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	<title>Dhanya Fernando, Author at Breaking Muscle</title>
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	<title>Dhanya Fernando, Author at Breaking Muscle</title>
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		<title>3 Wrist Strengthening Exercises to Prevent Yoga Injuries</title>
		<link>https://breakingmuscle.com/3-wrist-strengthening-exercises-to-prevent-yoga-injuries/</link>
		
		<dc:creator><![CDATA[Dhanya Fernando]]></dc:creator>
		<pubDate>Tue, 05 May 2015 16:00:00 +0000</pubDate>
				<category><![CDATA[Fitness]]></category>
		<category><![CDATA[yoga]]></category>
		<guid isPermaLink="false">https://breakingmuscle.com///uncategorized/3-wrist-strengthening-exercises-to-prevent-yoga-injuries</guid>

					<description><![CDATA[<p>Wrist injuries are common in yoga, yet we ignore them and move in to poses that put pressure on our wrists without knowing how our muscles support this complex joint. We can learn to take care of our wrists by understanding alignment and anatomy. The strength of the muscles in our arms and shoulders will determine our wrist...</p>
<p>The post <a rel="nofollow" href="https://breakingmuscle.com/3-wrist-strengthening-exercises-to-prevent-yoga-injuries/">3 Wrist Strengthening Exercises to Prevent Yoga Injuries</a> appeared first on <a rel="nofollow" href="https://breakingmuscle.com">Breaking Muscle</a>.</p>
]]></description>
										<content:encoded><![CDATA[<p>Wrist injuries are common in yoga, yet we ignore them and move in to poses that put pressure on our wrists without knowing how our muscles support this complex joint.</p>
<p><strong>We can learn to take care of our wrists by understanding alignment and anatomy.</strong> The strength of the muscles in our arms and shoulders will determine our wrist strength.</p>
<p>Wrist injuries are common in yoga, yet we ignore them and move in to poses that put pressure on our wrists without knowing how our muscles support this complex joint.</p>
<p><strong>We can learn to take care of our wrists by understanding alignment and anatomy.</strong> The strength of the muscles in our arms and shoulders will determine our wrist strength.</p>
<h2 id="causes-of-wrist-injuries">Causes of Wrist Injuries</h2>
<p><strong>Wrist injuries can be caused for many reasons, but the one that stands out the most is poor alignment of the shoulder.</strong></p>
<p>Congestion in the neck and shoulders can impede blood flow and nerve transmission into and from the wrists. Other causes of wrist pain include osteoarthritis, carpal tunnel syndrome, lack of flexibility, tendonitis, repetitive strain injuries, sprains and other sudden injuries.</p>
<blockquote><p>&#8220;If the wrists are not strong or flexible enough to prevent the bones from touching, impingement can happen and aggravate the tendons and ligaments in the area.&#8221;</p></blockquote>
<p>Dr. Kevin Launder, a kinesiologist at Illinois State University, said, &#8220;Wrist pain is often caused by impingement, an injury that occurs when your radius (arm bone) hits your wrist bones. It typically happens in people who do a lot of yoga.”</p>
<p><strong>In yoga, we are mostly in postures that extend the wrist.</strong> For example, plank pose puts a lot of pressure on the joint. If the wrists are not strong or flexible enough to prevent the bones from touching, impingement can happen and aggravate the tendons and ligaments in the area.</p>
<h2 id="the-anatomy-of-our-hands-and-wrists">The Anatomy of our Hands and Wrists</h2>
<p><strong>The hand is designed to bear weight, but it also has a complicated joint structure.</strong> It has many stable yet flexible parts with complex muscles and joint actions. 39 muscles work the wrist and hand, while at the same time no muscle works alone.</p>
<p>The wrist is an ellipsoid-type synovial joint, allowing for movement along two axes. <strong>This means flexion, extension, adduction, and abduction can all occur at the wrist joint.</strong> All the movements of the wrist are performed by the muscles of the forearm.</p>
<blockquote><p>&#8220;Over time, wrist extensors may become weak relative to the wrist flexors, which leads to an imbalance. This means when you are in downward dog or any other weight-bearing pose on the hands, your body will find it difficult to properly distribute the weight to your wrists.&#8221;</p></blockquote>
