Carpal Tunnel and Yoga
Knowing where your carpal tunnel is and its function is important for those doing yoga and for those with occupations requiring repetitive loading of the hands and forearms. Without this knowledge, you may be causing damage to this important canal without realizing it. Many people can recognize the symptoms of carpal tunnel syndrome, but identifying the risk factors is much more valuable. In order to do this, you must understand what the carpal tunnel is and what its function is.
What is Carpal Tunnel Syndrome?
The carpal tunnel actually is a tunnel on the palmar side of your wrist. This tunnel houses our forearm flexor tendons as well as our median nerve. When the space available for the median nerve is compromised, carpal tunnel syndrome symptoms appear. These symptoms can include pain, numbness, tingling, weakness, or even burning into the majority of the palm of your hand, palmar side of your index to pinkie fingers as well as the tips of the back side of the same fingers.
How Do We Get Carpal Tunnel Syndrome?
Each of our tendons is encased in a tendinous sheath known as synovium. When our tendons are irritated from overuse, the synovium becomes inflamed. This inflammation decreases the area of the carpal tunnel allocated for the median nerve.
The position of the wrist can also decrease the space available for the carpal tunnel; this can happen through excessive flexion or extension of the wrist.
The last way the median nerve can be affected is through direct compression over the carpal tunnel.
Examples of the Above Reasons for Carpal Tunnel Syndrome
It has been proven that repetitive forceful contractions such as factory work or over-gripping a mouse or even a kitchen knife can lead to synovium inflammation and subsequent carpal tunnel syndrome.
Let’s tie this to yoga; when you are in upward dog or plank for that matter, are your shoulders over your wrists? If your shoulders are in front of your wrists, your wrists are in too much extension and this will lead to decreased space for the median nerve over time.
Excessive wrist flexion is not seen in yoga, but perhaps you sit at a desk that is too low for you and your wrists are continually flexed to accomplish your typing tasks. Perhaps you slept with your wrists fully flexed only to wake up in the middle of the night with numb hands? If you do, remember that your median nerve is essentially being compressed and therefore causing your symptoms.
This is a very common cause of carpal tunnel syndrome in yoga as most people do not know how to properly place their hands on the ground in poses such as upward and downward facing dog pose. Look at the palm of your hand and draw a line from the tip of your middle finger to the crease of your wrist; now do the same from your thumb to the crease of your wrist. Where these two lines intersect is the location of your carpal tunnel. Place your hand on a flat surface and draw the meaty portions of the palm of your hand towards each other to create an arch at your carpal tunnel. Create this arch while distinctly planting each of your fingers into the ground instead of just resting on your carpal tunnel while in poses such as upward and downward dog; this will protect your carpal tunnel.
How Yoga Can Help Carpal Tunnel Syndrome?
Evidence exists in the medical research community that yoga can be an effective method for treating carpal tunnel syndrome. A study written up in the Journal of the American Medical Association showed yoga to me more effective than splinting in the management of carpal tunnel syndrome. Often, in such studies, the poses are modified to better suit the subjects with considerable symptoms.
The idea behind yoga helping is that it can floss the median nerve through the carpal tunnel to help mobilize the nerve; stretching may relieve compression on the carpal tunnel; improved joint posture could diminish intermittent compression on the nerve; the effects of blood flow restriction on the median nerve could also be improved with increased blood flow; and possibly yoga could decrease the risk of double crush nerve entrapment symptoms related to nerve entrapments closer to the neck or armpit.
Take Home Points
Through avoiding synovial sheath inflammation, excessive wrist flexion or extension, and compression of the carpal tunnel, you should be able to dodge carpal tunnel syndrome. There are a few other risk factors that play into this condition such as diabetes, obesity, pregnancy, hypothyroidism, arthritis, and trauma. Therefore, we should make a concerted effort to avoid the risk factors that are within our control. If you DO have carpal tunnel syndrome, check in with your health care practitioner to determine if yoga could be helpful for you! Be sure to be mindful of your wrists on your mat; wrists certainly are important in our lives so keep them as healthy as you can!
Click the following link for additional research information on yoga for CTS.
