Understand the difference between general back pain and herniated discs
Practicing yoga with back pain is one thing. Practicing yoga with a herniated disc is something completely different! Differentiating between the two is a big guessing game for most yoga teachers. It’s difficult because the symptoms of back pain and herniated discs overlap.
Symptoms of generalized back pain
- Muscle ache
- Limited movement
- Pain traveling and moving to various areas
- Inability to stand up straight
Symptoms of herniated disc
- Pain shooting down the back of one or both legs
- Inability to lift leg if laying on the floor
- Limited movement
- Inability to stand up straight or at all
Two things that can appear to be herniations and contribute to back pain
- Trigger points
- Kidney stones
Where to start
If there is any doubt about whether you have a serious problem such as a herniated disc, go see a doctor and if possible have an MRI. Having more information is always better than having less information. At the very least you are then able to make better informed decisions about how you want to work with what you have. You can read further about what happens in the body when you have a herniated disc on pages 184-187 (1st ed.) of my book: Functional Anatomy of Yoga.
What to do if a diagnosis of a herniated disc has been confirmed
For the remainder of this article I want to focus on practicing with back pain if you know (meaning diagnosed by a doctor) that what you’re dealing with is a large bulge or a herniated disc. What I am suggesting here is not meant to be taken as the only thing you should do. This protocol could change as symptoms change.
WarningPlease note that none of this should be attempted if you are in an acute stage of disc herniation. My suggestions are for only after things have calmed down and you have been checked by a professional!”
My suggestions are particularly pertinent to those that are doing a practice that contains a number of forward bends. Ashtangis take note! If you don’t know already, I teach Ashtanga vinyasa yoga. The majority of practitioners that I work with are working within the primary series which contains a number of forward bends. For those that want to practice yoga with herniated discs, the primary series of Ashtanga seems ridiculous because the most common (there are always exceptions) movement that should NOT be done when you have a herniated disc is to flex the spine. Flexing the spine means shortening the front of it. Since the majority of herniations head backward and off to one side, when you flex the spine the disc gets compressed and could further herniate. Not a good idea!
So what to do?
What we need to do is redefine how to approach the forward bending yoga posture in this situation. Where does that forward bend happen from anyway? A forward bend is made up of about 2/3rd hip joint movement and 1/3rd spinal movement if your hamstrings are flexible. If the hamstrings won’t allow that much movement, then the most typical compensation your body will do is to flex the spine more than the remaining 1/3rd needed for a forward bend. In an effort to minimize the amount of spinal flexion and potential disc compression, we want to emphasize the amount of movement at the hip joint.
How do we set up the forward bend?
The way we do this is rather simple. The difficult part is letting go of how you think the forward bend is supposed to be or what it’s supposed to look like. What we do is arch the back and maintain the lumbar curve from the beginning. From that point you only fold forward as far as your hip joint will let you. The moment your lumbar curve starts to flatten out, just stop. In addition, re-emphasize the lumbar curve by trying to create an anterior tilt in your pelvis. Send your pubic bone down toward the floor while lifting the chest. If you’re grabbing your ankles, feet, or using a strap, you can use the leverage created by holding them to help draw your ribcage up and forward and accentuate the lumbar curve.
The rest is simple, just hold it there and breath.
I have 4 buldge and an anular tear in the lumbar area about six months ago I been doing very gentle and had to stop practice for a while because of practice worsening pain even in modified practice. I just did a three days of Mysore w forward folds felt fine during but know am questioning it as I feel some pressure building up so I’m going to head the advice of this article and teacher telling me to watch forward folds. My question to you is how long typically does it take for buldges to heal then? And will I ever be able to fold forward again normally without worrying about making matters worse. Trying to let it go but its hard .
Thanks so much.
I have herniated disc in l4-l5 which i got operated 6 months back because it was causing unbearable pain in my left leg and i was not able to stand properly. After 3 months of surgery pain in my leg as well as back decreased substainsialy but now again some pain started in my left hip and also little pain in lower left leg.
What should i do?
I have a job of sitting 11 hrs/day
How about practicing yog with herniated cervical disc? Mainly c5-c6. I love doing handstand. I am recovering now and getting back to my routine slow but do you thin khandstand will, in future, aggrevate it?
Thank you for your artice.
I too have (had) a herniated disc for he past 12 yrs… in fact still have some ‘nerve’ symptoms if I fail to practice my yoga consciously.
I agree with all your advice on how to carry out forward bends..
What I do miss is that one should also BEND ones knees when practicing the forward bends because it then allows the hamstrings some freedom… freeing the pelvis to move forward more from the hips,.. and most beginners, and back ache and herniated disc sufferers, have VERY short hamstrings,… not to mention the majority of the modern sedentary population actually!…
this is why back problems have become an epidemic in our modern western sedentary population.
One of the things I do advice those who have a herniated disc is to have their ilio-psoas muscles looked at by a professional bodytherapist/physiotherapist/osteopath,.. and if possible have tis muscle deeply and thoroughly massaged and released/relaxed… and to learn to actively stretch en relax this muscles by themselves.. to become conscious of releasing all the tension that often builds up in these emotionally reactive/sensitive muscles,.. and it is the build up of (emotional) tension in these muscles that is often the cause of lower back and hernaited disc problems…this is also why working with breathwork (pranayama) and the proper use of the mula and uddyanna bhandas is essential in the healing process that yoga can provide for these lower back injuries..
Plenty of gentle and back strengthening back bends in the form of (baby) cobras and the Sphinx, the locust etc.. will help encourage the herniation to be ‘sucked’ back in, and release the possible nerve impingements it causes. these poses create more space betwen the vertabraa and encourage equilibrium in the antagonististic muscles of the back (as opposed to the focussed overstrengthening of the frontal abdominals encouraeged by popular fitness media who seems enamoured with showing off the six packs as the trophies of a successful fit body!)
I most definitley advice my students with such back issues to avoid all forward bends in the acute fase of their injury and only attempt them .. as you already wrote in your article.. with a very straight lower back,… and bend knees.. moving forward from the pelvis/ hips.. it is the gradual opening/mobilsation of the hips joints that is of importance here.
Thanks again for your article