<p>The anterior forearm (top side of the arm) has the wrist flexors muscle group. These flex the hand at the wrist and each of the phalanges (these make the fingers).</p>
<p><strong>This muscle group tends to be tense due to overuse.</strong> Conversely, the underside of the forearm, the extensor muscle group, going from the palm to the inner elbow, is fairly weak in most of us due to the lack of use.</p>
<p>Over time, wrist extensors may become weak relative to the wrist flexors, which leads to an imbalance<strong>.</strong></p>
<p><strong>This means when you are in downward dog or any other weight-bearing pose on the hands, your body will find it difficult to properly distribute the weight to your wrists.</strong></p>
<p>Since your body is intelligent, it will recruit one muscle group to compensate for another and thus the imbalance can lead to injury.</p>
<p class="rtecenter"><img decoding="async" loading="lazy" class="size-full wp-image-13462" src="https://breakingmuscle.com//wp-content/uploads/2013/08/shutterstock147943889.jpg" alt="" width="600" height="564" /></p>
<h2 id="wrist-anatomy">Wrist Anatomy</h2>
<p><strong>The two bones of the lower arm, the radius and the ulna, meet at the hand to form the wrist.</strong></p>
<p>The wrists are made up of eight small bones called the carpal bones. They connect the hand to the forearm. The shape of the carpal bones, as well as the overlying ligament (the transverse carpal ligament) creates a kind of tunnel (the carpal tunnel) through which the tendons of the flexors and the median nerve travel.</p>
<p>The forearm bone closest to the thumb, the radius, is a larger than the ulna. This bone is capable of bearing more weight because of its size.</p>
<p><strong>Due to this, it is essential that we place more weight on the mounds of our thumb, index, and middle finger and less so on the ring and pinky side.</strong></p>
<blockquote><p>&#8220;To protect this sensitive joint, more weight should be placed on the heel of the hand while at the same time, using the fingers pads to distribute the weight evenly.&#8221;</p></blockquote>
<p>Most often, due to weak upper arm and shoulder strength, our weight automatically falls on the outside of our hands. This weight on the heel of the palm will lift the index finger off the floor placing a great degree of tension on the ulna, which isn’t designed to bear as much of a load.</p>
<p><strong>To protect this sensitive joint, more weight should be placed on the heel of the hand while at the same time, using the fingers pads to distribute the weight evenly.</strong></p>
<h2 id="downward-facing-dog">Downward Facing Dog</h2>
<p><strong>Downward facing dog is the most commonly noted pose where students experience wrist pain.</strong></p>
<p>It is also a great pose to refine the alignment of our upper body. Since the hands are a part of the foundation of the pose, we need to pay as close attention to them as we do to our feet.</p>
<p>The downward dog pose is commonly held for a few breaths to get a proper stretch, and during this time students often neglect to distribute the weight evenly between the hands and the feet.</p>
<p><strong>Downward dog is an exceptional pose that builds strength across the shoulders, while increasing the range of motion in the upper body.</strong></p>
<p>That being said, if your shoulder blades are collapsing in your dog pose, with your upper arms rounding, elbows moving out, and your weight placed on the heel of your hand, you will be out of optimal alignment in the upper body.</p>
<p class="rtecenter"><img decoding="async" loading="lazy" class="size-full wp-image-57483" src="https://breakingmuscle.com//wp-content/uploads/2015/05/img1200.jpg" alt="" width="600" height="450" srcset="https://breakingmuscle.com/wp-content/uploads/2015/05/img1200.jpg 600w, https://breakingmuscle.com/wp-content/uploads/2015/05/img1200-300x225.jpg 300w" sizes="(max-width: 600px) 100vw, 600px" /></p>
<p class="rtecenter"><span style="font-size: 11px;"><em>If your shoulder blades are collapsing in your dog pose as shown at right, you will be out of optimal alignment.</em></span></p>