Hatha Yoga Poses
Swami Svatmarama’s Hatha Yoga Pradipika (Light on Yoga) is one of the most influential early texts on hatha yoga practice. Written sometime between the 14th and 15th century CE, the text includes descriptions of 16 hatha yoga poses, eight pranayama (breathing) techniques and a number of different seals (mudras) to be used to redirect prana (energy) during meditation.
Swami Svatmarama believed that the regular practice of Hatha Yoga asanas could give “steadiness, health, and lightness of body.” As such, he recommended that the practice of yoga asana should be performed as the first step in the practice of Hatha Yoga.
Many of the postures in the Hatha Yoga Pradipika are variants on the full lotus pose, and as such are relatively advanced in nature. This article includes a brief survey of 10 of these hatha yoga asanas, an overview of their benefits and instructions for their practice.
Virasana stretches the ankles, gluteal muscles and other smaller muscles in the hips.
In modern day practice Virasana is performed with the shins facing downward with both legs parallel to the sides of a yoga mat. In contrast, Swami Svatmarama’s description of Virasana much more closely resembles the modern day for of Gomukhasana, (Cow-Face Pose). Instead of folding the legs back near the sides, this pose is done with one leg crossed over the other.
While the modern day equivalent of this posture includes specific positioning exercises for the arms, Swami Svatmarama only includes instructions on leg positioning.
Come to Dandasana, (Staff Pose – a seated posture with both legs straight). Cross your right knee over your left knee, and draw your right foot back near the side of your left hip. To do the same with the other leg, lean to your left and draw your left foot back near the side of your right hip.
One you’ve wrapped your legs into the initial position, lean forward and use your hands to press your knees closer together. With practice, one knee will stack on top of the other. Draw your feet tightly back near your sides, ground both sitting bones downward into the floor, lengthen your spine upward, and forward fold over your legs to deepen the stretch.
Kukkutasana, (the Rooster’s Pose) strengthens the chest, shoulders, arms, and wrists, and improves balance. Full performance of the posture requires the ability to comfortably sit in Padmasana (the Full Lotus pose)
From a seated position, draw your right foot into the half lotus pose by placing the blade edge of your right foot in your left hip crease. Lean back, grab your left foot, and draw it up and over your right knee in similar fashion. Continue sliding your left foot up the front of your thigh until the edge of the left foot rests near the right hip crease.
Once you’ve positioned your legs in the full lotus pose, thread your right wrist and forearm into the space between the muscles of your right calf, inner thigh muscles and hamstrings. Slide your left wrist and forearm into the same position on the other side.
To enter the final posture, rock backward slightly to get momentum. Next, rock forward quickly onto your hands and lift your buttocks off of the ground.
Uttanakurmasana (the Upside Down Tortoise Pose) stretches the muscles of the hips and the back. The pose also tones the abdominal muscles.
After holding Kukkutasana for some time, allow your hips to settle back down to the ground. Keep your arms threaded through your legs and roll onto your back. Belly crunch up, slide your arms even further through your legs, bend your elbows and hold your chin with both hands.
The Hatha Yoga Pradipika lists a number of specific benefits for Matsyendrasana (the Lord of the Fishes Pose). These benefits include increased appetite, the destruction of multiple diseases and the awakening of kundulini energy.
From Dandasana place your right foot in the half lotus pose. Roll your weight toward your right hip and cross your left ankle over the top of the right knee as if you were going to do the full lotus pose. Allow your left foot to rest on your thigh, just near your right knee.
To initiate the twist, draw your left knee toward your chest so that your left knee faces upward and place your left foot on the floor. Twist your torso to the left, cross your right elbow over the leg and grab your left foot with your right hand. Place your left hand on the floor behind you to stabilize the balance, or alternatively, wrap your left arm behind your back to grab your right inner thigh.
Paschimottanasana (the Intense Back Stretch) is a deep stretch for the entire posterior chain of the body. The posture creates openness in the calves and hamstrings and can relieve tension in the back muscles as well.
According to Swami Svatmarama, Paschimottanasana is one of the most important hatha yoga asanas. He claims that the posture increases health, reverses the breath’s flow, improves digestive power and flattens the belly.
While the modern form of this posture is typically taught with a relatively straight spine, Swami Svatmara’s variation integrates strong spinal flexion for a deeper stretch to the back muscles. Because of this, the text directs the practitioner to rest their head on their knees as opposed to the shins.
