Yoga Journal Singapore — April-May 2017

24

april / may 2017

yogajournal.com.sg

By Ray Long, MD

How can I prevent low-back

pain in twists?

INTERCOSTALS

r ctice well

ANATOMY

ALL TOO OFTEN when we move into a yoga pose, we prioritize getting the

shape right over creating that shape safely. Twists are a prime example

of this. Think about the last time you did Parivrtta Utkatasana (Revolved Chair

Pose). Did you move into the posture with the primary goal of going “deep”

into the twist, without first considering which muscles you’d need to engage

so you could rotate safely? If you answered “yes,” that might be one reason

you experience low-back pain in twists.

It doesn’t help that many of us are primed for low-back pain in general.

For starters, as we age, it’s estimated that a whopping 9o percent of

Americans develop degenerative disk disease, a condition in which the

intervertebral disks dry out and lose height. This can lead to stiffness and low-

back pain, which tend to worsen over time. Then, there’s the fact that

somewhere around 4o to 75 percent of the population has some type of

asymptomatic (painless) herniated disk. These disk deficiencies limit the

spine’s mobility, which can make twisting—a movement that demands both

agility and spinal flexibility—potentially more painful.

However, when done properly, twists have the potential to help your low

back feel great. Twisting can activate the muscles around the lumbar spine

and abdominal core, increasing stability as well as blood flow and

oxygenation to the area. Twisting also appears to increase hydration of the

intervertebral disks, which may help to counteract the changes caused by

degenerative disk disease.

Before you twist

Before you ever even rotate, the first step is learning how to stabilize your core

by engaging the muscles surrounding the lumbar spine. Step two involves

not twisting too deeply—at least until this stabilization work has become

second nature. If you already suffer from low-back pain, this work is especially

important: Research shows that those with low-back pain tend to lack the

ability to engage the muscles surrounding the lumbar spine and also have

weak core muscles. The good news? Do the work I describe here and there’s

a good chance you’ll not only stay pain-free as you twist, but you may also

have less low-back pain off the yoga mat.

To stabilize anything in the body, you must contract muscles. In this case,

you want to focus on the muscles surrounding the lumbar spine. These

include the psoas, quadratus lumborum (QL), and gluteal muscles, all of

which are connected to the fascia that surrounds the spine. Also crucial:

contracting the transversus abdominis (TA) muscle, which creates the “corset”

that starts in the front body, wraps around the torso on both sides, and then

attaches to the thoracolumbar fascia—the tri-layered connective tissue

enclosing muscles associated with the thoracic and lumbar spine.

LATISSIMUS

DORSI

THORACOLUMBAR

FASCIA

EXTERNAL

OBLIQUE

QUADRATUS

LUMBORUM (QL)

GLUTEUS

ABDOMINAL MAXIMUS

APONEUROSIS

INTERNAL

OBLIQUE

TRANSVERSE

ABDOMINIS

(TA)

TENSOR FASCIAE LATAE

QUADRICEPS

ILIOTIBIAL (IT) BAND

HAMSTRING