<p><strong>Here are a few alignment principles for the shoulders, arms and hands in almost any weight-bearing pose.</strong> These actions can first be practiced at the wall to lessen the weight bearing involved. Then, you can work your way to the mat.</p>
<ol>
<li>Hands placed shoulder width apart.</li>
<li>Distribute the weight to the finger pads (towards the index finger side) away from the heel of the palm.</li>
<li>Press all the finger pads and knuckles evenly onto the surface.</li>
<li>Straighten the arms to engage the triceps and squeeze them in.</li>
<li>Broaden across the upper arms and expand the chest.</li>
<li>Firm your shoulder blades against your back then widen them and draw them toward your tailbone.</li>
<li>Maintain your head between the upper arms without letting it hang.</li>
</ol>
<p class="rtecenter"><img decoding="async" loading="lazy" class="size-full wp-image-57484" src="https://breakingmuscle.com//wp-content/uploads/2015/05/img1199.jpg" alt="" width="600" height="800" srcset="https://breakingmuscle.com/wp-content/uploads/2015/05/img1199.jpg 600w, https://breakingmuscle.com/wp-content/uploads/2015/05/img1199-225x300.jpg 225w" sizes="(max-width: 600px) 100vw, 600px" /></p>
<p class="rtecenter"><span style="font-size: 11px;"><em>Downward dog at the wall can help establish good wrist alignment.</em></span></p>
<h2 id="strengthening-the-wrists">Strengthening the Wrists</h2>
<p>Correcting habitual misalignment and stretching the wrists is a great way to start a strengthening program for the wrists.</p>
<p><strong>But in general, there isn’t much you can do in yoga to isolate the muscle groups and strengthen them.</strong> You can do simple exercises that strengthen the ligaments, though.</p>
<h2 id="wrist-curls">Wrist Curls</h2>
<p>This can be done with 1-5lb weights or with a clenched fist. Do 3 sets of 12-15 repetitions.</p>
<ol>
<li>Begin seated and hold two weights in each hand.</li>
<li>Rest your wrists over your knees with your palms facing down.</li>
<li>Slowly curl the wrists in an upward motion and pause at the top for a second before releasing them down again. Take caution not to overextend.</li>
<li>Repeat the same exercise with the palms facing up.</li>
</ol>
<p class="rtecenter"><img decoding="async" loading="lazy" class="size-full wp-image-57485" src="https://breakingmuscle.com//wp-content/uploads/2015/05/img1197.jpg" alt="" width="600" height="450" srcset="https://breakingmuscle.com/wp-content/uploads/2015/05/img1197.jpg 600w, https://breakingmuscle.com/wp-content/uploads/2015/05/img1197-300x225.jpg 300w" sizes="(max-width: 600px) 100vw, 600px" /></p>
<p class="rtecenter"><span style="font-size: 11px;"><em>Wrist curls exercise</em></span></p>
<h2 id="ball-squeeze">Ball Squeeze</h2>
<p>Take a stress ball or tennis ball and grip it in your palm as firmly as possible with your fingers. Hold for 5 seconds and repeat about 10 times. Switch hands. There are a few variations you could do with a ball squeeze.</p>
<p class="rtecenter"><img decoding="async" loading="lazy" class="size-full wp-image-57486" style="height: 500px; width: 375px;" src="https://breakingmuscle.com//wp-content/uploads/2015/05/img1228.jpg" alt="" width="600" height="800" srcset="https://breakingmuscle.com/wp-content/uploads/2015/05/img1228.jpg 600w, https://breakingmuscle.com/wp-content/uploads/2015/05/img1228-225x300.jpg 225w" sizes="(max-width: 600px) 100vw, 600px" /></p>
<p class="rtecenter"><span style="font-size: 11px;"><em>Variations on ball squeeze exercises</em></span></p>
<h2 id="towel-wring">Towel Wring</h2>
<p>Take a dry towel and twist the towel in opposite direction, as if to squeeze the water out of it. Hold the contraction at the end for a few seconds. Be mindful of overstretching as this can aggravate your already injured wrists. Switch sides and repeat 8-10 times.</p>
<p class="rtecenter"><img decoding="async" loading="lazy" class="size-full wp-image-57487" src="https://breakingmuscle.com//wp-content/uploads/2015/05/img1204.jpg" alt="" width="600" height="450" srcset="https://breakingmuscle.com/wp-content/uploads/2015/05/img1204.jpg 600w, https://breakingmuscle.com/wp-content/uploads/2015/05/img1204-300x225.jpg 300w" sizes="(max-width: 600px) 100vw, 600px" /></p>
<p class="rtecenter"><span style="font-size: 11px;"><em>Towel wring exercise</em></span></p>
<h2 id="be-aware">Be Aware</h2>
