Yoga therapy for the wrists

The wrist consists of eight bones, arranged in two adjacent rows. The lower row bones are connected with the metacarpal bones and the upper row bones are connected with the forearm bones, respectively, thus forming the wrist joint, surrounded by a complex ligament apparatus. The main function of the joint is adduction (palm up) and abduction (palm down) as well as flexion and extension of a wrist up and down.

If it is not the case of a congenital or already manifest disease as hygroma, joint capsule hernia, arthritis, etc., the cause of pain may be mechanical trauma or chronic micro trauma. Certain people tend to encounter with this problem more often such as yoga beginners, athletes and people whose profession is connected with the routine pressure on a wrist joint – musicians and PC-related professionals. For the latter it may be caused by a constant load on the same muscles during a non- physiological position of hands, for example, during prolonged work with the keyboard or mouse.

Yoga beginners may start experiencing a wrist pain during an incorrect asana practice associated with excessive straightening of the wrist and excess load on the joint. In the women's practice, the complaints appear in the asanas with an emphasis on hands when a considerable weight is transmitted and incorrectly allocated. Example: Chaturanga Dandasana.

Men`s practice has got another feature- because of a muscle stiffness and limited mobility of the shoulder joints, due to the compensatory principle, all of the load goes onto wrists. Example: Urdhva Dhanurasana.

Balances and handstands can also be potentially dangerous. Tempted by the desire to fulfill a spectacular asana beforehand, it is possible to damage the wrist joint.

Acute case: if it is a fresh injury, see a specialist.

All potentially dangerous practices of asanas should be temporarily excluded and wait for recovery, despite the fact that this process can be time consuming.

Medical aid: Non-steroidal anti-inflammatory drugs and treatments, which improve local blood flow. Well-known homeopathic medicines in common use: "Rus", "Arnica". Ayurvedic phytocomplex "Yogoradzh Guggul", ointment "Revmatil" with mahanarayana oil.

Orthopedic equipment: roll up your wrist with an elastic bandage or wear a wristband. Apart from fixing the joint, it would mechanically remind that the hand should be protected, besides it gives an impact on the active zone, which will be discussed below.

Massage and marma therapy: self-massage is very useful for your wrist - a circular motion and light pressure on the perimeter. There are active biological points on the wrist described in many sources of oriental medicine. In particular, according to marmavidya (the science of vital points of the body and energy centres) Manibandha Marmi, located on the wrist, refers to Sandhu Marmi, vulnerable points of joints. Marma damage, using the yoga language, is dangerous for it may lead to the loss of prana. In addition, any damage of the active point is considered as an indicator of an organic system dysfunction associated with it: wrist is traditionally associated with cardiovascular and respiratory systems. Also, according to marmavidya the state of a wrist indicates a person's ability to adequately express themselves in the outside world. Thus stimulating marmas can restore normal relationship between the subtle and physical bodies, which contributes to improving health and harmonization of vital energy.

Yoga therapy: yoga therapy offers a wide range of exercises and asanas to relieve stress of the affected zones, releasing and creating space within the joints, strengthening muscles and ligaments, as well as increasing mobility in the joints. All of this will be discussed in detail below.

I am going to describe the general principles of selection of asanas and exercises which you can use to create a therapeutic programme. (Most of the proposed measures are not applicable in the acute phase).

A. Asanas to relieve stress in the surrounding muscle tissue

Example: "Savasana for Hand" from Iyengar Yoga. Place sandbags on the area of forearms and palms and feel how this area relaxes under the weight.

B. Asanas for traction and creation of space within the joints

Positions are found that allow self-traction of the wrist. Padahastasana can be a good choice, when the basic idea is to place hands under the feet. Feet, pressing on hands, extend and straighten them. Then, with the hands fixed, wrists should be gently, almost in a static mode, stretched.

Variation of Vajrasana, when your hands are placed in the folds of the knees, holding them between the thighs and calves. Then stretch the wrists on the same principle.

From any body position (standing, sitting…) firmly catch with one hand the other relaxed hand and gently pull.

Also, any stretching to the tips of the fingers are suitable, when the hand opened, trying to "reach" the wrists. You can do this in Tadasana, extending hands, as usual, down or sideways.

