Editor's note: The below are intended to be general recommendations for yoga practitioners and teachers. They are not a replacement for the personal advice of a health professional. Yoga teachers should remain within their : This means not attempting to diagnose, treat, or offer medical advice to students.
Yoga teachers will often say, “If it hurts, don’t do it.” Or they may offer similar injunctions to encourage students to avoid pain-causing movements and poses. Avoiding unnecessary suffering is a worthwhile and lifelong lesson; but while pain as a reference point has virtues, it also has limits.
Yoga teachers and practitioners alike can benefit from considering the complexities of pain. If teachers examine how pain plays out in yoga class and the words we use around it, we may be inspired to alter both the way we cue and the specific practices we instruct. Students with a more nuanced view of pain may also be inspired to change their relationship to their practices and to the signals they receive from within.
Introducing the possibility that yoga could cause pain may itself be important. “I don’t think yogis are necessarily aware of the pitfalls of movement therapy, but the reality is we can get hurt practicing yoga,” notes Dr. Kirstie Segarra, director of Integrative Health and Medical Massage at the University of New MexicoTaos, structural integrator, and author of Myofascial Yoga. By encouraging students to pay attention to sensations like pain, teachers make it clear that yoga, like all other physical endeavors, carries some potential for injury. Such awareness prevents students from going into autopilot mode, assuming that every pose is safe for them.
Pain has much to tell us. “Pain is an experience with a purpose to ‘protect,’” says Shelly Prosko, a physiotherapist and pioneer of PhysioYoga with more than two decades of experience in the area of chronic pain. She is also a yoga therapist, Pain Care U Trainer, and co-author/co-editor of Yoga and Science in Pain Care: Treating the Person in Pain. A healthy pain system is a good thing, according to Prosko: “If you are mindful, aware, and attentive, the ‘pain system’ or ‘danger system’ will alarm you if you are approaching damage.”
Furthermore, caveats about pain in yoga can give students permission to rely on their own expertise regarding the needs of their own bodies. This can help to increase their interoception (awareness of our bodies from the inside out) in yoga and also throughout all of life. “If we listen, our bodies will speak to us,” Prosko says.
However, pain isn’t always a foolproof reference point. While the cue to avoid pain may work for someone who knows their limits and has a well-functioning pain-response system, “Pain is a complicated subject, and to say ‘Don’t do it if it hurts’ is simplistic,” says Segarra.
Below are some facts about pain that have implications not only for how yoga teachers cue, but also for how students approach yoga practice.
1. Pain is only one of many signals worth listening to.
Thinking of pain as the sole signal that injury is occurring or is imminent may not do enough: “Tingling, numbness, and shaking and nausea can be warning signs, too,” says Bill Reif, a physical therapist and author of The Back Pain Secret: The Real Cause of Women's Back Pain and How to Treat It.
It is important that students be attuned to these other sensations as well. The advice he shares here speaks to the other valuable signals that tell us that we have passed our safe ranges.
2. Fast practices may shrink the “buffer zone.”
In some circumstances, we may not notice that something hurts—or causes other deleterious sensations—until it is too late. “In theory, if movement is mindful, relatively slow, controlled, there will be a ‘buffer’ zone from the time we are first aware of pain to the moment tissue damage might occur,” says Prosko. But faster practices can reduce that buffer zone, allowing “little to no time between when the pain is experienced and the injury is sustained.”
This is not to say that we should move slowly in every single yoga practice. It’s a myth that slowness alone will prevent all injury, and Prosko emphasizes that power and speed are also important aspects of human movement. Rather, we can increase challenges and pace gradually, allowing ourselves or our students to maintain awareness of inner sensations while moving at a clip that doesn’t outpace that awareness.
3. New students may not know their edge.
“Students need to be guided into listening to their bodies and staying behind their limits until they are ready to move into something if their structure allows,” Segarra says. “This isn’t something that is taught in our culture. It needs to be learned.”
“Don’t do it if it hurts” may not be helpful to beginning yoga students who can sometimes perceive poses as “hurting”—misinterpreting the new sensations they are feeling as pain and backing away from a pose (or from yoga altogether) before fully exploring it. Some students may benefit from knowing that “A stretching sensation is to be expected. Soreness may come in the days following new poses. That’s normal,” Reif says. “But a sharp, burning, or electrical sensation is never good.”
