Easy Modifications to Make Yoga More Comfortable

by Amber Burke & Bill Reif

Editor's note: The below are intended to be general recommendations for yoga practitioners and teachers. They are not a replacement for the personal advice of a health professional.

Even when yoga is strenuous, ideally it is free of strain. We practitioners should aim to steer clear of sensations like pain, tingling, and numbness, and no pose should stress our joints or put us at risk of injury. While students are often encouraged to “listen to our own bodies,” and to tailor practice so as to avoid discomfort and make poses safer, it is not always clear how to do that.

Below are some general suggestions on making practice feel better for those who feel discomfort in particular areas of the body, or who have an underlying condition that could be aggravated by certain movements or positions. By avoiding some poses, emphasizing some alignment points already in our repertoire, and adding a few modifications designed to take weight or pressure off an injured or vulnerable area, we can substantially increase ease and safety.

It is important, however, that any injuries be properly diagnosed by a medical professional. If you are a student, let your teacher know about any injuries you may have and any medical advice you’ve been given. If you are a teacher, ask your students about injuries, as well as the movement recommendations they’ve received from doctors.

If pain or numbness persists even with the suggested modification, back off and take a rest.

1. Wrist or Forearm Discomfort

(e.g., from carpal or ulnar tunnel syndrome, De Quervain’s syndrome, wrist sprain, old Colles’ fracture)

If you do repetitive activities with your hands, you may find that the nerves in your wrist become aggravated, especially after multiple vinyasas.

Poses/actions to avoid if they cause discomfort: Placing your wrists in extension (as in poses like plank) while bearing weight.


Plank pose with wrists in extension

The alignment and modifications that may help: Avoid further irritation to the three nerves that run through your wrist (medial, radial, ulnar) by keeping your wrist “flat,” or in its neutral position whenever possible; in other words, create a smooth line from the forearm to the back of the hand.

Instead of practicing plank and similar poses with your palms down, practice them on fists, knuckles down, index-finger sides of hands forward, and wrists flat. To create a neutral wrist, you could also practice plank and similar poses with hands around dumbbells (with the dumbbells running parallel to the long sides of your mat, with wrists flat).


Alternatively, instead of plank, practice forearm plank with palms down or hands holding a block between them.


As wrist pain eases, it may be possible to simply lessen wrist extension rather than avoiding it entirely. For example, place a wedge under the front of the mat that tilts your fingers and palms downward in poses like table, plank, and downward dog.

2. Elbow Pain

(e.g., from lateral epicondylitis [tennis elbow], or medial epicondylitis [golfer’s elbow])

Those who do repetitive activities with their arms may find that the tendons or ligaments around the elbows become torn and/or inflamed.

Poses to avoid if they cause discomfort: Since the muscles and tendons that extend your wrist attach to your elbows, it may be wise to avoid practicing any pose in which you bear weight with your wrist in extension. Steer clear of poses that place weight directly on top of the elbow, such as crow, side crow, or similar arm balances.

The alignment and modifications that may help: Practice plank pose (and similar poses) with neutral wrists as described in #1 (using fists or dumbbells) to prevent pulling on the tendons that attach to the elbow. Be careful not to hyperextend your elbows; instead, press your inner upper arms away from each other until your biceps engage. Be sure to keep your collarbones broad and your shoulders back while externally rotating your upper arms until the eyes of the elbows point toward the thumbs of each fist.


Maintain external rotation in your upper arms as you lower toward chaturanga. (External rotation will help to keep your elbows near your torso as you bend them to go into chaturanga, alignment that encourages balanced work from the muscles on the inside and outside of the elbow.) Since a greater degree of bend in the elbows places more pressure on them, do not lower so far that you feel strain.


3. Neck Pain

(e.g., from disc problems or muscular strain)

Forward head posture, in which the head is habitually positioned in front of the shoulders, is correlated with neck pain. Those who work at a desk or use handheld electronic devices often find that their heads move forward; over time, this may reduce neck length, stress the muscles of the neck and the intervertebral discs, and even lead to a rounding of the upper back.

