Yoga has been an important part of my life for nearly 25 years. One of the reasons I am so passionate about teaching Yoga is that with proper training and supervision, it can help keep you healthy at nearly every stage of your life.
Of course, Yoga does not make one immune to physiological changes. What Yoga can do, however, is to help us to maintain a level of strength and flexibility that is both safe for our joints and balanced for our changing bodies.
How many of you wake up feeling a little stiff? As one ages bone density diminishes, cartilage padding the joints become thinner and the surfaces of joints do not slide as easily over one another. With age, joints become “stiffer” due to the gradual dehydration and chemical changes in our tissues.
This natural process can not only make Yoga physically more challenging, but can also increase the risk of injury, or exacerbate existing physical problems, if poses are not performed thoughtfully. Indeed, I wish I had known in my earliy days as a Yoga student how Yoga can be used as a tool to slow the physical effects of aging.
So, does this mean that people in their forties, fifties or sixties should stop doing Yoga? Of course not!
What this does suggest is that both new and experienced students should take a moment to understand how a change in physiology based on age or injury translates into a need for closer attention when practicing Yoga.
As part of my new YOGATONE 360 blog, I’m going to share how I insure that my students learn Yoga in a way that heals rather than harms vulnerable areas of the body. For those who might have been previously injured, or who experience pain, I hope to be able to offer insight into alignment that can prevent further damage.
For example, poses you do for a herniated disk are different than poses you would do if you suffered from stenosis. (Of course, it is always important to get a diagnosis of your pain from a doctor, allowing you and your Yoga instructor to treat it properly.)
I use very direct cueing as a way for students to not only feel what muscles are supposed to be strengthening or stretching, but also to guide students into alignment that will be as safe as possible for their body.
I always tell my students we are all built differently as even our bones and length of ligaments, muscles and tendons can be different. This translates into making some slight adjustments that work best for your body.
The YOGATONE 360 blog will be your resource for understanding your body and how it is meant to move. Knowledge is power. For those who don’t want to read through the entire blog post, they can scroll to the bottom where I will share a checklist of the safest cues for each pose discussed.
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One of the ways I try to offer added value to my Yoga students is through an understanding of and respect for exercise physiology. In the early 1990’s, my interest in health and fitness led to the pursuit of a Master’s degree in Corporate Fitness and Exercise Physiology at the University of Illinois, Chicago. This knowledge helps to guide my Yoga training and teaching, minimizing the possibility of injury while safely maximizing the benefits of Yoga for those who might be recovering from an injury.
Indeed, in designing the YOGATONE 360 class I did so with an eye towards both preventing injury and helping those who have been injured.
I work regularly with a physical therapist both to discuss ways that Yoga can complement the physical therapy a student might be receiving while discussing injury prevention through a balanced approach to increasing strength and flexibility while avoiding the over-taxing of joints.
For example, the Toning section of YOGATONE 360 targets much of what you would do if you were to go to a physical therapist for your back, hips or shoulders.
Lower Back Pain and Yoga
Not simply the result of aging, lower back pain affects nearly 8-in-10 Americans at some point during their lifetimes. Respected Yoga teacher and author, Dr. Ray Long, suggests in a Yoga Journal article that, “somewhere around 40 to 75 percent of the population has some type of asymptomatic (painless) herniated disk.
These disk deficiencies limit the spine’s mobility, which can make twisting—a movement that demands both agility and spinal flexibility—potentially more painful.” Perhaps counterintuitively, women experience back pain more than men with 30% of women suffering with back pain versus 26% for men, according to the CDC.
If you’re reading this blog post, you likely need no convincing that back pain is, well, a pain!
Yoga can affect back pain in both positive and negative ways. Let me start by cautioning you to consume online articles and videos about the positive and negative effects of Yoga on back health with a large grain of salt.
The blaring headlines promising “miracle cures” or “imminent paralysis” are meant to persuade you to “click”, rather than inform. Yoga means many things to many people, and I’m often alarmed by the lack of knowledge that many random online articles reveal.
Without proper acknowledgment, understanding, and adaptation, Yoga has the potential to increase lower-back pain and exacerbate the causes of that pain. This is why I believe it is essential to partner with a knowledgeable Yoga instructor who considers the age, ability and the physical limitations of each student.
