The human body is a marvel of engineering. It can perform innumerable tasks with relative ease, both general and precise. It is astonishingly durable, when you really think about it. It responds marvelously to the different challenges of each and every day with remarkable consistency and malleability. It exists in a constant state of adaptation, regeneration, and growth, depending on what challenges and movement patterns it encounters on a day to day basis. This is a necessary miracle; if the body does not adapt it breaks under the weight of experience. However, as students of yoga we should understand that some adaptations have long term consequences that, if left unattended, can be detrimental to our health.
Western culture is not designed to support healthy bodies. Our daily routines often generate physical adaptations that cause us pain, limit our vitality, and undermine our longevity. The harsh reality is that sitting down, texting, and working at computers all create unhealthy body adaptations. Our daily habits create misalignment. Good yoga teachers and students can spot these misalignments and work to correct them through informed yoga practice.
One of the most common misalignments that I see in my students is a pronounced compression in the low back (it's really at the meeting of the mid and lower spine, but I'm just going to say "low back" for the sake of simplicity). It is often mistaken for a healthy lumbar curve, but there is a very real and functional difference between the two. A healthy lumbar curve evenly distributes the weight of the body along the length of the spine. A compressed low back instead puts a large amount of the load on a specific part of the spine, right where the thoracic and lumbar sections meet.
You can see the difference between low back compression and lumbar curve pretty easily. It looks like this:
Low back compression on the left, healthy lumbar curve on the right. Red arrow courtesy of the internet.
In students with low back compression the abdominals are weakened and the belly falls forward, the psoas muscles are usually shortened and tight, and the QL muscle in the back grips intensely. This is a rampant condition in Western culture, where we sit down all the time. Sitting down shortens the psoas and compresses the low back. A healthy yoga practice should work to correct this situation, but if you pay attention in a hot room you'll find a whole lot of sharp angles in the back. Often, the most committed students have lumbar compression just as bad as the average sedentary American who practices no yoga at all.
Quadratus Lumborum, or "QL" muscles, run from the back of the hip bones to the back of the lowest ribs.
Psoas Major, part of the greater Iliopsoas - the Hip Flexor or simply "psoas" - muscle group along with the Iliacus, runs from the low spine to the thigh bones, across the hips. Image credit
So what gives? Why do serious, dedicated, long-term students of this practice have this issue? And what can we do to support healthy alignment?
BACK BENDS
26 & 2 can be transformative for the spine, but in my experience many students are not getting the full benefit of the practice. Part of the problem is the language we use in backbends. A healthy back bend will lengthen the psoas evenly and relieve tension there, but it needs muscular support from the abs to avoid collapsing. But there's pretty much nothing in the traditional dialogue that talks about keeping the core strong as you lean back, so students often collapse into their backbends. This collapse drops the weight of the body right into that T12-L1 area, where the spine is most mobile (aside from the neck). The solution to this drop is core support in the front body. It's important to remember, as students and teachers, active (not clenched) muscle engagement in the belly while lengthening into the back bend.
Likewise, tight psoas muscles will make the legs externally rotate in a back bend. If you look around the room in standing back bends you will regularly find - often in the deepest back benders - that students' feet and/or knees have turned out. This little alignment cheat releases the psoas and makes the pose less effective. It is important in the backbends to look for this external rotation and correct it whenever possible, even if it means we can't go as deeply into the pose. (Note: I have personally removed command in the 2nd set of Camel to "open the knees 8-10 inches," as this adjustment is really just another form of external rotation. The pose gets easier and 'deeper' with this modification simply because it releases the psoas.)
FRONT SIDE COMPRESSIONS
The back bends are only part of the story. The heart of the issue lies in the poses designed specifically to address low back compression, and the way they often get left behind in class. These poses are the front side compressions - primarily Standing Head to Knee, Standing Separate Leg Head to Knee, and Rabbit. These are powerful poses and they should, in a healthy practice, alleviate low back compression. But this isn't often the case. Instead, these three poses tend to get lost in the series and their effectiveness is compromised. There are many reasons why.
1 - EXHAUSTION
One reason these poses can be ineffective is their position in the series. Standing Separate Leg Head to Knee (SSLHTK) comes right after Triangle, and Rabbit follows Camel. By the time these poses come around students are often exhausted and their focus is diminished.
