Reducing Shoulder Impingement
Many Yoga poses and flows involve large movements at the shoulder joint. Some of these movements have the potential to create shoulder impingement when improper technique and movements line are applied. If this shoulder impingement continues over time, chronic injury can form leading to pain and dysfunction.
What is Shoulder Impingement?
Shoulder impingement is caused when the arm is lifted above the line of the shoulder. The head of the arm bone (humerus) lifts and rotates into a portion of the shoulder blade (acromion on the scapula). Covering the head of the arm bone are the 4 rotator cuff muscles: the supraspinatus, the infraspinatus, the subscapularis, and the teres minor. Acting as cushioning against pressure and friction, there are bursa sacs that lie between the muscular capsule and the acromion.
When the arm is lifted high over the level of the shoulder, the head of the humerus presses into the acromion. This pressure and friction can develop into inflammation of the bursa (bursitis) or the tendons the muscles (tendonitis). This inflammation can worsen due to repeated impinging actions that can eventually lead to increased pain and limited movement.
Where can Shoulder Impingement Occur in a Yoga Practice?
Shoulder impingement can occur in variety of Yoga postures and flows. Here is list of common yoga postures that set the arm bone above the line of the shoulder and can generate damaging frictional forces in the shoulder joint if one is not mindful:
- Sun Salutations – the motion of folding into Mountain Pose (Tadasana) into Standing Forward Bend (Uttanasana) often incorporates a large sweeping motion of the arms over the head.
- Extended Side Angle Pose (Parsvottanasana)
- Extended arms in Child’s Pose (Balasana)
- Half Moon Side Stretch Pose (Ardha Chandrasana)
- Gate Pose (Parighasana)
How to Reduce the Incidence of Shoulder Impingement in Yoga Poses
The first method in reducing the pressure caused by shoulder impingement is to eliminate arms transitions that move the arm bone through large sweeping motions. In Sun Salutations, consider keeping arms in the forward plane, instead of lifting arms out to the side, back, up and then over head. By lifting the arms forward instead, there is less pressure being created against the head of the humerus as the arm bone moves back and up.
The greatest amount of pressure tends to occur where the arm is situated high above the shoulder line with the arm bone back in line with the neck and the arm bone rotated internally (medially) so the palm faces forward.
If the yoga posture requires the arm to be overhead and in line with the neck (like Extended Side Angle Pose), take extra note of the position of the hand. The hand should be turned inwards towards the body creating an external rotation of the arm bone. This external rotation has a tendency to draw the head of the humerus down from the acromion and scapular structures. This outward rotation of the arm bone offers secondary benefits as it encourages the shoulder blades to draw down away from the ears, thus bringing more integrity to the shoulder girdle and freedom to the trapezius and neck regions.
If you are ever experiencing regular pain in the shoulders, consult a health care professional to have your condition properly diagnosed and treated. Continue to acknowledge that Yoga poses are a means to create expansion and vitality. With mindful alignment and awareness to joint positioning, you can maintain space and energy flow through the shoulders and readily avoid impinging movements.
Addiction Recovery Through Yoga
With all the images online of toned women in tights pulling themselves into pretzel-like poses, it’s easy to focus on the physical side of yoga, thinking of it as an exercise class that ends with a mini nap. But the ancient practice of yoga can also help with drug and alcohol addiction, diseases that affect millions of us in this fast-paced, modern world.
While yoga can be a powerful tool for personal transformation and recovery, many people write it off before even stepping onto a mat, saying they’re not flexible enough or they can’t afford the classes. Yet the mind-body connection, stress relief and personal growth that can occur through the regular practice of yoga can be just what a recovering addict needs. Yoga encourages a person to reconnect to their breath, body, mind and heart. Here are just a few ways yoga can help release the mind and body from the grips of drug and alcohol addiction.
Yoga Eases Stress
“It was such a crazy/stressful/hectic day… I need a drink” is such a common phrase in our culture, it’s easy to forget that there are healthy ways to cope with stress. Many addicts have become so dependent on their substance of choice, they’ve forgotten that movement or even just a few deep breaths can bring a real sense of calm to the day. And that moment of calm can lead to healthier choices as you move toward a sober life.
The benefits of mindful movement and breathing, which are at the center of many yoga classes, have been proven to increase overall health.
According to the American Institute of Stress, 20 to 30 minutes of deep breathing has been shown to help the body kick into a relaxation response, where stress levels drop and blood pressure decreases. “Deep breathing increases the supply of oxygen to your brain and stimulates the parasympathetic nervous system, which promotes a state of calmness,” according to an article on the organization’s website. “Breathing techniques help you feel connected to your body—it brings your awareness away from the worries in your head and quiets your mind.”
