Bending with back pain

Fred Bender | | comments: 0

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It is commonly understood that when bending over to pick up an object, it is mechanically more efficient to bend the knees and to do the lifting with the larger and stronger leg muscles than to keep the knees straight and to lift with the smaller lower back muscles.

In yoga class, many practices involve bending over with straight knees to stretch the hamstrings. Stretching the hamstrings is excellent for lower back health, but with knees straight, the room for error is narrow, and many students mistakenly bend at the waist (figure B below) rather than the pelvis (figure C) putting their lower back at risk.

Bending at the waist puts enormous stress on the intervertebral discs of the lumbar spine that can lead to their bulging or herniation.

This image demonstrates the bio-mechanics of forward-bending:

back pain causes

In forward bending, the whole pelvis pivots from a vertical to a horizontal position over the femur heads, and the tailbone lifts upward opposite the spine's descent as seen in figure C where the woman's pelvis tilts forward at a 90° angle in relation to her femurs. The ability to tilt the pelvis this far is enabled by long hamstrings which run from the hip to the lower leg (as indicated by the straight black line behind her femurs).

With short hamstrings, as in figure B, the pelvis is restricted from tilting to a 90° angle. To bend further, the woman has to excessively flex her lumbar vertebrae putting herself at greater risk for disc bulging and herniation.

This is precisely what happens when someone bends at the waist even if their pelvis is perfectly capable of pivoting over the femur heads. We often hear instructors say, "Place the hands on the hips and bend forward." But place the hands where on the hips? There is a great distance between the top and bottom of the hips. Many people mistakenly place their hands at the very top of the hips with the index fingers and thumbs resting on the rim of the pelvis. This hand placement has the psychological effect of cutting off any movement below the hands while folding in half at the lumbar region at the top of the hips. Their tailbone remains fixed, pointing downward (see the difference between the tailbones in figures B & C). This puts their lumbar discs under tremendous stress.

However, if the hands are placed at the bottom of the hips where the pant pockets and femur heads are, this allows the pelvis to tilt forward and tailbone to start to move upward.

In yoga, some schools consider Figure A a correct forward bend where the stretch is distributed equally between the hamstrings and lower back muscles with both hip and spinal flexion whereas other schools consider Figure C a correct forward bend where the hamstrings take all the stretch with hip flexion and the lower back none, i.e. no spinal flexion. Certainly for people with back problems, Figure C would provide the least amount of strain. Figure A allows for a moderate lengthening in both the lumbar and hamstring regions whereas Figure C shows a more cautious bend to avoid excessively flexing the lumbar spine.

For those who suffer occasional or chronic lower back pain, I suggest eliminating forward bending completely from both standing and sitting positions due to likely compression in the lower back. In my lower back yoga class, we gently lengthen out the hamstrings while lying on the floor in a supine position to avoid even the slightest stress to the lumbar spine.

Knee bending

Tight hamstrings restrict the pelvis from tilting further forward. Bending the knees provides slack to the hamstrings thereby allowing the pelvis to continue tilting. With knees bent, the leg muscles bear the brunt of lifting a heavy load rather than the much smaller lower back muscles. For further lower back support, drawing in the abdominal muscles assists in proper lifting, much like a delivery person who wears an abdominal belt. Drawing in the abdominals is especially important when the object is off to the side, like when lifting luggage, which involves lateral flexion.

In cases of serious back pain, bending at the bathroom sink to brush one's teath can be problematic. This requires bending the knees as best one can (open the cabinets underneath the sink if possible) and pulling in those abdominals!

Take a class

I have applied these principles in my lower back yoga class with twenty-eight practices to alleviate compression of the lumbar discs. If you'd like to try it, it is available as an iphone app. See a preview.

 

1 Class

7 Classes

If you liked this post, you may like:

A breathing exercise for back pain
Stabilize your lumbar vertebrae during abdominal strengthening
The impact of tight hamstrings on the lower back

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A breathing exercise for back pain

Fred Bender | | comments: 0

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One can modify the breath to lengthen the lower back in a safe and effective manner to reduce compression of the lumbar discs.

Basic Breathing Mechanics

In yoga, breathing can be manipulated in many ways depending on one's intention: to energise, to relax, to concentrate, or to stretch. For our purpose to lengthen the lower back, natural diaphragmatic breathing will have zero effect. Increasing the volume of the breath to include thoracic and clavicular breathing can provide some increased force to lengthen, but it requires important modifications to provide the optimum stretch for the lower back. So, let's first look at the three breathing processes that affect lung volume:

Abdominal breathing

In its relaxed state, the diaphragm muscle rests in a dome-like shape separating the abdominal and thoracic cavities. When the diaphragm contracts, it exerts a downward pressure on the abdominal organs, forcing the abdomen forward since the spine prevents the organs from moving back. As the diaphragm moves down, lung volume increases but pressure decreases in relation to atmospheric pressure, so an inhalation takes place to balance out the pressure.

