A Yoga Practice to Relieve Lower Back Pain

One of the most common musculo-skeletal complaints that my clients come to yoga for is relief of their lower back pain. The reasons for lower back pain can be wide and varied, and this is one instance in which one-to-one private yoga therapy work can be invaluable.

 

No two back pain clients are the same and I find that students can react very differently to the same set of poses thus necessitating a very personalised, exploratory and slow approach to the practice.

 

That said, there are some poses and exercises which I have found generally to be beneficial for clients presenting with lower back pain or tension. The overarching principle of all of these exercises is to create a sense of spaciousness and very gentle traction in the lower back, helping to relieve compression between the vertebral discs and reduce clenching or spasm of the muscles that attach to the lower back, ribcage and pelvis.

 

As always its best to get yourself checked out and diagnosed by a health professional so that you know what you are dealing with. Most of my clients come to me once they’ve gone through that stage, and this is the type of sequence that I might give to a client working with a low-grade chronic ache in the lower back, rather than any acute severe or sharp pain. It’s worth reiterating that none of these exercises or poses should be acutely painful and if they are, it’s best to come out.

 

I like to sometimes give my clients the concept of an intensity scale to help them make sense of and interpret the sensations that they’re experiencing as they practise. If you think of a sensation intensity scale of 1-10, with 1 being extremely mild and 10 being distractingly intense, then we ultimately want to be working between a level 4-7. Any less intense and we may not be getting the fullest benefit of the movement, any more intense and it tends to cause the body to tense up and tighten, having the opposite desired affect.

 

Do have a read through of the instructions before having a go at the following sequence. There are some important alignment points to take into consideration to protect and support the lower back throughout each pose. As always keen to hear feedback and feel free to ask questions in the comment section below!

 

Thanks to Tummee.com for the sequence images!

 

Supine Pelvic Tilt Tuck

Why it helps: A simple movement-based exercise that helps to bring greater awareness and sensitivity to the lower back. This is a nice subtle movement to massage the muscles of the lower back, sacral area, pelvis and buttocks. Done with sensitivity this can help to give more understanding of where may be tight or tender and to bring a gentle sense of release and relief to any gripping or tightness in those places. Note that all of these movements are quite subtle and the hips remain on the floor throughout.

How to do: Start on your back in constructive rest pose with the knees bent and feet flat on the floor.  Lie on your back with your knees bent, feet flat on the floor about hip-width apart, knees pointing straight up. Put a blanket under your head so your forehead and chin feel level and your neck is comfortable.

  • Pelvic tilts
    Inhale and allow the spine to gently arch away from the floor, creating space between your lower back and the floor. As you exhale press the lower back into the floor and feel the tailbone tuck under as the lower belly and glutes firm. Note that the hips stay on the floor the whole time. Repeat this arching and lengthening movement 10 times in sync with the breath.
  • Pelvic side-to-side rocks
    Rock your weight from one buttock to the other. Repeat 10 times
  • Pelvic circles
    Now imagine you’re tracing a circle with your hips on the floor. Go 5 times circling in one direction and 5 times circling in the other direction.
  • Figure of 8s
    Now start to trace a figure of 8 pattern with your hips on the floor. 5 times in each direction.

 

Constructive Rest Arms Overhead Pose

Why it helps: This pose can create a mild sense of traction or lengthening in the spine, helping to decompress the vertebral discs, whilst promoting a subtle sense of core support on the exhale. Lovely to do if you’ve been stuck in front of a computer for too long!

How to do:

Start on your back in constructive rest pose with the knees bent and feet flat on the floor. Sense that your spine is in a neutral position – there is a natural gentle inward curve in the lower back away from the floor, an outward curve of the upper back into the floor, and a gentle curve of the neck away from the floor. Support the head with a blanket or cushion if it feels like the head is tilted back – the forehead and chin should be level.

Start with your arms resting by your sides. Inhale to slowly reach your arms up and overhead towards the floor behind your head. As you take the arms up try to keep the lower back ribs on the floor and avoid overarching the lower back. Instead feel for lengthening the spine as the arms reach overhead.

Exhale and gently drawing the lower abdominal muscles back towards the spine lower the arms back down by your sides.

Try to keep the movement smooth, slow and controlled, moving with the breath and avoiding rushing.

Repeat this movement 5 times.

