Can yoga help with Shoulder Arthritis:

Much of yoga is weight-bearing, which is going to compress a joint. This is beneficial for healthy joints, as a controlled level of weight-bearing will build bone density and maintain cartilage shock absorption. However such yoga poses may need to be avoided or modified when dealing with arthritis. It is important to remember that extreme mobility exercises may also irritate arthritis, so I recommend keeping all movements within a realistic and achievable level of flexibility.

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1. Tadasana Variations

Tadasana is a wonderful diagnostic pose. Because in shoulder terms it is not weight bearing, and because the spine is in a neutral position, it allows us to play with shoulder mobility, and explore where pain begins in various arm positions.

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a. I recommend exploring arms out to the sides, reaching out like in Virabhadrasana 2, and exploring internal and external rotation (palms down, palms up). If your arms feel too heavy, you can bring your fingertips onto your shoulders, which effectively makes the arms lighter. 

You can try the arm variations described below, using a brick or belt, as these props help to create space inside the glenohumeral joint of the shoulder.

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b. Hold a brick behind the back, and grip it with the palms, not the fingers. Squeeze the brick, straighten the arms, draw the shoulder blades back and down, and and see if you can push the brick down.

 

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c. Hold a brick between the palms, and attempt to lift it above the head. Grip it with the palms, not the fingers. Squeeze the brick, straighten the arms, and lift the brick. Also lift the armpits, and spread the shoulder blades. You may find you cannot lift the brick as high as shown in the picture. No problem, lift to your comfortable limit.

 

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d. Put a looped belt around the wrists, behind the back, and hit out into it. Straighten the arms, and extend the hands downward.

 

 

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e. Put a looped belt around the wrists, straight out in front, and hit out into it. Straighten the arms, and extend the hands forward and upward. As the arms rise you will get to a stiff point, where you will want to poke out the chest and sway the back. Resist, take the lower front ribs in, and keep the abdomen engaged. Also lift the armpits, draw the elbows in and spread the shoulder blades.

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2. The Pendulum
This a wonderful way to release pressure in the shoulder. Bend over a chair, and put your knee and hand on the seat of the chair. Let the arm of your arthritic shoulder hang, and allow the weight to create space in the shoulder socket. You can then let your arm swing gently, which will decompress the joint.

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3. The Swing
In Tadasana hold a a stick or broom handle behind you, and swing it from side to side. This will gently limber up the shoulders without strain. You can play with an overhand or underhand grip, and how wide you place your hands also. I recommend having the feet apart for this one. It will help you to stay rooted as you mobilise the shoulders.

Remember, taking the arms above shoulder height may be painful. Remember: try taking the arms behind the back before taking them forward, as this will help with mobility. 

You can then do the same action with the stick or broom handle in front of you, and explore your range of mobility by swinging it from side to side in front of you.

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4. Trikonasana, Virabhadrasana 2
Standing poses which put no weight into the shoulders or arms are really useful when managing shoulder arthritis. Both Utthita Trikonasana and Virabhadrasana 2 are primarily leg and pelvic poses, but they also have great potential as a gentle shoulder mobilising and strengthening pose. You may find that you cannot hold your arms at shoulder height, so you can just release them onto the hips. Once you feel that you are strong enough to go a little further, why don’t you try doing the pose with a stick or broom handle?

In Utthita Trikonasana vertical arms may be too challenging due to shoulder pain, but you can use your strong shoulder to support your immobile shoulder using a staff or stick.

As you hold the poses, feel the shoulder blades spread and reach out into the fingertips, to create space in the glenohumeral joints.

I recommend playing with the shoulders in the pose. If you can take the arms out to the sides, explore how the shoulders feel as you externally rotate the upper arms. Try turning the palms upward. Compare how the shoulders feel when you broaden the shoulder blades vs. the collarbones. Get to know your comfortable range of motion in the pose!

You can also explore the range of comfortable motion in your shoulders in any other standing poses, as they bear no shoulder weight.