From Dandasana, straighten both legs. Grab the flesh of your buttocks and slide your sitting bones backward to tilt your pelvis forward. Internally rotate your thighs by rolling your upper thighs inward and reach forward to grab your big toes. Ground downward through your hip-creases, pull your belly in and elongate your spine. Forward fold, and allow your head to rest on your knees.
Mayurasana (the Peacock’s Pose) is a challenging posture that strengthens the wrists, chest, shoulders, back muscles, and the gluteal muscles. Regular performance of the posture also improves balance.
The Hatha Yoga Pradipika attributes a number of benefits to this hatha yoga pose. According to the text, this posture is said to be good for digestion and is purported to have the ability to overcome poisonous snakebites. It’s also credited with the ability to overcome numerous diseases, including enlargement of the spleen and enlargement of the abdomen.
Come to a kneeling position on your shins. Sit on your heels and slide your knees apart until they’re slightly wider than hip’s width apart.
Place your hands on the floor between your legs, with your wrists facing forward and your fingers facing your waist. Lean forward, place your elbows on your abdomen and transfer your weight forward until your knees lift off of the floor. Maintaining the balance, straighten both legs as you continue to hover.
Dhanurasana (the Bow Pose) stretches the hip flexors, abdominals, chest and shoulders. The posture also strengthens the back muscles.
In the modern day form of this hatha yoga asana, the arms are extended backward and the ankles are clasped in order to open the chest. The version in the Pradipika integrates a more challenging overhead bind into the posture for a much deeper shoulder opening.
Lie down on your belly and prop yourself up on your elbows like a sphinx. Bend your legs and externally rotate your ankles so that your toes point outward toward the sides of your mat.
Rotate your torso to your right, turn your right hand upward, and clasp the inner arch side of your right foot with your right hand (or alternatively, your big toe). Press your right foot upward into your right hand and rotate your elbow outward and upward until your elbow points toward the ceiling. Continue to hold on, rotate your chest left, and do the same on the other side.
Bhadrasana (the Auspicious Pose) stretches the the inner thighs and opens the muscles of the pelvic floor.
In modern practice, this hatha yoga asana is more commonly known as Baddha Konasana (the Bound Angle). While the modern form of Baddha Konasana often integrates spinal flexion with a variety of different forward folds, Swami Svatmarama’s variation is done while remaining upright.
Draw your heels toward your inner groin and allow your knees to drop outward like the pages of an open book. Place your hands behind you on the floor, lean forward slightly and slide your hips closer to your heels.
Once you’ve positioned your hips and legs, reach around to grab your feet or big toes with both hands. Sit up tall and press your knees outward and downward toward the ground.
Padmasana (the Lotus Pose) is an excellent pose for seated meditation because it makes it very easy to avoid slouching. The posture also creates openness in the hips and inner thigh muscles. In addition, the Hatha Yoga Pradipika mentions that this hatha yoga pose also clears blockages in the body’s energy channels (nadis) when done regularly.
Come to a comfortable, cross-legged seated position with your right leg crossed in front of the left. Pick up your right foot with both hands, swing your right knee out to the right hand side of the room, and draw your heel closer to the front of your body. Continue pulling your right foot inward toward your belly and slowly swing your right leg to the left until the edge of your right foot rests in your left hip crease.
Once the right leg is in the half lotus pose, place one hand behind you on the ground and lean backward. Use your other hand to pull your left leg upward and over your right knee. Slide your left foot to the right hip crease.
Once your legs are in the full lotus pose, Swami Svatmarama recommends that you sit up tall, place your upturned hands on your thighs, and redirect your eyes to the tip of your nose.
The Hatha Yoga Pradipika mentions that Savasana (The Corpse Pose) is restful for the mind and good for removing fatigue.
Lie on your back with both eyes closed. Slide your legs apart until your legs are positioned hip’s width apart or wider, and let your big toes fall outward toward the sides of the room. Slide your arms out from your sides as well. Your palms can either face upward or downward.
Close your eyes, and redirect your focus to your breath.
Please note, all asymmetrical postures should be done on both sides. A full overview of all 16 hatha yoga poses can be found in Brian Dana Aker’s translation of the Hatha Yoga Pradipika.