 

Half Wind Release Pose

Why it helps: This can be a useful pose for lengthening the back of the hip and same side of the lower back as the bent knee, reducing tight or cramping muscles. Be mindful to keep the lower back in neutral.

How to do:

Gently hug the right knee in towards the chest, holding it with both hands either on the shin or behind the knee. You can keep the left knee bent, foot on the floor or for a stronger release straighten the left leg out along the floor.

Try to maintain a neutral lower spine here (it should feel like you could still slide a pencil behind the small of your lower back) and allow both buttocks to rest evenly on the floor so that the hips and pelvis are level and balanced. Relax the upper back and shoulders. Place a blanket or cushion behind the head if needed to keep the neck neutral. Take 5 slow deep breath into the right side of the lower back and hip. Switch legs.

 

Table top to Child Pose Flow

Why it helps: This soothing movement is a nice way to combine breath with a subtle opening up of the lower back. This can help to reduce spasticity in the muscles of the lower back and hips whilst taking pressure off the discs of the lower back.

How to do:

Start in table top position. Bring your hands under the shoulders and knees under the hips.

Inhale keeping the spine in neutral. As you exhale gently draw the lower abdominal muscles in towards the spine and pressing through the hands and arms draw the hips back towards the heels. Allow the elbows to soften and bend bringing the head to or towards the floor. Inhale to return back to table top position.

Repeat this movement forwards and backwards 5-8 times with the breath. On the last rep, if comfortable hold childs pose with the hips towards the heels, elbows bent and head resting on the mat for 3-5 breaths.

 

Downward Facing Dog Pose Variation Both Knees Bent Chair

Why it helps: Another great posture to mildly traction the lower back. It is also gives relief and length to tight hamstrings, calves, upper back and shoulders all of which can contribute to lower back tension.

How to do:

Hold onto to a ledge, table or back of chair and place your hands shoulder-width apart. Walk your feet back, bend your knees and align your heels under your hips as you stick your hips backwards. Work on maximising the length in your spine. Check that your knees are also in line with your toes.

Gently lower the chest down so that eventually the spine is parallel to the floor (or just above) and the ears and upper arms line up with each other. Relax and soften the upper shoulders away from the ears.

Make sure your breath remains fluid and easy without strain or tension. Stay for 5 breaths then draw the belly back to the spine to support the back as you lift the chest and with a straight spine walk the feet in coming out of the pose. Repeat one more time.

*Optional variation: Straighten one leg as the other knee bends. Keep the weight even between both feet. You should feel a good stretch on the outer hip/thigh of the straight leg.

 

Sleeping Pigeon Pose Wall

Why it helps: This is a great pose for releasing tension and tightness in the back and sides of the hips and pelvis which can be  a contributing factor to lower back discomfort. Be sure to keep the lower back in neutral and fully supported, avoid rounding the lower back.

How to do:

Start by carefully taking your legs up the wall – your hips will be about 1-2 feet away from the wall and you may want to put a folded blanket or towel under your hips and under your head for more comfort. It is important that the lower back stays neutral and on the ground during this pose so additional support with a blanket under the hips may be needed.

Bring your right ankle above your left knee and slowly slide your left foot down the wall until you feel a good stretch through the outer right hip. Keep your hips on the floor (or blanket) and keep the natural inward curve of the lower back intact. Try to make sure that both hips and buttocks are evenly resting on the floor or blankets. Rest your arms wherever is comfortable.

To make the stretch less intense have your hips further away from the wall, for more intensity scoot your hips closer to the wall.

Breathe deeply and steadily into your lower belly for 1-3 minutes. Gently explore extending and lengthening the exhale.

Switch legs.

 

Corpse pose Variation Chair

Why it helps: This variation of Corpse pose is often much more comfortable than the traditional variation lying on the floor with the legs straight. Using the chair helps to take any pressure off the lower back and can help to bring a sense of neutrality back to the lower back, hips and pelvis. The guided breath practice is helpful for relaxing the body and restoring the nervous system to a state of ease and relaxation.

How to do:

To finish practice bring your lower legs up to rest on a chair, so calves are supported and the legs are bent to roughly 90 degrees with the thighs vertical and shins parallel with the floor.

Put a folded blanket behind the head for more support and comfort.

Visualise breathing in and out of your right nostril for 5 breaths. Then visualise breathing in and out of your left nostril for 5 breaths. Finally breathe slowly and smoothly through both nostrils for 5 breaths.