Abdominal breathing

On exhalation, the diaphragm relaxes back up into its dome-like shape reducing volume and increasing pressure in relation to atmospheric pressure, so an exhalation takes place to balance out the pressure.

Abdominal breathing accounts for approximately 75% of breathing capacity.

Thoracic breathing

External intercostal muscles between ribs are responsible for separating the ribs to create more volume, less pressure, facilitating inhalation. Internal intercostal muscles between ribs are responsible for depressing and retracting the ribs to reduce volume, increase pressure, facilitating exhalation.

Thoracic breathing accounts for approximately 20+% of breathing capacity.

Clavicular breathing

Clavicular breathing involves the lifting of the clavicle bones along with the shoulders to draw breath in the upper regions of the pear-shaped lungs.

It accounts for a small percentage of breathing capacity.

Full Yogic Breathing

Full yogic breathing utilises all three breathing processes (abdominal, thoracic and clavicular) to reach vital lung capacity to enhance vitality and to affect consciousness. However, if the objective is to use the internal pressure created by breathing to lengthen the lower back, it is necessary to modify full yogic breathing.

Breathing Exercise for the Lower Back

Most lower back conditions result from compression of the lumbar vertebrae. In this exercise, our goal is to manipulate the breath to create pressure in such a way as to lengthen the lower back, safely and comfortably.

Lying on the floor with knees bent and feet on the floor, (1) we contract the pelvic floor muscles (the muscles between the sex organs and anus) as if sucking the pelvic floor up within the body, then (2) we pull in the lowest abdominal muscles as deeply as possible as if glueing the skin of the belly to the front of the lumbar spine. These two internal contractions stabilise the pelvis and lumbar vertebrae.

breathing for back pain

We next apply thoracic and clavicular breathing only. There is no abdominal breathing, because the abdomen remains pulled in to stabilise the pelvis and lumbar vertebrae.

low back pain breathing low back pain breathing

Thoracic and clavicular breathing have the effect of lifting the ribcage up and away from the stabilised pelvis. There is one bony structure (the ribcage) moving away from another bony structure (the pelvis), thereby lengthening the space in-between - the lumbar vertebrae.

Many people find it difficult to restrict abdominal breathing. To verify, one hand can be placed on the side of the ribs and one hand on the belly. Only the hand on the ribs should move during inhalation.

It is very easy to regulate the amount of stretch one experiences by controlling the depth of the breath. If one doesn't feel any stretch on either side of the lumbar vertebrae, one has to breathe deeper to lift the ribcage even further from the pelvis. Conversely, one should not force beyond a comfortable lengthening of the spine. Forcing, even if just by the breath, will have the same deleterious consequences as forcing by any other means. However, with not so many moving parts and by stabilising the lumbar vertebrae, this is as safe a practice as they come, and with 8-12 breaths a minute, one can consciously stretch the lower back 30-60 times in 3-5 minutes effectively sculpting the lower back in a way that provides relief from a compressed state while taking as many breaks as necessary along the way.

Take a class

This breathing stretch is one of twenty-eight practice videos for the lower back now available as an iphone app. See a preview.

 

1 Class

7 Classes

If you liked this post, you may like:

Bending with back pain
Stabilize your lumbar vertebrae during abdominal strengthening
The impact of tight hamstrings on the lower back

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Image source: abdominal breathing



Stabilize your lumbar vertebrae during abdominal strengthening

Fred Bender | | comments: 0

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The majority of lower back problems I see in my back classes results from compression of the lumbar discs. Therefore, I focus on three main areas to reduce compression in that region:

  • Core abdominal strengthening
  • Hamstring stretching
  • Hip movement

When it comes to abdominal strengthening, there is a wide range of possible exercises one can do, but most risk arching the lower back which may compress the lumbar vertebrae even further. Practicing abdominal strengtheners in a supine position on the floor allows the floor to assist in lumbar stabilisation and provides a clear reference point as to whether one is arching the lower back or not in the execution of them.

Core strengthener 1

back pain relief - core exerciseslow back pain exercisesback pain exercises core strength

In the above sequence, keeping the knees bent throughout the movement reduces the load upon the abdominal muscles as they draw the legs in to the chest and then control their descent back down with eccentric contraction. Even so, the movement back to the floor is likely to arch the lower back unless one makes a concerted effort to actively press the lower back down. This effort requires both abdominal strengthening and posterior pelvic tilting.

