Friday Q&A: Which Forward Bends Are Safe?

Q: Nina's post earlier this week on how to get comfortable in forward bends was very informative (see Getting Comfortable in Forward Bends). But I was wondering whether both versions shown in the photos--the one with the rounded back and the one with the neutral spine--are safe for everyone.

A: Forward bends always need to be approached with awareness, caution and respect, especially for people with acute low back injuries or chronic low back conditions. People with herniated discs, facet irritation, or degenerative joint conditions in their spines may find that too much bending forward will increase their pain.

Several leg muscles attach to your pelvis and tight leg muscles can restrict the movement of your pelvis, which needs to be able to roll over the top of your hip joints. If your leg muscles are tight, sometimes sitting on a folded blanket can allow you to get the proper movement of your pelvis. However, if you have very tight hamstrings and don't have the ability to keep the natural curve in your low back as you bend forward, then the version with the bolster under your thighs may still be problematic.

Rounded Back Version: Could Be Problematic

In addition, there are some people with conditions for which forward bends are contraindicated, meaning that the risk is greater than the benefit. This includes individuals with severe osteoporosis as well as individuals who may have had vertebral compression fractures in the past. For them the neutral spine version with the chair or bench may be safe, but, again, be sure to  proceed with caution.

Neutral Spine Version: Proceed With Caution

In general, cultivating flexibility in your hip rotators and hamstrings can help you achieve a neutral spine in your forward bends, which will help keep your lower back safe.

—Shari

Featured Sequence: Low Back Care

by Baxter

Several weeks ago, I introduced some thoughts on low back pain and yoga (see here). As I mentioned, the majority of episodes of lower back pain are related to short-term issues of muscle strain or spasm, or other soft tissue and joint situations that usually resolve in six weeks or so. However, it is possible that a regular yoga practice or a special sequence directed at the lower back area can speed up that process and get you back on track a bit sooner. I have frequently observed that for students who come to class for the first time, acute low back strain often requires only a few sessions in my Back Care Yoga class before the student is well enough to return to or advance to a regular yoga class. In this setting, the variety of poses that may be helpful is a bit larger than with more serious lower back injuries or conditions. For example, you can be a bit more comfortable with some twisting and forward bending poses, which often have to be modified in the other situation.

This week I would like to give you a very brief sequence of poses to consider when addressing low back pain. (The poses in the sequence are all poses that we have already featured individually on the blog.) My intention is to add to this basic sequence over time. However, I have found that it is better to start with shorter practices and advance things as you are ready. Some of the poses in this sequence can be done dynamically, with you moving in and out of the pose with your breath, while others are done more statically, with you holding the pose for 30-60 seconds in most cases.

1. Reclined Hip Stretch Sequence (Dynamic). See here for a complete description of pose. 

2. Reclined Leg Stretch Sequence (Static). See here for a complete description of the pose.

3. Hunting Dog Pose (Static). See here for a complete description of the pose.

4. Half Dog at the Wall (Static). See here for a complete description of the pose.

5. Locust pose (Dynamic). See here for a complete description of the pose.

6. Knee to Chest pose (Dynamic). See here for a complete description of the pose.

7. Corpse Pose (Savasana) with Blanket Roll Behind your Knees (Static).

Notice how you feel after the practice and how you feel the next day. We’ll eventually add more poses to our back care routine, but these are a good start for you.

Featured Pose: Knees to Chest Pose (Apanasana)

by Baxter and Nina

Knees to Chest pose is a great way to warm up at the beginning of a practice or to cool down at the end of a practice, especially after a backbend or forward bend practice. This pose allows you to check in with the tightness or openness of your hip and buttock muscles and soft tissues, as you gently massage your lower back and abdomen. Because your knees are bent, the tension on the hamstring muscles is greatly reduced, making it safer than straight leg stretches for those nursing a sore or injured lower back. It’s very easy to do, doesn’t require props, and doesn’t take up much space, so this pose is one you can do almost any time or anywhere for quick relief of low back pain or discomfort after sitting for long periods of time, such as at a desk, in a car, or on an airplane.

This pose goes by different names Sanskrit names, depending on the yoga lineage. In the Krishnamacharya tradition, it is called Apanasana, with apana referring to the downward moving inner energetic wind of the body. So the pose is associated with anything that needs to exit the body from the perineum, including waste from the GI tract, as well as reproduction functions (it is sometimes recommended for menstrual irregularity, although Baxter knows of no evidence to support this). In other traditions, the pose is called Pavanmuktasana, which means wind-relieving pose. That name is self explanatory!

Baxter prescribes this pose for:

•    low back relief
•    tight hips
•    GI conditions where sluggishness is a problem (such as constipation)
•    general relaxation prior to Savasana

Instructions: Lie on your back with your knees bent and feet on floor.

Next, hold onto your knees with your hands, keeping your arms straight. On an inhalation, lift your feet up just a bit. Completely relax your leg muscles and let your arms do all the work.

Then, on your exhalation, bend your elbows and draw your knees toward your chest.

On your inhalation, straighten your arms and release your knees to the starting position. Repeat six times, moving with your breath.

Baxter recommends the dynamic version of this pose (moving with your breath) for low back pain, but if you are using the pose for other reasons and you prefer holding the pose for a longer period of time, you can keep your knees to your chest for 30 seconds to one minute.

Cautions: If you have knee problems, hold your hands behind your knees (between your calves and thighs). If the bones of soft tissues of your lower back or pelvis are sensitive, lie on a folded blanket or other padding.