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5. Bharmanasana
Bharmanasana is commonly known as tabletop pose. It can gently strengthen the arms and shoulders, without irritating shoulder arthritis. Try grounding into the finger bases, particularly the index fingers (as they tend to lift). then push the floor away, and grip into the upper arms. As you push the floor away let your shoulder blades spread. Once again try to bring space into the shoulders by lifting out of the hands, rather than sinking down into the hands (and shoulders).

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6. Bharmanasana into Adhomukha Virsasana
From Bharmanasana you can sit back onto your heels into Adhomukha Virasana, keeping the hands on the floor in front of you. feel the armpits open and the shoulders stretch out. The more you can sit back the more you will create space in the glenohumeral joints. 

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7. Ardha Adhomukha Svanasana
If you can do all of the above poses without pain, you could think of bringing Dog back into your yoga practice. Adhomukha Svanasana is a weight bearing pose, so if you are rehabilitating a dislocated shoulder or working to stabilise shoulder instability, I recommend doing Adhomukha Svanasana with your hands on a height. It can be the seat of a chair, or the wall. If you know Samadhi yoga studios, the upstairs window ledges are perfect for this. Having the hands on a height takes much of the weight out of the shoulders, allowing you to control the amount of effort and stretch, and to focus more directly on spreading and drawing down the scapulae, and drawing the humeral heads into the glenohumeral sockets.

How yoga can help with Frozen Shoulder:

Yoga is a really useful tool in helping to recover or heal shoulder pain of many types. It is a safe and controlled method of rehabilitation, and the mindful approach of yoga lets us carefully work to but not beyond our safe limit. 

A key note: resting does not help frozen shoulder. It can lead it to freeze further as the adhesions multiply.

Yoga can really help with frozen shoulder. Yoga should be practiced carefully and sensitively, so as to prevent muscle guarding⁴, and a more painful and inflamed shoulder later.

1. Supta Tadasana
 Supine tadasana or mountain pose, actively lying on the floor. While on the floor you can explore arm movements while using the floor for support. Do you remember making snow angels when you were younger. Imagine you are out in the snow again. Tuen your palms upward and explore how large you can make your snow angels wings.You may find that your arms will only go to shoulder height, and that is fine. Rather than pushing into pain why don’t you try rotating your arms in the shoulder sockets?

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2. Urdhva Hastasana or Ardha Hastasana in Supta Tadasana
That is a long title for a simple pose: supine Tadasana with arms attempting to go above the head. Ardha means half. With normal range of motion we would hope to take the arms onto the floor above the head, but while caring for an injury we are happy to take the arms halfway, straight up toward the ceiling. With a frozen shoulder you will probably find that one and will move and one is very restricted. Why don’t you take a stick or a broomhandle, and hold it in both hands. Then try and lift the arms over the head into the pose. The healthy shoulder would provide strength and support for the injured shoulder.

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3. Tadasana variations
Tadasana is a great pose to help to read the body. It is very active yet neutral in its positioning, so you can use it to take stock of pain levels and/or progress. I recommend using it to explore shoulder mobility. Try taking your arms back behind the body, arms out in front, arms to the sides. Remember, taking the arms above shoulder height may be painful. Remember: try taking the arms behind the back before taking them forward, as this will help with mobility. You can use a a stick or broom handle to help control and guide the injured shoulder.

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4. Creeping Urdhva Hastasana
Face a wall, and take your hands onto the wall. Your distance from really depends on how much movement you have in your injured shoulder. Begin creeping your fingers up the wall. The elbows will bend as the arms rise. Watch the width of the elbows, try to keep them at shoulder width. As your fingers walk up the wall, you will need to step closer to the wall. Walk the fingers as high as you can, and then hold at that height. If you want to add more weight and work into the shoulders,  you can stand further from the wall, to ease weight and lighten the work stand closer to the wall.

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5. Virabhadrasana 2
Virabhadrasana 2 or Warrior 2 is primarily a leg and pelvic pose, but it also has great potential as a gentle shoulder mobilising and strengthening pose. You may find that you cannot hold your arms at shoulder height, so you can just release them onto the hips. Once you feel that you are strong enough to go a little further, why don’t you try doing the pose with a stick or broom handle?