Then let go of the guided breathwork and allow the body to rest fully for 3-5 minutes before ending your practice.

A Yoga Sequence for Better Sleep

One of the first things I ask my private clients is about the quantity and quality of their sleep. In my years of teaching and asking this question I would estimate that less than 10% of my students feel that their sleep is either adequate or restful. Some complain of having difficulty getting to sleep, whilst others find themselves waking up too early or in the middle of the night. Lifestyle factors and busy schedules mean that for many of us sleep is no longer a priority and gets squeezed out to make time for other things.

We now know however, the huge toll a lack of sleep has on our physical and mental health. Poor sleep hygiene has been linked to a greater risk of many chronic diseases such as diabetes and obesity, as well as an increase in mental health issues, such as anxiety and depression.

Knowing the implications of poor sleep habits is important but it can also make us feel further stressed and anxious about the fact that we are not getting enough sleep, which in turn makes it harder to fall asleep in the first place – a vicious cycle!

What I love about yoga is its pragmatic outlook and that it offers us so many wonderful, practical and realistic tools and techniques for managing our health.  Scientific research has shown that yoga can have a beneficial impact on our ability to not only fall asleep more easily, but also to improve the quality of the rest that we do get. This might be explained by the fact that yoga is a wonderful way to help us down-regulate our stress reactions and ‘turn on’ the ‘relaxation response’. The poses are also wonderful for reducing physical tension and tightness, which in turn can make it quicker and easier for us to drop into a state of deep rest.

Below is a short sequence of breathwork practices and yoga poses that I give to clients with insomnia and other sleep-related issues. The whole sequence takes around 30 minutes to complete but can be shortened by omitting a couple of the poses or doing shorter holds as time permits. Needless to say this would be an excellent practice to do prior to bed perhaps with a candle and some relaxing music playing – just make sure you’re already in your pj’s and ready to roll into bed afterwards! 🙂

 

Thanks to Tummee for the graphics!

 

  1. Alternate Nostril Breathing

This is a fantastic technique for soothing stress and switching on the parasympathetic nervous system – the branch of our nervous system that regulates rest and relaxation.

The key to this technique (and to all breathwork practices) is to be comfortable and in a position that supports a natural length to the spine and open-ness around the ribcage. You may like to practice sitting cross-legged or in a chair, whichever is more comfortable for you.

Start by closing your eyes and establishing a natural and even breath through the nose, aiming for around 4-5 seconds breathing in and out.

Now using your right hand place the middle and index finger to rest between the eyebrows. Inhale, and as you start to exhale, close the right nostril with your thumb and breathe out through the left nostril. Inhale through the left nostril, and as you start to exhale close the left nostril with your ring finger and breathe out through the right nostril. Continue in this way, breathing in through one side, exhaling through the opposite side for 2-5 minutes. The breath should feel natural, effortless and without strain – adjust the length and pace of the breaths accordingly.

 

  1. Eye Exercise Palming

This is a lovely technique for soothing tired eyes or feelings of strain or tension around the sockets of the eyes.

After practicing a few rounds of Alternate Nostril Breathing, release your hands and rub them vigorously together for 20 seconds until they feel warm. Place your warm hands over your closed eyes and allow the heat to soak in through the skin and muscles around the eye sockets. Repeat 3 times in total.

 

  1. Childs Pose with a Bolster

A lovely pose to free up tension in the lower back and hips, and its gentle cocooned shape promotes a sense of safety, quietness and rest.

You can use a yoga bolster or a couple of pillows/cushions stacked up to a comfortable height. From hands and knees position, bring your big toes to touch and widen your knees to outer hip-width apart. Sinking your hips towards your heels, lay your upper body over the bolster or support. Turn your head one way and allow your arms to come to rest around the sides of the bolster. Allow your breath to deepen and feel it move into your lower back, side ribs and belly. Hold the pose for a total of 2-5 minutes, switching the turning of the head half-way through.

 

  1. Reclined Hero Pose with Blankets

We have a lot of latent energy stored in the strong muscles at the front of our thighs and hips and these areas can get very tight from long periods of sitting  – stretching this area out can help to free up tension here, as well as gently open up the chest and ribcage making it easier to take slow, deep restorative breaths.

