Yoga Teacher Confidential: Secrets of Becoming a Great Yoga Teacher

40. Handling Nosebleeds, Cramps, and Dizziness in Yoga Class: Minor Medical Emergencies with Grace

• Sage Rountree • Episode 40

Share episode

As yoga teachers, we’re often prepared for the flow—but what about the unexpected? From nosebleeds and nausea to cramps and emotional releases, minor medical situations happen more often than we expect. In this episode, I share practical, professional ways to respond to these common classroom incidents without derailing your teaching or unsettling your students.

You’ll learn how to recognize early signs of trouble, maintain class momentum while tending to individual needs, and communicate clearly and compassionately—no drama required. These stories and strategies will help you create a classroom culture where both self-care and safety are normalized.

I also share the general principles I use to handle these situations with skill and composure, so you’re never caught off guard.

We cover:

  • What to do when a student gets dizzy, nauseous, or emotional
  • How to handle nosebleeds, cramps, or cuts without disrupting the class
  • Tips for preventing minor issues before they start
  • How to build a culture where rest and modification are welcome
  • The quiet power of professional, compassionate leadership

Want to become (almost) everyone's favorite yoga teacher? Get in the Zone at Comfort Zone Yoga, my virtual studio focused on teacher development. I have a ton of Sage advice in there for you—let's chat there!

For more insights, subscribe to Yoga Teacher Confidential, check out my YouTube channel, and follow me on socials:

And come explore my mentorship program, continuing education workshops and 300/500-hour teacher training programs. It's all at sagerountree.com.

Tell you something, I once had a student get a nosebleed in the middle of class. I. Blood started dripping onto her mat, creating what looked like a scene from Dexter. Another student noticed before I did and gasped loudly. Suddenly all eyes were on this poor student whose nose was steadily dripping bright red blood. She was completely unaware of what was happening in that moment.

I had to make a quick decision:

halt the entire class for one student's minor issue or find a way to address it without disrupting everyone's experience more than the gasping and staring already had. What I did next taught me an important lesson about handling minor medical situations with grace and with minimal disruption. I. Welcome to Yoga Teacher. Confidential Secrets of Becoming a Great Yoga Teacher. I'm Sage Rountree, and today we're discussing part two of our series on medical emergencies in yoga class. Today let's talk about how to handle those more minor issues that arise without needing to stop your entire class. In our previous episode on emergencies, episode 34, we covered serious medical emergencies that require immediate action and often class cancellation. Today we're focusing on those more common, less serious situations that still need attention, but don't necessarily warrant pressing pause on everyone's practice. Let's start by acknowledging what makes these situations challenging. When a student experiences a minor medical issue, you're faced with multiple responsibilities simultaneously. Caring for the affected student, maintaining a safe environment for everyone else, and preserving the flow and focus of your class. It's a balancing act that requires quick thinking and clear communication. The good news is that most minor issues follow really predictable patterns and that they can be handled with a handful of well-rehearsed responses. Let's walk through some of the most common scenarios you might encounter and how to address them effectively. First, let's discuss dizziness or lightheadedness. This might be the most common minor issue you'll encounter, especially in classes with inversions or rapid transitions, or if you teach in a heated room, signs that a student might be experiencing dizziness includes the sudden and unsteadiness. Reaching for support, closing their eyes and pausing mid sequence, unusual palor, going pale or excessive sweating. They might also simply tell you, Ooh, I feel dizzy. When you notice these signs, approach the student calmly and quietly. Position yourself so you can speak to them without projecting to the entire room. Ask them to confirm what they're experiencing with the simple. Are you feeling lightheaded? If they nod or say yes, guide them to the nearest safe position, which is usually sitting on the floor for the rest of the class. Continue your instruction while keeping an eye on the affected student. You might say something like, as you move into the next pose, remember that you can always pause and sit if you need to take a break. This normalizes what's happening with the disease student while continuing the flow for everyone else. Once the dizzy student is seated safely, you have several options. If another teacher or assistant is available, signal them to attend to the student. If you're teaching alone, continue leading the class while periodically checking in on the student. You might suggest they sip water or place their head between their knees if there's seated, or lie down with their legs elevated on a bolster or against the wall. In my experience, most dizzy spells resolve within a few minutes with some rest. The student will often rejoin class when they feel ready. If the dizziness continues or gets worse, or if it goes along with other symptoms like nausea or vomiting or confusion, then you might be dealing with something more serious that could require ending the practice for the day or seeking medical attention.

