Showing posts with label yoga injury. Show all posts
Showing posts with label yoga injury. Show all posts

Saturday, December 5, 2020

Recognising the true teacher

Today I am moved to write on a rather tricky matter. Our world of yoga, like the rest of the world I suppose, has the capacity for people to cross the line between what is appropriate and what is not. 

In a yoga class we should be able to feel safe. Yoga as a practice of body/mind/spirit integration cannot be effective if we do not feel safe. Learning does not take place if we do not feel safe. Yet there are many ways we may not feel safe, and may not be safe in a yoga class.

Ahimsa - non-harming

In the classical yoga of Patanjali's Yoga Sutras, the principle of Ahimsa, non-harming, is the first yama of the five ethical practices that comprise the first limb of yoga. If yoga is truly adhereing to this principle, we would be safe in yoga classes. 

Ahimsa encompasses not only not harming others but also not harming ourselves. In the contect of not hurting ourselves in yoga classes, I believe we may lose some of our agency due to the culture of the class.

Safe from physical injury

In modern postural yoga, physical adjustments have become a norm. Highly respected pioneers of modern postural yoga paved the way for extreme force being applied to bodies to achieve an idealised position perceived as the correct way to do a pose. When yoga becomes gymnastics, when it shifts into the realm of competitive sport, when it becomes ambitious, misjudgement can come in, clear discrimination can dissolve.

The ambition to be "best"

The visual representations of yoga on magazine covers and on yoga memes almost always depicts postures with considerable wow factor. "Good yoga" is identified as being able to bring the body's joints into extreme flexions and extensions, and to be able to hold the body's weight on the hands or even on on one hand.

Many yoga classes perpetuate this idea. When a yoga teacher has bought into that ideal, and perhaps has a body type that is capable of getting into some of the postures, has perhaps trained in a system that lauds such postural work, then the culture of the class is to work the body to achieve the ideal. I've been there, in my youth, the idea of sitting in lotus posture seemed so important, that I worked my legs quite forcefully trying to achieve it. What did I get from it? Injuries in my ankles, and in my sacroiliac joint. 

So with an ambitious culture, students are encouraged to self harm.

Injury caused by adjustments



Have you ever received an adjustment in a yoga class that injured you? I have. I was doing my teacher training at the time, which made what happened even more shocking. The teacher who made the adjustment was a recent graduate of the same training, so I have a fair idea of the principles under which she was trained. In that training I was hearing messages about asking for permission before touching, about the unique structures of the human body and how one size never fits all. In this class, the teacher approached and without asking permission, pushed my pelvis to force "alignment" according to her ideas about what that should look like. I hurt for a week. To my horror, she showed up as an unannounced teacher in another studio I attended, ran the same lesson plan and tried to do it again! 

Now I refused that adjustment the second time because I saw it coming. I had quite a while to prepare myself to say no. I was also empowered by what I was learning in my teacher training. I knew that it was not OK, and that I had the right to say no. The problem was, the first time, I had no opportunity to give or withhold consent.

Informed consent

Informed consent implies two things. Firstly, that the person understands what is being consented to and secondly, that given that understanding, clearly says yes, feely and unpressured.

In the case I have related above, the first time, when the adjustment was made, it came out of the blue. We were asked to line up with our backs to the wall, place our feet in a particular position, and do triangle pose, with our lower hand right down to the ankle. The teacher then went around and pushed everyone's pelvis against the wall. I was first. I was not asked if I wanted an adjustment and I was certainly not told what that adjustment would be. There were at least twenty people in that class, and the teacher progressed around the room doing the same adjustment on everyone. You could argue that after the first few, if people were paying attention, they would have known what was coming. But nobody was then asked if they wanted to receive the adjustment. There was no culture established in that class that people were permitted to choose not to receive the adjustment. 

On the second occasion, it just so happened that I was last. I watched as the same scenario played out around the room, and when she got to me I refused. Even though I knew my right to refuse and was determined that I should, I spent her whole round summoning my courage to do so and I stated my refusal with more force than the situation demanded because of my nervousness and stress. Afterwards I felt embarressed. I still remember it. Refusing the teacher's adjustment when I was not asked for permission, the stress involved, was not something I could easily forget.

I have also seen a scenario play out in a workshop. The teacher asked for a volunteer, but did not say exactly what was going to be done. I felt uncomfortable when I saw the teacher walking on the volunteer. I wondered about the volunteer's informed consent, but I did not speak up. I wish I had.

When things become inappropriate or even abusive

In the scenario above not only was there a potential physical harm in the "adjustment" and a lack of informed consent, the area of the body was a very personal place. The walking was on the groin. Additonally the teacher was male, and the volunteer, female.

Think for a moment. If you had known this would be the "adjustment" would you have consented?

The peer pressure and class culture can make it hard to say no, and can even persuade you to participate. If I felt uncomfortable with the first volunteer and her experience, I was amazed at the number of additional volunteers who queued up for the adjustment. 

What a strategy - get the first person to receive an inappropriate manipulation by a total lack of informed consent, thus normalising it, and then they will queue.

And we need to navigate that. It is not easy. It is not easy as a student, if a teacher you respect begins to behave in a way towards you that makes you uncomfortable. It is not easy in a teaching fraternity to call the behaviour we may suspect we are witnessing.

First step - Being safe with ourselves

It is an important lesson to learn on the yoga path, that we should be able to feel safe with ourselves. I will perhaps write a whole blog post about this another day. However, without the ability to feel safe with ourselves our ability to open to the truth of who we really are might be hampered by fear. In the context of not doing ourselves harm we must always keep any promises we make to ourselves.