As you hold the pose, feel the shoulder blades spread, so that the glenohumeral sockets move into the humerus heads. 

I recommend playing with the shoulders in the pose. If you can take the arms out to the sides, explore how the shoulders feel as you externally rotate the upper arms. Try turning the palms upward. Compare how the shoulders feel when you broaden the shoulder blades vs. the collarbones. Get to know your safe range of motion in the pose!

You can also explore the range of comfortable motion in your shoulders in other standing poses, as they bear no shoulder weight.

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6. Uttitha Trikonasana
Uttitha Trikonasana has a similar spacious shoulder opening feel to Virabhadrasana 2, except that the arms are vertical. Again explore spreading the shoulder blades, allowing the glenohumeral sockets to move into the humerus heads. Vertical arms may be too challenging due to shoulder pain, but you can use your strong shoulder to support your immobile shoulder using a staff or stick.

 

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7. Bharmanasana
Bharmanasana is commonly known as tabletop pose. It can gently strengthen the arms and shoulders, without irritating  a frozen or injured shoulder. Try grounding into the finger bases, particularly the index fingers (as they tend to lift). then push the floor away, and grip into the upper arms. As you push the floor away let your shoulder blades spread.

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8. Ardha Adhomukha Svanasana
If you can do all of the above poses without pain, you could think of bringing Dog back into your yoga practice. Adhomukha Svanasana is a weight bearing pose, so if you are rehabilitating a dislocated shoulder or working to stabilise shoulder instability, I recommend doing Adhomukha Svanasana with your hands on a height. It can be the seat of a chair, or the wall. If you know Samadhi yoga studios, the upstairs window ledges are perfect for this. Having the hands on a height takes much of the weight out of the shoulders, allowing you to control the amount of effort and stretch, and to focus more directly on spreading and drawing down the scapulae, and drawing the humeral heads into the glenohumeral sockets.

How yoga can help with shoulder dislocation and instability:

Yoga is a really useful tool in helping to recover or heal shoulder pain of many types. It is a safe and controlled method of rehabilitation, and the mindful approach of yoga lets us carefully work to but not beyond our safe limit. With shoulder instability strength training is highly recommended, as we want to create firmness and stability in and around the shoulders, as well as supple flexibility. As we mentioned at the start of the article, muscles give our shoulder joint its stability. 

While we would never wish an injury on anyone, having an injury really sharpens your awareness of the injured area. Injuries often give warning signs, but we often choose not to heed them.As you recover from a shoulder injury it is really useful to apply a heightened awareness to the action and movement of your shoulders as you practice yoga, as you work out, as you work, as you relax.

Sometimes in a yoga class you will hear conflicting instructions, like “reach the arms up as you take the shoulder blades down”. These kind of instructions have a poetic symmetry, but are not physiologically sound. Instructions like this are really not helpful, especially  when recovering from shoulder dislocation or managing shoulder instability. What your shoulders need is stability as has been said already. You should aim to draw the head of the humerus into your shoulder as you practice yoga (or do anything) to keep that stability. But what if you are reaching out, or stretching up? If you cannot draw the head of your humerus into the shoulder socket, then you should draw the shoulder socket into the head of the humerus! Lets put that into simple yogi terms: Virabhadrasana 1, Warrior 1, you extend your arms up over your head. People often say “take your shoulder blades down as you reach your arms up”. That is going to add to your shoulder instability. You need to lift your scapulae to your arms. In simple terms, lift your armpits. Try it right now: reach your arms straight up, and lift your armpits with them. Keep a spread in the back of the neck to reduce cervical tension, but lift the arms and armpits. Do you feel the stability in the shoulders? Something else you will feel is you can take your arms further back with less strain!

A few key points to bring onto your mat to benefit your shoulders:

1. Virabhadrasana 2
Virabhadrasana 2 or Warrior 2 is primarily a leg and pelvic pose, but it also has great potential as a gentle shoulder strengthening pose. Try holding the arms out at shoulder height in it for a few minutes and you will know what I mean. It does not put the shoulders under any strain, only healthy strengthening stress. It opens the chest, develops Deltoid muscle ⁷ strength and shoulder stability.

