Yoga Poses for RSI

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Computer Injuries: The Next Generation

.If you have RSI, you need to use extreme caution when you are doing yoga. While Yoga can help people with RSI make great gains in terms of managing pain and recovering varying degrees of hand function, the poses and pacing of their practice must always be geared toward protecting the hands from further injury.

A balanced Yoga practice that includes judiciously chosen postures, breathing and meditation can improve function and reduce symptoms of RSI. Yoga reduces anxiety and increases self-awareness, both important to the healing process. The Yoga precepts of yama and niyama, such as self-study and truthfulness, encourage people to look at lifestyle patterns that can lead to injury and reinjury. The spiritual aspects of Yoga can offer the most healing benefits, because people can learn to be happy under difficult circumstances. 

In my experience, many people report that they have injured or reinjured themselves by doing asana that was inappropriate, or practicing too vigorously or with improper form. People with RSI are often highly motivated, and they approach their rehabilitation with the same gusto they approached working (and injuring themselves) at their computers.

Yoga, if expertly modified for the person’s injury by a highly skilled and knowledgeable teacher, can be enormously helpful for people with RSI; however, the wrong practice can make matters significantly worse. Unfortunately, many people with RSI who seek out Yoga make their injuries worse by taking standard Yoga classes, which can place great strain on the hand during common postures such as sun salutations , downward-facing dog and cat pose. For this reason, it is highly unadvisable for people with RSI to take group classes.

Developing a Practice for RSI

The challenge for Yoga teachers and therapists is to both understand general principles of practice for RSI and how to adapt to the individual. Some of these general principles are counterintuitive to many teachers, and many common approaches will worsen symptoms for some individuals. For example, when teachers are faced with students with an upper extremity injury, unless they are very knowledgeable about RSI (which is extremely rare), they often immediately want to focus on the point of injury. Thus they may give wrist-strengthening exercises or suggest common modifications of the hand position in weight-bearing postures, but this approach can exacerbate symptoms.

Many teachers suggest using the common modifications for weight-bearing poses because they don't know that many people with RSI simply cannot bear any weight on their upper extremities, no matter what position they are in. These kinds of boiler-plate modifications can place subtle pressure on the student to perform a standard postures at any cost. Often students will go along to please the teacher or to keep up with fellow students, straining themselves in the process.

These suggested modifications remind students of their pain and physical limitations, instead of focusing on pleasure and what they can do. Such suggestions also inspire fear in the students that they will be asked to do something they know is painful, which sets off a stress reaction in the nervous system. The discomfort students experience in these modifications will also convince them that the teacher does not understand the true extent of the injury.

Because of the danger of reinjury and the uniqueness of each student’s history, students are typically first seen one-on-one. Each student needs the teacher’s undivided attention and a practice tailored to his or her unique needs. 

When you are interviewing a teacher, make sure that they respect your right not to do anything that's painful to you for any reason at all. It is far better for you to get a good book and practice the poses on your own stopping whenever you need to in order to avoid reinjury.

​Here are important guidelines for practicing Yoga if you have an upper extremity injury such as RSI. No single protocol will work for every person with RSI.

• 
  Be cautious about overhead reaches. Postures requiring upward reaches, such as the first movement in a sun salutation, should be avoided in cases of thoracic outlet syndrome. Overhead reaches can also be painful for people with shoulder injuries. (In fact, reaching for anything can be painful for people with RSI.)
• Holding arms up for sustained periods, as in warrior II, can tire the arms. Fatigue is a risk factor for RSI.
• Most people with RSI can’t support weight on their hands comfortably, as in poses such as cat and downward-facing dog (adho mukha svanâsana). For this reason, arm and hand balances are also contraindicated.
• Postures that put body weight on the hands can lead to pain, too. In fish (matsyâsana) and certain versions of locust (shalabhâsana), many people with RSI can’t comfortably bear their body weight on their hands. Many of these poses can be safely modified by using bolsters or other props.
• Avoid Yoga toe-holds or any binding, grasping, pushing, or pulling movements. It requires arm strength to hold the limb, which can strain forearm tendons.
•  Strong stretches should be avoided when there is injury to the nerves. Cow face pose (gomukhâsana) can be too strong a stretch for people with a limited range of motion in the shoulder joint. As is often the case with many âsanas, this posture may be modified by holding the hands in a position the student finds comfortable
• Avoid balance poses that require use of the hand to brace against falling.
• Some inversions are problematic. Shoulderstand (salamba sarvangâsana) can be too much for someone with weak arms. Ths pose also requires a lot of arm strength to get in and out of, and if the student is bracing for a fall, could lead to pain. Plough (halâsana) and headstand (sirsâsana) can be problematic for the same reasons.
• Certain relaxation poses can present problems. People with RSI should avoid progressively tensing and dropping the limbs to relax them for corpse pose (savâsana). It will likely be painful for them to squeeze their hands and drop them. Some people won’t be able to lie with palms up, either, because of restriction in the shoulder.

For more, sign up for  the Yoga for RSI Teacher Training.