Building Upper Body Strength the Easy Way

by Nina

It’s only natural, I guess, that when you start blogging about yoga, your friends are going to ask for your advice, even when you’re on vacation. Luckily for me, I love helping my friends and truly enjoy giving them short private lessons, and seeing their eyes light up when they realize there are some easy yoga solutions to their problems in one of my ideas of FUN.

This time my friend Carol asked me about her right shoulder and wrist, the ones she over-uses when she spends so much time in front of the computer moving her mouse around. She was under the impression that to protect her shoulder and wrist she should not use them very much, even when she was doing yoga. To baby them, in other words. I assured her that, to the contrary, to protect her shoulder and wrist she should be both strengthening and stretching her shoulders, arms, wrists, and hands. Then I gave her a quick private lesson to show her some easy poses she could do on a regular basis.

For her wrists, I showed her the wrist flossing sequence (see Featured Sequence: Wrist Flossing) that is so helpful for preventing carpal tunnel syndrome and other wrists problems. For stretching her shoulders, I showed her a passive backbend over a blanket roll, with her arms overhead and straight, using a strap around her upper arms to make it easier to stay in the pose for around three minutes. I also taught her the doorknob version of Upward Plank pose (Purvottanasana) because she could easily do this in her work place and it’s a nice counter-pose to sitting hunched in front of a computer (see Upward Plank variations). Of course there are many other shoulder stretches, many of which we’ve been covering in our office yoga series (Arm Circles, Eagle pose Arms, Cow-Face pose Arms, etc.).

But what about building upper body strength? I assured her that, no, she didn’t have to do handstands or arm balances, and there were many easy yoga poses that help build upper body strength. Then I quickly ran through a lot of suggestions for her that I thought I share with you today. Hopefully, in the near future, we’ll be able to explore some of these poses in greater depth.

Any pose where you put weight on your arms builds upper body strength, including Cat pose, Downward-Facing Dog, Upward-Facing Dog, Plank pose, Sideways Plank pose (Vasithasana), Upward Plank pose (Purvottanasana), and so on. If you are worried about putting weight on your wrists, you can use a wedge to change the angle of your wrists, do some of the poses with your forearms on the floor instead of just your hands (for example Downward-Facing Dog with forearms on the floor). You can even do Upward Plank pose standing a few feet away from the wall, with one hand on the wall, your outside leg in Tree pose, and your second out to the side or overhead (I swear, I will take a photo of this one of these days). One of my favorite upper body strengtheners, which I learned from yoga teacher Julie Gudmestad, is to move back and forth, several times, between Downward-Facing Dog and Plank pose.

Plank pose

Also, any pose where you hold your arms up or out to the side builds upper body strength, including Warrior 1, 2, and 3, Tree pose, Triangle pose, Extended Side Angle pose, Half Moon pose, and so on. Do you doubt me? Try keeping your arms in position instead of releasing them as you change from the first side to the second side of Warrior 2 (or any other pose). I bet you’ll find it’s harder than you expected.

There are so many possibilities that I once taught an entire workshop on the subject. Here is the mini practice I sent those students home with:

1. Cat pose

2. Downward-Facing Dog pose

3. Standing Forward Bend

4. Two Sun Salutations with Plank instead of Chaturanga

5. Sideways Plank pose (Vashithasana)

6. Upward Plank pose (Purvottanasana)

7. Child's pose

I hope this inspires you to incorporate some upper body strengthening into your home practice!

Friday Q&A: Ganglion Cysts

Q: I get a ganglian cyst at the top side of my wrist and sometimes the top of my hand from doing poses that put pressure in those areas. Plank positions, Upward-Facing Dog, etc. Any recommendations?

A: Dear Ganglion Cyst,

Thanks for writing in about this. I, too, have had a cyst in my wrist area many years ago that was of the ganglion cyst variety. These cysts are considered benign, and may grow up out of the tendons of the wrist and hand bones. Scientists still do not know what causes them, so prevention is not an issue.  But dealing with them once they arise is an issue, especially if they interfere with your regular activities.

