Yoga with an Upper Limb Prosthesis

Yoga is a mind-body practice enjoyed by millions of people, including many who were born with a limb difference or experienced limb loss later in life. I’m grateful to say that I’m one of those millions of yoga practitioners, as well as a 200-hour certified yoga teacher and a member of the Arm Dynamics marketing team. In this article, we’ll explore the benefits of yoga in general and discuss why this practice can be especially helpful for people with an upper limb amputation. We’ll also talk about prosthetic devices for yoga and offer a few resources for learning about poses or participating in online classes.

Though it may sound a bit cliché, yoga can help heal the body and mind by encouraging people to slow down and focus on their breath, taking deeper inhales and longer exhales. The breath is what moves you through sequences of yoga postures or asanas. In balancing poses, focusing on the breath allows you to hold the pose for several inhales and exhales. A regular yoga practice brings people to a quieter, more introspective place where they can release their thoughts, stretch their bodies and relax.

Our patient Shaholly, who was born with a shortened right arm, experiences multiple benefits from her yoga practice. “I love to unwind with yoga. It helps align my body and reenergizes me when I’m sore or feeling out of whack. Practicing yoga also helps me feel more connected and grateful for my body.” Below, you can see Shaholly moving into adho muhka shvanasana / downward facing dog.

Many upper limb amputees are trauma survivors who experience depression, anxiety, PTSD, and other distressing emotions. Some people have a negative self-image related to their limb loss or even a sense of shame about looking different. Yoga and its relaxing qualities can help you in the quest to accept your differences and work through psychological challenges.

If you have a congenital limb difference and are thinking about trying yoga, you may not be sure where to begin. If you’re an amputee who did yoga before your limb loss, it’s important to understand that you can usually return to your yoga mat with the right "tool." Either way, our team of upper limb specialists can help you practice yoga safely while balancing out your body and having fun.

When our patients want to participate in yoga or other kinds of exercise, we introduce them to a range of various activity-specific prosthetic devices. A shroom tumbler is the most helpful device for yoga, especially when it comes to bearing weight on your hands, like in plank pose, lunge / runners lunge, or downward facing dog. Shaholly has tried other terminal devices for yoga and thinks the shroom tumbler provides the most stability. “This device is amazing for yoga compared to some other attachments that I’ve tried. It mimics an open hand pressing against the floor when I’m moving from downward facing dog to plank to cobra.”

A couple of years ago, our patient Angel went through her yoga routine to show us how she relies on her shroom tumbler. It’s there to stabilize any pose where the "hand" touches the ground, like in the pose below, where she demonstrates marichyasana III, a seated twist.

Yoga has many balancing poses. Wearing a prosthesis makes it easier to maintain balance since it evens out arm length and weight on both sides of the body. That’s true in standing postures where your arms are resting at your sides or raised above your head, and also for poses where you extend one leg while balancing on the other, like virabhadrasana III / Warrior III. The weight and symmetry of the arms — whether extended forward, reaching back, or out to the sides like wings — are key to balancing poses and reduce overuse issues with the other hand and arm.

Yoga props like blocks and straps make it easier to get into some yoga postures. Blocks bring the floor closer to your hands. For example, in forward fold with a block, when you bring your fingertips or hands towards the ground, you could rest them on a tall block and use it to stabilize your pose while the leg muscles begin to release and lengthen. A block also helps with balances where one hand is reaching toward the floor like ardha chandrasana / half-moon pose. A strap adds length to your arm to allow for stretches that open up the shoulders and hips like utthita hasta padagusthasana / hand to big toe pose.

We want our patients to tell us if they have any concerns about how their prosthesis fits and feels during yoga. Nate, our patient in Oregon, was going to yoga twice a week, wearing a shroom tumbler on his right side. When both hands were on the ground in plank pose, he had discomfort in his left wrist due to a previous injury, so he placed a folded towel under his hand for extra support. It relieved the pain but caused his prosthesis to be too short. With Nate’s feedback, we lengthened his device to match the right side including the towel, and he returned to his weekly yoga routine feeling comfortable and balanced on both sides.

To get a taste of what it’s like to do yoga with an upper limb difference, you can check out yoga teachers with limb differences like Melanie Waldman, visit her Facebook page, Yoga with Melanie Waldman, and her blog, WheresWaldman. There’s also Dan Nevins, a wounded warrior, bilateral amputee and yoga teacher who says, “This yoga practice is completely modifiable to any kind of disability. This practice saved my life.”

While some people with an upper limb difference may choose not to wear a prosthesis when doing yoga, this limits their ability to do poses and can also lead to imbalances or injuries to the body. Before she had an activity-specific device, Shaholly tried doing yoga without a prosthesis. ”I didn’t care for it because it felt very asymmetrical. And I think it’s really important to use my right arm and hand as much as possible since that side is more atrophied and needs to be strengthened.” In the photo below, Shaholly steps forward with her left foot into lunge / runners lunge. 

In yoga, resting is just as important as doing active poses or vinyasa flow.Yoga classes and home practices have a standard final pose: savasana / corpse pose. You lie down on your mat, close your eyes, and sink into the rare space of a still mind and body for several minutes. Those who are new to yoga may find this to be a difficult pose because it requires them to do nothing — very counter to American culture. When it’s time to sit up, there’s a sense of calm refreshment and a quiet mind to tamp down emotional stress.

For people who are interested in learning about yoga, there are more options now than ever before, especially since the pandemic, when thousands of yoga studios began offering classes via Zoom. The Zoom yoga classes I've attended are the next best thing to being in a room full of like-minded people — sometimes you can even see the other people doing asanas in their individual boxes on the screen! Other times, you just see the teacher. One excellent, free resource that I use myself and recommend to others is Yoga with Adriene. You can also check out a book called Yoga for Amputees.

If you are considering joining a yoga class, but aren’t quite sure yet, don't let the idea of doing yoga intimidate you. Yoga is intended to be the opposite of competing or trying to keep up with other people in a group exercise class. Each person has their own level of comfort and flexibility and energy. One of the primary tenets of yoga is “do no harm,” which means that we don't do poses or stretches or balances that hurt our bodies. There are easy ways to modify any yoga pose to make it safe. Over time, your body will loosen up, stretch out, relax. Your breath will deepen. And you will move into a deeper sort of mind-body practice. Doing yoga with an upper limb prosthesis is an excellent way to help you integrate your prosthesis into your body image and to become more comfortable with who you are and how you navigate life.

If you’d like to learn more about using an activity-specific prosthesis to help you practice yoga, or if you’d like to know if your device could handle the poses, please contact us. If you have any comments that you’d like to leave, please do so below. We hope you have found this article helpful.