When I started teaching yoga in 1981, back pain was the most prevalent concern that caused people to visit their doctor. As we’ve progressed into the computer age, new challenges for the human form have emerged: neck, shoulder and wrist pain and concern about carpal tunnel syndrome.

The carpal tunnel is a narrow, rigid passageway of ligament and bones at the base of the hand that houses the median nerve and tendons. Sometimes, thickening of irritated tendons or other swelling narrows the tunnel and compresses the median nerve. The result may be pain, weakness, or numbness in the hand and wrist that radiates up the arm and is accompanied by occasional sudden sharp pain. Women are three times more likely than men to develop carpal tunnel syndrome, perhaps because their carpal tunnel itself may be smaller. A physical examination of the hands, arms, shoulders, and neck can help determine if the symptoms you feel are related to daily activities or to an underlying disorder, and an exam can rule out other painful conditions that mimic carpal tunnel syndrome.*

According to the National Institute of Neurological Disorders and Stroke, many alternative therapies, such as acupuncture and chiropractic care, have benefited some patients with carpal tunnel syndrome, but their effectiveness remains unproven. An exception is yoga, which has been shown to reduce pain and improve grip strength among patients.* It appears that a Down Dog a day keeps the doctor away!

To understand how yoga can help carpal tunnel and other conditions caused by repetitive motion, we first need to look at the anatomy of our arms. Our shoulders are designed for full range of motion and expression. Therefore, our shoulder joints are formed only by a group of muscles known as the rotator cuff. There is no ball and socket in a shoulder to give stability as in our hips. The arms and head host 80 percent of the nerve endings in our bodies, so muscular imbalances in the shoulder girdle and neck can easily impinge on the many nerves that are present. It’s important that we address our posture to create a relative muscular balance in our chest, shoulders and arms to retain or regain the freedom and healthy function of our arms and wrists.

Learning the proper anatomical actions that stabilize the shoulder girdle when stretching is of utmost importance. By using the muscles of the back and side body, mainly the rhomboids, serratus and trapezius, we can draw our inner shoulder blades down away from our ears and pin the bottom tip of our shoulder blades to our back ribs. Activating the back muscles effectively stabilizes the rotator cuff and allows the muscles of the front shoulder and chest to release, decompressing the nerve pathways that run from the neck to the arms.

The yoga poses outlined here are chosen to help you open your shoulders and chest progressively and keep weight off your hands to avoid further irritation where inflammation may be present. Remember: go to your edge, stop, breathe, wait and smile. Relief is just a breath away! Hold each position for 20–30 seconds at a time.

Pose 1: Urdhva Hastasana (arms straight overhead)
Raise your arms above your head, keeping them as straight as possible with your palms facing in. Draw your inner shoulder blades down and continue wrapping the outside of your arms toward your face. Imagine your shoulder blades and press the bottom tips of them against your back, lifting your chest. Breathe.

Pose 2: Garudasana (eagle arms)
Cross your right arm over your left at the elbow. Keeping your palms facing out, draw the left hand toward your face and entwine the right arm around the left. Soften your neck by lowering your chin. Draw the inner shoulder blades down and apart. Breathe deeply. Change sides and repeat.

Pose 3: Ardha Ghomukhasana (bottom arm only)
Take your right arm out to the side, palm facing back. Place the back of your right wrist against your spine. Roll your right shoulder back and lift your breastbone. Press the wrist into your spine to help activate the back muscles and pin the right shoulder blade to your back ribs, expanding your chest. Repeat with your left arm.

Pose 4: Bharadvajasana in a chair (twist)
Using a stable chair without arms, sit sideways. Place a four-inch yoga block (or large book) between your knees. The block will stabilize your pelvis and low back. Inhale and raise your arms up. Exhale and turn your navel and ribs toward the chair back. Clasp either side. Begin the twist from your navel and progress upward, turning with each exhalation. As you lift your breastbone high, drop your shoulders down and pin your shoulder blades to your ribs. Repeat each side twice.

Pose 5: Maricyasana I in a chair (open twist)
Place your mid-buttock against one side of the chair. Open your legs to a right angle. Raise your spine up with your shoulders rolled back. Draw your right arm back and place your hand to the outside edge of the chair that is behind you. Place the back of your left hand inside your left knee. Inhale and raise your chest and pin your shoulder blades to your back ribs. Exhale and turn your top chest any amount. Breath slow and deep. Repeat each side twice.

Pose 6: Maricyasana III in a chair (twist)
Sit with your feet square on the floor. Place a block between your knees. Raise your right arm, turn from your navel, and place your elbow outside your left knee. Inhale and lengthen your spine and draw your shoulder blades toward your waist. As you exhale, press your right armpit forward to turn your chest from the bottom up. Roll your left side back. Keep your neck long and neutral. Breathe. Repeat each side twice.

Pose 7: Sideways Arm Stretch at the wall
Stand one foot away from the wall. Walk your right hand up. Lift your breastbone and turn your shoulder back and down. Slowly walk your hand back. Keep turning your shoulder and extending into your fingers. Stretch your front chest. Breathe. Repeat each side twice. Note: If you feel tingling in your fingers, back off 10 percent, turn and lengthen your arm.

Pose 8: Urdhva Hastasana at the wall
Facing the wall, stand back 12 inches. Walk your hands up the wall, wrapping the outside of your arms toward your face and your inner arms back. Raise up on your toes to walk your hands further up. Attach your hands to an imaginary hook and slowly lower your feet to the floor, allowing your chest and side body to hang and stretch. Note: If your inner arm is hurting, separate your hands and turn your outer arm toward the wall even more.

Pose 9: Baddhanguliyasana (arms extending forward)
Interlace your fingers in front of you, palms facing out. Extend the web of your fingers into each other, then roll your shoulders back and down as you reach out with your palms. Breathe. Change the interlace of your fingers.

Pose 10: Reverse Wrist Flexion
Place the back of your palm on the chair beside you, fingers pointing back. Turn your upper arms and shoulders back, broadening and lifting your chest while pinning your shoulder blades to your ribs. Stretch one wrist at a time or both together.

*Source: National Institute of Neurological Disorders and Stroke, www.ninds.nih.gov/disorders/carpal_tunnel/detail_carpal_tunnel.htm

Lillah Schwartz is a certified Iyengar yoga instructor. She pioneered yoga in Asheville with the founding of Lighten Up Yoga Center in 1981. To inquire about private yoga sessions with Lillah that include a personalized yoga DVD or other yoga classes, visit www.Lightenupyoga.com or call 828-254-7756 to book an appointment.

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