ANATOMY - 8 carpals (PRACTICE - find a partner, see if you can feel
all 8 bones:-), they articular with each other, with the metacarpals
on your hand and with the radius, (The ulna articulates with a disc
rather than the bones themselves) No two of these bones have the
same movements! That’s one complicated joint! Actually almost
like many different joints. These bones are circled by a
retinaculum. This thick band of connective tissue is like a cuff
holding the bones and holding the long tendons that run elbow to
fingers in place close to the bone. That’s alot literally bound up
in there. PRACTICE - on one another, smooth out the flexor (palmar)
retinaculum.
There are NO muscles specific to the wrist! There are muscles that
pass through the wrist and the wrist itself is controlled by the
muscles of the forearms. So how do we support the wrist when we are
in poses that are weight bearing or creating force on the wrist? We
have to use the forearms, which are usually weak and tight from
everyday use. Its a funny thing, when we are weightbearing on our
feet in yoga, we get that we have to engage the feet and the legs,
its the only way to stand tall. But when we are weightbearing on the
hands, we tend to just let them be curled and soft. Initially, it
may be uncomfortable to support the hands as we develop strength and
flexibility in the muscles but it must be done if they are to do
their job.
PRACTICE – Lifting
the arch of the hand. Notice that there is an indentation in the
palm of your hand. With your hand flat, Increase the depth of that
indentation. You can do this looking at the palm of your hand and
seeing it happen. You should do this with every posture that is
weightbearing on your wrists. Try it in table, Down Dog, and Plank –
palms down, fingers wide, lifting the arch of the hand. You will feel
this in your hands and forearms.
The nerves that pass through the wrist mostly originate in the neck.
Nerve pain felt in the wrist could be a result though of compression
anywhere from the neck to the wrist.
Common Wrist Syndromes:
Tendonitis, Rheumatoid Arthritis, Osteaoarthritis, Carpel Tunnel
Syndrome, Thoracic Outlet Syndrome
There is an arch in the carpals - the carpal tunnel - many tendons
pass through here as does a major nerve. If the retinaculum is
tight or the bones have shifted or there is inflammation in the
tendons, this will cause irritation of the nerve as it rubs against
its surroundings and becomes compressed.
PRACTICES for improving ROM and Strength in the Wrists:
moving each finger joint with the wrist in neutral. Can even use the
other hand to limit the movement of other joints. Work with both
flexion and extension. And work with moving one finger at a time.
Strengthen by bending first joint and pressing outward to lengthen
fingers to straight. This is done with the wrist bent. Can resist
with other palm or floor.
Hand in fist by side working with lateral flexion. Can also be done
with a weight in hand.
Hand in fist, elbow
flexed, flex and extend wrist. Can also be done with weights.
Losing ROM in larger
joints (i.e. shoulders) places greater strain on smaller joints (ie
elbows and wrists) we are very familiar with this of course in
relation to knees and hips, but also true in wrists esp for poses
that put pressure on the wrists. Opening your shoulders can make
your wrists happier :-)
Tightness in the muscles over your thoracic outlet can not just
impinger nerves creating pain in wrists, but can restrict
blood/oxygen flow further exacerbating the situation and making
healing challenging. Rounded upper back, hunched shoulders = bad
news for wrists.
Even a misalignment in your hip or spine can contribute to wrist pain
(see above). So, for the best possible comfort in a pose, esp a pose
with weighted hands, watch the alignment of your WHOLE body!
Practices for
encouraging full ROM in shoulders:
PRACTICE - Facing wall, pigeon toed to encourage lumbar curve - arms
up back of hands to wall, then quarter way down, then halfway down,
holding about 1 minute in each position. This encourages proper ROM
function and engagement in shoulders, elbows, and wrists. Don’t
strain but notice where you feel restriction, this gives you info as
to what to work on to gain greater everyday comfort.
PRACTICE –
Supported Fish
PRACTICES TO BRING
INTO YOUR ASANA TO ALLEVIATE STRAIN ON THE WRISTS:
PRACTICE - arm in front of you with palm down. Rotate your palm up.
You cannot do this without moving your whole arm - it requires proper
mobility in shoulder and elbow, not just wrist. We do this rotation
in the shoulder in Downward Dog to engage the shoulder and and
serratus anterior without compromising the thoracic outlet - this
also helps alleviate pressure on your wrist as you are no longer
“hanging out” in your joints. TRY IT in Down Dog, plank and
table pose.
Whenever your wrist rotates, the ulna and radius cross over each
other like crossing your fingers. This narrows your wrist,
particularly inhibiting if you have carpel tunnel syndrome. This
repetitive motion can cause pain and burning in the wrist. PRACTICE-
Down Dog, Plank and table without rotating the wrist. Anytime you
have a body part weighted on the floor, you always want the most
surface area possible! This can also be an eye-opening practice in
Side Plank. Just remember, Side Plank is an awesome pose for wrists
when your alignment is right on (lining up your wrist, elbow and
shoulder joints vertically) but its a TERRIBLE pose for your wrists
when your alignment is off.
PRACTICE - stand with elbow tucked in to side, bent to 90 and palm
up. Now, rotate your palm down keeping your elbow tucked in. If the
palm doesn’t turn all the way over, it may be because the elbow
doesn’t have its proper range of motion and is asking the wrist to
do more rotation than its built for. This limitation in the elbow
may be coming from elbow or shoulder. Working with this rotation
with both palm and Shoulder/Upper Arm fixed can really change your
Chataraga for the good!
*Basic reminders for
poses where the hands are weightbearing -
Press palms down
with fingers spread wide
Lift the arch of
your hand
Turn the eyes of
your elbows forward without locking your elbows.
*In Chataranga and
Plank – type poses, remember they are core poses NOT upper body
poses, reach back through your heels, engage your core!
*In Down Dog-type
poses, don't worry about getting your heels to the floor. Bend the
knees and take your weight back, chest toward knees and reduce the
angle of your wrists (they should be coming toward flat toward the
floor.
Good references:
Pain Free by Pete
Egoscue for whole body practices
Yoga Body by Judith
Hanson Lasater – text not practices.
Anatronica.com or
Gray's Anatomy for anatomy
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