YOG-A-NATOMY

Facilitated by Dr Brent Cesare with Zenergy Physical Therapywww.ZenergyHolisticPT.com ZenergyHolisticPT@gmail.com

PREVENTION TOP 3

1. Stay in the “Yum”

2. Maintain a gentle smile

3. Maintain fluid natural breath during asana

5 Most Injured Areas of the Body in Yoga

1. Neck

2. Low Back

3. Knee

4. Shoulder

5. Wrist

Types of Injury

• Sprain

• Strain

• Intervertebral Disc

• Nerve Injury

SPRAIN

Define Sprain : Ligament Injury from Tensile Stress, when the joint is moved beyond its normal range of motion and the ligament is stretched beyond its capacity.

Symptoms: Pain, swelling, bruising, difficulty moving joint, maybe a “pop”

Classification: First degree – mild, only a few fibers of ligament tornSecond degree- moderate, tear of part of a ligamentThird degree – severe, complete tear of the ligament

Most common sites: Ankle, knee, Shoulder, and Wrist

STRAIN

Strain – Tendon or Muscle Injury from Tensile Stress, when muscle fibers tear as a result of overstretching. (AKA – “pulled muscle”)

Symptoms: Localized pain, stiffness, and discoloration around site of muscle

Classification: First degree – damage to individual muscle fibers (<5%)Second degree- more muscle fibers torn but not full tearThird degree – severe, complete tear of the muscle

Most common sites: Hamstring, Achilles, Adductor, Iliopsoas, Rotator Cuff

DISC INJURY

Intervertebral Disc Injury– Injury where the ligaments around the disc, called Annulus Fibrosis, weaken from too much load, and tear. Most mild herniations heal within a few weeks. If the tear is big enough, there may be a “herniation” where the material from inside the disc herniates or bulges out and may irritate the nerve.

Symptoms: Vary considerably from little (or none at all) to severe pain, which can be localized or radiating depending on the tissues Involved. If the nerves are involved, numbness/tingling and loss of strength may occur.

Most common sites: L4-5, L5-S1 comprise 95% of disc injuries

10 Yoga Fouls

1. Hold…Hold …Hold Your Breath

2. Belief: “No pain, no gain.”

3. Compete with your neighbor.

4. It’s a Race. Perform asana as fast as possible.

5. Perform strenuous asanas first/prior to warm up

6. Practice the Postural Law of Detachment

7. Overly Strutting & Flaunting Your Stuff.

8. Renounce Listening to Your Bodys Wisdom

9. Use heavy weights/force to go deeper.

10.Mistake dizziness as a sign of kundalini rising.

JUST BECAUSE YOU GOT IT –DOESN’T MEAN YOU HAVE TO USE IT

TOP 10 (Static) MISALIGNMENTS1. Feet: Arches collapsed 2. Knees hyperextended3. Externally hips4. Femurs forward5. Overly tucked posterior pelvic tilt or overly arched

anterior pelvic tilt6. Shoulder internally rotated or shrugged7. Scapula off back body8. Elbows hyperextended 9. Weight off mound of index finger 10. Head forward of spine

*Special Thanks to Somer with Evolve Physical Therapy & Yoga for Misalignment Slides

Common Misalignments: Feet

Misalignment:

1. Arches collapsed

2. Weight off big toe mound (more toward fifth toe)

3. Feet externally rotated

Corrective Cues:

• Lift & spread toes

• Lift inner heel up toward inner groin

• Draw mound of big toe toward inner heel

• Press base of big toe on the ground

• Point second toes forward

• Take inner thigh bones back

Common Misalignments: KNEES

Misalignment:

1. Knee hyperextension

2. Collapsing knees inward

3. Knee going over toes (with lunges/chair pose)

Corrective Cues:

• Microbend knee• Contract quadriceps• Take top of thigh bones back

• Lift arches of feet• Engage outer glutes• Press down through heels• Isometrically draw heels together

• Take top of thigh bones back (“stick butt out”)

• Weight more in heels

Common Misalignments: Hips

Misalignment:

1. Top of femoral heads forward - AKA hanging on front of hips

2. Shifting hips to the side

- AKA more weight on one leg

Corrective Cues:

