Musicians' Health Collective

Musicians' Health Collective: Supporting the health of musicians (and normal people)

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Top 5 Challenging Wrist Poses in Yoga : Why Do my Wrists Hurt Part 2

On Monday, I posted a bit about why your wrists might not easily explore full ranges of extension, especially if you spend your whole musical and technological life in flexion.  I additionally had two students in my yoga classes yesterday that complained of wrist pain, and it reminded me that we teachers can do better in teaching progression and strength. First though, what are some of the postures in yoga (and pilates and other movement disciplines) that might create full wrist extension?

This is sometimes seen as "table top," or the beginning of cat cow, or quadruped. It may come at the beginning of class, but it can be hard on the wrists if the range isn't there.

This is sometimes seen as "table top," or the beginning of cat cow, or quadruped. It may come at the beginning of class, but it can be hard on the wrists if the range isn't there.

1.  Table Top/ Cat- Cow/ Plank

Whether at the top of a pushup or the beginning of a spine warm-up, this set up requires full wrist extension.  One way of modifying it is to make a fist and use the knuckles as the contact point with the ground.  Another option is to roll up the edge of your mat and decrease the angle of wrist extension needed.   Planks on top of physio balls are equally demanding, as well as side planks, so keep in mind that pilates and traditional gym classes may also be taxing.

2.  Downward Facing Dog

I mentioned this last time, but DFD requires wrist extension, but not to 90 degrees.  It's usually less taxing than the plank to pushup situation, but as with other weight bearing poses, it’s about progression, building strength over time, and not suddenly doing 50 Downward dogs out of the blue.

3. Chaturanga to Upward Facing Dog

This posture,  upward facing dog , requires the body weight to be lifted on the wrists, whereas cobra keeps contact between hips and the mat. That's a little tough on the wrists sometimes.

This posture, upward facing dog, requires the body weight to be lifted on the wrists, whereas cobra keeps contact between hips and the mat. That's a little tough on the wrists sometimes.

This sequence, often called the vinyasa, requires full range of wrist extension.  The easiest thing to do is to skip it when you're tired, or just lower to your belly and do a baby cobra.  Upward facing dog itself is super taxing because of the extension, transition through the pushup, and weight combination. This sequence of events is often glossed over in yoga, but it’s a stylized pushup, and pushups are great if your body is prepared, adapted, and ready to be loaded with your body weight, but if not, you may need to work up to the strength required to perform the activity. (Yoga teachers and pilates can also do a better job of training students to get to this point rather than just asking people to do them!)

4.  Any arm balance.  

This pose is commonly called  crow  or crane, depending on the variation. For obvious reasons, it can be a bit tough on the paws.

This pose is commonly called crow or crane, depending on the variation. For obvious reasons, it can be a bit tough on the paws.

Whether it's crow, side crow, twisted scissors, handstand, or galavasana, your entire body weight is balanced over your hands.  If you have weak wrists, limited range of motion, or have no idea if you should be doing arm balances, you probably shouldn't.

5.  Full wheel (AKA. Urdhva Dhanurasana)

For years, this was my wrist nemesis.  It requires shoulder mobility and wrist mobility, and I always wanted to do it because everyone else could.  Even now, I can't hold it for a long time, and I have to be really mindful about warming up my body before I attempt it.  Stick with bridge if you're sensitive, or put the hands on blocks against the wall to decrease the range (or grab a hold of the teacher's ankles).  

Now that we've looked at some of the wrist extension culprits, we'll address some ways to modify postures to make them more wrist friendly, and how to work on building your range and strength over time.  


Why Do My Wrists Hurt During my Workouts? Part 1

One of the questions I'm most frequently asked is why yoga makes our wrists hurt so much in yoga, pilates, planks, and other movements.   First thing, let's look at the small bones of the wrist and what's going on in there.

Can you tell I'm excited about my new model skeleton?

Can you tell I'm excited about my new model skeleton?

Our wrist is a somewhat delicate joint, at least in comparison to the foot, which has a very similar structure.  The eight carpal bones are very small and fit between the radius/ulna and the metacarpals.  (The phalanges are what we think of as the finger bones, but clearly, fingers start from the wrist, not the knuckles!)

We flex the wrist to type and text, we extend the wrist to do plank and down dog.

We flex the wrist to type and text, we extend the wrist to do plank and down dog.

It also means that we may not have the same range in the opposite direction that some people do.

It also means that we may not have the same range in the opposite direction that some people do.

There are many different styles of yoga, but the many flow styles these days emphasize vinyasas or the sequence of plank, chaturanga, to upward facing dog.  Even if those terms don't mean anything to you, think plank to pushup, repeated over and over, which occurs in many fitness formats.  So why does this sequence hurt so many folks?  Well, most musicians (and normal people) keep their wrists in partial flexion, whether they are desk bound, using their phone, keyboardists, string players, woodwind players, teachers, etc.  That partial flexion adds up over the years, especially if we never use the opposite range of motion- wrist extension.  The tissues of the palm, hand, and forearm, stay partially contracted, and then limit our range of extension.  One day, you decide to try yoga, which demands a lot of wrist extension plus you decide to LOAD your whole body weight on top of it, and then you wonder why things hurt.     Staying in one position for a long time (like 15-20 years, many hours a day) keeps the muscles and connective tissue in that position- making it difficult to adapt to the opposite shape of extension.

