Ep 44: Sequencing for General Shoulder Injuries

Shoulder injuries make me think of a lack of range of motion and overhead shoulder movement. I've been reflecting on a few times when I had shoulder issues myself and couldn't lift my arm overhead. 

Frozen shoulder was by far the worst because it was persistent pain over an extended period of time, which of course affected my personal practice and my every day life. 

When I think back on it, all of my shoulder injuries occurred in my right shoulder. So it's fair to say that my right shoulder has been through some things. 

If you want to start offering more than saying, "Do what feels right"  and teach modifications & alternative movements that will make the class more supportive of what your students need... Well, that's what this episode includes, how to alter your sequencing for students with general shoulder injuries. I'll focus on general shoulder injuries and ways you can alter or modify your sequencing and other tips in order to make your classes more accessible for students who cannot reach overhead.

Transcript

Yeti Stereo Microphone-1: 0:00

When I think about injuries, I think about overhead shoulder movement or the lack of it a lot. I've been reflecting on a few times when I had shoulder issues myself and couldn't lift my arm overhead. The first was a rotator cuff tear. The second was from a vaccination. When I was preparing to go to India for a 300 hour yoga teacher training. And the third was from frozen shoulder.

Yeti Stereo Microphone-2: 0:28

Frozen shoulder was by far the worst because it was persistent pain over an extended period of time, which of course affected my personal practice. I should probably record an episode on my experience with frozen shoulder. I have so much to say about it and how I managed living through the condition. Plus everywhere I go. It seems as though I meet someone who either has frozen shoulder. Or they know someone with it and all three of these cases, it one affected my practice mentally and two affected it physically because I could not raise my arm overhead. When I think back on it, all of these happen in my right shoulder. So it's fair to say that my right shoulder has been through some things. In this episode, I do want to focus on general shoulder injuries and ways you can alter or modify your sequencing. And other tips in order to make your classes more accessible for students who cannot reach overhead. Imagine you have a student who comes to class with a shoulder injury that reduces their overhead range of motion. You may ask yourself, what can I do as the teacher? That's more than saying, do what feels right. And offer some modifications movements or exercises that will make the class more supportive of what he or she needs. Well, that's what we'll discuss in this episode, how to alter your sequencing for general shoulder injuries.

2:13

Welcome to the Essential Conversations for Yoga Teachers podcast with me. I'm Monica Bright, and I've been teaching yoga and running my yoga business for over a decade. This is the podcast for you if you're a yoga teacher, you're looking for support, you love to be in conversation, and you're a lifelong student. In this podcast, I'll share with you My life as a yoga teacher, the lessons I've learned, my process for building my business, and helpful ideas, tools, strategies, and systems I use and you can use so that your business thrives. We'll cover a diverse range of topics that will help you whether you're just starting out or you've got years under your belt and you want to dive deep and set yourself up for success. I'm so glad you're here. Listen, I don't take myself too seriously, so expect to hear some laughs along the way. Now, let's do this together.