Poses to avoid if they cause discomfort: If you are experiencing neck pain, avoid poses that potentially compress the cervical vertebrae. These include inversions like shoulderstand and headstand that place pressure on the head and/or neck. Also, avoid moving into big backbends like camel pose before shoulder alignment has been established, and avoid extremes of neck extension: In poses like camel (and even in savasana) do not tip your head back to the point that the back of your neck creases.


Tipping the head back in camel pose: Avoid if it causes discomfort.

The alignment and modifications that may help: In mountain pose, roll your shoulders up and back, and draw your shoulder blades toward your spine until there is a crease between them. Tuck your chin enough that the back of your neck lengthens, reach up through the crown of your head, then bring your ears back over your shoulders as much as you can while keeping the back of your neck long.

Keep this spaciousness across your chest and length at the back of your neck in poses ranging from savasana to camel. lf the back of your head does not come to the mat comfortably in savasana, place a blanket under your head to keep the back of your neck long.

To modify camel pose, in a high kneeling position, take hold of a strap between your hands, with your hands a little wider apart than your hips and your palms facing forward. Roll your shoulders into place, and tuck your chin slightly, drawing your ears back until they are roughly in line with your shoulders. Keep your chin slightly tucked as you focus on lifting your heart and perhaps take the strap an inch farther back. (Do not take the strap so far back that the tops of your shoulders roll forward.) Stay here for several breaths, keeping the back of your neck long instead of tipping your head back.


Camel pose alternative

4. Shoulder Pain, Rounded Upper Back, Upper Back Pain

(e.g., from shoulder bursitis, biceps tendinitis, rotator cuff strain and thoracic kyphosis)

In part because of prolonged periods of sitting or time spent carrying or lifting heavy loads (including small children), our upper backs may round and our shoulders roll forward—a suboptimal position that can cause upper back pain and make the shoulders susceptible to injury when bearing weight or performing repetitive motions. (For practice suggestions that will help position the shoulders well and minimize the rounding of the upper back, check out our article "Yoga for Kyphosis.")

Poses you may need to avoid: Since it can be risky to support much weight with the hands and arms if your shoulders and upper back are not optimally aligned, steer clear of poses such as side plank, forearm balance, and chaturanga. If downward facing dog does not feel good, skip it.

The alignment and modifications that may help: Work on shoulder alignment by rolling your shoulders onto your back, then drawing your shoulder blades toward your spine as much as possible. Avoid rounding your back in weight-bearing poses like tabletop and plank. Instead, flatten the area between your shoulder blades.

In poses like chaturanga and baby cobra, stay broad across your collarbones rather than letting your shoulders round forward. When your arms are higher than your shoulders, as in urdhva hastasana (upward reaching pose) and warrior I, allow the outer edges of your shoulder blades to lift up (pressing your shoulder blades down your back when your arms are overhead disrupts the scapulohumeral rhythm and impinges on the spaciousness of the shoulder joint).

Until you are able to maintain optimal shoulder alignment, stick with poses that put less weight on the shoulders: You can practice tabletop instead of plank, downward facing dog, side plank, and other strenuous arm balances.


If downward dog or plank cause discomfort, tabletop can serve as a great alternative.

Take weight off your shoulders in chaturanga by lowering your knees to the floor and bending your elbows only a small degree.


5. Loss of Bone Density (Osteoporosis)

One’s degree of bone loss, which can only be assessed by a physician, must be considered when determining the degree to which a practice must be modified. Those with significant loss of bone density are generally advised to avoid extreme ranges of movement, especially extremes of spinal movement. The thoracic spine is particularly vulnerable; not only can fractures here lead to a rounding of the upper back, but a rounding of the upper back can lead to fractures. (A detailed sequence designed for those with osteoporosis can be found here.)

Poses you may need to avoid: Forward folding is considered the riskiest movement for those with osteoporosis, especially when the spine is flexed (rounded) with no support under the hands. A deep unsupported standing forward fold, for instance, places a greater load on the thoracic vertebrae than it would when modified with the hands and arms supporting some of the body’s weight. Big backbends, sidebends, and twists should also be avoided. Further, it may be unsafe to begin an inversion practice after your diagnosis, though some students with longstanding inversion practices and a minimal degree of bone loss may be able to continue with their doctor’s okay.