First off, I'd recommend that you confirm your diagnosis of this common and benign form of a mass that can appear on and around the hands and wrists. A trip to your family MD should do the trick,  with the caveat that they may recommend an ultrasound or drawing a bit of fluid from the mass to confirm that it is indeed fluid filled.

Once you have a confirmed diagnosis, it is important to decide if modifying your practice is needed. The main reason to do so is if the cyst is causing you pain,  especially in the poses you mentioned. If it is,  you may be able to avoid those aggravating poses until the cyst gets smaller. Over half of all ganglion cysts will resolve on their own without specific treatment. So we are talking about any pose that bears weight on the hands and wrist joint and takes the wrist into full extension.  As noted, plus a few more, such as, Plank, Chaturanga, Upward-Facing Dog, Handstand, and most other arm balances done on the hands could all make things worse before they get better.

Avoid the old folk remedy of smashing the cyst with a bible or any other large book for that matter. This has not been shown to beneficial and the cyst can return and be harder to treat if treatment is ultimately necessary. If you want more information on the western medical approach to ganglion cysts, check out this website: emedicinehealth.com. And let us know how things unfold for you and your cyst.

Namaste,
Baxter

A: Since your pain symptoms could be worsened by excessive pressure on the wrists, you should modify the poses that cause pressure. The way to think about pose modification is to look at your wrist and if your wrist "folds" are visible, then there is pressure on the wrist itself.  I might use a chair for Dog pose or do Dog pose with the forearms on the floor (or chair) . The same modification can be used to do Plank pose. Shoulderstand would also have to be modified. Doing the chair version of Shoulderstand, which is less active, would keep the wrists from being vulnerable and keep them in a neutral position. Standing poses, forward bends and twists don't  need modifications. But as long as the cysts are present, I would avoid active Dhanurasana (Upward Facing Bow pose) and other backbends where you use your hands to support yourself and wait till they reabsorb. Passive backbends would still be possible. —Shari

Friday Q&A: Is Loren Fishman's Osteoporosis Sequence Safe?

Q: You say that people should not do the same poses all the time. What about programs like Dr. Fishman's osteoporosis study, which has participants doing the same sequence of poses every single day?

A: Thanks for this question. Indeed, if a person does the same sequence day in and day out, you could run the risk of a repetitive strain injury. The fact that Dr. Fishman's sequence is only supposed to take 10 minutes a day to do means that the practitioners are not holding the poses terribly long, which would reduce this risk considerably. However, a review of the poses taught (see here) reveals several poses that I feel could be potentially injurious to the wrists, neck and lower back, these being Upward Bow pose and the deep seated forward bends. I would consider other poses if I were to design such a practice, but Dr. Fishman does mention tailoring the sequence to students individual needs. I would suspect that this had to be done quite a bit.

Recall that the number of patients that started the study was much larger than those that completed the study. (117 vs 11). Interestingly, there is no discussion as to what caused so many to drop out  and why they were unable to do a 10 minute practice everyday. One factor could have been boredom, which is why I often suggest that students alternate practices from day to day to help maintain better focus and follow through. And it is possible that some found the sequence too advanced, despite the individual adjustments offered. The bottom line, in real life, when you can vary your practice, I highly recommend you do so.

—Baxter

A: With Baxter's blessing I'm going to tell you why I wouldn't want to do this sequence on a daily basis. I'll start by telling you that the three yoga injuries I've sustained have all been repetitive strain injuries. I was a pretty enthusiastic practitioner for a number of years, and did a lot of standing poses and sun salutations. And the injuries I had were: sacroiliac joint injury (common among dancers and yoga practitioners, but not the general public), tennis elbow (possibly from sun salutations), and housemaid's knee (from kneeling too much on the bare floor).