On the other hand, some students who have engaged in activities like contact sports or ballet, in which they’ve been encouraged to ignore pain signals in pursuit of an external goal or a performance ideal, may not be attuned to even sharp sensations in yoga and may hasten toward, or past, their edge. For these yoga students, “Don’t do it if it hurts” may at first seem like foreign or dismissable advice. The challenge, then, is to make a project of re-attunement—one in which pain and inner experiences are valued over attainment of an external goal.
For students just beginning to explore how their bodies respond to yoga, teachers may want to clarify the distinction between an acceptable stretching sensation and sharp pain, always going slowly enough that students can notice when the former becomes the latter, and encouraging students to prize inner sensations over outward achievement. Until new students find their edge, Reif recommends they take milder versions of poses, avoiding extremes, and gradually increase the intensity and duration of their practice over weeks or months.
4. Sometimes students don’t experience pain immediately.
“If it hurts, don’t do it” implies that the reverse is also true: If it doesn’t hurt, we can do it. In fact, not all pain is immediate, and yoga students may not always know in the moment that a pose may be causing harm. Reif has treated many yoga students who didn’t feel pain at the moment of injury. For instance, some students may not realize until later that they tore their hamstrings forward-folding or torqued their knees in frog or lotus. “Pain may occur a day or two after the pose that caused the problem,” he says, adding: “The answer as to why pain may be delayed varies widely. It depends upon the severity and type of the injury, the structures involved, and there may be a subjective component—everyone has a different pain threshold.”
Additionally, with more time in a pose, we may actually become less sensitive to what’s going on in our bodies. Segarra says to “Keep in mind that long holds—say 90 seconds or more—turn off the brakes of the golgi tendon organ [a receptor that senses changes in the tension we apply to our muscles]. Then you can go farther into a pose, but you also risk overstretching something if you aren’t careful and don’t know your limits.”
Poses repeated multiple times (like those of the vinyasa) may eventually cause irritation, even for students who were initially able to do them with ease. We may be tempted to think of misalignment as the culprit in such repetitive motion injuries, but Prosko avoids generalizations about the alignment that works for everyone. “Lowering to with rounded shoulders may cause shoulder irritation over time in some people and not in others, but so might performing repetitive chaturanga in what we are taught as 'proper' alignment,” she says. Just because we don’t experience pain during one repetition of a pose or movement does not mean it is “good for us” to do repeatedly and heedlessly.
“It’s so important for [teachers] to help students cultivate awareness and discernment,” Prosko says. “The more aware and mindful we are, the greater the likelihood that we will hear the whispers that the body is telling us after the 100th chaturanga—before it is injured, it will warn us, instead of not being aware of the pain until the 2,000th time, after injury has occurred.”
Knowing that pain or irritation is not always immediately apparent may validate what many of us already do as teachers and students: move toward challenging poses gradually, over a period of weeks or months, granting time to notice the effects of ever-greater stretches. We may also want to avoid extremely long holds in the end ranges of poses, and to limit repetitions. We can diversify transitions instead of relying exclusively on the vinyasa, for example, or balance the active energy of repetitions with a softer receptivity to inner whispers.
5. Pain is a matter of priority.
“If it hurts, don’t do it” assumes there is nothing impeding a student’s ability to perceive important pain signals at critical junctures.
In some cases, part of the reason we do not experience pain at the moment of an injury may have to do with our pain system’s hierarchical tendencies. “Our pain system works on a priority basis,” says Prosko. “Sometimes we may not experience pain if our nervous systems decide that something else is more important. For example, perhaps we don’t experience pain when we sprain our ankle while saving our own life by escaping from a fire. Or perhaps it’s a priority based on competition: An Olympic athlete focused on the win, at any cost, may not experience pain when an injury was sustained during the performance.”
According to Prosko, if a student’s attention is on something other than their own internal sensation—for instance, on achieving a pose or maintaining “ideal” alignment, or if they are distracted by fatigue—it “may override any danger messages trying to ‘get through’ the system, and subsequently may interfere with consciously experiencing the pain. In all of these cases, it is possible that the pain experience arises later on, once the priority is removed.”