As you hold the pose, feel the shoulder blades spread, so that the glenohumeral sockets move into the humerus heads. I recommend playing with the shoulders in the pose. Explore how the shoulders feel as you externally rotate the upper arms. Try turning the palms upward. Compare how the shoulders feel when you broaden the shoulder blades vs. the collarbones. Get to know your safe range of motion in the pose!

You can also explore the range of comfortable motion in your shoulders in other standing poses, as they bear no shoulder weight.

Tadasana is an effective pose for playing with the shoulders, collarbones, sternum and spine, in a neutral standing posture.

Uttitha Trikonasana has a similar spacious shoulder opening feel to Virabhadrasana 2, except that the arms are vertical. Again explore spreading the shoulder blades, allowing the glenohumeral sockets to move into the humerus heads.

Uttitha Hasta Padangusthasana is a strong leg strengthener and hamstring stretch, but it also has a shoulder aspect. Use the Latissimus Dorsi ⁸ rather than the shoulder muscles to lift the leg. The Latissimus Dorsi muscles are the largest muscles on the back, and by strengthening them you can take pressure off the shoulders.

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2. Forearm Plank with Props
Once you feel you are able to start bringing some weight bearing back into your shoulders you could try this. The belt and brick stabilise the shoulder joints, allowing you to develop strength. Feel the humerus heads draw firmly into the joints, and draw the scapulae down toward your lower back ribs. If you do it carelessly you will feel the shoulder blades push toward each other, creating a furrow in the upper back. Keep the scapulae spreading away from the spine as you draw them down. Hit out into the belt to create resistance.

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3. Chaturanga Dandasana with Knees on Floor 
Chaturanga Dandasana. The pose we love to hate. It is a challenging pose, and applies a heavy load into the shoulders. The classic pose is probably too strong when recovering from a shoulder injury, so I recommend putting the knees on the floor. Now if you have been to my classes you will know that I usually do not encourage this, as the abdominal muscles switch off when the knees rest down. However it takes some of the load out of the shoulders, and makes it accessible. If you find that it is manageable then you can explore doing it with the knees on a bolster instead of the floor, which brings more weight back into the shoulders and upper body.

In Chaturanga Dandasana with knees down be mindful of the shoulder blades and collarbones. Like Forearm Plank with props draw the scapulae down toward the lower back ribs, keeping space between them. Grip the back of the armpits, and broaden the collarbones.

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4. Setubandha Sarvangasana 
If you have healthy and injury free shoulders and spine this is a very pleasant pose. However if you are recovering from an injury you will feel the effort in the pose, and appreciate more fully the effort it involves and benefits it brings. It opens the chest and strengthens the rear shoulders, the rhomboids and the lower fibres of the trapezius. 

Grip the elbows in using the upper back muscles, and have the forearms vertical. Keep the hands off the hips, and see if you can widen the hands by gripping in the rear armpits and drawing the scapulae down and in.

Hold as long as is comfortable.

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5. Purvottanasana Arm Action 

Like Chaturanga Dandasana, full Purvottanasana applies a heavy load into the shoulders. But if the bodyweight is reduced, it becomes a useful strengthening, stabilising pose, with some great built in chest stretch and external shoulder rotation. 

Do this asana variation either sitting crosslegged, or with the legs straight out in Dandasana. 

I recommend the classical hand position, facing forward, unless there is a wrist injury. People often ask can they turn their hands out or even back, as this “feels nicer”. I agree that it feels nicer, but it is less stable in the shoulders. 

In the pose the focus should be on drawing the shoulder blades down and in, and once again closing the rear armpits. Feel the skin on the rear upper arms descending, to help to lift and broaden the chest.

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6. Bhujangasana 

Bhujangasana is a back arch, but has built in shoulder and chest benefits. It opens across the collarbones and front ribs, creates a larger breath space, externally rotates the arms and creates firm shoulders. 

