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Wrist Pain In Yoga | Understand the Anatomy

Wrist Pain In Yoga

One of the most common complaints I get from students is that of wrist pain in yoga. They often claim it is “from all of those chaturangas”. Yes it is true that we are human beings and by the looks of it, we were created to support ourselves on our feet.  After all, we are a species evolved enough to not need our hands for locomotion. Downward facing dog, chaturangas, and other hand supported yoga postures are, however, an integral part of many yoga practices. Students often ask me if they should rest in child’s pose if they feel wrist pain in downward facing dog, or if they should do forearm plank instead of full plank to avoid wrist pain. My immediate response is “yes”.  My immediate response after that is generally, “Let me see your downward facing dog.” With many students, the pain is often a result of how they are supporting themselves with their hands and wrists. Finding a firm foundation with your hands in downward facing dog can save you from nagging and sometimes serious wrist pain in yoga practice.

Wrist Pain In Yoga

It is important to have a basic understanding of the anatomy of the wrist and hands in order to understand how to create the strongest foundation through them. To begin with, look at your own hand. Notice that your palm has a concave surface. This is useful for cupping water into your hands and even more useful for creating support. Consider the creation of an archway in a building. The stone (or other building material) in the center is the “keystone” of the arch. Just like a building, your hand has arches that provides significant support to both the hand and the wrist. (See the images above.) This is the support that is key to preventing wrist pain in yoga practice.

Carpel Tunnel Wrist Pain In Yoga

The arch closest to your wrist is the proximal transverse arch. There are some very important structures under this arch in your hand. In fact, this arch is actually a passageway to a tunnel. You may be familiar with the term “carpel tunnel syndrome”.  Simply put, carpel tunnel syndrome is the irritation of the structures that run through the tunnel that lies below the proximal transverse arch. These structures include the median nerve and the tendons of the muscles that are responsible for wrist flexion (bending your wrist so that your palm moves towards your forearm).

Wrist Pain In YogaHold your hands out in front of you with your palms facing up. Bend your wrists so that your palms come up towards your face. This is wrist flexion. Lower the palms away from you (with the backs of your hands going closer to the floor) and you have wrist extension. It is important to realize that wrist flexion and extension are always what they are, but may appear different depending on the position of your forearms. Now hold your hand out in front of you with your palms facing down. Bend your wrists so that your palms go closer to the floor. This is still wrist flexion. Bend your wrists in the other direction so the backs of your hands come towards your face.  Now you have wrist extension. Image A  demonstrates wrist extension and flexion.

The muscles that flex your wrist (or cause wrist flexion) run down from your elbow along the side of your forearm where your palm is. You can feel the meaty part of these muscles close to your elbow. Look at the image below and to the left and notice that the muscles have long tendons. These are the tendons that run through the carpel tunnel. Feel your own wrist flexor tendons just above your wrist (on the palm side). The muscles that extend your wrist are in an opposite location . As seen in the image below and to the right, the wrist extensors run down from your elbow along the side of your forearm where the back of your hand is. You can feel the meaty part of the wrist extensor muscles close to your elbow on the backside of your forearm. These muscles also have long tendons that you can see in the picture and feel on yourself.

Wrist Pain In Yoga

Let us put these muscles into action to support you. Place your palms flat on the floor. You may even come into downward facing dog. Notice that your wrists are now in a position of wrist extension. They will always be in extension when you are supporting yourself on your hands with your palms down. Consider now, the force that is being put on the concave arches of your hand. Your own body weight will deliver pressure to flatten these arches. You can, however, prevent this collapse by activating the muscles that flex the wrist. Remember, the muscles that flex the wrist have their tendons resting in the tunnel. If they are activating, they will be able to oppose the force on them. You may hear your yoga teacher tell you to imagine that you are dragging your palms towards your feet when you are in downward facing dog. This is a very effective way to activate the wrist muscles to provide a supported foundation.

Now come into a seated or standing position and place your hands out in front of you with palms facing down and lifted in the air. Bend the wrists so that the back of your hands comes towards your face (wrist extension). Imagine your hands are supporting you in downward facing dog and you “drag” your hands towards your feet. That is, you move your palms down towards the ground. The action you did is wrist flexion. You had to activate the wrist flexor muscles to do this. Go back to your downward facing dog (or onto your hands and knees) and again “drag” your hands towards your feet. Notice that your wrists are strong and active. You are creating energy to support your tunnel rather than collapsing into it.

Wrist Pain in Yoga HandstandAnother common instruction from yoga teachers is to push your palms down into the mat. However, pressing your palm, particularly the center of your palm, into the mat may encourage you to activate your wrist extensors. The activation of your wrists extensors will cause wrist extension and ultimately compression of the arches and carpel tunnel. Rather than pressing the palms into the mat, consider spreading all of your fingers as wide as you are able to and press all ten fingertips and the pads under each of your ten knuckles firmly into the mat. Notice how this allows you to create the natural arch in your hand. Like an old stone building, if the keystone structure is in place over the arch, the arch acts as a foundation on which great structures can be built.  Can you say handstand?

It is not uncommon to see a beginner yoga student create a very narrow and collapsed foundation in their hands as seen in the picture below on the left. For this student, I start by telling them to spread their fingers and push into their fingertips. It is also common for students to allow the outside of their hands to take the majority of the support rather than pressing thumb and index finger into the mat. This is also stressful on the wrists as weight is not distributed equally. This is one of the common causes of wrist pain in yoga. More experienced students will usually have their fingers spread wide and all ten fingers engaged. However, look at the center picture below and see what you can observe. Do you notice a collapse in the wrists?  It may be difficult to see, but now look at the picture below on the right.  You may actually notice less wrinkles in the tops of the wrist. More importantly, this student has created a cupping action in the palms. That is, there the natural arches of the wrist and hand are preserved and supported. You may also notice that there is more lift out of the wrists on the picture on the far right. The cupping of the palms creates a foundation for the body and brings  the weight out of the wrist. This student has the firm foundation for a long standing practice with a lot of arm balances rather than a lot of wrist pain in yoga.

Wrist Pain In Yoga

Trish Corley is a Baptiste certified yoga teacher and a licensed doctor of physical therapy. 

Trish leads several Baptiste inspired and anatomy related workshops and yoga teacher trainings.

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1 Comment

  1. fyggs on May 31, 2019 at 6:58 am

    Thank you!

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