To clear the way for pain signals to be perceived, we can encourage ourselves or our students to notice not only inner warning signals but also any potential distractions from those signals. If we notice distractions, we may have to shift our focus away from attainment, from the news, from our plans, to the pose at hand. We may even have to change our environments, for example, by finding a class without the acrobatic yogis who tend to distract us. Sometimes it can also be helpful to turn off the music, draw the blinds, or move away from the mirror.
6. Some students always feel a degree of pain.
What does “Don’t do it if it hurts” mean to students who are already hurting? Some 20 percent of U.S. adults have chronic pain. For these students, although pain will be present to some degree throughout yoga practice, it may not necessarily indicate harm.
Reif recommends that instructors always talk to their students in chronic pain about the advice they have received from their doctors. “Usually, people experiencing chronic pain have seen several healthcare professionals, and they may have been given guidance and advice on what motions to do or not do for a specific problem. All yoga teachers should respect these protective guidelines.”
While Reif would encourage students with chronic pain to immediately stop what they are doing when they feel sharp pain, he says, “There can be a disconnect. Pain may not be a reliable indicator of harm. Unlike acute pain, chronic pain can be unrelated to tissue damage.” He compares chronic pain to an engine warning light on the dashboard that is still going off once the engine has been repaired. In that case, “It’s the sensor itself that’s the problem.”
When students’ “danger sensors” (the nociceptors that detect noxious stimuli) aren’t functioning properly, Reif recommends exercising caution, perhaps working one-on-one with students and taking a yin or restorative approach: “This way, students can ease into any asana and feel changes and stop before aggravating any symptoms. They can gradually reconnect mind and body, one goal of yoga.” During these sessions, he suggests students practice mindfulness by substituting pain-focused thoughts with a focus on breathing or mantra, or any other meditative technique that works for them.
Segarra points out that a multitude of factors are at play in pain, including the mind: “It isn’t always about an injury in the tissue.” In her holistic approach, she begins by focusing on what students can do without pain. “I find it helpful to teach what feels effortless, what feels good, and then take baby steps, make micro movements, from there,” she says. “Sometimes when students move in ways they enjoy or feel natural, they are pain-free.” For instance, can a student reach a high cupboard without pain? Bend over to pick up a pen without pain? Play a sport, an instrument, or engage in an active hobby without pain? These movements may hint at what other students could do safely and even lead to breakthroughs. Segarra explains that if someone notices that lifting an arm in yoga hurts, but lifting the same arm in the same way to paint a canvas doesn’t hurt, this can illuminate the degree to which the mind is involved in pain and open the potential for repatterning.
Chronic pain can be a remnant of an injury that has since healed physically. As Reif puts it, “Even if the original stimulus is removed, the pain reflex remains”—and it can also lead to the hyperactivity of the entire pain system, which lowers the pain threshold and causes even the mildest of movements to register as painful. Prosko says, “Stimuli or ‘inputs’ into the danger detection system that wouldn’t normally give rise to a pain experience—like bending forward or turning your head—now do.”
Though many movements may cause pain for those in chronic pain, not moving is often not the best solution. “Telling people to stop moving when it hurts doesn’t necessarily do anything to change the overactive danger-detection system,” Prosko says. “Furthermore, if people with persistent pain consistently avoid the painful activity, fear-avoidance behaviors may develop and the danger-detection system may become even more overprotective or overly ‘sensitive.’” But ignoring the pain isn’t a good idea, either. “If we cue people to ignore or push past the pain in yoga classes, particularly if they don’t feel safe while doing it, then the alarm systems can ‘turn up’ even louder,” Prosko says.
To prevent an already overly sensitive system from becoming even more hypersensitive and to help people with chronic pain recover movement, Prosko tends to help her students traverse close to the point where the pain begins (or starts to increase), working with them to “calm the system, and create a sense of safety.”
To Prosko, pain is a “complex biopsychosocial-spiritual phenomenon.” To help yoga teachers and those living with chronic pain navigate its complexity, she recommends the research-based trainings that Pain Care U offers. In addition to her own book, Yoga and Science in Pain Care, other valuable resources for yoga teachers are Neil Pearson’s and David Butler and Lorimer Moseley’s .