When practicing this pose there are a few points which I recommend:

• Do not fix the shoulders at the expense of the spine. Draw the navel in, and root your legs into the floor. This will keep your lumbar spine stable. 
• Grip in the elbows, and draw the rear upper arm skin down. 
• Keep the shoulders down and back.
• Broaden the collarbones.
• Use each inhale to create lift in the chest and front body. Use each exhale to help draw down the scapulae.

Hold as long as is comfortable.

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7. Dhanurasana

Dhanurasana is a backbend which stretches out the chest with little shoulder work. The arms and hands have to just hold on, and the legs are the lifters. Try it and you will see. People try to lift from the arms, and forget the legs. Hit the feet up and back and you will feel the pose come to life.  you can use the pose to open the front chest and firm the rear shoulders, working as hard or as soft as you feel best benefits your shoulders.

Hold as long as is comfortable.

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8. Ustrasana

Camel pose, or Ustrasana agin creates firmness in the shoulders and upper back, while creating space and openness in the upper chest. It is more challenging than Bhujangasana or Dhanurasana in the shoulders, because it also strongly externally rotates the humerus head in the glenohumeral joint. Couple that with the back-bending aspect of the pose, and it makes for a lot of work! With that in mind I recommend using two bricks to give some space and make the pose accessible.   Do not force yourself into the full back-bending version of the pose. Enjoy the space that the bricks give you, and over time you will slowly and safely progress into the prop-less version of the pose.

Ustrasana Action with Reduced Backbend

The shoulder and chest opening aspect of the pose can be explored without arching fully into the backbend. You can take the arms out and back, turn the palms out to create spacious external arm rotation, and draw the scapulae onward and downward.

Hold as long as is comfortable.

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9. Ardha Adhomukha Svanasana

If you can do all of the above poses without pain, you could think of bringing Dog back into your yoga practice. Adhomukha Svanasana is a weight bearing pose, so if you are rehabilitating a dislocated shoulder or working to stabilise shoulder instability, I recommend doing Adhomukha Svanasana with your hands on a height. It can be the seat of a chair, or the wall. If you know Samadhi yoga studios, the upstairs window ledges are perfect for this. Having the hands on a height takes much of the weight out of the shoulders, allowing you to control the amount of effort and stretch, and to focus more directly on spreading and drawing down the scapulae, and drawing the humeral heads into the glenohumeral sockets.

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10. Triangular Forearm Support  featured in our first episode. It is proscribed for rotator cuff injuries, but it really helps to build stability with a healthy level of functional flexibility. 

Interlink fingers, and place the elbows (shoulder width apart) on a wall. Step the legs back, keeping one closer to the wall for steadiness, and ground the forearms into the wall. Extend  the head away from the wall, opening your armpits toward the floor. Hold for 30 seconds.

How yoga can help with shoulder impingement and rotator cuff tendonitis:

,Yoga is a really useful tool in helping to recover or heal shoulder pain of many types. It is a safe and controlled method of rehabilitation, and the mindful approach of yoga lets us carefully work to but not beyond our safe limit.

1. Tadasana Variations

Tadasana is such a simple pose that it is often overlooked. Because in shoulder terms it is not weight bearing, and because the spine is in a neutral position, it allows us to play with shoulder mobility, and explore where pain begins in various arm positions.

a. Arms Back, External Rotation
Take the hands behind the back, with the palms facing forward. Explore rotation in the shoulders, especially external rotation, where you feel you are turning the thumbs out and back. What is important is not the angle of the thumbs or palms, it is the rotation in the shoulder socket, so make sure it is shoulder rotation and not wrist or forearm rotation masquerading as shoulder rotation. Draw the shoulder blades downward and inward, without puffing the chest forward. Hold as long as is comfortable.

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b. Arms in front at Shoulder Height
From Tadasana, take the arms out directly in front of the shoulders, with the hands shoulder width apart. Start with the palms facing down. Hold it with the fingers together rather than stretching apart, as this brings extra muscular engagement to the forearms. Explore external rotation by turning the palms in to face each other, and then try turning the palms to face upward. As with Tadasana a. what is important is not the angle of the thumbs or palms, it is the rotation in the shoulder socket, so make sure it is shoulder rotation and not wrist or forearm rotation masquerading as shoulder rotation.Hold as long as is comfortable.