• Take top of thigh bones back

• Shift more weight into your heels

• Distribute your weight evenly through both feet

• Press the ground away from you through both feet evenly

Common Misalignments: PELVIS

Misalignment:

1. Too much posterior pelvic tilt

AKA:

- Overly tucked

- Flattened lumbar curve

1. Too much anterior pelvic tilt

AKA:

- Overly arched

- Excessive lumbar curve

Corrective Cues:

• Take top of thigh bones back

• Tilt top of sacrum forward (30°)

• Tilt pubic bone down

• Lift pubic bone up

• Draw lower belly up & in

• Tailbone slightly down

Common Misalignments: LOW BACK

Misalignment:

1. Flattened lumbar curve- Too much posterior pelvic tilt

2. Excessive lumbar curve - Too much anterior pelvic tilt

Corrective Cues:

• Take top of thigh bones back• Tilt top of sacrum forward (30°)

• Tilt pubic bone down & back

• Lift pubic bone up• Draw lower belly up & in• Tailbone slightly down• Lengthen sides of the torso• Usually accompanied with knitting

ribs in• Connect pubic bone toward lower

ribs

Common Misalignments: SHOULDERS

Misalignment:

1. Forward shoulders

2. Shrugging shoulders

Corrective Cues:

• Bring weight to back of head

• Draw scapula up (lengthens sides of torso), back & down

• Bring weight to back of head

• Relax shruggers

• Draw scapula back & down

Common Misalignments: ELBOWS

Misalignment:

1. Hyperextended (weight bearing)

2. Elbow not fully straight in down dog

Corrective Cues:

• Microbend the elbows

• Isometrically hug muscles to bone

• Draw forearms toward one another

• Middle of wrist in line with outer shoulder in down dog

• Externally rotate shoulders

• Contract triceps

Common Misalignments: WRISTS (weight-bearing)

Misalignment:

1. Index finger pad off floor

2. Hands not active

Corrective Cues:

• Press pad of thumb, index & middle fingers down

• Lift upper arm bones away from floor

• Spread fingers

• Press down through the whole hand (palm & fingers)

Breathing

“There is one way of breathing that is shameful and constricted. Then there’s another way; a breath of love that takes you all the way to infinity.”– Rumi

ANATOMY: LOW BACK

• Disc Pressure is highest in forward bends, lifting, slump sitting, and twisting

• Disc Pressure is less when lying, standing upright, or in supported backbend

• Higher disc pressure, if repeated or prolonged, relates to increased chance of disc injury

TOP 5 WAYS TO PREVENT LOW BACK INJURY with Forward Bends

1. Bend Knees during transitions in and out of forward bends2. Never FORCE the spine of yourself or your student into a forward

bend (including pushing on students back to assist with more motion, eg Pascimottanasana)

3. Sit well – teach students to maintain normal lordosis of lumbar curve when sitting, in asanas such as Baddha Konasana. Can also use prop/blanket under hips/sit bones to help prevent lumbar flexion in sitting. Lengthen spine.

4. Maintain well rounded practice – forward bends should be balanced with side bends, backbends, and rotation.

5. Bending at the hips should be emphasized before flexing the back. Practice the 90 degree rule: Do not start to flexing the lumbar spine in a forward bend (such as Pada Hastasana) until the hips can achieve 90 degrees of flexion.

TOP 5 WAYS TO PREVENT LOW BACK INJURY with BackBends

1. Feel comfortable, backbends should be without strain to the low back or neck.

2. Move into backbends slowly, to avoid the tendency to fulcrum3. Advise student to lift the chest, raising the breast bone

(“Sternum”, which will aid in activating the thoracic spine and spinal extensors for support,

4. In standing, verbally cue students to gently engage their abdominal muscles and bandhas for support of the low back (This is an eccentric contraction of abs).

5. Smooth, fluid movement

**Some teachers recommend contracting the gluteus maximus to help off-set hyper-extension of the lower lumbar spine – I think this is a good idea.