Yeti Stereo Microphone-2: 3:22

Welcome back to the podcast. And if you're a new welcome to you first. Thank you for listening. If you're taking notes, I love it. And I'm excited for the value that you get from every episode. My hope with this podcast is that you have a resource to come back to, and it feels like the space where you can ask the questions. You've been dying to get answers to. You've noticed that we've been talking. About pain and injuries a lot lately. Right? And I have stressed how important I believe it is for movement teachers to understand the human body, especially because we are teaching movement and working with actual bodies. So it's really important to understand how, what we're teaching affects. People's bodies. Scroll down to the show notes because I created an ebook for you on sequencing for different injuries. I do realize that learning this information feels interesting, but it might also feel like a lot to learn. Whenever I begin to learn something new that might seem overwhelming. I always think I'm just going to take baby steps. You will learn bits and pieces here and there. And then the pieces will begin to join and it all begins to make sense. That's exactly what happens to me as well. When I started learning about pain and injuries, it seemed like an uphill battle. I even thought this is too much. Some concepts you have to hear again and again, and one day it clicks. This is a natural process. So don't be overly concerned by it. Okay. The ebook is sequencing for different injuries and I'll leave a link to it in the show notes. Download it. I promise you it will help to lay the foundation for you. And it will be a great resource for you to return to. All right. The question is, what can I do as the teacher? That's more than saying, do what feels right. And offer some modifications movements or exercises that will make the class more supportive. Of what a student with a shoulder injury needs. I want to be able to help these students. And also I would like some tips to modify my classes. So that they feel included whenever they come. What are some different things I can do as the teacher. This is such a perfect question because through trial and error, I learned what to do and what not to do in class. And in my own experiences with injuries and studying injuries so that I truly understand what's physically happening in the body. I kind of hate to say it, but if you get injured, You'll have an entirely different perspective on how to teach. And work with injured students. Because you've been there. And you understand what it feels like to try to practice yoga. And you can't lift your arm. But again, navigating an injury is the best teacher because you are the injured and you will learn what it feels like to live with it. Accomplish your daily activities and practice yoga While also working on healing and recovering. There are several ways to adjust your sequencing, to accommodate and support a student with a shoulder injury, particularly one who struggles with raising their arms overhead. I'm going to share six different approaches that you can take. The first is, I want you to think about replacing overhead movements with more shoulder friendly variations. Instead of asking the student to raise their arms overhead, for example, in chair pose, or let's say warrior one. Offer alternatives that don't require shoulder flection. That's arms. Overhead. But instead keep the shoulder joints in a more neutral position. You could sequence with hands on hips or hands in undulate moodra in front of the heart. You won't need to change your sequence much or at all. And this removes the teaching environments overhead and still allows you to focus on engagement of the lower body. You could even theme your class around Anjali mudra, for example, and asked students to notice what it feels like to practice a different arm position. Or what it feels like to place the palms together. And can students connect to that feeling? Another arm variation you could use is cactus arms. In poses that typically involve overhead. Our movement suggests cactus, arms elbows bent at 90 degrees poems forward, which requires some shoulder flection. Abduction and a degree of external rotation, depending on how you cue to enter cactus arms. You can try this variation out. It does include some shoulder movement, but it may be just enough so that the student in pain can handle this shoulder variation without reaching overhead. Second you'll want to think about modifying downward facing dog. And other shoulder weight bearing poses. Poses like downward facing dog can exacerbate shoulder pain. If you think about arms overhead. And the discomfort this might cause students. These kinds of poses are adding additional load or weight bearing on the shoulder joints. And you can already imagine that that probably would not feel the best. So offer supportive alternatives. How about tabletop instead of downward facing dog? Suggest tabletop with your hands and knees on the mat. In order to reduce the amount of weight on the shoulders. And the amount of flection in the shoulder joints. Another variation is dolphin pose. If a student can't tolerate some weight, bearing dolphin pose is like downward facing dog, but with the bend in the elbows and the forms connected to the mat, bending the elbows will serve to create a lever, therefore making the arms shorter. And was shorter arms and the student's body closer to the floor. It can reduce how much weight is put on the shoulders. And for some students. This might be an option. So try that out. A third option is to incorporate active shoulder stabilization. First and I want to stress. This is very important. You need to ask the student how it feels to reach their arms straightforward. And what it feels like to bear weight on the shoulders. That could