In the above practice, stabilizing the lumbar vertebrae is more important than the actual movement of the legs. In cases of lordosis, where there is an excessive arch of the lower back, it is virtually impossible to return the feet all the way to the floor while maintaining the back completely flat. No problem. The beauty of this practice is that one doesn’t need to reach the floor. One can simply move back and forth within the range of motion that allows the lower back to remain completely flat. Core strengthening achieved safely with the least amount of compression to the lumbar discs!

Core strengthener 2

back pain

In the above practice, the movement of the leg away from the core risks bringing the lumbar vertebrae into an arched position. By maintaining the lower back flat during the outward movement of the leg, one engages the core abdominal muscles while stabilizing the lumbar vertebrae at the same time.

For those with a large arch, as is the case with lordosis, it will be extremely difficult to maintain the back completely flat. However, one can vary the angle of the extended leg. Extending the leg more vertically for someone with lordosis allows one to maintain the lower back stabilized on the floor while still engaging the core abdominals. In addition, one can regulate whether the leg is extended completely or only slightly (as shown) which will allow one to fine-tune the abdominal work safely.

Take a class

There are several other safe abdominal strengtheners in my lower back yoga class with a total of 28 practices in all to alleviate lower back discomfort. It's available as an iphone app. See a preview.

 

1 Class

7 Classes

Other blog posts:

Bending with back pain
The impact of tight hamstrings on the lower back
A breathing exercise for back pain

The second main area that we focus on in the lower back yoga class is lengthening tight hamstring muscles. To stay informed when new posts are published, please visit and like our Facebook page.

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The impact of tight hamstrings on the lower back

Fred Bender | | comments: 0

mobile version

The majority of lower back problems I see in my back classes results from compression of the lumbar discs. Therefore, I focus on three main areas to reduce compression and to increase space in the lumbar region.

The first main area is on abdominal strengthening, and I draw particular attention to stabilizing the lumbar vertebrae during abdominal strengthening here. The second main area is on lengthening tight hamstring muscles.

Hamstring anatomy

hamstring

The hamstring is composed of three distinct muscles that originate together on the hip at a landmark called the ischial tuborosity. The muscles continue along the femur before the different muscle bellies branch off, cross the knee joint and insert onto the tibia and fibula bones of the lower leg.

Hamstring action

As the hamstring crosses two joints (the hip and knee), it has an effect on both. The primary action of the hamstring muscle when it contracts is to bend the knee. A secondary action is to assist in extending the hip. Below is an illustration of the left hamstring muscle contracted to its shortest length, with flexed knee and extended hip.

hamstring stretch

Impact of tight hamstrings on the lower back

In forward bending, the pelvis (two hip bones and sacrum) begin to tilt forward, but tight hamstrings limit the range that the pelvis can tilt forward, because the tight hamstrings attach to the hips. Bending further forward (without bending the knees) immediately puts undue stress on the lumbar vertebrae (as illustrated in the image below):

back pain causes

We want the hips and pelvis to have more range to tilt forward thereby reducing the load on the lumbar vertebrae. This is why we lengthen the hamstrings. Notice the difference in the range that the whole pelvis can tilt in the image below where hamstring length is considered normal.

forward bending

In the leg sequence of lower back yoga, we aim to lengthen the hamstrings in as safe a manner as possible. We start with practices (not pictured) that warm up the hamstrings before stretching them fully and in a supine position to limit risk of compression to the lumbar discs.

hamstring stretch for back painback pain relief

In both examples above, the hips are flexed, not extended, and the knees are straight, not bent, thereby lengthening the hamstring muscles all  while the lower back remains in a safe supine position with floor support. These simple stretches will enable freer movement in the pelvis, thereby reducing stress on the lumbar vertebrae in forward bending.

Bending forward with knees bent

In forward bending, once the pelvis tilts as far forward as possible, always remember that bending the knees will give slack to the hamstrings and allow the pelvis to tilt even further forward without putting undue stress on the lumbar discs. Without bending the knees, once the pelvis reaches its maximum tilt, the hamstrings are at their greatest length, so one begins to stress the lumbar discs in bending any further forward.

A note for those with knee problems

During the hamstring stretches, if you can straighten the knee, please do so, but the knee should not be locked nor hyperextended. In the first practice above, you can keep the knee “soft” while the femur and tibia form a straight line.

Some people have difficulty straightening the knee. Straightening should not be forced as one must honor the limitations within the joint capsule. For the first practice above, a cloth belt or elastic band is used to allow the leg to remain further away from the body which makes it easier to straighten the knee. However, if straightening is not possible, continue with the knee slightly bent. No problem. For the second practice above, one is directed to lie right against the wall with a pleasant passive stretch on the hamstrings. However, if the knees cannot straighten, one can simply move some distance from the wall to allow the knees to straighten a bit more. The idea is to remain comfortable while gently lengthening the hamstrings over an extended period of time.

