Not all yoga practices are created equal – even more so when underlying back issues are involved. Research shows 80 percent of Americans have reported at least one episode of back pain in their lifetime with over 60 percent complaining of pain that is chronic in nature.
With a multitude of treatment options available, many people are opting for alternative options such as physical therapy and yoga. However, the variety of yoga styles offered today is so vast and diverse that it makes finding a class or instructor that caters to populations with back issues all the more difficult.
Yoga Instructors Are Not Physical Therapists
Have you ever had a student come up to you after class asking questions about health issues with their body and how to fix them with yoga? More often than not this happens and it’s okay. Never feel pressured to answer questions that are out of your scope of practice. Even if you happen to work in the medical field, it’s always advisable to refer a student back to their health care provider for questions that are health or pathology related.
As a yoga instructor, our main purpose is to hold space for our class and create an environment that nurtures self-growth, safe movement, and non-judgment. Yet, there will always be those students that are curious about how yoga can help body issues such as back pain.
Back pain is one of the main reasons people considering attending a yoga class. More healthcare providers are recommending it to their patient’s as studies have continuously shown numerous benefits of a regular yoga practice. When it comes to back pain, especially chronic in nature, most people receive the greatest benefit from consistent targeted exercises and stretching activities that are designed specifically for spinal health.
Unfortunately, not all yoga styles are appropriate for those with chronic back pain, due to excess strain on the areas of the body that may already be tight or weak. Rapid repetitive movement typically found in a vinyasa class or even transitioning from a forward fold to standing can aggravate symptoms resulting in spasms or increased pain.
Even though many yoga instructors may not have the same training as a Physical Therapist, there are considerations we can familiarize ourselves with that will protect our students with back pain.
Recommendations for Teaching to Students with Back Pain
1. Anatomy is key.
Educating yourself in the main areas that are common for back pain can allow you to theme your classes to target these areas and bring relief to your students without them even realizing! For instance, the spinal erectors are a common muscle group known to spasm, which can easily happen when transitioning from a flexed posture to spinal extension or vice versa. This is a result of a lack of core engagement or coordination with the movement. Proper cueing of the core musculature and breath support aids a student in protecting and stabilizing the spine during movement while decreasing load placed on the spinal segments.
2. Target the hips.
The hips tend to hold the most tension in the body. The musculature of the lumbosacral and hip complex can dictate how the pelvis is positioned and therefore affecting the spine. Utilizing asana that mobilizes and increases extensibility of the external hip rotators, hip flexors, and hip extensors is important to incorporate in a practice for back pain sufferers. These areas are the most common for restriction.
3. Avoid drastic and rapid twisting motions.
When it comes to back pain, most people remain in a slightly stressed and guarded state. Exaggerated or intense rotation of the spine can over stimulate the protective musculature of the spinal column resulting in increased risk of spasms or pain. It is advisable to approach asana that requires rotation of the spine with gentle intentions and focused breath to promote core engagement.
4. Focus on deep core engagement and full exhalation.
The transverse abdominis and diaphragm are directly connected to promote stabilization of the spine. Cue full exhalation during movements where core stability is required such as chair pose, twists, and rising from a forward fold. This allows activation of deep core stabilizers while teaching your students how to breath in a more functional capacity.
5. Incorporate fluid spinal warm-ups and gentle cool-downs.
The spine enjoys gentle fluid motion before and after increased activity. More often than not we are sitting longer and placing ourselves in less than ideal postures. Fluid motion hydrates the joints and tissues allowing them to functionally slide and glide over one another. When we are stagnant, these tissues are more rigid, less viscous, and resistant to movement. Nourish your students with neutralizing movements before and after practices for the greatest and safest benefit.
With more and more people seeking yoga as an alternative to harmful pain medications and expensive trips to the doctor and physical therapist, yoga instructors will see an influx of students requiring instruction that is heavily steeped in anatomy, biomechanics, and proper education of spinal pathologies. Continued education in these areas are extremely important for yoga instructors to consider, not only to protect students, but also to evolve into a highly specialized instructor who students can turn to when there is no one else!
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