Hands & Wrist Pain: Top tips for pain-free practice
Updated: 2 days ago
One of the most common things students ask me about is pain in the wrists and heel of the hand in weight bearing poses like downward facing dog, plank, tabletop. This can be a real barrier to enjoying your class because all you can think about is the soreness in your wrists.
"Is it normal to have painful wrists?"
It's important to discuss the difference between discomfort and pain here - discomfort is something that is tolerable; we put ourselves in some strange positions in our yoga practice so sometimes we come across areas that are tight and tough, but not pain. Pain is something that is sharp, electrical and makes you go "ooh ouch thats not good".
Any pain in a yoga practice is not normal. The purpose of pain is it is your body's alarm system to say something isn't right and you need to do something about it. Pain shouldn't be ignored.
Sadly, ignoring pain and not tackling the root cause or practicing correct technique leads to injury. Yes, you can get injured practicing yoga. I've had many - including a wrist injury that required a medical procedure to fix. I am certainly one to say yoga can help with many things, but practicing without care will certainly lead to injury eventually.
If anything you do causes you pain - do not do it. I can't stress this point enough. If you're a student of mine, please chat to me and I'll give you an alternative or teach you the correct alignment and activation after class. Any good teacher worth their salt anywhere else would do the same for you. If they don't... find a new teacher.
"Will I always have this? What can I do to get rid of it?"
The good news is that with practice, awareness of what you are doing and applying the correct technique; you'll be able to get yourself to a much more comfortable space.
WRIST STRUCTURE AND HOW YOUR RANGE OF MOBILITY CAN AFFECT PAIN LEVELS
To start, we're going to look at what we are asking our wrists to do when we are bearing weight on our hands - and why your unique anatomy has an impact on your practice.
OUR WRIST JOINTS
Our wrist is a mobile joint - it can move through a wide range of movement to allow us to pick small or large items up, carry things and general tasks humans are designed to do. The main motions relevant to yoga are shown below.
When we are bearing weight on our hands, we are putting our wrist joint into varying levels of extension depending on the particular pose. Our level of extension available will depend on our range of motion and the gap we have between our active and passive range.
RANGE OF MOTION
Active range of motion is our mobility when we use our muscles and connective tissues to move our body into a position, without using external forces to get ourselves there.
Passive range of motion is our mobility when we use external forces and/or relax our bodies to go into a range of motion.
APPLYING THIS TO OUR PRACTICE
The larger our active range of motion is the less we are moving into our passive range of motion when applied to a pose like downdog or plank. The gap between the two ranges can be a factor in any wrist pain.
If your wrists make a T shape this means the gap between your active and passive range is very small.
You may find the majority of these poses accessible already and your focus would be more on optimising the activation in your hands (more on that shortly).
If you are like the Y image this means there is a larger gap between your active and passive range of motion.
You are likely to find it more challenging to place your wrists into the degree of extension required for some poses.
You are having to stretch more degrees meaning this might just not be comfortable at the moment, and can be a contributory factor to any pain.
A lot of the time, this is just how our bodies are built. There are things we can do to improve our active range of motion, and also make our practice more comfortable.
Stretching the wrists before your yoga practice - rolling through the wrists, from table top rocking forwards and backwards.
Building active range of motion requires muscle strengthening work. Stand with hands at shoulder height on a wall and press the finger tips in to the wall.
Progress to resting an arm on a table with the wrist supported by the table edge and move the wrist through flexion and extension. Start with something small like a light ball and work your way up to a tin can.
Wrist wedges are available from many yoga equipment suppliers. These effectively bring the ground up to your wrists on a slope, meaning the degree of extension required is lessened, making you more comfortable in the meantime.
HAND PLACEMENT AND ACTIVITY
This is hands down (geddit?) the most common mistake I see in many of my classes and this is my main port of call when someone comes to me with wrist pain (after checking their active range of motion.)
WHAT ARE "ACTIVE HANDS" AND HOW DO I GET THEM?!
In short, we're using the entire surface area of our hand, not just our wrists:
We are always pushing the hands firmly into our mat. The firm push engages the muscles all the way up from the fingers to the shoulders and down the back and this activity helps us become strong and stable in each of our poses.
NOTE: In "advanced" inversions like handstand, or hand balances like crow or any full weight bearing it is encouraged to have the finger tips down, second knuckle lifted then the base knuckle (in green on the graphic) anchored down - like spidered legs, this is often cued as spider fingers during a class. This is because our fingers do a lot of the "steering" in an inversion and provide our stability. This technique isn't essential if you're not doing inversions or hand balances but it is nice to be aware of this progression.
WHY THIS IS IMPORTANT
We're holding a percentage of our body weight up with our hands (50% in downward facing dog, up to 100% in crow, handstand) in any weight bearing pose.
Our wrist joints aren't made to support a significant proportion of our weight in a non engaged way. Think about our ankles that support our bodies and the size of that joint with all the ligaments and muscular support - our wrists don't have this.
When our hands are not engaged, all the weight is going into the heel of the palm and solely through the wrist joint causing pain in the wrist and heel of the palm. Often our shoulders and elbows try and get involved and over compensate for this, causing issues elsewhere because of muscles trying to do jobs they aren't designed for. We feel like we are sinking into the mat rather than powering away.
WHAT THIS LOOKS LIKE IN PRACTICE
Lots of creasing in wrists - heavy into heels of palms
Fingers peeling away - weight rolling to outside of hands
Weight dumping towards mat
Minimal wrist creasing
Grippy fingers drawing towards palm
Actively pushing the mat away with the whole hand
HOW DO I KNOW IF MY HANDS ARE ACTIVE OR NOT?
Simple - take a look at them next time you practice. You can run through the cues again in your mind, pressing and activating those areas in each pose.
The back of your wrist is often a give away. It can look very creased when the hand isn't engaged (particularly useful for downward facing dog).
Make a mental note to come back to it throughout class. The more you do this, the more your body builds muscle memory and it starts to become automatic.
There's no one perfect hand placement as everyone's body is built differently.
You know you've got the right placement for you when you find a feeling of lift away from the mat - the whole hand pushing down, strong and stable through the upper body. Basically; you're looking for feeling steady and comfortable in your shape.
Traditionally; yoga teachers have said middle finger forwards to the top of the mat. This is still a great option; but it might not allow for best power and pushing the hands into the mat for all students.
My personal preference and how I teach is first finger forwards. Having the hands a little wider allows for more rotation into the shoulders which makes it easier to push the hands down firmly.
You can also rotate the hands further so the tips of thumb and little finger are in a line if that is more comfortable.
Try exploring these options in your next practice and you might find the shape for you is different to what your teacher cues. Take the option that works best for you and your body for your practice going forwards.
Check the overall alignment of your pose - are your shoulders over your wrists in plank or beyond them (for example)? The general alignment of your pose could be slightly off and improving that might contribute to happier wrists.
Give it time - strengthening and increasing active range of motion takes time, so be prepared to put a couple of months of work in.
Get your technique checked regularly. As your practice evolves your body changes, and your technique will adjust over time. I offer a regular Perfect Your Poses Workshops (or if you prefer 1:1s) for diving into key techniques and alignment and this is a great way to have an in depth check-up.