Now let's look at the sequence:

1. Triangle Pose (Trikonasana)
2. Downward-Facing Dog Pose (Adho Mukha Svanasana)
3. Upward-Facing Dog Pose (Urdva Mukha Svanasana)
4. Bridge Pose (Setu Bandhasana)
5. Upward Bow Pose/Rainbow Pose (Urdva Dhanurasana), without or with a chair
6. One-Legged Forward Bend (Janu Sirsasana)
7. Two-Legged Forward Bend (Paschimottansana)
8. Boat Pose (Navasana)
9. Reclined Leg Stretch (Supta Padangusthasana)
10. Marichyasana 1 twist
11. Lord of Fishes twist (Matsyendrasana)
12. Reclined Twist (Jathara Parivarthasana)

After I got over the shock of trying to imagine doing all those poses in 10 minutes, without any warm-ups, I examined the poses in detail. First, two of the poses in the sequence are known for causing sacroiliac joint injuries, Triangle pose (Trikonasana) and One-Legged Forward Bend (Janu Sirsasana), with One-Legged Forward Bend a particularly guilty party. For me, personally, I've concluded it's just not good to do either of those poses every single day. Then, as Baxter mentioned, there is a very deep backbend in the sequence, Upward Bow, and doing this every day could put a lot of strain on the wrists and elbows, but of just as much concern to me is that it is followed immediately by a deep forward bend, taking the lower back into such extreme movements with no rest between. In particular, the Two-Legged Forward Bend is known for causing lower back strain. The combination of the deep backbend followed by the deep forward bend could cause a lot of back strain (personally, I would have moved the forward bends to the end of the sequence). The sequence ends with three twists, asymmetrical poses that are also hard on the sacroiliac joint, with no symmetrical counter pose to finish the sequence. (On the bright side, no danger of housemaid's knee here.)

I understand some of the thinking behind this sequence, which tries to engage all the different muscles of the body to strengthen as many bones as possible, within a short sequence, and uses the twists to "release" the back after the strain of the backbends and forward bends. However, if I were to design an osteoporosis practice, for safety's sake, I would develop five or more different sequences that the practitioner could alternate between on different days, rather than trying to cram everything into one single practice. There are so many wonderful poses in the yoga tradition, why would you limit yourself to just 12?

—Nina

Featured Sequence: Wrist Flossing for Wrist Care

by Nina

In Baxter's post on wrist care (see "Wistful Wrists: How to Keep Your Wrists Safe"), he recommended a wrist "flossing" sequence developed by Tom Alden that was featured in Timothy McCall's book Yoga As Medicine. This is a wonderful sequence you can do if you over-worked your wrists doing yoga, have wrist problems, such as carpal tunnel syndrome, or just want to give your hands and wrists a break during a marathon typing session. There are three different "flossing" movements:

1. Palms Down. Start by interlacing your fingers and turning your palms to face the ground. Move your elbows out the sides, so both arms are parallel to the floor. Gently pull your wrists apart, so you feel a slight traction, then raise your right arm and lower your left, bringing your right wrist into a forward bend and your left wrist into a backbend. Allow your right arm to do all the work, while your left arm is passive.

Repeat the movement on the other side by using your left arm to do all the work while your right arm is passive. Go back and forth any number of times.

2. Palms Facing You.  Start by interlacing your fingers and turning your palms in to face the ground. Move your elbows out the sides, so both arms are parallel to the floor. Now turn your palms inward, to face you. Gently pull your wrists apart, so you feel a slight traction, then move your right arm outward and your left inward, bringing your right wrist into a forward bend and your left wrist into a backbend. Allow your right arm to do all the work, while your left arm is passive.

Repeat the movement on the other side by using your left arm to do all the work while your right arm is passive. Go back and forth any number of times.

3. Palms Facing Away. Start by interlacing your fingers and turning your palms to face the ground. Move your elbows out the sides, so both arms are parallel to the floor. Now turn your palms outward, so they face away from you. Gently pull your wrists apart, so you feel a slight traction, then move your right arm inward and your left outward, bringing your right wrist into a forward bend and your left wrist into a backbend. Allow your right arm to do all the work, while your left arm is passive.

Repeat the movement on the other side by using your left arm to do all the work while your right arm is passive. Go back and forth any number of times.

