Wrist Pain in Your Yoga Practice

Wrist pain is a common complaint in a yoga studio. How often have you found yourself rubbing your wrists after a sequence of arm balances? Or how often do you see your students rubbing their wrists after working on arm balances?

Often times we ask our bodies to perform movements that perhaps they were not built to perform or simply not physically ready yet to take on that challenge.

Balancing your body on a delicate joint when placed in a position that it never typically sees during the day is a lot to ask of that joint. Coming into a handstand, Chataranga Dandasana, plank pose or Crane, typically requires more extension in your wrist than you would ever use during your normal daily activities. Not to mention that once you place your wrist in a highly stretched position, you then ask it to hold a good percentage of your body weight. That’s asking a lot….don’t you think?

Let’s stop and take a closer look at our wrists now to have a better understanding of what we are working with.

The wrist is a complex series of bones, joints, ligaments and other forms of soft tissue that connect the arm to the hand, to facilitate fine motor skills, such as typing, writing, pinching and pointing. That’s correct! The wrist was not meant for you to stand on or balance your entire body weight on. That’s not to say you can’t do it, but it makes sense to know how flexible your wrists were meant to be and how much they can bend before you start asking them to hold up your bodyweight.

Many people use the joints of the wrist and hand for weight bearing activities, especially in the gym and in various sports, such as push ups, planks, yoga, gymnastics and cycling. Unlike the foot and ankle, the wrist was not built as sturdy.

The main joint of the wrist is the radiocarpal joint, which is surrounded by a joint capsule and is filled with synovial fluid. The radiocarpal joint is made of up the distal end of the radius (larger bone in the forearm (thumb side) and the first row of carpal bones : scaphoid, lunate and triquetrum. The shape of this joint is condyloid, (like a modified ball and socket) therefore it allows motion in various planes. (Flexion and extension and side to side movement (referred to as radial and ulnar deviation).

The wrist is also comprised of the distal radioulnar joint (the connection between the 2 bones in the forearm), which helps you turn your palm face up and face down. The last joint of the wrist is the ulnarcarpal joint. The distal end of the ulna (thinner bone in the forearm, think pinky side) articulates with the lunate and triquetrum, but is separated by a small disc called the Triangular Fibrocartilage Complex, or TFCC, which covers the end of the ulna. The TFCC can be compared to the meniscus of the knee, and just like the meniscus, it can also be damaged during weight bearing activities, or a fall on an outstretched hand.

The first row of carpal bones articulates with a second row: consisting of the hamate, capitate, trapezoid and trapezium. Each small bone articulates with the adjacent bone in the wrist, which makes this part of the body so complex, yet it allows for the intricate functions of the hand and wrist.

The stability of the wrist comes from the many ligaments that connect each small bone to the next. The band of ligaments on the palmar aspect of the wrist is thicker in size as compared to the band on the back of the hand. This thickness is beneficial when is comes to weight bearing activities.

Muscles that control the gross movements of the hand and wrist are located mostly in the forearm, with tendons that cross over the wrist and attach to the bones in the hand. Muscles that cross the palmar aspect of the wrist (wrist flexors) tend to flex the wrist and fingers, like when you make a fist. The muscles that cross the back of the hand (wrist extensors) tend to extend or straighten the fingers and extend the wrist. Intrinsic muscles are located in the hand and are in charge of fine motor movements. When muscles on opposite sides of the wrist work simultaneously, they tend to stabilize the wrist or work to ulnarly or radially deviate the hand (tilt the hand towards the pinky or towards the thumb.)

Typical range of motion in the wrist joint is about 70° of flexion and extension, and about 20-30° of side to side movement.

To perform plank pose, push ups, Chataranga Dandasana or any other arm balance, you typically need around 90° of mobility in wrist extension. However, having 90° of wrist extension is not the only answer. Of course you want to make sure you have the available range of motion in your wrists before moving into a pose. But you also need to make sure the strength is there as well.

Having a certain amount of strength in a neutral wrist (0° of extension) is not the same as having strength in 90° of wrist extension. When the muscles are being stretched that much they typically are not as strong in that position. They need to be trained to respond and contract with the same amount of strength in 90° of extension, as well as any range in between, in order to be successful and not sustain an injury.

What can you do to limit your chances of injuring your wrist? First, make sure you have the available range of motion before you place the weight on. Then, you need to train the muscles to get strong in the desired position, start small and build bigger. Don't jump right into launching your body up into a handstand.

Building core strength is equally important when thinking about trying an arm balance. Any arm balance, whether it’s plank pose or handstand, requires a great deal of core strength. Build the core in non-weight bearing positions as much as possible before asking the tiny joints of the hand and wrist to support your entire body weight. Instead of flinging your body up into hand stand, gradually build your strength to allow the body to naturally float up into a handstand position, or other arm balance, when it’s ready. Don’t forget about the shoulder joint as well. Having stability in the shoulder joint is crucial to reducing your chance of injury and being successful in most arm balances.

To re-cap, first make sure you have the available 90° of wrist extension, then build strength in the wrist in varying degrees of wrist extension building up to 90°. Improve your core strength, in non-weight bearing ways first, so that when you are ready try more difficult poses like handstand, your body is ready to take on the challenge. Proper alignment and adequate strength and range of motion should not be overlooked when working towards more difficult arm balances. Don't rush it. The journey is as much the reward as achieving the end result.

Click the link below to view Sara's video on Wrist Pain in Your Yoga Practice. If you have any questions about wrist mobility or strength and would like to learn more, please schedule an appointment at the R3finery.

https://youtu.be/kNKtfBBLQ20