Back Pain and Spinal Flexion

Why is it that most yoga teachers believe that spinal flexion helps alleviate back pain? Let's explore.

What is spinal flexion? Flexion of the spine occurs when your rib cage rounds closer to your pelvis or thighs. In most yoga classes, flexion is achieved by performing common Forward Folds, such as Balasana (child's pose), Uttanasana (standing forward fold), and Paschimottanasana (seated forward fold).

However, there is no anatomical support for yoga teachers' choice to put students with low back pain immediately into a forward-folding position.

Flexion does not alleviate dysfunction in most cases of low back pain. (Notable exceptions are the rare conditions spondylolisthesis and sponylolysis, affectionately known as "Spondy," in which vertebrae have fractured and slipped forward, rather than backward.) And when tight hamstrings are the cause of the pain, which is typical, then flexion can be disastrous.

A quick anatomy lesson: The spine and pelvis are meant to float slightly above the heads of the femur with the help of beautifully constructed soft tissue (tendons, ligaments, muscles, fascia, etc, etc.) that is designed to be flexible enough so that our legs are free to move us forward (think "walking"). But when we sit all day and have not ever used our deep abdominal support system effectively, our bodies simply collapse into our hip joints, which become tight and inflexible. Our lower back falls into flexion, losing its natural, anterior curve. The muscles of our hips (hamstrings, glutes, hip flexors) get shortened and tight, while the muscles of our back get stretched and weak.

A tight hip complex, and a low back that lacks stability, are directly implicated in most cases of back pain. Therefore, what the vast majority of low back-pain sufferers need is NOT, as you will frequently hear in yoga class, "space in the low back." There's too much space in the low back already; what the back is crying out for is strength.

So why would most yoga teachers instruct back-pain students to do forward folds immediately at the beginning of class--and sometimes throughout class--without doing some serious back-strengtheners and hip-stretches first?

One reason: Lack of extensive training in, or experience with, functional anatomy. They've heard that space in the low back is good, so that's what they teach.

If you have back pain, please be careful with your yoga class selections. Even better, practice my proven, at-home method for strengthening the core and back and eliminating back pain, the Hauber Method. With that, you'll be ready to practice almost ANY yoga class without back pain. Although, I recommend the poses in Yoga without Back Pain.