So there’s two remedies:

1) build the range of motion in extension, and 2) progressively load those tissues to build up strength. If we never use our wrists in extension, we need to gently progress with range of motion and weight, rather than putting 130-230 pounds on our hands out of the blue. That means you can’t go from zero to full plank/push up hour without some gradual change to optimize adaptation.

My wrists are sometimes tight- you can see that it's hard for my thumb to fully rest on the floor without a small bend..

My wrists are sometimes tight- you can see that it's hard for my thumb to fully rest on the floor without a small bend..

Let's get more specific- planks require full wrist extension (meaning that the distance between the back of the hand and forearm is 90 degrees) whereas down dog is more of a 60 degree angle, depending on many factors.  

Notice that the angle between the forearm and wrist is acute, whereas the other is a right angle?

Notice that the angle between the forearm and wrist is acute, whereas the other is a right angle?

Imagefrom the Melt Method, which has a terrific hand and foot massage kit!

Imagefrom the Melt Method, which has a terrific hand and foot massage kit!

So then, imagine repeating full extension over and over again when you don't actually have that full range, or you only have it on one side. In addition, it’s been days, weeks or months since you’ve done yoga, so your body hasn’t been loaded this way. 

First, let's test the range you have in your wrists right now, shall we?  Bring your forearms together in front of your chest, then allow your wrists to extend comfortably.  Don't force it.  Do your wrists naturally open to a 180 degree angle?  Or is one side more acute (hello left hand for me!)?  That explains why full extension might aggravate things!  I'll talk a bit more about poses that are wrist intensive next time, and how to help your wrists out, and possibly gain more range in the long run.

Going Beyond "You're Doing it Wrong" : Finding the Root of Injury

Injury Categories.jpg

When we talk about musician injuries, we tend to think overuse: playing too much or fundamental misalignment, which is sometimes (but not always!) the case.  It can also be easy to blame oneself for such an injury, or to receive blame from others that your setup isn't good, that you didn't take breaks, or “you’re doing it wrong.”  

This is not always the case!  In Elizabeth Andrews' book, "Muscle Management for Musicians," she outlines three different categories, which I've found helpful to look at and evaluate, both for students, teachers, and professionals.

Yes, this is real. It's a contrabass flute.

Yes, this is real. It's a contrabass flute.

1.  Musician Versus Instrument: This can mean the size and shape of your particular instrument (one viola vs. another) or having to play a lot of contrabassoon/bass flute/subcontrabass sax/etc. in relation to your normal workload.  This can also be as simple as pointing out that not everyone can reach the keys on a flute (without contorting one's hand) or that a full size string bass is not for most people.  There are an infinite number of ways to alter one's setup to potentially help support the body, and those changes definitely fall into this category.

2. Musician Versus Environment: This is a category orchestral players are certainly aware of- chairs, stand height, conditions of the room/space/concert hall, temperature, etc.  This can also include clothing restrictions (violinists in tuxedos, high heels for performance, or simple elevating one foot to play bass or guitar) or even carrying one's instrument (s) upstairs, around the city, etc. Wielding a contrabassoon is not the easiest! For string players, this could also include the way one has to rotate one's chair or torso to share a stand, or the cramped sitting positions of the orchestral pit. This category also includes the acoustical aspects of the space- perhaps creating conditions that are excessively loud, resonant, or putting players too close together.

3. Musician Versus Self: In my mind this includes the other things we do that stress our arms, body, voice, spine, etc., which includes computer use, cell phone use, driving, standing (!), sleeping, etc.

I love Elizabeth's categories, and although I've altered the descriptions a bit to be more relevant, I think they're great points.  I would however, add a fourth category.

4. Musician Versus Music: Sometimes, even against your best intentions, the repertoire that you're studying, playing in ensemble, or preparing for an audition is too much for your body.  I've previously talked about how Paganini may have been hypermobile- for some folks, the extensions and left hand demands of the caprices are too intense and not practical.  This is true for a lot of contemporary repertoire in general- as our levels of mastery and virtuosity have skyrocketed, so have the demands of our pieces, often bringing near impossible pieces into the forefront of music.  (For example, some violists find the extensions in the Schnittke concerto to be too extreme.)  That doesn't mean that those pieces don't deserve study, they just may not be the right piece for you, or for you right now, or for you with your current instrument.  Another example might be an orchestra or opera company planning to do a Ring Cycle performance, which is a huge undertaking for any instrumentalist.  The rehearsal schedule alone might be very taxing, let alone the music itself, especially if you have never played them before and are learning the repertoire for the first time.  Even if you're doing your best to take care of yourself, the repertoire, concert schedule, rehearsal schedule, or audition list might be too much for you, either now or in general. 

I've always been afraid of taking an opera orchestral job because of the challenges (physically and mentally) of playing cycles of Wagner operas. Loud volumes, orchestral pits, and an infinite amount of string notes scare me!

I've always been afraid of taking an opera orchestral job because of the challenges (physically and mentally) of playing cycles of Wagner operas. Loud volumes, orchestral pits, and an infinite amount of string notes scare me!

If you've been injured, reflect on what it was that may have caused or exacerbated the injury- which categories were applicable?  Having an awareness of these categories can certainly prevent future injuries, especially if you know what previously caused an injury.

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