Empowering yourself and others


In conclusion, we owe it to ourselves and to all others to be brave. Brave to say no, and brave to call it out when we see it. Doing so will empower us all. And if any feeling of "oh oh!" arises, trust it, don't suppress it. Step back from the situation, say, to yourself and everyone else, this does not feel right. This is truly courageous, and it helps to have planned it ahead. 

How to recognise the true teacher? 


You will not feel afraid. You will feel empowered, never knocked down, encouraged to independence, not dependence. The true teacher will stir your quest to learn, but never claim to be the sole source of the answers. 



Photo credits: Images of yoga adjustments are from the blog yogamarie.weebly.com and mariehallagerandersen.weebly.com/ and were accessed on 2 December 20.

Wednesday, April 25, 2018

The sacro-iliac joint and why it is vulnerable in yoga

Recently I taught a workshop on the sacro-iliac joint but a number of folk have told me that they were disappointed to miss it, so this month I am putting down a few thoughts about it. I must begin with a disclaimer, I am not a physiologist nor an anatomist, just a humble yoga teacher. I am presenting my understanding as simply as I can. So where is this sacro-iliac joint?
Photo credit: Wikipedia
Location: the Sacro-iliac joint is the junction between the spine and the pelvis.
Photo credit: One Health Osteopathy 
It is not meant to move much - the above picture shows the ligaments that bind the joint front and back. They form a dense webbing, intended to keep this joint very stable.

So why is it a joint? Why are the bones simply not fused together like the vertebral bodies of the scrum itself?
Please take a moment to look at this video. It is very short but it illustrates why.



Some movement is required in the joint for the normal functioning of walking and other movements of the body. This little animation is an exaggeration however. The degree of movement is actually very small, around 2 degrees. If you have as little as 4 to 6 degrees you will be experiencing pain.

So the next logical question is, how on earth do you get into the situation where you have instability in one of the sacroiliac joints.

How does a sacroiliac joint become unstable?

As with any joint it can be injured due to the immense pressure brought on it by an accident such as a severe fall or car accident. Falling onto the buttocks, perhaps when falling off a horse or motorcycle, is a common cause.

Repetitive strain is another way. When an action that is asymmetric is repetitively applied it can gradually loosen the bonds of the ligaments. The repetitive rotation of a golfer, batsman or bowler would be the kind of action that could gradually lessen the integrity of the ligaments.

Force through one leg can place a tremendous asymetric strain on the joint. This could be one major trauma as in a motor accident. But when an athlete repetitively lands on the same leg, perhaps a figure skater, ballet dancer, or hurdler, this again will lessen the integrity of the ligaments.

Women are more prone to sacro-iliac joint injury than men

Notably during pregnancy, but also during the menstrual cycle, and during lactation, a women's body has elevated levels of hormones that cause the ligaments to become prone to overstretching.

Can yoga practice contribute to sacro-iliac joint instability?

I believe so, especially if we attempt to force the body into positions its structure will not allow. Here are some examples.

Seated twists while trying to keep the pelvis anchored

House photo - Yoga Spirit Studios
Many people are taught to anchor the pelvis in a seated twist. Unfortunately this sets up precisely the conditions which can lead to over-stretching of the ligaments which bind the joint, and down the track might lead to the debilitating pain of sacro-iliac instability.

When twisting in a seated position, allow the pelvis to turn slightly in the direction of the twist and then direct the movement into the thoracic spine, not the lumbar, in order to keep both the lumbar spine and the sacro-iliac joint safe.

Forcing external rotation of the hip

This can happen in attempts to do open kneed seated postures, from simple cross legged, to lotus pose. But even being over zealous in padagusthasana could create a problem.

It has to do with the shape of your hip socket in relation to the shape of the top of your thigh bone. There is a tremendous variation in the way we are built and no two hip joints are really the same. This picture illustrates that.


If your head of your femur (thigh bone) runs into the rim of your acetabulum (hips socket) in external rotation (turning the leg so the toes point outwards) and abduction (leg going out to side) and you try and force this, it is like using your thigh bone as a tyre lever to prise open the sacroiliac joint.

So how do you know if you run into such a bony constraint? You will feel a jamming sensation on the leading edge, that is, in the hip in the direction of the movement.

It is not a case of needing to become more flexible. No amount of flexibility is going to change the shape of your hip socket. In such a situation the yoga lesson is contentment, Santosha, with what you have, Satya, honouring the truth of your body, and Ahimsa, doing no harm to your body. Take the sitting posture that is right and comfortable for you.

What to do if you have sacroiliac pain?

Cease all the postures that aggravate it. This will include:
  • Forward bends
  • Asymetric poses, such as warrior poses
  • Anything that twists, including triangle pose, reverse triangle and so on, which are also asymetric, so double reason there.
The job now is to begin to train the surrounding muscles to take up the work of the overstretched ligaments in order to provide stability in the pelvic region. Now that is your core muscles, and I include in the core group the following, some of which are often not counted as core:
  • transverse abdominus
  • miltifidus
  • spinae erectus
  • iliopsoas
  • pelvic floor
  • quadratus lumborum
  • internal and external obliques
Here are some pictures to help you identify those.







There are many ways for you to proceed with this core training, and many lovely yoga practices to help as well. Just do 70% of what you think you can do in any one session, and only begin to reintroduce the full range of postures when you are pain free. And when you do, practice with a new awareness of pelvic stability.

Your well trained yoga teacher can help you to identify practices that will help you and which ones to avoid.

Finally, listen to your body. It is immensely wise.