C. Exercises to strengthen ligaments and muscular system of wrists

Sukshma-vyayamas of Dhirendra Brahmachari are perfect choice for this. Both arms are extended strong forward parallel to the floor, hands closed in yogic fists, move wrists up and down, rotate in a circular motion. The same is true when fingers are straightened or folded into a "claw". Hands can be extended forward, or elbows bent, elbows moved apart and hands to the chest.

Use any variation of joint exercises. Also, do not neglect the similar exercises on the mobility of foot and ankle. First of all, it is the ankles that are connected with wrists according to the conformity system. And secondly, it helps to switch the dominant. Physiologist A. Ukhtomsky at the beginning of a last century described the dominant principle, according to which, the centres of muscular tension tend to steadfastly maintain their excitement. In this case, we have got a bad stereotype of a "sick wrist", which needs to be overcome.

Wrist micro push ups from Mardjariasana when the palms are placed on the floor or from Uttanasana with palms on the wall, slowly lift the palms base, while remaining focused on your fingers and then slowly return the hands to the starting position.

Exercises using sport equipment. It can be very useful to squeeze carpal expander, fixing the ultimate phase of an isotonic contraction. If you go to the gym, twist the wire to the crossbar, with the load fixed to the other end.

D. Asanas to increase the wrist mobility

Effective variation: Namaskarasana- hands joined in front of a chest, strongly pressed against each other and slowly bring hands down to the waist, careful not to allow the palms base to draw apart.

Bend your elbows and pull them apart, bring hands to the chest and interlace your fingers. Then gently pull the wrists apart.

Crisscross straight arms and interlock your fingers. Turn the lock inward and outward.

If the condition requires restricting the load on a wrist then some asanas from a general practice can be easily replaced by the alternatives. Such possibility is, however more, suitable for static forms of yoga.

Those, experiencing wrist pain, instead of hands can press forearms against the yoga mat. For example, instead of Adho Mukha Shvanasany try Dolphin pose, instead of Chaturanga Dandasana – press forearms against the floor, and rather than Urdhva Mukha Shvanasana – chose Sphinx pose or Bhudjangasana.

Pressing fists against the floor. For simple hand balances keep fists closed tightly and press third phalanges against the floor.

Props. Use the wedge, placing it under hands, so that the palm base was on the widest part of the edge and the middle part of the palm with the base of the fingers were evenly distributed along the slope.

In order to get a proper hand work in "dangerous" asanas, pay attention to hands in a position where they rest on the floor, such as Adho Mukha Shvanasana. Set your palms slightly wider than shoulders, middle fingers parallel and look forward, fingers spread wide apart and actively pulled in different directions. Make sure that your fingers are not twisted against axis - this should indicate of a force vector shift. Nail plates facing up, not sideways.

Self-test: Feel the line between the index finger and the thumb, press it against the floor, press the base of the entire palm against the floor and try to lift the remaining three fingers from the floor, if this can be done relatively easily, it is likely that the palm is working properly, and if you fail and observe pale skin of a little finger, the weight had moved onto the outer edge of the palm or, even worse, remained entirely on the wrist.

To adjust position of hands, make sure that skin folds of wrists are parallel to the front edge of your yoga mat. Turn the skin fold lines slightly in and forearms slightly out. Then, reduce the weight on the palms base by pressing fingers tightly against the floor, and lifting the palms centre (sometimes called "the arch of palms") up from the floor. Going back to marmas, press hardly the space between the thumb and the index finger, this is Kshipra (fast) marma, which gives a lot of positive effects. This part of the palm often tends to shrink and lift off the floor. Then, pressing this part of the palm against the floor, roll the inner wrist and inner forearm outward. At the same time try to draw the outer forearm toward the little finger, pressing down the outer palm. Practice until these two movements become simultaneous and natural. Do not get discouraged by a wordy description, it is quiet easy to put into practice.

Palm hyperextension should be avoided. Be careful not to let the angle between the outer palm and the forearm become less than 90 degrees. In case of a stiff shoulder try to spread the palms a little sideways.

When the pressure is on hands and palms are parallel do not let the elbows splay out to the sides. Try to keep middle fingers, middle wrists, forearms, elbows, shoulders and shoulder joints in the same plane. If you find it difficult place the knees one the floor but keep the elbows close to the torso.

When you press the palms against the floor try to push your hands away and concentrate on your breathing, exhaling through the centre of the palms. You will feel how this force lifts you off the ground. You will then get a sensation that your body is strong and light at the same time.

Translated by Nataliya Blatt