Back pain is a common issue for many adults, and the leading cause of disability worldwide. As people continue to search for the causes and the cures for back pain, yoga was in the headlines once again. A 2017 study published in the Annals of Internal Medicine recommended that before prescribing medication, doctors should suggest exercise such as yoga to treat back pain.
Yet yoga, as with any physical practice, is not without risks. Read on for five ways to avoid back pain in yoga class—helping to ensure that your practice heals instead of harms.
Many of us have at one point in our lives sung some version of the old song Dry Bones (“The toe bone’s connected to the foot bone,” etc.). I often reference some part of these lyrics in my yoga classes to remind my students that everything is connected. In her book YogAlign, Michaelle Edwards reminds her readers of the importance of a holistic view of the human body: “Because all parts of our body affect the whole, shortening and contraction in the front can put tremendous strain, or pull, on the back line of our body. The body is interconnected; you cannot move one part without affecting another.”
Recognizing that your body is a system rather than a collection of parts is the foundation for avoiding back pain in your practice. Edwards specifically questions the value of “six-pack abs” in relation to the health of our backs. She argues that tight abdominals can lead to back pain and weakness by shortening the front line of the body, creating an imbalance that leads to back pain. Rather than prescribing crunches, she encourages a mindfully toned core built through anatomically informed asana, deep breathing practices, and embracing an active lifestyle.
Recognizing that your body is a system rather than a collection of parts is the foundation for avoiding back pain in your practice.
Edwards also incorporates into her teaching self-massage of the entire body. I often use her “toe weave” and foot massage at the start of my classes, reminding my students that because everything is connected (and the back line of fascia connects the soles of the feet to the back before running all the way to the top of the skull), practicing self-care for our feet may positively affect our back health as well. So I have students come to their backs and take a few minutes to massage each foot, and then weave the fingers of their right hand in between their left toes, building toe strength by squeezing the fingers with the toes. This is then repeated with the opposite foot.
Approaching your practice from the mindset of connectivity is critical to avoiding back pain.
The late T.K.V. Desikachar was one of the most respected yoga teachers of the modern era, and his teachings continue to influence thousands of students and teachers. One of his greatest contributions to yoga was his emphasis on creating a personal practice. In his book The Heart of Yoga, Desikachar states that “It is only possible to find the qualities that are essential to asana if we recognize our own starting point and learn to accept it.” Knowing your starting point is an important first step to discovering your edge.
In an essay in Living Yoga entitled “A Nonviolent Approach to Extending Your Limits,” Ken Dychtwald discusses the importance of exploring your edge. To avoid your edge ensures stagnation, while going beyond it can cause harm. Dychtwald defines the edge, in part, as “the fine line between self-destruction and self-improvement.” Avoiding back pain, or any type of pain in your practice, involves starting where you are, honoring that space, and then mindfully exploring your edge.
Practically speaking, avoiding any sharp pain on the mat is the most obvious way to make sure that you don’t cross over your edge. And Desikachar believed that breath can be one valuable way to protect the integrity of your practice. He was a proponent of ujjayi breath (also known as “sounding breath” or “ocean breath”). “If we do not succeed in maintaining a gentle, even, quiet sound, then we have gone beyond our limits in the practice.” Use your breath as a tool to help you stay within your limits—protecting your back and moving toward a practice you can sustain for a lifetime.
I teach primarily gentle and restorative styles of yoga. I often begin my classes by asking my students to explore places in their practice where they can increase their comfort. “Where can you be slower? Softer?” I ask them. Making use of yoga props is a great strategy for taking care of your entire body—especially your back.
Ideally, teachers and students will communicate with one another about places to incorporate props throughout a yoga class. There are two postures, however, where it might not be apparent that the use of props can greatly aid in a healthy expression of the pose. First, many classes begin in an easy seated, cross-legged (sukhasana) position so that students can develop their breath practice and get centered. But what if easy seated pose feels anything but easy? If so, in sukhasana try placing a folded blanket under your bottom, or sit on a block or bolster. If practicing sukhasana with props still results in discomfort, try vajrasana (thunderbolt pose). Since our hips are intricately linked to our lower backs, avoiding the external rotation of the hips required in sukhasana can be a gentler option for many people’s backs. Finally, most of us spend at least several minutes of our yoga practice in rest pose (savasana). This is the second place I strongly encourage my students to integrate props into their practice. It can be disheartening to arrive in this blissful final pose only to feel a tightening sensation in your lower back. If you find that lying flat on your back results in lower back pain or tension, try bringing a large bolster (or perhaps two folded blankets) under your knees. I find that after trying out this option, most students do not return to a traditional savasana—choosing instead to practice in a way that’s more comfortable for their lower backs.
Forward folds are a bit controversial in the yoga world, with some people arguing that they can lead to back pain and injury, and others believing they should remain a staple of everyone’s yoga practice. Again, the words of Desikachar seem important here: “The yoga practice must be tailored to fit each person.” Do forward folds serve your practice? How so? What steps can you take to find the forward fold option that best aligns with the needs of your body? For example, I now spend less time in forward folds—and when I do practice them, I always bend my knees.
Julie Gudmestad is one of my go-to experts on yoga anatomy and forward folds. In her Yoga Journal anatomy column, Gudmestad has stated that, “While forward bends can be wonderfully relaxing and introspective, they can also strain or injure your low back—especially if the backs of your legs are tight.”
In my own personal practice, generously bending my knees in forward folds, whether standing or seated, has decreased my persistent lower back pain, both on and off the mat. And to again quote Desikachar: "You should not use the muscles in the arms to attempt to intensify the forward bend.”
Here too, experiment with how your body interacts with forward folds. If you suspect they might be troublesome for you, try skipping them for a few weeks and then slowly build in the gentlest option, carefully considering how your folds impact the health and agility of your back. Pain or pulling in the lower back in forward folds are the strongest indicators that you need to modify or choose another posture. In addition, if your breath practice becomes strained in your forward folds, your body may be communicating that you need to rethink them. Finally, asking your yoga teachers to analyze your forward fold posture could lead to insights that will protect and serve your lower back.
One of the concepts that has greatly influenced my yoga teaching and practice is what Katy Bowman calls “nutritious movement.” Bowman is a biomechanist and author who advocates a big-picture approach to health and wellness. One hour of yoga each day is a great start, but how are you moving for the remainder of the day? Are you sedentary or active? Do you move mindfully or do you reinforce negative habits in your body and posture? Approaching yoga as just one piece of the puzzle, rather than the sole solution to back pain, seems to me a more realistic approach. It also helps me take some of the pressure off of my practice; rather than seeing it as the only fix for my instances of recurring back pain, it is one piece of my larger spiritual and physical practice. When I move more mindfully and “nutritiously” in the twenty-three hours of my day off the mat, I am less likely to experience pain during my hour on the mat.
Approaching yoga as just one piece of the puzzle, rather than the sole solution to back pain, seems to me a more realistic approach.
Guided by the yogic philosophy of ahimsa (non-harming), we can view these strategies to prevent lower back pain as part of a bigger picture: to create a healing and empowering yoga practice that serves our highest good. Taking steps to protect our lower backs in yoga class will ensure that our practice can continue to sustain us for many years to come.
Do you experience chronic back pain? What are some of the best ways that you’ve found to prevent back pain in yoga class?