Come into kneeling, taking the feet a little wider than the hips so that you are sitting between your feet. Your toes should point straight back. If this is too much for the ankles or knees, explore putting a blanket or two under your hips. Come to lie yourself back over a stack of folded blankets, a yoga bolster or a pile of cushions. You should feel a pleasant stretch and sense of opening across the front of the body. If this position feels too strong in knees, ankles or your lower back, then explore the next pose instead. Remain here for 2-5 minutes.

 

  1. Reclined Butterfly with a Bolster

This is a good alternative to the previous pose particularly if you have sensitive knees or lower back. Gently helps to open up tightness in the chest, shoulders and inner thighs – all sources of unconscious tension from long periods of sitting or stress.

Sit your hips up against the edge of a yoga bolster or pile of cushions/blankets. Lie back over the support. Put some extra height behind your head to ensure that the forehead is slightly higher than the chin – this will make the pose more restful and relaxing. Bring the soles of your feet together and allow the knees to open out with gravity. Allow the arms to come to rest by your sides with the palms facing up. Remain here for 2-5 minutes.

 

  1. Side-reclined Shoulder Stretch/Supine twist

Twists are inherently balancing for the left/right sides of the body and provide a lovely ‘squeeze and soak’ effect for the spine and abdominal organs.

Lying on your back, allow your knees to drop to the right as you allow the belly and upper body to twist to the left. Stretch the arms out to allow an opening in the chest. Explore bringing your knees up higher or further away from the chest to find the position that feels most comfortable for your lower back. Consider putting cushioning under the bottom knee or between the thighs if more comfortable. Hold for 1-2 minutes and then switch sides.

 

  1. Sleeping Pigeon at the Wall

This is a fantastic pose for relieving lower back and hip stiffness and tension from sitting for long periods. The support of the wall and floor also makes this a supportive and safe option for people with lower back issues.

Extend both legs up against the wall, with your hips about 10-15cm away from the wall. Bring your right ankle over the top of your left knee and slowly slide the left foot down the wall until you start to feel a stretch in your outer right hip. Make sure your lower back stays on the floor, so only go as far into the stretch whilst maintaining this alignment. If you want more stretch, shift your hips nearer to the wall. It may also be required to put a blanket or two behind the head to ensure that the forehead is slightly higher than the chin. Relax the arms and shoulders in whatever position feels restful to you. Hold for 1-2 minutes and then switch sides.

 

  1. Legs Up the Wall Pose

Another great wall yoga pose for helping to relieve tired legs, as well as gently opening up the back of the body without placing undue strain or tension on the lower back. Gentle inversions such as this one, with the legs above the heart, have a quietening, soothing effect on the nervous system, helping to promote a sense of deep rest and relaxation.

Place your legs up the wall with your hips a comfortable distance from the wall. If your legs are tighter you will need to move your hips slightly further away, you can also bend your knees slightly. To increase the inversion effect, put a rolled up blanket or yoga bolster under your hips by pressing your feet into the wall, lifting the hips and sliding it underneath. Put additional padding behind your head as needed for comfort. Allow the arms to rest by your sides and settle into relaxed abdominal breathing. Allow the eyes to close, jaw to unhinge and feel the muscles of the back slowly

A Yoga Sequence for Knee Health

Please remember that this post only provides general guidance around knee health. If you have had a knee injury or recent knee surgery there are many factors that need to be considered before engaging in any rehabilitative exercise regime and its best to consult your doctor, health-care team or physio before starting yoga. 

It may seem a rather obtuse or clinical title for a yoga sequence – certainly not as sexy as A Yoga Sequence for Better Sleep for example (although that is coming soon!) – but building greater knee strength is a subject matter close to my heart, and has been a massive part of my yoga regime for years.

In fact the whole reason I came to yoga was because I had dislocated my knee several times and I faced the hearbreaking realisation that a dance career was just not going to be for me. Yoga early on presented an alternative. I loved the movement, the mindful connection to breath. The grace. It’s not a coincidence that many yogis and yoga teachers are ex-dancers.

Whilst yoga is often touted for its ability to enhance flexibility and range-of-motion, what I often find gets missed is yoga’s fantastic strengthening and stabilising qualities. To be sure it doesn’t have the grunt appeal or forehead-mopping benefits of lifting heavy weights or working with a resistance band but I believe yoga has a LOT to offer those of us with sore, sensitive or unstable knees.  As always it’s all about what you practice.

