Yoga with back pain

Yoga is an ancient art of exercising body, spirit and mind. It was nurturing physical and mental health of people for hundreds of years – keeping them strong, young, and flexible. Yoga exercises can be immensely beneficial for both your overall and spinal health, but if this is the path you wish to choose, you should also consider that:

  • Not all yoga forms are safe for your spine; some advanced exercises may damage your back and put your spinal health at risk.
  • The most common yoga injuries are to the knees and wrists – then to the spine.
  •  Yoga doesn’t injure a person, person’s ‘ego’ does that – by wanting to do too much, too soon, people put themselves at risk. Everyone has their own pace, and if you are planning to practice yoga – take your time and know your limitations.
  • If you are practicing yoga in a safe manner with an instructor experienced or, at least, familiar with back rehabilitation, it very well may become one of your best choices of exercise that’s out there – careful approach will help you to benefit fully!

How can yoga cause or worsen the existing spinal problem

First things first: any type of exercise, whether it is swimming, table tennis, or step aerobics – has a potential for a back injury. Most of the types of exercise have also very tangeble health benefits – thats why we do them. Evaluating the physical activity whether it is good for you or not, involves comparing risks with the benefits, and if ratio of benefits to risks is high, we consider it a good idea (in a nutshell).

Talking about yoga, easily the 90% of yoga asanas are safe and beneficial for health (and spine), i.e. they are low risk and carry substantial health benefits. Another point is that most yoga poses (asanas) can be modified to the practicing individual’s needs and limitations, therefore becoming safe for practice for him or her. Point being, considering yoga’s low risk and high benefit ratio, you should definitely try it, but if you already have some health problem (including back pain, sciatica, or anything going on with the neck) you should find an instructor with a background in physical therapy, and you should let him/her know about your condition prior to starting yoga. And when you start, watch out for these factors:

  • Stretching too far and/or holding the stretch for too long, e.g forward bends like pashimotanasana, uttanasana, and the likes – if you stretch too far, the ligaments of the spine will not recoil after the stretch (especially if you hold it longer that 20 – 30 seconds). Improving mobility at the expense of spinal stability is always a bad deal – you’ve been warned.
  • Extreme back bends – will load and possibly damage the facet joints of the lumbar spine. Ustrasana (or Camel pose) would be a good example of a risky pose, where the weight of the upper body is loading the already challenged by the backbend lumbar spine. Another one is Dhanurasana (Bow Pose), if you’ve some sort of facet joint ailment in the lower back, and/or don’t know exactly what are you doing in this pose – things can get really bad, really quick. Is there safe way of performing it? No. You might be getting away with it for a while, if you are naturally (genetically) bendy backwards. But if you’re recovering from any type of a back problem at the moment (or have had one in the past) – wait for trouble. Because it will come. Avoid completely.
  • Contortionism of any kind. If you aren’t considering a career in circus – forget the ‘scorpion’, the ‘legs behind the ears’, or any other ego-busting tricks. They have no health benefit whatsoever, and only serve one purpose: proving other people that you are better than them at something. Get it out of your system immediately.
  • Headstands. The size of a lumbar (lower back) vertebrae exceeds same of a cervical (neck) vertebrae by 200-300%, so does its ability to bear weight. Spine of the neck is for fine movement, lower back is for the weightbearing – don’t stand upside down if you are a beginner. Again, as for other asanas, there are better and safer ways of performing the headstands. It is all about bringing more weight on the elbows and forearms while in the headstand, effectively taking the strain (or compression) off the neck, but this is for an experienced yogi – beginner might not have enough control and body awareness to be able to use these methods. Bottom line: don’t be in a hurry and your time will come. With existing neck problem – avoid.
  • Shoulder stands (Halasana, Salamba sarvangasana, etc.) – are really hard on lower neck/upper back region. There is a way of doing it in a more spine-friendly way, but only a more advanced yoga practitioner would have enough control and body awareness to perform it perfectly.
  • Purvottanasana (or Upward plank pose), and its variations – a great posterior myokinetic chain of muscles enhancement exercise. What makes it dangerous is lowering the head back and extending (back-flexing) the neck to its extreme from this awkward position. If your posterior chain muscles are in good form and you are in full control in this pose, then the risk is minimal. However, any weakness in trapezius, rhomboids, triceps, or posterior deltoids won’t let you to squeeze the shoulder blades and lift the chest out providing for the smooth entrance into the pose. In this case you are likely to lead your body into the pose with powerful neck extension movement which will jar the facet joints of your cervical spine, and with time, cause permanent damage to your neck. If you recognise yourself in this situation – keep the chin tucked in throughout the pose and don’t attempt any backward movement of the neck until you are done. Really small compromise and removes the risk completely.
  • Coming to a yoga class with an existing injury. It never seazes to puzzle me how many people with serious spinal conditions are advised by their doctors to partake in a yoga class to resolve it. Class is designed for a group of people, not for your individual spinal problem – therefore some of the exercises may be of no benefit, or even dangerous for you. A good example would be Trikonasana (Triangle pose) and a spinal disc bulge. When you do trikonasana to the side away from your disc’s bulge, your condition might improve with time, but do it to the side of the bulge, and you are risking for it to become a proper herniation (indication for surgery). In the class you would do both sides every time, unaware that one of them is a strict contraindication.

Bottom line: if yoga is your treatment of choice for an existing spinal condition – your treatment regimen should be designed by an instructor experienced in spinal rehabilitation, and taught on individual basis.

P.S. Once you make sure you practice yoga in a safe manner, without trying to become an acrobatic sensation, or a next Olympic wonder – relax, breathe, and go with the flow. You are going to get better, stronger, healthier both physically, and mentally. It is not a coincidence that our spinal health clinic operates from a yoga studio. Connecting the dots yet?

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Your own physical condition and diagnosis may require specific modifications or precautions. Before undertaking any course of self-treatment you should consult a doctor or physiotherapist.

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