如果你不能遵守规则,在世界上任何一种身体活动中你都可能伤害到你自己。
——比克拉姆.乔德瑞 哈他瑜伽的安全教育是成为一名好的瑜伽老师的基本要素。
瑜伽通常是在一个组的环境里进行的,在那里,学生能根据自身的适应性、综合的健康状况、年龄和身体的弹性不同而有所变化。对老师而言,这就面临一个挑战:就是应该让所有在这个环境里的习练者都了解到练习中的利害关系。接下来作一些常规的安全引导,包括禁忌情况。这并不是说没有遗漏了,因为还有很多变数需要考虑。当遇到不确定时,应当建议学生他们应当就其合适性、特殊体式或者运动的可能性与主治医生做些商议。安全教育也包括建议学生自己要用关注诸如胸部的疼痛、心律不规则或者心跳微弱,以及所有身体发出的暗示正处于过度疲劳的迹象,以此承担对自身健康应有的责任。
STANDINGPOSTURES/BALANCE 站立和平衡 站立和平衡,最安全的体式有助于发展全身力量以及柔韧,让学员体会到身体端正的姿态,可以作为充足的预备热身以及在必要时对体式进行适当的调整。
对于初学者来说,花时间练习站立体式是很重要的,因为这些体式唤醒来自双脚的能量,发展脚,脚踝,膝盖和臀部的力量和柔韧。通过这种方式,双腿成为脊柱稳定的根基。站姿是其它体式的基础。身体最容易受伤的三个部位:颈部、腰椎、膝。《瑜伽》近期文中提到:大腿后侧筋腱、骶髂关节是另两个较常见受伤的部位。不过在站立中容易受到的伤害可以通过以下几条简单的原则的学习去避免,同时这些原则中的大多数也适用于其它体式:
1 、尽可能放松并且伸展颈部后侧的肌肉从而保护颈部。如果不确定是不是放松或是颈部后侧的肌肉被伸展,可以建议学员目光向前而不是向上看比如在三角式或是侧角式时。
2、对于腰椎,一个基本原则是在所有站立姿势中尽量伸展拉长、避免这个区域的过度弯曲。正确使用腹部肌肉对腰部的支撑,温和的Uddiyana收束将有助于腹肌对腰部的支撑。
3 、正确的练习、并根据实际情况进行调整,站立姿势可以加强膝关节周围的肌肉和韧带的力量。只有股四头肌被加强的时候虚弱的膝关节才能得到加强。
4、避免大腿后侧筋腱的过度伸展。应该鼓励学员在站立前屈时微微曲膝,然后尽可能保持舒适的情况下一点点伸直膝盖。
5、骶髂关节最好的保护方法就是在站立时保持这个区域的宽度
正如已提到的,大部分而不是全部的体式要求有好的平衡程度。有各种各样的平衡和影响平衡的条件可能会影响到一个学生在练习站立体式时是否可以毫不费力,特别是站立平衡。这包括有视力问题、耳疾问题、忧郁、多发性硬化、药物治疗和问题导致的对中耳的不良作用。在这些和其它一些平衡体式的作用案例中,学生应当被告知需要特别的照顾。帮助他们适当调整姿势,或者在个别案例中学生会从借助于墙、椅子来完成体式并从中受益。
因为站姿是相当艰苦的练习,有些体式需要因为那些患有心脏病、血压不正常的学生而有所改变。举例:战士I式和II式,可以把手放在臀部上相当于把手举起来。有严重心脏病和高血压的症状的学生意味着他们要尽量避免站立并前弯体式同时进行,或者仅仅是向前弯到臀部线以上保持脊柱水平,这样心脏就不会低于臀部。这些体式的改编也可以教授给那些脊柱有问题和有疝气的学生。患有青光眼、视网膜脱落、内耳有液体流出和严重的鼻炎等症状的学生,做前弯的体式都不是很适合,因为任何一个脊柱前弯都会很容易比平时的不适更容易招致疼痛。
SEATED POSTURES 坐姿 几乎所有的坐着的体式都需要臀部和膝关节有良好的灵活性。
过去,膝盖曾有问题的学生被劝阻去尝试做那些传统的体式,诸如莲花式,尽管随着不断提高臀部的柔韧性,这个体式最终可以尝试在适当的时候安排到课程里。
一般来说,应该避免对有红肿发炎迹象的膝盖施加压力。膝盖部位有关节炎的情况需要被十分慎重地对待。在膝盖和脚踝下加上垫子,会对膝盖起到很好的保护作用,对那些跪下的体式比如雷电坐。
如果有静脉曲张的情况,缩短坐的体式的时间会比较有益,诸如雷电坐姿。无论如何,当一些反应发生时,学生应当停止继续练习。通常,长时间的双腿交叉背部挺直的坐姿或者跪姿是不合适的。
