Musicians' Health Collective

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

Filtering by Tag: wrists

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.

Human Body Mythbusters: Musicians' Edition

So I'm sure I've ranted before that musicians should take anatomy/physiology classes and learn a bit more about self-care, but more importantly, let's look at some of the most frequent myths I get to bust in lessons, classes, friendly conversations, and emails. 

A lovely small image from Gray's Anatomy.

A lovely small image from Gray's Anatomy.

1. Your rotator cuff is one giant muscle, and you can tear it.  Well, yes, you can, but the rotator cuff actually refers to four muscles that assist in the movement of your arm and scapula.  If someone tells me they hurt their shoulder and "tore my rotator," I always ask them which one, which they inevitably can never answer. ( At least figure out what range of motion hurts, and then remember which muscle you hurt.  "Everything hurts" is not helpful.)

2. Your core refers to your abdominals exclusively.  I despite this misunderstanding, perpetuated by the fitness realm of "burn," "shred," "melt," and "tone," your abs.  Your core, refers to the entire muscular sheathing of your viscera and spine, which includes your abdominals (6 pack, obliques, transverse), back muscles, diaphraghm, psoas, and more, depending on your definition.  Some folks define core as include hip musculature too, so that's open for debate.  Either way, your 6 pack is not your core, although it is part of it, and doing sit-ups will not invariably cure back pain although strengthening the whole core might help.

Image courtesy of radiologyinfo.org

Image courtesy of radiologyinfo.org

3.  Your fingers start at your knuckles.  Nope.  While this is not intuitive, the bones that make up your metacarpals and phalanges originate at your wrist.  Your wrist position while playing your instrument directly affects your ability to use your fingers, and when you think of fingers articulating, they begin their articulation from the wrist.  In addition, your have minimal musculature in the hand, but instead the bulk of your musculature in your forearms.

4.  Your respiratory diaphraghm cannot be stretched.  So your diaphraghm is a muscle, which means that it can be tight, loose, weak, and strong, in various degrees.  Your diaphraghm is also a muscle nestled within your rib cage which helps your lungs to inflate and deflate. In addition, the muscles around your ribs can also be tight, loose, weak, and/or strong, which also affects your respiration.  There are interesting ways to stretch your diaphraghm (for another day-ooh la la!) as well as open up the muscles on the sides of the ribs, which can help your breathe more easily and more fully (good for most musicians and people at large).  PS.  The narrator in this video has a hilarious accent.

Amazing and interesting!

Amazing and interesting!

5.  The tongue is one big muscle.  Your tongue, ladies and gentleman, is a structure composed of eight separate muscles, attaching at various bones including the hyoid bone, mandible, and styoid process.  Without dwelling on the anatomy too much, take a look at this picture and be amazed!

6.  Standing with my feet turned out is natural.  Nope.  I've had a chat about this before, especially in relation to violin pedagogy, but here are a few thoughts.  Just because everyone does something, doesn't mean it's natural.  Everyone currently sits 6-8 hours a day, but that's not biologically natural.  Just because everyone turns out their feet doesn't mean that's natural either.  The more you turn out your feet and legs, the more likely you hyperextend your knees and flatten your pelvic/low back curves.  When your feet face parallel (or close), you walk in a manner that is more biomechanically sound for feet, knees, and hips, and can help change your pain patterning.

BONUS!  (Just thought of a few more to add as of 5 PM today.)

7. Sitting, standing, and playing with poor posture won't affect my long term body health.  Nope.  I've talked about this a lot, and I'm sure it gets boring to read about, but the way you move affects your tissues!

8.  Wearing High Heels Regularly Won't Affect My Body.  This is a biggie.  If you only wear them to sit in, then sure, you might be ok.  Walking and standing in them regularly will affect your alignment, your back, your knees, and possibly cause you bunions.  Save them for super special occasions and don't regularly concertize or audition in them.

9. Many of the great players had ridiculous setups and strange posture.  They didn't hurt -why can't I play that way?  In regards to string technique, much has changed in the last fifty years.  We no longer teach to learn how to play, but we teach folks (hopefully) in a way that not only imparts knowledge of how to play an instrument, but how to play it sustainably for a long time.  I can't know if famous musicians of the twentieth century were ever in physical pain from playing.  My guess is, yes, they were in pain sometimes, and no, there weren't an abundance of tools at their disposal for improving their setup.  My friend Molly Gebrian said this quite eloquently last week: "Great players played well not because of their (idiosyncratic) technique, but in spite of it."  That means you don't necessarily want or need the setup of famous 1940's violinists.

10.  If I just take an anti-inflammatory drug, all of my wrist/arm/shoulder/back pain will go away.  So if you just treat the symptom (pain/discomfort/tingling) and don't address the cause (misalignment, tension, overuse, too much playing, poor sleeping/standing/sitting alignment, etc.) the pain will most likely be chronic.  NSAID's can be important sometimes in treating serious inflammation and wounds, but we often medicate without thinking of the obvious thing: our body has an inflammatory response to treat tissue damage for a biological reason.  

"Overuse of the muscles causes cells to break down, releasing waste products, which produces pain and inflammation.  Cleanup crews in the form of white bloods cells called macrophages carry away the cellular debris. If you take anti-inflammatory drugs at this time, the natural inflammation process is disrupted and instead of being cleansed away in the blood stream, the trash settles into scar tissue." - Dr Emil Pascarelli

Maybe reconsider the next time you reach for the Advil, and instead ask, "why do I hurt?" and "Is there any other way I can treat this right now?"


While the body is a complex and interesting structure, many of our bodily misconceptions have affected how we play and how teach.  If one of these concepts resonated with you (pun intended), think of how it can help your students and your own practice!


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