One more note on dizziness:

Prevention is the best approach, as in so many things. Remind your students to move slowly in and out of inversions to stay hydrated and maybe suggest that they eat something light a couple of hours before class. These simple reminders can significantly reduce the occurrence of dizziness in your classes. Now let's return to the nosebleed scenario I opened with. Nosebleeds can look really dramatic, but they're rarely serious. They're more common in heated classes, in dry environments or during inversions, especially for the students who are prone to them. In the class I mentioned, I quietly approached the student and pointed out that she was experiencing a nosebleed. I helped her with tissues. I then directed her to sit against the wall. You pinch the soft part of your nose while leaning slightly forward, not backward, as we more instinctively think we should. For the rest of the class, I continued teaching while occasionally checking on her, I suggested a simple modification for her to rejoin without inversions. Once the bleeding stopped and the entire situation was ultimately handled with minimal disruption, and most students did remain focused on their own practice. If you are teaching a notice, a student with a nosebleed, here's a quick protocol. First, get them out of any inversion or any active pose safely. Provide tissues, of course, if available. This is why we always keep several boxes scattered around the studio, guide them to sit and apply that pressure to the soft part of their nose for about 10 minutes. Advise them to breathe through their mouth, of course, and to avoid sniffing or blowing their nose, which can restart the bleeding. While they're managing the nosebleed, continue teaching, but perhaps avoid calling for additional inversions until the affected student has recovered. Check on them periodically with the glance or quick quiet check in. Little thumbs up. And a shrug of your shoulders is a way to check in once the bleeding stops. The student can usually rejoin class, though I do recommend that they skip any further inversions, including standing forward folds and down dog for the remainder of that class. Now, if a nosebleed doesn't stop after 10 or even 20 minutes of direct pressure, or if it's accompanied by some other symptoms like dizziness or confusion, you're handling something more serious that will require medical attention. Of course, that is beyond your scope of practice as a teacher, but it's time to help the student with a reference or even to call 9 1 1 or your emergency services number. Another minor, but potentially disruptive issue that can suddenly onset is muscle cramping really sudden and painful. Cramps commonly affect the feet, the calves, I get those all the time, or the hamstrings and they can cause students considerable discomfort. If you notice a student grimacing or suddenly grabbing at a muscle, they're likely experiencing a cramp Approach them quietly confirm with a whispered muscle cramp. If they nod, help them find a comfortable position where they can address the cramping muscle. Often your hamstrings will cramp when you're trying to reach your hand to your foot in a dancer pose or in a lizard lunge where you're reaching your hand for your back foot. In that case, you can have the student turn their toes under and reach back through their heel, or get up and walk around for a calf or foot cramp, suggest that the student straighten their leg and gently flex their foot, perhaps with a strap if needed for any other hamstring cramps, not the quad stretch. The key is to lengthen the cramping muscle rather than continuing to contract it, but sometimes it's useful to contract it even a little bit more and concentrate on releasing it. While your student addresses their cramp, continue leading the class. You might offer a general modification that benefits everyone. If anyone is feeling tightness in your legs or you start to cramp, remember, you can always use a strap to up the ease factor here. This normalizes modifications without singling out the cramping student. Now physical touch can be helpful for muscle cramps. Think about petillage massage, but always ask for consent first, especially when a student is in pain. A simple, may I help you stretch this muscle is sufficient. If they agree, you can provide gentle assistance while continuing to guide the rest of the class verbally. Most cramps resolve within a minute or two, sometimes less, with gentle stretching. Once the student is comfortable, they can usually rejoin your class sequence, though you might suggest they take a more modified approach for the remainder of class to prevent recurrence. Let's move on to cuts and scrapes, which happen more often than you might expect in a yoga class. And sometimes the student arrives with a cutter, a scrape that begins to bleed in your class. At my old studio space, in a mill building with historic wood planking, the original historic wood floors, we occasionally had students catch their toes on old nails or rough spots in the floor. There were divots where the mill machines had been and the nails would like to lift up. Any change of humidity, we kept a hammer on board for that reason. It'd be really weird when a student walked into class and I'm standing there holding a hammer. But that's what we needed to do to keep the nails in the floor. Now, if a student gets a small cut during class, your response should prioritize both hygiene for the cut and minimizing disruption for the rest of your students. First, approach them quietly assess the situation. See the recurring theme here. For minor pets, hand your student a tissue or direct them to the nearest first aid supplies. In my studio, we keep band-aids and Neosporin in our first aid kit in the office closet. It while your student addresses their cut, continue teaching the class. You might offer a seated or a reclined pose that gives everyone a moment to regroup while the injured student takes care of their cut. This creates space without explicitly