Take a class

The lower back yoga class has 28 practices to alleviate lower back discomfort. It's now available as an iphone app. See a preview.

 

1 Class

7 Classes

Other blog posts:

Bending with back pain
Stabilize your lumbar vertebrae during abdominal strengthening
A breathing exercise for back pain

The third main area that we focus on in the online lower back yoga class is hip opening. A post on that is upcoming. To stay informed, please visit and like our Facebook page.

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Image Sources: Forward bending illustrations



Low back pain breathing

Fred Bender | | comments: 0

Low back pain is often caused by compression of the intervertebral discs due to long periods of sitting with poor posture and weak muscle support. This breathing exercise lifts the ribcage away from the pelvis in a way that stretches the lower back and decompresses the discs. Good for disc degeneration, disc bulging, and herniated discs only AFTER a back crisis has passed and no inflammation is present.

Preview it here:

Take a class

This breathing stretch is one of twenty-eight practice videos for the lower back now available as an iphone app. See a preview:

 

1 Class

7 Classes



Core exercises for back pain

Fred Bender | | comments: 0

Core exercises are important to alleviate back pain. However, many core exercises create more pain than benefit. Preview this exercise taught for 15 years in our lower back yoga class. You stabilise the lower back on the floor as you move the knees in and out at a range that suits your comfort zone.

Take a class

There are several other safe abdominal strengtheners in my lower back yoga class with a total of 28 practices in all to alleviate lower back discomfort. It's available as an iphone app. See a preview:

 

1 Class

7 Classes



Back pain relief exercises - free iphone app

Fred Bender | | comments: 0

For back pain relief, preview our free iPhone "Floor Class" app - 7 practice videos in 10 minutes. Based on a real class taught since 2000:

 

Free Class

7 Classes App



Back pain stretching: What is a muscle spindle?

Fredric Bender | | comments: 0

Most people know that lower back pain is often the result of compression of the lumbar discs. Modern-day causes can include long periods of sitting at a computer with poor posture and weak muscle support. Stretching is important to reduce this compression, but the intensity with which one stretches varies greatly from person to person and can affect outcome.

At the first sign of back pain, people tend to overstretch into stiffness. Within the belly of striated muscle tissue lie “spindles” which are sensory receptors that pick up the speed and intensity of a stretch. If a stretch is too fast or too intense, the spindles trigger a reflex arc to the spinal cord and back out to the muscle to contract in order to protect one from tearing the muscle fibers (as pictured below).

One’s mind wants to go one way, but one’s spindles know better and intercede. What results is that one wrongly equates a feeling of stiffness and resistance with stretching when in reality one is actually locked into a contraction and going nowhere.

For this reason, I never instruct my back students (or any students for that matter) to stretch. Instead, I encourage them to lengthen into softness and maintain that length patiently over time. This keeps the muscle spindles at bay. They habituate to the new length and fire less frequently. The muscles sense they are safe and can release deeper into the length. This brings  much more differentiated sensation and a feeling of openness and space. This slowly breaks the protective holding pattern or reactivity commonly found among those who suffer back pain. 

The student can then use the breath to refine the lengthening. In other words, rather than using the body parts to stretch, one uses the breath to explore the inner space, gently increase volume, decompress, and develop a better self-awareness and connection within.

However, all stretching and no strengthening is a lopsided approach. More about the proper combining of the two in a future blog post.

Take a class

I have applied these principles in my lower back yoga class with twenty-eight practices to alleviate compression of the lumbar discs. If you'd like to try it, it is available as an iphone app. See a preview.

 

1 Class

7 Classes

If you liked this post, you may like:

A breathing exercise for back pain
Stabilize your lumbar vertebrae during abdominal strengthening
The impact of tight hamstrings on the lower back

To receive alerts of newly published blog posts on lower back advice in your Facebook feed, please visit and like our FB page. like button



To be informed of future posts, please join my twitter feed or like my Facebook page.

Back pain exercise montage

Fredric Bender | | comments: 0

Making hard effort does not equate to a better result. Making smart effort does.

Take a class

I have applied these principles in my lower back yoga class with twenty-eight practices to alleviate compression of the lumbar discs. If you'd like to try it, it is available as an iphone app. See a preview.

 

1 Class

7 Classes

If you liked this post, you may like:

A breathing exercise for back pain
Stabilize your lumbar vertebrae during abdominal strengthening
The impact of tight hamstrings on the lower back

To receive alerts of newly published blog posts on lower back advice in your Facebook feed, please visit and like our FB page. like button



To be informed of future posts, please join my twitter feed or like my Facebook page.