Can I do yoga if I have a bad back? Can I take a class?

Yoga is a gentle practice that is ideal for maintaining back strength and flexibility. It is also one of the most effective tools to help reduce low back pain, the most common source of pain and disability in older adults.

Unfortunately, yoga injuries are on the rise among older adults. A study published in theOrthopedic Journal of Sports Medicine of November 2016 found that between 2001 and 2014, the rate of yoga-related injuries increased eightfold among people aged 65 and older, with the most common injuries affecting the back, such as strains and sprains.

So the question is, how can you protect your already painful back from a therapy that has the power to soothe it?

The benefits of yoga

Yoga involves a series of poses, also called postures, and emphasizes breathing techniques. The postures teach you to stretch and strengthen your muscles, which reduces muscle tension, develops flexibility and strength, and improves balance and bone strength.

For low back pain, yoga can be especially helpful to the muscles that support your back and spine, such as the paravertebral muscles that help you curve your spine, the multifidus muscles that stabilize your vertebrae, and the transverse abdominis, which also helps stabilize your spine.

The benefits of yoga are not limited to the muscles. The slow movements and continued focus on correct breathing can improve the emotional aspect of back pain by helping to reduce stress and relieve anxiety and depression.

What's wrong

Yoga is still a form of physical movement, and as with any other type of exercise, injuries can occur, especially to the back. The main problems often occur when people don't follow proper form and speed, and they "fall" quickly into a yoga pose without gradually "lying down" in it, according to Dr. Elson.

It's a bit like jerking around lifting a dumbbell and doing fast reps instead of a slow, controlled movement, or running on a treadmill at top speed without steadily increasing the pace. The result is an increased risk of injury.

In yoga, you must first use your muscles to create a solid foundation for movement, then follow proper form that slowly lengthens and stretches your body. For example, when twisting the spine in a seated position, which can be very therapeutic for low back pain, it's not about twisting as fast and as far as possible.

"Instead, you should first activate your core muscles and feel the spine lengthen. Then, slowly rotate until you feel resistance, and hold the rotation for as long as you feel comfortable," Dr. Elson says.

Tips for protecting your back on the carpet

  • Avoid twisting and stretching at the same time. This can compress the intervertebral joints.
  • Rely on accessories such as blocks and bolsters for extra support when you need it.
  • If you can't reach your toes, hold a yoga belt in your hands and pull it around your feet.
  • Lean forward while sitting rather than standing and support your belly as you return to an upright position.
  • Always ask for help to change a pose, and stop any movement that makes you uncomfortable.

Make the right moves

Ask your doctor about starting a yoga program if you have low back pain. Dr. Elson suggests avoiding yoga if you have certain back problems, such as a fractured spine or a herniated disc (slipped disc).

Once you have the green light, you can protect your back by informing your yoga teacher of certain pains and limitations beforehand. He or she can give you protective modifications for certain poses or guide you through a pose to make sure you do it correctly without stressing your back. Another option is to look for yoga studios or community centers that offer classes specifically designed to relieve back pain.

Remember, the bends, twists and stretches of yoga are often what your lower back needs to feel better, so don't be afraid to try. "By practicing yoga mindfully, people can safely stretch and strengthen tight and sore back muscles," says Dr. Elson.

Solution:

Use ice, beer or ibuprofen, a heating pad or a hot bath/shower to relieve soreness for 24-48 hours. This is common after many types of exercise, but the body needs a rest period to heal and regenerate. If you don't feel better after a few days, see a doctor, especially if you experience numbness, tingling or weakness in your limbs.

Let your body guide you. You should feel a slight stretch, not a strong tension during the poses. Take a class with a certified instructor to make sure you are using the correct form. Ask your instructor for beginner versions of the poses done in class as you build strength and flexibility. Some poses help strengthen the back and core, such as bridge pose, side plank and plank. The knee hug helps release tension in the back and is even more soothing when you add a gentle side-to-side rocking motion. Keep it up!

Finally, if you do all of the above and are still in pain, you should see a fellowship-trained orthopedic spine specialist who can determine if it is a spinal problem that is causing the pain, rather than just muscle soreness commonly felt after exercise.

Karen is a 53-year-old grandmother and bank employee who, until recently, suffered from persistent back pain. After six months of treatment with muscle relaxants and two months of treatment with opioids, she still had pain most of the time. Aware that working long hours at a desk and lifting a toddler while her heart was out of shape was probably part of the problem, Karen discovered that taking a walk during her lunch break could provide some relief - but only a little. Then a co-worker whose sciatica had been relieved by yoga therapy recommended it to Karen. She decided to give it a try and signed up for my Tuesday night back care class.

His choice was consistent with clinical guidelines for the treatment of low back pain recently published by the American College of Physicians. After reviewing various noninvasive treatments for low back pain and finding that medications provide only small to moderate improvement in pain levels, the ACP recommends that for pain lasting less than 12 weeks, "nonpharmacologic treatment with superficial heat (moderate quality evidence), massage, acupuncture, or spinal manipulation (low quality evidence) should be tried first, and, for those with chronic back pain, as Karen does, "non-pharmacological treatment with exercise, multidisciplinary rehabilitation, acupuncture, mindfulness-based stress reduction (moderate quality evidence), tai chi, yoga, motor control exercises, progressive relaxation, electromyographic biofeedback, low-level laser therapy, operant therapy, cognitive behavioral therapy or spinal manipulation (low quality evidence).? Studies recommend anti-inflammatory drugs only if there is little response to these low side effect methods.