 

5 Reasons Why Yoga is Great for Knees:

  1. Its low impact i.e. in most forms and styles of yoga we don’t jump or bounce therefore reducing the amount of load, force and therefore stress on the joint.
  2. We use a lot of Closed Kinetic Chain (CKC) style movements and postures which are generally safer for knees that feel weak or unstable and are easier to control and therefore maintain good form whilst doing. CKC movements involve having the foot fixed on a solid surface e.g. the floor, as you do the movement or posture.
  3. We move slowly and mindfully which gives us a chance to focus on good tracking alignment of the knee (misalignment of the knee is a big factor in weak, unstable or injured knees). By taking our time as we consciously move in and out of positions we can retrain our habits and postural tendencies.
  4. Yoga recognises the holistic nature of the body and that knee problems often have their source in musculo-skeletal imbalances further up or down the body. Remember that the site of the injury is often not the source of the problem. When I have clients come to me with knee injuries, I always look at what’s happening in the position and alignment of their feet, hips and spines.
  5. In yoga we build isometric and eccentric strength which are fantastic for building strength and stability in our joints.
    • In isometric work we are holding the muscles and joints in a loaded static position – think of what happens to the muscles of your legs as you hold a Warrior 2 position for example.
    • In eccentric strength work, we gradually lengthen the muscles as we load them, for example, when we hinge forwards from standing into a forward bend the hamstrings are eccentrically lengthening.

 

Designing a Well-Balanced Yoga Practice for Knee Health

With the above in mind, the following sequence is designed to not only work all of the muscles that surround and stabilise the knee but also some muscle groups that seem relatively distant and unconnected. We will also work on stretching out some muscles that when tight can often cause knee tracking issues. Here’s a nifty table that outlines some of the major muscles and connective tissues you need to address for optimal knee health.

Strenghten Stretch
Quadriceps (muscles on the front of the thigh) Iliotibial Band or ITB (a tract of connective tissue running down the side of the upper leg)
Hamstrings (muscles at the back of the thigh) Outer quadriceps (when tight can pull the knee-cap outwards)
Glutes (your bottom!) Tensor Fasciae Latae or TFL (a muscle on the outer side of the hip)
Adductors (the inner leg muscles) Adductors (the inner leg muscles)
Vastus Medialis Obliqus VMO (a small tear-shaped muscle in the inner knee)

 

A couple of tips for practice:

As always the devil is in the details. I often say to my students – you spend the first 6 months in yoga just learning the basics, where do your hands and feet go, the general shape of a pose, remembering to breathe. You spend the rest of your life learning all the little details that make this practice so rich and exciting!

With that in mind there are a few small alignment tips that I think make all the difference when you are working on knee health.

 

  • Root down through the heel bone. When you press your heel firmly into the floor you will feel the muscles and connective tissue around your sitbone engage helping to strengthen the glutes and stabilise the hips. Strengthening the glutes plays a HUGE role in knee health.
  • Check your foot to knee-cap positioning again and again. The knees are the prisoners of whatever is happening in the feet and the hips! If the feet are turned out but the knees are pointing forwards (or even inwards) then your knees end up taking the strain of this misalignment. Happy knees are ones which track in the same direction as the centre of the ankle/2nd or 3rd
  • Engage the VMO. Getting the VMO (that tiny little tear-shaped muscle at the inner knee) to switch on can be tricky. If you’ve injured your knee it is likely that this muscle won’t be firing properly. Rooting through the heel bone can help to switch this muscle on but I also like to bring my fingertips to the area to help give me tactile feedback so that I know when it’s engaging.
  • Do not lock the knee. There is a tendancy for many students to “lock” the knee cap backwards in standing poses, particularly balance poses. Unfortunately this can often lead to torsion, instability and potential wear and tear of the knee joint. Instead we want to keep what I refer to as a slight micro-bend of the knee joint (the leg will still look straight) whilst engaging ALL of the musculature evenly around the knee (front-to-back and side-to-side).

The following practice gives some ideas for the sorts of poses that I regularly use with clients when working improve knee health. All of the poses/movements are designed to be repeated several times through until you feel a comfortable level of fatigue in the muscles without losing good form and technique. The exception to this is the two standing balances – Standing Quad Stretch Pose and Tree Pose which should be held for 30 seconds on each side, and the supine stretches at the end of the sequence which you can hold for up 1 minute on each side. Enjoy and feel free to leave any questions or comments below! 🙂