The MAD Lifestyle

Yoga for a Healthy Spine

By Sally Parkes, currently a key member of HFE's technical expert team

Yoga for a Healthy Spine

Yoga is an ancient Indian practice that seeks to connect the physical, mental and spiritual dimensions of the body. Derived from the Sanskrit word ‘yuj’, it literally translates to ‘unity of the mind and body with the universal spirit’. The traditional style of this 5000-year-old practice aims to help students overcome a number of physical, mental and spiritual limitations with the goal of realising the self – the ultimate goal of yoga is enlightenment. Traditional yoga is still seen by many to be on the fringe of a religion; however the modern practice is somewhat different from the original linage.

Modern styles are largely based on the principles of Hatha Yoga, and have become increasingly popular in the west over the past 10 years (Tidle et al., 2005; Saper et al., 2004). This style of yoga, which is usually taught to groups of participants in a class environment, almost exclusively focuses on the physical dimensions of yoga, including asana (postures) and pranayama (breathing patterns). Some classes, particularly those which last longer than 60 minutes will also include a period of meditation (dhyana), but there is usually less emphasis on this component.

Yoga and Back Pain

Low back pain represents a significant public health concern that has reached epidemic proportions. To date, mainstream treatment models have been largely ineffective at tackling this condition, forcing many sufferers to turn to alternative and complementary medicines in a quest for pain relief. In the USA, the extent to which those in pain have turned to yoga for relief is so great that the National Institutes for Health have officially classified yoga as a ‘recognised’ form of Complementary and Alternative Medicine (CAM) (NCCAM, 2003).

Yoga affords a variety of physical benefits, including improved muscular strength, flexibility, relaxation and posture. Some have termed these benefits as “side effects” (Varambally and Gangadhar, 2012) whereas others have argued that the benefits are a direct result of holistic nature of the practice (Khalsa, 2007). Many yoga participants are initially attracted to the discipline in search of a cure for their ailing health, with musculoskeletal conditions like low back pain being common motivators (Posadzki and Ernst, 2011).

A recent study conducted by Cramer et al, (2013) found strong evidence for the short-term effectiveness and moderate evidence for the long-term effectiveness of yoga as a suitable therapy for those suffering with chronic low back pain. Similarly, Posadzki and Ernst (2011) concluded that although it was not possible to identify the specific mechanisms by which improvements in pain were realised, yoga does have the potential to alleviate chronic low back pain.

Intervertebral Discs and Low Back Pain

There are a wide-range of factors that give rise to symptoms of low back pain and many of these are idiopathic (specific cause unknown). Of those disorders that are diagnosed, a sizable number of these cases include damage and dysfunction to the intervertebral discs (e.g. herniation, annulus sprain). It is beyond the scope of this article to discuss any of these specific conditions, or to explain the structure or function of the entire spinal column - it is assumed that the reader already has a basic understanding of this subject. A greater emphasis is placed on the mechanism by which the intervertebral discs’ function during movement because this is potentially an area in which yoga postures can have a positive and beneficial effect on those suffering from disc-related low back pain.

The spinal discs are avascular structures that have no direct blood supply - they therefore rely on movement to create a pressure differential within the disc. When the disc is compressed, its fluid content decreases - when the compressive forces are removed, the discs’ fluid content increases. This hydraulic-like mechanism is called ‘imbibition’ and causes nutrients (namely glucose and oxygen) and fluid into the disc, while removing metabolic waste products like lactic acid (Urban et al., 2004). If the supply of nutrients is restricted or removed, the disc will eventually fail and pain and dysfunction will often follow. It is for this reason that sustained postures (e.g. sitting at a desk) and overly repetitive movements (e.g. bending and twisting) provide the perfect environment for disc-related injuries to occur.

Yoga Asanas for a Healthy Spine

Asana is the physical limb of yoga that requires participants to perform postures which incorporate both static and dynamic movements. These postures are often arranged in such a way that one posture seamlessly meets the next, creating a flowing sequence of movements.

As is the case with any programme of exercise, asana need to be selected in such a way to promote balance and symmetry within the musculoskeletal system. This is especially important when teaching yoga to participants with low back pain because too much repetition may exacerbate symptoms. Yoga teachers should select asana that target many muscle groups and in a variety of yoga postures to foster balanced mobility in the spine, to lengthen and widen constricted or stiff muscles, and to strengthen those that are underutilised (Williams et al., 2003). Asana practice that includes controlled dynamic movements can greatly help to keep the discs nourished, whereas static postures can help to strengthen the stabilising muscles and connective tissues (ligaments, tendons, fascia etc) in this area.

The goal of yoga when for low back pain sufferers is to relieve pain and overcome functional limitations caused by a chronic low back pain disorder (Williams et al., 2003). This is achieved gradually over time by correcting underlying dysfunctions that may be present, by performing asana in an anatomically correct manner. Unlike most conventional medical treatments that seek to find a solution through a combination of analgesic medications and surgery, yoga therapies aim to provide those with chronic low back pain with a programme that they can use daily to manage their own condition more effectively.

The following sequence of asana includes natural flowing movements designed to extend, rotate, stretch and strengthen the spine in a variety of movement planes, thereby ensuring that all surfaces of the intervertebral discs are nourished.

