Q: I have students who continue to be challenged in their wrists. I use props to alleviate the strain (blocks under palms, push up bars, forearms, etc.). What else can help?
A: As I was prepping to answer this inquiry from one of our readers who teaches yoga, I went back and reread the posts on the wrists that we have done over the last three years, and there are quite a few! So, I want to link some of those here so that anyone interested in learning more about this potentially vulnerable area of the body can look over those as well.
Wristful Wrists: How to Keep Your Wrists Happy and Healthy
Friday Q&A: Wrist Flossing
Featured Sequence: Wrist Flossing for Wrist Care
Friday Q&A: Ganglion Cysts
Featured Pose: Wrist Circles
As we look at the issue of yoga practitioners who are “challenged in their wrists.” it’s important to acknowledge that there are a variety of issues that could cause someone to be challenged, from new onset pain, chronic wrist pain, specific diagnoses such as carpel tunnel syndrome or ganglion cysts, repetitive strain (like the kind I got today from working with a hammer and staple gun for two hours on Sunday night!), to arthritis in the wrist or even at the base of the thumb. So, if you have unexplained wrist pain, my first recommendation is always to always get your wrist evaluated, or, if you are the teacher, to encourage your student to do so. Knowing the underlying cause of the pain can be helpful in guiding you in healing it or in modifying your yoga practices so as to minimize aggravating the condition and hopefully promoting healing as well.
Another recommendation is to play with all the modifications you can employ in the key position of on all fours or “Hands and Knees.”
This is the starting position for several common poses, including Cat-Cow pose (Marjaryasana), Hunting Dog pose, Plank pose variations, in which your wrists are in extension and bearing weight.
In the typical position of the hands flat on the floor, make sure you are distributing the weight evenly between the heel of your hand and the ball of your hand (where the first knuckles are located). It is so common for practitioners to be dropping all the weight of the upper body down into the heel of their hands and not utilizing the entire palm for support. My colleague Richard Rosen encourages his students to create a suction cup effect in the center of the palm as well as the channel between the base of the thumb and the pinky finger, as he feels it takes pressure of the carpal tunnel (through which tendons and one large nerve flow).
Also, practicing hands and knees on your finger tips will take much of the pressure off the wrist joints and can be used for easier poses like Cat-Cow and Hunting Dog, but would likely not be so effective in Plank. But in other poses where one or both hands is touching the floor or a block, such as in Lunge or Triangle pose (Trikonasana), the fingertip method can be very helpful. Keep in mind that your fingers may not be used to this kind of extra work, so you want to start with short periods of time in the poses and gradually work up to longer holds as your fingers and hands get stronger.
Another simple modification is to make a fist with your hands and place the flat proximal phalanges (the closest finger bone to the hand) on the floor, with your two hands oriented so the inner wrists face one another. This specific orientation keeps the weight on the wrist joints very even between the thumb and pinky sides of your wrists. It can work nicely for hands and knees, but should not be used for Downward-Facing Dog pose (Adho Mukha Svanasana), as it will jam and compress the pinky side of your wrist joints. So, when transitioning from one position to another, take a moment to reposition your hands and wrists to avoid the risk of aggravating your challenged wrist. And with the fist variation, it is helpful to keep your fingernails trimmed so you can tuck your fingers into your palms to make a stronger, more stable fist.
For some practitioners, a little lift under the wrists and heel of the hands can complete relieve pain and pressure in the hands. One inexpensive way to accomplish this it to simply tightly roll the front narrow edge of your yoga mat under a turn or two. Because it will tend to want to loosen or unroll, hold it in place with one hand as you get the other hand into position. Ideally the heel of your hands should press into the center of the rolled mat and the ball of the hands and your fingers will be on the bare floor in front of your mat. You will still want to press the heels and balls of your hand down evenly as recommended above. This can work well for Hands and Knees position as well as Plank and Downward-Facing Dog pose and might even provide enough support for one handed poses where one hand has to support the weight of the body, such as Side Plank pose (Vasithasana).
You can use a yoga prop called a yoga wedge similarly to the mat roll, but you have to make sure to catch the heels of your hand on the top edge of the wedge and let your palms and fingers steam forward and down the slope of the wedge. Your wrists need to feel slightly lifted so they do not sag down behind the top edge of the wedge, which could undo all the good you are trying to do! I will sometimes place the wedge under the front edge of the yoga mat to increase the stickiness of my hands on the slope of the wedge, so play around with that, too.
I have also had quite a bit of personal experience with the Gripitz prop, which many studios have available for students to use, and think that with proper use and understanding, they can be helpful. That said, I almost always see students who have not been given any specific guidance on proper use using them in a potentially detrimental way. Perhaps at another time I can do a post with photos to clarify my take on using those correctly.
Another consideration is playing around with Downward-Facing Dog pose variations that can be less impactful on your wrists (see Featured Pose: Downward-Facing Dog Variations). One of my favorites is the chair version; but again, you have to make sure the heels of your hands catch the front edge of the seat correctly and your wrists stay lifted and don’t drop down at all in front of the edge. And in fact, Nina did an entire post on protecting your wrists in this pose (see Protecting Your Wrists in Downward-Facing Dog Pose), so take a look at that as well. 
And although this is not an exhaustive list of options, I will end with encouraging you to design a practice for yourself or your students that does not involve any weight-bearing poses for the wrists in the sequence. This will give you or your students with wrist challenges a wonderful yoga practice that will still have many benefits while completely resting the wrists. Also, if weakness in the wrists could be contributing to the wrist challenges, consider something as simple as playing with a squeeze ball periodically throughout the day to strengthen your forearm, hand and finger muscles. Improving strength can sometimes resolve many wrist issues. That should give you all some ways of working with those challenged wrists!
Bay Area readers can learn about wrists in person with Baxter at his upcoming Workshop on Wrists and Elbows, Sept. 20th, 2-5pm at Mountain Yoga, in Oakland, California. See here for further information.
—Baxter
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