Last Updated Oct 2012
A healthy spine is essential to achieve a healthy lifestyle. People who suffer from back pain are generally less healthy than those who do not. Those who had back pain or who want to prevent its occurrence should master the following:
- Learn basic anatomy of the spine, including how to achieve ‘neutral spine position’ in quadraped (hands and knees), supine (lying face up), seated and standing postures.
- Understand how to locate and engage core muscles: transverse abdominus, pelvic floor multifidus, and longus coli muscles and their relationship to the Bandhas.
- Learn appropriate breathing techniques: Victorious/Ujjyi or TATD Breath, to be done with asana and Diaphragmatic Breath, for relaxation
- Incorporate above concepts in Asana practice
- Learn the benefits of Relaxation and Restorative postures
Today we’ll review spinal anatomy and ‘neutral spine position.’ All physical therapists and most yoga instructors are familiar with the concept of normal spinal curves but we often neglect to spend a lot of time helping clients to really master the ability to find and maintain these curves. I use the phrase ‘neutral spine position’ or NSP to indicate a natural inward curve of the lower back (lumbar lordosis), a slight outward curve between the shoulder blades (thoracic kyphosis) and an inward curve of the neck (cervical lordosis).
These curves are important because they provide the optimal alignment of the facet joints of the vertebrae, the least amount of pressure on the discs, the most space for the nerve roots exiting the spinal canal and the best length-tension ratio of the trunk muscles. Ultimately they help us to achieve strength without tension. Spine Universe is a good physical therapy resource for reviewing more detail about the structure of the spine. They have great pictures that show the joints, ligaments, nerves and blood supply of the spine.
Asana and Back Pain
When a client is recovering from a back injury, one of the safest ways to resume asana is to limit poses to those they can do with a neutral spine position. However, sometimes patients are unable to even get into a neutral position due to a mechanical block, pain or both. These are the people who need manual physical therapy and/or medical intervention before attempting to practice asana. A yoga practice that includes meditation, pranayama and review of yamas and niyamas is helpful and should be encouraged during periods of limited physical activity.
When practicing neutral spine position, the first goal is to be able to find the posture independently. Initially, this best done with a teacher or partner who can observe and give feedback about spinal alignment because even the most experienced yogis are often not fully aware of subtle shifts in posture. The next goal is to improve stabilization and muscular endurance while holding NSP in various postures.
Asanas in which you or your clients can practice actively holding a neutral spine position, in order of difficulty:
- Mountain/Tadasana
- Hero/Virasana
- Tree Pose/Vrksasana
- Plank or Plank on the Wall
Hover/Chaturanga Dandasana. This pose requires a good deal of core strength as well as arm strength. It can be modified by practicing in a kneeling position or by using a bench or tabletop.
Warrior III/Ardha Chandrasana. This pose also requires good core strength as well as adequate flexibility in the hamstrings in order to achieve NSP.
Half Moon/Ardha Chandrasana. Adequate flexibility of the hamstrings and adductor muscles is necessary for NSP. This pose can be supported with props and/or a wall.
Supine asanas in which your clients can be supported in a neutral spine position by placing folded blankets, towels or small bolsters under the lumbar and cervical curves:
- Reclined Hand-Foot /Supta Padangusthasana
- Legs on the Wall/Viparita Karani
Try to keep your spine as healthy as possible to avoid or lessen your neck and back pain.
In part 2 of this series, I will review the anatomy of some common diagnoses and how they relate to spinal curves.
About the Author: Lisa B. Minn is a licensed physical therapist and yoga enthusiast. She has been incorporating aspects of Yoga her physical therapy practice since 2001 and became a certified yoga instructor in 2004. You can read more about the therapeutic applications of yoga on her blog, ThePragmaticYogi.com.
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