The alignment and modifications that may help: Throughout as much of yoga practice (and as much of your life) as possible, aim to create a neutral spine (by aligning your ears, shoulders, and hips) and find as much spinal length as possible (by reaching the crown of your head away from your tailbone). Roll your shoulders onto your back, and bring your shoulder blades toward your spine, as if trying to make a crease between your shoulder blades.

Avoid moving so deeply into forward folds that your spine rounds; instead, forward fold only to the degree to which you can still keep your spine long. For instance, instead of practicing uttanasana—a standing forward fold—practice a high version of ardha uttanasana, with your hands on your thighs or on a chair and your spine long.


Instead of forward folding into paschimottanasana, stay in staff pose.


Take precautions against falling, since falls can lead to fractures; have a wall or a chair available for support during balance poses, and take transitions slowly.

6. Moderate to Severe Hamstring Tightness/Pain

(including hamstring microtears or a history of hamstring strain)

Tightness at the back of the legs, caused by athletic activity or prolonged sitting, can inhibit one’s ability to forward fold. Forward folding repeatedly without time to recover, or while in suboptimal alignment, may lead to hamstring tears.

Poses to avoid: For those with hamstring tightness or tears, there is often no need to avoid any particular pose, though the way you practice forward folds might need to be adapted. This is discussed under modifications.

The alignment and modifications that may help: A pelvis that is tilted too much in either direction (forward or back) is correlated with feelings of hamstring tightness. So work to create a neutral pelvis, tilted forward enough that your lower back curves in gently while your belly draws in and up on each exhale to support the spine. Because misaligned movement can lead to injury or tightness, when standing (both in and out of yoga class), track your knees toward the centers of your feet, and root down through the four corners of each foot. (See this article for more alignment suggestions for the hamstrings.)

If you have tightness or microtears in your hamstrings (most often felt underneath the buttocks), fold forward only as much as you can without pain, tingling, or numbness. Those with tightness or microtearing should work up to forward folds over time, starting first with hamstring stretches done lying on the back, lifting one leg toward the ceiling with a strap around that foot.

When those poses begin to go well, progress to seated poses with your legs extended. Leaning back with your hands a few inches behind your hips is one way to create spinal length while seated: This position may make it possible for you to curve your lower back gently inward and reach out through the crown of your head.


Leaning back in staff pose

Gradually work to keep this elongated spine while seated upright, with your hands alongside your hips. As that becomes more accessible, begin folding forward with your hands alongside your hips or on your thighs, keeping your legs straight and pausing at the first degree at which you feel a stretch. (While bending the knees is not unsafe as long as the knees track well, that common modification may cause a student to avoid stretching certain areas of their hamstrings in a quest to bring their hands nearer to their feet.)

Once it is possible to fold forward with some ease, progress to a standing forward fold with your hands on your thighs, a chair, or blocks (not dangling, since hamstring issues may make the SI joints, intervertebral discs, and lower back muscles especially vulnerable to strain).


Generally, in all folds, we want to aim to cultivate a gradual rounding from the lower to upper spine. However, when hamstring tightness is combined with lower back pain, students should typically avoid folding to a degree that rounds the lumbar spine.

7. Lower Back Pain

(e.g., from muscle strain, disc problems, sacroiliac joint dysfunction)

While there can be many factors at play in lower back pain, some involve injury or a slumped or overarched seated position held for a prolonged period. Pregnancy or asymmetrical movement can be among the causes of sacroiliac joint dysfunction (explained in this article and this ebook), another cause of back pain.

Poses you may need to avoid: Depending on the source of pain, either deep backbends or deep forward folds—or both—may be problematic. Rolling up to stand, a difficult movement for many students to make safely, places a great load on the lumbar vertebrae and may aggravate lower back pain.


The alignment and modifications that may help: Work to maintain a neutral spine with a gentle inward curve in the lower back, belly drawing in to support the spine. Forward fold by hinging at your hips instead of by rounding at your waist. Limit how far you go into forward folds or backbends, at least until you ascertain which of these is aggravating for you.


