Exercise and painExercise and pain
Contraindications
to get a release and needs many repetitions (Pullig
Schatz 199 2 ). The pain of both muscle and scar
stretching must not cause any radiating pain and must
stop after the stretching is finished.
In any other type of pain, such as joint pain or
radiating pain or in paresthesia, such as tingling or
numbness, check how the exercise is being per-
formed. If the pain or tingling or numbness persists
despite the exercise being performed correctly and
adjusted to what the patient can tolerate, an investi-
gation is necessary. Exercising despite the feeling of
pain may be dangerous. If pain-sensitive nerve fibers
are stimulated, they release chemical substances
that may cause inflammation of the adjacent vessels
(Silbernagl 200 7 ).Pain after exercise
If pain occurs after exercising, thorough observa-
tion, and possibly investigation, is necessary.
Pain after exercising often indicates an inflam-
matory process such as arthritis. You need to check
how the exercise was being performed – its quantity,
quality, and intensity. In particular, hypermobile
patients may overwork themselves during exercise.
If they are not very aware, they may not feel the
effects of the overwork until afterwards.
Muscle soreness or stiffness after unfamiliar or
intensive use of muscles is probably caused by mul-
tiple microruptures of muscle fibers (Pschyrembel
2007 ).
In summary, where there is pain after exer-
cise the main pillars are the medical investigation
and the style of exercise. If the medical investi-
gation is clear, the exercise approach should be
checked. In the beginning the help and correction
of a well-trained yoga teacher should be sought.
With increasing practice, mindfulness and aware-
ness are progressively cultivated. Natural biofeed-
back can help you to be aware of the very first
signals that something is not right (Pullig Schatz
1992 ). Yoga practice is a good training for learn-
ing to feel and interpret these first warning sig-
nals. With increasing practice this learning can be
applied to everyday life to improve posture and
movement patterns, to be more aware of them,
and to learn to avoid unhealthy postures, move-
ments, and habits.Contraindications
As for any other therapeutic and medical treatment
there are contraindications for prescribing certain
yoga āsanas for certain conditions. Some very expe-
rienced yoga teachers may succeed in their work by
intuition based on profound knowledge and long
experience. However, a thorough consideration is
necessary.
Where there is acute disease, a life-threatening
condition, or a condition needing surgery or special
medication yoga therapy is not indicated.
The variety of approaches and modifications is
rich in yoga. Once the necessary medical measures
have been applied, at the very least a gentle resting
pose with appropriate support or sensitive breathing
can make the patient feel better. There are contrain-
dications to performing full āsanas (Iyengar 2001 ).
Inversions should not be practiced in cases of high
blood pressure, glaucoma, or during menstruation.
Much of the knowledge about indications and con-
traindications for certain āsanas is based on empiri-
cal evidence. There is plenty of scope for further
research on therapeutic yoga (Raman 2008a).
One remarkable recent finding relates to intra-
ocular pressure. Measuring the pressure in 75 sub-
jects during headstand showed that in all cases the
intraocular pressure was twice as high as before
starting headstand. Therefore according to present
knowledge glaucoma patients should avoid standing
on their head, even if they are well controlled with
medication. Another observation has shown that
intraocular pressure in a resting pose has been lower
in subjects regularly practicing headstand than in
a group who were not practicing inversions. More
research is necessary into the preventive evaluation
of headstand for glaucoma (Baskaran et al. 200 6 ,
Raman 2008b).
As mindfulness is an essential principle for per-
forming yoga, students and patients should refine
their awareness during their practice. In this way
they will improve their ability to feel what they can
do and what it is best to avoid. This also depends on
their constitution and state of mind, which changes
from day to day.
Mindfulness, awareness, and clear observation are
also very important for the teacher and therapist.