2 - DIFFICULTY
Standing Head to Knee (SHTK) only has a front side compression in its final form, which is not practiced by many students, and those who do practice it are usually more focused on balance and locking the knee than front side compression. So we don't get much real stretching in the back here, usually, simply because the pose is so challenging to most students.
Rabbit is a somewhat confusing, claustrophobic shape, and you can't see the people around you. As a result, many students lack the confidence to really explore the pose.
SSHTK can feel nearly impossible for some students with the amount of emphasis teachers put on getting the head to the knee. If they can't meet that one goal, they often decide the pose is simply beyond their capacity. Or, once they have met that one goal, they make the whole pose about straightening the front leg and keeping the head in.
3 - LACK OF UNDERSTANDING
I regularly ask the most experienced students in the room if they feel any stretch in Rabbit, and the answer is almost always a slightly embarrassed "no, nothing." And if you ask what benefits students feel in SSLHTK, they usually tell you they feel the throat compression (which is good), and perhaps a stretch in the hamstring, but not much in the back.
Looking at the shape of these poses it's pretty obvious that the back should experience some sort of stretch or at least opening. The torso is rolled forward, lengthening the back muscles. However, in my experience with students, they rarely feel any opening in the mid and low back.
I have found that when entering these poses, students lose core support and put almost all their focus on bending the neck inward/compressing the throat. The dialogue is part of the issue here, as it talks much more about head placement ("forehead must touch the knee" and "if forehead isn't touching the knees, you can walk the knees right and left") than extending the spine. People with a lot of mobility in the neck can usually perform these commands and still not get a stretch. In these two poses, look to the most flexible students in the room; very often the forehead touches the knee and the lower back is flat as a board. In order to stretch the QL muscles, and the rest of the back muscles, you need to create an even curve down the length of the spine.
The real issue is that many students don't know that they should experience a stretch in the back during front side compressions. We even have the dialogue phrase, "this is not a stretching pose, it is a compression pose," which leads to the misunderstanding that the back doesn't stretch during effective front side compression. The term "front side compression" is itself confusing, as it highlights the front body shortening instead of the back body lengthening. Simply telling students to look for the back stretch, or at least back expansion, in SSHTK has been helpful in my teaching.
The truth is, real back stretching and opening in Rabbit and SSLHTK may have not have been really necessary when the original Bikram dialogue was designed, because sitting/typing/texting hadn't done as much damage to people's bodies at the time the yoga was first developed. But today, for modern students, this expansion - performed slowly, mindfully, and with proper core support, is absolutely essential to the long term progress of a practice.
4 - FEAR
The low back, much like the hips, contains a great degree of emotional tension. Clinical trials have established a correlation between Fear-Avoidance and chronic low back pain. As students of yoga, we know that often a physical opening corresponds with an emotional release. So if you're going to open your low back, you're going to have to face some fear. Fear avoidance will make students unconsciously protect the low back from a true stretch and opening. Confidence is essential to moving deeply into the proper pose. This of course doesn't mean be reckless in your front side compressions, but their practice requires deep honesty and exploration. Students who are afraid to work into their low back tension will often times clench and struggle in Rabbit and SSLHTK, with very little progress, sometimes for years.
WHAT TO DO
I have spoken with many yoga students who abandoned their 26 & 2 practices because of low back pain. Many of them remained committed to yoga and found healing in other forms. Their attitudes have almost universally been positive toward 26 & 2, but they feel certain that something inherent to the style is damaging to their bodies.
I think we can do better. This series has built in solutions for low back compression, we just have to teach/practice them correctly.
ABDOMINAL SUPPORT
We all know that good front body engagement supports the forward bends and front side compressions. We talk about it often. However, our directions about the abs and core strength can get misinterpreted in class and even make the problem worse.
The popular idea of abdominal muscles is that of "abs," specifically of the six pack/washboard type. Tell a student to use their abs/core/belly strength/etc... they will invariably clench these muscles. But these muscles (Rectus Abdominus) just pull the ribs and hips closer together. Alone, they do not necessarily support length in the spine. Another issue with this limited engagement in the "abs" is that they can make the QL muscles clench, to brace against the tension in the front body, exacerbating the problem. (You can try it now. Just think of the "six pack" muscles in your own body and clench them. You'll immediately notice a hardening and bracing happen in your low back.) Pretty much all of this happens unconsciously, but it happens.