TOP 5 WAYS TO PREVENT NECK INJURY

1. Avoid hyperextending neck with backbends. (Cobra). Maximally extend upper back before lengthening neck.

2. Maintain a little neck tension on the front of the neck with neck extension.

3. Avoid placing pressure on head during inversions (fish, headstand, shoulder stand, wheel)

4. Utilize mid back with twists. Don’t force neck into rotation.

5. Correct forward head posture to avoid repetitive strain.

KNEE ANATOMY

• KNEE HEALTH • Bones: Femur, Tibia, Patella, Fibula• Muscles: Quadriceps, Hamstrings, Calf muscles• Ligaments: ACL, PCL, MCL, LCL, medial• Cartilage: Medial & Lateral Meniscus• Joint type: Hinge• Normal Range of Motion: 0 degrees extension – 135

degrees flexion• Most injuries will occur from hyperextension – knee

extending past it’s normal• range of motion• Structures limiting extension: ACL and posterior

knee capsule/ligaments• Structures limiting flexion: Quadriceps tightness or

heel blocked by buttock•

• Key Points :• Align knee over ankle -• (Micro-bend) Keep the knee “soft” – especially with

balance postures•

• Asana Awareness to maintain Knee over ankle• Bridge, Equestrian, Warrior I and II

TOP 5 WAYS TO PREVENT KNEE INJURY

1. Microbend knee in standing/balance postures, as to not hyper-extend.

2. Maintain knee over foot with asanas requiring knee flexion/lunges/warriors. Avoid bending knee too far in front of foot.

3. Avoid knee moving medially to foot.

4. Energize/activate quadriceps, adductors in standing poses.

5. Maintain arches/use toes & entire foot for balance.

SHOULDER ANATOMY

• SHOULDER HEALTH• The shoulders are utilized on almost every asana in Yoga. The Gift of the Shoulder

Complex is to help us place our hands exactly where we want them, to engage our body with our environment. Thank your shoulders!

•

• Bones: Scapula, Humerus, Clavicle• Muscles: Rotator Cuff, Deltoid, Latissimus Dorsi, Pectoralis Major, Pec Minor, Teres

Major• Ligaments: Coraco-humeral, Gleno-humeral, Coraco-acromial• Cartilage: Glenoid Labrum• Joint type: Ball and Socket• Normal Range of Motion: Flexion 180’, Abduction 150’, External and Internal

Rotation 90’• Various shoulder injuries can occur in Yoga:• The shoulder has more freedom of movement than any other joint in the body/

but this also makes it susceptible to hypermobility and injuries to tendons (rotator cuff) and ligaments if overly stretched

TOP 5 WAYS TO PREVENT SHOULDER INJURY

1. Avoid pushing your shoulder beyond its limits to gain more flexibility. If you feel weak or unstable in shoulders, focus more on stability than range of motion.

2. Develop body awareness to minimize poor shoulder posture, where the scapula is elevated (shoulders are toward the ears) or protracted

3. Strengthen shoulder muscles when possible to avoid shoulder injury. The rotator cuff muscles (subscapular is, infraspinatus, supraspinatus, teres minor) help with creating more space for the shoulder (humerus to move around the scapula bone) when raising the arms overhead.

4. Learn to move your shoulder girdle (scapula and humerus) as a unit

5. Stabilize the shoulder when possible by activating the muscles around the shoulder joint to offer more strength and stability.

TOP 5 WAYS TO PREVENT WRIST & ELBOW INJURY

1. Spread fingers and place weight across entire hand.

2. Activate hand muscles. use entire hand for support.

3. Maintain neutral wrist: Avoid hyperextending wrist.

4. Maintain neutral wrist: Avoid excessive internal or external deviation.

5. Press weight through hand, so not to hinge weight on wrist.

TOP 10 PREVENTION TECHNIQUES IN YOGA

1. Listen To Your Body: Yum-Yuk2. Slow, Smooth Breathe: Strain indicator 3. Move Slowly – through transitions4. Move Mindfully 5. Move Easefully “Never Force”6. Know Your Body (Strength & Weaknesses)7. Consciously contract/energize around weak areas8. Beginner Mind9. Breathe-Mind-Body Awareness10.Find the Sweet Spot: Energy, Flexibility, Strength