For Karen, yoga is affordable and accessible, and she now attends classes twice a week. Karen appreciates that I have a background in yoga therapy and back care and have worked alongside doctors and physical therapists. Therapeutic yoga classes are usually a little more expensive than other yoga classes, but she thinks it's worth it to pay that little extra. In addition to her yoga classes, Karen has taken up warm water swimming and has begun a daily 20-minute meditation practice vipassana (insight) designed to help her cope with stress and pain. After several weeks on her new regimen, Karen began to experience much less back pain and was able to lift her granddaughter without pain. Life, she says now, is simply better.

As a yoga therapist, I work on back health more than any other topic, and my public back care classes are the most attended! Here are some simple tips I gave to Karen, which I also offer to others with chronic back pain. (Keep in mind that not all yoga classes are appropriate for people with back pain. Talk to your doctor or physical therapist about the types of movements that may be contraindicated for you, look for a therapeutic class and teacher who is knowledgeable about back care, and let your teacher know about any pain, injuries or contraindications you have)

  • Do not lose not your natural lumbar curve. A slump or rounding of the spine, perhaps due to spending long hours in an office chair that promotes poor posture, can take a toll on the back. In most yoga poses and throughout the day, whether you are sitting or standing, it is important to maintain the natural inward curve of the lower back, keep the back of the head aligned with the back of the pelvis (without dropping the head forward or backward), and keep the shoulders broad and in line with the hips. While your yoga teacher may instruct you to have a "flat back" (often to keep you from losing your natural spinal curves by rounding or covering the back), a totally flat back is not what we are looking for. The natural curves of the spine - a slight inward curve in the lumbar spine (lower back), a slight outward curve in the thoracic spine (upper/middle back), and a slight inward curve in the cervical spine (neck) - are important for shock absorption and optimal spinal health, so we don't want them to disappear!
  • Adopt healthier sitting and standing positions to help strengthen the back. Practice high sitting positions, either in a chair or on the floor, using props such as a stack of folded blankets or a yoga bolster, while making sure to maintain the natural curve of your lumbar spine. Use this new posture every time you sit. When sitting or standing, use a core support, with a slight lift of the lower abs and pelvic floor, and "think big" with an axial extension (upward lift) of the spine.
  • Do not let not feet turn over when standing or walking. For many people, external rotation of the feet is both a result and a cause of shortening of the piriform (the culprit of sciatica). When this deep hip rotator is tightened, the psoas (which runs from the lumbar spine to the upper thigh) can also contract, which can lead to lower back pain. To help stretch a tight piriformis, practice the supine pigeon pose, lying on your back with one knee pressed against the center of your chest, or a figure 4 stretchFor a tight psoas, lie on your back and cross one ankle over the thigh of the opposite bent leg. For a tight psoas, a pose in bridge supported with a yoga block under the pelvis and a high slot or low(anjaneyasana) practiced with a slight anterior (forward) tilt of the pelvis can help.
  • Keep your feet parallel. If your toes tend to spread, spread your heels far enough apart so that they are behind your toes. You want the second toes of each foot to be relatively parallel to each other and your knees to be in line with the center of the foot. Do this while standing (whether in a mountain position, working at a standing desk or any other time), walking or sitting. (Note that while parallel feet are a good indication for most people, they are not appropriate for everyone. See Bernie Clark's article Should your feet be parallel in the mountain position and in the cross-country dog position? for more information)
  • Do not you gathernot from a forward bend with straight legs. This action can compress the discs in the anterior spine and aggravate back pain.
  • Get up from a forward bend with knees slightly bent, and use core support (a slight engagement of the pelvic floor and lower abdomen) as you lift your torso.
  • N Don't forget core strength. Yoga sequences are often more focused on stretching than strength. Stretching can be great for relieving tension in the back muscles, and poses that we might associate with a good back stretch, such as marjaryasana (cat-cow), balasana (installation of thechild), ananda balasana (happy baby) and supine twists, may be enjoyable, but they do little to build core strength, which is important for back health. To strengthen the back of a structure, we need to balance the support in the front. This is why poses that integrate abdominal and back strength are important for back health.

You can build abdominal strength with postures like paripurna navasana (boat), utkatasana (chair), board and forearm, and vasisthasana (planking), and back strength with postures like salabhasana (grasshopper) and virabhadrasana III(warrior III). Strengthening the abdominal and back muscles promotes better alignment of the spine, and these are the types of poses you might look for in a yoga class focused on back health.

Taking care of your back means developing healthy posture and movement habits and practicing postures and exercises that can build muscle strength that will give your spine the support it needs. Today, medical professionals are even beginning to recommend these methods over medications for the treatment of temporary or chronic back pain. If you're suffering from back pain, try putting down the pills (with your doctor's approval), sitting up straight, moving with more awareness and hitting the mat for a yoga session that will help you strengthen your muscles and reduce tension, so you can alleviate that annoying pain and get back to the joys of uninhibited movement.

Learn yoga with a professional

As you can see, if you have back pain, you need to approach yoga in the right way. Indeed, a badly executed yoga posture or a bad preparation to your session will not bring you the expected results. 

For good results and to avoid aggravating your back problem, seek the advice of a yoga teacher. Of course, it is not always easy to find a yoga class near your home, but there are other ways to practice this wellness activity. These solutions are sometimes very simple and often go through the net. 

It is therefore possible to take yoga classes from home. This is what Bienêtre offers you, a yoga video studio. Depending on your availability, the courses given by a real therapist can be followed by watching videos. 

Each week, this Yin yoga teacher publishes a new class that you can access 24 hours a day thanks to the replay. Each session addresses a different theme and practice. Meditation, yin yoga or breathwork will help you to heal your wounds of abandonment, injustice or to tame sadness or fear, for example, without hurting your back. 

These online courses are designed for both regular practitioners and beginners.


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