A recurring question I receive from yoga students is about issues with wrist discomfort and injuries. Having had a history of wrist injuries due to competitive sports, I am sensitive to how students work with their hands within poses and overall sequencing in the practices. Due to the nature of most hand positions in yoga poses, there is a tendency to collapse into specific areas of the wrist and, without due care, this can lead to detrimental effects.
A very common position for the hands in yoga poses is ‘shoulder width apart’: arm balances, Upward Facing Dog, Downward Facing Dog, Cat pose etc. The consequence of this hand position is the ease to shift body weight into hypothenar region of the hand. Studies have been conducted measuring the force loads in the hands as hand position is varied. When the hands are set in a wide pushup stance, the force loads were found to be localized in thenar region (thumb pad). When the hands were brought in closer to a tricep pushup position (more classic hand position for yoga poses), the force loads shifted to the hypothenar region (pinky finger side of the hand/wrist).
When we look at the anatomy of the forearm and wrist, it is compelling to see that at the thenar region of the wrist, the radius (lateral forearm bone) broadens and has a large connection to the wrist bones. Unlike the radius, the ulna does not articulate with the carpal bones instead articulating with a cartilaginous disc known as the triangular fibrocartilage complex (TFCC) which lies between each. Without this complex, the radius would assume 95% of force loads. With this TFCC structure, the radius experiences about 80% of force loads where as the ulna experiences about 20%.
Knowing these structural elements of the wrist along with how force loads shift depending on hand placement, we need to be mindful that the hypothenar region of the hand is not necessarily an advantageous place to apply force. Therefore, we need to apply applications of force distribution to insure that we are dissipating the force over a greater surface area and out of the hypothenar region.
I have played with many ‘hand applications’ including the suggested ‘finger tip pressing’ and ‘palm doming’. I personally do not find these work and more so, just create extra tension in the wrists (as these movements facilitate the forearm flexors). I prefer to engage in simple techniques of feeding energy out of the hypothenar area and sending these force loads diagonally across to the index finger and index pad. Also key is the utilization of mild wrist pronation (internal rotation of the forearm) in many poses. Many loaded postures like Downward Facing Dog create a lifting motion of the index finger pad and direct enormous weight into the hypothenar region due to a tendency to supinate the wrist (external rotation). Note: with any pronation in the wrist/forearm, the kinetic chain of the entire arm and shoulder needs to be considered – how does the adjustment of the forearm affect the integrity further up the chain and do any counter adjustments higher up need to be applied?)
Other tips for nurturing the wrists in yoga:
*sequence your practice so that you are not chronically loading the wrist with constant weight on the hands – design flows that provide discernible rests for the wrists
*consider occasionally doing practices that are completely free of placing weight on the wrists – yes, this is possible as you can see in flows that I have done for my students
*if pushup/plank positions are a challenge, try these poses with wider hands – develop your strength in the more classic pushup position before attempting the yoga/tricep variations
*be extra mindful when practicing on carpet and thick yoga mats – thick, soft surfaces readily causes additional sinking and compression into the wrists
Kreg Weiss 
“be extra mindful when practicing on carpet and thick yoga mats – thick, soft surfaces readily causes additional sinking and compression into the wrists” — I have a question about this statement. I recently purchased a thick yoga mat made of memory foam. I was told that it would alleviate some of the pain I experience during yoga due to carpal tunnel. Should I be careful with this mat? It bugs me deeply that I really can’t practice because of the pain in my hands. I might try checking out your hands free flow video…thanks.
I would be ‘mindful’ of any claims that a certain type of mat can alleviate pain – there are a great number of variables involved with the wrists in terms of bone structure and mechanics – we are all built definitely. my suggestion is to test with lightly loaded poses like Cat to see how your wrists responds (during and after). and yes, definitely check out my wrist-free practices to give you ideas of alternative ways to practice without loading the wrists
Are you recommending that when, say in downward dog, we rotate our arms and hands inwardly? As a court reporter and former word processor, I definitely have wrist issues which have occasionally prevented me from doing yoga for a day or two, and I am always careful and don’t do certain positions (balancing crow, etc). Maybe for one of your online classes you could talk more about what hand positions work for you? Thanks!
Hi Mandy,
In Downward Dog (DD), I like to feel and visual energy moving out of my ‘outer’ wrist (pinky finger side) diagonally towards my index finger knuckle pad and down that index finger. Some energy will also shift out of the pinky finger region of the palm and over into the thumb pad region. This action is created partially by pronating (internally rotating) the forearm that transmits into the wrists. But once you do this inner spiral of the forearm, you will need to counter spiral (externally rotate) the upper arm bones a bit to insure that the elbows are not pointing outwards. Once these spirals are in place, try to laterally rotate the shoulder blades (think of the shoulder blades spreading outwards without elevating towards the ears) as this will reduce shoulder impingement and engage the serratus anterior muscles (muscles between the shoulder blade and ribs). This will establish a stronger bridge of stabilization from the thorax to the arms. I also like completely the upper body tweaks with a final subtle hollowing of the under arms (aka armpits). Let me know if this helps. Namaste Kreg