Monday, September 22, 2008

Low back pain - Limbering up the lumbar spine

I've just spent three wonderful weeks in Sicily staying with another two families near Siracusa. One of the wonderful things about my "work" is that a even during the holidays yoga plays a part. Often when those around me hear that I am a yoga instructor, they are curious and even "brave" enough to experiment in this practice perhaps never before approached. This is because most people have some sort of ailment they'd like to get the better of. And Roberto is no exception. One of the family members on this southern holiday he arrived from Milan in considerable discomfort from quite severe lower back pain.

Roberto has suffered from lower back pain for about ten years. This all started in Venezuela where he went for an unfortunate ride on a motorboat which was going a little too fast and driven a little over enthusiastically for a time period which was simply too long for his back to handle. The boat which was constantly hitting the surface of the water caused vibrations to the spine which translated into micro traumas of which he is still paying for today. His intervertebral disks (the cartilaginous shock absorbers of the spine that provide a “cushion” between the vertebrae whilst holding them together) in his lumbar spine have been literally "squashed" and bulge out slightly causing him great discomfort, and the passing of time has not helped the situation.

Where and what is the lumbar spine
The lumbar spine consists of five vertebra and which make up the third and lowest (inward) curve of the back (the inward curves of the spine are called "lordosis"). Your ribs are attached to your thoracic spine, below which begins the lumbar spine - If you draw an imaginary straight line from your navel back through your body towards your spine it would correspond with part of the lumbar region. Unless your navel is particularly high!

If you consider that with age and the force of gravity your spine is being constantly "weighed" down and shortened (in fact if you think about it those of 30 years of age tend to be taller than they are at 60 - people do shrink with age as their spine succumbs to years of literally being put under pressure. Unless you do yoga of course!). So ten years down the line it is not surprising that Robert's back problems have not been resolved but have steadily worsened.

So due perhaps to the holiday atmosphere but more so the constant pain he decided to dabble with yoga.

Roberto (like most in Milan) is a busy man and I didn't want to neither take up a lot of his time (I didn't want to put him off basically!) nor overwhelm him on his first yoga experience, so I decided to give him four simple yoga positions to try each morning. A simple daily ten minute yoga "program" to get him hopefully on the right track to a pain free if not healthy back.

If there are any of you at home who suffer from something similar I invite you to give this sequence (ideal for beginners but just as useful for those more "advanced") a little try. I would be very interested in and grateful for any feedback.

So here it is:
1) Firstly a lengthening of the lumbar spine is advisable. I opted for something passive and pleasurable. Lying on the yoga mat, tummy up, legs bent at the knee, slip a rolled up towel under the lower half of your lumbar spine. This causes the pelvis to tilt slightly encouraging the natural lowest inward curve of your spine to flatten against the floor. This means the intervetrabral disks which have been squashed (in Roberto's case), are relieved by being given a little more room.

I recommend for those trying this at home that you remain in this position for as long as you have time for and for as long as you feel comfortable. And it should be comfortable!

2) Now the knees are pulled to the chest, and rest comfortably in the crook of your elbow. If you can grab hold of your wrist great, if not any part of your hand will do. If this position should cause the chin to come up and head to tilt back (as in Roberto's case) it is necessary to tuck a cushion under the head in order to keep the chin down and therefore the cervical spine (your neck) in the correct position.

3) The feet are then raised to the ceiling (this for many guys, especially those - including women - who are relatively inflexible, may be sightly challenging). The hands should clasp the inner edge of the foot. The knees are in line with the ankles. If your knees resist this aperture, no problem but don't be tempted to widen the gap between your ankles if this means losing the alignment with your knees. Your chin should be tucked in and down slightly , so use a cushion under your head if necessary ("Alla Roberto").

4) Sitting up now (depending just how much your back causes you pain, you might find rolling on to one side and pushing yourself up with your hands compromises your back less. The same goes for pregnant women practicing yoga and getting up from the floor).
Bring your legs forward out in front of you into a diamond/kite shape (knees out to the side and feet together.) The further away your feet are from you the more challenging this asana will be, and the more your spine will be lengthened. Bring your hands passively resting on to your feet and your elbows outside the line of your tibia. Allow your head to fall down ward passively and with every out breath feel the force of gravity pulling your back and head toward the floor (but DON'T bob up and down! Simply allow your body to fall down a millimeter more and stay there until the next out breath when you may feel the desire to lower even further. If you feel the need to bring yourself up with every in breath it means your pushing yourself too far.)

Another good thing to do would be a twist. Lying on your back, soles of your feet against the floor, wide apart from each other yet tucked in quite close to your buttocks, allow both knees to come down to your left and turn your head to the right. Your arms are spread out either side of you, in line with your shoulders. You will have one leg resting on top of the other. Remain in this position as long as you like, allowing the knees to fall downward with every out breath. When you wish to change, gently pull the knee of the top leg up towards the ceiling and allow the lower leg to passively follow. Re-align your feet and then repeat bringing both knees down to the opposite side.

I would dedicate ten to fifteen minutes to this sequence, and suggest that it is practiced upon waking, although it will at any time of day, bring relief. The best results come with patience and constant practice over a long period of time. Am I asking too much?!

I'm hoping that Roberto will have the self discipline and time needed to try it out for at least a couple of months after which I'll "invite" him back to share his feedback with you (but only if it's positive! ;-) .