That being said, Yoga – properly taught and practiced – has proven to be helpful in reducing the symptoms and often the causes of lower back pain.
What Are The Most Common Physiological Causes of Lower Back Pain?
You’ll forgive me, but it’s time to get technical for just a moment to discuss the physiological reasons for lower back pain. The typical triggers for back pain – too much time at a desk, being overweight, improper lifting of heavy objects, lack of exercise and not having good alignment, etc. – are well known.
The important question is, how do these triggers exploit weaknesses in our spine, muscles, bones, tissues or nerves, forcing our body to respond with pain signals.
Muscle or ligament strain: Sprains and strains account for the most acute back pain. When muscles and tendons are pulled beyond their limit, pain signals are sent to the brain. If the strain is constant, as sometimes occurs when you’re in poor physical condition or overweight, muscle spasms and cramps can amplify the pain.
Bulging, herniated, ruptured or misaligned disks: Disks between the vertebrae in your spine act as cushions, helping to protect the nerves that run up and down the spinal column. When the disks are compressed, bulging, or herniated, they can put pressure on the spinal nerve sleeve, causing pain.
The technical term, Radiculopathy, is used to describe this condition where pressure on the nerve root causes pain, tingling, numbness and perhaps loss of sensation that can travel to other areas of the body.
Intervertebral disc degeneration: As part of the aging process discs can lose fluid not only making us less flexible but also decreasing the space between our vertebrae which can cause pain. This can make everything from twisting, back bending, and forward bending somewhat painful, especially if you are unaware of safe alignment. These movements are, of course, much of what your body is asked to do during your Yoga, so we’ll talk much more about this.
Arthritis: Osteoarthritis of the spine is generally associated with aging, or the result of injury/trauma in younger people. Osteoarthritis of the spine is the breakdown of cartilage of the joints and discs in the neck and lower back. It’s a degenerative joint disease that causes inflammation, swelling and often low-level generalized pain. It can cause stiffness or pain in the back and/or neck, and in some cases can be evidenced with numbness or weakness in the arms and legs. The good news is that the pain and stiffness can be reduced through exercise, including Yoga.
Skeletal irregularities: I’m using this term broadly to include congenital anomalies of the spine, scoliosis, spinal stenosis and other skeletal issues that apply unwanted pressure on the spinal cord.
If your eyes have not totally glazed over by now you may have noticed that lower back pain, in general, can be categorized as either over-taxing muscles, tendons, or ligaments in the back or contorting the spine in such a way as to put pressure on the nerve bundles protected by the spine.
With this in mind, how can teachers and practitioners of Yoga maximize the healthy, restorative powers of forward bends while minimizing the risk of causing or exacerbating lower back pain?
Forward Bends Without Stressing or Distorting the Spine
How many of you have heard your North Shore Yoga instructor intone, “bend from the hips!” when executing a forward bend such as Uttanasana. Forward bends are intended to stretch the hamstrings, lengthen the spine and to encourage introspection.
Performed properly, all three goals can be safely accomplished. However, I see far too many students who focus on how deeply they can bend without paying close attention to how their body is responding to the pose.
Keep Your Spine in a Neutral Position
I like to begin a conversation about Yoga and lower back health by focusing on how the spine responds to a forward bend. As Olga Kabel wonderfully described in a SequenceWiz article, the spine can be molded into three positions when performing a forward bend including swan dive, neutral spine and nose dive. For our purposes we’ll use the more generic equivalent terms of over-arched, neutral and rounded. The photographs below suggest how the spine is aligned in each position.
When you over-arch your low back during a forward bend such as Uttanasana, the vertebrae are elongated along the anterior side of the spine and compressed along the posterior side. If your hips and spine are well aligned, maintaining a neutral position, there’s minimal risk in overarching your back. However, if you aren’t properly aligned, or you suffer from reduced elasticity of the disks in your spine, overarching can irritate spinal nerves.
Similarly, rounding your back during a forward bend, or bending from the waist and flexing your lumbar spine instead of the hips, compresses the anterior side of your spinal disks with similar potential negative results.