<p><strong>It is important to be aware of how fatigued you get while doing any weight bearing on the hands and to give yourself enough rest between poses.</strong></p>
<p>Good wrist strength is essential to our everyday activities and yoga can be a great tool to teach us more about how to take care of our wrists.</p>
<p>You&#8217;ll also enjoy:</p>
<ul>
<li><a href="https://breakingmuscle.com/3-stretches-to-help-achy-wrists-and-prevent-carpal-tunnel/" data-lasso-id="58692">3 Stretches to Help Achy Wrists and Prevent Carpal Tunnel</a></li>
<li><a href="https://breakingmuscle.com/3-drills-for-building-wrist-flexibility/" data-lasso-id="58693">3 Drills for Building Wrist Flexibility</a></li>
<li>Finger and Wrist Stretches to Combat Your Modern Lifestyle</li>
</ul>
<p><span style="font-size: 11px;"><strong><u>References:</u></strong></span></p>
<p><span style="font-size: 11px;">1. Keller, Doug. “<a href="https://yogainternational.com/article/view/healing-and-preventing-wrist-injuries" target="_blank" rel="noopener" data-lasso-id="58695">Healing (and Preventing) Wrist Injuries</a>.” Yoga International. N.p, 20 June 2013. Web</span></p>
<p><span style="font-size: 11px;">2. American Academy of Orthopedic Surgeons. <a href="https://orthoinfo.aaos.org/topic.cfm?topic=A00063" target="_blank" rel="noopener" data-lasso-id="58696">Tips to prevent yoga injuries</a>, March 14, 2007.</span></p>
<p><span style="font-size: 11px;">3. Hamill, Joseph, and Kathleen Knutzen. <a href="https://www.amazon.com/Biomechanical-Basis-Human-Movement-Edition/dp/0781791286" target="_blank" rel="noopener" data-lasso-id="58697"><em>Biomechanical Basis of Human Movement</em></a>. Philadelphia: Lippincott Williams &amp; Wilkins, 2003. Print</span></p>
<p><span style="font-size: 11px;">4. Fishman, Lauren M, Ellen Saltonstall, and Susan Genis. “Understanding and Preventing Yoga Injuries.” International Journal of Yoga Therapy, June 2009. Web</span></p>
<p><span style="font-size: 11px;"><em>Photos 1 and 2 courtesy of <a href="http://www.shutterstock.com" target="_blank" rel="noopener" data-lasso-id="58699">Shutterstock</a>.</em></span></p><p>The post <a rel="nofollow" href="https://breakingmuscle.com/3-wrist-strengthening-exercises-to-prevent-yoga-injuries/">3 Wrist Strengthening Exercises to Prevent Yoga Injuries</a> appeared first on <a rel="nofollow" href="https://breakingmuscle.com">Breaking Muscle</a>.</p>
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		<title>How to Avoid Injury in Yoga: Every Body Is Different</title>
		<link>https://breakingmuscle.com/how-to-avoid-injury-in-yoga-every-body-is-different/</link>
		
		<dc:creator><![CDATA[Dhanya Fernando]]></dc:creator>
		<pubDate>Mon, 23 Feb 2015 22:00:00 +0000</pubDate>
				<category><![CDATA[Fitness]]></category>
		<guid isPermaLink="false">https://breakingmuscle.com/uncategorized/how-to-avoid-injury-in-yoga-every-body-is-different/</guid>

					<description><![CDATA[<p>Honor your body’s limits and it will follow your instructions. I like to exercise the notion that prevention is better than a cure, as well as the idea that yoga should be practiced with a mindful observation for the limits of our bodies. In a yoga class, the quality of your poses matter more than the amount of...</p>
<p>The post <a rel="nofollow" href="https://breakingmuscle.com/how-to-avoid-injury-in-yoga-every-body-is-different/">How to Avoid Injury in Yoga: Every Body Is Different</a> appeared first on <a rel="nofollow" href="https://breakingmuscle.com">Breaking Muscle</a>.</p>
]]></description>
										<content:encoded><![CDATA[<p><strong>Honor your body’s limits and it will follow your instructions.</strong> I like to exercise the notion that prevention is better than a cure, as well as the idea that yoga should be practiced with a mindful observation for the limits of our bodies.</p>
<p>In a yoga class, the quality of your poses matter more than the amount of poses you go through. <strong>And by learning how to honor the poses and our bodies, we can prevent needless injuries.</strong></p>
<div></div>
<h2 id="all-bodies-are-different">All Bodies Are Different</h2>
<p><strong>Yoga postures have often been thought of as a form of exercise</strong>. But from an ancient perspective, they are not merely exercises, but techniques that place the physical body in positions that cultivate awareness, relaxation, concentration, and meditation.</p>