The above points may inspire more subtlety in our approach to and language around pain and yoga. To summarize, in addition to a cursory “If it hurts, don’t do it,” we may also want to:
• Continuously reorient ourselves or our students to inner experience—for instance, guiding attention toward the feelings that attend each movement or pose.
• Consider other sensations that can serve as warning signals, such as tingling and numbness.
• Practice or teach at a pace that allows for a buffer zone where feelings of discomfort can be perceived.
• Differentiate between true pain and an acceptable level of discomfort.
• Move focus away from external achievement, and avoid pushing our students or ourselves toward end ranges abruptly or for long holds.
• Acknowledge possible distractions and minimize them if possible.
• Allow for the possibility that pain may not always be felt at the moment of injury, or may be felt continuously.
But even if we or our students are keyed in to internal warning signals, is it clear what to do about them? Saying “If it hurts, don’t do it” may leave students wondering what to do instead. Throughout practice, instructors may need to offer modifications to make yoga more comfortable. Simply giving students general permission to modify poses may not be enough; Segarra notes that teachers may need to be very specific in their suggestions, especially for new students, who “may not yet have the somatic awareness to modify the asana in an appropriate way.”
Ideally, these variations would be suggested by teachers who “offer genuine permission in a non-judgmental tone of voice,” Prosko says.
To make teaching language itself less judgmental, we can avoid situating one version of a pose as somehow “fuller” or more “advanced” than a variation, and removing phrases like “if you can’t do” and “if you are not sufficiently flexible/strong/experienced” from our lexicons. For example, rather than designating one version of a standing wide-legged forward fold, prasarita padottanasana, as its “fullest expression” and saying, “If you are less flexible/can’t come all the way down into the pose, you could put blocks under your hands or elbows to stay up higher,” you could simply say, as Prosko suggests: “In this wide-legged forward fold, you could choose to be here, here, or here, pausing at the point where you may notice a change in any sensations, and see if you can create some space, breathe comfortably, and find ease.”
Similarly, “Stay here in ardha , half splits, if this is the right pose for you today” is more inviting than “If you can’t do full splits, this is the less advanced version.” Instructors can also support students by practicing the variations themselves: “Half splits is what I’m doing today” validates a student’s decision to do the same.
According to Prosko, it’s important that yoga teachers be forthright about safety and respect for the value of the body’s warning signals but at the same time avoid language that invokes a sense of fear or fragility in any students (particularly those who may already have considerable anxiety about movement). “Our language as yoga teachers may perpetuate this ‘threat’ or danger state if we say things that lead people to believe that more damage is being caused if they move a certain way,” she explains. Mentioning danger, injury, and pain throughout yoga class can actually predispose students to become more pain-focused or even to avoid yoga altogether.
According to Prosko, instead of repeatedly sounding the gong of pain or danger, teachers could “Use language that highlights the incredible capacity of our human body to be adaptable, strong, and resilient, and that promotes trust and confidence in our body and a sense of self-efficacy.” To promote students’ trust in themselves, and in yoga, Prosko’s language tends toward the positive; she speaks less, for example, about “avoiding injury” and more about “creating safety.”
To keep the slant of class positive, “If it hurts, don’t do it” could be reworded as “To make this pose feel even better, you could try this.” Or the suggestion “Some people find rolling up to stand hurts their backs” could become “Some people like rising from a forward fold to standing while keeping a long spine.” While “Bend your knee to this degree so you don’t hurt yourself” sounds a touch menacing, “Does bending your knee this much feel good to you?” is a positively worded inquiry that encourages students to check in with themselves.
Indeed, Prosko prefers exploration over directives, often asking questions (How do you feel here…What happens if…What’s it like to…) so students can discover what works best for them. “From my perspective,” she says, “yoga is ultimately not about telling people what they should or shouldn’t do.” In her view, commands, even well-intentioned commands like “Don’t do it if it hurts,” may impede self-actualization, one of yoga’s goals.
“One path to self-actualization involves inquiry, exploration, awareness, compassion, patience, courage, and balancing effort with letting go,” Prosko says. She reminds us that, as yoga teachers, perhaps one of the best ways to facilitate the self-actualization of our students is “to create safe and compassionate environments that allow students to develop their own awareness and discernment skills so they can gain deeper insight into what it takes to keep themselves safe and prevent future suffering.”