To release your lower back in savasana, support your knees and/or shins and feet with a bolster or chair seat.


8. Knee Discomfort

(e.g. from patellofemoral alignment syndrome, tightness around the IT band, chondromalacia patella, crepitus)

Students may develop knee pain or crackling sounds as the result of injury, time spent kneeling, or long-term poor knee tracking (some degree of “knock-knees” or “bowlegs,” the former of which may be helped by a practice that addresses this common leg misalignment). Younger students may even feel knee pain as a result of growth spurts.

Poses to avoid: Avoid kneeling on the mat without padding beneath your knees. All movements that cause repeated clicking of the knees should be avoided.

The alignment and modifications that may help: In general, the knees should track toward the center of each foot. If you have knee pain, avoid hyperextending your knees, which can overstretch the ligaments in back and potentially allow the patella (kneecap) to move off course. Regardless of whether you feel pain in your knees when they are on the mat, place padding under them. Why? This can prevent compression of the patella, irritation of the underlying tissue, and possible knee-tracking issues later on.


Similarly, whether or not you feel pain while in a kneeling position, place support underneath your sitting bones so that your knees do not have to bend as deeply.


Final Considerations

The suggested practice modifications are by no means the only ones that might help you avoid discomfort; rather, they are just a few examples of ways in which weight can be taken off an injured or vulnerable joint in order to make a pose more comfortable. As you continue to tailor practice for yourself or your students, you can find more useful modifications if you keep these considerations in mind: Which poses in the sequence could place pressure on an area that is already hurt or at risk? And how can you lighten the load on that area?

Photography: Andrea Killam

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Amber Burke

Amber Burke lives in Taos, New Mexico. When she is not writing about yoga, she teaches alignment-based and restorative yoga at the Taos Spa and Tennis Club and occasionally at Ojo Caliente Mineral... Read more>>  


Bill Reif

Bill Reif, the author of The Back Pain Secret: The Real Cause of Women’s Back Pain, is a Masters of Physical Therapy graduate of SUNY Buffalo & Emory University Physical Therapy programs, the... Read more>>  








Rediscover Yoga: 3 Simple Ways to Rekindle Your Love for Practice

by Colin Hall

The honeymoon phase of a relationship is a wonderful and curious thing. You never know how long it will last and how powerfully your life will be pitched about in the tempest of infatuation. Intoxicating newness can take over your thoughts and make your body burn with passion. But what happens when the buzz wears off?

Yogis are people who have fallen in love with yoga. If you are reading this you are probably a yogi. You may have fond memories of your first few yoga classes, or even your first few years of practice—when it was fresh and new. You were excited to learn more. You devoured yoga books, searched for yoga blogs, made yoga friends, talked yoga talk, and thought yoga thoughts. Yoga made you a little weak in the knees.

For some of you that feeling has never disappeared. You continue to fall in love with yoga over and over again.

But for some of you, not so much. Maybe life got in the way. Whether it was a growing family, a new job, a sickness or injury, or moving away from your favorite yoga studio, the excitement faded and your relationship with yoga became a little less “whoa” and a little more “meh.”

Do you wish you could rekindle the fires of your passion for yoga?

Are you ready to rediscover yoga?

Rediscovering “whoa” might seem like a tall order. But really, there are a few simple things you can do to keep your yoga feeling fresh and new. Below are three secrets I’ve found work magic in rediscovering one’s romance with yoga.

Secret #1: You rediscover yoga every time you practice. You may imagine that you are practicing the same postures over and over again, but the postures do not exist without you. And you are constantly changing. Your body, your thoughts and emotions, your physical sensations are always in flux.

Just like when you're in love with a person, you and your partner are changing all the time. Couples run into trouble when they grow apart. The key is not to hold on to some romantic notion of the way things used to be but to grow and evolve together.