<p><strong>But for most of us, the typical yoga class experience goes something like this:</strong></p>
<ol>
<li>You arrive on the mat and perform a certain pose because the instructor says so and your neighbor seems to be doing it pretty well (at least in your eyes).</li>
<li>You realize you aren’t able to go as far in a pose because you’re experiencing some discomfort.</li>
<li>You don’t want to look like a wimp because you think the whole class might be looking to see how far you have gotten in your pose so you push too far. (Everyone else is thinking everyone is looking at them, too, by the way).</li>
</ol>
<p>The truth is, no one is looking at you. Yoga isn’t a team effort so the whole class need not synchronize. It’s an individual effort to see what your body can perform that day.<strong> How you approach and perform each pose will be the benefit you get from each class. </strong>This can be done by paying attention to the instructor and the cues he or she is giving.</p>
<h3 class="rtecenter" id="yoga-isnt-a-team-effort-so-the-whole-class-need-not-synchronize-its-an-individual-effort-to-see-what-your-body-can-perform-that-day">&#8220;<em>Yoga isn’t a team effort so the whole class need not synchronize. It’s an individual effort to see what your body can perform that day.&#8221;</em></h3>
<p>It’s important to keep the competitive mind and ego by the door and work with what your body can do. We can appreciate a beautiful yoga photo, but that doesn’t mean we need to recreate that shot with our own bodies. We must all remember there is a balance.<strong> Even after years of dedication and practice, some poses may never be right for my body, and I doubt that all poses will be right for you as well. </strong>The acceptance of this simple fact can be our motivation to respect that all bodies are different.</p>
<h2 id="the-dangers-of-overstretching">The Dangers of Overstretching</h2>
<p>Most often, the causes of injuries in yoga are overuse and overstretching. <strong>Overstretching is the reason many people do yoga one day and don’t show back up on the mat the next.</strong> It’s not that they don’t want to. It’s that they can’t because they overdid the stretch at the last session and are probably in pain.</p>
<p><img decoding="async" loading="lazy" class="size-full wp-image-37522" src="https://breakingmuscle.com/wp-content/uploads/2015/02/shutterstock154233917.jpg" alt="" width="600" height="400" srcset="https://breakingmuscle.com/wp-content/uploads/2015/02/shutterstock154233917.jpg 600w, https://breakingmuscle.com/wp-content/uploads/2015/02/shutterstock154233917-300x200.jpg 300w" sizes="(max-width: 600px) 100vw, 600px" /></p>
<p>One of yoga’s great gifts is the increased ability to understand and listen to our own body. But this awareness takes time and can be clouded by the encouragements of teachers and other students who may not realize when we are overreaching. <strong>To avoid injury, your body may compensate by using a weaker muscle to get into a certain pose. </strong>Over time, this will lead to misalignment or injury.</p>
<p>When a muscle is being lengthened, it’s not just the muscle cells stretching out, but also the surrounding connective tissues. When we say we’re stretching a muscle, the actual stretch comes from these connective tissues. <strong>When too much of a stretch happens, the tissues will lose elasticity and become less functional.</strong> This means it will not return to its original shape once it is overstretched. Over time, this will lead to muscle weakness.</p>
<h3 class="rtecenter" id="our-bodies-are-built-uniquely-therefore-work-with-where-you-are-not-from-where-you-think-you-should-be"><em>&#8220;Our bodies are built uniquely.Therefore, work with where you are, not from where you think you should be.&#8221;</em></h3>
<p>Connective tissues have good blood circulation that can facilitate recovery, but when we continually overstretch, the soft tissues surrounding the muscle, including tendons and ligaments, become susceptible to developing micro tears. <strong>If we don’t change our practice, these micro tears will lead to larger tears and eventually to injuries. </strong>Regardless of whether our bodies are tight or flexible, during yoga practice, it is easy to go beyond our means and take a stretch to a level that may develop these kinds of tears without notice.</p>