Nearly all yoga classes encourage students to consciously inhale and exhale, which brings peace to the mind and body, even as we move through a practice. If you commit even further, and regularly practice at home or at a studio, you might find yourself using deep breathing or a short yoga sequence to help you stay strong through a moment of temptation or stress.
This is especially important for addicts, as many suffer from post-acute withdrawal symptoms, or PAWS, in the early stages of recovery. These symptoms often include anxiety and mood swings. One study has shown that yoga directly helps to increase GABA, a neurotransmitter that aids in relaxing the nervous system, therefore improving your mood and decreasing anxiety.
Yoga Increases Self-Awareness
Addicts are often accused by their loved ones of being selfish. But devoting regular time to the kind of reflection that comes with yoga can be beneficial to those in recovery. More meditative types of the practice, like Yin Yoga, where there is little movement and just a few poses done in a single class, can create a meaningful space for really checking in with ourselves. While the questions that come to mind might not always be pleasant, these classes are set up as safe spaces for students to release emotions, and teachers are aware that their students might be struggling with all kinds of personal issues while in their studio. This type of contemplative yoga can help with anxiety, depression and even sleep issues. By dealing with some of the other factors that might be causing stress and unhappiness in your life, you might have more resolve or energy to commit to a recovery plan or time in a rehabilitation center.
Addressing the Roots of Addiction
Yoga is not superior in dealing with one addiction over another. Yoga begins to address the roots of a problem rather than the symptoms, making it a common tool among recovery from many addictions. If someone struggling with alcohol or drug addiction gets sober only to find him- or herself struggling with another addiction, such as food or gambling, yoga practices can be implemented to support in recovery from both addictions.
Yoga for General Wellbeing
Yoga can also be used as a tool to support general wellbeing regardless of addiction. For example, long deep breathing, or “yogic breathing,” has been shown to reduce levels of the stress hormone cortisol and increase stress resilience. Yoga can also be used to assist in dealing with trauma. According to Dr. Bessel van der Kolk, an expert in the field of trauma treatment, yoga may be more effective than many medications in treating PTSD. “Medication can be quite nice to sort of dampen some of the symptoms,” he states. “But in the end, people need to own their bodies, they need to own their physical experiences. And, in order to overcome your trauma, it needs to be safe to go inside and to experience yourself.”
Yoga asks you to show up for yourself. Although deep breathing can help relieve stress at any moment during the day, a physical yoga practice requires regularly carving out time for yourself. Even if you are just going to spend a few minutes stretching in your living room, you still must make the time to practice. As with any other type of physical exercise, you’ll see more benefits if you practice regularly. Yoga, for example, has been proven to ease chronic back pain and joint pain. Some studies have found that it can also help with mental health issues.
German researchers, for example, studied a small group of women who described themselves as “emotionally distressed.” Over a three-month period, they took two 90-minute yoga classes a week. At the end of the study, their stress, anxiety and overall health all improved. Similar studies have also shown the one-off benefits of even attending a single yoga class. The uniting factor in all of these cases? The participants showed up for themselves and attended a class. They might have had stressful days or felt anxiety about trying yoga or were plagued by depression, but they put all of that aside and spent the hour (or more) bending, breathing and stretching.
It’s easy to put off a yoga practice: to buy a mat or a DVD and let it go dusty. Or to attend a single class, but never step foot in the studio again. But the more you commit to yourself, and a regular mind-body practice, the more overall benefits you’ll begin to see and feel. A single healthy decision, like deciding to roll out your yoga mat, can change your focus for the day and encourage another healthy decision. Over time, those mindful moments will add up, perhaps leading to an overall more positive outlook and healthier lifestyle.
The Art of Surrender
Yoga requires us to surrender. The first of the 12 steps in Alcoholics Anonymous is “We admitted we were powerless over alcohol, that our lives had become unmanageable.” In a similar vein, yoga asks again and again that we drop everything that is not necessary in our lives. Most teachers will begin the class with a mind-clearing exercise and a short moment to set an intention. This helps us focus on the moment, and release all the other stresses in life. Similarly, some poses require surrender, as well.
Maybe there’s a complicated pose in class that you simply cannot twist your body into. That doesn’t mean you have to flop down on your mat or write the pose off for good. It simply means that accepting that today, that pose is not happening.
The same idea is true during some of the more “relaxing” poses. While your body might be still in a seated position, you may feel your mind racing. Again, yoga teaches us to simply surrender and to be present with who we are, where we are, right now. By engaging in a regular practice, we learn that acceptance comes with not being able to control the world around us but by allowing the world around us to exist as it is. By doing so we learn the art and gift of peaceful surrender.
In terms of learning to let go of expectations and limitations, yoga can be a boon for those who are recovering from addiction. In AA, the moment of surrender becomes “the firm bedrock upon which a happy and purposeful life is built.” The same is true in yoga: When we accept that a pose is out of our reach or that our minds cannot be quieted, we might finally find a moment of true freedom.