be too much. I mean, I probably would ask this question before. teaching tabletop and dolphin pose in the sequence. Also. If these are movements that feel okay to do for the student, you can sneak in exercises to help strengthen and stabilize. The muscles around the shoulder joint to support recovery. I am a big believer in the fact that you do not have to tell the students everything you plan to do or teach in the class. But instead, give them an experience of doing the movement and then maybe talk about it after class or leave the conversation for the next time you see the student. And ask them how they felt a day or two or three. After that class, you can gauge from what the student shares, whether or not these shoulder stabilization exercises are appropriate for them going forward. One option is a scapular pushups. Those are, uh, one of my favorite things to do. So in a modified plank. On knees or forearms. I prefer knees down, teach scapular, protraction and retraction. Allowing the shoulder blades to spread apart and then squeezed together. This engages the shoulder stabilizers without requiring overhead movement. I would even introduce this movement in tabletop. So students get the gist of the movement and then included in the sequence going forward throughout class in modified plank or even plank pose. If bearing weight on the shoulders in tabletop or dolphin or downward facing dog is too much change the orientation of the scapular pushups and make them wall presses. Have the students stand facing a wall. Please their palms on to the wall at shoulder or chest height. Then perform the same movement and protract and retract the scapula, which will cause them to push away from the wall. And when they retract the scapula lean a little bit closer towards the wall. It's just a natural movement. When you move the scapula. This is another way to strengthen around the shoulders without raising the arms overhead. And this exercise students might feel a stretch and engagement across the upper back while stretching and engaging the rhomboid muscles. These are muscles that connect the scapula to the thoracic spine. You can do these scapular pushups in all different orientations. You could start lying on your back. Teaching students to reach their arms towards the ceiling. Turn their poems towards the ceiling and practice supine, scapular, pushups. Then change to tabletop with hands and knees on the mat. And practice scapular pushups. Then progress to modified plank. With scapular pushups. And then finally, if the student can tolerate it, plank pose with scapular pushups. And then remember you could always regress it completely and go to wall presses. The fourth variation is one of my favorites to incorporate into classes. It is shoulder mobility exercises. My favorite are shoulder circles. There are so many variations of shoulder circles that you can teach First encouraged the student to do small controlled shoulder circles with arms by their sides. Or at a lower angle, think the arms are about five inches away from the hips In an inverted V-shape. Then have students continue the circles as they begin to apt up their shoulders Out. And up and away from their body in the goods. Arm's parallel with the floor. Here you can have students practice full circles. I have circles quarter circles or to stay in one spot that feels good to work in. Also if the arms straight feels like too much for the shoulders, have students been their elbows or shorten the lever and make their desired circle with their elbows? Now, this might seem like a lot, especially for a student with a shoulder injury. That's why you would break up these variations of shoulder circles throughout your entire sequence. Therefore you will be sneakily adding shoulder mobility exercises throughout the whole class. This helps with mobility, moving at the joints and strengthening at the same time without veering into potentially overstretching already. Injured soft tissues. You can also offer gentle. Passive stretches that respect the shoulders, current range of motion. I try to thread the needle in table top or a prone position, cue thread, the needle to gently. Flex and horizontally abduct the shoulder joint, which is reaching the arm across the chest. You'll want to keep the motion gentle and cue students to stay within a range. That's pain free. if the student has a torn rotator cuff. I'd suggest staying away from a passive thread, the needle, you can change this to a dynamic movement. So think tabletop. Lift the right arm up towards the ceiling while you twist your chest and turn towards the right. And then as you reach the right arm underneath the left arm, resist the urge to touch the shoulder. To the floor. And then open back up towards the right. Turning the chest to the right, lifting the right arm up towards the ceiling. And again, twist left, reach a right arm. Underneath the left arm without lowering the shoulder to the floor, do those dynamic twists. Three five times. It will encourage this movement crossing the arm over the chest, but without adding in that passive. stretch. Any poses or sequencing that requires stretching the muscles more. Would be a no-go for students who have torn rotator cuffs, stretching an already torn or injured muscle. Is not the recommendation for recovery. Okay, moving on. The fifth and a very useful option is to use props for support. Props like straps blocks and bolsters can be very helpful in your classes. Let's use supportive bridge pose with one block underneath the pelvis. And the other block held between the hands. In supportive bridge, introduce shoulder mobility by having the student hold a block between their hands and lift the arms towards the ceiling. Or to the height that they can manage without paying. Practice this shoulder exercise with a block throughout class