See http://www.tomalden.com/ for information about Tom Alden. For information about Timothy McCall and his book Yoga As Medicine, see http://www.drmccall.com/.

Wistful Wrists: How to Keep Your Wrists Safe

by Baxter

Following last week's hoopla around the New York Times article "How Yoga Can Wreck Your Body" and my interview on San Francisco public radio’s KQED last Thursday (see Can Yoga Be Bad For You?), Nina and I realized that it might be helpful to look at the most commonly injured areas of the body (from yoga or otherwise—more often otherwise!), and see if we could recommend a few helpful ways of avoiding injury or working with trouble when it arises.

I already mentioned Loren Fishman’s survey of 2009, in which he identified the areas of the body most likely to get injured. Wrists ranked number one among yogis surveyed. The main risk factor for modern yogis is the fact that contemporary hatha yoga, the practice of postures, relies heavily on poses that bring lots of pressure and force onto the wrists. The list of these poses includes such favorites as Cat/Cow, Plank Pose, Downward-Facing Dog, Upward-Facing Dog, Push-up Pose (Chaturanga), most of the arm balances (which we should rename accurately hand and wrist balances), and even the bottom hand in the asymmetric standing poses like Triangle pose.

There are very few manual labor jobs anymore that require us to have our hands on the ground supporting our weight. In fact, from an evolutionary point of view, we have evolved to our upright posture so having our hands on the ground is no longer necessary for our survival, except for that precious few months before we begin to walk as pre-toddlers. And modern society places our value as workers squarely on having a functional brain and adept hands to plug into our computers and produce! So the rest of our body is superfluous to the economy. Forgive my tendency to be hyperbolic, but we are stuck between and rock and a hard place. Yoga is wonderful way to reconnect with our whole self, and yet we must simultaneously be cautious with the delicate wrist area. And in fact one could argue that yoga asana is helpful in conditions such as osteoporosis in actually requiring us to bear weight on the wrists, a common area affected by thinning of the bones.

A Rock and Beyond by Philip Amdal

What’s a yogi to do? Well, from the start, gradually introduce weight to the hands and wrists if you are new to yoga. This came up again and again in last week’s discussion: beginners should start at the beginning with a competent guide (aka teacher) and gradually advance and integrate the yoga asanas. Secondly, consider the wrists you bring into your practice, taking into account any preexisting conditions that could put you at greater risk of injury while doing yoga, such as a history of carpel tunnel syndrome, other repetitive stress injury to the area, family history of arthritis, and so on.

You might want to invest in slightly thicker yoga mat to give your hands and wrists a bit more padding. When placing your hands on your mat, make sure to have equal pressure on the first knuckle area of your hand (what I call the ball of the hand) and the heel of your hand (which is closer to the wrist joint). It can be helpful to create a slight lift under the heel of your hand using either the front of your yoga mat rolled under tightly, or by placing a wedge under the front of your mat so it slopes toward the front of mat. There are also specialized gloves that have a small built in wedge in the palm of the glove that can be helpful, as well as a prop called the Gripitz. (For the latter, I find it is helpful to go over the use of the Gripitz with students to keep it helping and not aggravating their wrists.)

And there is nothing better than rest for an angry wrist, so if you have one, consider designing a non-hand weight bearing practice with your teacher that you can do as your wrists settle down. It should not be difficult to create a satisfying practice with the myriad poses that do not require much support directly from your wrists and hands. 

Another factor to consider as that many of the poses mentioned earlier require your wrists and hands to do a movement called extension (the wrist is bending back toward the arm), and there is a risk of hyperextension if you are not paying attention. Conversely, the opposite action of extension, flexion of the wrist (with the wrist bending forward away from the arm), is sorely missing in the asana practice. Practicing flexion of your wrists is a helpful counter-pose for wrist health. So if you are having wrist problems, you might start practicing the “wrist flossing” exercises described in the book Yoga as Medicine by Dr. Timothy McCall, featuring the wrists of moi. My students and I have found them helpful over the years in balancing our wistful wrists!