Yin Yoga for people with herniated discs

There are often many questions about Yin Yoga and specific spinal conditions. Feel free to ask your question here, or check out other posts or contribute input from your own experience.
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Bernie
Posts: 1236
Joined: Sat Sep 23, 2006 2:25 am
Location: Vancouver

Yin Yoga for people with herniated discs

Post by Bernie »

I was recently asked the following questions about a student doing Yin Yoga with herniated discs:
  • G has history of 2 herniated discs L4/L5 & L5/S1, many years experience with hatha yoga, is a very dedicated and mindful student, interested in Yin but concerned about it. G is ok in forward bending as she does well with hinging on hips. Her concern is in prone poses: she does not feel safe enough to relax her muscles to get into the deeper fascia and connective tissues. I have offered adaptations, eg. blocks for Bridge pose but this did not help. She has also experienced some nausea when doing Yin, although this is improving. Can you help me guide G so that she can continue to thrive in her Yin practice and feel safe. Thank you so much, K.
Hi K. It is great that you care so much about your student. Unfortunately, it is impossible to diagnose someone you have not met. You have described G to a degree but I have not met her. I would love to know what type of disc herniations she suffers from. This could dictate the nature of her therapy. If the disc bulges posteriorly, then flexion postures may be contra-indicated as that could make the bulging worse. However, not all disc bulges are posterior. Some are diagonal or lateral bulges, which means twists or side bends may be contraindicated. Some disc bulges are radial, which means that the layers of lamination of the annulus fibrosus may be separating. Again, twisting for this situation may not be great.

Often therapists will prescribe movement that push the bulge back into the disc: for example, for posterior bulges McKenzie Therapy is suggested, which is basically Sphinx pose. If the bulge is posterior, flexion could push the bulge further out, but extension (Sphinx or Supported Bridge) could tuck it back in, thus gentle backbends held for a while may be therapeutic. Likewise with a lateral bulge, say to the left for example: side bends to the right could make this worse while side bends to the left may make it better. Deep twists may make all sorts of bulges worse as the disc becomes compressed during twists.

It is key that you find out what direction her herniations took, what her doctor and therapists suggest and what she finds beneficial and what she knows doesn’t work for her. You are not a therapist or a doctor, so resist the urge to take on that role. At best, you can teach her to pay attention to her own body so that she can make her own decisions. Education is more important than direction. Suggest some things but teach her how to attend to sensations and learn what works for her. She can attend to the sensations that arise while she is in the pose, when she comes out, and over the next day or two. Start slow: don’t go very deep at first and have short holds (1~3 minutes). If this feels safe, she can, over time, work towards a deeper edge and longer holds, if and when that seems appropriate.

For her nausea some Yin Yoga students do suffer from this but I would be very curious about when she notices it. In what postures? After how long being in the pose? I know some students get these sensations when doing Sphinx pose with their heads lifted. This can compress the vertebral arteries which run through the cervical spine and feed the brain. If those are compressed, blood flow to the brain could be reduced which can cause lightheadedness and nausea. Also, some students find deep twists of the head or neck trigger these sensations, perhaps due to too much stress along the vagus nerve. So, attend to when these sensations arise and modify the postures, especially the position of the head and neck.

Of course we are more than just our spine. G may prefer to keep her spine quite neutral and focus on working her legs, hips and shoulders. Props can be quite useful for keeping the spine neutral. There are lots of other yin postures that may work for her that don’t involve one or two particular spinal movements. And, it would be good to know which spinal movements she should minimize or avoid so you can plan around those.

I hope the helps!
Cheers
Bernie
Kathleen@*+
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Joined: Tue Oct 05, 2021 7:11 am

Re: Yin Yoga for people with herniated discs

Post by Kathleen@*+ »

Thank you for your response regarding G and herniated disc I have more information for you from G.
Her report says, "there is a moderate central-left paramedian disc protrusion at L4-L5. This is causing significant impression on the thecal sac and may be impinging upon the origins of both the left and right S1-L5 nerve roots." It also says "there is a large central disc protrusion at the L5-S1 level".
I am grateful that G is well informed. I realize that I am a yoga teacher, not a Dr. and I do trust my students to know and look after their body.
G does this very well. However, her question to me was, "how can I relax in the prone poses of yin or what can she do while everyone else is in eg. Spinz/Seal. In her Hatha Yoga class she does well with lengthening and engaging her muscles. However with her new interest in Yin Yoga, she is trying to figure out how to be in the poses with relaxed muscles. I/We really appreciate your responses. K
Bernie
Posts: 1236
Joined: Sat Sep 23, 2006 2:25 am
Location: Vancouver

Re: Yin Yoga for people with herniated discs

Post by Bernie »

Thecal sac impingement on the nerve roots can be caused by so many things: spinal stenosis, scoliosis, congenital deformation of the bony areas nearby, osteoarthritic changes, and probably many other things that I am not aware of. In G’s case, the diagnosis is a disc bulge. I can imagine that since the bulge is in a central-left direction, side bending and twists to the left may help push the bulge back into the disc. But, other therapies may be more effective, like neuromobilizations. Has G been given any spinal flossing exercises? They may help.

In any case, your question is about what to do when Sphinx is not available. One option I offer students who cannot do Sphinx is to simply lie on their belly. For some, that is all the backbending they need. Can G tolerate even that? She could try sliding one knee along the floor up beside her torso to reduce the amount of backbend. Another version is to place a low bolster under her pelvis while lying prone, as this may reduce stress in the lumbar spine while giving a bit more in the middle and upper back.

Another option I suggest is a low, supported bridge. While the rest of the class is lying prone she can roll over to supine and place a low support (a thin bolster or rolled up towel or blanket) under her pelvis and again get a little bit of lower back stress. Another idea: have her do a mid sitting backbend: sit up (legs either crossed or straight), hands on the floor behind her (maybe on blocks, or be on knuckles, fingertips or place elbows on a chair) and lean back a bit. It is like a mini-Camel. She could also lean back against a wall with a bolster behind her lower back so that there is a lordotic curve there (no forward flexion/slouching). Final idea: a reclining Butterfly with a bolster under her spine. Again, this will provide a little bit of backbend.

Good luck, G!
Kathleen@*+
Posts: 2
Joined: Tue Oct 05, 2021 7:11 am

Re: Yin Yoga for people with herniated discs

Post by Kathleen@*+ »

Hello Bernie

I would like to thank you on behalf of G for the suggestions and modifications that you gave for G for her herniated disc. G explored a few of them and sent an email stating that they worked very well. She said, "these modifications worked VERY well for me. Thanks for exploring this with me.
Thank you for helping me support a student, so that she can now deepen her Yin practice and for me as a teacher always learning.
All the best, Autumn Blessings, Kathleen
Bernie
Posts: 1236
Joined: Sat Sep 23, 2006 2:25 am
Location: Vancouver

Re: Yin Yoga for people with herniated discs

Post by Bernie »

That is good to hear. Thanks, Kathleen.
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