Utkanasana - Chair Pose

The purpose of Chair Pose is to develop strength and endurance of the quadriceps, hamstrings and spine. It also encourages the spine to extend, which is greatly beneficial to the whole of the back area.

  • Begin in Tadasana (Mountain Pose) with the feet hip width apart
  • Inhale and extend the arms over the head and press the palms together whilst lengthening the spine
  • Exhale whilst flexing at the hips and knees to bring the body into squat position
  • Maintain a neutral spine whilst breathing evenly and deeply.
  • Inhale, releasing the legs and allow the arms to lift the body back to standing position

Rolling Down

Rolling Down is a gentle movement that mobilises the spine, improving body and postural awareness. It also helps to stretch the back muscles and the hamstrings.

  • Start with the feet hip width apart and introduce a slight bend in the knees
  • Contract the abdominal muscles, tucking the pelvis under slightly
  • The neck should be relaxed and the chin dropped to the chest
  • Roll down through the spine slowly, ensuring the arms remained relaxed
  • When the hands reach knee height, roll back up until standing

Bhujangasana – Cobra Pose

Cobra Pose is great for increasing mobility in the spine; it also helps strengthen the muscles in the hamstrings, triceps, gluteals and calves. Another benefit is the stimulation of the digestive organs, due to the slight pressure applied to the abdomen.

  • Start in a prone position with the legs straight and the inner thighs, knees and ankles touching
  • Hands should be palms down and directly under the shoulder.
  • Inhale to lift the upper body off ground, working towards straightening the arms
  • Allow the crown of the head to move upwards, then exhale and release the pubis to the ground
  • Inhale to lengthen the spine whilst allowing the chest to move forwards

Ardha Chandrasana – Crescent Moon Pose

This pose encourages lateral flexion of the spine. While it is not a movement not normally performed outside of yoga practice, it does ensure that the middle of the spine and rig cage maintain healthy mobility.

  • Stand in Mountain Pose and extend the arms over the head, interlacing the fingers and extending the first finger
  • Ensure the pelvis is tucked under slightly and the shoulders are dropped down away from the ears
  • Keep the chin level to floor and the legs strong, stretching the body upwards
  • Exhale and bend sideways whilst maintaining lift through the spine
  • This pose assists in mobilising and opening the hips, improves balance and proprioception, and stabilises the scapula and pelvic girdle.

Parivrtta Trikonasana - Revolved Triangle Pose

Revolved Triangle Pose is ideal for stabilising the scapular, ankles and pelvis. Due to the nature of the movement, it also mobilises the lumbar spine and assists with rotation.

  • To begin, stand with the feet one and half metres apart, turn the right foot outwards 90 degrees and ensure the left foot is parallel or turned slightly inwards
  • With the hips square to the front, facing towards the right foot, inhale and raise the arms to shoulder height
  • Hinge forwards from the hip, folding to floor. Inhale and lengthen through the spine
  • Rotate the torso and place the left hand on the floor, palm down and simultaneously extend the left arm upwards

About Sally Parkes

Sally has a degree a degree Sports and Exercise Science and been teaching since 1998. She has a wealth of experience in both practicing and teaching Hatha Yoga, with a particular interest in Ashtanga and Iyengar Yoga. She has studied in India, Thailand and the UK, and teaches people from all walks of life regardless of age, ability or experience. Sally is the author of The Student’s Manual of Yoga Anatomy and is currently a key member of HFE's technical expert team, providing ongoing support for their yoga teacher courses.

References

Cramer, H., Lauche, R., Halle, H., Dobos, G. (2013). A systematic review and meta-analysis for low back pain. Clin J Pain. 2013 May;29(5):450-60.

Khalsa SB (2007) Yoga as a therapeutic intervention. In:Lehrer PM, Woolfolk RL and Sime WE (eds) Principles and Practice of Stress Management. New York:Guilford Press, pp. 449–462.

NCCAM. Mind-body interventions. 20 Sep 2003. URL:http://nccam.nih.gov/health/whatiscam/.

Posadzki P and Ernst E (2011) Yoga for low back pain:A systematic review of randomized clinical trials. Clinical Rheumatology 30:1257–1262.

SaperR,EisenbergDM,DavisRB,CulpepperL,PhillipsRS. Prevalence and patterns of adult Yoga use in the United States:Alternative Therapies in Health and Medicine. 2004;10:44-49.

Williams, K., Steinberg, L., & Petronis,M.S. (2003). Therapeutic Application of Iyengar Yoga for Healing Chronic Low Back Pain. International Journal of Yoga Therapy – No. 13 (2003) 55.

Tindle, HA, Davis RB, Phillips RS, Eisenberg DM. Trends in use of complementary and alternative medicine by US adults from 1997 to 2002. Alternative Therapies in Health and Medicine. 2005;11:42-49.

Urban, J.P., Smith, S., Fairbank, J.C., (2004). Nutrition for the Intervertebral Disc. Spine (Phila Pa 1976). 1;29(23):2700-9.

Varambally, S and Gangadhar BN (2012) Yoga:A spiritual practice with therapeutic value in psychiatry. Asian Journal of Psychiatry 5:186–189.

This post is tagged with yoga, yoga anatomy, yoga asana, yoga poses, yoga for healthy spine, yoga for your back

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