“We enter the path of practice through the door of knowledge, perhaps from a Dharma talk or a book. We continue along the path, and our suffering lessens, little by little. But at some point, all of our concepts and ideas must yield to our actual experience. … The boundary has been crossed, and our practice cannot be set back. We do not have to transcend the ‘world of dust’ (saha) in order to go to some dust-free world called nirvana. Suffering and nirvana are of the same substance. If we throw away the world of dust, we will have no nirvana.”
–Thich Nhat Hanh, The Heart of the Buddha’s Teaching
This isn’t Yoga for Climate Action per se, but it’s really hard to take Climate Action if your back is all effed up. In the spirit of self care and community care, I want to offer this document about lower back pain management to anyone who might find it useful. Please let me know if you have questions or comments.
A vast majority of westerners will suffer from low back pain in their lifetime that can range in intensity from dull to crippling. The modern, sedentary way of living interacts poorly with our precariously designed skeletons; walking on two legs is a recent development, and the cost of this evolution is a predisposition to injuries around the lower vertebrae, usually L4, L5, and S1. Western medicine lags in the treatment of chronic pain, tending toward surgical intervention that can limit mobility and aggravate this delicate area. Yoga instead offers some sophisticated tools for pain relief and management:
- Stretches connective tissues to help return to proper alignment
- Strengthens surrounding muscles to support proper alignment
- Breaks up scar tissue, increases blood-flow to injured areas, speeds healing
- Increases body awareness, helps make subtle adjustments and avoid aggravation
- Breath awareness useful in managing acute pain
- Cultivates self-compassion and patience, essential for well-being
- Cultivates a steady awareness of the impermanent nature of all things, including pain and the body
When we feel threatened, overwhelmed, exhausted, our postural defense is the fetal position. We want to protect our vulnerable bellies, hearts, and groins. Cold weather can also make us huddle. If we already spend much of our time in a seated position, an additional forward curve is likely to overstretch the dorsal spine and compress the ventral spine. If you add a pair of crossed legs or other asymmetrical leg position, this creates the conditions for lateral compression and overstretching. These imbalances can displace discs over time, or create the conditions for a sudden injury. Sciatica is often a symptom of disc misalignment (although it is sometimes the result of piriformis syndrome, in which the sciatic nerve passes through the piriformis muscle, and compresses it painfully).
Everyday preventative measures
The basics for joint health are:
- Drinking enough water, especially first thing in the morning and at night
- Walking everyday, which moves all the joints in the body in a way that nourishes them (joints are bloodless capsules, and get their nourishment when movement and hydration allow nutrients to pass through the surrounding membrane)
- Enough sleep at night, so the joints can spend time without force on them
For spinal health there’s more to do:
- Don’t sit for the first hour you’re out of bed, while your vertebrae have a chance to re-settle into upright, compressed position.
- Don’t sit for extended periods (Of course you have to, but get up often, alternate your position, kneel, and lie on your belly. Talk to your boss. It’ll be fine.)
- Use a lumbar pillow, rolled up towel, sweatshirt behind the low back/sacrum when sitting or driving to recreate the lumbar curve.
- Stretch your spine in the 6 basic ways at least once a day: forward, back, left, right, twist left, twist right.
- Backbends; stretch your abdominals and your psoas muscle, the deepest core muscle. It gets tight and pulls your spine into a forward curve if you don’t stretch it regularly.
- Err on the side of pigeon toed when standing and walking, pay attention to your gait as you walk; external rotation of the legs can cause or aggravate sacral/lumbar compression.
- Don’t splay your knees out when you sit: keep your thighs parallel.
- When you bend over, bend from the hips, keeping the spine extended.
- When you lift heavy things (or not so heavy), lift with your legs, keeping the spine extended.
- When pain is not acute, do as much activity as you can tolerate. Long periods of inactivity will weaken the supporting, stabilizing muscles.
- Massage, acupuncture, chiropractic, and alternating applications of heat and cold can help relieve pain.
- Notice trends in your life, what circumstances or events lead to flare-ups? Be particularly mindful when these circumstances arise.
- Practice yoga and self-observation regularly, allowing the benefits and information to accumulate.
- Be generous with yourself. It’s the only back you’ve got, so do what you need to do to take care of it. Think long-term, take time for yourself and get strong.
Key Actions in Asana
Quadricep contraction—In forward folds this releases the hamstrings, freeing the pelvis to tip forward, preventing low back overstretching.
Thigh rotation—Whenever the legs are in rhythm with the spine, internally rotate the thighs. Only when the leg is flexed at the hip as in Baddhakonasana or Trikonasana’s front leg should it be externally rotated. Be aware that the knees and feet do not point in or out, but face straight forward.
Pelvic tilt—forward tilt in forward folds, backward tilt in backbends. If your hips are flexed (ie. seated), always forward tilt! Consider your pelvis to be part of your spine.
Navel to spine—Engage the abdominal muscles to act as a kind of muscular ribcage around the viscera, keeping the front and back body in rhythm.
Axial extension—lengthen the crown of the head from the base of the spine in all postures. Lengthen first, then fold, bend or twist, stretch without compressing.
Here’s a Sequence to Try
Virasana for seated meditation; lengthwise block under the front edge of sitbones. Try abhaya mudra (no fear mudra)
Cat/Cow for spinal warm-up, observation
Half Moon Side Stretch: Lengthen first, then bend
Uttanasana: Quads contract, strong internal rotation, sitbones lift and separate
Ardha Uttanasana: Heels of hands at heads of hips, axial extension, strong internal rotation of thighs
Plank: internal rotation of the thighs, neutral pelvis, heels press back
Sphynx: Internal rotation of thighs, axial extension, pelvis tips back
Bhekasana: pubic bone presses down, thighs internally rotate, femurs parallel, heart faces forward
Virabhadrasana 1: Pelvis tips back, square and level, support back heel with a blanket if it pops up from the floor
Parsvottanasana: Pelvis tips forward, square and level, axial extension. Place hands in fists behind the back, and traction upwards to keep lumbar spine long
Ustrasana: hips remain against the wall and a block between the thighs to create a strong internal rotation. Place hands in fists behind the back, and traction upwards to keep lumbar spine long
Adho Mukha Svanasana: Forward pelvic tilt, internal rotation of thighs, axial extension
Paschimottanasana: pelvis tips forward, heart lifts, or Supta Paschimottanasana with strap to keep the sacrum on the floor
Jathara Parivartanasana: Move hips (to left when twisting right, and vice versa) to keep spine in line as you twist. To focus the twist in the low back keep your shoulder down, to focus the twist in the upper back keep your knees down and let the shoulder come up
Savasana: prop (bolster or blanket roll) under the knees to take pressure off the lumbar spine