Yoga can build strength, body awareness, balance, and mobility, but the demands vary widely across practices. A slow restorative class, an Ashtanga practice, repeated Vinyasa flows, hand balancing, deep backbends, and long passive holds do not load the body in the same way. Rehabilitation should reflect the practice you are returning to.
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Steady Physical Therapy & Performance provides one-on-one yoga-informed physical therapy in San Francisco. Dr. Susie Lunardi is a physical therapist, strength and conditioning specialist, and registered yoga teacher (RYT-200). Care is designed for practitioners who want to reduce symptoms while preserving the meaningful parts of their practice and building the strength and control needed for long-term participation.

Common reasons yoga practitioners seek care

• Shoulder pain during chaturanga, downward dog, arm balances, handstands, or binding
• Wrist pain with weight bearing, repeated extension, or transitions
• Low-back pain during backbends, forward folds, twists, or prolonged sitting
• Hip or groin pain in deep flexion, external rotation, lotus variations, or splits
• Proximal hamstring pain aggravated by forward folds or repeated stretching
• Neck symptoms during inversions or weight-bearing transitions
• Hypermobility with joint pain, instability, fatigue, or difficulty sensing end range
• Uncertainty about how to modify practice without giving it up entirely

More mobility is not always the missing ingredient

Yoga practitioners are often accustomed to responding to discomfort by stretching. That can be useful when range is genuinely limited and the stretch is well tolerated. It can be counterproductive when the painful area is already exposed to repeated end-range loading, when a tendon is irritated, or when the sensation of tightness reflects fatigue or protective muscle activity rather than short tissue.

The evaluation asks whether you need more range, better access to the range you already have, more strength near end range, improved load distribution, or a temporary change in practice volume. The answer is often a combination, but it should not be assumed.

Alignment is a tool, not a moral rule

Traditional alignment cues can help organize a pose, but human anatomy varies. Not every practitioner should be forced into the same hand position, shoulder angle, stance width, spinal shape, or hip rotation. A cue is useful when it improves comfort, control, or the intended experience of the pose. It is less useful when it creates fear of normal movement or implies that one visible difference is inherently unsafe.

Rehabilitation may explore hand placement, prop use, range, transition strategy, breathing, speed, or load. The goal is to find options, not to label your practice as correct or incorrect.

Yoga and shoulder pain

The shoulder has substantial mobility and depends on coordinated work from the rotator cuff, shoulder blade muscles, trunk, and arm. Repeated chaturanga, downward dog, arm balances, and inversions can expose the shoulder to high volume even when no single repetition feels heavy.

Assessment may include shoulder range, rotator cuff strength, scapular control, pushing endurance, tolerance to compression, and the way weight is transferred through the hands. Treatment may temporarily reduce the number or depth of loaded transitions while strength and capacity are rebuilt. Avoiding every weight-bearing pose indefinitely is rarely the desired endpoint.

Yoga and wrist pain

Wrist symptoms may be influenced by available extension, how force is distributed through the hand, shoulder and trunk support, the firmness of the surface, and the cumulative number of loaded transitions. Modifications can include wedges, fists, parallettes, reduced extension, changes in hand angle, or a temporary shift in volume. These are strategies, not failures of practice.

Hypermobility: flexibility and stability can coexist

Generalized joint hypermobility describes range; it does not automatically mean a person has a connective-tissue disorder or will develop pain. Some hypermobile people are asymptomatic. Others experience recurrent sprains, joint irritation, fatigue, or difficulty controlling end range.

Physical therapy may emphasize proprioception, progressive strength, pacing, and the ability to create tension when a pose or transition requires it. You do not necessarily need to avoid end range forever. You may need a more deliberate dose and enough strength to enter, hold, and leave the position with control.

What treatment may include

• Pose- and transition-specific assessment
• Manual therapy when it creates a useful change in comfort or motion
• Rotator cuff, scapular, trunk, hip, and lower-extremity strength
• Closed-chain loading for shoulders and wrists
• End-range strength and isometrics for hypermobile joints
• Breathing and bracing strategies when they improve control without excessive rigidity
• A graded plan for reintroducing the sequence, duration, and frequency of practice

Frequently asked questions

Do I need to stop yoga?
Not necessarily. A useful plan often preserves non-provocative parts of practice while temporarily modifying the poses, ranges, or transitions that repeatedly aggravate symptoms.

Are deep poses bad for hypermobile people?
Not universally. The relevant questions are whether the position is controlled, whether symptoms increase, how often it is repeated, and whether the person has adequate strength and recovery. Some practitioners benefit from reducing passive end-range time while building active control.

Will strength training make me less flexible?
Appropriately dosed strength training does not necessarily reduce useful flexibility. It can improve the ability to control and tolerate range. The program can be designed around the mobility required for your practice.

Can you coordinate with my yoga teacher?
Yes. Clear communication about temporary modifications and progression can help you return to class without receiving conflicting instructions.

Schedule a yoga-informed physical therapy evaluation in San Francisco to build a plan that respects your practice while addressing the strength, control, and load factors behind your symptoms.