Likewise, the command "suck the stomach in" implies some kind of internal suction, probably from a deep inhale. We can be misled by this image, and as soon as the exhale arrives they drop their bellies down again and all support is gone. We might also associate this single command with pushing the rib cage forward and up, which creates a "stomach sucked in" image in the mirror, but just makes the low back compression worse. This action in the ribs is most visible in pranayama, when the dialogue says to suck the stomach in so "rib cage visible in the front mirror."
Healthy abdominal support includes the deep muscles of the core and hips. Here are some commands I use to create better abdominal support:
-Pull the belly button back towards the spine.
-Draw the hip bones together. (I usually point out the hip bones first so they don't get confused. In this case I am referring to the Anterior Iliac Crests, the bones in the front of the hips that are often visible in very lean people.)
-Pull your belly button up to the ceiling. (When in a front side compression.)
-Imagine there is a lasso around your belly button and it is pulling up to the ceiling. (When in a front side compression.)
-Draw in your low belly, below the belly button.
-Pull your low ribs toward the spine. Breathe to the collar bones.
These commands help activate the deep abdominals and truly support length in the low back. Explore the concept of spine lengthening in front side compressions in your own practice to develop your own language.
STANDING SEPARATE LEG HEAD TO KNEE
When teaching this pose, try not to emphasize head touching the knee too early. Eventually, this command becomes important, but students often clench too hard too early or lose the hip alignment if they become obsessed with just this one direction.
Instead, try telling students to take their time getting the forehead to knee and emphasize drawing the belly in/toward the spine as they slowly curl into the pose. This way, they avoid gripping in the back and adding stress to the posture, which will only prevent progress.
I also like to tell students it is fine and occasionally even preferred to keep their hands separate on the floor. In time, hands in prayer becomes a powerful tool for compression in the belly, but it can be distracting for those who have not yet created length in the spine. I tell students to put fingertips down on either side of the heel and press down into the floor as they put the head to the knee. The spine will act as an accordion, compressing on the front and lifting into length in the back. Once this is established, keep pressing down with the hands. For added compression and stretch, try to push the floor towards the front mirror (or whichever way the front foot is pointed).
RABBIT
Ooooooh boy. Rabbit. Much can be said about this one, but it's not a stretch to say that this pose is understood the least by the average student.
I'm going to put up a video tutorial on this one eventually, but if you are a capable student or teacher try this method:
-Enter Rabbit as normal, all the way to lifting the hips up and getting the elbows straight. Make sure the grip is very secure. Do not roll to the back of the head, go no further than an inch past the point of the skull.
-Pull the belly button up to the spine.
-Press the heels together.
-Press the feet down into the mat.
-Keep the grip strong. Without letting the feet come off the floor, try to pull the heels directly up to the ceiling. Keep this action going through three or four breaths, then exit the pose slowly.
My experience is that this command - pull the heels straight up - fully engages the pose to the student's potential. Move slowly with it, the experience can be somewhat intense (remember how we talked about fear), and make sure to take care of your body. Don't try to push through pain or bounce in the pose, and never throw yourself in and out of it quickly.
FINAL NOTES
There are other poses in the series that are good for addressing low back issues, namely Fixed Firm, Janusirasana, and Half Tortoise, but we will leave those for another time. Until then, I'll leave you with a few notes.
-In Half Tortoise, don't overemphasize the forward stretch. It'll just grip your shoulders and back more. Let gravity do some work, and feel the belly press onto the thighs.
-Fixed Firm is not intended to be a back bend. (That's right. I said it.) Don't try to back bend it, you'll just increase low back compression.
-Keep both hips down in Janu. The hip of the bent leg side loves to get light and even lift off the floor. This releases the QL stretch.
Thanks for coming on this ride with me, friends. Let me know if you have any questions or want to hash this stuff out. Keep your practice alive; explore, breathe, and trust yourself.
*This is not medical advice. Take care of your body. Remember to be patient, listen to your body, and always practice with qualified teachers.