Yoga for Upper Quarter Rehabilitation

Written by Linda Kochan, OTR/L

Virtual Hand to Shoulder Fellow ‘20/’21

I recently had the opportunity to utilize yoga elements to treat an adolescent with a musculoskeletal disorder complicated by hypersensitivity to the volar aspects of the palms and fingertips. The patient could not carry a backpack to school due to back pain and was experiencing difficulty with dressing/bathing and activities involving the use of the hands due to hypersensitivity.

Yoga asanas, the physical poses, and their transitional movements can be adapted to provide the benefits of proper joint alignment, awareness of the body's position in space, and progress aerobic capacity, strength, and active range of motion (AROM).[1]

breathing techniques have been shown to decrease the body's response to stress.

Taylor (2011) reports that these techniques "are used as energy management tools helping to curve the effects of increased stress, mood imbalance, and pain.” Pranayama, yoga breathing exercises, can range from shallow, rapid breathing to deeper, slower breathing. These breathing exercises may calm the mind and body, reduce stress and anxiety, and promote an oxygen-rich blood supply.[2]

Yoga is often referred to as a moving meditation. A slow pace, along with the prolonged holding of poses, can facilitate a more meditative experience. Mindfulness, known as dhyana, refers to the quality or state of being conscious or aware of what a person is sensing or feeling. Meditation through yoga can reduce both stress levels and pain.

Yoga can be used to improve scapular positioning and upper quarter posture. Each yoga asana can promote an increased awareness of asymmetries in the posture, such as asymmetrical shoulder or rib cage alignment, and provide feedback on the positioning of arms and fingers. In turn, the therapist can facilitate this mind/body connection and utilize the body's neuroplasticity to correct posture and alignment.

For the adolescent patient mentioned above, I taught them beginning yoga poses (asanas) and breathing exercises (pranayama). I also provided cues to incorporate elements of mindfulness (dhyana). Weight-bearing through the palms of the hands was incorporated into several asanas. The patient's home program included yoga asanas as well as tactile desensitization with rice. Upon completing therapy, the patient returned to their prior level of function in both school activities and self-care tasks, and perhaps a long-term yoga practice.

1. Taylor, M., Glantino, M.& Walkowich, H. The Use of Yoga Therapy in Hand and Upper Extremity Rehabilitation. Rehabilitation of the Hand and Upper Extremity. Mosby, 2011.

2. Walker, Meredity. (2020). "77 Surprising Health Benefits of Yoga". Retrieved from http://www.intrayogatherapy.com.