There are a lot of misconceptions about yoga and back pain. This article will go over those misconceptions, as well how to decide if yoga is right for you. I love yoga and practice it occasionally. I do not deter patients from practicing yoga in general either. However, before you introduce it follow this article to decide if yoga is best for your body right now.

Yoga is rooted in ancient Indian philosophy. It is believed through the practice of breathing, meditation, and the physical practice of certain postures and poses called “asanas,” yoga can unite your spirit with a universal spirit (depending on the person this may be the Earth, God, or something similar).

I’d like to debunk a few myths about yoga for you. One myth is that yoga is good for low back pain, but the truth is that yoga is good for some, but not all types of low back pain. Another assumption made about yoga is that if you’re unhealthy or out of shape, that you should do yoga to be healthy, but yoga is not right for everyone.

1. Improves Muscle Flexibility. 

With the prolonged stretches or poses, your flexibility does improve.

2. Improves Muscle Strength and Tone.

Holding positions for prolonged periods works your muscles isometrically (strengthening when the muscle does not change in length). This is especially true if you “keep strong” while you hold your poses, rather than relaxing completely to try and increase your range of motion.

3. Improves Your Balance. 

Some of these poses are quite challenging to maintain for multiple breath counts. Continued practice of these poses will improve your balance ability.

Not in some cases. Many yoga poses challenge the limits of normal flexibility. Then, once you have achieved the apparent “end” of your limits, you are invited to stay there and breathe for multiple counts, inviting you to extend those limits even further.

All of our joints have a natural stopping point. The purpose of these natural end points include:

1. Protection of Essential Life Structures. 

Example: The Neck. We cannot turn our heads around 360 degrees like owls in order to protect the arteries that supply blood to our brain.

2. Impact of Bone-on-Bone. 

Example: When you reach the end of elbow extension, that means the ulna (one of the forearm bones) has met the humerus (the upper arm bone). Trying to stretch this point further would degrade the bone. Over time (typically years), this would cause significant arthritis.

3. End of Ligament (Passive Structure) Length. 

Ligaments are supportive structures that connect one bone to another bone. They are never meant to stretch. If you over-stretch a ligament you will sprain it or if taken too far, you will tear it. The ligaments typically make their complaints heard by achy pain. For example: When you sit with bad posture for too long and your low back starts to ache, this is typically the ligaments indicating they’ve been asked to support you for long enough and they would like a break from the stress.

If you are suffering from a type of low back pain that is due to structures being stressed due to too much movement, practicing yoga that increases movement further will only lead to increased pain. Full range of motion (ROM) is good. Additional ROM is not necessarily better, especially when dealing with types of low back pain that come from too much movement to begin with.

Yoga is Not a Good Place to Start for People with:

1. Severe Back Pain.

If your pain is severe and you would rate it as an 8/10, 9/10, or 10/10 pain on a scale from 0-10, you should not start with yoga, and should see a doctor or physical therapist first.

2. Low Back Pain with Pain in Your Buttock or Leg.

This type of pain suggests Sacroiliac Joint Pain and Dysfunction that is typically caused by too much movement at this joint. Yoga will typically make this pain worse, so you should go to physical therapy prior to starting.

3. Low Back Pain accompanied by Numbness or Tingling that Travels into Your Leg.

Numbness or tingling suggests nerve and/or disc irritation. Aggressive stretching is not a good idea at this time, so instead make an appointment with a physical therapist

4. If Your Low Back Pain Started with a Bending, Lifting, and/or Twisting Injury and it Hurts to Bend Forward (Note: You must answer YES, to both of these for this to apply).

This suggests possible disc irritation. Aggressive stretching that involves twisting and bending is not a good idea at this time. Physical therapy is recommended before starting yoga.

5. If You are Newly Pregnant or Recently Had a Baby.

Congratulations on your bundle of joy! Due to the hormones in the body while pregnant, during childbirth, and while breastfeeding, the body is at its most loose and mobile. Yoga will typically loosen things further and increase pain, so consult a physical therapist before you start.

Yoga is a Good Place to Start for People with:

1. Gradual Onset of Low Back Pain Over Months or Years.

2. If the Low Back Feels Mildly Tight Rather Than Severely Stiff.

3. You Feel Tight in General and Want to Improve Your Mobility/Flexibility, but Your Pain Levels are Low.

This is an extremely logical thought process, but the body’s symptoms can be deceiving.

When the body perceives that a body part (e.g. the low back or the sacroiliac joint) is moving too much, the body starts to protect itself. It does this by making the muscles in the region tighter. It’s as if the body is saying, “I have been telling you that this body part is hurting by giving you some pain. You didn’t listen. You’re still allowing that body part to move too much. If you won’t listen, I’ll just make everything super tight in that area and force you to not move it as much.” The real solution is to actually stabilize the body part that is hurting through strengthening exercises. ANY stretching will actually make you feel worse.

Strengthen and stabilize. Especially gluteal strengthening and core stabilization. If you are cleared for yoga, follow these 5 Physical Therapy Tips for Practicing Yoga to help your Low Back Pain:

1. Seek Full Range of Motion with Lack of Tightness, Instead of as Much Range of Motion as Possible.

When practicing yoga, your focus should be on going through range of motion with the absence of tightness. This will help keep your joints, muscles, tendons, and ligaments happy and without excessive stress.

2. “Stay Active” During Your Poses.

True or long-term yogis typically do not like this suggestion. Much of the teachings surrounding yoga is about letting go of tension and relaxing into your poses and stretches. This is great for your stress and your energy, but not great for you orthopedically. My suggestion to “stay active” during your practices opposes this thought.

When you’re in an aggressive pose, I would prefer for people to keep their muscles subtly activated to make sure your joints and ligaments still feel supported. Muscles simply need to be supportive, no aggressive tension or contraction is required.

3. Beware of Deep Lunging Poses.

If you have a history of sacroiliac joint (SIJ) pain, I highly suggest you limit or eliminate deep lunging poses completely.

I request that people keep the following poses to a minimum:

• Crescent
• Pigeon
• High Lunge
• Low Lunge
• Side Angle Pose
• Half Moon
• Any Other Pose Like Poses Above

Deep lunges, such as crescent, are stressful to the pelvis and the low back.

By having your thighs in a split position close to the pelvis, you are pulling one half of the pelvis one way, while the other half of the pelvis goes the other way. This is very stressful to the joints that connect the pelvis into a stable ring (these are the sacroiliac joints).

I typically approve of Warrior I, Warrior II, and Triangle Poses as long as your legs are not in an extremely long stride.

4. Beware of Deep Squatting Poses.

Anytime you are in a deep squat (your buttocks is close to your heels) you are increasing pressure on the pelvis and the pelvic floor. Be cautious with these positions if you have a history of sacroiliac joint pain or pelvic floor dysfunction.

5. You Should Have Control of Every Degree of Flexibility You Have.

If you pursue exaggerated flexibility, working on having strength, stability, and neuromuscular control into that range is essential to keeping your body pain-free.

Yoga is not good for all types of low back pain. If you have low back pain, you should be evaluated and treated by a physical therapist first to ensure you have a proper diagnosis for your back pain. Tell your physical therapist that your goal is to practice yoga and they can help guide you through a safe and healthy practice!

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