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c. Arms in front at Shoulder Height with stretchy Band

From Tadasana, take the arms out directly in front of the shoulders, with the hands shoulder width apart, holding a stretchy band. Start with the palms facing down. Keeping the hands and arms at shoulder width, externally rotate the hands by turning the palms in to face each other, and then try turning the palms to face upward.

 As with Tadasana a. & b. what is important is not the angle of the thumbs or palms, it is the rotation in the shoulder socket, so make sure it is shoulder rotation and not wrist or forearm rotation masquerading as shoulder rotation. Watch the elbows, the inner elbows should externally rotate as the hands rotate.

Hold as long as is comfortable. Take a rest, and then cycle through slow external and internal rotations.

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d. Namaskarasana
Take the palms together into prayer pose in front of the chest. Explore the effect of firmly pushing the palms together, rather than just making the shape.
Are there any noticeable differences when you push the finger-bases together, compared to the heels of the hands? Explore differences in sensation when you take the fingers higher, and when you take the elbows higher or lower.

A really useful variation is to to lift the hands, and take the elbows closer together, perhaps even take the forearms right in to touch if possible. As you draw the elbows allow the shoulder blades to spread. As the forearms touch, raise the arms and hands, and feel how, as you push the arms together, you strongly engage the chest muscles, the pectoralis major. 

Hold as long as is comfortable

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2. Creeping Urdhva Hastasana

Face a wall, and take your hands onto the wall. Your distance from really depends on how much movement you have in your shoulder(s). Begin creeping your fingers up the wall. The elbows will be bent as the arms rise. Watch the width of the elbows, try to keep them at shoulder width. As your fingers walk up the wall, you will need to step closer to the wall. Walk the fingers as high as you can, and then hold at that height. If you want to add more weight and work into the shoulders,  you can stand further from the wall, to ease weight and lighten the work stand closer to the wall.

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3. Garudasana Arms

Garudasana arms is a wonderful way to open across the upper back and shoulders. When you pick up a shoulder injury, the greater area tightens up, not just the injured area. So it is worth opening around the whole area, not just focusing on the exact area of the injury. When you take one elbow under the other and ant attempt to wrap the forearms around each other and bring the hands together, you will feel a strong spreading of the shoulder blades.

If getting the hands together is too challenging, you can use a strap to hold the hands in place. I find it more useful to hold a strap rather than just have the hands floating, as the strap give stability and creates resistance. 

Once you are in the pose, work on lifting the elbows and hands, and take the wrists forward away from the face.

Hold as long as is comfortable, and then repeat on the second side.

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4. Gomukhasana Arms

What a wonderful stretch this has in store for you! Gomukhasana externally rotates one arm and strongly internally rotates the other arm. It stretches the tricep and latissimus Dorsi on one side, and the trapezius and rhomboids on the other side. However with an injury the full version of the pose will probably not be possible, so we will use a strap to give some space and make it accessible.  With that in mind please do not force yourself into the full version of the pose. Enjoy the space that the strap gives you, and over time you will slowly and safely progress into the prop-less version of the pose.

Hold a strap in your right hand, take the right arm up over your head, bend the elbow, and let the right hand and belt drop back behind your head.Take your left arm up your back behind you, and take hold of the strap. You can explore straightening your right elbow, which will pull your left arm up your back. Proceed with caution, try to explore the feeling of stretch without moving into pain. 

Hold as long as is comfortable, and then repeat on the second side.

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5. Ardha Adhomukha Svanasana

If you are a regular in my classes you will know that Adhomukha Svanasana is one of my favourite poses. I think it has so much to give! However, it is also a weight bearing pose. So if you are rehabilitating a rotator cuff tear of shoulder injury, I recommend doing Adhomukha Svanasana with your hands on a height. It can be the seat of a chair, or the wall. If you know Samadhi yoga studios, the upstairs window ledges are perfect for this. Having the hands on a height takes much of the weight out of the shoulders, allowing you to control the amount of effort and stretch, and to focus more directly on spreading and drawing down the shoulder blades.

