn't quite have the sense of oh hey this stuff could be not useful to do every single day right so so knee injury so again we kind of look at these silly poses they're so silly look at the silliness so if he didn't have all of this external rotation here he would be squishing his knee and maybe crunching up his meniscus right some people do have it so you know we can hey if you've got open hips and you can do padmasana without hurting your knee with it being a hinge joint awesome but what are some of the things that we've learned that we can say to students to make sure that they're protecting their knee and yoga do not go to the point of pain should not hurt what are what's the knee mantra yeah treat the knee like a pure hinge joint yeah so the shin the tibia and the femur just for best practices always stays aligned if you can't get your thigh externally rotated that much then you're not going to do padmasana onto the range of motion of your hips and educate students that hey everybody's got different hip shapes that's totally fine all right any questions about injuries do we feel like we have a clear understanding of our scope of practice and some strategies for managing conversations that might come to us okay good [Music] you