对于柔韧性有限的学生而言,用折迭起来的毛毯或者瑜伽砖放在坐骨下面,可以帮助膝盖低于臀部的高度位置和使骨盆与腰部的区域建立起更好的结合。
FORWARD BENDING POSTURES 前屈 请参考上文中关于站立前屈的部分。
针对腰椎间盘突出、椎间盘的纤维外环感染炎症、强直性脊柱炎(脊椎炎)、坐骨神经痛以及下脊椎或髋骶关节发生退行性疾病的学员(在作这样的体式时)需要特别谨慎。不适宜作这个体式的人还包括:近期作过腹部外科手术,肝、睥的炎症。另外,针对怀孕后期的准妈妈们,过度的前屈也是不适当的。
针对以上提到的学员情况,可以将坐立前屈进行适当的调整从而将体式变成更适合:双腿分开、利用伸展带增加脊椎的长度。
针对大腿后侧筋腱较为僵硬的学员可以建议:双膝微微弯曲从而使下背部得到伸展;另外可以将瑜伽砖或是毯子折迭后放在臀部下方,使得骨盆前倾。
LATERAL BENDING AND TWISTING POSTURES 侧弯和扭转体式 有严重的心脏和血压问题,孕晚期以及肝、脾炎症的学员禁做。如果怀孕或者近期做过腹部外科手术的学员,不适宜练习强烈的侧弯和扭转体式,体式要有所调整。对于那些有关节炎或者风湿病的学员,侧弯和扭转体式就要柔和些并有所调整。有疝气的学员尤其注意,在这些体式中,体式带给食道和胃部的压力会导致胃酸倒流到咽喉。
在侧弯体式如三角伸展式中,不提倡学员过分向下弯曲,除非他们身体下部具有必要的内部支撑和力量以保证他们安全收回体式。在扭转体式中,学员在扭转之前能够伸展脊柱并且在扭转体式中还保持脊柱伸展,这一点非常重要。在坐姿扭转体式中,柔韧度欠佳的学员可以在臀部下方使用折迭毯子或者瑜伽砖,这样会更好地保持骨盆和腰椎的协调,保证最大限度地伸展和扭转脊柱。
高血压和心脏不好的学员禁做倒立体式。由于倒立体式会增加眼部压力,因此对于有眼疾的学员,比如说青光眼和视网膜脱落,倒立体式也是很危险的。针对患有退行性催眠(不知道怎么翻,哪位高人指点?)、骨质疏松或者严重的颈部关节炎症学员,倒立体式也不适合。经期和内耳疾的学员也禁做倒立。倒立还会加重间隙疝气的症状。甲状腺肿大的学员在做肩倒立或者犁式体式时要适时调整体式,不要做完全的锁喉。
患有风湿和关节炎、孕期(孕妇重心位置不定)以及不利平衡的病症如多发性硬化、视力问题、耳疾等,不适合做倒立体式。不过,可以根据具体情况作适当调整。
学员如果有诸如颈部扭伤之类的情形,最好不要着急作倒立体式如肩倒立或者头倒立。除非没有任何炎症或者颈部经由其它体式的锻炼已得到加强。
做好倒立体式的关键就是要有控制地开始和结束体式。如果学员的内在和外部力量欠缺,教师要劝阻他们不要做肩倒立和头倒立。体重超标的学员如果勉强做倒立体式,会很容易受伤。上述情形的学员可以根据情况选择做半肩倒立,倒箭式和半头倒立。
YOGA BREATHING 瑜伽呼吸 呼吸技巧的习练应该是循序渐进的,学员最好培养呼吸意识以及充分利用肺活量的能力,在练习需要屏息的高级呼吸法之前必须习练如何将呼吸和动作相结合。高血压、心脏或胸部有问题以及处于孕期的学员,不要屏息超过4秒。
RELAXATION 放松 孕期超过30周的孕妇禁做挺尸式,因为子宫会挤压内部腔静脉从而导致血压降低和晕眩。如果使用引导词想象,要注意这种想象可能会对某些学员产生干扰。在深度放松时,某些心理问题会浮现出来,因此老师要充分了解自己的学生。在结束放松进行坐姿散盘(或其它坐姿)之前,一定要确保学员“躺在地上”---学员意识到自己的身体以及身体和地面的接触,所处的房间以及周围的环境。之后进行坐姿时要脊背挺直,稳稳坐住。
原文:
YOGA – SAFETY GUIDELINES
“In any physical activity in the world youcan hurt yourself if you don’t follow the rules” – Bikram Choudhury.
