Learn how to prevent shoulder injuries and pain with simple tips and modifications.
As a yogi and Physical therapist, I am familiar with shoulder pain due to lots of yoga classes. After some investigation, I figured out that Chaturangas are the culprit of my shoulder pain, due to my poor mechanics and strength. Chaturanga is a difficult pose that we encounter A LOT in class. The great things is there is always modifications for this pose as you build strength and good form. So why can we get pain in our shoulders in yoga? Overuse and repetitive motions such as Chaturanga. If your shoulders and shoulder blades (scapula) are incorrectly position and inactive during weight bearing postures such as plank for example, that puts a strain on your shoulders, more specifically your rotator cuff and biceps muscles. The incorrect alignment and positioning of your joints and lack of activation of the stabilizing muscles of the shoulder can over time cause tendonitis, muscle strains and even muscle tears.
The rotator cuff is a group of muscles that come together as tendons to form a “cuff” over the head of the humerus (upper arm bone). The muscles include the supraspinatus, infraspinatus, subscapularis and teres minor, which originate from the scapula (shoulder blade).
Here are some tips to prevent, protect and maintain strength and good form in your shoulders during your yoga flow.
1. Identify good shoulder alignment
Stand tall, extend your arms forward, wrists at shoulder height, wrist extended to 90 degrees, and arms parallel to the ground.
Draw your shoulders back so that they are in the same plane as your ears. Bend elbows, bring top side of palms towards the front of your shoulders. Notice how your shoulders are rolled forward, you maybe also feel tension or extra pressure in front of shoulder joints. This is how I was performing Chaturangas for a while and overtime my shoulder started to hurt. When your shoulders are rolled forward, that is putting a lot of pressure to the pectoralis (chest) muscles, biceps muscle and strains the front of the shoulder capsule.
2. Practice correct shoulder alignment
Once again stand tall with shoulders extended, flex wrist to 90 degrees, forearms parallel to the ground, draw your shoulder back in line with your ears. Maintain shoulder firm in this position, bend elbows to 90 degrees so that your elbows hugs your ribs and forearms are parallel to the floor.
This is the CORRECT position for the arms, with the shoulder still engaged back and in line with ears, rather than rolled forward. Notice the muscles around your shoulder blades (rotator cuff muscles) working to draw your shoulder blades firmly down and back. I tell a lot of my patients imagine as if you’re pinching a penny between your shoulder blades. Maintain these muscles of the shoulder blade during your Chaturanga, your shoulder and shoulder blade are now in good alignment and the muscles are working to stabilize and keep your shoulders and upper back strong. If you disengage these muscles, your shoulder will instantly drop forward.
I always encourage taking different modifications throughout class. The two modifications I offer include skipping Chaturanga and holding high plank with proper shoulder alignment shown below and taking Chaturanga on your knees (I do this one all the time)
The following exercises allow you to activate and increase your endurance strength of the shoulders and upper body that we use while we perform Chaturangas.
- Bend your elbows to 90 degrees so forearms are parallel to the floor.
- Rotate hands away from each other and notice how your shoulder blades pinch back together. Keep your shoulders relaxed away from your ears.
90/90 with Jazz Hands
- Lift your arms out to the sides. Bend elbows to 90 degrees so that forearms are parallel to floor, your fingers are pointing forward and palms face down. Relax your shoulders away from ears.
- Your elbows must remain at shoulder height, and remain in line with your ears. Maintain this alignment. Keep your neck relaxed.
- Maintain your elbows and shoulder alignment and externally rotate your arms until fingers point straight up towards the ceiling. Palms face forward, elbows at 90 degrees. Notice how your shoulder blade muscles beneath and around are activated pressing scapula down into your back. The tips of the shoulder blades are pressing on your back, allowing more opening and good upper extremity form in your chest.
- Now rotate your hands, palms facing toward you face, thumbs pointing towards the back wall. Notice how your biceps are turned on, this secures the heads of the arm bones in the shoulder joints, strengthening and protecting the tendons at the front of the shoulder capsules.
- Now rotate hands and forearms outward (external rotation), palms face away from ears. Continue to rotate your hands and forearms and notice the muscles of the shoulder blades, upper back and shoulder working and creating stability in your joints. Notice how your shoulder blades are not pinching towards each other; they stay where they are and hug the back.
Wall Slides to Strengthen Serratus Anterior
- Begin in a standing position upright holding a towel against a wall (or hands against the wall) at shoulder height.
- Slowly slide your hands and/or the towel straight up the wall, straightening your elbow. Then lower it back down, and repeat.
- Make sure to keep your back straight during the exercises, core engaged, and only raise your arm(s) as far as you can without pain.
Hope these strengthening exercises bring awareness and mindfulness to your chaturangas! If you have questions regarding shoulder pain, feel free to make a free consult with one of our skilled and highly trained physical therapist at Coury and Buehler Physical Therapy!
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Karina Abrew, PT, DPT, RYT
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