Tendonitis

Yoga is well known for its therapeutic effects. Science is starting to back up what many yogi’s have known for thousands of years. Students will start taking yoga classes because some part of their body hurts and they hope to find relief. But what if that yoga class you took to feel better is making you feel worse?

Millions of people are doing yoga and with numbers like that statistics are bound to stand out. Injuries are one of them. Books are starting to fill up shelves about the various injuries that you can get if you aren’t paying attention in your practice. The most common one I see is tendonitis.

Tendonitis is an inflammation of the tendons, a fibrous tissue that connects muscle to bone. This inflammation typically occurs due to repetitive use and improper alignment of the joint causing the tendon to rub against something instead of moving smoothly. Symptoms include pain and tenderness along a tendon, usually near a joint and pain that’s worse with movement. Tendonitis can occur anywhere in the body where there is a tendon, the most common is in the shoulders and knees. In yoga, I primarily see it in the shoulders.

If you practice any type of flow yoga (power, vinyasa, ashtanga, etc) you are susceptible to this injury. New students can develop it by not being strong enough to do a proper chaduranga. They often do the pose with slouching shoulders and their stomach reaches the ground before their chest does. This puts a lot of pressure and strain on the shoulder joint and tendons. If this is you, roll those shoulders back and down and put your knees down till you get strong enough. In stronger students it’s more an issue of not getting into the pose properly. You move fast in a flow class and there isn’t always time to get into the perfect pose. Bad alignment causes damage.

Another thing to consider with alignment is your carrying angle. This is the angle made by the axes of the upper arm and the forearm with the elbow in full extension. If you stand tall with your arms by your side, palms facing forward you can check your angle. If your forearms lay close to your thighs you have a small angle. If your forearm sticks out, creating a triangular type shape between your arm and your thigh, then you have a bigger carrying angle. (See photo below, this is a big carrying angle.)

If you have a big carrying angle you need a wider base when putting weight on your hands. When you do your flow through from plank to down dog you will need to widen your hands to about mat width (you’ll want to experiment here and see what width feels comfortable). With a wider stance it allows the shoulder joint to move correctly.

To help heal your tendonitis, which unfortunately will never fully go away, it is prone to flare-ups once you develop it, there are a few tricks. First, especially after it first presents itself, is to cut back on all poses that move the joint. Skip the flow class for a bit and try a different type of yoga. Once the flare-up has subsided you can go back to your beloved flow class. You will constantly need to be mindful of any more flare-ups. You should also cut back on your chadurangas. Go from plank to up dog to down dog, or just straight back to down dog. This will limit a lot of extra rotation in the shoulders, especially when in a typical flow class you can do this sequence dozens of times. To keep up your strength hold your plank longer before going back to down dog. If you find after a class your shoulders bother you, you need to cut back the chadurangas or perhaps cut them out completely.

To treat the inflammation ice works great. Also a topical anti-inflammatory called Arnica works well, especially if it is put on shortly after the flare-up. I’ll put mine on after class and it is usually better by the next day. In my own practice I have cut out a lot of my chadurangas and just hold my planks. This has cut back on my flare-ups considerably. It’s not easy when our bodies age or are injured, we have to learn to let go of our ego, the health of our body depends on it.