<p>Our bodies are built uniquely.<strong> Therefore, work with where you are, not from where you think you should be.</strong> <a href="https://orthoinfo.aaos.org/topic.cfm?topic=A00063" target="_blank" rel="noopener" data-lasso-id="90391">The American Academy of Orthopedic Surgeons</a> believes the rewards of yoga outweigh the possible physical risks, as long as you perform with care, moderation and according to your individual flexibility level.</p>
<h2 id="tips-to-prevent-yoga-injuries"><strong>Tips to Prevent Yoga Injuries</strong></h2>
<ul>
<li><strong>Discuss any known illness or injury with your instructor prior to class so he or she can recommend modifications</strong>. Serious muscle damage and injuries can result if proper precautions are not taken, especially for people with preexisting musculoskeletal conditions.</li>
<li><strong>There is no such thing as a perfect yoga pose</strong>. Be patient and gradually build to the pose that best suits your best ability.</li>
<li><strong>Learn how to practice yoga poses with correct alignment</strong> &#8211; not by looking at your neighbor but by listening to the instructor. Some teachers might make adjustments, but if they don’t, feel free to approach them after class to ask about how to improve certain poses.</li>
<li><strong>Invest in a private session or two.</strong> You can polish your yoga practice, learn your strengths and weaknesses, get feedback, and work on challenging poses.</li>
<li><strong>Use props as a modification for poses where there is tightness</strong>. They will help you to feel the pose better in order to engage the correct muscles.</li>
<li><strong>Select a class level appropriate for you </strong>and where you are in your practice.</li>
</ul>
<p class="rtecenter"><img decoding="async" loading="lazy" class="size-full wp-image-37523" style="height: 499px; width: 500px;" src="https://breakingmuscle.com/wp-content/uploads/2015/02/yogasquare.png" alt="" width="600" height="599" srcset="https://breakingmuscle.com/wp-content/uploads/2015/02/yogasquare.png 600w, https://breakingmuscle.com/wp-content/uploads/2015/02/yogasquare-300x300.png 300w, https://breakingmuscle.com/wp-content/uploads/2015/02/yogasquare-150x150.png 150w" sizes="(max-width: 600px) 100vw, 600px" /></p>
<h2 id="summary">Summary</h2>
<p>In addition to every body being different, also remember that every day is different. <strong>On any given day, our bodies might not be able to move in the same way we did yesterday or a week ago.</strong> Pay attention to how your body feels each day and do not go beyond your limits. Be mindful.</p>
<p><strong>You Might Also Enjoy:</strong></p>
<ul>
<li><a href="https://breakingmuscle.com/increase-strength-by-integrating-yoga-10-essential-postures-for-strength-athletes/" target="_blank" rel="noopener" data-lasso-id="90392"><strong>10 Essential Postures for Strength Athletes</strong></a></li>
<li><strong><a href="https://breakingmuscle.com/6-tips-for-an-injury-free-yoga-class/" target="_blank" rel="noopener" data-lasso-id="90393">6 Tips For an Injury Free Yoga Class</a></strong></li>
<li><strong><a href="https://breakingmuscle.com/your-yoga-crystal-ball-stop-injuries-before-they-happen/" target="_blank" rel="noopener" data-lasso-id="90394">Your Yoga Crystal Ball: Stop Injuries Before They Happen</a></strong></li>
<li><strong>What&#8217;s New On Breaking Muscle Today</strong></li>
</ul>
<p><span style="font-size: 11px;"><u><strong>References:</strong></u></span></p>
<p><span style="font-size: 11px;">1. American Academy of Orthopedic Surgeons. “<a href="https://orthoinfo.aaos.org/topic.cfm?topic=A00063" target="_blank" rel="noopener" data-lasso-id="90396">Yoga Injury prevention</a>.” Orthoinfo.aaos.org. March 2012.</span></p>
<p><em style="font-size: 11px;">Photos courtesy of<a href="http://www.shutterstock.com/" target="_blank" rel="noopener" data-lasso-id="90397">Shutterstock</a>.</em></p><p>The post <a rel="nofollow" href="https://breakingmuscle.com/how-to-avoid-injury-in-yoga-every-body-is-different/">How to Avoid Injury in Yoga: Every Body Is Different</a> appeared first on <a rel="nofollow" href="https://breakingmuscle.com">Breaking Muscle</a>.</p>
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