to create a through line from start to finish. This gives the students something to hold on to while they work on shoulder mobility. For some students, this is very helpful because they can focus on something else. Other than just the movement. And another example, suggest that students use a strap in seated forward folds. When you teach seated forward folds like paschimottanasana or John cue the use of a strap so that the student can hold on to it. Instead of trying to reach forward or overhead for their ankles or their feet. This can help this student resist a potentially painful position. By reaching their arms overhead. Finally think about shifting the focus of the class to core engagement. And or lower body engagement instead of upper body movement. You do this by emphasizing core strength and lower body engagement imposes, you're already teaching to support overall stability And it allows the shoulders to take the backseat. All standing poses can be cued to focus on lower body engagement, theme your classes around brooding grounding, and engaging the lower body to connect what you're teaching to what you're theming. Think about varying your sequences by altering poses. Offering different arm and hand placements and think outside the quote unquote normal alignment rules. And teach something new. For example, think about this transition. Warrior to extended side angle and reverse. Warrior. All with hands at heart center or underlay moodra. This is a very familiar group of poses. But you can change the monotony of them and the lower body intensity just by changing up the hand placement. So think about how can you teach a different, ideally the same variation of an arm or hand placement in various standing poses light Asana. Warrior one. Warrior two. Warrior three. High lunge or Crescent pose tree pose. And chair pose. Could you teach. Hands on hips and all of those. Could you teach hands at heart center and all of those poses? Could you teach shoulder circles and all of those poses. There's so many variations. So, let me finish with some final suggestions with teaching students with general shoulder. Injuries. Focus on breath, awareness and teach relaxation. Encourage students to focus on breath, work, pranayama that can potentially promote relaxation and can also reduce muscle tension. Around the shoulders. For some students breathwork can be extremely relaxing and stress reducing. So incorporate breath work either at the start or the end of class. See if that helps. Also teach body awareness and proprioception. Teaching students to get and stay attuned to their body. Moving only within a pain free range. And to back off immediately, if they experience any discomfort. The goal here is to help students learn where their pain free range is and give them the permission to work, where it feels right in their bodies. This teaches students to be aware of their own bodies, as opposed to what other students are doing in class one, students learn to attune to themselves. It's kind of hard to get disembodied. Neither one of these options requires you to change your sequence much. I mean, you may need to eliminate one or two poses to make time for a short breath practice, but you can teach about proprioception and body awareness through your queuing and language throughout class. I think it's so important to encourage students to continue their yoga practice. Even if they are injured. It's just about finding out what movements can be tolerated and staying within the pain free range. This approach keeps them engaged in their yoga practice without exacerbating their shoulder issues. We can teach this as yoga teachers, if we have the knowledge to do so. I truly love being in conversation with you and answering your questions. I don't think we talk enough about how our teaching can help students in pain or with injuries. I hope that this episode sparks some deeper thought around how transformative your classes can be. It's important to realize how easily we can incorporate small things into our classes. That can affect the entire experiences. Students have. Don't forget to download the ebook sequencing for different injuries. The link is in the show notes. I promise you it will help you form a foundation for teaching students with injuries. And it'll be a great resource for you to return to, again. And again, I've also added a link in the show notes for you to send me a quick text message about your thoughts on this episode or any other. I won't know your phone number. It's just a new addition to the platform I use. That allows for an easy way for you to communicate with me. Once you click on it, it will take you to your messages. Don't delete the code. That's how your message will get to me. And I would love to know your thoughts on this topic. I love diving into these conversations because there are so many important discussions to be had in the teaching world. You know that my goal is for you to love the yoga teaching life. And allow it to be fulfilling and rewarding, and sometimes it takes some work and a few conversations to get there. If you loved this episode, let me know. I subscribe to the podcast. So you're always in the know when a new episode drops. And share it with another yoga teacher who you think would love to be in on these conversations. Thank you for helping to spread the word about this podcast. And if you've been taking notes in your journal, As you listen to these episodes, I'm so glad you are. And I would love to hear about it. Finally, if you download the ebook, you'll be joining my newsletter. That's just for yoga teachers. I've got more exciting teachings coming soon. So I want to tell you all about them. The link is in the show notes below, and I would love for you to join it so we can always stay connected. All right. That's it for now. Bye.

25:44

Mhm.