Safe teaching of Hatha Yoga is an essentialpart of being a good Yoga teacher. Yoga is generally taught in a group situationwhere students can vary considerably in terms of fitness and general healthlevels, age and flexibility. For teachers, this presents a challenge, whichshould be addressed by building awareness of common areas for concern. Thefollowing gives some general guidance on safety, including contraindications.It is not intended to be exhaustive as there are too many variations toconsider. When in doubt, students should be advised to consult their doctorconcerning the suitability or otherwise of particular postures or movements. Safeteaching also involves advising students to take responsibility for theirwellbeing by heeding such signs as chest pains, cardiac irregularity andfaintness, all of which are indications that the body is under strain.
STANDINGPOSTURES/BALANCE
With adequate preparation and modificationwhere necessary, these are amongst the safest postures, helping to develop bothstrength and flexibility throughout the whole body and teaching good bodyalignment. For beginners, it is especially important to spend time on standingasanas as they awaken the energy in the feet and increase strength and mobilityin feet, ankles, knees and hips. In this way, the legs become a firm base ofsupport for the spine. Standing postures, then, provide the foundation forother groups of asana. The three parts of the body most susceptible to injuryin any asana work are the neck, the lumbar vertebrae and the knees. A recentreport in Yoga Journal (1) indicates that the origin of the hamstring muscleand the sacro-iliac joints are the next most common sites of injury. Instanding postures injury can be avoided by following these simple guidelines,most of which are relevant for other types of asana:
1. Protect the neck by keeping it as relaxedas possible and maintaining length in the back of the neck. If in doubt,students should be advised to keep the gaze forwards rather than looking up inpostures such as Trikonasana and Parsvakonasana.
2. For the lumbar spine, a general guidelineis to lengthen and avoid overarching this area in all standing postures. Thecorrect use of abdominal support in the form of a gentle Uddiyana bandha willhelp to facilitate this.
3. Practised correctly and modified wherenecessary, standing postures can help to strengthen the muscles and ligamentsthat surround the knee joint. To strengthen weak knees, the quadriceps group ofmuscles need to be strengthened.
4. To avoid over-stretching the hamstrings,students should be encouraged to enter standing forward bends with slightlybent knees, which can be straightened as much as comfortably possible once inthe pose.
5. The sacro-iliac area is best protected bymaintaining width in this region in all standing postures.
It has been said that most if not all Yogaasanas require a degree of good balance. There are various balance-affectingconditions that may influence the ease with which a student can performstanding postures and in particular, standing balances. These includeblindness, deafness, anxiety, multiple sclerosis, the effect of medication andproblems affecting the middle ear. In these and other balanceaffecting cases,students are advised to take special care. Modifications to the posture can beused or in some cases the student may benefit from the support of a wall, chairetc.
As standing postures are rather strenuous,some may need to be adapted for those with heart and blood pressure conditions.For example, Warrior I and II can be practised with hands on hips rather thanwith arms raised. Severe heart and high blood pressure conditions may meanavoiding standing forward bends altogether or bending only from the hips with alevel spine so that the heart is never lower than the hips. This modificationmay also be given in cases of spinal disc problems and hernia. Glaucoma, detachedretina, inner ear discharge and severe sinus infection are all contraindicatedfor standing forward bends, as are any spinal conditions where a forward bendproduces pain rather than mere discomfort.
SEATED POSTURES
Almost all seated postures require goodmobility of the hip and knee joints. Where there is a history of knee problems,students should be discouraged from attempting classical postures such asPadmasana, although with work on improving hip flexibility the posture may beattempted in due course. Generally, pressure on inflamed knees must be avoided.Arthritic knee conditions should be treated with caution. Padding can be usedto support knees and, for kneeling postures such as Vajrasana, ankles.
In cases of varicose veins, short periods ofsitting in postures such as Vajrasana may be beneficial. However, studentsshould discontinue the practice if a reaction occurs. Generally, longer periodsof sitting in tight cross-legged or kneeling postures are inadvisable.
For students with limited flexibility, theuse of a folded blanket or block placed under the sitting bones can help tolower the knees to below hip level and create better alignment of pelvis andlumbar area.
FORWARD BENDINGPOSTURES
See comments above on standing forward bends.Exercise extreme caution in the case of students who present with any form ofprolapsed disc in the lumbar area, annulus fibrosis (inflammation of fibres ofspinal discs), ankylosing spondylitis (inflammation of vertebral joints),sciatica and any degenerative condition of the lower spine or sacro-iliacjoint. Other prohibitions include recent abdominal surgery and inflammation ofliver or spleen. In the later stages of pregnancy, extreme forward bends arecontraindicated For all above conditions a modified seated forward bend withlegs apart and the use of a yoga belt to encourage lengthening of the spine maybe suitable.
Students with tight hamstrings should beadvised to either bend the knees slightly to facilitate increased movement inthe lower spine or else use a folded blanket or block which will tilt thepelvis forwards.
