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.

Core Stabilisation for Back Pain 101

First of all what is core stabilisation?

In yoga, the term ‘core’ is used to broadly describe all of the musculature that supports and stabilises the lumbar spine, sacrum and pelvis. Stabilising muscles do not change length during movement; rather they stabilise and support the trunk during movement, which can be particularly helpful for students in the rehabilitation and prevention of lower back pain.

 

What muscles are involved?

Studies have shown that core stabilisation exercises which train and strengthen the deep abdominal muscle called the Transverse Abdominals (TA) and the deep spinal stabilisers called the Multifidi can be effective in helping to reduce pain and the risk of re-injury. One study, in particular, showed that people who’d been trained to strengthen their spinal stabilisers had only 30% recurrence of lower back pain after one year, versus a control group who were not given any spinal strengthening exercises and suffered an 84% recurrence rate.

The TA is the deepest layer of the abdominal muscles. Its muscle fibres wrap around the spine like a wide belt or corset, attaching at the bottom of the ribcage and at the top of the pelvis all the way around. When the TA engages it has the dual action of:

  • narrowing the waist, as if you were tightening drawstring pants and;
  • gently zippering the lower belly in and up as if you were doing up a tight zipper on your jeans

The Multifidi, on the other hand, are a group of tiny individidual muscles that provide stability to the spine, keeping the vertebrae in a safe position. These muscles come into play when:

  • the lower back is either neutral, such as when you’re standing with good posture in Mountain Pose
  • in slight back-bending or extension movements, particularly performed against gravity, such as Bird-Dog pose.

Bird-dog pose

It’s important to understand that the co-contraction of TA at the front of the trunk and the Multifidi at the back of the trunk will serve to maintain a neutral curve in the lower back and pelvis. Hence core stablisation techniques which work both the TA and Multifidi are all exercises in which the trunk is kept still and in neutral whilst the arms and legs move to provide challenge.

 

How do I engage the Transverse Abdominals and Multifidi?

To get a sense of how to engage these muscles start by lying on your back in Constructive Rest Pose. Have your knees bent, feet on the floor about hipwidth apart and parallel. You should notice that your lower back is in its neutral curve and we want this to remain the case throughout the whole exercise.

Constructive Rest Pose

 

To engage the TA:

Bring your fingertips to the skin just to the inside of your frontal hip points. In a relaxed state the skin beneath your fingers should feel relaxed and soft.

Breathe in allowing the belly to relax. As you breathe out imagine narrowing the hip points towards one another as if you were tightening a drawstring, and at the same time, zipper the lower belly in and up as if you were doing up a tight pair of trousers. The muscle beneath your fingertips should feel like it firms. The belly will also flatten slightly, as if you are sucking the contents of your abdomen up and back towards your spine. However do not flatten your lower back or tilt your hips back during this contraction as this will stop the multifidi from serving their proper function, which is to maintain the neutral curve of the lumbar spine.

Breathe in to release the contraction, as you breathe out repeat. This is a subtle engagement working at about 10-20% of your maximum effort. Repeat for 5-10 breaths.

 

To engage the Multifidi:

Continue with the above exercise but this time, as you breathe out imagine the muscles of the lower back contracting slightly upwards the naval at the same time as the TA engages drawing the naval in and back towards the spine. It’s as if the front and back of your body were coming closer together or co-contracting to meet in the middle of your body each time you exhale.  Again, the engagement is subtle and the pelvis or lower back should not move. Repeat for 5-10 breaths.

 

One final, important word

Whenever we work to strengthen an area of our body it is important to maintain an awareness of the bigger picture or overall intention of a yoga practice. Core stabilisation exercises therefore should become part of a bigger overall practice that serves to create greater function, strength and mobility throughout the whole body in normal everyday movements. As Aline Newton says so eloquently in her book “Stabilisation: The Core and Beyond”:

“ From the perspective of the body in motion, the work of the transversus system is not to make the trunk stable like a fortress, but to help make possible the transfer ot movement been hands and feet. Holding tension in the center of the body severely interferes with smooth transmission of the forces across the joints that is the basis for graceful movement.”

With this idea in mind, in my next blog post we’ll explore some of my favourite exercises for teaching core stabilisation to my clients that train to stabilise the core and lower back whilst mimicing real life movements. Stay tuned!

Credits to Tummee for their awesome images!