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forward bends/herniated discs

 
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hearthands



Joined: 21 Jun 2010
Posts: 1
Location: Upstate NY

PostPosted: Mon Jun 21, 2010 9:12 pm    Post subject: forward bends/herniated discs Reply with quote

Hi,

I wanted to get a sense of the range of opinions regarding how appropriate other teachers/practitioners find forward bending asanas for students with herniated lumbar discs. I have had students present at my studio who have been told not to do any forward bending, standing or seated, by their physical therapists. I understand that extreme care needs to be taken during the acute stage and I also understand the theory behind this position (that forward bending will cause the disc to move posteriorly) but I feel it doesn't take into consideration that disc herniations can occur in any part of the disc. Personally, I find back bending to be much more irritating to my own lower back issues. There also doesn't seem to be the same restriction placed on forward bending of the cervical spine with herniation. There seems to be such a range of opinions (some very strongly held) and I want to be able to give my students a more informed response to this dilemma. I do believe that there isn't a one size fits all approach that works for everyone and that the beauty of yoga lies in its individual application and expression.


Thanks. I really look forward to your responses!
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Bernie



Joined: 23 Sep 2006
Posts: 1042
Location: Vancouver

PostPosted: Tue Jun 22, 2010 12:56 am    Post subject: Herniated Disc Reply with quote

For the readers who are not familiar with "bulging discs" or "herniated discs," you may want to start with a short visit to this page, and look at the drawing that shows what these conditions are: http://www.spineuniverse.com/conditions/herniated-disc/herniated-bulging-discs You will see that, because the nucleus pulposus (the jelly in the middle of the jelly donut) is being pushed backwards when we do a forward fold, health care professionals will caution any patient to avoid forward folding in yoga classes or during daily life. This is good advice for people suffering from these conditions. [Just a little point: it is not the disc that is pushed backwards, just the jelly in the donut that is squished out.]

However, there are many causes of lower back disorders. While backbends are often recommended to help people with bulging or herniated discs (a practice called Mackenzie Therapy), for people with other back issues, such as spondylolisthesis (see this forum post for more: http://www.yinyoga.com/forums/viewtopic.php?t=488 ), backbends are not a good idea.

Herniation can occur in any disc, but generally this happens mostly in the lumbar and cervical spine. The thoracic spine does not flex/extend very much (with the exception of T11/12 joint). Regardless, wherever herniation occurs, whether in the neck or the back, forward folding is not a good idea.

You are right that one size fits all doesn't work; each body is unique and requires its own therapy. However, if the condition has been investigated by a professional and in her best judgment forward bends should be avoided for that student, I would suggest, as their yoga teacher, you honour that prescription. Like any physician, our first duty is to "do no harm." We should not risk making things worse.

As you say, "the beauty in yoga lies in its individual application," which means there is an onus to understand a student's particular problem and then work out the best approach for her practice. Not all lower back problems are helped by backbends, or forward bends. It all depends on the student's unique condition.

Cheers
Bernie
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