Rotator Cuff Injuries

Your Shoulder Rotator Cuff is a group of four muscles: subscapularis¹⁰, teres minor¹⁷, supraspinatus²⁰, and infraspinatus²¹. These muscles surround your shoulder joint and hold the head of your humorus bone firmly in your shoulder socket. You can injure your rotator cuff muscles in many ways, but repetitive movements with force, having the arm overhead is a classic way to pick up an injury: think of serving at tennis as an example.

More often than not the injury is a tear in the tendon of the supraspinatus muscle. This tear can be just a small fraying of the tendon, a partial tear, or a full tear where the tendon disconnects from the bone. 

An injury of the rotator cuff muscles can feel like a dull ache, and it often feels worse at night, when we roll onto the shoulder during sleep. You will often find the pain is accompanied by a weakness in the arm, and difficulty taking the arm up or back.

Conventional treatment of a shoulder rotator cuff injury is either surgical or non-surgical. Obviously non-surgical treatments are explored first, including rest, ice, and physical therapy. If these options do not clear up the pain, a steroid injection is often suggested. 

An injection of Hydrocortisone can ease pain and aid recovery, the effects should last 3-6 months. The injection is often given with an ultrasound scan, so that the steroid can be administered to exactly the correct spot. Studies have shown that the effects of a steroid injection do not last longer than 3 months ²², but that can be enough time for recovery to occur.

If non-surgical methods are not effective, keyhole surgery, or arthroscopy, is often recommended.

How yoga can help with rotator cuff injuries:

Weight bearing can be an issue with a rotator cuff injury, as can raising your arms above your head. However modified versions of these movements in yoga poses have been shown to help to rehabilitate a moderate tear.

1. Tadasana Variations

Tadasana is such a simple pose that it is often overlooked. Because in shoulder terms it is not weight bearing, and because the spine is in a neutral position, it allows us to play with shoulder mobility, and explore where pain begins in various arm positions.

a. Hold a brick behind the back, and grip it with the palms, not the fingers. Squeeze the brick, straighten the arms, draw the shoulder blades back and down, and and see if you can push the brick down.

 

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b. Hold a brick between the palms, and attempt to lift it above the head. Grip it with the palms, not the fingers. Squeeze the brick, straighten the arms, and lift the brick. Also lift the armpits, and spread the shoulder blades. You may find you cannot lift the brick as high as shown in the picture. No problem, lift to your comfortable limit.

 

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c. Put a looped belt around the wrists, behind the back, and hit out into it. Straighten the arms, and extend the hands downward.

 

 

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d. Put a looped belt around the wrists, straight out in front, and hit out into it. Straighten the arms, and extend the hands forward and upward. As the arms rise you will get to a stiff point, where you will want to poke out the chest and sway the back. Resist, take the lower front ribs in, and keep the abdomen engaged. Also lift the armpits, draw the elbows in and spread the shoulder blades.

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2. Wall Chaturanga Dandasana

Classical Chaturanga Dandasana on the floor involves a lot of weight bearing, more than a shoulder injury may appreciate. It can be done standing up however, with the hands pushing into the wall. It is the same pose anatomically, except that your axis has shifted 90 degrees, which hugely reduces the weight bearing. To add more weight, you can stand further from the wall; to ease weight bearing, stand closer to the wall.

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3. Adhomukha Svanasana

If you are a regular in my classes you will know that Adhomukha Svanasana is one of my favourite poses. I think it has so much to give! However, it is also a weight bearing pose. So if you are rehabilitating a rotator cuff tear of shoulder injury, I recommend doing Adhomukha Svanasana with your hands on a height. It can be the seat of a chair, or the wall. If you know Samadhi yoga studios, the upstairs window ledges are perfect for this. Having the hands on a height takes much of the weight out of the shoulders, allowing you to control the amount of effort and stretch, and to focus more directly on spreading and drawing down the shoulder blades.