stopping class for a minor issue. For small cuts on extremities, like fingers or toes, students can usually handle basic first aid themselves. You may need to help them apply a bandaid. However, you should check whether the wound is clean before they return to their mat. Make sure that they're not leaking through their bandaid. Blood on props or on the floor creates hygiene concerns for everyone. Now if a cut is more significant, is if it's bleeding heavily or if it's in a location, the student can't easily reach. To apply pressure, you may need to provide more direct assistance, and in this case, it's appropriate to give the class a brief hold. Take five. Everyone please take five breaths and down dog or five minutes to explore practice on your own while we rectify this situation. This gives you a moment to help without completely ending class. At my old studio with those wood plank floors, we learned to scan the floor regularly for the protruding nails or even for splintered areas. Like I said, we kept it a small hammer on the prop rack to tap down any nails that we found between classes because prevention ultimately will save you from dealing with many potential injuries. Another common minor is issue in class is sudden nausea. This can happen during intense twists or inversions and in heated rooms, and it often catches students by surprise. If you notice a student becoming pale or swallowing repeatedly or suddenly stopping their practice with a distressed expression, they might be experiencing nausea. Approach them quietly. Ask if they're feeling sick, if they confirm immediately. Guide them to a comfortable seated position or suggest that they lie on their side for the rest of the class. Continue your instruction while keeping an eye on the affected student. You might say, "as we continue, remember to move at a pace that feels good in your body today." This gives permission to the nauseated student to take things slowly without explicitly calling attention to them. Provide the student with simple recommendations like taking slow, deep breaths through the nose, or focusing their gaze on a fixed point or pressing their thumb into the inside of their wrist, an acupuncture point for nausea or sipping water if available and palatable. If your student needs to leave class to use the restroom, make it easy for them to exit unobtrusively. You might subtly position yourself near the door to open it for them if needed, especially if they need to run out with a hand over their mouth if they continue teaching without interruption. Most episodes of nausea pass pretty quickly, and the student can then rejoin class after a few minutes of rest if they're feeling up to it. But you might suggest they take a more gentle approach for the remainder of practice. If the nausea continues or if it's accompanied by those other concerning symptoms like dizziness or sweating, the student should probably end their practice for the day. Sometimes the minor issue isn't physical, but emotional. A student experiencing an unexpected emotional release during class, this could manifest as tears or trembling or shaking, or any sudden intense emotion. When you notice a student having an emotional response, your approach should balance respect for their process with attention to the overall class environment. First, create space for them without drawing undue attention to the situation. If the class is in a pose where it's appropriate, you might move near them and quietly ask, would you like some support or would you prefer space? Many students prefer to process their emotions privately, but with the container of the class, in this case, simply making eye contact to acknowledge them maybe with a hand on your heart perhaps offering a reassuring nod is plenty. Continue teaching the class, perhaps offering language that normalizes emotional experiences In yoga. I think we've all had them. You could say something like, as we open physically, we sometimes release stored emotions as well. This might surprise you, but whatever comes up is welcome here. It's all part of the practice. If a student seemed overwhelmed or if they seemed disruptive, you might quietly suggest that they take child's pose or another comfortable resting position. A Shavasana legs to the bolster, legs up the wall. In the rare cases where a student is unable to contain their powerful emotions, and they're making a lot of sound that could be disruptive to the class, heavy heaving sobs. Uh, some sounds like that you might need to ask them what would work best for them to take an early Shavasana, maybe in the adjacent studio, or to step out and sit quietly in the lobby or to go to the bathroom or something else. Remember that emotional releases in yoga are normal and often really therapeutic and cathartic. Your role isn't to fix or even to control the emotion, but to create a safe container in the classroom so that it can be experienced and integrated. Most students feel really grateful for classes where their authentic emotional experiences are allowed, are held with compassion rather than treated as emergencies or things to stop. Occasionally you might encounter a student experiencing mild asthma symptoms or breathing difficulties. While of course, severe respiratory distress is a major emergency. Uh, referred to episode 34 here, milder symptoms can often be managed without disrupting class. If you notice a student taking their inhaler or wheezing slightly, or seeming to struggle with breath, approach them discreetly ask if they have what they need to manage their symptoms such as an inhaler. Many students with asthma are really well versed in managing their condition and simply need a moment to use their medication. Likewise, your diabetic students know what to do. Even just a quick thumbs up with a quizzical expression can give you the info you need so that you feel like your student is capable of managing their own symptoms, and you can continue with class. While your students address their breathing or their blood sugar, continue teaching, but