The statistics on back pain
are staggering. A whopping 85% of the U.S. population will suffer from back pain at some point in their lives. Ninety percent of these cases will involve low back pain. Back pain is one of the top reasons why Americans stay home from work, and the second-leading surgical procedure. Yoga is known for its healing qualities, but is it possible that yoga postures may also contribute to back pain?
As a seasoned yoga teacher with a reputation for smart practice, students have long come to me for help recovering from and avoiding yoga injuries. Complaints and concerns about back pain are particularly common, especially with yoga styles that involved extreme and sometimes vigorous forward and backward bending, as well as rapid or asymmetrical twisting. As a teacher, I emphasize safe yoga
and effective practices based on anatomically optimal alignment and individual modification.
As an advanced yoga practitioner, the story was different. For decades, I followed a different set of rules. In my own practice, I was willing to take risks with my body and push for the perfection my senior teachers demanded. My yoga postures were technically precise and well-sequenced, but more extreme, held for significantly longer periods of time, and continued off the mat.
Then one day my back spasmed and I found myself in the ER. The attending physician suspected a herniated disc. An MRI revealed a bulging disc at L4-L5. Although it was not herniated, the disc was pressing against delicate spinal nerves, causing excruciating pain. Nearby, surrounding muscles spasmed, clenching my sciatic nerve. This type of pain, I was told at the hospital, can be worse than childbirth.
I was booked for spinal surgery, but opted out in favor of non-invasive treatment. Among the most cutting edge non-surgical back pain treatments is a posture based method developed by former yoga teacher, Esther Gokhale. Her acclaimed book, 8 Steps to a Pain-Free Back, is a National Book Award Winner and a bible for many back pain sufferers. I bought my own copy in addition to her DVD, Back Pain: The Primal Posture Solution. I was so impressed that I arranged to work with Esther Gokhale one-on-one.
In studying the Gokhale Method, I became aware of the harm I was inadvertently causing my body through strict adherence to stylized yoga postures on and off the mat. The impact of pelvic distortion was particularly eye-opening. Gokhale explains that the architecture of the human body is designed for pelvic anteversion. This means that the pelvis naturally tips forward, as opposed to the backward pelvic retroversion found in most yoga asanas.
(Standing Mountain Pose) is a classic example. This apparently benign foundational standing posture involves drawing the sacrum (tailbone) down, under, and forward as the pubic bone draws upward toward the chest. Tucking the tailbone is a spinal action that lengthens the lumbar spine, not a squeezing of the buttocks. Colloquially known as “Tadasana of the Pelvis”, the action is ubiquitous in modern yoga posture practice. Seen in almost every pose, from Chaturanga Dandasana (Four-Limbed Staff Pose) to Virabhadrasana (Warrior Pose), mastery and transference of Tadasana alignment principles is considered essential for and a mark of technical asana competence.
As a student of Iyengar
Yoga since my teens, Tadasana has long been a mantra. With typical Iyengar brusqueness, my instructors would bark, “More Tadasana! Stand in Tadasana! Walk in Tadasana! Run in Tadasana!” While training in India with a senior Iyengar Yoga teacher who works closely with B.K.S. Iyengar
, I once complained about a shooting pain while walking in Tadasana. My instructor’s response? “More Tadasana!”
Tadasana is a stylized yoga pose that can be beneficial in certain contexts and when practiced for discrete periods of time, but it may become harmful when practiced incessantly or when inappropriately incorporated into other activities, such as walking and running. As noted above, when we practice Tadasana, the spine is artificially lengthened downward as a result of pelvic retroversion. This causes the backside of the spine to open up while the anterior portion of the discs are compressed. The gelatinous disc contents are in turn pushed backward, risking disc bulging, herniation, and sequestration.
When we retrovert the pelvis, we also disengage the glutes – the powerhouse of all athletic movement, and destabilize the spine. With the glutes disengaged, the lower back is forced to absorb more pressure and weight than it is meant to handle, stressing the spine and resulting in back pain. For anyone who spends time running, hiking, and walking, doing so with a retroverted pelvis virtually guarantees eventual injury.
Yoga should support rather than replace our primal architecture, just as it should enhance rather than distort optimal movement patterns. To this end, it is essential to understand and honor the human body’s inherent bio-mechanics. As yoga practitioners, we risk becoming so well-trained in stylized postures that we stray from nature’s architectural genius. By studying the fundamentals of primal posture and setting boundaries with respect to our posture practice, we can minimize the risks of asana while maximizing the rewards. Back pain can indeed stem from yoga asana, but an intelligent posture practice can equally restore and strengthen our natural alignment, keeping us safe from injury for a lifetime of rewarding practice.
Esther Gokhale, 8 Steps to a Pain-Free Back: Remember When It Didn’t Hurt (2008)
Esther Gokhale, Back Pain: The Primal Posture Solution (DVD 2012)
Dr. Eric Goodman & Peter Park, Foundation: Redefine Your Core, Conquer Back Pain, and Move with Confidence (2011)