Let me add a word of caution here. If you suffer from a known or unknown herniated or bulging disc, and you bend from the waist instead of the hips, you could push the center of the disc back which can exacerbate, or even create a herniation. Many Yoga classes, especially Flow classes, can have over 40 forward bends making proper alignment extremely important.
The solution, of course, is to pay attention to your body and if you experience discomfort when engaging in a forward bend with either a “Swan Dive” or “Nose Dive” curvature to the spine, take a pause and speak with your teacher. Even if you do not have pain, you could end up saving you’re back in the long run by being aware of staying neutral in the spine, or as close to it as you comfortably can, for your body.
For my students who have a history of chronic back pain, or who experience lower back discomfort during forward bends, I suggest that they work to maintain a neutral position from the pelvis through their back as they execute either standing or sitting forward bends.
In the Yogatone 360 class we have a maximum of eight forward folds. The reason is quite simple. Because a forward fold is an activity that we do do every day, usually many times a day, the repetitive motion of forward folds, especially without awareness to alignment, can overtax the low back.
Here are a couple of tips that can help you maintain a neutral position with support for the lumbar spine. First, bracing through the core and always hinging from the hips is the foundation for a forward fold. Second, bending the knees while executing forward folds can help to alleviate back pain, maintain better alignment, and help to bend from the hips rather than the waist.
It is widely believed that bending forward with straight legs places more pressure on the lumbar spine. While a straight-legged forward bend is not wrong, and may actually feel better for some students, I like to cue students to bend the knees in a group class when I cannot see every single person’s alignment. Overall I think it is just safer.
Third, don’t tilt your chin up, or bend your head down, as this can distort the position of your spine. The photos below illustrate how these three tips can help maintain a neutral spinal position.
Understand How Hamstring Muscles Affect Pelvis and Spinal Positioning
In fitness magazines, you’ll often see Yoga enthusiasts doubled over when executing a standing forward bend. Though visually impressive, it’s not a goal that I suggest for students that suffer from back pain.
The muscle and ligament flexibility needed to allow the pelvis and spine to remain inline is just not something that most people can do safely without overstretching.
Pelvic alignment is critical to keeping your spine in a neutral position. As you bend forward at the hips, if your hamstrings are tight, they can pull the pelvis backwards. The natural reaction from the spine, which is attached to the pelvis, is to flex and round as you bend forward, compressing the anterior side of the spinal disks.
To counteract the movement of the spine caused by the backward movement of the pelvic rotation, I recommend that you concentrate on keeping your pelvis and sacrum moving as a unit in line with your spine. If you place one hand on your low belly and one on your low back and then bend forward, you should feel very little movement under your hands.
The proper movement comes at the hips with the spine staying long and neutral. There is a slight anterior tilt of the pelvis to come into a forward fold. once in the forward fold, there is a slight rounding (flexion) throughout the whole spine. It will take some practice to internalize the spine, sacrum and pelvis as a unit, but with time that mind-body connection will come.
If you feel too much tension in your hamstrings, and either you can feel or your instructor tells you that your lower back is rounding, bend your knees slightly to relieve pressure on the hamstrings. You should quickly feel how the pelvis and spine become one again and how the spine lengthens.
Once you’ve mastered the sensation of the pelvis, sacrum and spine moving in concert, practice bracing your abdomen as you bend forward. This will create support for your lower back by helping to control the position of the pelvis and give support to the lumbar spine.
By the time you’re ready to focus on the contraction of your abdomen it will be second nature for you to know how it feels to keep the spine in a neutral position.
Find a Knowledgeable Instructor and Don’t Be Afraid to Ask for Help
Yoga can and should be therapeutic for mind, body and soul. At the core of Yoga is the student-teacher relationship. Take the time to finding experienced, knowledgeable teacher who takes the time understand your individual needs and limitations.
The right teacher will help you to maximize your physical and spiritual potential safely, effectively and gracefully. Feel free to post your questions and comments below.
Checklist for safe and strong standing forward fold:
- Find neutral spine.
- Hinge at your hips not your low back or waist.
- Bend your knees if that feels more comfortable for you or if you find that your low back is rounding forward.
- Create a gentle tone/brace in your belly.
- Come out of it with the same alignment.