BACKWARD BENDINGPOSTURES
Back bends which require significant effortsuch as Dhanurasana (Bow) and Chakrasana (Wheel) are unsuitable for studentswith high blood pressure and/or angina. Most backbends are contraindicated forpregnancy, particularly in the later stages.
Caution should be exercised with students whopresent with arthritic and rheumatic conditions, hiatus hernia, peptic ulcersand back conditions which are aggravated from the practice. Students with lowback pain may benefit from the use of a raise under the pelvis and hips toreduce the angle of the lumbar curve when practicing backbends performed from aprone position. Some students may also find it helpful to work with moderatetension in buttocks, hips and legs to reduce compression of the lumbar spine.
Students with kyphosis (excess posteriorcurvature of thoracic spine) should be advised not to take the head back inbackbends. Modifications or use of support under the wrist can be given tothose with wrist conditions such as carpal tunnel syndrome for backbends suchas Urdhva Mukha Svanasana (Upward-Facing Dog) where the hand is a base ofsupport.
LATERAL BENDING ANDTWISTING POSTURES
Prohibitions include extreme heart and bloodpressure conditions, late pregnancy and inflamed liver or spleen. In cases ofpregnancy and recent abdominal surgery, stronger side-bending and twistingpostures may not be suitable and a modification should be given. For those witharthritic or rheumatic conditions, side-bending and twisting postures should begentle and modified. Special care should also be taken in the case of hiatushernia where pressure on oesophagus and stomach could cause acidic juices toflow back into the gullet.
In side-bending postures such as Trikonasana,students should be discouraged from going too far down until they havedeveloped the necessary internal support and strength in the lower body toenable them to safely exit the posture. With regards to twists, it is importantthat students are able to lengthen the spine before twisting and to maintainthat length once in the posture. Again, the use of a folded blanket or blockunder the buttocks in seated twisting postures will help less flexible studentsto achieve a better alignment of pelvis and lumbar, enabling optimum spinallength and rotation.
INVERTED POSTURES
Prohibitions apply for those with high bloodpressure and those with heart conditions. Inverted postures can increasepressure in the eye and so are dangerous for those with eye problems such asglaucoma and detached retina. Inverted postures are unsuitable for thosesuffering from degenerative kyphosis, osteoporosis or anyone with a severearthritic neck condition. Contraindications also apply to menstruation andinner ear problems. Hiatus hernia may be aggravated by inversion. Those withenlarged thyroid should be given a modification in the case of Sarvangasana(Shoulder Balance) and Halasana (Plough) where full chinlock would beinadvisable.
Inverted postures may also be unsuitable inthe case of certain rheumatic and arthritic conditions, pregnancy (where thecentre of gravity is constantly changing) and balance-affecting conditions suchas Multiple Sclerosis, blindness or deafness. However, in some cases modificationsmay be given.
Students suffering from neck injuries such aswhiplash should be advised to wait for some time before attempting invertedpostures such as Sarvangasana(Shoulder Balance) and Sirsasana (Head Balance).These postures should only be attempted when there is no longer anyinflammation and the neck has been strengthened by other posture work.
The ability to enter and exit these postureswith control is essential. Those who lack the necessary internal and externalstrength should be actively discouraged from attempting inverted postures suchas Sarvangasana (2) and Sirsasana. Those who are overweight are particularlyvulnerable to injury if they try to force themselves into these postures. Inmany cases, modified postures such as Half Shoulderstand, Viparita Karani (Legs-up-the-Wall Pose) andHalf Headbalance will be safer alternatives.
YOGA BREATHING
The progression in teaching breathingtechniques should be very gradual. Students should have developed breathawareness, the ability to make full use of lung capacity, and have practisedsynchronising breath and movement before moving to the more demandingtechniques involving breath retention. Holding the breath for more than 4seconds is inadvisable for people with high blood pressure, heart or chestproblems or during pregnancy.
RELAXATION
Savasana (Corpse pose) is contra-indicatedfor pregnant women beyond the 30-week stage as uterine pressure on the interiorvena cava may lead to fall in blood pressure and dizziness. (see PregnancyGuidelines) As a general point, care should be taken if using guidedvisualisation as the particular visualisation may create a disturbingexperience for some students. During deep relaxation emotional problems can bebrought to the surface thus causing distress, so a teacher need to be fully awareof his/her students. It is important to end the relaxation practice by ensuringthat students are ‘grounded’ – aware of the physical body and the contact ofthe body with the floor, the room and the wider environment, prior to sittingin Sukhasana (or other seated posture) with upright spine and firm base.
Notes
(1) See “Insight from Injury” by CarolKrucoff in Yoga Journal, May/June 2003
(2) In the above article, a leading US Yogateacher and therapist reports that Shoulderstand is now the most common postureto produce injury,particularly in students over the age of 40.