Is Your Yoga Asana Practice Good For Your Back?

I received a text from a good friend who is a practicing orthopedic and pelvic floor Physical Therapist a couple of days ago. She wrote "the amount of people that cannot bridge and preserve their spinal and pelvic alignment shocks me" And then she went on to write something that, while potentially being incendiary, is also true..."And it is almost always someone who has practiced yoga for 20+ years"

True.

As physical therapists, we know that if someone cannot stabilize their pelvis in double limb support, they are not doing it when the forces are doubled or tripled (when they are hiking or jogging).

Why might yoga be antithetical to a stable spine?

I want you to know, before we go further, that I am a yoga practitioner (having studied under Djuna Devereaux and Sarah Steen), and I practice yoga asana several times weekly- including this morning.

I think about the requirements of spinal stability as being multifactorial. It is based on:

1) The ability to maintain spinal stability. This requires muscle tissue to contract and control forces

2) The ability to clearly sense and feel changes in the spine when it moves

Both of these might be challenged in women, more so than men, when we practice yoga or non-neutral spine pilates. This is primarily due to the fact, that people born with 2 x chromosomes, are born with and generate less Type IIb, power producing fibers, and less muscle overall in their lifetime. Meaning: we have to work harder to create and sustain muscle. This gets even tougher every decade after age 30.

To get some insight into the issue, Stuart McGill, PhD in biomechanics and author of many publications and investigations into how to protect structures of the spine, has stated that we need to recognize that if we make a spine more flexible, we lose some stability, conversely, if we make a spine more stable (strong) we lose some flexibility. You have to give up one, to get more of the other.

This is a basic concept in materials science, and any engineer and biomechanist is on board with this. When you invite in flexibility, you allow for more motion but less power production and less protection in some respects.

The spine is like a vertical bridge- between the pelvis and the skull. Ideally, the spine transmits forces from the lower extremity (ground reaction forces that occur when we walk, run, hike) and sustains the weight of our head, shoulders and trunk (including our viscera). When we habitually stretch support structures: fascia, muscle, ligament- we lose stability of those same structures.

Orthopedic research has made clear again and again, that where our spines are the most flexible, is where the degeneration of our passive tissues- ligaments, the annulus (ligaments surrounding the weight bearing cartilage), discs occurs the most. In addition, without thicker/ hypertrophied muscle, especially within the deep group of transversospinal muscles- the multifidi and rotatores, we cannot sustain compression or generate enough stability to keep our spines quiet.

How do we remedy this issue? Create hypertrophy of muscle (specifically along the back of your spine, and glutes). How do we create muscle hypertrophy? Strength training!

I have been hearing a lot of mixed messages lately about what constitutes strength training and what does not.

But strength training requires that you lift weight- maybe initially beginning with just your body weight (in the case of someone in rehab, this may even bee too much), then progressing the load you are lifting. This is done a specific amount, several times per week.

If you are a women not actively injured and uncertain about how to go about building muscle safely- join us in Practical Strength Foundations class!

The second issue that yogis, dancers, pilates practitioners, people born hyperflexible or with Ehlers-Danlos syndrome (a connective tissue disorder) face when attempting to bridge well, is the ability to sense where the pelvis/spine are in space.

Now, the point about muscle hypertrophy and strength will assist in more clearly feeling the spine/ body position. As we build larger muscle fibers, we have more ability to sense where we are in space. Also, those muscle fibers can create more force to help stabilize over and underlying passive tissue (ligament/ fascia).

In addition, avoiding over stretching of muscle, fascia, ligament will create a better picture of where your body is when you move it by improving clarity among mechanoreceptors (sense receptors of the body that detect length, pressure, positional change, vibration).

In order to imagine this, think about one of those radar receivers we have all seen. On the screen is usually a bull's eye - which represents 100 miles out in every direction- and when a plane or ship comes into the vicinity of the radar, it is detected visually and "blips" occur, sounding a presence. As the foreign plane gets closer to the receiver, the blips speed up getting more frequent, possibly louder.

When we habitually stretch a tissue, sometimes stretching beyond our physiologic norms, we start to lose signal from tissue letting us know when it is moving- we lose clarity from the muscle spindles and other mechanoreceptors woven into the muscle, fascia, and ligaments.

It is like the radar, rather than being a bull's eye, only listens for signals 5 meters away (maybe just like a dot). Additionally, when the objects get closer, the blip does not speed up.

We might be stretching a tissue closer to failure, but the body can no longer illicit the signaling to let us know.

In the orthopedic clinic, we unfortunately observe this very frequently among women who have stretched and performed mobility, without also strength training. If women are not strength training, they are losing muscle and undergoing muscle atrophy.

It happens much less frequently with male clients (who, by the way, often need more flexibility than their female counterparts) than with our female cohort. Again, I trace this back to biological changes (people born w XY chromosomes grow and maintain muscle more throughout their lifetime than their XX counterparts and are also socialized to participate more in fitness that builds muscle). Many women still maintain a fear of building muscle or "getting too bulky". This is not a real fear-it speaks to a misunderstanding of what it takes to build muscle, potentially underlying internalized misogynistic ideations about women's bodies, what muscle/ how it works within us and also, how it looks- if only it were that easy to create muscle hypertrophy!

One of my friends who is a wonderful yoga teacher states "Yoga is not a physical practice". I love that. When you study Patanjali's 8 limbs of yoga, and have a wonderful yoga teacher, you really get the depth of what yoga can be in your life. I know that yoga has helped me process trauma that may have side lined my life. It has given me connection, joy and an in road into meditation and deeper spiritual pursuits. I am extremely grateful for the practice, the yoga community and lineage and my teachers. And I also know that in our current society, we make our focus outward, and many people do use only yoga for a physical practice.

At the very least, we want our movement to be like an awesome buffet- offering up many different experiences to delight, challenge and stabilize us. We practice yoga on a Monday with modifications (you can check out my workshop on modifying yoga asana for more spinal safety here), and then Tuesday we lift weights. On Wednesday we might kayak or hike.

In a more thoughtful way, as Physical Therapists, we use movement prescriptions methodically- to offer bodies more of what they lack. In this way, we look at movement almost in an aryuvedic way- if a body lacks glute stability, and demonstrates excess pelvic mobility, we enhance the stability and turn down or avoid the emphasis on mobility.

In the past year, I have had several yogis attempt to join my beginning strengthening course, only to realize that they were already injured or advance too quickly through to my tougher courses and continue to re-injure themselves. This all points to the same pattern of break down- too much mobility, not enough strength/ stability in tandem with tuned down signaling from interoceptors. It always bums me out when this happens, as I know that that woman is much more likely to take on the message "I tried strength training and it hurt me" even though strength is exactly what is needed. This fear is known as kinesiophobia, and is a major cause of chronic pain and progressing orthopedic pathology.

Muscle is life, and to be strong enough for life, is a pre-requisite to continuing to move against gravity lifelong.

At a time when we seem (at least in the orthopedic clinic) to be in an epidemic of weakness, why are we offering more and more mobility/ flexibility opportunities and avoiding muscle hypertrophy/ stabilization?

And, are we confusing our yoga for our physical practices?

Happy Moving!

xxTrina