Yoga today is not the same as yoga 20 years ago. Yoga is much more injury-conscious, trauma-sensitive, and inclusive than it was when I first fell in love with it. It is also radically different than it was 100 years ago at the Mysore Palace, where Krishnamacharya was teaching B.K.S. Iyengar and Pattabhi Jois. And that yoga is a world apart from the kriyas and mudras of medieval hatha yoga, which hardly resemble the devotional practices of the bhakti yogis.

I am astounded when I hear someone say they find yoga boring. There is no yoga per se. There are hundreds of yogas. Maybe millions. There are as many yogas as there are yogis.

Which means that no matter how many years you have been practicing, you have but scratched the surface of yoga. At least in the interest of humility, please never say you are bored with yoga.

Secret #2: You are creating the yoga you practice. Yoga doesn’t exist as an object out there somewhere in the universe. As one of my teachers said, “Yoga exists in the bodies of its practitioners.” That means you are making it. You are not in yoga. Yoga is in you.

If you are getting bored with yoga, change it. You have the power.

Lineages of yoga are like safe deposit boxes. They are repositories of tools, techniques, legends, and philosophies—all of which are invaluable resources for a yogi, but they do not contain the yoga. Yoga takes place in yogis, not in lineages or schools.

Don’t tie yourself to a particular technique or tradition if it no longer serves you. That doesn’t mean you should walk around being outwardly hostile to yoga traditions. It just means recognizing when it is time to try something new.

You are driving this train.

Don’t fool yourself into thinking that you are driving anyone else’s train though. It is hard enough to prevent your own train from being derailed. Just because you are creating the yoga you practice does not mean you have the power to create someone else’s yoga for them. Be powerful, but stay humble.

Secret #3: As your study of yoga deepens, it seems to grow more and more complex. But remember that the best things are always the simplest. Yoga can end up seeming like a fashion show with designers sending out models in outrageous costumes, pushing the envelope and challenging the limits of what is possible. But no matter what styles end up on the runway, there is nothing like a comfy pair of jeans and a crisp, clean T-shirt.

The best value in yoga lies in the basics. There is much adventure to be had in complex inversions, backbends, and arm balances. But it is expensive. It requires a huge investment of time and energy. And the return on your investment? Challenging postures look really cool. Beyond the aesthetic/performative element, these postures can also present you with obstacles to be overcome. In many ways complex and impressive postures are like Mount Everest. Why do them? Because they are there. But you certainly do not need to scale Everest, with all its associated dangers, in order to enjoy the simple beauty of going for a hike.

Think back to your first few yoga classes. Think back to when you first fell in love with yoga. What was it that captured your heart? Most likely, it was something simple. You felt energized or relaxed, or maybe you slept better. You moved more easily, you stressed less, or you simply felt playful and content in your body.

Think back to when you first fell in love with yoga. What was it that captured your heart? Most likely, it was something simple.

Focus on the basics. Attend to the things that make you feel good. By stripping your yoga down, away from ever more complex alignments, vinyasas, or philosophies, you can re-engage with the feelings that made you fall in love in the first place.

You can fall in love again.

Take my word for it. I fell in love with yoga when I read Patanjali’s Yoga Sutras in my second year of university. I fell in love again when I met a brilliant teacher in Calgary, Alberta. I fell in love again when I started teaching a class for seniors at a community center. I fell in love anew when my wife and I opened our yoga studio in Regina, Saskatchewan, and again by watching my students become teachers.

I fall in love with yoga when I find a new teacher, read a new book, take a new class, or learn a complementary modality. I fall in love whenever I am forced to relearn something I thought I knew. The one thing that all my favorite teachers have in common is that they pull the rug out from underneath me. They challenge my assumptions, reveal my blind spots, and make me reconsider things I thought I knew.

Whenever the rug is pulled out from under you, you have an opportunity to be swept off your feet.

This is all about you and your relationship with yoga. Maybe you never fell out of love. Maybe you broke up with yoga and married CrossFit. That’s okay. But if you and your practice are having a lover’s spat or worse and you want to reconnect and rediscover your passion, you need to take risks.

Be bold and daring. Open yourself to new projects and possibilities. Unlearn, relearn, and unlearn again. Because rediscovering yoga is all about embracing beginner’s mind.

Lisa KanneComment