The fronts of the shoulder joints are structurally vulnerable in this position. If the scapulae are not mobilized in the direction of adduction and some elevation, too much pressure could be put into the anterior shoulder joints, resulting in an overmobilization of the subscapularis or damage to the joint capsules. Because this is a bound pose, the pressure into these vulnerable joints is greater.
This pose can be explored in a variety of ways by emphasizing different actions: by deepening the action in the spine, by increasing hip extension, or by using knee extension to deepen spinal and hip extension. The balance of actions in the hips and knees will be affected depending on whether the hamstrings or the quadriceps are more activated. Because this is a bound pose, with the hands grasping the ankles, it is also possible to put too much pressure into the knees. Thus, the alignment of the legs at the hips and the activation of the feet are important to maintain the integrity of the knees.