perhaps shift to a less physically demanding interlude. Again, you could offer a seated pose, a gentle stretching sequence that allows everyone to recover while the affected student manages their symptoms, and then rejoins the group. Of course, if breathing difficulties worsen or if the student seems genuinely distressed, this becomes a more serious situation requiring the protocols we discussed in episode 34 on major emergencies. One final scenario worth discussing is the student who becomes overwhelmed by heat, especially in hot yoga classes or during summer months in non-air conditioned studios. Signs that a student is struggling with heat include excessive sweating beyond what's normal for the hot setting, redness in the face, difficulty catching their breath, or sudden need to sit down. If you notice these signs, approach your student quietly, suggest modifications to help them cool down. These could include taking a seated position and just doing simple arm movements instead of doing full sun salutations, taking off any extra layers of clothing that they could. Sipping on cool water or applying a cool tout to the back of their neck. If one, if there's one available while your student manages their temperature. Continue teaching, but perhaps reduce the intensity for everyone. You might say. Let's take a few moments to find stillness and connect with our breath. This gives the overheated student as well as the others who might also be struggling a chance to self-regulate. Most heat related issues in yoga classes are really minor and they resolve quickly with rest and cooling measures, but be vigilant for signs that it's developing into heat exhaustion or heat strokes, such as confusion or dizziness that doesn't get better with rest or stopping sweating even though it's still hot. Those are symptoms that would require more immediate intervention like we discussed in episode 34. Quick sidebar. I understand that in some hot studios, students are discouraged from leaving the studio space. While I understand it's easier for the teacher to keep eyes on them if they stay, I would never suggest stopping a student from caring for their own needs. Your students have their own agency. Now that we've covered specific scenarios, let's discuss some general principles for handling minor medical issues in class. First, prepare in advance, keep a small teacher's kit with basic slight tissues, band-aids, uh, polysporin or Neosporin, and perhaps hard candy for low blood sugar. Know where the studio is, first aid supplies are located. Have the studio's address handy in case you do need to direct emergency services. Although this is rarely necessary for the minor issues we're discussing today. Second, develop the eyes in the back of your head. Develop your peripheral awareness. First off, always teach with your eyes open, but also train yourself to scan the room regularly while you're teaching. Looking for signs that a student might need assistance of any kind. Often you'll notice subtle cues. A grimace a sudden pause, a hand to the forehead before a student explicitly asks for help. Third, use your voice strategically when addressing a student with a minor issue. Lower your voice and speak directly to them for the rest of the class. Maintain your regular teaching voice and continue guiding the practice. This creates a natural division of attention without making a big production out of the situation. Fourth, leverage community when appropriate. If you have regulars who you know are healthcare professionals, you might quietly enlist their help for these minor issues, allowing you to continue teaching the class. They will probably already volunteer to help, but if you need to ask them for help, be sure to do it respectfully and without putting anyone on the spot. Fifth, normalize modifications and normalize rest in every class explicitly. Give permission for students to modify to rest in child's pose or to step out whenever they like. When this is established as the norm of your classroom culture, any students experiencing minor issues will feel way more comfortable taking care of themselves and way less likely to disrupt the class. Finally follow up with your students appropriately after class. Check in with the student who experienced a minor issue to ensure they're feeling better. If the issue was related to a specific pose or a specific practice, you might have some guidance on how they could approach it differently next time. This shows care while also helping to prevent recurrence. If your studio policy prevents you accessing student's contact information, send a message to the student via the studio manager or owner. Let me leave you with this thought. How you handle minor issues in class, communicates volumes about your capabilities as a teacher. When you can address these situations calmly, efficiently, with equanimity and without creating unnecessary drama, you demonstrate a level of professionalism that builds trust with your students. Remember that yoga is ultimately about awareness, and that includes awareness of the humans practicing in your class with all those humanity, all their physical vulnerabilities and all of their needs. Approaching minor medical issues with compassion and skill is not an interruption of your teaching. It's an integral part of it. It's an extension of your teaching. Here's an affirmation to help you remember. I respond to unexpected situations with calm presence, balancing individual needs with group flow. I respond to unexpected situations with calm presence, balancing individual needs with group flow. If you have stories about handling minor medical situations in your classes or questions about scenarios we didn't cover today, I'm happy to hear from you. Join our discussion at The Zone, my free community for yoga teachers, at comfortzoneyoga.com. There's a link for you in the show notes. Thank you for listening to Yoga Teacher Confidential. I'm Sage Rountree, and I'll see you next time.

People on this episode

Head Shot

Sage Rountree

Host