I heard an interesting theory that older women who have osteoporosis in their spine, shouldn’t practice forward bends because of the risk for additional fractures. This theory is a result of a study of three patients who experienced new pain and fractures after doing “yoga flexion exercises”. I find it curious since our everyday lives are full of flexion. Try putting on pants or socks without flexing your spine. Should the women avoid those activities as well?
After careful reading it becomes clear that when the study talks about “strenuous yoga flexion exercises”, it doesn’t mean just forward bends. It specifically lists poses like Paschimottanasana (which is a forward bend), but also Bridge pose and Shoulderstand, both of which put the cervical spine in the extreme flexed position. So the study isn’t really talking about forward bends, but more about extreme spinal flexion. Why would we ever recommend that to somebody with osteoporosis in the spine?! In addition, another study shows that the negative effects of “strenuous yoga flexion exercises” are neutralized by doing extension poses. Isn’t that how we usually structure our yoga practices?
There are many forward bends that are very useful for the body; and even deep forward bends like Uttanasana and Paschimottanasana done with proper technique and adapted to the needs of the student, should NOT stress the spine. Today we begin a conversation about the kinds of forward bends that are out there, what they are for and how we can minimize the risk while practicing them.
To bend forward means to flex the spine, which happens every time you move your chest toward your thighs (and visa versa). If we arrange forward bends according to intensity, it would look like this:
The main quality that all forward bends share is that they create a stretch in posterior (back) structures of the body. One thing that we need to remember is that all of those structures are interlinked via fascia. Thomas Myers in his book Anatomy Trains had adopted the term myofascial meridians to describe those lines of pull that run through a sheet of fascia and connect and envelop several muscles. He calls this particular line of tension the Superficial back line (SBL).
The SBL connects and protects the entire posterior surface of the body. It has an important postural function – it supports the body in the full upright position, which means that it is loaded all day, every day. It also creates spinal extension (back bending). If the muscles along this line are underdeveloped, the body will tend to collapse forward; if they become overdeveloped, the body will have a tendency to lean back. Forward bends help relieve tension all along the SBL and stretch it in parts or as a whole.
We use forward bends to work the entire SBL: to both stretch and strengthen (depending on the pose) the muscles along the spine, as well as the muscles of the shoulder and pelvic girdles, and legs. In addition, forward bends strengthen the abdominal muscles (if you engage them when you practice), and gently compress abdominal organs, increasing circulation to the area.
We do have our priorities when it comes to stretching the structures of the back. The lower back is ALWAYS the most important part. This is the area that usually takes on the majority of the load, and it is the most important in terms of supporting the spine and creating a healthy relationship between the spine and the pelvis.
In addition to stretching the lower back, you might choose to emphasize the upper back, hamstrings or calves; some poses will be more suited for that than others.
Let’s take a look at different types of forward bends and what we can expect to get out of them.
Group 1 poses offer safe and effective stretching of the lower back.
Group 2 poses create a deeper stretch for the back (especially when the stretch is facilitated by the hands), and also stretch the upper back, neck and hamstrings. Keeping the legs apart will introduce a stretch in the inner thighs. Flexing the ankles will stretch the calves as well.
Group 3 poses isolate and emphasize the stretch on one side of the body, which is very useful when working with structural asymmetries.
Group 4 poses strengthen the upper and lower back. The strengthening effect will intensify if one or both arms are raised.
Thinking of yoga poses in terms of their usefulness fundamentally changes your approach to a yoga practice. Then poses become tools that you can carefully select and arrange for either therapeutic or developmental purposes.
Next week we will talk about technique – how do we bend forward without stressing the spine? We will also discuss some of the potential “release valves” (potentially harmful movement patterns) that students can adopt in forward bends and how we can troubleshoot them. Tune in!
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